Transcribed from the Journal of Alternative and Complementary Medicine, January 1995, what follows is an intresting and informative look at erotopenia - literally meaning libido deficiency. Part one is for health professionals, but provides useful insights for everybody interested in or suffering from erotopenia...
Health practicioners, do you encourage your patients to talk about their sexual and emotional problems? Are you truly holistic in your approach, or do you feel safter referring people with psychosexual difficulties to specialists - clinical psychologists, sex therapists or marriage guidance counsellors?
Sexual Health
Erotopenia: The Silent Epidemic Part 1
Most practitioners of complementary medicine have had little practical training in psychosexual counselling. Many are a trifle embarrassed when patients talk about their intimate sexual problems. This coyness is also found in doctors. They appear to start their careers with an unexpected disadvantage, for surveys have revealed that medical students are more ignorant of sexual matters than students following other courses of undergraduate training1. This ignorance is not necessarily dispelled during their medical training, which frequently offers no tuition in psychosexual counselling. This leaves them ill prepared to handle their patient’s intimate problems and concerns.
Sex today is freely debated in the Sunday newspapers, but far less openly discussed in the doctors’ surgery. Both therapists and patients maintain a conspiracy of silence. The taboo subject is raised obliquely if at all. The guidance is needed for a friend, or is made part of a totally impersonal query. ‘Did you see the magazine article about impotence?” Or: “Why do so many people today suffer from loss of sexual libido; is there something wrong with our diet, or is it because of the stress and strain of modern life?”
The empathic therapist recognises the true nature of these veiled allusions and encourages further discussion. Others prefer to ignore the cries for help and opt to remain clinically aloof. In doing so they not only fail to respond to their patients’ needs, but also waste a golden opportunity to establish a closer practitioner-patient relationship.
The hands-on therapist - whether family physician, osteopath, beauty therapist or hairdresser - is in a highly privileged position. By the very nature of their work, they should find it easy to get “in touch” with their clients. When patients lay bare their bodies they also lay bare their souls. Apart from the time we spend with our lovers, when else are we as intimate with another human being?
One of the secrets of highly successful hairdressers is that they have the gift of acting as counsellors and friends as well as skilled technicians. This is certainly true of Kenneth, the doyen of American hair stylists, who was said by Vogue to be “a kind of hair psychiatrist who not only changes women’s looks but their lives and careers.” The same blend of friendship, sympathy and warmth is offered by most successful complementary medical practitioners, often under the guise of “a good bedside manner”. Often it is this “feel good” factor which keeps their appointment books full, rather than any special quality of the treatment they provide.
The Disease That Dare Not Speak Its Name
Many patients are relieved merely to talk about their psychosexual problems. Some are reassured merely to be told that the difficulties they experience are commonplace, rather than unique to them. This is especially true of loss of sexual desire - which is today’s commonest sexual problem.
Professor Raul Schiavi, Director of the Human Sexuality Program at the Mount Sinai Hospital, New York, reports that hypoactive (low) sexual desire is now the “most prevalent sexual dysfunction in women2.” The problem is equally common in men, among whom it often causes a depressing decline in potency and self-esteem.
Thousands of patients have visited the Detroit clinic of the world-famous Kinsey Institute for Research in Sex, Gender and Reproduction. Their problems have been varied, but according to the clinic’s Director of Education, Dr Paul Pearson, the bulk of complaints have related to problems of sexual “frequency and interest”, rather than to specific sexual disorders such as premature ejaculation, vaginismus (vaginal tightness causing discomfort) and dyspareunia (pain that occurs only or primarily during sexual intercourse)3. The commonly asked questions were “Why have I lost my interest in sex?” “What has happened to my sex drive?” “Why am I so much less sexy than my partner/girlfriend! husband / wife?”
These questions were not answered by the sex gurus of earlier times - Marie Stopes, Havelock Ellis, van de Velde, Kinsey, Masters and Johnson - nor are they tackled in the standard textbooks of sexual medicine. In fact the disorder is so poorly considered that even its name is a subject for continuing dispute. At present some authorities refer to it as hypoactive sexual desire, others as reduced libido, inhibited sexual desire or erotopenia (a term with much to commend it since it does not adopt a narrow, etiological viewpoint).
The Anatomy Of Sex
There are practical ways of stimulating the brain’s sex centres, and also of lessening the influence of the brain’s inhibitory centres.
The ancient poets thought that love was an activity of the heart. Most modern sexologists seem to think that it is primarily a function of the genitalia. Both concepts are wrong, for the main sex organ is not the heart, penis or clitoris, but the brain. Thought control is enough to give some people an orgasm, as during erotic dreams or day-time fantasies. Repressive thoughts can just as easily put a curb on sexual expression, which is the root cause of inhibited sexual drive.
The brain’s limbic area houses the neural centre responsible for sexual arousal. This is stimulated by thoughts, and also by a wide range of physical sensations - visual, tactile, auditory and olfactory. It responds to a provocative glance, a whiff of perfume or a few lines of erotic poetry. “When this system is active a person is “horny”,” explains Dr Helen Kaplan, Director of Human Sexuality Program, New York Hospital, in her book Disorders of Sexual Desire4.
Sexual desire can be enhanced by stimulating the brain’s limbic centre. This can be done in a variety of different ways, as will be explained in the second of these articles, and in far greater practical detail in my book Sex Drive, written to meet the need for an up-to-date, holistic guide to treating erotopenia, not by drugs, but by natural means. The book offers advice on everything from aphrodisiacs to energy diets, and includes twenty-three specially designed “sexercises”.
There are practical ways of stimulating the brain’s sex centres, and also of lessening the influence of the brain’s inhibitory centres. Sex drive in all animals is a balance between the forces of stimulation and inhibition. Like a car, the brain is provided with both an accelerator and a brake. This, unfortunately, is where humans out-perform every other living creature. In the course of our evolution we have developed a powerful cerebral cortex which enables us to maintain a stranglehold over our animal passions. It is the excessive use of this inhibitory control which produces most cases of psychogenic erotopenia.
Neurological experiments have located several sexual inhibitory areas, the most important of which lies in the temporal lobes of the cortex. If the activity of these areas is deadened by alcohol, sexual repressions fly out of the window. Animal experiments have been carried out in the past, which mercifully would not be tolerated today. These revealed that when the temporal lobes of male monkeys were destroyed surgically they became “sex-obsessed to the point of insanity.” When they were alone they masturbated indiscriminately, even if they were falling asleep or dangling upside-down from the roof of their cage. If they were in groups, they became insatiable sex maniacs, copulating continually and indiscriminately with males, females, keepers, cage walls and anything else that came to hand5.
To the behavioural psychologist the treatment of erotopenia begins and ends with establishing a correct balance between the twin forces of stimulation and inhibition. This overlooks a host of other contributory factors.
Survival Of The Fittest
At other times a loss of sexual libido arises as an unwanted side effect of modern medication, the chief pharmaceutical offenders being sedatives and narcotics such as diazepam, the tricyclic anti- depressants and monoamine oxidase inhibitors.
Nature has a vested interest in ensuring that only the fittest survive to propagate the species. For this reason it is teleologically understandable that people who are unfit, overweight or malnourished should lose their sex drive. Improving a patient’s health is often enough to enhance their libido. According to Marie Stopes, physical fitness is the best possible aphrodisiac. “Spend long days out of doors in healthful but not too exacting exercise,” was her recommendation6. This was recently confirmed by two London psychologists who found that fitness training was one of the finest ways of overcoming erotopenia. “However,” they concluded somewhat pessimistically, “since most men would consider taking an early-morning run round the local park too drastic a step to take in the interests of their libido, the optimistic search for a true aphrodisiac is bound to continue7”.
Chronic fatigue also plays havoc with sexual vitality, as was discovered by Dr Marion Hilliard, head of Obstetrics and Gynaecology at the Women’s College Hospital, Toronto. She had no doubt that persistent exhaustion was the root cause of many women’s difficulties. “What detracts from the happy bedroom?” she wrote towards the end of her career. “The first and most important thing is fatigue. No doubt about it, a happy married life takes energy!8”
The modern combination of tiredness, stress and sustained work pressure is another potent passion killer. This I discovered some years ago when I carried out a survey of a large group of senior British executives and found that nearly one in three confessed to being too tired at the end of the working day to make love9.
At other times a loss of sexual libido arises as an unwanted side effect of modern medication, the chief pharmaceutical offenders being sedatives and narcotics such as diazepam, the tricyclic anti-depressants and monoamine oxidase inhibitors. Oestrogen and antihypertensive agents containing reserpine and methyldopa are other common culprits.
For others erotopenia is a symptom of sub-clinical malnutrition. A woman suffering from iron deficiency anaemia struggles to cope with her routine chores and has no energy left for amorous fun and games. A man whose diet lacks zinc may also have a lowered zest for love. The average Briton consumes only 67 per cent of the recommended daily intake of zinc and the risk of deficiency is particularly great in sexually active men, since 1 milligram of zinc is lost with every ejaculation10.
Professor Derek Bryce-Smith of Reading University believes that zinc supplementation plays an important role in counteracting reduced sex drive and impaired male fertility. “I am not claiming it is a panacea,” he cautions, “just that it has been neglected”11.
(The second part of this article contains further advice on the treatment of erotopenia, concentrating particularly on lifestyle changes.)
© United Health Promotion Ltd 1994
Transcribed from the Journal of Alternative And Complementary Medicine, January 1995
REFERENCES
1. Lief, H.I., in Complementary Sexual Behaviour: Critical Issues in the 1970s 1973 Baltimore: John Hopkins University Press, pp 441-53
2. Schiavi, R.C. et al. Hormones and Behaviour 1989, 23, P 221
3. Pearson, P. Super Marital Sex 1987, London: Futura, p272
4. Kaplan, H. Disorders of Sexual Desire 1979, London: Balliere Tindall p7’9.
5. Kliver, H, and Bucy, P.C Arthives of Neurology and Psychiatry 42, pp 979-1000.
6. Stopes, M.C. Enduring Passion 2nd. edit 1929 London: Putnam & Co. Ltd. p108
7. Wilson, G and Nias, D., Love’s Mysteries, 1976 London: Open Books, p76.
8. Hilhiard, M. Woman and Fatigue: A Woman Doctor’s Answer 1960, London: MacMillan.
9. Norfolk, D. Chief Executive magazine. September 1986.
10. Bryce-Smith, D and HodgJdnson, L, The Zinc Solution 1986, London: Arrow, p 184.
11. Quoted in the Daily Telegraph, 14th. August 1989.
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This information is supplied for educational purposes only and is not intended to offer diagnosis, treatment, or prevention of any disease. Always seek professional medical advice when necessary.