• Sexual disorders in men

    A person is going through earthquakes, epidemics, horrors of diseases and all sorts of tortures of the soul, but for all time for him the most tragic tragedy was, is and will be - the tragedy of the bedroom.

    L. Tolstoy

    Consider disorders of sexual function in men with the following diseases: neuroses, ischemic heart disease, chronic alcoholism, chronic prostatitis.

    The concept of "neurosis" was introduced in the late 18th century by the Scotsman Kelden. He belongs to the idea of ​​uniting into one group of patients suffering from such a disease, in which it is impossible to establish any visible changes in the cells and tissues of the body. Kellen wrote that neuroses are "disorders of sensations and movements that are not accompanied by a fever and do not depend on the local defeat of any organ, but are due to the general suffering on which the movements and thought specifically depend."

    The great Russian physiologist IP Pavlov and his students revealed the physiological essence of all manifestations of neuroses, proved the importance of environmental factors in their origin, and outlined ways for the treatment and prevention of these diseases. A great contribution to the development of IP Pavlov's theory of neuroses was made by VN Myasishchev, and later by BD Karvasaroky. Attaching great importance to the personality and its relationship with the environment, BD Karvasaroky defines neuroses as psychogenic - "as a rule, a conflict neuropsychic disorder that arises as a result of a violation of a person's particularly significant life relations."These can be irreplaceable losses, failures, difficult conflict situations in which the patient has found, etc. The impossibility or inability to find a rational way out of this situation entails the mental and physical disorganization of the individual, in other words, the development of the neurosis.

    It is important to emphasize that modern people react very sensitively to verbal abuse or rudeness, the consequences of which are difficult to foresee. And often after many years the humiliation caused by the word can revive a strong sense of anger or impotent despair: it has long been said that the wound inflicted with the sword heals, but the tongue does not. In a word, you can kill a person. Doctors can give many examples of myocardial infarction or hypertensive crisis caused by insult or rudeness.

    The World Health Organization notes that in recent decades, the number of nervous and mental diseases has increased significantly. For the most part neuroses arise on the basis of family conflicts. The spouses now have higher requirements for each other, they come up with more complex spiritual criteria to what is commonly called "personal happiness."If you look into the family conflict without prejudice, almost any of them is not very serious. But to judge what can and can not become a cause of a neurosis is not an easy matter. The strength of the impact, which can cause a breakdown in the activity of the nervous system, is determined not by the intensity of the stimulation, not by the amount of information that it carries, but by the significance of this information for that particular person. What excites one can leave the other indifferent. Each person has especially vulnerable psychological "zones", the impact on which is perceived painfully, for example, criticism of appearance, abilities, unfair reproach, ridicule. Destructive for the nervous system is not a strong single irritation, but weak, but repeatedly repeated. It is this traumatic nervous system that is created in families where conflict relations and mutual discontent are constantly maintained.

    Basic forms of neuroses - neurasthenia, hysterical neurosis, obsessive-compulsive disorder.

    Neurasthenia, which in literal translation means "nervous weakness", is the most common form of neurosis. Neurasthenia develops gradually. Its main manifestation is increased irritability, followed by exhaustion. Patients come to extreme excitement over trifles. They are irritated by the bright light, strong sounds, and sometimes the ticking of the clock, quiet music. The person becomes captious, angry and often comes into conflict. If under the conditions of production by effort of will he manages to gain himself, then in a domestic setting he becomes unbearable because of constant discontent, faultiness towards his relatives. Patients are worried about fatigue. After a day's work, they lose interest in the environment, do not find the strength to read, watch a movie. One of the most constant and painful manifestations of neurasthenia is insomnia. Sleep in such cases is short, anxious, not refreshing. Already in the morning, the mood is reduced in patients, there is no feeling of rest after sleep. Often patients complain of a memory disorder, they can not remember new formulas, numbers, etc. Almost constant complaint with neurasthenia are headaches.

    Often with this neurosis, the sexual function is impaired. This is expressed by a decrease in sexual desire, a violation of erection and ejaculation, which is usually due to anxiety, self-doubt, suspiciousness.

    Symptoms similar to those of neurasthenic can result in hypertension, atherosclerosis and others, so you should always consult a doctor.

    The diagnosis of a neurosis is not perceived correctly by everyone, it is sometimes believed that this is not a disease at all, but something like debauchery, inability to control oneself, almost a simulation.

    Citizen F., 40, turned to the impossibility of having sexual intercourse with his wife because of a weakening erection. With a thorough examination of no organic disease in F. not identified. As a result of conversation it was found out that five months ago the daughter was in a serious condition in hospital with a purulent appendicitis. The wife expressed reproach to her husband about the fact that he did not send an "ambulance" in time, as he thought that the pains themselves will pass. F. strongly experienced what had happened, his sleep, appetite worsened, his mood decreased, and the result was a worsening of his sexual function.

    In this case, the patient suffered a mental trauma that had a retarding effect on the central nervous system, and through it on sexual function.

    The inability to satisfy a woman gives rise to an inferiority complex in men, which is compensated by foresight, excessive complaisance, helpfulness. The wife not only abuses this, but completely subordinates her husband."She becomes the head of the family".Such relations do not satisfy, however, her. Subconsciously, they contradict her desire to rely on a life partner, whose opinion can be considered. The husband not only loses her respect, she despises him, as a sexual partner he causes irritation. Hence the conflicts, scandals and neuroses. By the way, neurotic women talk about a "very good" husband.

    Hysterical neurosis, or, as it used to be called, hysteria, was known since ancient times. The manifestations of a hysterical neurosis are manifold. It was not for nothing that this disease was called "great pretender" or "chameleon".All manifestations of the disease, despite their diversity, can be divided into three main groups: hysterical, hysterical fits and hysterical movement or sensitivity disorders.

    These patients are highly emotional, theatrical. They describe in detail all manifestations of their state, hotly experiencing grief and joy. Because of the most insignificant reasons, their mood fluctuates sharply. Patients characterize the tendency to K-fantasy, thickening of colors, unconscious deceit. Typical is also increased suggestibility and self-hypnosis. Sometimes, in extreme circumstances, hysterical fits can occur, manifested in various forms: from severe seizures to the complete cessation of movements in the patient. Fits can flow In the form of trembling of the whole body or individual parts - hands, feet, head. Violation of movements in hysterical neurosis can be manifested by paralysis, which often occurs as a consequence of conflict situations. The disease in this case can be desirable, since for a certain period of time "will help to remove the patient from an unpleasant situation for him. Recently, with such a neurosis, violations of the functions of the internal organs: pain in the region of the heart, palpitations or disturbance of the heart rhythm, hot flushes or cold extremities, respiratory, gastrointestinal, urinary, and sexual dysfunction. Patients require a survey, which, in their opinion, should reveal serious diseases.

    The neurosis of compulsive states as an independent form of neurosis is highlighted recently. The main symptom of the disease is the loss of a sense of the real. A person loses the ability to properly assess the environment, can not navigate the events. His thoughts, memories are often more vivid than real phenomena. Losing the sense of the real makes it impossible to make any specific decision. The doubts of the patients are all the more excruciating, that they arise on insubstantial occasions. The impossibility of a critical perception of the environment generates anxiety, a constant expectation of trouble. The fears of the sick are, as a rule, related to what will happen to them in the future. They are not left uneasy, that others can notice their inferiority. Not wishing to compromise themselves, patients prefer to remain silent, become shy, timid. The phenomenon of obsession is one of the main signs of this neurosis.

    Very often anxious, hypochondriac personalities have a neurosis of expecting failure, which blocks the onset of an erection. These people closely monitor the state of their body, they are more concerned about not a loved one, but he himself. And so the leading thought is: am I capable of rapprochement or not? The nervous system does not work to maintain excitation, but is busy with another - inappropriate control of sensations at this time. Sensual analyzers are sent not to the partner, but to himself, to his organs. But the more such a man is absorbed in introspection, self-examination, the more strongly in his brain the "focus of expectation of failure" is excited. As a result, instead of increased excitation, inhibition of the sexual function occurs, since the "focus of failure expectation" becomes more significant, more powerful than the sexual dominant.

    Very often this disorder occurs in elderly men who, due to circumstances, had to refrain from intimate affinity for a long time.

    One of the frequent causes of sexual disorders is the neurosis of expectation, caused by a false perception of their physical inferiority. The impetus to the development of such a neurosis may be some accidental breakdown, provoked by fatigue, prolonged prior abstinence, unfavorable situation, etc.

    During the rest in a sanatorium, a forty-seven-year-old man showed interest in a young woman, but did not take any further actions. A week after the meeting, the woman created an "exciting situation", but artificially tightened the love game. The man was in an excited state for an hour, and when the partner agreed to the intimacy, the erection disappeared, the sexual intercourse failed. The woman did not hide her displeasure, saying reproach: "And when does your wife live with you?" Dejected by a failed attempt, the man painfully suffered a setback and even left earlier for a few days. When returning home for a week avoided sexual intimacy, referring to malaise. The spouse suspected something was amiss, as earlier the husband showed increased activity after the sanatorium treatment. The first attempt to conduct sexual intercourse with his wife failed. Such actions take revenge for themselves.

    There are often cases of neurosis in a man when self-doubt has a retarding effect on sexual function. Can not you cultivate in yourself?doubt, fix attention to random failures. After all, they are possible for every completely healthy person. If a man does not live sexually for a long time, then often he has a weakening-sexual desire, when he renews it - it increases. However, the spousal behavior of the spouse, reproaches to the husband's address can fix these difficulties, and then special treatment will be required.

    Crisis situations in our days often become the cause of neuroses, cardiovascular diseases.

    If a person is in a crisis situation, then he needs everyday psychotherapy, which everyone can do. First of all, it's just a hearty conversation with him. The main thing is to listen to it, give it, speak to it, "ease" the soul. You do not need to impose any advice on the victim, although it may seem that he is waiting for them from you. It is better to give him the opportunity to come to this or that decision on his own. Having spoken out, throwing everything out, a man: calms down. Gradual change of negative emotions is positive.

    No one, of course, will object to such a truth: a significant role in maintaining the balance in the nervous system is played by positive emotions, negative ones have the opposite effect. The connection between these experiences and the disease makes it possible to understand and appreciate the wisdom of the ancient council: "Do you want to behealthy - drive out of your heart all the vexation. "

    Among the diseases of the cardiovascular system ischemic heart disease occupies a leading position.

    We were tasked to: identify sexological disorders in patients with ischemic heart disease( CHD);identify the age groups most susceptible to sexual dysfunction;Analyze the prevalence of sexual dysfunction in physical and mental labor, among urban and rural residents, as well as highlight indicators of interest in the survey and treatment of sexual dysfunction in the ballroom of each of these groups.

    At the time of the examination, 96.7% of the patients were married. Sexual disorders were detected in almost half of IHD patients and 40% of them expressed concern about this and expressed a desire to be examined and undergo treatment. The most frequent sexual disorders were observed among intellectuals and residents of the city, than in rural areas and engaged in manual labor. The greatest number of IHD patients with sexological disorders was detected in individuals after 50 years and slightly up to 40 years.

    Patients who were concerned about a sexological disorder had some personality traits: suspiciousness, irritability, quick temper, indecisiveness, uncertainty, jealousy.

    Patients with coronary artery disease complaining of sexual dysfunction were found to have sexual disorders that were characterized by a change in sexual behavior, a weakened erection, a violation of ejaculation, blunted orgasm, decreased sexual desire and the rhythm of sexual activity.

    Often among patients with IHD there is an opinion that during intercourse, myocardial infarction may occur. Japanese researcher Eno analyzed the death caused by cardiovascular diseases, found that out of 5559 deaths occurred during "intimacy in 0.6% of cases. Analysis of the causes of death during sexual intercourse makes it possible to reveal in 80% of cases a combination of such factors as alcohol intoxication, sexual intercourse with a casual partner in inadequate conditions, arterial hypertension and pronounced general atherosclerosis.

    The patient M. told about the event, which he considers almost fatal for himself. However, this is not an event - just a phrase thrown in a married couple's wife, a half-joke, half-reproach. ..

    It happened six months after the heart attack that he had suffered. A forty-year-old man, he coped with the disease relatively quickly, after passing a course of treatment first in the rehabilitation department of the hospital, then in a sanatorium.

    Now worried about one thing: was the male worth? Can I return to the familiar rhythm of an intimate life?

    The first attempt at intimacy has convinced that the potency has decreased. Perhaps he would have taken it more calmly if he had known that it was not just a matter of illness. After a more or less prolonged period of abstinence, even a completely healthy man, who previously had a regular sex life, may experience a temporary decrease in potency.

    Confused by failure, he guiltily and tenderly kissed his wife. And he heard in reply: "You just have to kiss the cheek. .." He did not try any more. The mood fell, the state of health worsened.

    The case, I must say, is quite typical. A special sexological examination of a large group of patients suffering from coronary heart disease and who underwent myocardial infarction revealed in every second a sexual disorder that occurred immediately after the disease or some time later.

    Is ischemic disease itself a potential reduction in potency? As a rule, no. More often than not, it's not about somatic disorders, or, at least, not only in them. The decisive role is played by reaction to the disease, attitude towards it.

    Among patients with sexual dysfunction, the overwhelming majority was characterized by the desire to "go into the disease", increased fear of a heart attack, and vulnerability of the psyche. The importance of the sexual sphere in the hierarchy of the vital values ​​of men also has a great influence on the development of sexual disorders. "These disorders often arise in those who devote special attention to potency, concentrating on the thought of its possible loss. And the stronger the fixation on these problems, the less likely the success in restoring the potency.

    Sometimes a man, realizing how much his nervous condition prevents him, starts taking tranquilizers and in increased doses. He really ceases to worry, but all other emotions fade, lethargy appears, the potency decreases even more.

    Risky and attempts to excite themselves with the help of alcohol. This is a serious threat to the heart and in no way an incentive for the reproductive system. On the contrary, in the state of intoxication, the probability of failure increases.

    Potency, reduced by psychological factors, is best restored by psychotherapy. And "a personal" psychotherapist "of a man can become a loving, subtly-feeling wife.

    Sexual function is the only physiological function of a person that is performed in pairs. And naturally, its decline, like its normalization, depends on two - men and women. This dependence "becomes especially evident when one of the two has some kind of frustration. Namely, this situation is created in those cases when a man, weakened by a transferred myocardial infarction, who has experienced contact with the disease of nervous stress, begins to restore his status as a spouse. And his wife during this period needs a maximum of tact, understanding, willingness to meet him.

    Fear of failure in intimacy is a specific male fear. A loving woman must understand the humiliation of this fear and find the means to dissipate it, soften it. After all, this fear should be strengthened - and intimacy will become really impossible. It is worth to get rid of it - and the potency will increase. The ironical reaction of the wife, her obvious or poorly hidden discontent, a remark like "you only have left. ..", of course, are murderous. In the case of our patient, this observation played the role of a push to develop the so-called false impotence, the main cause of which lies precisely in the man's insecurity.

    If excessive demands are placed on the husband, who only begins to recover from his life after the illness, then too much, underlined removal of his spousal duties can also play a negative role.

    Assurances that "now you can not do this," suggest a bitter thought to the man about his inferiority. As soon as a significant link emerges from the conjugal union, doubts arise in its strength. A loophole is created for jealousy, since the wife easily tolerates abstinence, which she herself insists on. And in the end - her husband's health is slower, health is restored, the general tone is reduced.

    The resumption of intimate relationships is of great importance for the psychological rehabilitation of the patient.

    About when it is possible to remove the prohibition imposed by the disease, what restrictions in intimate life are necessary( and whether they are necessary in general, if its rhythm before the illness was quite moderate), it is best to consult a cardiologist. But, say, such a conversation did not take place. What are the indicative criteria to choose?

    Now most of those who underwent myocardial infarction are being rehabilitated in cardiological sanatoriums. Here they are engaged in exercise therapy, gradually adapting to physical stress. If at the end of the period of sanatorium treatment the patient is already able to walk quickly, climb the stairs for one or two flights without experiencing any unpleasant sensations in the heart, then, as a rule, he will not be harmed by the physical strain with which, of course,for intimacy is intimate for a man.

    Soviet scientists VP Zaitsev and VS Koshelev pas-worked recommendations on the timing of renewal and the characteristics of sexual activity after a previous myocardial infarction, presenting them in the form of the following main provisions.

    1. Sexual life should be renewed when a certain level of exercise tolerance is achieved( the possibility of fast walking or climbing the stairs for one or two spans without pathological signs), the appearance of sexual desire, the presence of a positive psychological attitude as in a patient who has had a myocardial infarction.and his partner.

    2. Intimate relationships should be restored to a constant partner in the usual conditions.

    3. Sexual life should be conducted in accordance with the degree of expression of sexual desire.

    4. It is necessary to exclude some factors( alcoholic drinks, abundant food, reception of hot baths), which can significantly increase the load on the cardiovascular system.

    5. If unpleasant or painful sensations in the heart or behind the breastbone, sometimes noted during intercourse, it is necessary to take Validol or nitroglycerin.

    Do I need any medications when I decrease the potency? This issue, of course, solves the sex-therapist, "But the couple should remember that with sexual disorders, it is not so much medications and special treatment that are important, as much understanding, an intuitive search for a measure of sexual activity.

    To regulate this area of ​​relations is extremely difficult for each married couple to develop their own rhythm over the years, their own, as a rule, the same temperament. The resumption of intimate life after a heart attack has been transferred, as it were, completes the rehabilitation period, helps to overcome its psychological consequences, to get out of the illness.

    During the so-called male menopause( the offensive of which in principle is rather difficult to establish due to the absence of any noticeable clinical symptoms), a slow decrease in sexual activity occurs. So, for example, if a twenty-five-year-old man can feel the need for daily intercourse, then after fifty years this need can be limited to once a week. However, it is preserved, and the difference here is only quantitative.

    In men, the menopause appears later than in women, in most cases between 50 and 60 years. However, under certain conditions, the so-called early menopause, which is especially severe, can occur at a younger age.

    As a physiological process, the climacteric period in most cases occurs without any painful manifestations, at a satisfactory level, working capacity, energy, and memory remain. If the compensatory reactions do not work, a "breakdown" occurs in the body, accompanied by pathological manifestations occurring in 15-25% of men of this age.

    Most patients complain of increased nervousness, fast fatigue. They become irritable, quick-tempered, the slightest setbacks, unpleasant news out of oneself, cause a melancholy mood, spiritual depression. Some become capricious, prone to quarrels and conflicts, they have less interest in work, at home, in their favorite pursuits. Complaints over poor sleep, headache, memory loss predominate;often they have cardiovascular disorders, manifested by angina, hypertension and vegetovascular syndrome. In 80% of men with a pathological menopause, there are violations of sexual function, manifested by a decrease in sexual desire, weakening of erection and premature ejaculation. With aging, not only the function of the testicles, but also the prostate gland decreases. Reduction of the activity of the sexual glands entails a violation of the entire interconnected system of endocrine glands( thyroid, adrenal, pituitary and others).For example, irritability, insomnia, palpitations are sometimes associated with dysfunction of the thyroid gland.

    Sometimes it is possible to hear the opinion that sexuality is harmful to the elderly in the menopausal period. This is not true. Moreover, it is sexual dissatisfaction that can be a factor contributing to various pathological processes. Sexual activity of a man in pre-primary( menopausal) age should be considered a normal and healthy phenomenon. It should not be the source of any internal conflicts or suspicions of pathology: it is just as natural as during the period of puberty. Sometimes menopause due to a lack of sex hormones and violations of endocrine regulation takes a pathological course. But despite the pathological menopause in 50% of men spermatogenesis persists to 60 years and later.

    I., 42 years old, lawyer, was sent to us for consultation, divorced for 4 years. He complained of periodic attacks characterized by increased blood pressure, palpitation, headache, general weakness, irritability, fear of death. In the last 3 months he was repeatedly treated in the cardiology departments of clinics and hospitals, but the effect was only at the time of treatment, after the discharge the seizures were repeated. At a neurologic inspection the diagnosis has been established: a pathological climax with a syndrome of a vegeto-vascular dystonia, a neurasthenia. As a result of specific treatment, the patient's condition quickly improved, the attacks stopped.

    We have known for a long time the tools that allow you to keep your health and vivacity up to the very old age without the help of a doctor. This is physical exercise, tempering and moderation in food.

    There have long been known and actions that cause great harm, among them - the abuse of alcohol.

    Alcoholism is a chronic disease that develops on the basis of regular consumption of alcohol. His first sign is the emergence of craving for alcohol and the loss of self-control when drinking, changing the tolerance of alcoholic beverages. The emerging psychic dependence on alcohol is characterized by the need to achieve intoxication as the best mental state of the body.

    Attraction to alcohol can arise in a sober state, prompting the initiation of drunkenness;it can appear in the process of consuming alcohol and then forces you to drink more and more. Finally, it often occurs during a hangover, after drinking alcohol on the eve of alcohol.

    The attraction differs from desire, desire, that does not lend itself to reasonable arguments, it is difficult to struggle with, it concentrates and directs all psychic energy and interests to satisfy the need without taking into account the real situation and possible adverse consequences. And the loss of self-control leads to the fact that a person can drink at the most inopportune time or under the most inappropriate circumstances. After drinking, he experiences an irresistible desire to take alcohol;again and in even greater numbers. Those doses, which used to cause a noticeable state of intoxication, are not enough with the development of alcoholism, there is an increase in tolerance( tolerance) to alcohol. In a person who does not suffer from alcoholism, a certain amount of alcohol for him causes toxic poisoning-an outbreak, and the body uses a protective reaction-vomiting. Until a certain time, the body as it struggles with alcohol intoxication. However, the development of mental dependence pushes the drinker to increase portions of alcohol and to suppress the protective reaction of the body.

    There comes a period when the usual doses of alcohol do not cause the "necessary" stage of intoxication, but the alcoholic wants to still experience this condition. This continues until, at a later stage, when the protective forces of the organism are depleted, the tolerance of alcohol is again lowered. Then even small doses cause intoxication. One of the important symptoms of this stage is the hangover state: poor health, irritability, malignancy and other disorders that occur in the absence of alcohol in the body. Most often they occur in. outh. Sometimes they are so pronounced that medical treatment is needed to eliminate them.

    Systematic drunkenness leads to irreversible shifts in the genital area of ​​the man, as catastrophic changes undergo the seminiferous tubules. As a result, the formation of spermatozoa decreases( or completely ceases).

    In addition, alcohol poison causes endocrine disruptions, as a result of which the activity of the testicles is falling, metabolism in the body is broken: it suffers from oxygen starvation, which, in turn, leads to a decrease in sexual desire and erection.

    Alcoholics are inclined to cultivate a version not only about the "curative" effect of alcohol, but also about the harm of alcohol treatment, allegedly causing impotence. The opinion that alcohol increases sexual desire, lengthens the time of sexual intercourse, that is, positively affects sexual functions, even some doctors supported in due time.

    Observations of recent years prove irrefutably that there is a link between alcohol abuse and sexual disorders, although in some people alcohol initially lengthens the sexual intercourse. But in the future there comes a reckoning: first of all, the excitability of the nerve centers is weakened, as a result, the erection occurs less frequently and more sexual sexual stimuli are required to achieve sexual potency. In addition, during the sexual intercourse there is a delay in ejaculation, or it may not happen at all. Subsequently, the sexual desire is reduced, the function of the sexual glands is disrupted, the production of sperm decreases, impotence occurs.

    Each organism has an individual sensitivity to poisons and to alcohol as one of them. Therefore, its harmful effect is manifested in some quickly, and in others through a longer time.

    It should be noted that chronic alcoholism has a destructive effect on sexual intercourse in marriage. At the beginning, relations between spouses deteriorate, quarrels and scandals arise, especially after one of the spouses gets drunk. For the sake of vodka the alcoholic sacrifices the family, the happiness of his wife and children, and also worsens the financial situation of the family.

    As a result of the violation of sexual function in people with chronic alcoholism, there is a "delirium of jealousy", "adultery".Alcoholics, under the influence of their delirium, begins at every step of the spouse to see treason and scandals even in the presence of children. This attitude of the alcoholic husband to his wife quickly leads to the extinction of feelings towards him, which negatively affects the sexual life.

    At the reception came the forwarder of one of the plants of Voronezh E., 47 years old, married 22 years, has two children. He complained of a weakening of the erection and a decrease in sexual desire. From the conversation it turned out that he had been abusing alcohol since he was 29, at first he drank from time to time, then became accustomed to drinking and began to drink on weekends, and sometimes even at work by the end of the shift. There was a strong attraction to alcohol, lost the gag reflex to alcohol. From the age of 35 began to get drunk, several times got into the sobering-up station. In the last 3 years with his wife asleep separately, the spouse began to avoid sexual life. In conversation with his wife E. it was found out that the husband in a state of intoxication is trying to have a sexual act, although an erection at the time of the attempt is absent, despite her help. After unsuccessful attempts the husband arranges scandals, became suspicious, quick-tempered, distrustful, jealous even to distant relatives. The last two years they live sexually very rarely - several times a year. During the examination, the patient was diagnosed with chronic aseptic prostatitis with an early age-related decrease in sexual activity, provoked by alcohol;chronic alcoholism of the II stage.

    Is it appropriate to quote Shakespeare here?"Wine awakens red tape and at the same time suppresses it. It causes lust and trouble action. "

    At the end of the last century the German professor A. Trout wrote about the influence of alcohol in the genital area. He believed that the effects of alcohol are related to:

    a) recklessness in sexual intercourse in the presence of increased sexual desire and lack of a brake;B) the prevalence of sexually transmitted diseases due to the same recklessness;C) the commission of the majority of sexual crimes due to the same recklessness associated with increased eroticism and motor excitement;

    d) strengthening, sometimes awakening of sexual perversions;

    e) alcohol is also the inevitable companion of prostitution and pandering, which without it could not even exist in their present coarse form;

    e) alcohol-induced senseless eroticism persists in public places and often becomes cynical and rude, disrupting all decency.

    The biggest mistake of people who abuse alcohol is that, after discovering in their sexual sphere any changes, they, instead of completely giving up alcohol, are waiting for help from some "miracle pill".

    "The second heart of a man" is figuratively called the prostate: as an organ of internal secretion, it affects the entire body, takes part in the regulation of the sexual function of a man. It is estimated that up to 40% of men over 40 years of age suffer from prostatitis, an inflammatory process in the prostate gland. In recent years, there has been an increase in the incidence of this organ, which is facilitated by a sedentary lifestyle and an increase in mental tension.

    Prostatitis is more common among those who are forced to lead a sedentary lifestyle in connection with the specifics of the work: drivers of cars, tractors, people engaged in mental work, etc. Very often prostatitis is observed in people leading a disorderly lifestyle, irregular sex life,venereal diseases.

    In the emergence of prostatitis, an important role is played by infection. Among the infectious pathogens that cause this disease, bacteria: staphylococcus, streptococcus, E. coli, enterococcus and others, as well as chlamydia, trichomonads, mycoplasmas, viruses.

    For the onset of the inflammatory process, only the penetration of an infectious agent is not enough. The state of the body's immunological system and the presence of nonspecific protective equipment are important. In the human body, the protective function is performed by the enzyme lysozyme, which has a bactericidal action, that is, the suppressive vital activity of the microorganism.

    Venereal diseases, primarily trichomoniasis and gonorrhea, with insufficiently effective treatment can acquire a chronic, flaccid course and cause inflammation in the prostate gland. Trichomoniasis prostatitis is difficult to treat, is prone to recurrence, because the cause of the disease are both spouses. Insufficiently effective treatment of one of the spouses negates the best results of the second.

    Inflammatory diseases in the prostate gland can occur and hematogenously, that is, by transferring the infection from other foci of inflammation with blood. In particular, it happens with cystitis, prostatitis, colitis, tooth decay, inflammation of the tonsils, sinuses, bronchi and lungs, liver, bile ducts, kidneys, etc.

    However, the presence of infection in the prostate gland is not enough for development inher inflammatory process. In the emergence of prostatitis, an important role is played by local factors: metabolic disorders in the gland, circulatory disorders, increased vascular permeability, stagnation in the organ. Stagnation in the prostate gland is facilitated by a sedentary, sedentary lifestyle, the interruption of sexual intercourse for the purpose of preventing pregnancy, as well as irregular sexual life.

    With the flow of prostatitis are divided into acute and chronic.

    In acute prostatitis are most common: frequent urination, pain in the perineal region and sacrum, often worse with defecation, sometimes pain passes into the anus. Body temperature rises to 37-40 °.Characterized is also difficulty urinating. Such patients need inpatient treatment.

    About chronic prostatitis, the most common pain syndrome, which can be localized in the genital area, womb, perineum, in the urethra, during ejaculation or after sexual intimacy. However, pain can also appear in the area of ​​the sacrum, the anus, the rectum, the waist, and the abdomen. Often there is itching, excessive sweating, a feeling of cold in the perineum. In the early stage of prostatitis urge to urinate, mostly at night, increases. Later, there is a thinning of the jet during urination, incomplete emptying of the bladder. Among the general symptoms, increased irritability, lethargy, weakness, rapid fatigue, decreased appetite, narrowing of the range of interests, quick temper, decreased efficiency.

    In chronic course, prostatitis causes a number of pathological processes in various parts of the central and peripheral nervous system, the psychoemotional sphere, causing sexual disorders. Over time, the erection becomes weakened, the sex drive decreases, the duration of the sexual act is shortened to 15-30 seconds. Organic sensation during ejaculation becomes erased, sometimes the erection disappears during the sexual act without bringing to orgasm and ejaculation.

    These symptoms are reflected in the psyche and the performance of patients, riveting attention to the disorder, and contributes to the development of neurotic disorders.

    At the reception came About, 43 years old, the driver of long-distance traffic, married 15 years. The last three years, he began to note the weakening of erections, sometimes he experienced difficulties even when he inserted a member into the vagina, periodically worried about pain in the sacrum. The rhythm of sexual activity since 32 years is irregular, since the duration of business trips ranges from seven to 15 days. It happens that a day you have to sit at the steering wheel until 16 o'clock. In occasion of pains in a loin addressed to the neuropathologist who appointed or nominated treatment, but improvement was insignificant and is short-term. The examination revealed an increase and soreness of the parts of the prostate gland. After the urological and sexological treatment, the pain in the waist disappeared, the sexual function was restored.

    It should be noted that often, despite the cure for inflammatory processes in the genitals, sexual dysfunction persists. This is explained by the fact that many functions of the regulatory mechanisms affect the sexual function.

    As a rule, treatment of prostatitis is long. The disappearance of painful symptoms and the normalization of laboratory studies are not evidence of a complete recovery. The disease is prone to relapse, that is to resume. They arise when drinking alcohol, taking irritating food( salting, spicy, smoked), with hypothermia, violating the rhythm of strong-willed life, with inflammatory processes of the sexual organs of partners, etc.

    To prevent this disease, regular hygienic gymnastics,walking a wide step, running, outdoor games( tennis, volleyball, etc.).At the same time, muscle tone is restored, and the functions of internal organs are improved. Do sports provide positive emotions, give a nervous discharge.

    The complex of therapeutic gymnastics includes special exercises aimed at improving blood circulation in the pelvic organs, strengthening the muscles of the perineum, pelvic floor. These include deep squats, walking half-sinking, alternate attacks on the right and left legs, walking with high lifting of the knees, rotational movements of the lower extremities in the supine position( "bicycle").

    Of great importance is nutrition. Food should contain the necessary amount of proteins, fats, carbohydrates, vitamins, microelements. It is unacceptable to overeating, which has a negative effect on the digestive organs, raising to them increased demands. In the diet should include fruits, berries, various juices, vegetables( beets, zucchini, cabbage, etc.).Many vitamins in black currant, citrus, chokeberry, strawberry, blueberry. Carotene is found in carrots, beets, pumpkins, apricots, peaches, alycha, apricots, melons. Useful watermelons, which are well washed urinary organs, helping to cleanse the body of toxins.

    In case of any disorders in sexual function, a person should seek medical advice from a doctor for the timely treatment of the disease.

    In men 55 years of age and older, the prostate gland changes in the form of a glandular tissue that forms a tumor, which is called adenoma.

    The development of the adenoma is also facilitated by the patient's lifestyle. Most often, adenoma of the prostate gland occurs in people of mental work, leading a predominantly sedentary lifestyle, with excessive diet and lack of physical labor. People with physical labor suffer from adenoma of the prostate gland much less often. There is an adenoma from the glands located in the prostate gland under the urethra. Adenoma, increasing in size, pushes out its own prostate tissue and squeezes the urethra, thereby preventing free urination. This leads to a significant change in the kidneys, ureters and bladder. Changes in the organs of the urinary system affect the function of other organs and the general state of the body. Deformation of the urethra and violation of the process of urination occurs regardless of the shape, weight and size of the adenoma. If the normal prostate gland weighs 20-30 g, then adenomatologically changed - 100-120 g, and sometimes more. Adenoma of the prostate breaks the anatomical relationship of the latter with the bladder and the lower parts of the ureters, their normal function, prevents complete emptying of the bladder. This, in turn, leads to incomplete closure of the ureteral anus;during urination, when the contraction of the muscles of the bladder occurs, intravesical pressure rises, part of the urine is thrown upward into the renal cavity, and causes infection of the kidney tissue.

    The disease of the prostate adenoma not only disrupts the function of the bladder and upper urinary tract, but also leads to changes in the reproductive system - the expansion of the ejaculatory ducts and seminal vesicles.

    There are three stages in the clinical course of the prostate adenoma.

    In the first stage( the stage of precursors), a characteristic sign of an increase in the gland is the increased frequency of urination, especially at night, the urine stream becomes thin, falls vertically downwards, splashes. Further difficulties with urination intensified.

    The first stage is manifested by unpleasant sensations in the perineum and in the lower abdomen. During this period, the patient sometimes notes that under the influence of various causes( colds, dampness, hypothermia, excesses or inaccuracies in nutrition), there is a difficulty in urination, requiring prolonged exertion, and sometimes urinary retention may occur.

    In the second stage, the symptoms of the disease are similar to the symptoms of the first stage, but they manifest themselves more intensively. Patients complain mainly of urination disorder, a feeling of incomplete emptying of the bladder. During the beginning of decompensation, urination becomes more frequent, and the time for emptying the bladder is longer. Patients are forced to take different positions and push themselves, trying to increase pressure on the bladder with the abdominal press, which can lead to the formation of hernias or prolapse of the rectum. The bladder stretches, the ability to contract decreases, which causes the formation of residual urine, the amount of which increases over time, reaching 300-500 ml or more. Urination becomes not only frequent, but also painful.

    It should be noted that simultaneously with the violation of urination, gradually develop violations of the upper urinary tract, there are changes in the kidneys - enlargement of the pelvis and calyces, inflammatory processes, it is possible the formation of stones.

    In this stage, adverse factors such as colds, dietary errors, urinary retention, fatigue, mental stress, and alcohol use can lead to a complete urinary retention. In the third stage of prostatic adenoma of residual urine becomes even more - up to 1 -1.5 liters. Significantly reduced the sensitivity of the bladder, patients suffer less from the delay of urine and believe that there has been an improvement in their condition, nocturnal urges cease to disturb them. For this stage, involuntary discharge of urine is characteristic. This incontinence occurs day and night, and then the patients resort to the help of a permanent urine receiver.

    M., 70 years old, appeared at the reception. His main complaint is the frequent urination and the weakened pressure of the jet at this moment. You have to push yourself to the end of the act of urination. During the night, wakes up every 30 to 40 minutes, at least seven times, with a urge to urinate, although the amount of urine does not exceed 50 ml.

    From anamnesis: for seven years, as the diagnosis of prostate adenoma was diagnosed, is undergoing outpatient treatment for this disease, but did not notice any improvement. Since 57 years old he suffers from hypertension. Two years ago, while preparing M. for surgical treatment for adenoma, his blood pressure increased sharply and he was refused surgery.

    After the course of physiotherapy, the condition of M. significantly improved: the pressure of the jet increased during urination, at night it began to wake up no more than once. Patients with adenoma, who are contraindicated in surgical treatment, are recommended to conduct preventive courses of physiotherapy at least once a year.

    In the prevention and reduction of the probability of prostatic adenoma disease, the leading role belongs to the hygiene regimen and proper nutrition.

    The diet is one of the main factors of prevention. Diet should be aimed at the possibility of "not disturbing" kidneys and urinary tracts, diuresis. It is necessary to drink tea with milk, fresh milk, yogurt, yogurt, sour cream, cottage cheese, butter, dairy, vegetable, cereal, fruit, beef, poultry and fish in boiled form( 100 g per day), preferably in the firsthalf a day, cereals and flour products in moderation, salt - no more than 3-5 grams per day. First of all, it is necessary to take care of the vitamin A, B, C vitamins in the diet of the patient, to take complex vitamins such as "Decamevit", "Undevit", etc. Try to avoid travel associated with sudden climate change and living conditions, not to allow a generalcooling, prolonged sitting, which causes a rush of blood and stagnation in the pelvic organs. Do not overdo urine.

    The state of the gastrointestinal tract is important: constipation can disrupt urination, promote infection and delay urine. With constipation, light laxatives are prescribed. Completely exclude spices, pepper, mustard, canned food and smoked meat.

    Alcoholic beverages and beer are not allowed.

    It is beneficial to take systematic walks, especially before going to bed, using a rather hard bed, which excludes the sagging of the pelvic organs.

    Let's consider in more detail how to overcome the effects of weakening of erection and rapid ejaculation, which, according to sexopathologists, are most common in sexual disorders in men.

    Failure to achieve or retain an erection is the most important sexual problem that can disturb a man. An accidental failure with an erection can occur if you are not really attuned to this, or you are not really attracted by the person with whom you have entered into sexual intercourse. Sometimes the weakening of the erection is facilitated by a natural anxiety that can be caused by nervousness on the threshold of a new connection or a sense of guilt from the illegality of the relationship. Temporary failures only matter if you end up sticking to yourself the label of an "impotent" or allowing you to take hold of an obsession about repeating the fiasco in the future. We will provide self-help measures that can reduce the consequences of failure to a minimum. The main thing is that they will help you to avoid the anxiety that can cause sexual dysfunction, and to establish your marital relationship.

    1. Be engaged in sex only when you are attuned to it.

    2. Take for granted that you are a person, not a machine. Your feelings and sexual performance need not always be the same. Once you are in a state of great readiness, and sometimes you need additional stimulation. Your constant partner can not understand this until you tell her about it.

    3. Avoid accidental encounters, at least until your self-confidence grows. You will worry less and function better if you can create a stable relationship with a partner whose reactions you know and which you trust.

    4. Do not judge your data by marking the condition of your penis. Mutual satisfaction can often be achieved without sexual intercourse, although in a situation of physical intimacy, an erection can develop without your conscious participation.

    5. If you can not get an erection or you lose it just before the sexual act or during it, do not get too upset. Just explain what happened( "I guess I'm too tired tonight. Let's try again tomorrow morning"), and do not feel guilty. However, be sure to convince the wife( partner) that this is her fault. The most important thing is not to retire physically and morally just because sexual intercourse at the moment is not obtained. Stay close with your wife in any way you like, excluding sexual intercourse. If you like to be alone, regardless of whether there is an erection or not, you will have less concern about the possibility of failure the next time.

    In the treatment of erectile dysfunction, an active partner should take an active part, with whom you should discuss the sekoototherapy program together.

    The name of sex therapy, or sexual therapy, has arisen and is being applied in the scientific literature through the work of American sexologists Masters and Johnson. The method is based on therapeutic work with partners, aimed directly at the sexual symptom.

    Classes should be conducted in a comfortable environment( closed doors, comfortable temperature, soft light, pleasant music) for an hour of day three. Partners should create an atmosphere of mutual understanding and a pleasant mood, try to take their mind off everyday worries, remember joint pleasant experiences and experiences.

    A man and a woman are completely naked. One of them, usually a woman first, lies in the position on the abdomen, and the other begins to lightly touch the body. They use different kinds of touches, and the passive partner gradually changes the position of his body. This is repeated three times for 5 minutes. First, you should not caress the genitals and chest of a woman, you can later touch and these parts of the body.

    After mastering the first lesson, they move on to the second. A man lies loosely on his back, and a woman takes such a position that access to the male penis is convenient. The man guides the woman's hand and teaches her to stimulate the penis in such a way that it gives him the greatest pleasure. You should focus on pleasant experiences in this regard, but do not seek to ensure that during stimulation, an erection or ejaculation has necessarily occurred. When a sufficient erection appears, the woman ceases to stimulate the penis for a while, diverting the attention of the man from sexual arousal, so that the resulting erection disappears. Stimulation is carried out for half an hour, so that an erection occurred during this time approximately 3 times. At the end of the session you should achieve ejaculation.

    The third lesson begins the same as the first. When a certain degree of sexual arousal is achieved, the partner sits on the man's knees and in this position stimulates the penis. If necessary, it can be moistened with petroleum jelly. If he is not very tense, then the woman brings him closer to the entrance to the vagina and stimulates them with the clitoris and small labia.

    If the penis is straining, the woman gradually introduces it into the vagina. She remains sitting alone and concentrates on the sensations that cause the penis to be in the vagina. The man is also at rest and concentrates on the same sensations. With a decrease in the tension of the penis, it should be removed from the vagina and the manual stimulation again. If you re-appear an erection, the training continues. After a while, the woman begins to produce slow frictions, trying to focus on the sensations of moving the penis into different parts of the vagina. During this lesson, you should remove the penis several times from the vagina and reintroduce it again after a while. It is advisable to interrupt the frictions approximately 3 times, and then to achieve ejaculation.

    Slowing of ejaculation can be achieved with the help of the "squeezing" technique. This method is as follows. If the ejaculation is close, at your signal the partner should immediately rise and tightly squeeze the penis. Squeezing the penis directly under the head for 15-20 seconds, the partner inhibits your irresistible desire to ejaculate and temporarily weakens the erection. Repeat the procedure 2-3 times.

    When you achieve some control in this way, you will be ready to perform sexual intercourse. The partner sits on you and directs your erect penis to your vagina. Both do not move to those holes until you warn it at the right time that it's close to orgasm. She immediately rises and applies a squeeze. Repeat exercise 2-3 times, then allow yourself to ejaculate.

    When you are fully confident that your control has improved, you must carefully carry out sexual intercourse. Using the same "woman on top" position, start jolting and ask your partner to move her hips slightly. However, she should be ready to go up and squeeze the penis as soon as you give her a signal. In a few weeks you should learn to have a sexual intercourse, such as a pause - contraction for 15-20 minutes without ejaculation.

    Now try to have sexual intercourse in other poses. Control may remain difficult in the traditional "man on top" position. If you do the "squeezing technique" exercise at least once a week for the next 3 months, at the end of this period you will gain control over the ejaculation that will be useful in all types of sexual activity.