Doctor, how can I lower my libido?

Dear doctor,

I am a Healthy Nation fan. For the last three years, my sex drive and libido has gone abnormally high and my penis gets erect strongly almost every time. I can also take up to an hour to ejaculate even in the first round of sexual intercourse and my appetite for sex has become insatiable. I am single and the high sex drive is now like a disease. How can I lower my libido in a way that doesn't affect my health until marriage and how will I raise it after? Kindly advise.

Dave

Dear Dave,

You may have compulsive sexual behavior, otherwise known as hypersexuality or sexual addiction. This happens when normally enjoyable sexual behaviours become difficult to control, take too much of your focus and become disruptive to you or others, which can affect your mental health, self-esteem, relationships, studies or work.

Symptoms of compulsive sexual behaviour are Recurrent and intense sexual fantasies, urges and behaviours that take up a lot of time and feel as though they are out of control. Another indicator is when you try unsuccessfully to control these fantasies, urges or behaviours. Sometimes you use the behaviour to deal with other issues such as loneliness, anxiety, depression, anger or stress.

Compulsive sexual behavior may develop due to changes in the chemical messengers (neurotransmitters) in the brain, or due to some diseases or medication affecting the brain.

 Your brain may also form pathways that make sexual behavior into an addiction over time. Other possible contributors to this are alcohol and/or substance abuse, other mental health disorders, including having a gambling addiction, having a history of being physically or sexually abused, and having family conflict. Easy access to sexual content and privacy also increase the risk of developing a sexual addiction.

This behavior can be managed through psychotherapy, support groups and use of medication. It would be helpful for you to be seen by a mental health professional both for therapy and for diagnosis and management of any other mental health problems.

There are different medications that may be helpful in controlling the urges including some anti-depressants, mood stabilisers and naltrexone. For those whose sexual urges are dangerous to others, then anti-androgen medication may be used.

In the meantime, you need to identify what your triggers are, set healthy goals and find healthy outlets for negative emotions and urges. You also need to avoid risky situations, reduce your privacy and install a software that blocks access to sexual content on your devices.

The delayed ejaculation (taking 30 minutes or longer to ejaculate) may be generalized, that is, occurring in all sexual activities or it may be situational, that is only under certain circumstances.

It may be due to physical illness, use of certain medications, frequent masturbation, or due to psychological issues e.g. relationship problems, anxiety, depressions, stress, taboos, or differences between the reality of sex versus sexual fantasies. There is no specific treatment for delayed ejaculation, and addressing any underlying issues should help with the condition.

I usually have headaches almost every day so I have been taking a lot of painkillers. I am wondering if this is harmful to my health and if there is any other way to deal with the pain?

Dear reader,

Almost everybody gets headaches at some point, and the causes are very diverse. In many cases, headaches are a symptom of an underlying issue.

The most common type of headache is a tension headache. Usually, the pain is on both sides of the head and it may feel as though there is a tight band around the head. It occurs due to tightening of the muscles around the neck and the scalp.

It may be triggered by fatigue, dehydration, hunger, light exposure (too little or too much), noise, congestion, stress, too little or too much sleep, or even poor posture. Tension headaches are usually not very severe, and resolve within an hour or so, with or without painkillers.

To prevent them, then you need to figure out what your triggers are and address them e.g. rest, take enough water, eat regularly, get adequate sleep, avoid noisy or congested surroundings, wear ear muffs if you work in a noisy place, reduce screen time (computers, tablets and phones), make sure you work in well lit areas, practice good posture and stress management. Sometimes taking a warm bath may also reduce the headache.

There are cluster headaches, which occur for several weeks at a time, and are very severe and do not respond very well to painkillers. The pain is usually concentrated around one eye, and there may be redness and tearing from the eye or a blocked or running nose. There are also migraine headaches, which are severe headaches, usually affect one side of the head, and may be accompanied by increased sensitivity to light and sound, nausea and vomiting.

Headaches may also be caused by hormonal changes, medications, too much alcohol, exposure to carbon monoxide, flu, sinusitis, and almost every illness, especially those affecting the head and neck region.

In most cases, headaches are not a serious problem, but if they persist or become worse with time, if they are very severe, if they are as a result of a head injury, or if they are associated with other symptoms like fever, drowsiness, confusion, slurred speech, stiff neck, vomiting, convulsions etc, then you need medical attention so that the exact cause may be identified and dealt with.

For most headaches, taking an over the counter painkiller that addresses headaches will clear the pain. However, if the headaches are recurrent, then it is good to be examined and treated for any underlying problems. There are also medications that are taken daily for several months to prevent headaches, and there are much stronger medications given to treat headaches if necessary.

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