Tuesday, August 4, 2020

“Doctor please help me…!!!”

“Doctor please help me…!!!”

            It was an ordinary evening for me when I was arranging my stuffs to start evening OPD after coming from visiting one rural hospital. I was about to finish doing the arrangements when the door knocked. Till the time I recognized that my door was knocked, I could hear the sound of a young boy asking for permission to come inside the cabin with harsh breaths. Before allowing him to come and sit; a teenage boy of average built came & sat on corner of chair with stooped shoulders, both hands clenched together in between legs. I kept my work aside and paid my total attention to him. Till that time I could realised that something bothered this “young man” majorly because the way he entered and sat was enough for me to grasp his anxiety. His face was pale and cold with full of perspiration. I thought what would have made this boy to rush my clinic so early. I received few glimpses of an emergency which this boy was trying to transmit through his gestures; still I was not able to guess the cause for it. When I calmly look at him, saying ‘yes, tell me’; his speed of rush was lowered down and he paused before starting the conversation. I thought ‘now what happened exactly? He was so hurried to talk with me’. This was the time I could probably start guessing about his cause for help.

 I took a lead to start the conversation by asking few preliminary details. After getting a bit comfortable, he started his story by saying-“Sir my name is Raj (name changed), I think I am impotent, my life is finished…please help me”. By gathering all of his energy to speak; he uttered that in just one sentence. He could not control his tears and started crying. I thought what would have made this 18yrs old boy thought like that to such an extent. I explored his problem more deeply when he shared more that- ‘He started watching porn on his mobile with his friends since schooling.  Raj was in relationship with a girl from few months. Two days before Raj and his girlfriend experienced some intimate moments. It was his first time with this girl that Raj was getting so closer. Before they both could enjoy the pleasure of sex, he suddenly ejaculated. He couldn’t understand how this has happen. It was so quick that he got very confused because this was totally opposite to what he usually watches in porn.’ Since that day he became so anxious as well as depressed, that he thought his manhood will never work again. In this same panic situation, he tried repeatedly to masturbate but Alas!...he failed, and became more & more anxious, more panicky and depressed. He was neither able to focus on his studies nor he was able to face his girlfriend. It affected their relationship, they both tried hard not to break off. This adds in the panicky state of Raj more. With this problem, he was not able to cope up but prefers to shut up his socialisation, involvement in studies. With the only thought of being impotent forever he passed many sleepless nights. He almost lost a hope that he could regain back his manhood in this life. And he landed up in depression.

After few sessions, with the help of Homoeopathic medicines and therapy Raj could come out of this situation and got his confidence back.

Raj is not alone; there are many Raj who comes to my clinic with more or less same situation. Their anxieties are not at all exaggerated but it needs to be handled by equally tender care and empathy. There was a time once when ‘Teen depression’ was thought of arising from academic failures. As the time has passed, the issues related to self esteem, identity establishment, sexual health are real goals for doctors to handle a teenager.  Their concepts related to sexual problems needs to be understand first from their point of view; which only will help them to overcome such circumstances. Before even understanding about sexual health, physical and mental sexual response; teenagers try to fulfil their excitement of pleasure and then they fail! The consequence would then include anxiety, fear, sadness, depression and loss of confidence. In early budding phase they loss their battle even before fighting.

Raj was lucky as he consulted a doctor but many teenagers like Raj are still suffering from such traumatic situations without consulting a right person. Either some of them are shy to come forward or some have accepted their situation and living with a heavy heart filled with full of shame under the burden of wrong perceptions.  I would like to request all of them to please consult their problems to appropriate person instead of falling in endless pit of anxiety and depression.


                                                      -©Dr. Narendra Yadav (MD-Homoeopathy)



Tuesday, March 10, 2020

“Sexual Dysfunction” ...What exactly it is?

 “Sexual Dysfunction” ...What exactly it is?

                To understand Sexual Dysfunction in a simplified manner, let’s divide this term into two. While keeping the dysfunction aside, first we need to focus on sexual part. So let’s try and understand the concept of normal Human sexuality. It is said that-

 “Human Sexuality is the integral and beautiful part of the wider psychic matrix”

So, why it has been said to be the part of psychic matrix? Have you ever thought about it? Dr. Helen Signer Kaplan in her book “The illustrated manual of sex therapy” precisely explained the impact of human emotions on the sexual inadequacy; and therapeutic correlation between emotions and sexual performance. (Kaplan H 1981) Yes! Sexuality has definitely related to our emotions and thoughts. In the past few years, we have witnessed major developments in our understanding of sex and sexuality, in all the three branches i.e. medicine, psychology and pathology the profound research has been done which infers that the human sexuality need multi-dimensional study  to understand how and why sexual function gets disrupted. Sexuality cannot be understood unless we consider various factors related to that person such as biological, clinical, social, cultural, psychological, personal etc. Hence, sexual function of an individual varies from person to person. It depends upon every individual- his perceptions, concepts and ideas about sexuality developed from his own socio-cultural background. Also, it will depend upon individual’s own sexual feelings, emotions, attitudes and beliefs.   

Now when the dysfunction occurs?   

Sexual Dysfunctions occurs when there is a disturbance in the sexual response cycle or by pain associated with sexual intercourse. Sexual dysfunctions are highly prevalent, affecting about 43% of women and 31% of men. Scientifically, it is characterised by disturbance in sexual desire and in the psycho-physiological changes that characterise the sexual response cycle and cause marked distress and interpersonal difficulty. NORMAL SEXUAL RESPONSE CYCLE includes four phases viz. desire, excitement, orgasm and resolution.

Desire phase includes persons fantasies and desire to have sex. When there is lack of desire in a person, it is known as Sexual Aversion Disorder or Hypo-active Sexual Desire Disorder. Women are more prevalent in these disorders than men. (2:1ratio). Excitement is the next phase of cycle when erection happens in men whereas vaginal lubrication and expansion occurs in women. When there is disturbance at this phase, it is known as Sexual Arousal Disorders such as Female Sexual Arousal Disorder, Male Erectile Disorder. Erectile dysfunction is the most common problem seen in men. Next phase of cycle is orgasm phase when there is peak of sexual pleasure. Muscles of pelvic area start contracting rhythmically. In men, ejaculation of semen occurs at this stage. Disturbance at this stage is known as Orgasmic Disorders such as Female Orgasmic Disorder, Male Orgasmic Disorder, and Premature Ejaculation. Premature ejaculation is also one of the most common sexual complaints of men, with approximately 30% of population. Resolution is the last phase of sexual cycle where pelvic muscles relax and person feels general well being.  (Masters W and Johnson V 1984) Also there can be Sexual Pain Disorders (i.e., Dyspareunia, Vaginismus), Sexual Dysfunction Due to a General Medical Condition, Substance-Induced Sexual Dysfunction, and Sexual Dysfunction Not Otherwise Specified. (DSM-5).

Sexual Dysfunctions affects life at various levels such as, Social, Professional, familial, and Psychological. Under Psychological domain, it affects interpersonal relationships between couples in terms of communication which can lead to conflicts & ultimately dissatisfaction. It may also leads to Infertility due to inability to conceive due to lack of successful intercourse (Richard D. & Burnette M 1996). This will further add the distress between couples in terms of fulfilling responsibilities & various roles. Like many other body processes when sexual function goes along smoothly, it is usually taken for granted and given little thought. But if sexual dysfunction is a problem in one way or another, it can be source of Anxiety, Anguish & Frustration that often leads to general unhappiness & distress in personal relationships. At the personal level of a partner, he or she experiences Loss of confidence, low mood, low self-esteem, negative thoughts about self, suicidal thoughts, unworthiness etc. This further becomes major cause for depression. This not only affects person who suffers but also the surrounding people in their family or society. Sexual dysfunctions can become cause of Divorce in married couples.  As the number of patients are increasing day by day it is important to give attention to this issue and require addressing problems early as possible.

 -©Dr. Narendra Yadav (MD-Homoeopathy)




“Doctor please help me…!!!”

“Doctor please help me…!!!”             It was an ordinary evening for me when I was arranging my stuffs to start evening OPD after coming...