If you have clicked on this article and started reading it, you must have some curiosity or incomplete understanding of the complicated and multifactorial phenomenon we call sex.

Well, I would not feel bad because you are not the only one. In fact, most professionals who have gotten there PhD’s or even medical degrees in treatment of the human body did not have a single course in medical school about sexual health.

In fact, yours truly, a physician of 20 years who is more experienced in hormonal health of women and men and treating hormonal issues for the last 10 years, still had ignored the importance of sexual health and its role in the overall health of any individual. It was not until I learned and became a member of legitimate physician societies that are devoted to the full understanding and treatment of sexual health with evidence-based studies, that I have incorporated the practice of sexual health as a part of my already effective hormonal health management in both males and females.

I will try to give a simple outline of what an individual needs to do to improve their sexual health with their partner if they are having concerns or even if they are unaware of any issues, it is important to be educated on the overall process of what we call sex.

Why is it complicated?

Unfortunately, what we learn in elementary school, sex classes, high school experiences and in recent years with the advent of YouTube and digital media, the act of sex is highly misrepresented and is not as simple as most of us think.

Most of us know the basics of the sexual cycle which is visual stimuli from men and auditory stimuli from women that gets transferred to our brain (which we all know is extremely complicated — but let’s break it down into nerves and neurotransmitters), this signal gets transferred into a state of ”wanting”, which then sets off a series of hormonal and physiological factors in our bodies that put us in a state of “liking” and “readiness” for the actual sexual act and experience which ultimately leads into an orchestra of different body parts, which give us “pleasure” whose peak we call “orgasm”.

Believe it or not; what I explained above is just a simplified version of the whole story. The multitude of physiological factors that take us from the state of desire to the state of arousal, to the state of a plateau, to the state of orgasm and refraction are just mind-boggling and intricate to the point that even in 2021, we still require PhDs and a highly educated Medical Doctors that are in full research mode to understand how to best deal with this complexity.

But here is a cheat sheet of the basics that are involved:

• The brain along with all its neurotransmitters (Serotonin, Dopamine, Norepinephrine, GABA, Acetylcholine, and others) are the first physiological components that need to be optimized in the above cycle.
• The main sex hormones (Testosterone, Estrogen, progesterone, and their proportional balances to each other) are also critical factors in interacting with the above neurotransmitters (up regulating them or down regulating them) and leading to the steps of the above sexual cycle.
• Blood flow is the “freeway” that allows the above hormones and neurotransmitters to do their job efficiently. For this reason, individuals with cardiovascular compromise such as elevated sugars (prediabetes and diabetes) or elevated cholesterol levels (even if not to the point of need for medication), elevated inflammation, or other imbalances in the body such as vitamin insufficiencies, mineral insufficiencies can also throw off the appropriate and efficiency of the above hormones.
• Lack of sleep, lack of exercise, and appropriate diet, obesity, joint pain or musculoskeletal pain, lack of energy, lack of self-confidence, depressed moods, can all be signs of underlying medical conditions or other hormonal issues which are routinely missed by typical physicals done by your primary physician. An overall evaluation is extremely critical to evaluating your bodies receptiveness to the above sexual cycle.
• Anatomical deviations must be taken into consideration.
• Natural physiological changes that happen in the latter stages of life of menopause (women after age 50) or andropause (men after age 40-50) definitely affect our main organs that engage in sexual acts which may prevent some individuals from wanting to get involved in the above cycle.

Obviously, there are a lot more involved that I cannot even begin to list in this article.

But the main point is that there is a way to understand and diagnose the underlying issue which is causing your concern behind your diminished sexual activities or health. And it is not limited to sexual counseling or just simple behaviors or adaptation.

In conclusion: How do you optimize, improve, or maintain your sexual health?

• The good news is that there are physician societies that are educating and treating certain physicians in this field of sexual health.
  • You must find one of these physicians who have that specialty in sexual health and hormonal health.
• Although most individuals resort to seeking help from their gynecologists or endocrinologist, it is important to know that not all physicians in those specialties have experience in sexual health or even hormone optimization.
• But when you do find that physician who has expertise of comprehensive health including hormonal health and sexual health, then you should communicate your issues with him or her so that the appropriate tests would be done to enable your physician to lay out a tailor-made plan for you to optimize not only your hormonal health but your physiological health along with your medical health.
• This is (as my patients call it) a “life-changer” as it will assist in you to enjoy a happy and healthy future as you did in the past.