Men losing their desire

-“Doctor…My husband does not want to have sex—I’m desperate.”

Claudia X. is a very good looking and charming lady in her early 40s that had decided to stay at home to take care of the couple’s three children while her extremely busy physician-husband toils for long hours in his office. She dared to make that confession to me, as we’ve been good friends for years. She asked me if I had heard about a possible lover in his life, which I denied.

Her husband is not dating another woman. Her husband did not become gay. Her husband still loves and respects her. Something ominous is at play in their couple.

Her husband is just part of a growing cohort of men that refuse to have sex. What was unthinkable just a few years ago is now a reality to contend with. Women have been complaining about the unrestrained lust of men for ages. Well, now they have to face the fact that many of them are just not into it.

The “hypoactive sexual desire” is a clinical complaint that has become more common in offices of primary care practitioners, urologists and psychiatrists. Physicians should first rule out metabolic or hormonal diseases that may affect libido by performing a good clinical examination and order testing. However many patients have normal results and they still don’t want sex. It could be episodic or continuous with varying degrees of physical limitations.

An unusual degree of stress can cause symptoms like fatigue, insomnia and lack of sexual desire in most human beings but it has temporary effects. The myth of “always wanting male” applies only to young, energetic individuals. But when the desire disappears in a middle aged individual, the possibility of sexual monotony and/or a couple crisis must be addressed by professionals.

There are good sex therapists that can discuss possible remedies like:

  1. Techniques to foster contact with one’s body and your companion’s
  2. Develop better foreplay and take more time to raise the libido
  3. Relaxation techniques like Yoga, Aerobics, Meditation
  4. Changes in dietary and lifestyle habits
  5. Use of new intercourse figures, erotic material, toys and lubricants

What do you think? Please tell us.

Don’t leave me alone.

The office romance

-“Doctor…My boss has an affair with a male co-worker—I hate her.”

Alyssa X. is a nice, hard-working middle-aged agent in the downtown office of a national real estate company who also juggles her marriage’s demands. After toiling long hours in the office and outside it (she has to show the units on sale and for rent to customers) she feels she has been neglected. She should have been promoted to a more senior position with better benefits. Lately she has been fuming about the no-so-hidden affair of her boss with a male employee that arrived one year ago, both married and with children.

They spend long hours in her corner office with the door tightly shut; her boss has given instructions to her secretary to never interrupt them and, in case of emergency, text her a message instead of just knocking on the door. She has a big suite with plenty of amenities like a sofa and a stocked fridge; on Thursdays her secretary replenish it with champagne and tasty snacks. They always “work” until late on Fridays, with the pretence of catching up.

In public her behaviour becomes more insulting as she always puts down most of the office employees while invariably, ostensibly praising his work. She looks distracted and has missed a few targets set by the central office. But nobody, including her superiors at headquarters, seems to care about it. A few days ago Alyssa dared to hint at the pernicious effects for the staff of the “in-house distraction” in a water cooler chat, which drew the ire of the philandering lady. Alyssa apologized. The workplace morale of the rest of the staff has been eroded by this situation.

-“What should I do, Doctor? I want to quit,” she said.

-“Mmm…that would only hurt you,” I replied. “What does Human Resources say?”

-“Nothing…as if everything were normal.”

-“Well, perhaps it has not properly entered their focus as they dismiss the rumours as malicious gossip…It’s not illegal to have an affair and should not be anybody’s business…But if it starts affecting the bottom line—”

-“That’s an idea…One of the executives from the main office comes to town next week …He usually inappropriately flirts with me but this time I’ll use that to my advantage …When we go for a coffee in Starbucks, I’ll casually lay the latest sales chart on the table.”

Never underestimate the camouflaged resources of a despondent woman.

What do you think? Please tell us.

Don’t leave me alone.

The manly rebellion

“Where are all the men?” Emily asked. “Where are they hiding?”

-“Men? What men?” Annie retorted.

-“Nice single guys that like the company of women—that’s who.”

Emily grabbed her I-phone to scroll through her latest social feeds.

She shoved the apparatus into Annie’s face, practically fogging the screen.

-“Tell me the truth—is she really prettier than me, eh?”

-“Gosh… Still following him?”

-“Don’t want him to think that he still matters so—“

-“But he does… Gimme that!” said Annie, grabbing Emily’s phone.

Annie clicked “unfollow’ and then “unfriend” in Emily’s Facebook page.

-“There you are…End of story.” Annie said, handing her the phone back.

-“Can still follow him in Twitter—“

-“Whatever—what you’re looking for does not fit in a tart tweet.”

In my novel, Emily, the main character, shares with her deep frustration with Annie, her cousin and confidante: she cannot find a good man to commit. It’s a very common complaint of modern women who, in spite of having earned a well-deserved economic emancipation and social recognition, are unable to translate that personal success in their amorous relationships. They had exhilarating romances, with plentiful sex included, with gorgeous men; but when they tried to upgrade their relationship, men invariably skedaddled.

There is another perspective on this issue. An article in the New York Times describes the rebellion of some men working in Silicon Valley’s high-tech industries against what they consider blatant discrimination and harassment.

Paradoxically enough it is not a movement of old-timers bent on conserving the socio-economic status quo that relegated women to labor positions of lesser recognition and pay for generations. They are mostly young men. They are congregating in chat rooms, message boards, Facebook pages, to complain about the excesses of the “politically correct” attitudes of the Human Resources departments in the still male-dominated tech industry. They are afraid to openly challenge them but their subterranean rebellion is gaining traction, forcing the administrators and investors to pay attention.

There are radical voices that call for outright secession. The MGTOW. To the perennial feminine question of” where are all the good men”, they reply: “back in your 20s, where you left them.” It’s a social movement for men only that has been gaining more public profile in spite of women’s anger. According to their web page, they are willing to have relationships with women but they are dead fast opposed to any kind of serious commitment. It is full of horror stories that resemble the tales of escapees from plantations. It unabashedly supports the choice of many men of remaining single forever.

One well educated lady looked at me intensely a few days ago and told me:

-“Doctor…Are you a secret member of the MGTOW.”

-“No,” I replied. “Why would you say that?”

-“Well, you’ve been separated for years, you like women’s company but live alone…In spite of your charming personality, you stay stubbornly single.”

-“Mmm…You think so?”

What do you want me to say? Some guys might have been engaging in that lifestyle for years without even knowing there were more of them out there.

What do you think? Please tell us.

Don’t leave me alone.

Dating her friend’s Ex

-“Doctor…My girlfriend just dumped him—and I’ve always liked him.”

Amongst the trickiest situations a lady can find herself in modern times is to start dating the former boyfriend or husband of one of her closest friends. And it puts all her counsellors, including us physicians, in a tricky bind.

Unlike many men—who wouldn’t even dither at the real chance of having a romantic tryst with one of his girlfriend’s female buddies—women in general place their close friendship with other women in pride of place. Considering that women are terribly territorial (yes ladies, face the truth), it doesn’t really matter if she had dumped that deadbeat years ago. She still considers him as part of her story and is unwilling to share him in any form except as fodder for continuing criticism and sarcasm in her conversations.

Sandra X. told me about her personal quagmire in my office many years ago. She then proceeded to ask that most dreadful question:” what should I do?” You might be wondering what I said. Surely not a detached: “dunno know.” At the time I was younger and less conservative in my dealings with women.

-“ Well, this is really difficult….But I think that you should be the one that breaks the news to her before even going into the first date with him, eh.”

-“Asking her for permission?”

-“Not that…Just tell her what’s going on and that you’re emotionally torn.”

Following my advice, Sandra told her friend about the possibility of dating her Ex. On hearing the news she got extremely upset, to the point that she never talked to her again. Dismissing her friend’s anger, Sandra went on a date with her former boyfriend. It went so well that they had another one…Then they went on a trip….They finally got married. Now they have a solid family with two beautiful children, something she always wanted.

Sandra was steadfast and valiant in a decision that changed her life forever.Perhaps that valour might be more difficult to muster in our hyper-connected age where you can count on the predictable backlash in all the social media. However I do believe that women are more courageous than men overall; if she believes that he might be a good prospect, she will take that leap of faith.

Les femmes…Celles qui nous poussent a devenir un peu plus courageux.

What do you think? Please tell us.

Don’t leave me alone.

The virtual misogyny

-“Doctor…Most men in my office hate me—not that they say it in my face.”

Kim X. is a successful defense lawyer in one of top law firms in Brickell but in spite of having earned her standing, her male co-workers deeply resent it. Most of the vitriol consisted of whispered asides at the water cooler that she was able to identify; when she showed up men changed the conversation. However she recently had the suspicion that the misogyny migrated online.

The under-representation of women in the top tier of public administration, business corporations and academia has been extensively documented. That concealed discrimination has been buttressed by a workplace culture that discreetly demeans women and their work as objectionable conversations rarely occur in the open. Misogyny is still alive but hides underground. The water cooler setting has been replaced by the computer or the smartphone.

However the use of the digital media leaves an indelible archive behind. Computer experts have refined some machine-learning techniques adapted to explore patterns in large bodies of text, which can quantify some gossip. Alice H. Wu, a student in the University of California at Berkeley, studied more than a million posts from an anonymous online message board known as “Economics Job Market Rumors” that is well visited by the economists.

That forum is completely anonymous and it’s impossible to find out the gender of the person posting a comment, let alone if he/she is an economist. But the subject of each post can be identified by gender: man or woman. Ms. Wu adapted machine-learning techniques to find the terms associated with the posts about men and those about women. Here are the top ones for gals:

  1. Hotter
  2. Lesbian
  3. BB (baby)
  4. Sexism
  5. Tits
  6. Anal
  7. Marrrying
  8. Feminazi
  9. Slut
  10. Hot
  11. Vagina
  12. Boobs
  13. Pregnant
  14. Pregnancy
  15. Cute
  16. Marry
  17. Levy
  18. Gorgeous

The anonymous online discussions of men about women usually involve topics related to their personal behavior, physical attributes or gender issues. In contrast the discussions about men are focused on the field of work or strictly professional issues like job opportunities, career moves or counsel. This data might no be representative of the entire field of economics but an active minority can certainly sour the workplace environment for women.

Gossiping is part of every workplace and we have to deal with it in stride. However the spreading of false or inaccurate information about a colleague can seriously damage her career prospects and skills evaluation process. Once a rumour spreads in an inter-connected place, it takes a life of its own and continues to exponentially grow.

What do you think? Please tell us.

Don’t leave me alone.



She likes it too

-“Doctor… when we make love, he’s the only one reaching a climax—not fair.”

Almost all the physicians—as well as their hairdressers—have at one time or the other heard that complaint from some sexually unsatisfied ladies that we were treating.

One of the most perplexing things we found when we arrived in the USA in 1982 is the evident, contradictory, sometimes even baffling disconnect between the open diffusion and distribution of pornography with the prudish reluctance to maturely discuss about our sex lives. In New York you could gorge on tons of sexual displays in “Peepland” of Times Square but common issues of human sexuality were carefully wrapped in secrecy. And the problem of female insatisfaction did not even register in the radar screen. It seems that other modern societies like Australia share the same social challenges.

In a recent study published in the “Journal of Sex and Marital Therapy” researchers of the Kinsey Institute interviewed more than a thousand heterosexual Australians between the ages of 18 up to 94 years old who dared to talk openly about what they usually hide below the bedsheets. The data showed that only 61.6% of women claimed to reach an orgasm during their sexual intercourses while 85.5% of men claimed they did. Almost 38% of the participating women said that they needed stimulation of the clitoris to reach an orgasm in 75% of the sexual encounters they had had; the investigators said that previous sexual studies did not properly address the issue of clitoral stimulation.

Ian Kerner, a sex therapist and NY Times best-selling author, published a great book titled “She comes first” where he patiently describes the female anatomy and how to safely stimulate sexual receptors all over their bodies. It is a practical tool for the modern man who cares about his partner’s pleasure. However the value of experience and good mentorship cannot be overstated.

Long, long time ago, in a country far, far away (before I became a monk of Medicine) a lady took the time to patiently teach me some anatomy lessons. With the passage of time, my memory ebbs and flows…But on a specially sunny day, some of those memories come back like a bubbly wave of sea water hitting the beach and I feel compelled to sit down to write about it. This is an excerpt from my novel “Madame D.C. Book I – Three Voyages” where I dared to write about a subject that I might not have wanted to openly discuss.  Maurizio, one of my three lead characters, has been clandestinely dating a married lady called Renata who used to work as a lap dancer in a strip club.

“In the beginning, Renata allowed Maurizio to have a straight ride in the enchanting routes of her curvaceous anatomy—like in the opening stages of “Il Giro d’Italia”, the most famous Italian cross-country cycling contest.

After a few races to the finish line, it was time for the mountain techniques. Slowly yet steadily Renata wanted to teach him the secrets of how to make a woman reach the heights of erotic pleasure. The Cima Copi. Cunnilingus.

One day Renata decided to start upgrading his skills to a higher level.

-“Hold it, dear,” said she, pushing him aside when they were naked in bed.

-“What’s wrong? Don’t want to make love tonight?”

-“No, silly…Just want to start in a different way…That’s all.“


-“How about if you give me some kissing? You know where.”

-“What? Freud said that clitoral orgasms were infantile—”

-“Did he really? What the hell did Freud know about pleasure? He talked too much about women but never really listened to one…I wonder what his wife felt about his ballyhooed analysis…I’m sure she never had an orgasm.“

-“Stop it! All right… I’ll do it.”

Maurizio slowly positioned his face in front of her vulva, ready to comply.

-“All mine.” With blind bold strokes, his tongue swiped her vulva.

-“NOOO,” Renata said, pushing him aside. “You’re hurting me—get out.”

He straightened in bed. “What? Didn’t you ask for it?”

-“Of course I did…But you got to do it in a more gentle, methodical way… First you must learn the basics—bring that small mirror on the commode.”

Maurizio handed her the item. She placed it in front of her exposed vagina.

-“All right…This fatty mound is my mons pubis…See it?”

Maurizio twinkled his nose. “Yes, teacher.”

-“Pay attention now…We’re heading south …Here we have the start of the labia majora…See? The exterior is rough, hairy, the interior smooth, oily.”

During her sessions, she teaches him the secrets of feminine pleasure.

He watches. He listens. He explores her hidden, humid architecture. Soon the screaming of ‘la figa calda’— camouflaged by the lullaby of the waters—indicates that her pupil is graduating with Honours.”

What do you think? Please tell us.

Don’t leave me alone.


The red thread of Fate

-“Doctor…We were always meant to be together again—it’s our Fate.”

Sally X. is a retired schoolteacher, widow and grandmother who has married her high school sweetheart after connecting back in a classmates’ reunion. Tom had left his native Miami right after finishing high school and went to work in Houston, Texas. Eventually he married and had two daughters, besides prospering in the oil drilling business. He always remembered Sally.

The “red string of Fate” is a Chinese legend that states that the Gods tie an invisible red piece of thread to the ankles of two people who are eventually meant to be together; it can be elongated to great length and can’t be broken. The goddess Yue Lao, is the lunar deity in charge of fixing marriages.

For the Japanese culture the red string is attached to the pinky fingers of the two persons that are meant to reunite. Unlike other amorous tales, that link is not only for lovers but for the persons we might share a common task with. They claim that there is a direct connection between the heart and the pinky; in other cultures, a promise is sealed by two persons crossing their pinkies.

Three modern films have used this legend as the basis of their scripts:

  1. “Dolls” by Takeshi Kitano
  2. “Sayonara” by Joshua Logan
  3. “El hilo rojo” by Daniela Goggi

There are many Japanese mangas that use this legend to propel their plots.

Sally X., exuberant with her newfound happiness, asked me point blank:

“Don’t you want to reunite with a special woman of your past? Come on.”

For a moment I demurred as I mentally scanned a line up of good memories.

-“ Perhaps…But I’m afraid that we’ve all changed so much over the years.”

What do you want me to say? Even with some kind of common thread, it’s better to let some memories stand as they are, without any scary updates…

What do you think? Please tell me.

Don’t leave me alone?