Coffee drinking and sexual desire - prostate cancer, bicycle riding and sexual interest, vaginal spotting, penile implants, diet and fertility, spontaneous orgasm - The Doctor's Casebook - column

Nutrition Health Review, Fall, 1990 by Edwin Flatto

Coffee Drinking and Sexual Desire

Q: What causes prostate cancer?

A: Several important environmental and epidemiologic studies

suggest an increased incidence of prostate cancer in association

with certain risk factors. These factors include: (1) exposure to

automobile exhaust fumes or particular air pollution, (Blaire &

Fraumeni, 1978; Kippling & Waterhouse, 1967; Winkelstein &

Kantor, 1969; Winkelstein, 1982) and (2) high fat diet and too much

vitamin C (Blair & Fraumeni, 1978; Graham et al., 1983; Reddy

et al., 1980). The epidemiologic studies have shown an increased

risk for prostate cancer in conjunction with: (1) An increased

number of sexual partners (Schuman et al., 1977; Steele et al., 1971),

(2) frequency of sexual intercourse (Steele et al, 1971, (3) use of

prostitutes (Schuman et al., 1977), (4) extramarital sexual

relationships (Steele et al., 1971) and an early age at onset of sexual

activity (Schuman et al, 1977).

Together, these studies link sexual hyperactivity and promiscuity

with an increased risk for prostate cancer. In contrast, a study

by Ross et al (1981) reported in Catholic priests a slightly higher

incidence of prostate cancer than in controls.

Q: Perhaps my question is ridiculous, but is it possible that

drinking a cup of coffee a day stimulates sexual desire?

I am a 60-year-old female.

A: A recent study at William Beaumont Hospital in Royal Oak,

Michigan, showed that of 185 women who drank coffee, 62%

reported that they engaged in sexual activity, while only 37.5%

of 40 women who did not drink coffee engaged in sexual activity.

Among male coffee drinkers, there was a prevalence of sexual

activity among those who drank at least one cup a day. It is believed

the coffee raised the blood pressure going to the penile arteries.

Q: I'm a long-distance bicycle rider. Is it a coincidence that

I lose sexual interest for weeks after a trip? Can such

activity contribute to sexual decline?

A: It is not the long-distance bicycle riding in itself but the narrow

so-called racing seat that can cause the problem. The wide seat

distributes the body weight to the ischium or lower portion of

the hip bone, whereas the narrow seat puts undue pressure on

the penile arteries causing trauma to the sensory nerve that

governs erection. The resultant ischemia, due to obstruction of

the circulation, can cause permanent changes in the penile arteries

in direct relationship to the perineal trauma.

Narrow bicycle seats should be used for short sprints only, and

the wide bicycle seat should be adapted for all other uses.

Q: I'm a middle-aged woman, not in menopause. Is it

abnormal to experience blood-tinged spotting after

intercourse?

A: There are a number of possible causes of vaginal spotting that

must be ruled out, such as excoriation or abrasion of the epidermis

of the labia of the vagina following intercourse, is common

especially if sufficient lubrication is not present. If this is ruled

out, a "Pap smear" and colposcopy of the cervix and vagina should

be performed to exclude or identify malignancy, premalignant

lesions, or any other irritations. If everything is normal, your

partner should be examined also.

Q: What is your opinion about the use of an implanted penile

device in dealing with impotence in a 50-year-old male?

A: In most cases, I believe that implants are unnecessary and only

if everything else fails should they be considered as a last resort.

A penile implant necessitates major surgery, and like all surgical

procedures, it has risks; may result in unplanned, undesirable

effects; and may cause pain and stress. Impotence is not an

incurable disease. It is also often misdiagnosed. For example, an

organic cause of impotence can be falsely suggested if anxiety

over the testing situation, use of certain medications, smoking,

drinking, or even depression can be the underlying cause. A recent

paper by V. Michal and associates found that 85% of men older

than age 35 complaining of impotence had a penile vascular

pathology that blocked the penile asteries and prevented an

erection. Clearly, a zero cholesterol, low-fat, high-fiber diet should

be the first therapy in these cases. There are many treatment

alternatives to penile implants that should be given an opportunity,

while the results of surgery are often irreversible.

Q: Can diet affect fertility?

A: Studies of animals show that fertility varies in relation to the

food supply. In a study of 66 apparently infertile women at the

University of Toronto, 16.7% had eating disorders; this was twice

the rate to be expected from their age group. Studies of women

during famine or food deprivation, such as war conditions, showed

that not only was fertility lowered, but the women who did conceive

had more pregnancy complications, smaller babies, more

spontaneous abortions, and babies born with lower Apgar scores.

Q: Can women have spontaneous orgasm during sleep?

A: Yes, it is quite common, especially among women who have

hyperactive sexual desire. This may also occur after a romantic

encounter or even after watching a romantic movie or play. There