Increasing number of young, Indian men are now facing sexual health problems. Many of then are either prediabetic or already diabetic.
Published Aug 19, 2024 | 4:31 PM ⚊ Updated Aug 19, 2024 | 4:31 PM
When we talk about obesity and its impact on health, non-communicable diseases such as hypertension and diabetes often come to mind. However, obesity also significantly affects sexual health and fertility.
During the inaugural Dakshin Healthcare Summit in Hyderabad, Dr Anuradha Katragadda, Managing Director of Anu Test Tube Baby Centre, and Dr Sunitha Sayammagaru, Diabetologist & Sexual Health Specialist, provided insights into the connection between obesity, sexual health, and reproductive issues.
Speaking at the panel discussion Managing Obesity, Infertility & Lifestyle Diseases at the summit organised by South First and TV9 Network, Dr Katragadda said that most couples —about 85 percent— conceive within the first year and by the second year, an additional seven percent manage to conceive.
“This means that the majority achieve pregnancy within the first year, and chances decrease significantly afterward. If a couple has been trying to conceive for one year without using contraception and there’s no pregnancy, they are considered to have infertility,” Dr Katragadda said.
She added that for women aged under 35, the timeframe to try is one year, but for women over 35, investigations and treatment should begin after six months. For women over 40, this process should start as early as four months. So, the timing depends heavily on the woman’s age.
“There are various causes of infertility—some preventable and others not. Lifestyle factors are a significant, preventable cause. Obesity, substance use, smoking, alcohol consumption, and other lifestyle behaviors can all negatively impact pregnancy rates,” she said.
For men, obesity can reduce sperm count and motility, and increased exposure to estrogens, whether through diet, dairy products, or environmental factors like bisphenol and phthalates, can lead to obesity and further reduce testosterone levels.
“In women, obesity can reduce pregnancy rates by almost 50 percent and lead to higher complication rates during pregnancy. Thus, obesity has a significant impact on both men and women, reducing the chances of conception and increasing complications during pregnancy,” she said.
She added maintaining a healthy lifestyle is crucial for achieving early and healthy pregnancies.
Dr Sunitha Sayammagaru said that lately she is noticing more young men, particularly those under 30, are approaching with sexual health problems.
“This is different from my experience in the UK, where it was more common to see middle-aged men with these issues. Here in India, even in Hyderabad, I’m seeing an increasing number of young men facing these challenges. When I delve into their history, I often find that they themselves are unaware of their health status until we conduct basic blood work,” she said.
She said that many of these young men are significantly obese, and their overall health is assessed, they’re often either prediabetic or already diabetic without knowing it.
Dr Sayammagaru said that it’s closely related to obesity, low testosterone, and increased estrogen levels, which can lead to erectile issues in men. For women, these factors contribute to vaginal dryness and painful intercourse.
“When it comes to diabetes, the issues are linked to nerve function and blood circulation in the pelvic organs. In men, this can result in erectile dysfunction, ejaculatory problems, and even retrograde ejaculation,” she said.
She said that for women, diabetes often leads to decreased vaginal lubrication. Both men and women may experience a decrease in libido, sexual arousal disorders, and even orgasmic disorders.
“Metabolic disorders significantly impact sexual health, which is particularly concerning when considering the context of infertility. These issues are becoming increasingly prevalent, especially among younger populations, and addressing them requires a comprehensive approach to managing overall health,” she said.
Moderator Dr Sudhir Kumar asked Dr Katragadda if IVF is the only treatment option, or do all couples need IVF? “When do you typically advise IVF, and what is the success rate? Is it 100 percent guaranteed, as some ads claim,” he enquired.
Dr Katragadda said that there are different reasons why a couple may struggle to conceive, and it’s important to start by evaluating the male partner first.
“IVF is one of many options, but it’s not the only treatment available. The decision to proceed with IVF depends on several factors, including the couple’s urgency to conceive and the woman’s age, which is crucial in determining the appropriate course of action,” she said.
She further said that the typical recommendation is to start with simpler treatments before considering more advanced options like IVF, especially if the woman is younger.
“Fertility rates naturally decline with age, particularly after 30, with the most fertile age range being 24 to 27. Many women seek help around the age of 36, but by then fertility may have already declined,” Dr Katragadda said.
She, however, pointed out that the treatment approach depends on the underlying cause of infertility. For instance, if the male partner has azoospermia (no sperm) or a very low sperm count, natural conception may not be feasible, and IVF with advanced techniques like ICSI (Intracytoplasmic Sperm Injection) might be necessary. Similarly, for women with tubal blockages or endometriosis, IVF may be the best option.
“It’s important to understand that IVF is not necessary for everyone, but its indications have broadened over time, making it more common. However, the success rate per cycle is not 100 percent—it’s around 40 to 45 percent. Couples should be cautious of advertisements claiming guaranteed success rates of 100 percent or even 75 percent, as these are not accurate,” she said.
She added that IVF success rates have improved significantly from single-digit percentages 46 years ago to about 40 to 45 percent today. While the chances per cycle are not perfect, the cumulative success rate increases with multiple cycles.
“By the end of three or four cycles, approximately 80 percent of couples can expect to conceive. So, while IVF has a good success rate, it’s important to manage expectations and understand its limitations,” she said.
(Edited by Majnu Babu).
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