Sexual and reproductive health is not much appreciated for an open discussion in our country. Perhaps this is why sexually transmitted infections and reproductive issues continue to be major public health concerns. Medicircle is conducting a series on sexual and reproductive health awareness to educate society to seek doctors for problems related to their sexual health and lead a happier life. The aim is also to reduce the spread of sexually transmitted diseases which is caused due to either casualness or unawareness.

Dr. Parag Shah is a Consultant Surgeon at Doshi Nursing Home, Mumbai, and is also associated with the Male Infertility Department, Wadia Hospital. He is a senior surgeon with more than 30 years of experience in surgery and is a circumcision expert. His publications are widely published and read. 

Sexual Problems are More in Patient’s Mind

Dr. Shah informs that males complain of many problems like premature ejaculation, early ejaculation, issues related to size and shape of the organ, pain during penetration, issues related to the tightness of the organ, etc. However, many of the problems are more in mind than really existent. He emphasizes that “Many information related to sexual organs and sexual issues are freely available on the internet. Not all, but a large number of the information, pictures, and stories are present on the internet in an exaggerated manner. These exaggerated versions increase the expectations in the patient’s mind. About 80% of problems are not problems rather exaggerated expectations. People are normal but think they are not normal due to this,” says Dr. Shah.

If One is Facing Sexual Health Related Problem, He /She Should Visit Doctor with Sexual Partner

Dr. Shah mentions, “We advise people facing sexual issues to come with partners because sex is not just related to an individual rather it involves both the partners. If both partners visit a doctor, then the doctor would be able to evaluate the expectations and knowledge of both and understand the problem in a better way. 80 % of the problems are due to difference in reality and exaggerated expectations, 10 % is associated with other medical problems like diabetes and blood pressure, etc. and rest of the 10% are a real sexual problem that can be treated with medication or surgery,” explains Dr. Shah.

Not Only Females factors but Male factors Can also lead to Infertility

Dr. Shah informs, “though there are genuine medical conditions due to which the problem of infertility can arise, there might be other issues too like lifestyle-related issues, environmental pollution, stress, processed food, etc. that can lead to infertility. Most of the time, women are blamed for infertility in our society but almost 50% of infertility cases can be attributed to males. It’s a common thought process that if males can penetrate and ejaculate, they are ok as far as the issue of infertility is concerned. However, Sexual potency and fertility potential are different things. Infertility issues can be due to sperm-related deficiencies. So, males should have infertility tests done too. Since the infertility tests for males are less complicated compared to females, males can get it done before the female partners and should not neglect visiting a doctor thinking that since they are sexually active, there can’t be complications in this regard in them.”

Significance of Circumcision

Dr. Shah explains, “People come for circumcision due to phimosis which is a condition in which the foreskin is too tight and cannot be retracted from the head of the penis. Smegma, which is a secretion that gets accumulated under the foreskin, might lead to infection in males with phimosis as there are lesser chances of completely cleaning the area. Sexually active males might cause infection in females as well and probably that’s why females suffer from issues like white discharge. Not only this, phimosis might affect sexual activity as well and males may suffer from issues like pain, cuts, bleeding, etc. during intercourse. That’s why circumcision is significant so that the problem of phimosis can get solved.” 

Dr. Shah further explains that “ZSR circumcision is a technique in which the foreskin is cut using a stapling device. It is a painless, bloodless, stitch-less cosmetic solution but there are duplicate devices available too and patients should get circumcision done through original devices only to avoid complications.

Varicocele, Low Sperm Count and Male Infertility

Dr. Shah informs, “varicocele signifies enlargement of the veins within the loose bag of skin that holds testicles (scrotum). Varicocele is a common cause of low sperm production and decreased sperm quality, which can cause infertility. Varicocele can be repaired through various surgical options. He further informs that “CDVL technique is one of the options which shows good results with nil recurrence rate and fertility rate improvement is 60-80 percent in a time frame of 1 – 2 years. It’s a day care procedure and patients resume normal activities very quickly.”

(Edited by Amrita Priya)