Encyclopedia of Family Medicine

Chapter 33 Sexual knowledge and eugenics (5)
① The fire of the monarch, the nocturnal emission caused by the disharmony between the heart and the kidney, the symptoms include less sleep and more dreams, and the dream is nocturnal emission, accompanied by restlessness and heat in the heart, dizziness, dizziness, lack of energy, fatigue, palpitations, palpitations, fear of forgetfulness, Dry mouth, short red urine, red tongue, thready pulse.It is suitable for nourishing yin and reducing fire, and communicating with the heart and kidney.Fang uses Sancai Sealing Pill to add and subtract:

Asparagus, Rehmannia, Ginseng, Licorice, Treats, Amomum, Coptidis, Cinnamon.

② Nocturnal emission due to damp-heat injection and disturbance of essence: symptoms include frequent nocturnal emission, or a small amount of semen outflow during urination, red and astringent urine or turbidity, dark yellow complexion, bitter mouth or thirst, restlessness, lack of sleep, sores on the mouth and tongue , the stool is often loose and smelly, the stool is yellow and greasy, and the pulse is wet and rapid.It is suitable for clearing away heat and promoting dampness.Addition and subtraction of Fangyong moss to distinguish clear drink:

Moss, Treats, Fuling, Plantago, Lotus Heart, Salvia, Calamus, Atractylodes.

③Strain and sad spleen: Nocturnal emission due to lack of energy absorption: Symptoms include palpitations, insomnia, forgetfulness, sallow complexion, drowsiness of limbs, lack of food and loose stools, and nocturnal emission due to exertion, thin fur, light quality, and weak pulse.The treatment should regulate and invigorate the heart and spleen, replenish qi and absorb essence.Fangyongluxiangsan addition and subtraction:

Ginseng, astragalus, yam, cornus, wolfberry, angelica, dodder, eucommia, antler gum, cinnamon, aconite.

[medicinal diet therapy]
"Lianzi Fuling Powder": 90g each of Fuling and lotus seeds, grind the two flavors into powder, take 15g each time, take it twice a day, and take it with warm boiled water on an empty stomach between meals.This medicated diet nourishes the spleen and kidney.Invigorate the essence and calm the nerves, suitable for nocturnal emission.

"Cistanche wine": Cistanche 30g, white wine 500g, soak Cistanche in water, scrape off the scales, wash and slice, soak in wine, drink after seven days, take a small cup each time, twice a day.This medicated diet nourishes the kidney and nourishes the essence, and is suitable for low sexual function and nocturnal emission.

"Peach meat silkworm chrysalis soup": 150g walnut meat, 60g silkworm chrysalis.Stir-fry the silkworm chrysalis first, then put them into a bowl together with walnuts, add some water, simmer until cooked through, and take it at any time.Suitable for spermatorrhea.

4.hypersexuality
Hypersexuality refers to the requirement of sexual desire exceeding that of ordinary people, regardless of whether it is day or night.Sometimes sexual intercourse several times a day is still not satisfied.

[Cause]
(1) Cerebral cortex dysfunction caused by disease.

(2) Pituitary tumors.

(3) Mental patients, libido suppression activity disorders.

(4) Women suffering from vaginal trichomoniasis, fungal vaginitis, tuberculosis, hyperthyroidism, etc. can cause hypersexuality.

(5) Long-term excessive consumption of tonics or certain stimulants.

(6) Repeated sexual stimulation or excessive lust for pornography, etc.

[treat]
(1) Life adjustment: arrange life reasonably, separate husband and wife appropriately, focus more on study and work, carry out some hobbies and recreational sports, and distraction is the best way to overcome hypersexuality.

(2) Strengthen moral cultivation, cultivate noble sentiments, devote vigorous energy to work and labor, and divert ideas.

(3) For those who are mentally ill or caused by other diseases, the primary disease should be thoroughly treated.

(4) Wear loose clothes to avoid stimulating the penis and clitoris.

(5) For those with persistent penile erection, pinch the foreskin frenulum and the back of the coronal sulcus with thumb and index finger for a while, or use cold compress to make it soft.

(6) Drug treatment: more sedatives, such as diazepam, chlordiazepoxide, etc., if there is no effect, hormone therapy can also be used. Men use estrogen such as diethylstilbestrol, and women use male hormones and methyl testosterone or testosterone propionate. Or go to the hospital for treatment.

5.low libido
Low libido can occur in both men and women, including no libido, lack of libido, and lack of libido.After the age of 55 for normal men, and for women after 50, the libido will gradually decline, which is a physiological phenomenon.Before this age, under the appropriate or repeated sexual stimulation, there is no desire to have sexual intercourse, or the previous sexual desire is good, and the person who later appears indifferent to sexual intercourse and hyposexuality is called hyposexuality.

[Cause]
(1) Psychological factors: Improper sex education, receiving wrong sex education since childhood, thinking that sex life is obscene and unclean; having concerns about pregnancy and childbirth; pain in the first sex life, insufficient preparation for sex life in the future, no sexual pleasure, Lead to aversion to sex life, resulting in a gradual loss of libido.

(2) Disease factors: systemic or local diseases can cause loss of libido, low libido, such as diabetes, pelvic inflammatory disease, etc.; endocrine diseases can cause ovarian and testicular insufficiency, such as thyroid disease and Sheehan's syndrome; neurovascular diseases , such as decreased excitability of the sex center, dysfunction of nerve ending receptors in the clitoris and vaginal mucosa, and insufficient blood supply to the male penis.

(3) drug factors: antihypertensive, heart disease, diuretic drugs and sedative hypnotic drugs can cause low libido.

[treat]
(1) Psychotherapy: Help patients understand sexual knowledge, give spiritual comfort, and correct inappropriate sexual intercourse.

(2) Etiological treatment: treat the original disease and stop using drugs that may cause sexual dysfunction.

(3) Hormone therapy: men with low libido can be treated with male hormones, methyl testosterone or testosterone propionate, and women can be treated with diethylstilbestrol, as well as traditional Chinese medicine.

6.frigidity

Sexual frigidity is more common in females. Foreign scholars report that about 35% of women have no interest in sex life and hold a cold attitude. The specific manifestations of sexual frigidity are:

(1) Loss of sexual desire or even complete refusal and aversion to sexual intercourse.

(2) No orgasm: Although there is sexual desire and does not refuse sexual intercourse, but cannot achieve orgasm during sexual intercourse.

(3) Few orgasms, and thus lack of interest in sex life.

[Cause]
(1) Psychological factors: Improper sex education at home since childhood, thinking that sexual behavior is obscene and shameful; having sexual trauma experiences such as rape, incest, homosexuality, and sexual abuse, and sexual guilt; fear, fear of sexual pain, fear of pregnancy, and marital affection Incompatibility; environmental interference affects sex life, etc., and long-term psychological depression leads to frigidity.

(2) Physical factors: physical weakness, excessive fatigue, various chronic diseases, decreased central excitability, insensitivity of nerve ending receptors in the clitoral and vaginal mucosa; chronic wasting diseases leading to decreased secretion of sex hormones, etc., can cause frigidity.

[treat]
Frigidity requires comprehensive treatment: sex knowledge education, psychological counseling, drug therapy, etc.

(1) Psychotherapy: Provide guidance on sexual knowledge, eliminate emotional gaps between husband and wife, eliminate anxiety, give spiritual comfort, create a living atmosphere, and correct inappropriate sexual intercourse methods and postures.

(2) Treat the original disease: treat the cause of the original disease, such as pelvic inflammatory disease, which causes pain during sexual intercourse, and sexual intercourse can only be performed after it is cured.

(3) Sexual behavior therapy: Both husband and wife should pay attention to grasp the appropriate timing of sexual intercourse. Before sexual intercourse, the husband should give his wife sufficient caress to stimulate his wife's sexual desire.All kinds of sexual acts that try to satisfy the wife's sexual requirements can be used.

(4) Local treatment: If there is inflammation in the vagina, antibacterial and anti-inflammatory symptomatic treatment should be given.For vaginal dryness, a lubricant, such as lubricating jelly or 3% menthol lubricating jelly, can be applied to the vaginal or clitoral area before intercourse.

(5) Hormone therapy: It is used when the above treatments are ineffective, and it should be carried out under the guidance of a doctor.

7.Vaginismus

Also known as coitus phobia syndrome, it refers to the involuntary, strong, and reflexive contraction of the muscles around the vaginal opening when the patient tries to have sexual intercourse, closing the vaginal opening tightly, making it difficult or impossible to insert the penis.It is a psychosomatic disorder that seriously affects a woman's sexual responsiveness.This kind of muscle spasm can be caused by continuous spasm due to sexual intercourse, or it can appear due to imagination or premonition that sexual intercourse is coming, and even a gynecologist's vaginal digital examination cannot be performed.Vaginismus can seriously interfere with a couple's sexual life and can last for years if left untreated.

Vaginismus can be divided into four degrees according to the condition:
Grade I: Spasms limited to the perineal muscles and levator ani muscles, which can be overcome by the patient's efforts to relax.

Grade II: The spasm involves the entire pelvic muscles.

Grade III: Perineal muscles, levator ani muscles, pelvic muscles, including buttocks muscles also participate in involuntary contraction, lifting the entire buttocks.

Grade IV: On the basis of Grade III, the legs are adducted, the whole body is dodged backwards, even shouting, and the upper limbs also appear involuntary movements.

[Cause]
(1) Psychological factors: Affected by feudal consciousness and religious concepts in childhood or adolescence, sexual activities are regarded as indecent, evil and obscene behaviors, and a negative misunderstanding of sexual life is formed; or the hymen is too tough during the first sexual intercourse. Severe pain, resulting in a fear of sexual intercourse; or the man's rough action during the first sexual intercourse caused severe pain and trauma; or sexual trauma, such as rape, or incest; these factors can make patients fear and fear sexual intercourse Disgust, if things go on like this, form a defensive reflex.

(2) Organic factors: such as vaginal stenosis, vaginitis caused by various reasons, hymen scars, pathological injuries caused by trauma and childbirth, etc.Although these organic lesions do not directly cause vaginal orifice spasm, they can indirectly cause pain during penis insertion and sexual intercourse, thereby inducing vaginismus.

[treat]
(1) Psychotherapy: Strengthen sexual knowledge education for patients, so that they can correctly understand and treat sexual life correctly, and relieve all kinds of ideological concerns and fears.

(2) Treat various organic diseases, treat various inflammations, repair injuries, etc. Before the organic diseases are cured, sexual intercourse should be avoided, so as not to cause painful intercourse, and vaginismus will continue as a protective reflex.

(3) Qigong therapy: Qigong relaxation exercise has a certain therapeutic effect on vaginismus, especially vaginismus caused by psychological factors is more effective.

(4) Behavioral therapy: let patients master the technique of vaginal muscle relaxation, which has a certain curative effect on vaginismus. The tightness has a sense of control.Gently insert your middle finger or index finger into the vaginal opening, and at the same time experience the contraction and relaxation of vaginal muscles.Then slowly insert one finger completely. If the vagina can relax naturally after inserting one finger, then slowly insert two fingers. When the two fingers are fully inserted, you can gently circle the vagina.This process can also be done with the help of a doctor.The second is to be touched by the husband before the couple have sex.Repeat the above action by the husband.After the fingers are accommodated in the vagina, the penis is inserted into the vagina, and the woman makes sexual intercourse first until the final sexual intercourse is completed.

(5) Desensitization treatment: It is suitable for patients who have difficulties in mastering the technique of vaginal relaxation by themselves, or can be desensitized by a doctor. The operation is: the patient takes the supine position, stretches both legs, uses a lubricated cervical dilator, slowly Slowly insert into the vagina, and then gradually increase the number of the cervical dilator until it exceeds the diameter of the penis, and the patient still feels no pain. At this time, the patient's fear of sexual intercourse can completely disappear.During subsequent sexual intercourse, the man should pay attention to improving the posture of sexual intercourse, try to make the woman feel comfortable, relax the whole body, give enough caress, and do not be simple and rude.

(6) Drug treatment: For those who are sensitive to nerves, sedatives such as chlordiazepoxide and diazepam can be taken appropriately.Or 10 minutes before intercourse, apply 10% cocaine ointment.Lack of vaginal secretions, etc., can use sterilized liquid paraffin oil to avoid pain-induced spasms.

[prevention]
Prevention of this disease is important. Once the onset seriously affects the sexual life of the couple, it will bring huge mental pressure to both husband and wife, which is not conducive to physical and mental health, and even cause emotional discord and family breakdown.The prevention of this disease is that newly married women must understand some basic knowledge of sexual life and relieve tension.Men should also know how to caress, especially the first sexual intercourse should be gentle, to avoid rough damage to the vagina, leaving fear to the woman.

8.painful sex

Sexual pain can occur in both men and women, and is more common in inflammation, post-traumatic scars, stenosis, and so on.It must be treated, otherwise, it will affect sexual life and lead to sexual psychological disorders.

Painful sex for men
[Common causes]
(1) Excessive prepuce: skin scale irritates the inner mucous membrane and skin of the foreskin, causing allergies and inflammation, and causing painful sexual intercourse.

(2) Phimosis: The foreskin opening is narrow, the foreskin cannot be turned over, and the glans cannot be exposed, which can cause pain during sexual intercourse and affect sexual pleasure.

(3) The foreskin frenulum is too short: there is a frenulum from the glans to the root under the penis. This frenulum is too short. When the penis is erect, the frenulum is pulled too tightly and causes pain. In severe cases, there may be tearing and bleeding.

(4) Arched penis: ulcers in the coronal sulcus, leaving scars after healing, and congested erections during sexual intercourse cause traction pain.

(5) Prostatitis: The seminiferous duct is adjacent to the prostate, and the seminal vesicles are affected during ejaculation, which stimulates the prostate and causes pain.

(6) Stimulation by contraceptive substances: the skin of the penis is allergic to condom gel, contraceptive film, and ointment, causing allergic dermatitis, and friction of the glans during sexual intercourse causes pain.

[treat]
(1) Both prepuce and phimosis should be treated surgically, especially phimosis, which should be resected before marriage.

(2) If the foreskin frenulum is too short, it can also be loosened by surgery.

(3) Prostatitis should be treated with drugs, and those who are ineffective can be surgically removed.

(4) If you are allergic to contraceptives, you can change to other contraceptive methods, such as subcutaneous implants.

female sex pain
[Common causes]
(1) Genital diseases: vaginitis, clitoris, adnexitis, uterine prolapse, scar after episiotomy during childbirth, urinary tract infection.

(2) Pelvic diseases: such as cystitis, proctitis, uterine rectal abscess, etc.

(3) Improper sex life: lack of caress and preparatory actions before sexual intercourse, the woman's vagina is dry and not moist, which causes pain, or the man's rough actions cause discomfort and pain.

(4) Psychological factors: Unfortunate sexual experiences in the past have caused associations during sexual intercourse and produced psychological effects.

[treat]
Those caused by inflammatory diseases should be given antibacterial and anti-inflammatory agents, and sexual intercourse can only be performed after the disease is cured.

Psychological treatment should be taken due to psychological factors.

Sex life taboo

Sex life has added rich and colorful content to human life, and human beings cannot do without sex life.However, for the sake of health and better enjoyment of sex life, it is necessary to temporarily stop or prohibit sex life in some cases. Those who have the following conditions are not suitable or should prohibit sex life.

1.disease

Physical decline during illness, coupled with the consumption of a large amount of body energy and oxygen during sexual life, is not conducive to disease prevention, especially some diseases are directly affected by sexual life, or sexual life directly affects the treatment and prevention of diseases.

(1) All kinds of vaginitis: bacterial, fungal, and trichomonal vaginitis. In the acute stage, vulvar itching, burning pain, frequent urination, painful urination, painful sexual intercourse, and increased leucorrhea can occur.Vaginal mucosa is red and swollen, eroded or even ulcerated.If you have sex at this time, it will not only cause the woman's pain to intensify, but also aggravate the ulceration of the mucous membrane, leading to the aggravation of the disease, and even long-term cure.The man can also be infected by sexual intercourse, causing inflammation of the urinary and reproductive organs.Therefore, sexual life should be prohibited, and after 1 to 2 weeks of treatment, sexual life can only be resumed after the symptoms disappear and the clinical examination is normal.

(2) trauma and surgery
Male and female external genital injuries, deformity correction surgery, pelvic fractures, pelvic trauma, sex life should be prohibited, and sex life can only be resumed after the disease is cured.Whether you can resume sexual life after trauma to other parts and head, chest, and abdominal operations depends on the recovery of the disease and the doctor's order after discharge.

(3) Sexual accessory organ diseases

Diseases of the prostate, testis, epididymis, and uterus often directly or indirectly affect sexual life.For example, inflammation of the prostate can lead to pain in sexual life, and it can lead to impotence when taking drugs. During surgical treatment, it is easy to damage the nerves that control penile erection and cause organic impotence. Therefore, sex life should be forbidden during the treatment, surgical treatment and recovery period of this disease. .If the surgery damages the nerves and causes organic impotence, a penile prosthesis can be implanted for treatment.During the period of uterine, testicular and epididymis diseases, especially during acute onset, sexual life should be prohibited.Surgical resection of the uterus, testes and epididymis has little effect on sex life.

2.after contraceptive surgery
(1) Putting on the ring and removing the ring: placing an IUD in the uterus for contraception, which is the most common method of contraception for women in my country.During the circumcision, although the doctor performs strict disinfection, the cervix and uterine cavity will inevitably be damaged during the operation. Even a very slight injury of this kind will provide opportunities for bacterial infection.Moreover, the birth control ring is also a foreign body, which requires a gradual adaptation process for the uterus, during which a small amount of bleeding will occur continuously.Therefore, sexual life is prohibited within one month after wearing the birth control ring, otherwise it is easy to cause bacterial invasion and infection.

In the same way, if the birth control ring is placed in the uterine cavity, it will also damage the endometrium to varying degrees when it is taken out. Sexual life should also be prohibited, and sexual life can be resumed after half a month.

(2) Male vasectomy: refers to male vasectomy, which is a common method of male birth control.Although this kind of operation has little damage, it does not directly affect the penis.But it is also necessary to prohibit sex life for at least half a month.After the ligation operation, many people worry about affecting their sexual function, so they conduct exploratory sexual intercourse prematurely after the operation. During the sexual intercourse, local pain and discomfort at the surgical site often occur, coupled with mental stress, it is easy to cause interruption of sexual intercourse .This will aggravate the tension, and then try again... forming a vicious circle and affecting sexual function.The other is that male vasectomy relieves the ideological burden of fear of pregnancy, and premature and frequent sex life also affects male sexual function, leading to sexual dysfunction.

(3) Induced abortion: Sexual life must be prohibited after the induced abortion.There are two reasons for this. One is that it takes 1-2 weeks for the cervix to heal after being dilated during abortion. Spread and reproduce in the uterus, causing gynecological diseases such as endometritis and pelvic inflammatory disease.The second is that after the abortion, the ovarian function recovers quickly, and ovulation can occur again soon.If you have sex too early, you run the risk of getting pregnant again before your uterus has healed.There are often a small number of people who resume sexual life prematurely, and become pregnant before menstruation in that month, only more than 40 days after the previous induced abortion, and undergo artificial abortion again, the impact of the previous pregnancy has not been completely eliminated , Coupled with the changes of new pregnancy, the uterine wall will be obviously congested, soft in texture, poor in elasticity and tension, prone to surgical injuries, and even lead to perforation and infertility.Therefore, sex life should be strictly prohibited within one month after induced abortion.

(End of this chapter)