Treating Diminished Sexual Desire

Article excerpt

Treating Diminished Sexual Desire From The Doctor's Casebook

Q: Are there medications or injections available to increase sexual desire in a 65-year-old man? A: There are many causes for impaired sexual ability as well as desire. At least 50% of the probable cause may be physical, and the rest may be psychogenic. There is no treatment that covers all possible causes. To try to treat a man psychogenically when the root cause of his problem is clogged penile arteries or nerve damage is just as foolish as operating on a man who has a psychological problem. Before any treatment is started, the etiology, or cause, of the complaint should be sought first. A recent case involved a man in his mid-sixties who took oral testosterone to increase his libido and performance. The testosterone was later blamed as an etiological factor in carcinoma of the prostate which later developed. Testosterone, either orally or intramuscularly, should be administered only when there are definite clinical indications for it and only under a physician's supervision. Q: Do you recommend sterilization for a woman in her mid-twenties who has an unhappy marriage and does not want to have more children with her husband? A: A tubal ligation cannot always be reversed. If the woman eventually gets a divorce she may remarry and want to have a child with her new husband. There are many safe and less permanent methods of birth control, such as the "sponge" and "diaphragm." Everything changes, especially a young woman's mind. No one can foresee the future. In my opinion, it would be a great mistake for this woman to have the operation. Q: Does Alzheimer's disease affect sexual behavior? A: According to a recent book, Dementia: A Clinical Approach, by J.L. Cummings and D.F. Benson (Boston, Butterworth, 1983), 5% of those over 65 years of age are severely demented and 10% to 15% are mildly or moderately intellectually impaired. Dementia of the Alzheimer type (DAT) is the most common type of dementia in the elderly, averaging about half of all cases. Although there are few studies on record regarding sexual interest and performance of those suffering from Alzheimer's, the medical journal Medical Aspects of Human Sexuality interviewed the wives of 26 male DAT patients and reported that: 1) Less interest in sex by eight of the DAT patients after onset of the disease. 2) Greater libido exhibited by four DAT patients who wanted more frequent sexual activity than before onset of illness. 3) Ten of the wives were "unable" to have sexual relations with their husbands even though the husbands wanted sex. The report also cited hypersexuality in several cases studied, such as a Mr. …


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