Thanks to an e-mail from a reader who works as a clinician at an anti-retroviral therapy (ART) clinic in response to last week question,Â â€œthereâ€™s no association between sexual desire and anti-retroviral drugs and some of the factors that can drive one into sexual desire are those you have cited in the article.â€
Continuing on from last weekâ€¦.sex can be an important feature for intimate relationships and lack of it can adversely affect the relationship. People with HIV have reported lower sexual drive or inability to obtain and sustain an erection which can significantly impact quality of life and feelings of self-worth, and may even contribute to emotional problems, including anxiety and depression which further exacerbate low sexual drive.
There are three phases of sexual function: libido (sexual desire), arousal (erection in men and swelling and lubrication in women), and orgasm.
It is necessary for all three phases to function for sexual performance. There are a number of social, psychological and biological factors that affect each of these phases. It is possible for one to have desire without arousal or arousal without orgasm. A medical assessment of the problem would determine which phase of the performance is affected and the underlying factors causing it.
Some anti-HIV drugs and many of the drugs commonly used to treat depression can also affect sexual function. Additionally, appetite stimulants, have also been shown to cause loss of libido.
In men, HIV can also cause nerve damage that can result in erectile problems. In women, it is not uncommon to experience early menopause or sexual dysfunction because of vaginal dryness or thrush, pain or severe premenstrual syndrome (PMS).
Testosterone, a sex hormone, is critical to both libido and sexual performance and testosterone replacement therapy exists, although not sure if this is available in Malawi.
Women can be also offered hormone replacement therapy, though this should be carefully monitored for signs of masculinisation (becoming male as testosterone is a principal male sex hormone responsible for hairy chests, deep voice, muscle gain).
In Malawi, there are number of natural remedies that could work like gondolosi. Emphasis on COULD. Other herbal remedies like gingko biloba, yohimbine almost similar to commercial drugs like Viagra are believed (emphasis on BELIEVED) to improve blood flow to the male sex organs, increasing erection and performance.
But before resorting to these remedies, lifestyle changes can influence sex driveâ€”healthier diet, quitting smoking and recreational drugs, and avoiding overconsumption of alcohol all have positive benefits.
Exercising also has the added bonus of boosting self esteem.
Whether you and or your partner have HIV, that should not stop you from engaging in an intimate sexual relationship. If you are having problems, the first step is to communicate with your partner.Â
Just donâ€™t forget to wear a condom!