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Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD

1. “My sex drive is affecting my ability to concentrate.” (Reading this topic might change your career plans from becoming a doctor to becoming a leader.)
2. When will adults grow up, or wise up, regarding sex?

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Q: I am a college student who would like to become a doctor, but my sex drive is affecting my ability to concentrate while studying or in class. I had the same problem in high school, but I had a girlfriend at that time. I noticed that I could focus pretty well for a day or so after we had sex, after which the urge to merge dominated my thoughts . . . if you know what I mean. I've tried masturbation, of course, and it helps to some extent, but it isn't as effective as intercourse. What can I do? Is there a way to suppress libido?

Answer by , MD: Temporarily suppressing libido is possible, but I would not recommend it. Testosterone is the primary hormonal determinant of libido in both men and women. It is possible to reduce its production and/or effects, but you cannot hobble the effectiveness of such a fundamentally important hormone without causing a host of other problems. Testosterone increases some aspects of intelligence, and it is also one of the key underpinnings of our drive to succeed. As I discussed in Why geniuses are often so fond of sex, researchers discovered a link between giftedness (especially the eminently gifted) and prenatal exposure to higher levels of testosterone.

So what can you do? If you haven't already done so, read my relevant postings on this page in my site: I introduce the topic here, and expand upon it in a subsequent posting. Next, read The Science of Sex. In it, I explain how your level of sexual pleasure and gratification from masturbation can equal or exceed what you can obtain from intercourse or oral sex if you masturbate in a few especially gratifying ways that most people never try. If you want to fully restore your ability to concentrate, you must fully satisfy your libido—not just partially satisfy it, which is usually what results from the most commonly employed methods of masturbation. Like hunger and thirst, libido is one of our most basic drives. Ignoring it is all but impossible.

In the discussion mentioned above, I presented what I think are compelling reasons for teaching everyone how to masturbate in ways that feel as good (or better) than sex with a partner. Everyone knows how to masturbate, but most people never figure out how to make it so pleasurable that it is a great substitute for "real" sex. This creates an urge to have intercourse or oral sex with a partner to reap the added pleasure those activities provide compared with typical masturbation methods. This yearning for "the real thing" has one positive effect (enhancing the strength of a bond between a husband and wife), but many negative effects, including:

There is yet another reason why it is advisable to teach everyone how to masturbate so that it is just as pleasurable as intercourse: doing so would reduce the rate at which women are raped and murdered by men. A few decades ago, a myth took root that rape was motivated primarily by the pathological need for rapists to control women, not to derive sexual pleasure from them. I thought this notion was hogwash at the time, and my conviction has strengthened since I read about the work of professors studying this issue who agreed with my premise.

Young men trying to
study often daydream
about more pleasant things.

If rape were about controlling or exerting power over women, then why do rapists preferentially target young women, not grandmothers? Frail old women can't resist as well as young women can, so the grannies are easier to control. Why risk trying to rape a young woman who can kick, bite, claw, and punch much more effectively? Is it just because she looks better? Hell no! Rapists can do what lots of other people do: just turn off the lights and use your imagination! So why do rapists overwhelmingly prefer younger women? Because their vaginas can typically offer more sexual pleasure.** Anyone who truly cares about women and reducing the incidence of rape must come to grips with this unsavory fact. People who understand neuroscience know that the desire for pleasure motivates almost everything we do. It's why people daydream during boring lectures, why they prefer eating cake instead of lettuce, why they would rather read a good novel than a great dictionary, and why they favor countless other things that give our insatiably pleasure-seeking brains what they want: more fun.

** Founding Father Ben Franklin disagreed with me on that point. Franklin was indisputably a scientific genius and polymath with a sex drive in overdrive, like other geniuses such as Albert Einstein, Richard Feynman, Erwin Schrödinger, Marie Curie, and Robert Oppenheimer. One of the many topics he wrote about was how aging affects the bodies of women, including their vaginas and the pleasure they can impart to men.

If rapists were motivated primarily by the need to control women, there is no great antidote to magically erase that compulsion. Fortunately, rapists motivated by pleasure could be taught how to substitute other activities to satisfy their sexual cravings. Since it isn't possible to predict in advance who will and who will not become a rapist, the advanced methods of masturbation that I alluded to above should be taught to every student as part of the sexual education curriculum.

Everyone who follows the news knows that there is a pressing need for new strategies to combat the rape and murder of young women. Every day, countless sickos rape young women and often murder them afterwards. While some people might object to talking about masturbation methods in school, what is more objectionable: discussing that, or risking the rape and murder of innumerable women in the future? The next woman raped may be your daughter, sister . . . or you.

The prospect of a life sentence is not a sufficient deterrent for rapists. Our retributive legal system does not adequately deter people from crimes motivated by pleasure, such as rape and drug use. The "just say no" approach doesn't work. Neither does the "we'll lock you up for years" approach. So what would help? Offering alternatives that serve as satisfying substitutes for cravings that won't take no for an answer. (Incidentally, if you are tempted to use drugs for the euphoria they can provide, read Fascinating Health Secrets for legal and healthy ways to get a buzz.)

However, don't hold your breath waiting for politicians, educators, or religious leaders in the United States to adopt such a commonsense approach. If you haven't already noticed, our "leaders" are rarely the ones leading. Instead, they spend their careers hiding behind what they think are the most palatable veneers of acceptability. Talk about methods of masturbation in school? Heavens no! A "leader" who broached such a contentious subject would be viewed more negatively than "leaders" who never proposed any novel ideas in their careers, such as how to combat the rape and murder of women.

Most of you never witness the devastating aftermath of rape. As an ER doctor examining rape victims minutes to hours after their lives were indelibly changed, I've seen women in this tragic time. If you had the same ringside seat as I did, you would be more likely to share my urgency for implementing a new means to prevent rape. So rather than waiting for our "leaders" to lead, why don't you lead? Print this topic and the last one mentioned above in my site, and show it to your "leaders." They can say yes, or they can say no. If they say no, press them to explain why, and keep pressing them, because they will never be able to offer a justification that is more important than preventing rape. If the "leader" is hidebound and prefers the cowardly "let's just keep doing what isn't working" approach because he is more concerned with dodging hot potato issues than with doing the right thing, fire that "leader" and find someone who truly can lead. You, perhaps?

In discussing how sex is part of medicine, I mentioned how laughably immature many Americans are in regard to sex. The price for that immaturity is usually paid by individuals who cannot deal with sexual matters in a mature, adult-like, matter-of-fact way. Instead, they erect all sorts of bizarre rules about what is permissible and what is verboten, all of which make sense only to people who reek of neuroticism. (BTW, I offered $300,000 as an inducement to the first person to prove me wrong on this matter, and no one has even bothered to apply because I obviously have valid points.)

However, childish adults who get hives from adult discussions of sexual matters have made leaders and others afraid to broach topics, such as masturbation, that could unquestionably reduce the rate of rapes and murders that sometimes result from them. (See my article, PC police thwarting a remedy for rape.) The people who shy away from this topic are contemptibly spineless. Think of the women who were, or likely were, raped, such as Elizabeth Smart, Tara Grinstead, Jennifer Kesse, and missing nursing student Holly Bobo.

Millions of women have been raped, and before this day is over, many more will join the list. Punishment clearly is not a sufficient deterrent. I have a viable prevention strategy, but spineless and/or brainless people would rather see more women raped than to discuss masturbation in an adult-like manner. Such a discussion would have other benefits, too, such as reducing the divorce rate by making people less likely to rush into marriage for the wrong reason.

President Clinton fired Surgeon General Joycelyn Elders for suggesting that teaching about masturbation might reduce riskier forms of sexual activity, which it obviously would. Clinton's sexual rules did not prevent him from getting a blowjob in the White House from a young woman, and many of our politicians do things which make that seem downright normal. They'll do those scandalous things, but when a Surgeon General discusses masturbation, it is justification for firing her?


And the rapes and STDs go on, and on, and on.

When will we grow up, or wise up?

Yes, I know: many folks pat themselves on the back for being good people because they treat sex as if it is shameful instead of being a part of life as normal as your appetite for tasty food. More than a few of them think God will judge them more favorably for sweeping sex under the rug, but God wants people to help others as much as possible. Patting yourself on the back for treating sex like immature children is never preferable to doing something that would reduce the rate of rapes and murders, so anyone who wishes to fool themselves is a self-centered fool. God will not pat those folks on the back, he will kick them in the butt.

So, to repeat myself: When will we grow up, or wise up?

Greater sexual knowledge strengthens the bond between a man and a woman, which makes them less likely to divorce or be unfaithful. Every smart and wise pastor (etc.) should therefore champion this cause and foster sexual enlightenment to replace lingering taboos that are silly and counterproductive.

Greater sexual knowledge does nothing to encourage infidelity; in fact, it can help combat it. A neighbor as cute as Jessica Alba once kissed me unexpectedly when I had my eyes closed (so I couldn't fend off the kiss). She was a kissing superstar, on par with the other three I've known. I still don't fully understand why the pleasure of kissing is so variable, with some women giving dozens of times more pleasure.

It is definitely not a function of attractiveness. I went on one date with a woman I found unattractive and uninteresting. After a few hours of boredom, I was eager to go home, but she kissed me. I'd never before felt anything even remotely comparable to that kissing pleasure, so we kissed for hours. I then went through years of kissing duds, some very attractive, with so little receptive pleasure of kissing that I wondered if my lips had gone to sleep permanently. Then this Jessica Alba clone kissed me. Did her off-the-scale appearance and kissing ability encourage me to be unfaithful to my girlfriend, or even to go for another kiss? Absolutely not. I immediately let her know in no uncertain terms that I didn't welcome the kiss. Therefore, while I am very open about sex (something my medical school professors encouraged), I have zero desire to cheat even when given a temptation few men could resist.

Divorce is even more damaging to children than adults, so wise and responsible adults should do everything possible to minimize the risk of divorce and infidelity, yet most don't.

So, to repeat myself: When will we grow up, or wise up?

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