“I don’t feel like it tonight”: it seems an excuse not to have purely female sex, but, instead, it can be the signal of physical or mental pain associated with sexual activity, which also affects men, of which, however, little is said because males tend to mask this suffering and are reluctant to consult a specialist. In the face of pain, therefore, men are truly the weaker sex, unable to say it and with a lower reactive strength than women. The difference is evident in the andrological sphere, where physical pain is intertwined with psychic pain and vice versa. Very often the two types of pain are like a self-perpetuating vicious circuit: physical pain, such as in chronic pelvic pain, generates psychological suffering, with repercussions that can push the man to the point of avoiding sexual intercourse. The same goes for psychological pain such as that for the loss of sexual potency which favors its development with a reduction in relationships.
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The problem was highlighted by the experts of the Italian Society of Andrology (SIA) in the third edition of the Nature, Environment, Nutrition and Man Congress (Nau). According to specialists, the “sheet syndrome” affects 4 million men who, in two cases out of 10, give up sex due to physical and mental pain. The goal of SIA andrologists is therefore to propose a paradigm shift in the culture of pain which too often is given an exclusively feminine value.
Pain and sexual well-being
“Pain caused by an andrological problem can have a huge impact on sexual well-being, both individually and as a couple,” he explains Alexander Palmieri, Sia president and professor of Urology at the Federico II University of Naples -. While both men and women consider fulfilling sexual activity essential to maintaining a relationship, men tend to emphasize the importance of sex as an emblem of masculinity and success. Precisely because of the relevance attributed to sexual activity –they tend to hide the pain that eventually leads them to avoid actual sexual intercourse, starting a vicious circle harmful to the couple and to the man himself”.
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Suffering on the rise
Male suffering has increased significantly in recent years. “Recent epidemiological data have shown that one out of three males is affected by uro-andrological pathologies that can affect the entire span of life: from adolescence to advanced age. The timely recognition of some symptoms allows the treatment of pathologies such as hypogonadism, erectile dysfunction, premature ejaculation, infertility, prostate diseases on an inflammatory or infectious basis, which can often be underestimated or even misunderstood”, he explains Ciro Basile Fasolo, president of the Nau congress and author of the book “Homo Patiens” dedicated to pain in man.
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Physical and mental pain
Sometimes mental and physical pain are interrelated. “Body pain, as in the case of pelvic syndrome, chronic prostatitis or prostate cancer, can trigger an anxious state capable of aggravating the impact of the pathology on the sexual sphere. But also psychic pain that is not secondary to an organic pathology, such as that which accompanies male infertility or sexual dysfunctions can have repercussions of sexual aversion up to the total renunciation of relationships”, adds Palmieri.
The prostatitis
Prostatitis is one of the most frequent pathologies today, in particular, chronic prostatitis or chronic pelvic pain syndrome affects 10-15% of the male population and can occur in men of any age. “There are different types of treatment that allow you to manage this pathology – explains Palmieri – such as shock waves, or high-intensity acoustic waves that are transmitted through the skin in the affected area where they decrease pain and accelerate healing The problem, therefore, is not the lack of treatment, but the reluctance of men to ask for help from a doctor. Very often the diagnosis comes late, causing men more suffering, even psychological, which can instead be avoided”.
Erectile dysfunction
A similar argument also applies to erectile dysfunction, which affects over 3 million men in Italy and premature ejaculation. “What discourages men is admitting the psychic pain caused by these problems – adds Palmieri -. The patient feels embarrassed even talking about it with the specialist himself. He isolates himself in his suffering and finds it hard to ask for help. Many patients are young but they arrive to consult a specialist only after exceeding the age of 30. A timely and precise diagnosis is essential to help the patient in the search for the most appropriate therapy”.
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Personalized therapies
The discovery of new treatments, in fact, allows the specialist to prescribe personalized therapies to the patient. “Therapeutic innovation, connected to nutraceutical integration, and the multidisciplinary approach that can also include the involvement of the psychotherapist – concludes Basile Fasolo – require the specialist to update himself continuously and to change his way of thinking and approaching male health care: these are the main objectives of our scientific meeting”.