Homoeopathic management of sexual disorders

Dr Dinesh Kumar  

Introduction:
Sexuality and the desire for a child are strongly interconnected. The same applies to sexual disorders and the unfulfilled desire for a child.

Sexual dysfunction can be any problems that prevent a person or couple from experiencing satisfaction from sexual activity. Some 43% of women and 31% of men report some degree of sexual dysfunction. Sexual disorder is a problem that can happen during any phase of the sexual response cycle. It prevents you from experiencing satisfaction from sexual activity.

The sexual response cycle traditionally includes excitement, plateau, orgasm and resolution. Desire and arousal are both part of the excitement phase of the sexual response. It’s important to know women don’t always go through these phases in order. Sexual dysfunction is common, many people don’t like talking about it. Because treatment options are available, though, you should share your concerns with your partner and healthcare provider.

The types of sexual disorders: Sexual disorder generally is classified into four categories:

1. Desire disorders: Lack of sexual desire or interest in sex.
2. Arousal disorders: Inability to become physically aroused or excited during sexual activity.
3. Orgasm disorders: Delay or absence of orgasm (climax).
4. Pain disorders: Pain during intercourse.

Causes of sexual disorders:

1. Physical causes: Many physical and/or medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcohol use disorder and substance use disorder. In addition, the side effects of some medications, including some antidepressant drugs, can affect sexual function.
2. Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, concerns about body image and the effects of a past sexual trauma.
3. Disorders of chromosomal sex:

• Klinefelter syndrome.
• XX male.
• Gonadal dysgenesis.
• Mixed gonadal dysgenesis.
• True hermaphroditism.

4. Disorders of gonadal sex:

• Pure gonadal dysgenesis.
• Absent testis syndrome.

5. Disorders of phenotype sex

• Female pseudohermophroditism
• Congenital adrenal hyperplasia
• Non-adrenal female pseudohermophroditism
• Developmental disorders of mullerian ducts

6. Male Pseudo-hermophroditism

• Abnormalities in androgen synthesis
• Abnormalities in androgen action
• Persistent mullerian duct syndrome
• Developmental defects of male genitalia

7. Hypogonadism: This includes failure of production of spermatozoa and or secretion androgens.
8. Disorders can be classified into those arising from:

• Hypothalamic-pituitary defects.
• Primary gonadal defects.
• The presentation is often menstrual abnormalities such as primary or secondary amenorrhea.

1. Primary amenorrhea

Etiology:

• May be due to chromosomal Abnormality, eg Turner’s syndrome.
• Unrecognized or insufficiently treated congenital adrenal hyperplasia.
• The testicular feminization syndrome due to defective androgen receptor.
• Primary autoimmune ovarian failure is rare cause.
• Structural abnormalities of genital tract.
• Chronic systemic diseases.

Symptoms/ sign:

• Headache
• Visual field disturbances
• Short stature (Decreased growth hormone).

1. Secondary amenorrhea

Etiology:

• Acquired obstruction in the lower genital tract, operation, injury, chemical burn. Hysterectomy.
• Ovarian causes: Destruction of both ovaries by diseases, radiation or removal by operation.
• Primary ovarian failure: Hypochromosomal amenorrhea.
• Masculising of the ovary: Masculising cell tumor, adrenal like tumors.
• Disorders affecting the pituitary:
• Psychogenic from the higher centres via thalamus and hypothalamus.
• Basophil adenoma, Cushing’s disease.
• Acidophilic tumors.
• Pituitary failure due to chromophobe adenoma, cyst; Simmond’s diseases and postpartum, pituitary necrosis (Sheehan’s syndrome).
• Suppression of FSH by persistence of LH (Chiari Frommel Syndrome).
• Adrenal cortical hyperplasia, adrenal cortical tumors and adrenal failure (Addison’s disease).
• Hyperthyroid state and late stage of hypothyroidism.

Severe systemic diseases- Renal failure, Endometrial T.B.

1. Psychosexual disorders: are one of the minor psychiatric conditions and it includes sexual deviation or paraphilia. Other conditions like premature ejaculation and vaginismus also come under this group.

Etiology:

• Primary testicle diseases: Trauma tuberculosis, syphilis malignancy, orchitis.
• Hypergonadotropic: Leprosy, Lymphoma.
• Secondary to hypothalamic/ pituitary disease.
• Hypogonadotropic: tumors, alcohol, hypopituitarism etc.
• Sexual deviation: Sexual deviants are those people who do not get physical and emotional satisfaction in normal sexual intercourse but they practice other methods for getting sexual gratification which up to some extents are socially condemned. Some of the examples are:
• Exhibitionism: Exposing the genitals to a stranger.
• Sadism: Deriving sexual gratification by inflicting bodily pains. This method is strictly punishable.
• Pedophilia: Having sexual relationship with immature partners of either sex.
• Transvestism/ Eonism: Deriving sexual pleasure from wearing the clothing of the opposite sex.
• Fetishism: Sexual excitement leading to orgasm from part of the body of a woman or some article belonging to her that normally has no sexual influence on the mind of a man, shoes, hands underclothing, facial expressions etc.
• Bestiality: Sexual relationship by a human being with lower animals.
• Homosexuality: Sexual gratification from partner of same sex. Homosexuality between females is known as lesbianism.

Symptoms/ Signs: These depends on the age of the patient at the onset of disease.

• Pre-pubertal: If the disease occurs before puberty, the external genitalia and the secondary sex characteristics fail to develop. Patient grows to an excessive height because epiphyses of the long bones unite later than the usual age. Face is hairless, very scanty pubic hair present. Voice is high pitched. Anorexia nervosa.
• Post pubertal: Tiredness, Decreased libido and impotence. Decreased muscle power. Decreased body hair. Decreased shaving.
• Clinical features:
• Weight loss: It may be primary as in anorexia nervosa or it may be secondary to an underlying disease such as TB, malignancy or hyperthyroidism.
• Weight gain: May suggest Cushing’s syndrome, hypothyroidism or rarely a hypothalamic tumor.
• Hirsutism: May indicate androgen excess. Androgen secretary tumors may produce virilisation, clitrogmegaly, deepening of voice, sweating.
• Osteoporosis: With increased incidence of vertebral compression, fracture, fracture neck of femur and distal radius.
• Psychological: Anxiety, Emotional liability.
• Genitourinary: Dyspareunia (Senile vaginitis), Vaginal infection, Urgency of micturition, Irregular menstruation.

Investigations:

• Ultrasonography of lower abdomen
• Height, testicular size using orchidometer.
• Plasma testosterone, Plasma LH and FSH.
• Estradiol estimation if the gynecomastia is present.
• Bone age if delayed puberty.
• Klinefelter syndrome is confirmed by karyotyping or measuring leucocyte x-inactive specific transcriptase (exist).
• Pregnancy testing (It is the commonest cause of secondary amenorrhea).
• Serum FSH, LH, TSH, PRL analysis.

Miasmatic Background related to Sexual Disorders:

PSORA	SYCOTIC	SYPHILITIC	TUBERCULAR
Aglacatocemia, Amenorrhea Impotency, Irregular periods, too copious, too early or too late and sterility from lack of sexual desire, Polyp in vagina.   Leucorrhea of various types, Pains usually sharp, but never colicky, Night discharges in women with voluptuous dreams.   Nocturnal emissions, too frequent, with little errections.   Errections incomplete and wanting of errections.   Chronic knotty swelling of testicles. Disappearance of one or both testicles.   Indurations and enlargements of prostatic glands.   Sterility and impotency without organic problems.	Ectopic pregnancy Diseases of pelvic, Endometriosis, and sexual organs (Urogenital problems) such as endometriosis, prostatitis, salpingitis, orchitis, ovaritis.   Uterine disorders. Genital warts.   Ovarian tumours and malignancies where the tumors are encapsulated.   Leucorrhoea of the fish brine odour. Hydrocele.   Pelvic inflammatory disease (P.I.D).   Polycystic disease of the ovaries, ovarian cysts. Sterility and infertility from hormonal imbalance.   Uterine fibroids and polyps.   All varieties of sexual and pelvic disorders are generally sycotic in origin.	Abortion and stillbirths.   Azoospermia.   Cervical and vulval erosions and ulcerations.   Dysplasia of the cells (in the cervix and other mucosa).   Offensive menses. Ulcerative and degenerative verities of tumours.   Acrid, putrid and offensive leucorrhoea.	Many psychopathic sexual perversions are kept under tubercular miasm.   Uterine and vaginal polyps with profuse bleeding. Hemorrhage is bright red with vertigo, faintness, pallor aggravates from sleeping and laying posture.   Menses with diarrhoea, epistaxis, optical illusions, roaring in the ears, amelioratedby vomiting. Haemospermia- blood stain seminal emission. All varieties of uterus infections-profuse bleeding.   DUB-Dysfunctional uterine Profuse bleeding.   Hysterical symptoms after profuse flow.   Retroversion, Retroflexion, and Mal-position of uterus.

Treatments and management:

• Explanation and reassurance.
• Hormone replacement therapy.
• Diet rich in calcium supplements should be given milk and milk products.
• Regular mild to moderate exercises.
• Yogasna’s for Regular exercises.
• Teenagers should be given proper sex education and Psychotherapy.
• Avoid over use doses of multivitamins (Heavy metals) cause kidneys failure.

Yogasana Related to Management of Sexual Disorders:

• Yoga can not only help improve your physical and mental wellbeing, but it can also help you turn into a master in bed. There are a number of poses that can help improve blood circulation and strengthen muscles in the pelvic area. Easy poses that can help people scale peaks of ecstasy.
• What should be a creative act (sex) has become mechanical and routine for a few minutes of stress relief, Yogic postures make you supple and relaxed, so your body functions beautifully. Yoga helps your sensual, mental and physical aspects together to work in harmony.
• The benefits of yoga in enhancing sexual energy and libido (especially in men) have been well documented. Yogasana like pelvic lifts, and surya namaskar improve blood circulation and are crucial for sexual function.” Yoga can not only help improve your physical and mental wellbeing; There are a number of poses that can help improve blood circulation and strengthen muscles in the pelvic area. We asked fitness experts Bharat Thakur and Mickey Mehta to suggest easy poses that can help people scale peaks of ecstasy.
• Both recommended the cobra pose or bhujangasana, it’s back-strengthening abilities also extend to stimulating the body’s sexual chakra, improving the individual’s sexual performance overall.
• Mula bandha (or root lock) that is similar to a Kegel exercise. This neuromuscular lock balances your sexual hormones while simultaneously exercising your inner muscles, giving you a better control over orgasms.” It is that at a more advanced stage, this exercise should be performed during most yogic postures.
• Sit with your back straight, and legs folded in. Place your hands on your knees and exhale. Now hold your breath. Imagine having to stop passing urine while in the middle of doing so. Squeeze your genital-anal muscles and hold for 5-10 seconds. Slowly release while inhaling at the same time. Repeat 3 times.

1. Ustrasana:

This posture unblocks your whole body by opening your hips and spine, building better endurance. It also helps in de-stressing your whole system you’ll feel lighter and relaxed, yet energetic enough to perform better in bed. Stand on your knees, and slowly grip your heels with your hands pushing your hips forward, arching your back and dropping your head backwards. Breathe normally holding the posture for 10 to 30 seconds. Repeat 2-3 times.

2. Marjariasana:

A supple spine goes a long way in experimenting and lasting longer. This move helps build spinal strength and relaxes the lower back. Breathing rhythmically in this position, will also aid harmonizing your breath with your partner a popular tantric move to connect better. Directions: Place your knees and hands perpendicular to the ground, on the floor. Now inhale slowly while arching your back towards the floor. Hold for a moment and slowly exhale arching your back away from the floor, upwards like a cat. Repeat this cycle 10 – 20 times in a slow rhythmic fashion.

3. Baddha Konasana:

This posture primarily opens the hips and the inner thighs, increasing your endurance and your flexibility (in the groin area) to try more positions. Directions: Sit with your back straight and bring your feet together. Gently press your knees with your palms stretching the groin region and try to bring your knees all the way to the floor. Hold for 20-30 seconds. Repeat 3 times.

4.Setu Bandhasana:

This pose strengthens your pelvic muscles and your core. It will also ensure a rush of blood to your genital area as it stimulates the basic chakra in your body, increasing your libido. Attempt to perform Kegel’s exercises in this position to strengthen your pelvic muscles further. Directions: Lie on your back with your knees bent, and bring your feet as close to your buttocks as possible. Squeeze your thighs and buttocks, then lift your torso and press down on your feet. Try to lift your navel as high as possible. Hold the position for at least 30 seconds and work your way up to 3 minutes. When you have completed the set, slowly lower your back to the mat one vertebra at a time until you are flat on your back with knees still bent. Repeat the exercise 3 times.

5.Anjaneyasana:

A side from stretching your thighs, this position strengthens your pelvic floor. The weight bearing on your pelvis will increase the blood flow to the area, aiding cellular regeneration (a process that slows down as you age, reducing your libido). It also helps increase your balance capabilities for standing postures. Directions: From a standing position, step your right leg forward a few feet, and bend your right knee keeping your left leg straight. Your knee should be at a right angle to the floor. Do not allow your knee to extend past your ankle. Your arms can rest on your hips or if you need support, place them on either side of your right foot. Feel the stretch in your inner left leg and the strengthening in your right leg. Take 10 slow deep breaths as you hold the position. Return to the standing position, and do the same on the other side, bringing your left foot forward into the lunge.

6.Mandukasana

Staying in this asana takes some endurance, which will stand you in good stead when try a position you are not comfortable with. It helps build flexibility in the groin and thigh area as well. Directions: Stay on the mat in a table pose. Keep your ankles behind your knees and turn your feet towards the sides. Keeping your palms pressed to the floor lower yourself on the elbows and arms. Exhale and press your hip backwards to feel the stretch in your hips and thighs. Breathe in and hold for 30 counts. Rock your hip forward as you relax your breath. Come back to normal position and repeat.

Rubrics Related to Sexual Disorders:

Exhibitionism: Hyos.

Vaginismus: Acon, Bell, Berb, Cact, Canth, Ferr phos, Ham, Ign, Lyco, Nat mur, Plat, Plb, Puls, Sil.

Premature ejaculation: Berb, Calad, Calc carb, Carb veg, Con, Gels, Graph, Lyco, Nat carb, Nat mur, Phos, Plat, Sel, Sep, Sulph, Zinc.

Lasciviousness: Ambr, Apis, Cald, Calc, Canth, Carb veg, Chin, Con, Dig, Acid Fl, Graph, Hyos, Lach, Lil tig, Org, Phos, Acid Pic, Plat, Puls, Sel, Sepia, Sil, Staph, Sulp, Stram, Stram, Tarent, Verat.

Homosexuality (Love with one of her/ his own sex): Calc p, Lach, Nat m, Phos, Plat Sulph.

Homoeopathic medicines:

Agn c: The most effective point of attack of Agnus upon the organism is the sexual organism. Its lower sexual vitality, with corresponding mental depression and loss of nervous energy. It shows this distinctive influence in both sexes, but is more pronounced in men. Premature old age from abuse of sexual power. History of repeated gonorrhoea. Yellow discharge from urethra. No erections. Impotence. Part cold, relaxed. Desire gone (Selen; Con; Sabal). Scanty emission without ejaculation. Loss of prostatic fluid on straining. Gleet discharge. Testicles, cold, swollen, hard, and painful.

Arg n: Impotence, Erection fails when coition is attempted. Cancer like ulcers. Desire wanting. Genitals shrivel. Coition painful.

Bar c: Diminished desire and premature impotence. Enlarged prostate. Testicles indurated.

Calad: This remedy has a marked action on the genital organs, and pruritus of the region. Coldness of the single parts and inclination to lie down, with aggravation on lying on left side. Pruritus. Glans very red. Organ seems to larger, puffed, relaxed, cold, sweating; skin of scrotum thick. Errections when half-asleep; cease when fully awake. Impotency; relaxation of penis during excitement. No emission and no orgasms during embrace.

Lyc: No erectile power; impotence. Premature emission (Calad; Sel; Agn) Enlarge prostate. Condylomata.

Nuph: Produces nervous weakness, with marked symptoms in the sexual sphere. Complete absence of sexual desire; part relaxed; penis retracted. Impotency, with involuntary emissions during stool, when urinating. Spermatorrhoea. Pain in testicles and penis.

Phos a: Emissions at night and at stool. Seminal vesiculitis (Oxal acid). Sexual power deficient; testcles tender and swollen. Part relaxed during embrace (Nux). Prostatorrhoea, even when passing a soft stool. Eczema of scrotum. Oedema of prepuce, and swollen glans-penis.

Sabal: Indicated in irritable of the genito-urinary organs. General and sexual debility. Promotes nutrition and tissue building. Prostatic troubles; enlargement; discharge of prostatic fluid. Wasting of testes and loss of sexual power. Coitus painful at the time of emission. Sexual neurotics. Organs feel cold.

Sele: Marked effects on the genito-urinary organs, and often indicated in elderly men, especially for prostatitis and sexual atony. Great debility; worse, heat, easy exhaustion, mental and physical, in old age. Lascivious thought, with impotency. Mental labor fatigue. Extreme sadness. Abject despair, uncompromising melancholy. Dribbling of semen during sleep. Dribbling of prostatic fluid. Irritability after coitus. Loss of sexual power, with lascivious fancies. Increases desire, decreases ability. Semen thin odorless. Sexual neurasthenia. On attempting coition, penis relaxes. Hydrocele.

Amyl nit: After- pains; hemorrhage associated with fascial flushing. Climacteric headache and flushes of heat, with anxiety and palpitation.

Glon: Menses delayed, or sudden cessation with congestion to head. Climacteric flushing.

Ign: Menses, black, too early, too profuse, or scanty. During menses great languor, with spasmodic pains in stomach and abdomen. Feminine sexual frigidity. Suppression from grief.

Lach: Climacteric troubles, palpitation, flashes of heat, hemorrhages, vertex headache, fainting spells; worse, pressure of clothes. Menses to short, too feeble; pains all relieved by the flow (Eupion). Left ovary very painful and swollen, indurated. Mammae inflamed, bluish. Coccyx and sacrum pain, especially on rising from sitting posture. Acts especially well at beginning and close menstruation.

Lyss: Uterine sensitiveness; conscious of womb (Helon). Feels prolapsed. Vagina sensitive, rendering coition painful (Berberis). Uterine displacements.

Sang: Leucorrhoea fetid, corrosive. Menses offensive, profuse. Soreness of breasts. Uterine polypi. Before menses itching of axillae. Climacteric disorders.

Sep: Pelvic organs relaxed. Bearing down sensation as if everything would escape through vulva (Bell; Kreo; Lac c; Lil t; Nat c; Pod); must cross limbs to prevent protrusion, or press against vulva. Leucorrohea yellow, greenish; with much itching. Menses too late and scanty, irregular; early and profuse; sharp clutching pains. Violent stiches upward in the vagina, from uterus to umbilicus. Prolapse of uterus and vagina. Morning sickness. Vagina painful, especially on coition.

Sulph: Pudenda itches. Vagina burns. Much offensive perspiration. Menses too late, short, scanty and difficult; thick, black, acrid, making parts sore. Menses preceded by headache or suddenly stopped. Leucorrhoea, burning, excoriating. Nipples cracked; smart and burn.

Zinc m: Ovarian pain, especially left; can’t keep still (Viburn). Nymphomania of laying-in women. Menses too late, suppressed; lochia suppressed (Puls). Breast painful. Nipple’s sore. Menses flow more at night (Bov). Complaints all better during menstrual flow. (Eupion; Lach). All the female symptoms are associated with restlessness, depression, coldness spinal tenderness and restless feet.

Conclusions:

Counseling for couples with the unfulfilled desire for a child should invariably include explicit and appropriately tactful reference to sexuality and (functional) sexual disorders by the therapist.

Sexual dysfunctions (of organic or of psychic origin) as a cause of involuntary childlessness are relatively unusual. By contrast (temporary) sexual disorders resulting from diagnosis and medical therapy are common in couples with fertility problems, with women more frequently affected than men.

References:

1. Davidson’s Practice of medicine.
2. Gynaecology and obstetrics By Dr. S Arora.
3. Boericke Homoeopathic materia medica.
4. Miasma Dr. Subarata Kumar Banerjee.
5. Allens key notes homoeopathic materia medica.
6. Hompath Zomeo Pro Complete Homoeopathic Repertory.
7. Google scholar

Dr. Dinesh Kumar
M.D. (Hom.) Scholar, Department of Case taking and Repertory, Bakson Homoeopathic Medical College, Greater Noida
Mail :  drdineshrana88@gmail.com

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