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Men and Sexual Wellness – The Unbalanced Equation Today


Sex has always been perceived as the man’s domain and is considered a symbol of ‘male power,’ which holds more real in the patriarchal set of India.

The sexual issues and discords for the same reason are on the rise, and it’s high time that as a society we come out in open to support men who may be facing disturbances in their sexual life but are afraid to talk about them or seek help for the reasons of social stigma.

Just like any physical ailment in other parts of the body; sexual and mental wellness also requires professional advice, and it is certainly not a symbol of ‘prowess’ of any kind.

Especially in India, social pressures of all kinds are immense. Each gender has its challenges to fight. For the reason of fear of social humiliation, some battles are lost without even fighting them out.

As times are fast changing and roles of both men and women have evolved and undergone a sea of transformations, there is a significant shift in the tide which impacts sexual wellness of individuals. The word sex which was said in whispers in the dark room by the past generations is considered normal and is a subject getting accepted for a discussion.

Having seen a shift in rules, unfortunately, sexual health is still far from being openly discussed. Men today are grappling with various sexual ailments as the experts say much has to do with the unbalanced lifestyle.

Sexual dysfunction is any physical or psychological problem that prevents you or your partner from getting sexual satisfaction. Male sexual dysfunction is a common health problem affecting men of all ages and is on a rise. The problem is far from unusual for men in twenty somethings. For older men, the condition is typically related to atherosclerosis (clogged arteries), diabetes or high blood pressure. But up to a quarter of new erectile dysfunction (ED) patients are now under 40, and a scroll through online health forums shows an increasing number of young men are seeking therapy for erectile dysfunction.

Sexual Ailments in Men

Erectile dysfunction, premature & retrograde ejaculation, low libido and infertility are some of the most common health issues that men face. While these conditions have existed since generations; the growing occurrence and commonality is the primary cause of concern.

If you experience ED at whatever age after 40, add seven years, and you may experience a heart attack in 70 per cent cases. It is primarily a sign of poor cardio health, and if today it is erectile dysfunction, tomorrow it could be a cardiac arrest. Even cases of low libido are becoming increasingly common where the testosterone level in males is low, and the female hormone estrogen is high, which leads to a lack of interest in sexual activity in males.” Dr Rajiv Goel, Consultant Urologist & Andrologist.

“As per a study conducted globally, sperm count has dropped down by 50 per cent in the last 40 years, which is both serious and alarming. Low sperm motility wherein the sperm finds it difficult to move toward the egg, poor semen quality and sperm abnormality are other causes that lead towards infertility in men. Today in almost 50 per cent couples, there is the male contribution of infertility! But in many cases, only the women’s treatment is started while the men are not even getting a semen analysis done,” says Dr Renu Mishra, Senior Consultant Obstetrics & Gynaecology, Head of IVF and Miracle Fertility in Gurgaon who also adds that the scenario is changing, and men are coming forward and even opening up to donor sperms.

Erectile Dysfunction is one of the most prevalent sexual problems that men are reporting today. It is the inability to develop or maintain an erection of the penis during sexual activity and is also known as impotence. It is a common medical problem affecting approximately 15 per cent of men each year. Over 150 million men worldwide were estimated to have been affected by erectile dysfunction in 1995, and this is projected to rise to 320 million by 2025.

Age No Bar

“I see an average of 50 ED cases every week,” says Dr Rajiv Goel, Consultant Urologist &Andrologist with CK Birla & Columbia Asia Hospital. “If you are in the age bracket of 25 – 30, then it is often a short term process and can be corrected with medication. But ED above 40 is a signal that the body needs attention and is a representation of the overall health of the body.

Keep an Eye on Prostrate

Above the age of 50, prostate issues start cropping up in men as it is a part of the ageing process. Prostate cancer mostly is seen in the age group above 60 as cancer-fighting mechanism weakens and some cancer cells multiply. There is also a myth that if the ultrasound shows enlargement means prostate trouble is there. Symptoms are more critical than the size of the prostate. Even without urinary symptoms, prostate cancer still cannot be ruled out.

“Sexual issues have always been there, but there is a steep rise in the cases. The average age group of patients is between 25 – 38 years.”

Dr Yuvraj Arora Monga, Chief Consultant Physician & CEO, Monga Clinic

Sex therapist Dr Morgan Francis cites an increase in pornography viewing – watching porn three to five times a week can result in a loss of appetite for real-life sexual interaction because the brain’s dopamine reserves are consistently diminished from overstimulation.

According to Dr Justin Lehmiller, assistant professor of social psychology at Ball State University in Indiana, daily smokers are three times more likely to suffer from erectile dysfunction compared to non-smokers. Junk food is another culprit, as it increases your blood pressure and cholesterol, which restricts circulation and hardens arteries (not your penis).

“Prostate cancer cases are growing in India. We were healthy earlier but have gotten into western and processed food habits. The traditional Indian diet was the best, and we should keep the body’s cancer-fighting mechanism strong by eating, sleeping and exercising well. Today people are more aware and resourceful, so they come for check-ups if they face any sexual ailment,” adds Dr Rajiv.

Parameters for Sexual Wellness

There can be several factors that contribute to the deterioration of one’s sexual health and well-being. Besides genetic factors; lifestyle too has emerged as one of the biggest culprits to have created havoc with human health. Health experts opine that one of the major causes of growing diseases and ailments are the unhealthy lifestyle choices that one makes.

Lifestyle Dysfunctions

People today have become highly sedentary and excessively indulge in health hazards such as alcohol, smoking, junk food and poor sleeping patterns, which are the root cause of health ailments.

“Sperm count has decreased, testosterone levels have changed, issues like diabetes, high BP, obesity, high cortisol levels, bad cholesterol, low Vitamin D and stress are all rampant in individuals today. These are all linked to each other. People with diabetes have a low testosterone level. Those who are overweight must lose weight and cut down on belly fat, exercise religiously for at least 70 minutes six days a week, and you will see the difference. Cardio along with aerobics and strength training helps in working out core muscles and increases libido,’’ adds Dr Monga.

Common issues that men face in their relationships

Stress due to work or other factors are causing baseless friction in the relationship with the partner and is leading to marital discord, extramarital affairs, etc.

Not spending much time at home with the spouse is leading to emotional disconnection. To keep the bond going, one needs to spend time together, talk, listen, share, care and make love. But due to paucity of time, all this is missing in the relationships these days, which is causing strain, and the partners are looking to meet their emotional and physical needs outside the marriage.

Boredom in marriage – negligible or routine sexual activity, no common interests, both leading their independent lives are also a cause of concern.

Easy access to friendship with the opposite sex because of various dating apps is also a growing cause of worry. 40+ men on dating apps are mostly married, and the same goes for women too.

How to handle stress and improve the relationship?
  • Establish boundaries. Once home no work-related calls or conversations.
  • Spend quality time with your spouse and kids
  • Physical intimacy and affectionate touches are important
  • Work on bringing romance and excitement in the marriage.
  • Lead a balanced life.

Physical exercise and diet together play a crucial role in sexual wellness. For a male to live a better quality sex life and maintain a healthy prostate, it is vital that he is physically active, does exercise, cuts down on bad diet, alcohol and smoking.

“I don’t believe in only medication and strongly advise improvement in lifestyle and diet to improve the quality of sexual health,” says Dr Renu.

“Moreover, I feel women today are delaying family planning and should ideally not because as women age, the fertility goes down, and one should pay heed to the body’s biological clock.”

Pause to kill the stress

In current times stress is one of the major causes of sexual dysfunctions in men. Men are more affected by mid-life crisis today because of increasing responsibilities at the office and at home. As the work portfolio improves, travel increases hence a healthy lifestyle goes for a toss. The earlier trend was of joint families, so the responsivities were divided. Overburden and the struggle to perform well in every sphere can take a toll on men, which leads to stress, sexual disorders and loss of harmony in their marital relationship.

“Having kids and planning a family is not their priority nowadays,” says infertility specialist Dr Beena Muktesh. They usually delay the decision of getting married, seek live-in relationships and by the time they wish to settle down in life their semen quality deteriorates because of age, poor dietary habits and an unhealthy lifestyle.

Social Stigma?

Issues about sex or sexual wellbeing have always been a delicate matter, and people still are not very open to talking about these problems. Though there is a slight shift and people are now opening up and speaking out about their sexual dysfunctions or expressing their sexual preferences.

“Bottling things lead to more stress, which can cause depression if it’s not resolved timely. Unfortunately for many, there is a stigma of going to a therapist. It’s tough for men to admit that they have an issue or need help. Such men are likely to get into unhealthy and unhappy relationships be it at work or home and may also end up as workaholics or alcoholics,’’ says Vandana Dutta, a psychotherapist in Gurgaon.

“As men most times are not open to counselling, but they can be motivated to attend some counselling sessions in the form of open workshops like enhancing fertility or couple wellness as they may come for group discussions and later may connect to professional for individual problems,” shares Dr Beena.

While for some men, it may still be a stigma to openly talk about their sexual limitation as they consider that their sexual boundaries go against their tough, macho image. Some shackles of mind have broken and many more to break, to let men seek professional guidance and take aids and therapies to work on their overall wellbeing.

Seeking Professional Guidance

Why shy away? Some are now trying to reach out, and it is vital that they realise it is a sign of strength and not a weakness to visit a therapist. Like for heart issues, one visits a cardiologist, for eyes an ophthalmologist without any second thought, then similarly for any psychological problem it is alright to visit a therapist and is a medical necessity. Individuals should know that counselling is confidential so they should feel free to visit a therapist as he/ she is not going to judge them and will be sensitive to the client’s needs and empathetic towards them.

Inputs by Vandana Dutta, Psychotherapist.

This article was first published in the print version of SUBURB July 2019 issue.

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