#AskDrKK:What sexual advice to give to a patient with stable angina?

#DrKKAnswers:
1. Patients with angina often become symptomatic during sexual act (1,2).
2. 65 percent ends up with heart chest pain enough to stop activity (2).
3. Beta blockers and/or prophylactic sublingual nitrates, can prevent heart pain in these patients and permit a normal sex life (2).
4. Post angioplasty and bypass surgery patient do not carry excess risk
5. Asymptomatic chronic heart blockage patients also do not have an increased risk of symptoms during sexual act.

References
1. Arch Intern Med 1970; 125:987.
2. Int Rehabil Med 1981; 3:35.

AskDrKK: How a sexual act linked to physical exercise?

#DrKKAnswers:
1. Both are measured in terms of MET (metabolic equivalent of oxygen consumption).
2. 1 MET = 3.5 mL O2 uptake/kg per min (resting oxygen uptake in a sitting position).
3. Sexual act is equated to 2-3m METS during the pre-orgasmic phase and 3 to 4 METS during orgasm.
4. This is equivalent to walking at two to four miles per hour on a level surface [1].
5. Exercise stress testing is used to assess both exercise tolerance and tolerance for sex [2].
6. A sexual act causes a modest increase in myocardial oxygen demand that lasts only a brief time [3].
7. Exercise training attenuates the heart rate response [4] and reduces the small risk of heart attack following sex [5,6].

References:
1. Arch Intern Med 1984; 144:1745.
2. Am J Cardiol 2000; 86:51F.
3. Am J Cardiol 2000; 86:27F.
4. Circulation 1977; 55:738.
5. JAMA 1996; 275:1405.
6. Heart 2001; 86:387.

#AskDrKK: What is the physiology of sexual act?

#DrKKAnswers: 
 Sexual act includes arousal, erection, ejaculation, orgasm, refractory period, and resolution and depend on changes in the autonomic nervous system. Arousal and erection in men results from stimulation of parasympathetic nerves in the male penile organ; reduced activity of sympathetic pathways and release of nitric oxide from the endothelium (1). In women early sexual arousal results from activation of sympathetic nervous system (2).

References
1. Am J Cardiol 2000; 86:19F.
2. Am J Cardiol 2000; 86:30F.

Emedinews :Weight loss may improve sexual health of obese diabetics

Weight loss improves the sexual health of obese men with type 2 diabetes, according to a study published in the Journal of Sexual Medicine.

 A modest weight loss of 5% can lead to an easing of erectile dysfunction and improvement in  sexual desire 

within eight weeks and positive effects continue to improve in the next 12 months.

The typical weight reduction diet involves consuming low-calorie diet or a low-fat, high-protein, reduced-carbohydrate diet meant to decrease calorie intake by 600 calories a day.

#AskDrKK: Can weight loss help diabetic sexual functions?

#DrKkAnswers: Weight loss improves the sexual health of obese men with type 2 diabetes, according to a study published in the Journal of Sexual Medicine.

A modest weight loss of five percent can lead to an easing of erectile dysfunction and improvement in  sexual desire within eight weeks and positive effects continue to improve in the next 12 months.

The typical weight reduction diet involves consuming low-calorie diet or a low-fat, high-protein, reduced-carbohydrate diet meant to decrease calorie intake by 600 calories a day.