CME INDIA Presentation by Prof. Dr. Deepak K Jumani ACS(USA), FIAMS, FCSEPI, MBBS(Bom), PhD(USA), MRCPS(Glasgow). Asst. Prof. Dept. of Medicine, Sir JJ Group of Govt Hospitals & Grant Medical College, Mumbai. Consultant, Sexual Health Physician and Counsellor.

Destiny is not in our hands

Destiny is not in our hands. Situations like today – no temples, no Mosques, no churches, no Baba giri no God giris, no gardens, no restaurants, no gyms, no theaters – are also not in our hands but what is in our hands is our choices and we all have wisdom and we are learning to make right choices. Thanks to this lockdown.

Today I am going to share some innovative ideas of Lifestyle which of course include nutrition and inspire you for adapting a novel immune makeover which shall enable all to understand, accept, adapt and experience an ideal sex life.

Enabling good sexual health is a vaccine

  • In today’s scenario where COVIDemic 2019 has assassinated the whole world, the only vaccine which can prevent and enable good sexual health is a vaccine which we already have.
  • That Vaccine is Life style… Believe me all those who are at home following the swachatta and social distancing norms, this “No Vaccine Life style” will not only prevent this COVID19 infection to enjoy good sexual life not only today and also in future attacks of any such pandemics. In fact all those who survived getting COVID till this December end proves that either they have a strong immunity, or they are following strict safety norms of social distancing, wearing masks and sanitizing themselves, (S-SOCIAL DISTANCING, M-MASKS, S-SANITIZATION; – SMS) or have developed herd immunity.
  • Sex is our body’s normal and natural function of our life, like urination, defecation, eating, breathing, heart beats etc. Of all the human urges the urge to have sex is the strongest.

Covid Couple

How is sex life different in this pandemic times?

I shall narrate some of the experiences of my patients who visited me during this COVID times.

[1.] There is currently no evidence that the COVID-19 virus is transmitted through semen or vaginal fluids, but the virus has been detected in the semen of people who have or are recovering from the virus.

[2.] The safest type of sexual activity during the COVID-19 pandemic is masturbation. You are your safest sex partner.

[3.] Some suggest go online and have cyber-sex like video chat, sexting or involving yourself in online sexual activity, gaming etc. But I don’t recommend this as this is imbibing yourself into another health hazard of addiction to this behaviour.

[4.] In partners who are monogamous and are following all the norms of SMS, being at home and have saved themselves from exposure to COVID-19, can have sex with certain mandatory norms:

  • First, before sex you need to take a warm water shower and clean your bodies completely.
  • Second, All the bedsheets, pillow covers also need to be washed with warm water on daily basis.
  • Also, please remember bedroom ethics – bedroom is only meant for sleep and sex so you need to keep it clean and sterile all the time and allow less humans to enter in and avoid doing other activities like watching tv, using mobiles or laptops etc., or eating, drinking in the bed room.
  • Lastly, have a constant rhythm and frequency of your sexual acts like be it once or twice a week. Make it a pleasurable session rather than get into erotic boredom or monotony by doing it several times in a day or week.

[6.] In partners who are polygamous, which is a risky adventure, certain norms have to be followed which are mandatory not only in COVID times but even otherwise.

Most important is to minimize the number of sexual partners you have.

  • Avoid sex partners who have symptoms of COVID-19.
  • Avoid kissing.
  • Avoid sexual behaviours that have a risk of faecal-oral transmission or that involve semen or urine.
  • Use condoms and dental dams during oral and anal sex.
  • Wear a mask during sexual activity.
  • Wash your hands and shower before and after sexual activity.
  • Wash sex toys before and after using them.
  • Use soap or alcohol wipes to clean the area where you have sexual activity.
  • If you do have a partner who is not staying with you or is away from your, safest way is to spend good time on phone, sharing romantic and erotic thoughts and remain connected.

[7.] If you have a working partner who has to go to work, chances are that he or she who is travelling out of home for work may be exposed to COVID and may be asymptomatic. Such partners who travel out to work should take HCQS or Ivermectin as prescribed and also can indulge in sex but following these norms: Hot water shower for both partners before having sex, bed sheets and pillow covers to be cleaned but should wear masks covering the nose and mouth. There is no need to wear condoms if conception is not an issue as we know COVID virus has not been found in vaginal secretions or semen. Deep Kissing in such scenarios even with mask may be risky.

[8.] If you have already some symptoms of COVID and once you confirm having the same avoid physical contact for at least three weeks from the onset of symptoms. Starting with the treatment and eventually when COVID tests come negative, avoid having sex and kissing for one week after its negative and gradually start having sex following all the precautions of taking shower prior to bath and cleaning the bed sheets and pillow covers etc.

  • Do not involve yourself into rigorous sexual activity, as post COVID-19 infection, all the patients, whom we have seen, have a lot of weakness and feel generally low, even the libido is reduced. So, keep the frequency on low scale. May be once in a week or a fortnight.

Covid Couple

[9.] Today we see the number of cases have been increasing, which is mainly due to high scores of testing. This should not alarm us because the good thing is, we have a superb recovery rate as we have superb drugs like Remdesivir, Favipiravir and Toczi to help us to damp this virus. So, if the symptoms are nipped at the budding stage and treatment started right in time, we can cure almost every patient of COVID.

[10.] Some patients are scared of doing the COVID-19 tests as they have fear and anxiety of health authorities coming to their homes and putting banners in their home fronts etc. They also get into stigmatization and start feeling like a victim.

For such individuals, we have the following strategy:

  • We don’t do the COVID-19 tests but we do the following tests: CBC to look for lymphopenia, CRP which is raised, LDH and Serum Ferritin which are raised, and we do HRCT Scan to identify ground glass appearances and CORAD Scores etc. on the scan.
  • These tests are all diagnostic clues of COVID-19 and we start the treatment immediately and do not hospitalize them but yes home isolation is a must.
  • We also arrange oxygen cylinders for them at home and teach them how to start oxygen in case their saturations drop from 96%. We monitor these patients every three days with CBC and CRP and of course the symptoms of fever and cough or breathlessness. Once the CRP is back to almost normal, we repeat their HRCT and we find regression in the ground glass appearances compared to the previous Scans. So, this way we avoid getting them into being stigmatized and also treat their disease.
  • In such patients we refrain them from having sex for at least a month after the starting of treatment.

[11.] Some police men who were working as traffic police had psychogenic Erectile Dysfunction prior to lock down and the reason was their exposure to environment pollution as they were exposed to dust all the time. But during lockdown as there was no traffic and no environment pollution, they did get physiological erection and we studied around twenty cops who were on traffic duty especially young guys – 30 years to 35 years – all of them improved in their sex life. Literature has proven that Environmental pollution is known to cause endothelial dysfunction and I feel if this message is passed on to masses, Erectile dysfunction in younger men due to environment pollution can be cured without medication. This social awareness is a must.

[12.] Sale of Condoms, Use of I pill have increased during the COVID times for obvious reasons because all were encaged at home and wanted to avoid pregnancy.

[13.] Watching porn is on the rise, we have also seen rapes in rural areas of our country during this COVID times.

[14.] Being home all day, every day with a sexual partner with extra free time might mean you’re having sex more often. This can be a great way to build a connection with your partner and reduce stress and anxiety. But it’s important to make sure you’re still taking steps to avoid getting COVID – I mean SMS.

[15.] If you or your partner have some co-morbid condition like Asthma, or any lung or cardiac disease or any kidney disease, diabetes – try and avoid sex as much as possible; not even kissing. Following all SMS try and hold each other and spend some lovely time remembering about your romantic memorable days, play your favourite songs and watch old romantic movies and eat healthier food and you can dance together and do non coital erotic activities to keep yourself sensual and joyful.

[16.] Sexual activity is fine and safer amongst two consenting and monogamous partners if they have not been exposed to COVID virus, but in polygamous relationships or in relationship with unknown partners please avoid anal and oral sex as COVID virus’s presence in semen and vaginal fluid is absent but found in faeces.

[17.] Immunity boosting also helps in Sexual energy boosting. High protein diet, use of L arginine, Glutamine and other antioxidants like lycopene, pine bark extracts, and certain herbal medicines like shilajit, ashwagandha, brahmi all are known to help us not only fight COVID or any other ailments but also boosts sexual energies.

Covid Couple

Final thoughts

  • Lastly, all I can say is that sex is sacred and gift of god to us. But it has to be refined and pleasurable in this challenging times. Our own safety and our partner’s safety are in our hands. We have wisdom and we must hence make right choices
  • COVID-19 is a new illness but has had a tremendous affect on every individual across the globe. Economy has gone for a toss and every individual has been mentally affected by fear, anxiety and uncertainty. The deepest impact is that today our perception in our day-to-day lives have changed. Everyone whom we meet today, we fear that he/she would possibly be having this deadly virus infection and we tend to do something which we never did by desisting from that person – whomsoever he/she may be – in the panic and threat of the imbibed alarm of death.
  • Never in the Medical history, research geared up with such speed in search of the treatment and cure for this COVIDemic. There were several conflicting opinions on certain prophylactic measures. Universally it is understood that this COVID-19 has no cure whatsoever. The anxiety that COVID-19, viral infection, is no less than a death sentence has been deeply engraved in every gyri of our cortex.
  • COVIDemic outbreak has sparked newer pandemics viz, overwhelming information on news and WHO has termed this as “Infodemic.” Conferences and meetings have become digital in the form of webinars – “Webedmic.” Uncertainty and fear which thrive in the presence of sensationalized half-truths, negative sentiments and emotions – “Emodemic.”
  • COVIDemic will soon pass out as nothing remains for ever.

CME INDIA Learning Points

  • “The truth is that we still have more questions than answers” – François Peinado Ibarra
  • There is no concrete evidence that coronavirus disease 2019 can be transmitted via genital and anal contact. It implies that anilingus may represent a risk for infection.
  • Some studies have showed that, the largest amount of virus is present in saliva.
  • We should also consider fecal-oral transmission as virus has been detected in stool samples of infected patients.
  • It will be passed on via kissing and physical touching, which are common practices during partnered sexual activity.
  • Engaging in sexual and intimate activities with partners who live in the same household is safe as long as none of them shows COVID-related symptoms, although it is not 100% verified.
  • Sex during the coronavirus pandemic requires a whole new set of precautions.
  • During sex, wearing a mask is not likely to prevent transmission if one of the partners has COVID-19.
  • Negative emotions are known to negatively affect sexual intercourse.

Suggested Reading:

Impact of the COVID-19 pandemic on the sexual behaviour of the population. The vision of the east and the west. François Peinado Ibarra1,

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