Last update and review: February 14, 2020.
Introduction.
Low carb diets created rampant symptomatic hypogonadism among athletic lean people. Symptomatic hypogonadism means that not only hormone levels are suboptimal, but people do have objective symptoms of hypogonadism.
Objective symptoms of hypogonadism or “low testosterone”.
Sexual function questionnaires insist on morning erections, “sexual thoughts” and on other rather subjective markers. This is unsatisfactory.
Objective symptoms of hypogonadism are the initial trigger that causes dissatisfaction with sexual function. A number of other signs and symptoms, mostly subjective ones, follow.
Delayed ejaculation and loss of sensitivity are two objective symptoms of hypogonadism.
Definition of delayed ejaculation.
Delayed ejaculation (DE) is a recognized condition investigated by researchers in multiple studies.
At The New Neander’s Medical, we define delayed ejaculation as follows:
(a) the patient is bothered by delayed ejaculation;
(b) the patient can not ejaculate when he would like to, be it in 5, in 10, in 15 min or whenever he would like to;
(c) the patient reports subjective reduced arousal or reduced sensitivity.
Thus, we do not impose any specific cut-off time for ejaculation latency to define DE. “Ejaculation latency” is the time it takes to ejaculate.
Causes of DE.
Delayed ejaculation was ascribed to different causes, including somewhat dubious psychogenic or somatic causes (psychological, self-induced, imaginary).
The research of higher quality identified hypogonadism as the most probable cause of delayed ejaculation (DE).
Definition of Hypogonadism:
Hypogonadism is a clinical syndrome characterized by “low levels of testosterone”.
Hormones and drugs that may be causal in DE.
There are other plausible hormonal disorders that may be causal in DE. In a recent review, Chen, 2016, notes an inverse relationship between thyroid hormone levels and ejaculatory latency (i.e. the time it takes to ejaculate). Elevated levels of prolactin is another currently recognized possible cause of delayed ejaculation.
Some drugs may also cause delayed ejaculation. Notably, selective serotonin reuptake inhibitors (SSRIs).
Serotonin (5-hydroxytryptamine, 5-HT) is the most important central neurotransmitter involved in delaying ejaculation. (Corona, 2008).
Some popular dietary supplements and sleep supplements that contain 5-HTP, a direct precursor of serotonin, also can cause delayed ejaculation. Indeed, L-5-hydroxytryptophan (5-HTP) is the immediate precursor of serotonin. It is readily synthesized into serotonin without biochemical feedback (Hinz, 2012).
DE and low carb diets.
Delayed ejaculation and loss of sensitivity during sexual intercourse are relatively common symptoms in people who follow the popular carnivore, ketogenic and low carb diets.
In our consulting practice, we had to deal with several cases where, after switching to a restrictive diet, people started experiencing loss of sensitivity, delayed ejaculation and/or low sex drive. Interestingly, in our sample, there were healthy athletic people who were used to have rather high levels of testosterone and high sex drive.
We also encountered a couple of cases where the loss of sensitivity and delayed ejaculation were caused by excessive exercise.
The good news is that we have a reasonably good understanding of DE associated with restrictive diets and excessive exercise. We believe that the main cause of DE is a mild form of hypogonadism.
Based on our understanding, we designed several protocols that aim at restoring the normal physiologic function. Our protocols worked reasonably well so far, in particular, in healthy athletic men.
Digestive issues, medication, obscure supplements, alcohol, existing or emerging diseases or metabolic impairments can all be contributing factors in mild hypogonadism. They need to be investigated and addressed.
A note.
Some of the text in this article is extracted from our correspondence with our consulting clients. Our consultations at this time are in a written form. The text of this article can give you an idea of how we work.
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