Mens Health Blog. Medical Blog

posted by admin on Apr 29

Some people make the various steps in sexual knowledge and experience from childhood to maturity much more easily than do others. In this respect the shy introvert typically has greater difficulties that his more robust extrovert contemporaries. The introvert, either boy or girl, is inclined to be timid and embarrassed by matters of sex. As a result he withdraws from it. His knowledge is incomplete, and his emotional and physical contacts with the other sex are limited. He tends to fill in the gaps in his knowledge by daydreaming. His uncertainties and perplexities are increased, and the general level of his anxiety remains high. Strange as it may seem, such a pattern established in adolescence may later persist through marriage.

In an attempt to put an end to his complicated feeling in the matter, the shy introvert not infrequently decides to have a sexual experience. This usually lacks any spontaneous naturalness, and is often preceded by much thought and determination to bring himself to do it. The whole matter is out of character with his general personality, and instead of making things better the experience almost always has the reverse effect. The tension which accompanies it makes it physically difficult, and the sensitivity of the introvert adds guilt to his anxiety. Experience in psychotherapy with young people shows quite clearly that the inhibited introvert of either sex is greatly helped by talking over these matters with an experienced physician or psychiatrist.

I recently had come to me a young woman who was very shy—very nice, attractive in her quiet way, well-mannered, but painfully shy. Her brother is a doctor, and her sister happily married. Her parents, successful and easy in company, were socially ambitious for the girl. But she was held back; she just could not be natural with people. Then with tears and great distress she told me how a boy had touched her sexually, but really quite innocently. “I can never forgive myself.” Then when she had pulled herself together, “How do you know where to draw the line?”

This is a problem that we all must face. She is twenty, but so timid and shy that she draws the line too high. And in her present state this must necessarily be so. We must not forget that different people need different solutions to similar problems according to their individual personality.

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posted by admin on Apr 29

The simple answer to this question is ‘yes.’

Professor H Hippius, formerly chair of psychiatry in Munich, writes:

The 1996 German list of available drugs, the Rote Liste, includes 28 Hypericum preparations. Since these preparations are not chemically defined single-substances or combination preparations, but whole extracts of the St John’s Wort plant, it cannot automatically be assumed that the various medicinal preparations from various manufacturers have the same composition and therefore the same therapeutic efficacy at the same dosage.

I agree with Professor Hippius. In other words, since we do not know which substances in St John’s Wort are responsible for its anti-depressant effects, we cannot assume that all plant preparations are equivalent, even if the amount of hypericin, which is supposedly standardized across different preparations, is the same. I say ‘supposedly’ based on my experience with the use of certain generic anti-depressants. Generic anti-depressants are supposed to have the same amount and quality of the active compound in them as the original brand-name products. Yet I have often observed a relapse of depressive symptoms in patients who have previously been doing very well when they switch from a certain brand-name anti-depressant to its generic counterpart. If different brands of a synthetic compound produced under the supervision of the US Food and Drug Administration result in different clinical effects, how much more reason do we have to doubt the equivalency of different herbal products with their complex combinations of active substances and produced under much looser regulatory conditions? Consider, for example, how wines that are made from the same type of grape will vary in taste not only from one country or region to another but even from vintage to vintage. The substances in the wine that imbue it with its special bouquet and flavour will change with the soil, the amount of sunshine and the rainfall. A similar situation can be expected to apply to the composition of an extract of St John’s Wort, where the variable of interest is not the flavour but rather the anti-depressant effects or the side-effects of the preparation.

Once we acknowledge that herbal preparations are likely to vary in their composition, where does that leave us in terms of choosing the best preparation? At this point there have been no actual studies comparing one type of St John’s Wort preparation to another. Yet most of the research in which the anti-depressant effects of St John’s Wort have been established has been performed using the brand called Jarsin™ produced by the leading German manufacturer of the herbal remedy. This has led clinician and researcher Hans-Peter Volz of Jena in Germany to conclude that ‘taken in sum, the anti-depressive action of Hypericum is only sufficiently documented for Jarsin™.’

The good news is that Jarsin™ is now available over the counter under the brand name of Kira™. It is essentially identical to the German compound and is clearly the brand of choice at this time.

Another reason to use an herbal product known to be made under carefully supervised conditions is that you can feel more confident that there are no potentially toxic contaminants in the preparations, such as have been known to occur in other food supplements. The contaminant in L-tryptophan that resulted in several fatalities in the US was a particularly dramatic case in point.

Some local brands of St John’s Wort are less expensive than Kira™ and for certain individuals the cost difference may be a significant consideration. If this is the case, I would suggest at least starting with the Kira™ brand. If your depression does not respond, you can then be more confident that it is not because of the brand of the herbal remedy but for other reasons. Once your depression does respond to Kira™, if cost is a significant consideration you might then try to switch to a less expensive brand and see if you maintain the same level of anti-depressant response.

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