SkullRing.org Medical Weblog

In some cases sexual disinterest is a longterm prospect. Emotional factors are high on the list. Chronic depression or stress are frequently associated with loss of interest in sex. Alan became depressed after a series of business failures when he was in his thirties. ‘At the time I just wasn’t getting any sleep. I had so much on my plate that months would go by when I hardly thought about sex at all. It wasn’t until I saw the light at the end of the tunnel when things started to improve at work that I realized how little interest I had had in sex.’

How interested you are in sex depends heavily on the target of your affection. Sexual chemistry is a funny thing. ‘Chemistry’ implies a cocktail of ingredients — triggers — that set off another person’s sexual interest like a smile, a perfume, hair color, body movements. Romantic poets depend on it. No scientist has been able to explain it. It defies logical definition, yet it is such a vital element in any successful sexual relationship. Two people can be totally compatible as friends, enjoying each other’s company and sharing the same interests but if that intangible we call chemistry just isn’t there, then libido might be a bit evasive.

Being with the wrong partner can be the reason for a relatively lower interest in sex but consider the effect of partners being the wrong gender for you. The possibility that you are not interested in sex because you would actually prefer a partner of the same gender can be immensely confronting, particularly as it goes against the grain of a lifetime of conditioning. This rarely becomes an issue until strong sexual feelings are ignited by a person, an event, or a fantasy. And it can come as quite a shock, as it was for Kate.

‘I remember, as a teenager, having crushes on older girls at school but that wasn’t anything unusual amongst my friends. I started dating boys when I was about sixteen but I wasn’t really that keen on the whole process. When I met my husband we got on incredibly well together and I knew I was in love with him but I always had the feeling there was something missing. Although I didn’t avoid sex with him, I certainly didn’t initiate things very often. My girlfriends had always been very important to me but when I met Marie it was totally different. It sounds like a clich? but it was like I had been hit by a bolt of lightning. I remember being acutely aware of an intense sexual attraction between us and thinking, “I don’t want this to happen; it’s just too hard”, but it was impossible to stop the feelings. My libido felt like it was turbo-charged, and I realized this was what I really needed.

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What sort of compromises are possible? Clearly, if the underlying problem is disharmony in the relationship then sorting out the reasons for that will go a long way. It’s fairly well accepted that men and women speak a different emotional language to each other. An exercise that some relationship therapists use is to have the two partners, in turn, tell each other what they need from the other. Only when the first partner feels they have expressed themselves, is the second partner asked what they understood about the other’s needs. It’s amazing how often the message gets mashed up in the translation. It’s a great way to highlight the reasons people so often feel as though they ‘can’t get through’ to their partner. I recently saw a poster that put it so well: ‘I know that you believe that you understand what you think I said but I am not sure you realize that what you heard is not what I meant.’

Work pressure or the demands of a young baby can mean that you are so tired by the end of the day that all you want to do is go to sleep. If you’re exhausted and your partner wants sex, it can feel like another chore to tack on to the day’s list.

Sally has two children under two. ‘It’s not as if I don’t fancy him any more. I often find myself thinking about making love to him during the day. The trouble is, by the time I survive the evening bathing, feeds and bedtime routine I am all out of energy and sex is the last thing on my mind.’ If the issue is tiredness or lack of time, one way around it is the ‘negotiated quickie’ … that means talking about different ways of satisfying one or both of you when time or inclination is in short supply. Just as you don’t feel like a four-course meal every night for dinner and a quick snack does the job, each lovemaking session need not be a major event worthy of a chapter in a romance novel. Expanding your repertoire of alternatives to intercourse can solve a lot of problems. There are times when, for example, a woman wants to make love but would prefer not to have intercourse, like on the heavy days of her period. Alternatives like oral sex or mutual masturbation can be useful compromises.

Traditionally, masturbation has had a bit of an image problem. Even nowadays, it is not exactly a compliment to call someone a wanker. So many people have grown up with guilt, inhibitions, anxieties and generally negative feelings about it. It is very common for one partner to feel threatened by the other masturbating, fearing that it is an insult to their attractiveness or their ability to satisfy their partner’s needs. Of course, others find it not only acceptable but a real turn-on and will learn more about their partner’s needs by watching them masturbate.

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When Gary Mark Gilmore was asked why he impulsively and deliberately shot a motel manager in cold blood in 1976, all he could say was, ‘I just felt like it. I felt like I was watching someone else do it.’ In fact, Gilmore barely remembered the incident.

Could Gary Gilmore’s aggressive behavior have been an allergic reaction?

Quite possibly. Kenneth E. Moyer, professor of psychology at Carnegie-Mellon University, has seen many situations in which aggressive and sometimes violent behavior occurred after an individual ate specific foods to which he or she was allergic. And Dr Moyer isn’t the only researcher to link aggression with allergies.

‘Aggression as an allergic response is a well-documented phenomenon that has been known to researchers since early in this century,’ says Dr Moyer in an article entitled The Physiology of Violence, Allergy and Aggression’ {Psychology Today). Dr Moyer suggests that aggressive behavior is triggered when the brain swells in response to allergens, just as the skin often becomes irritated on contact with an allergen.

‘When this swelling occurs in an area of the brain that contains the nerve connections controlling aggression, the results can be immediate and dramatic,’ Dr Moyer continued. The individual usually becomes impulsive, combative, unruly, perverse and quarrelsome – a lot like Gary Gilmore, in fact. Behavior that an individual would otherwise control takes on a momentum of its own.

Not everyone with allergies is aggressive, obviously. In those who are, says Dr Moyer, the intensity of the symptoms varies from mild irritability, in which the person is a little more easily annoyed than usual, to a psychotic aggressive reaction. He cites a typical case: one ten-year-old girl experienced a prolonged asthma attack when exposed to alcohol. Several times during the reaction, she became extremely belligerent and tried to bite her mother, whom she did not even recognize.

The variety of allergens that can produce aggressive behavior ranges from pollens and drugs to many foods, of which milk, chocolate, cola, corn and eggs are some of the most common, according to Dr Moyer.

There is no easy way to test for allergy-triggered aggression, says Dr Moyer. The only definitive way to show that aggression and allergy are interrelated is to eliminate a suspected irritant from a person’s environment. If the symptoms disappear, the irritant is reintroduced to see if it provokes the expected aggressive behavior.’

Unfortunately, Mr Gilmore is no longer around to benefit from allergy research. But if you have a tendency towards aggression and extreme edginess, controlling allergies may help you keep your cool.

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To get the most out of your vitamin Ñ during hay fever season, take it with citrus bioflavonoids. Studies done on animals have shown that citrus bioflavonoids may favorably alter the body’s metabolism of vitamin C, raising the concentration of the nutrient in certain tissues and enhancing its availability to the body (American Journal of Clinical Nutrition).

Brian Leibovitz, a nutritional consultant in Portland, Oregon, has found citrus bioflavonoids to be the answer to many a hay fever victim’s prayers.

One hay fever sufferer in particular weathered every summer indoors, knowing that only the first frost would free him from his air conditioned prison, killing the ragweed that disabled him. Meanwhile, he took prescription antihistamines – eight a day. Yet he still suffered. Leibovitz recommended a nutritional programme that included six grams of citrus bioflavonoids a day. A few weeks later, during the height of hay fever season, the young man no longer required drugs to control his hay fever symptoms.

‘More than once, I’ve had hay fever patients who did not respond to vitamin Ñ recover when given citrus bioflavonoids,’ Leibovitz told us.

Dr Freyer also has found that vitamin Ñ works better when accompanied by B-complex vitamins, especially pantothenic acid.

‘I recommend 200 to 500 milligrams of pantothenic acid, plus another 50 milligrams of  complex,’ he says. ‘Sometimes, when a patient has impaired absorption – and many people with allergies do – I also give pancreatic enzymes. These help to break down the foods so vitamins can be absorbed better.’

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One woman who has endured four miscarriages told me, ‘Anyone who thinks life doesn’t start at conception has never had a miscarriage. Actually, the first one wasn’t so bad. It didn’t really connect for me that it was a baby I had lost … more like a blood clot or something … and I explained to myself that there must have been something wrong with the baby. Nature’s way of getting rid of abnormal babies … you know what people say to try and make you feel better. After I had my first live baby, my attitude really changed. It was much more real then. I wanted a big family more than anything in the world but I had three miscarriages in two years. The first went to sixteen weeks and the next two only lasted twelve weeks. Each time I had a miscarriage it was as though I had lost a baby at full term. It’s impossible to describe the pain of the grief. Lying in the hospital ward with a drip in my arm before the curette, it was so lonely. The staff were trying to be really understanding, but to them miscarriages were so commonplace that they were just a routine. I thought if one more person says “Better luck next time” I will just scream! One strange thing that happened each time I got pregnant was that I became incredibly protective of myself and the baby as a unit. I wouldn’t let my husband anywhere near me. Sex was out of the question and my only priority was getting the pregnancy to term. I wouldn’t do anything that would disturb the baby. I would cringe even if he wanted to give me a cuddle because I’d think, “Oh no, he wants to do it!” I really felt like I was being attacked.’

The harder it has been to get pregnant or to take the pregnancy to full term, the stronger this siege mentality gets and it really is understandable. In fact women with a history of repeated miscarriages may well be advised to avoid intercourse for the first few months of the pregnancy as a precaution, although most will do so anyway as an instinct. This is one of those situations when it is important that the woman’s partner understands the reasons the advice has been given. That makes it a team effort for a common goal, rather than the man feeling totally shut out of the pregnancy. I’ve heard it said that the Freudian concept of ‘penis envy’ is just a decoy invented by men to take the attention away from their ‘womb envy’, an unfulfilled desire to experience pregnancy for themselves. The point here is that the more pregnancy is treated as a team effort the less likely you are to run into problems, and that means men being involved and informed as much as possible at every stage.

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Antihistamines, as you might have guessed, block the release of histamine from mast cells, thereby reducing classic allergy symptoms such as headaches, itching or runny nose. In fact, they may be employed for any allergic reaction that’s blamed on histamine release, like hives. Too much antihistamine, however, can make a person sleepy. And antihistamines tend to dry out mucous membranes. The secretion of those membranes becomes so thick and dry that it can’t be expelled by coughing or sneezing, and it backs up into the sinus or respiratory tract. So what begins as the relatively simple runny nose of hay fever can end up as chronic, painful sinusitis or a stubborn, bone-dry cough – or both. Then you need a decongestant.

Nasal decongestant sprays and drops shrink swollen membranes in the nose and provide temporary relief of hay fever. If decongestants are relied on heavily, however, a rebound phenomenon occurs: after a couple of weeks, when the spray or drops are discontinued, the membranes swell again and congestion is worse than ever. Oral decongestants have their own drawbacks — they’re adrenalin-like, and can make people hyper. So if you’re a high-strung, nervous type, they’re the last thing you need.

As you can see, once a hay fever sufferer boards the drug merry-go-round, it’s sometimes hard to jump off. But herbs, exercise and vitamin Ñ can all help to clear up the congestion and misery of hay fever – without the unpleasant side effects of antihistamines and decongestants.

Certain herbs act as decongestants, clearing clogged mucus. A tea of fenugreek, anise or horehound, or a concoction of garlic oil in water, made into a tea, can clear up congestion in twenty minutes. The vapors of eucalyptus also work wonders: put leaves into a large pot of boiling water and boil for five minutes. Then turn off the heat and, with a towel draped over your head, breathe in the vapors.

Many hay fever sufferers have found that vigorous exercise – running, walking or bicycling – helps to clear the nose, too.

Vitamin Ñ acts as a natural antihistamine, reducing the swelling and inflammation that causes discomfort in nasal and sinus tissues. And, of course, it helps tremendously to avoid whatever triggers your hay fever.

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Inhalation challenge (nasal and bronchial provocation)

Because skin tests sometimes miss the mark entirely, some doctors use an inhalation challenge for allergy to inhalants. To test for mould allergy, for instance, a small amount of dried, powdered, sterilized mould is placed on the end of a toothpick and sniffed. Symptoms are expected to appear within five minutes if the individual is allergic to mould.

So far, these tests all carry an element of anxiety – the fear that you will react. No wonder – that’s the whole idea. The ideal allergy test, from the patient’s point of view, is one that’s accurate, yet doesn’t risk a reaction. Enter the RAST test.

RAST (radioallergosorbent test)

The RAST test measures the amount of IgE in your blood. It’s certainly safe, since the test is conducted on a blood sample in the laboratory. Anaphylactic shock, which occasionally occurs with skin testing, is impossible with a RAST test (although you still have to endure the discomfort of a needle). RAST is more sensitive than a puncture or scratch test.

‘One of the criticisms of the RAST test is that it’s expensive,’ comments Dr Jonathan V. Wright, from Kent, Washington, who uses the RAST test a great deal. ‘Unfortunately, no other test comes as close to it in accuracy.’

A RAST test measures the amount of IgE (allergy-provoking antibody) in the blood. In contrast, skin tests merely measure the weal-and-flare – indirect evidence of IgE activity. More precise measurement of IgE activity by RAST means that, if needed, allergy injections can be started at a customized dose, and relief can be expected in three or four months. In contrast, allergy injections based on skin tests are begun at a lower estimated dose and gradually increased until the optimal dose is reached, which sometimes takes six months to a year. (Incidentally, IgE levels run higher in smokers than non-smokers, for some unknown reason. Be sure to let your doctor know if you smoke so that factor can be taken into consideration when interpreting your RAST test.)

For all its advantages, the RAST test is somewhat controversial. Aside from increased cost, doctors must resist the temptation to rely on it too heavily for diagnosis. For instance, many people react positively to both skin and RAST tests for cereal grains, but eat them routinely with no ill effects. Like any allergy test, the RAST is meant to supplement, not replace, a good, thorough medical history. Consequently, many doctors feel that the most accurate way of testing for food allergy is still elimination and re-challenge.

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Cold Temperature

Some people break out in hives when they dash in and out of an air-conditioned store in summer. Or when they come into a warm house after shoveling snow. Or if they take a quick dip in a chilly pond or pool. Or even if they rinse their hands in cold water.

That’s called cold urticaria, and while it’s the drop in temperature that triggers the reaction, the symptoms appear as the body temperature warms up again. That increase in body temperature, it’s believed, releases histamine and other allergy-triggering body substances. Hives may develop all over the body, but they’re usually more prominent in the areas directly affected by the cold, such as uncovered hands or face. If very cold food is eaten, the lips and tongue may swell somewhat. And cold-induced hives may be accompanied by headache, vomiting, rapid heartbeat and fainting.

Cold urticaria is related to allergy to exercise, which also prompts a rise in body temperature, and is medically referred to as a ‘cholinergic’ allergy, which means that the allergy involves the nervous system. And cold allergy can be accompanied by water allergy, a rare and slightly different variation of cholinergic allergy.

It’s not always easy to tell the difference between cold urticaria, exercise urticaria or water urticaria. Widespread hives that develop after swimming, for example, could be caused by cold water, exertion (if it’s a heated pool) or by the water itself. To sort it out, doctors do what amounts to a patch test with an ice cube. If you don’t react, you’re not cold sensitive.

Allergy to cold temperature is very often part of one of a few other, underlying illnesses, and disappears when the disease is cured. In other cases, cold allergy simply subsides as mysteriously as it began. If not, common sense tells the individual to take precautions against exposure to cold. Where cold is unavoidable or the allergy is a major problem, many people have been successfully desensitized to cold temperature by gradual exposure to decreasing temperatures – either in a cold room or cold water – for progressively longer periods of time until cold can be tolerated.

If that doesn’t work, antihistamines may help. While we don’t encourage casual use of drugs, we do feel that in certain circumstances – such as this – medication is less of a hazard than the risk of a severe reaction to an unavoidable allergen.

Exercise

‘Allergy to exercise’ may sound like a lame excuse to stay chair-bound. But there actually are a few rare individuals who swell up and break out in hives after even mild exertion. A couple of laps across the pool or a few minutes of jogging leave them not only red and itchy, but possibly even dizzy, nauseated and exhausted. In most cases, antihistamines can help.

Asthma attacks, too, may be triggered by strenuous exertion. But those breathing difficulties may be due to the direct effect of cold, dry air on sensitive airways and are in no way related to exercise-induced hives.

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The driver of a cab I hired in Chicago told me that he was allergic to his new girlfriend. He didn’t know what it was about her, but he broke out whenever he got near her. He was certain it wasn’t anything obvious like perfume or cosmetics.

Far-fetched? Not at all. A few days later, I stumbled across a possible explanation. An allergist in that same city told me that sensitivity to human dander – hair and skin particles – has been written about in medical journals from time to time.

Of course, I never did find out how the cabbie fared. But his was just one of several types of odd allergies that I ran across while researching this book – allergies which I’ll review here in case you or someone you know happens to have a very unusual problem. Some of these allergies are so rare that doctors have had little opportunity to develop any real therapy – other than to avoid the cause of the problem. (Unless it’s something you’re willing to endure – like your girlfriend.)

Sunlight

Allergy to light may sound like the ultimate in hypochondria. But it does occur. And not only in people who are taking certain drugs or handling chemicals that activate skin problems in the presence of light, as we discussed in earlier chapters. Once in a blue moon (or sun), along comes someone who really is allergic to light per se – and then only to certain wavelengths: artificial light or light streaming through a window is okay, but direct light is a problem. The person’s skin gets red, swollen and tender, except for well-defined areas covered by sleeves, trousers or a hat – just like sunburn. But the skin flares up only moments after an exposure too brief to produce sunburn in most people. Sometimes the mock burn is accompanied by headaches, vomiting and burning eyes. Very rarely, light sensitivity can lead to anaphylactic shock.

People with allergy to sunlight don’t go to many beach parties. But they don’t have to go underground, either. Protective clothing is a must, of course. And sunscreens can be a tremendous help. Mildly sensitive people can build up their tolerance to sunlight by exposing small areas, a little at a time.

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In a relationship with an agreed basis of fidelity, finding out your partner has had or is having an affair is usually its biggest challenge. It strikes at the heart of your self-confidence and trust and it can shake the foundations of the strongest relationship. Very few people can cope easily with the thought of the person they love having sex with somebody else. Above all it makes you question your own sexual adequacy, leaving you to ask, ‘Why wasn’t I enough?’

It has been estimated that there is an infidelity at some stage in around seventy percent of marriages. That makes the affair a common social covenant but one which is largely denied, and for good reason. There is a very real risk that it will tear the marriage apart. You see it all the time. But the question must be put: is society hanging onto a fragile facade of fidelity? It is more constructive to acknowledge the situation and look at it in terms of primary and secondary relationships, rather than using the term ‘affair’ at all.

Concealing a secondary relationship can be seen as a survival tactic for the primary (or what you perceive to be the most important) relationship. It is not so much a case of deception but a realistic fear of loss — of the primary partner withdrawing their love or just walking out. That’s why Rule Number One has always been … ‘Don’t get caught.’ So Rule Number Two is ‘Don’t catch anything.’ The reality is that any extracurricular (or secondary) sexual contact will increase your risk of transmitting a sexually transmitted disease to your primary partner. Without meticulous attention to safer sex practices, the risk is multiplied. Even without the health implications for your primary partner, a sure-fire way to ‘get caught’ is to ‘catch something’ and pass it on.

The reasons people have affairs are wide-ranging. Sexual boredom may be one of those reasons and some people will see an affair as the solution to discover new sexual and relationship skills. An extension of this is when one partner is not interested in sex, the other has a stronger libido and they are unable to reach a compromise. The partner with the stronger libido might not want to forfeit the primary relationship but still needs the sex. Many people also feel emotionally deprived or unsatisfied in a single longterm relationship. Some marriages are undoubtedly eroded by a secondary relationship. The painful truth is that many marriages are surviving and growing because of a secondary relationship rather than in spite of it.

If you marry young and stay with that partner you may reach a time when the curiosity to find out what sex is like with someone else becomes an irresistible temptation. The catalyst for this is usually a specific attraction to another person, rather than a deliberate effort to ‘just do it with someone else’.

If one partner is bisexual they may live in a primary relationship with someone of the same or opposite sex but, because of the dual nature of their sexuality, they may have a series of casual encounters or another relationship to satisfy this duality.

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