Posts Tagged ‘climax’

Are You “Cliterate”? (Do You Have A Good Working Knowledge Of The Clitoris?)

March 18, 2017

Andrew Siegel MD  3/18/17

The clitoris—possessed by all female mammals—is a complex and mysterious organ. Even the word itself–and the way it rolls off the tongue as it is pronounced–is a curiosity.  Many men (and women as well) are relatively clueless (“uncliterate”) about this unique and fascinating female anatomical structure.  The greatest challenge of achieving cliteracy is that so much of this mysterious lady part is subterranean–in the nether regions, unexposed, under the surface, obscured from view–and therefore difficult to decipher.  

The intention of this entry is to enable understanding of what is under the (clitoral) hood, literally and figuratively. Regardless of gender, a greater knowledge and appreciation of the anatomy, function and nuances of this special and unique biological structure will most certainly prove to be useful.  In general terms, proficiency and command of geography and landmarks on the map is always helpful in directing one to arrive at the proper destination.  Consider this entry a clitoral GPS.

 

Klitoriswurzel,_Klitoris,_Klitorisschenkel

The clitoris is mostly subterranean–what you see is merely the “tip of the iceberg.”  The white lines indicate the “rest of the iceberg.”

(By Remas6 [CC0], via Wikimedia Commons)

Mountainous and Hilly Female Terrain

The vulva (the external part of the female genital anatomy) consists of hilly terrain. It is well worth learning the “lay of the land” so that it can be traversed with finesse. The mons pubis (pubic mound) is the rounded and prominent mass of fatty tissue overlying the pubic bone, derived from the Latin “mons,” meaning “mountain.” Located beneath the lower part of the mons is the upper portion of the clitoris.  The word clitoris derives from the Greek “kleitoris,” meaning “little hill.”

Mons_pubis_jpg

Lower abdomen, mons pubis and pudendal cleft

By Wikipicturesxd (Own work) [CC BY-SA 4.0 (http://creativecommons.org/licenses/by-sa/4.0)%5D, via Wikimedia Commons

The Epicenter of Female Sexual Anatomy

The clitoris is arguably the most vital structure involved with female sexual response and sexual climax. It is the only human organ that exists solely for pleasure, the penis being a multi-tasker with reproductive and urinary roles as well as being a sexual organ. However, I would argue that nature had much more than simply pleasure in mind when it came to the design of the clitoris, with the ultimate goal being reproduction and perpetuation of the species.  If sex was not pleasurable, there would little incentive for it and pregnancies would be significantly fewer. Think about non-human mammals—what would be their motivation to reproduce if sex were not pleasurable? (Male chimps and female chimps do not sit down together and plan on having a family!)  So, pleasure is the bait and reproduction is the switch in nature’s clever scheme.

The clitoris, like the penis, consists largely of spongy erectile tissue that is rich in blood vessels. The presence of this vascular tissue results in clitoral swelling with sexual arousal, causing clitoral fullness and ultimately a clitoral “erection.”

Penile-Clitoral_Structure

Comparison of penis (left) and clitoris (right), each largely composed of spongy, vascular, erectile tissue

By Esseh (Self-made. Based on various anatomy texts.) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC BY-SA 2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)%5D, via Wikimedia Commons

Clitoral size is highly variable from woman to woman—certainly as much as penile size. A very large clitoris can resemble a very small penis.

Interesting trivia: The female spotted hyena, squirrel monkey, lemur, and bearcat all have in common a very large clitoris referred to as a “pseudo-penis.”  When erect, it appears like the male’s penis and is used to demonstrate dominance over other clan members.  

The most sensitive part of the clitoris is the “head,” which is typically about the size of a pencil eraser and located at the upper part of the vulva where the inner lips meet. Despite its small size, the head has a dense concentration of nerve endings, arguably more than any other structure in the body. Like the penis, the head is covered with a protective hood known as the “foreskin.”

The head is really the “tip of the iceberg” because the vast majority of the clitoris is unexposed and internal. The clitoris (again like the penis) has a “shaft” (although it is internal) that extends upwards towards the pubic bone. The extensions of the shaft are the wishbone-shaped “legs” that turn downwards and attach to the pubic arch as it diverges on each side. Beneath the legs on either side of the vaginal opening are the clitoral “bulbs,” sac-shaped erectile tissues that lie beneath the outer vaginal lips. With sexual stimulation, these bulbs become full, plumping and tightening the vaginal opening.

One can think of the legs and bulbs as the roots of a tree, hidden from view and extending deeply below the surface, fundamental to the support and function of the clitoral shaft and head above, comparable to the tree’s trunk and branches.

vulva

Image above by OpenStax College – Anatomy & Physiology, Connexions Web site. http://cnx.org/content/col11496/1.6/, Jun 19, 2013., CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=30148635, no changes made to original

The Clitoral Response

With sexual arousal and stimulation, the clitoris engorges, resulting in thickening of the clitoral shaft and swelling of the head. With increasing clitoral stimulation, a clitoral erection occurs and ultimately the clitoral shaft and head withdraw from their overhanging position (clitoral “retraction”), pulling inwards against the pubic bone (like a turtle pulling its head in).

Interesting trivia: The blood pressure within the clitoris at the time of a clitoral erection is extremely high, literally at hypertensive (high blood pressure) levels. This is largely on the basis of the contractions of the pelvic floor/perineal muscles that surround the clitoral legs and bulbs and force pressurized blood into the clitoral shaft and head. The only locations in the body where hypertension is normal and, in fact, desirable are the penis and clitoris.

Why The Pelvic Floor Muscles Are Vital To Female Sexual Health And Clitoral Function

During arousal the pelvic floor muscles help increase pelvic blood flow, contributing to vaginal lubrication, genital engorgement and the transformation of the clitoris from flaccid to softly swollen to rigidly engorged.  The pelvic floor muscles enable tightening of the vagina at will and function to compress the deep roots of the clitoris, elevating clitoral blood pressure to maintain clitoral erection. At the time of climax, they contract rhythmically.  An orgasm would not be an orgasm without the contribution of these important muscles.

 

Bulbospongiosus-Female

Bulbocavernosus muscle (pelvic floor muscle that supports and compresses the clitoral bulbs)

 

Ischiocavernosus-female

Ischiocavernosus muscle (pelvic floor muscle that supports and compresses the clitoral legs)

(Above two images are in public domain, originally from Gray’s Anatomy 1909)

During penetrative sexual intercourse, only a small percentage of women achieve enough direct clitoral stimulation to achieve a “clitoral” orgasm, as this is usually restricted to women with larger clitoral head sizes and shorter distances from the clitoris to the vagina. Depending on sexual position and angulation of penetration, the penis is capable of directly stimulating the clitoral head and shaft, typically in the missionary position when there is direct pubic bone to pubic bone contact. However, vaginal penetration and penile thrusting does directly stimulate the clitoral legs and bulbs and the thrusting motion can also put rhythmic traction on the labia, which can result in the clitoris getting pulled and massaged.

Interesting trivia: Magnetic resonance (MR) studies have shown that a larger clitoral head size and shorter distance from the clitoris to the vagina are correlated with an easier ability to achieve an orgasm.

The clitoris plays a key role in achieving orgasm for the majority of women. An estimated 70% of women require clitoral stimulation in order to achieve orgasm. Some women require direct clitoral stimulation, while for others indirect stimulation is sufficient. Only about 25% of women are capable of achieving orgasm via vaginal intercourse alone.

With increasing sexual arousal and stimulation, physical tension within the genitals gradually builds and once sufficient intensity and duration of sexual stimulation surpasses a threshold, involuntary rhythmic muscular contractions of the pelvic floor muscles, the vagina, uterus and anus occur, followed by the release of accumulated erotic tension and a euphoric state. Thereafter, the genital and clitoral engorgement and congestion subside, muscle relaxation occurs and a peaceful state of physical and emotional bliss and afterglow become apparent.

Clitoral orgasms are often described as a gradual buildup of sensation in the clitoral region culminating in intense waves of external muscle spasm and release. In contrast, vaginal orgasms are described as slower, fuller, wider, deeper, more expansive and complex, whole body sensations. The truth of the matter is that all lady parts are inter-connected and work together, so grouping orgasm into “clitoral” versus “vaginal” is an arbitrary distinction. Most women report that both clitoral and vaginal stimulation play roles in achieving sexual climax, but since the clitoris has the greatest density of nerves, is easily accessible and typically responds readily to stimulation, is the fastest track to sexual climax for most women.

There is a clitoral literacy movement that is gaining momentum. Please visit:

http://projects.huffingtonpost.com/cliteracy for more information on the clitoris and this campaign to foster awareness of this curious organ.

Wishing you the best of health,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”:  www.HealthDoc13.WordPress.com

Dr. Andrew Siegel is a practicing physician and urological surgeon board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  Dr. Siegel serves as Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community that is in such dire need of bridging.

Author of MALE PELVIC FITNESS: Optimizing Sexual & Urinary Health http://www.MalePelvicFitness.com

Author of THE KEGEL FIX: Recharging Female Pelvic, Sexual and Urinary Health  http://www.TheKegelFix.com (much of the material from this entry was excerpted from this book)

What To Expect of Your Erections As You Age…20’s, 30’s, 40’s and Beyond

December 26, 2015

Andrew Siegel,  MD  12/26/15

I have written more than 250 blogs, this being the overwhelming most popular one with 50,000 plus views in 2015.  I am therefore reposting this as an encore final entry of 2015. 

shutterstock_side view manjpeg

It is shocking how ill prepared we are for aging. Nobody informs us exactly what to expect with the process, so we just sit back and observe the changes as they unfold, dealing with them as best we can. Although educational books are available on many topics regarding other expected experiences, such as “What To Expect When You’re Expecting,” I have yet to see “The Manual of Man,” explaining the changes we might expect to experience as time goes on. Some day I wish to author a book like that, but for the time being I will blog on what to anticipate with male sexual function as time relentlessly marches on.

“But the wheel of time turns, inexorably. True rigidity becomes a distant memory; the refractory period of sexual indifference after climax increases; the days of coming are going. Sexually speaking, men drop out by the wayside. By 65, half of all men are, to use a sporting metaphor, out of the game; as are virtually all ten years later, without resort to chemical kick-starting.”

Tom Hickman, God’s Doodle: The Life and Times of the Penis

Aging can be unkind and Father Time does not spare your sexual function. Although erectile dysfunction (ED) is not inevitable, with each passing decade, there is an increasing prevalence of it. Present in some form in 40% of men by age 40 years, for each decade thereafter an additional 10% join the ED club. All aspects of sexuality decline, although libido (sexual interest and drive) suffers the least depreciation, leading to a swarm of men with eager “big heads” and apathetic “little heads,” a most frustrating combination indeed.

With aging often comes less sexual activity, and with less sexual activity often comes disuse atrophy, in which the penis actually becomes smaller. Additionally, with aging there is often weight gain, and with weight gain comes a generous fat distribution in the pubic area, which will make the penis appear shorter. With aging also comes scrotal laxity and testicles that hang down loosely, like the pendulous breasts of an older woman. Many of my older patients relate that when they sit on the toilet, their scrotum touches the toilet water. So, the penis shrinks and the testicles hang low like those of an old hound dog…Time and gravity can be cruel conspirators!

So, what can you expect of your sexual function as you age? I have broken this down by decade with the understanding that these are general trends and that you as an individual may well vary quite a bit from others in your age group, depending upon your genetics, lifestyle, luck and other factors. There are 30-year-old men who have sexual issues and 80-year-old men who are veritable “studs,” so age per se is not the ultimate factor.

You may wonder about the means by which I was able to craft this guide. I was able to do so through more than 25 years spent deep in the urology trenches, working the front line with thousands of patient interactions. My patients have been among my most important teachers and have given me a wealth of information that is not to be found in medical textbooks or journals, nor taught in medical school or during urology residency. Furthermore, I am a 50-something year-old man, keenly observant of the subtle changes that I have personally witnessed, but must report that I am still holding my own!

Age 18-30: Your sexual appetite is prodigious and sex often occupies the front burners of your mind. It requires very little stimulation to achieve an erection—even the wind blowing the right way might just be enough to stimulate a rigid, gravity-defying erection, pointing proudly at the heavens. The sight of an attractive woman, the smell of her perfume, merely the thought of her can arouse you fully. You get erections even when you don’t want them…if there was only a way to bank these for later in life!  You wake up in the middle of the night sporting a rigid erection. When you climax, the orgasm is intense and you are capable of ejaculating an impressive volume of semen forcefully with an arc-like trajectory, a virtual comet shooting across the horizon. When you arise in the morning from sleep, it is not just you that has arisen, but also your penis that has become erect in reflex response to your full bladder, which can make emptying your bladder quite the challenge, with the penis pointing up when you want to direct its aim down towards the toilet bowl.

It doesn’t get better than this…you are an invincible king… a professional athlete at the peak of his career! All right, maybe not invincible…you do have an Achilles heel…you may sometimes ejaculate prematurely because you are so hyper-excitable and sometimes in a new sexual situation you have performance anxiety, a mechanical failure brought on by the formidable mind-body correction, your all-powerful mind dooming the capabilities of your perfectly normal genital plumbing.

Age 30-40: Things start to change ever so slowly, perhaps even so gradually that you barely even notice them. Your sex drive remains vigorous, but it is not quite as obsessive and all consuming as it once was. You can still get quality erections, but they may not occur as spontaneously, as frequently and with such little provocation as they did in the past. You may require some touch stimulation to develop full rigidity. You still wake up in the middle of the night with an erection and experience “morning wood.” Ejaculations and orgasms are hardy, but you may notice some subtle differences, with your “rifle” being a little less powerful and of smaller caliber. The time it takes to achieve another erection after ejaculating increases. You are that athlete in the twilight of his career, seasoned and experienced, and the premature ejaculation of yonder years is much less frequent an occurrence.

Age 40-50: After age 40, changes become more obvious. You are still interested in sex, but not nearly with the passion you had two decades earlier. You can usually get a pretty good quality erection, but it now often requires tactile stimulation and the rock-star rigidity of years gone by gives way to a nicely firm penis, still suitable for penetration. The gravity-defying erections don’t have quite the angle they used to. At times you may lose the erection before the sexual act is completed. You notice that orgasms have lost some of their kick and ejaculation has become a bit feebler than previous. Getting a second erection after climax is not only difficult, but also may be something that you no longer have any interest in pursuing. All in all though, you still have some game left.

Age 50-60: Sex is still important to you and your desire is still there, but is typically diminished. Your erection can still be respectable and functional, but is not the majestic sight to behold that it once was, and touch is necessary for full arousal. Nighttime and morning erections become few and far between. The frequency of intercourse declines while the frequency of prematurely losing the erection before the sexual act is complete increases. Your orgasms are definitely different with less intensity of your climax, and at times, it feels like nothing much happened—more “firecracker” than “fireworks.” Ejaculation has become noticeably different—the volume of semen is diminished and you question why you are “drying up.” At ejaculation, the semen seems to dribble with less force and trajectory; your “high-caliber rifle” is now a “blunt-nosed handgun.” Getting a second erection after climax is difficult, and you have much more interest in going to sleep rather than pursuing a sexual encore. Sex is no longer a sport, but a recreational activity…sometimes just reserved for the weekends.

Age 60-70: “Sexagenarian” is bit of a misleading word…this is more apt a term for the 18-30 year-old group, because your sex life doesn’t compare to theirs…they are the athletes and you the spectators. Your testosterone level has plummeted over the decades, probably accounting for your diminished desire. Erections are still obtainable with some coaxing and coercion, but they are not five star erections, more like three stars, suitable for penetration, but not the flagpole of yonder years. They are less reliable, and at times your penis suffers with attention deficit disorder, unable to focus and losing its mojo prematurely, unable to complete the task at hand. Spontaneous erections, nighttime and early morning erections become rare occurrences. Climax is, well, not so climactic and explosive ejaculations are a matter of history. At times, you think you climaxed, but are unsure because the sensation was so un-sensational. Ejaculation may consist of a few drops of semen dribbling out of the end of the penis. Your “rifle” has now become a child’s plastic “water pistol.” Seconds?…thank you no …that is reserved for helpings on the dinner table! Sex is no longer a recreational activity, but an occasional amusement.

Age 70-80: When asked about his sexual function, my 70-something-year-old patient replied: “Retired…and I’m really upset that I’m not even upset.”

You may still have some remaining sexual desire left in you, but it’s a far cry from the fire in your groin you had when you were a younger man. With physical coaxing, your penis can at times be prodded to rise to the occasion, like a cobra responding to the beck and call of the flute of the snake charmer. The quality of your erections has noticeably dropped, with penile fullness without that rigidity that used to make penetration such a breeze. At times, the best that you can do is to obtain a partially inflated erection that cannot penetrate, despite pushing, shoving and manipulating every which way. Spontaneous erections have gone the way of the 8-track player. Thank goodness for your discovery that even a limp penis can be stimulated to orgasm, so it is still possible for you to experience sexual intimacy and climax, although the cli-“max” is more like a cli-“min.” That child’s “water pistol”…it’s barely got any water left in the chamber.

Age 80-90: You are now a member of a group that has an ever-increasing constituency—the ED club. Although you as an octogenarian may still be able to have sex, most of your brethren cannot; however, they remain appreciative that at least they still have their penises to use as spigots, allowing them to stand to urinate, a distinct competitive advantage over the womenfolk. (But even this plus is often compromised by the aging prostate gland, wrapped around the urinary channel like a boa constrictor, making urination a challenging chore.) Compounding the problem is that your spouse is no longer a spring chicken. Because she been post-menopausal for many years, she has a significantly reduced sex drive and vaginal dryness, making sex downright difficult, if not impossible. If you are able to have sex on your birthday and anniversary, you are doing much better than most. To quote one of my octogenarian patients in reference to his penis: “It’s like walking around with a dead fish.”

Age 90-100: To quote the comedian George Burns: “Sex at age 90 is like trying to shoot pool with a rope.” You are grateful to be alive and in the grand scheme of things, sex is low on the list of priorities. You can live vicariously through pleasant memories of your days of glory that are lodged deep in the recesses of your mind, as long as your memory holds out! Penis magic has gone the way of defeated phallus syndrome. So, when and if you get an erection, you never want to waste it!

Wishing you a healthy, peaceful, happy (and sexy) 2016,

2014-04-23 20:16:29

http://www.AndrewSiegelMD.com

A new blog is posted every week. To receive the blogs in the in box of your email go to the following link and click on “email subscription”: www.HealthDoc13.WordPress.com

Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health: available in e-book (Amazon Kindle, Apple iBooks, Barnes & Noble Nook, Kobo) and paperback: www.MalePelvicFitness.com. Coming soon is The Kegel Fix: Recharging Female Pelvic, Sexual and Urinary Health.

Co-creator of Private Gym, a comprehensive, interactive, FDA-registered follow-along male pelvic floor muscle training program. Built upon the foundational work of Dr. Arnold Kegel, Private Gym empowers men to increase pelvic floor muscle strength, tone, power, and endurance: www.PrivateGym.com or Amazon.

Sex and the Mediterranean Diet

February 1, 2014

Blog # 139

Sexuality is a very important part of our human existence, both for purposes of procreation as well as pleasure.  Although not a necessity for a healthy life, the loss or diminution of sexual function may result in loss of self-esteem, embarrassment, a sense of isolation and frustration, and even depression. Therefore, for many of us it is vital that we maintain our sexual health. Loss of sexual function further exacerbates progression of sexual dysfunction—the deficiency of genital blood flow that often causes sexual dysfunction produces a state of poor oxygen levels (hypoxia) in the genital tissues, which induces scarring (fibrosis) that further compounds the problem.  So “use it or lose it” is a very relevant statement when it comes to sexual function, as much as it relates to muscle function.

Healthy sexual function for a man involves a satisfactory libido (sex drive), the ability to obtain and maintain a rigid erection, and the ability to ejaculate and experience a climax. For a woman, sexual function involves a healthy libido and the ability to become aroused, lubricate adequately, to have sexual intercourse without pain or discomfort, and the ability to achieve an orgasm.   Sexual function is a very complex event contingent upon the intact functioning of a number of systems including the endocrine system (produces sex hormones), the central and peripheral nervous systems (provides the nerve control) and the vascular system (conducts the blood flow).

A healthy sexual response is largely about adequate blood flow to the genital and pelvic area, although hormonal, neurological, and psychological factors are also important.  The increase in the blood flow to the genitals from sexual stimulation is what is responsible for the erect penis in the male and the well-lubricated vagina and engorged clitoris in the female. Diminished blood flow—often on the basis of an accumulation of fatty deposits creating narrowing within the walls of blood vessels—is a finding associated with the aging. This diminution in blood flow to our organs will negatively affect the function of all of our systems, since every cell in our body is dependent upon the vascular system for delivery of oxygen and nutrients and removal of metabolic waste products.  Sexual dysfunction is often on the basis of decreased blood flow to the genitals from pelvic atherosclerosis, the accumulation of fatty deposits within the walls of the blood vessels that bring blood to the penis and vagina.

Sexual dysfunction may be a sign of cardiovascular disease. In other words, the quality of erections in a man and the quality of sexual response in a female can serve as a barometer of cardiovascular health. The presence of sexual dysfunction can be considered the equivalent of a genital stress test and may be indicative of a cardiovascular problem that warrants an evaluation for arterial disease elsewhere in the body (heart, brain, aorta, peripheral blood vessels).  The presence of sexual dysfunction is as much of a predictor of cardiovascular disease as is a strong family history of cardiac disease, tobacco smoking, or elevated cholesterol. The British cardiologist Graham Jackson has expanded the initials E.D. (Erectile Dysfunction) to mean Endothelial Dysfunction (endothelial cells being the type of cells that line the insides of arteries), Early Detection (of cardiovascular disease), and Early Death (if missed). The bottom line is that heart healthy is sexual healthy.

Many adults are beset with Civilization Syndrome, a cluster of health issues that have arisen as a direct result of our sedentary lifestyle and poor dietary choices.  Civilization Syndrome can lead to obesity, high blood pressure, and elevated cholesterol and can result in such health problems as diabetes, heart attack, stroke, cancer, and premature death.  The diabetic situation in our nation has become outrageous—20 million people have diabetes and more than 50 million are pre-diabetic, many of whom are unaware of their pre-diabetic state! It probably comes as no surprise that diabetes is one of the leading causes of sexual dysfunction in the United States.

Civilization Syndrome can cause a variety of health issues that result in sexual dysfunction.  Obesity (external fat) is associated with internal obesity and fatty matter clogging up the arteries of the body including the arteries which function to bring blood to the genitalia.  Additionally, obesity can have a negative effect on our sex hormone balance (the balance of testosterone and estrogens), further contributing to sexual dysfunction. High blood pressure will cause the heart to have to work harder to get the blood flowing through the increased resistance of the arteries. Blood pressure lowering medications will treat this, but as a result of the decreased pressure, there will be less forceful blood flow through the arteries.  Thus, blood pressure medications, although very helpful to prevent the negative effects of hypertension—heart attacks, strokes, etc.—will contribute to sexual dysfunction.  High cholesterol will cause fatty plaque buildup in our arteries, compromising blood flow and contributing to sexual dysfunction.  Tobacco constricts blood vessels and impairs blood flow through our arteries, including those to our genitals. Smoking is really not very sexy at all!  Stress causes a surge of adrenaline release from the adrenal glands. The effect of adrenaline is to constrict blood vessels and decrease sexual function.  In fact, men with priapism (a prolonged and painful erection) are often treated with penile injections of an adrenaline-like chemical.

A healthy lifestyle is of paramount importance towards the endpoint of achieving a health quality and quantity of life.  Intelligent lifestyle choices, including proper eating habits, maintaining a healthy weight, engaging in exercise, adequate sleep, alcohol in moderation, avoiding tobacco and stress reduction are the initial approach to treating many of the diseases that are brought on by poor lifestyle choices.  Sexual dysfunction is often in the category of a medical problem that is engendered by imprudent lifestyle choices.  It should come as no surprise that the initial approach to managing sexual issues is to improve lifestyle choices.  Simply by pursuing a healthy lifestyle, Civilization Syndrome can be prevented or ameliorated, and the myriad of medical problems that can ensue from Civilization Syndrome, including sexual dysfunction, can be mitigated.

In terms of maintaining good cardiovascular health (of which healthy sexual function can serve as a proxy), eating properly is incredibly important—obviously in conjunction with other smart lifestyle choices. Fueling up with the best and most wholesome choices available will help prevent the build up of fatty plaques within blood vessels that can lead to compromised blood flow. Poor nutritional decisions with a diet replete with fatty, nutritionally-empty choices such as fast food, puts one on the fast tract to clogged arteries that can make your sexual function as small as your belly is big!.

A classic healthy food lifestyle choice is the increasingly popular Mediterranean diet.  This diet, the traditional cooking style of the countries bordering the Mediterranean Sea including Spain, France, Greece, Cyprus, Turkey, Southern Italy, and nearby regions, has been popular for hundreds of years. The Mediterranean cuisine is very appealing to the senses and includes products that are largely plant-based, such as anti-oxidant rich fruits and vegetables, whole grains, nuts, seeds and legumes.  Legumes—including peas, beans, and lentils—are a wonderful source of non-animal protein.  Soybeans are high in protein, and contain a healthy type of fat.  Soy is available in many forms— edamame (fresh in the pod), soy nuts (roasted), tofu (bean curd), and soymilk. Fish and poultry are also mainstays of the Mediterranean diet, with limited use of red meats and dairy products.  The benefits of fish in the diet can be fully exploited by eating a good variety of fish.  Olive oil is by far the principal fat in this diet, replacing butter and margarine. The Mediterranean diet avoids processed foods, instead focuses on wholesome products, often produced locally, that are low in saturated fats and high in healthy unsaturated fats. The Mediterranean diet is high in the good fats (monounsaturated and polyunsaturated) which are present in such foods as olive, canola and safflower oils, avocados, nuts, fish, and legumes, and low in the bad fats (saturated fats and trans fats).  The Mediterranean style of eating provides an excellent source of fiber and anti-oxidants.  A moderate consumption of wine is permitted with meals.

Clearly, a healthy diet is an important component of a healthy lifestyle, the maintenance of which can help prevent the onset of many disease processes.  There are many healthy dietary choices, of which the Mediterranean diet is one.  A recent study reported in the International Journal of Impotence Research (Esposito, Ciobola, Giugliano et al) concluded that the Mediterranean diet improved sexual function in those with the Metabolic Syndrome, a cluster of findings including high blood pressure, elevated insulin levels, excessive body fat around the waist and abnormal cholesterol and triglyceride levels.  35 patients with sexual dysfunction were put on a Mediterranean diet and after two years blood test markers of endothelial function and inflammation significantly improved in the intervention group versus the control group. The intervention group had a significant decrease in glucose, insulin, low-density lipoprotein cholesterol (LDL—the “bad” cholesterol), triglycerides, and blood pressure, with a significant increase in high-density lipoprotein cholesterol (HDL—the “good” cholesterol).  14 men in the intervention group had glucose intolerance and 6 had diabetes at baseline, but by two years, the numbers were reduced to 8 and 3, respectively.

Why is the Mediterranean diet so good for our hearts and sexual health?  The Mediterranean diet is high in anti-oxidants—vitamins, minerals and enzymes that act as “scavengers” that can mitigate damage caused by reactive oxygen species.  Reactive oxygen species (also known as free radicals) are the by-products of our metabolism and also occur from oxidative damage from environmental toxins to which we are all exposed.  The oxidative stress theory hypothesizes that, over the course of many years, progressive oxidative damage occurs by the accumulation of the chemicals the accumulation of reactive oxygen species engender diseases, aging and, ultimately, death.  The most common anti-oxidants are Vitamins A, B-6, B-12, C, E, folic acid, lycopene and selenium.  Many plants contain anti-oxidants—they are concentrated in beans, fruits, vegetables, grain products and green tea.  Brightly colored fruits and vegetables are good clues as to the presence of high levels of anti-oxidants—berries, cantaloupe, cherries, grapes, mango, papaya, apricots, plums, pomegranates, tomatoes, pink grapefruit, watermelon, carrots, broccoli, spinach, kale, squash, etc.—are all loaded with anti-oxidants as well as fiber. A Mediterranean diet is also high in omega-3 fatty acids, a type of polyunsaturated fat present in oily fish including salmon, herring, and sardines.  Nuts—particularly walnuts—have high omega-3 fatty acid content.  Research has demonstrated that these “good” fats have numerous salutary effects, including decreasing triglyceride levels, slightly lowering blood pressure, and decreasing the growth rate of fatty plaque deposits in the walls of our arteries (atherosclerosis), thus reducing the risk of cardiovascular disease, stroke, and other medical problems. Mediterranean cooking almost exclusively uses olive oil, a rich source of monounsaturated fat, which can lower total cholesterol and LDL cholesterol while increasing HDL cholesterol. It is also a source of antioxidants including vitamin E.  People from the Mediterranean region generally drink a glass or two of red wine daily with meals. Red wine is a rich source of flavonoid phenols—a type of anti-oxidant—which protects against heart disease by increasing HDL cholesterol and preventing blood clotting, similar to the cardio-protective effect of aspirin.

The incorporation of a healthy and nutritious diet, such as the Mediterranean diet, is a cornerstone for maintaining good health in general, and vascular health, including sexual health, in particular.  The Mediterranean diet—my primary diet and one that I have incorporated quite naturally since it consists of the kinds of foods that I enjoy—is colorful, appealing to the senses, fresh, wholesome, and one that I endorse with great passion. Maintaining a Mediterranean dietary pattern has been correlated with less cardiovascular disease, cancer, and sexual dysfunction.  And it is very easy to follow.  It contains “good stuff”, tasty, filling, and healthy, with a great variety of food and preparation choices—plenty of colorful fresh fruit and vegetables, a variety of fish prepared in a healthy style, not fried or laden with heavy sauces, healthy fats including nuts and olive oil, limited intake of red meat, a delicious glass of red wine.  It’s really very simple and satisfying.  Of course the diet needs to be a part of a healthy lifestyle including exercise and avoidance of harmful and malignant habits including smoking, excessive alcohol, and stress.  So if you want a sexier style of eating, I strongly recommend that you incorporate the Mediterranean diet into your lifestyle.  Intelligent nutritional choices are a key component of physical fitness and physical fitness leads to sexual fitness.

Andrew Siegel, M.D.

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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in March 2014. www.MalePelvicFitness.com

Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:www.promiscuouseating.com

Author of Finding Your Own Fountain of Youth: The Essential Guide For Maximizing Health, Wellness, Fitness & Longevity  (free electronic download) www.findyourfountainofyouth.com

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