have you ever felt like your genitals
might be getting a little numb or it
takes a little more stimulation than
usual to get you to climax I'm Dr Rena
Malik urologist and pelvic surgeon and
I'm going to be talking about everything
you need to know about decreased
sensation in the genitals first off
let's talk about causes so genital
numbness can show up in a few different
ways you might notice a loss of
sensation in the testicles perineum or
the skin around the penis or the vagina
you might notice a burning or tingling
or needle-like feeling or even coldness
in the genitals or you might see kind of
bluish or purplish skin now why would
this happen I'm going to go over eight
causes of genital numbness the first off
is age unfortunately age is one of the
reasons that you might be noticing that
your genitals are a little bit more numb
just like when you age your muscles and
Bones get older your neurons or your
nerves also get older this means that
specifically your peripheral nerves of
the nerves on the ends and fingertips
and the genitals they can't transmit
signals as effectively as they used to
from when we were younger these nerves
are responsible for sending messages
from different parts of the body
including our genitals to the brain like
hey I feel some pressure or I feel
someone touching me and so when they
stop working well you might notice this
decreased sensation or numbness and this
probably happens because of several
factors like reduced blood flow to the
nerves damage to the cells over time and
even changes in the tissues around those
nerves and how do we know this well in
1997 they looked at What's called the
penile vibratory threshold so they said
okay at what point do people notice
vibration when we start from a really
low setting and they plotted this over
the time of age and you can see here
that that threshold went higher and
higher as you aged and it got worse by
almost five standard deviations by the
eighth decade of Life number two
hormonal changes so it changes like low
testosterone in men or menopause in
women that result in decreased estrogen
levels can also result in changes in
sensitivity in women low estrogen can
cause thinning of the vaginal tissues
which can then affect sensation in the
vaginal Canal number three activities
that put a lot of pressure on the nerves
these can be things like sitting for
long periods of time we saw a lot of
this during covid because people were
sitting all the time at home using a
bicycle seat that tends to put more
pressure on the genitals and the
perineum so certainly a lot of very Avid
bicyclists or even Peloton users May
notice this or even in some cases
wearing really tight underwear or
clothing can sometimes lead to Temporary
numbness now the good news is usually
this goes away now if you're cycling or
you go on really long rides you might
notice that this numbness lasts for some
time now this is because that seat
itself applies pressure on the perineum
and that's the area between either in
women the vagina and the anus or in men
the areas between the scrotum and the
anus anything you're sitting on then
compresses the blood vessels and nerves
that pass through the perineum that then
causes that reduced sensation the next
cause is underlying conditions or
medical problems like diabetes multiple
sclerosis spinal cord injuries or even
skin conditions like lichen sclerosis
all of these can affect nerve function
and cause issues with sensation and
specifically diabetes is a huge one that
most people don't know about but having
poorly controlled diabetes can cause so
many issues with your sex life including
numbness next cause is pelvic floor
dysfunction or stress so when you have
pelvic floor dysfunction sometimes
people develop what's called high tone
pelvic floor dysfunction what that means
is the muscles in the pelvic floor tense
up really really tight and don't relax
and this is just where some people hold
their stress and so if that's occurring
with you and you wouldn't really know it
you might just be stressed you might
have no other symptom except for
numbness and this is because that
tenseness in the muscles then prevents
blood from flowing through to the areas
that need blood flow especially when
it's very very tense and sometimes it
can lead to things like inflammation in
the area and other issues next is
medications so side effects of many
medications can cause some form of
problems with nerve function or numbness
some of these medications include
celegine which is the medication people
take with Parkinson's disease and also
finasteride or antidepressants which
I've talked about previously as having
an impact on ejaculation and orgasm in
small numbers of patients next is a rare
one so I don't want you to take this out
of context but idiosyncratic
masturbation now what that is is when
you're masturbating using the same
technique over and over again usually
with a lot of pressure or using really
rigorous sex toys or vibrators set on a
really high level all of these things
can cause over stimulation and over time
can result in a change in sensation now
again usually this is temporary but if
you're doing it the same way every
single time your body can get used to
that specific stimulation and can have
difficulty enjoying other Sensations and
I've also talked about this in a video
about is masturbation harmful so check
that one out if you want to learn more
next is trauma specifically things like
childbirth in women can cause stretching
of these nerves which can cause some
changes in genital sensation fortunately
a lot of those get better weeks to
months after giving birth also if you
have direct injury to the pelvic area
like having a high impact car accident
or having a fall this can lead to
changes in sensation now if you develop
numbness in the genital area back pain
lower extremity pain as well as loss of
control of your bladder or bowels you
may have developed something called Kata
aquina syndrome now this is extremely
rare but if it does happen it's a
surgical emergency so you need to get to
the emergency room right away and bottom
line if your numbness is constant it's
not improving it's really important to
see a doctor to then get assessed to
make sure that there's nothing more
serious going on and specifically
nothing correctable going on now what
happens when you see the doctor so the
diagnosis of genital numbness is
typically made with a history and
physical in some cases there are other
tests like penile Doppler ultrasounds
that can assess the blood flow to the
genitals or even special screening tests
called biothesiometry and these assess
the sensation on your fingertip as well
as the genitals to vibration a lot of
times you won't get those treatments
because unfortunately there's very few
things that can reverse genital numbness
when it's there however sometimes you
can be referred to a neurologist for
some more additional testing of specific
nerves like the pudendal nerve for men
you also may want to get your
testosterone checked to see if there's
any hormonal abnormalities that might be
contributing to loss of sensation now
what can you do at home if you're
dealing with this problem so treatment
options depend on what the cause is but
you can take some steps to kind of
prevent or reduce the risk of getting
temporary numbness so one is make sure
to take a break from sitting for
prolonged periods try a standing desk
and when you're biking try to use a seat
that's wider in the beak area and wear
padded cycling shorts and you can even
find like ergonomic bike seats that
absorb more shock from the road so that
can minimize pressure on your nerves if
it's due to a medical problem like
diabetes for example it's very important
to get those medical problems under
control for diabetes keep good glucose
control to prevent further damage to the
nerves also if you're having issues
during intercourse there's a few things
I always tell my patients so one you
know it's important to understand the
spinal cord has certain areas that are
sensing types of sensation one is
pressure which is the one that's most
often used when you're having sex but
also temperature and vibration so if
you're having lack of sensation and all
the other things are normal you can try
using temperature which means you may
want to try heating or cooling
lubricants now be careful with these
because they can be irritating so I
always tell people check them on your
arm or your hand to make sure that one
you're not sensitive to them and two
start with really small amounts and
increase as needed you can also try
vibration so there's lots of different
sex toys on the market that you can use
to increase vibration to the area either
during intercourse before and those may
allow you to have better sensation or
reach orgasm or climax faster if you are
worried about pelvic floor abnormalities
or your doctor told you that you have
pelvic floor dysfunction see a pelvic
floor therapist and they can work with
you to determine how to relax certain
muscles and strengthen others so you can
really improve the function of your
pelvic floor so that's not causing any
issues or pressure on the blood flow or
the nerves to the area I hope you guys
found this helpful I see so many
patients who come to me and say you know
what doc it just feels a little bit numb
and it's a hard problem and so I'm sorry
if you're suffering with this if you
enjoyed this video you may want to check
out my video on what causes low libido
and what you can do about it as always
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