Food, Sex and Mental Illness

Dra Maria Zweig MD

Sexuality and eating are universal experiences for human beings, as a gynecologist I have been dealing with sexuality issues with my patient as no other medical specialty in medicine routinely does. That being said, I have seen woman struggling with problems related to sexuality for over 20 years, some are simple to resolve, others need a more comprehensive approach.

We are presently experiencing an epidemic of obesity, which affects women in various ways

  • Increasing cardiovascular disease
  • Hypertension, diabetes, and heart disease
  • Increasing uterine cancer (endometrial)
  • Increasing complications in pregnancy
  • Cesarean Sections, Preeclampsia, birth trauma
  • Incontinence or loss of bladder control

Some people have a healthy relationship with food; others battle with one issue or another throughout life. Problems such as:

  • Overeating
  • Unhealthy eating choices
  • Obesity epidemic
  • Metabolic syndrome

Certain people, mostly woman, suffer from outright eating disorder:

  • Anorexia
  • Binge eating
  • Bulimia

As physicians we understand the difficulty and complexity of dealing with these problems for our patients, so we often attack the situation through multi-disciplinary approach. Team may include a psychiatrist, psychologist, dietician, surgeon, internist and gynecologist. Behavior modification and long-term commitment is necessary.

The reason we bring up some women’s unhealthy relationship with food and mental illness such as binge eating and anorexia is because these are usually caused by low self-esteem and body image issues. Low self-esteem can cause women to enjoy sex less, a lack of confidence hinders women’s ability to feel sexy and wanted. We’ll help you deal with these issues in many different ways depending on your preference. Sex is something everyone should be able to enjoy, regardless of your body size.

As with food, many women enjoy a healthy sex life, but sex issue are common and no other situation ties women up in knots worse than when there is a sexual issue present. Guilt, recrimination and hiding of the problem are often present. Common complaints include:

  • Pain during sex
  • Low desire
  • Inability or dificulty to reach orgasm / climax
  • Fear of sex
  • Fear / phobia of being touched.
  • In a sexual setting
  • Casual setting
  • Medical setting

Sex is not the only part of a healthy relationship but it is an important part. Enjoyment of sex is an essential part of a healthy sex life. Some problems stem from a physical or anatomic origin:

  • Endometriosis
  • Present or previous infections
  • Lack of estrogen (atrophic vaginitis)
  • Previous surgeries causing scar formation, narrowing of the vagina
  • Birth malformation
  • Short or absent vagina

Other problems may arise from psychosocial trauma such as abuse; or erroneous expectation on our part. Poor sexual technique or instruction may be present. Half of the time it may not even be our problem but our partners’ problem that may be ailing us. In any case the solution has to begin with partner communication and seeking help. Again, depending on the problem present a multi-disciplinary approach may be called for; gynecologist, psychiatrist, psychologist, sex therapist may be utilized.  Problem solving is essential along with a loving and understanding partner.

Just to give you an idea of possible solutions available for some specific problems related to sexuality, these are some treatments available from a gynecologist point of view.

  • Hormonal: We can provide you with a prescription for a local estrogen which should help with painful sex and low sex drive.
  • Surgical: We perform in office and hospital procedures depending on your anatomic situation that needs to repaired or altered. Some examples of procedures include removal of obstacles present in the vagina like a septum, which is like a wall obstructing the vaginal canal, and removing of scar tissue from previous surgery, and pregnancy. Vaginal size can also be an issue, either too small of narrow which leads to painful sex, or too loose which can lead to a decrease in sensation and desire.
  • Psychological: We have seen many instances of psychological related sexual problems. These can arise from bad experiences or abuse. In this situation we would refer you to a psychiatrist and continue to work with our patients to help get over emotional scars.
  • For food related mental illness our doctors are trained to identify of symptoms of this disease like lack of period, dry skin, vaginal dryness, loss of hair, and low weight. Some solutions for this would be a referral to psychologist with expertise, diet plan and starting an exercise regimen.
  • Problems with the partner: For women especially, their sex drive is emotionally driven. We encourage partners to communicate problems they have with their experiences. Stressful situation in the household can also lead to a decrease in sex drive that can stem from financial issues or other family related issues. A good emotional connection with your partner is very important. Some performance issues may also lead to problems in the bedroom. Whether it is erectile dysfunction, they can’t bring it up or can’t keep it up. For situations like this we encourage patients to experiment in the bedroom with sex toys such as vibrators. We would also recommend the men to visit a urologist if problems continue. Excess fat in the stomach region of men can also lead to a decrease in testosterone, which decreases sexual desire.