Are You a Workaholic?

You might as well face it -- you’re addicted to work. Could your workaholism be hurting you?

By Neil Osterweil
WebMD Feature

Reviewed by Louise Chang, MD

On the seventh day, even God rested.

But for workaholics, the day of rest never comes. There is always one more email to read, one more phone call to take, one more critically important trip to the office that can't wait until Monday.

Weekends? Holidays? Family? As the uber-workaholic Ebenezer Scrooge put it, "Bah, humbug!"

"It used to be that I never went on vacation without my laptop and a couple of beepers," says George Giokas, who describes himself as a "reformed" workaholic. When he was starting his company, StaffWriters Plus, in the pre-BlackBerry mid-1990s, Giokas spent more than a few late nights and nearly every Saturday at the office, he tells WebMD.

As he confessed to the online edition of Business Week in 1999, "I've struggled with the weekend issue many times, trying to figure out why I absolutely have to work then. It must be ingrained in me to the point of being a kind of addiction -- like going to the health club every day. If I miss one day, I feel awful."

But Giokas has since learned that the problems that pop up when he's away from the office will still be there when he gets back, and that what happens in the office stays in the office.

"I'm not the sort of person to bring home problems," he says, "and I don't dwell on issues. I get a pretty good night's sleep."

Workaholism: A Life Out of Balance

Not every workaholic, however, is able to achieve the balance that Giokas has found.

Justin Blanton, who practices law in California's Silicon Valley, tells WebMD that he is a workaholic and that the problem has only gotten worse in the four years since he wrote the following on his blog:

"Whether I'm reading a Harry Potter book on my PDA while waiting in the deli line, checking email on my phone as soon as my date makes for the ladies room, or heading back to my computer each commercial break (no TiVo… yet) -- I'm always checking something."

"It's gotten worse in the sense that it hasn't let up at all, and I feel more compelled to be busy," Blanton says today.

In a culture that prizes work ethic, overachievement, and financial success -- where gazillionaires such as Warren Buffett and Bill Gates are household names, and Donald Trump has his own television show -- people who are addicted to working are seen by outsiders as smart, ambitious, and entrepreneurial.

"The system is almost built to reinforce workaholics," says Simon A. Rego, PsyD, associate director of psychology training at Montefiore Medical Center in New York City. "Those are the people who end up getting positive job evaluations, get opportunities for promotion, and see themselves getting bonuses or raises. It's almost like the system has a built-in model to give them free hits of what they're addicted to."

Even when out of the office, workaholics can satisfy their cravings with cell phones, PDAs, laptops, and WiFi, which ensure that work need never be out of reach.

But blaming technology for workaholism is like blaming the supermarket for food addiction or the corner liquor store for alcoholism, says Bryan E. Robinson, PhD, author of Chained to the Desk: A Guidebook for Workaholics, Their Partners and Children, and the Clinicians Who Treat Them.

Robinson and other clinicians who treat patients for work-associated stress say that working hard and having easy access to work does not automatically make someone a workaholic.

"It's important to understand the context," says Edmund Neuhaus, PhD, director of the Behavioral Health Partial Hospital Program at McLean Hospital in Belmont, Mass. "If you're working to the exclusion of your family, your marriage, other relationships, and your life is out of balance, or your physical health is out of balance -- when work takes an exclusive priority to everything else, that's the more extreme end of the spectrum where it becomes a problem," Neuhaus tells WebMD.

"The preoccupation with work is really at the core of what workaholism is," says Robinson, professor emeritus at the University of North Carolina, Charlotte, and a psychotherapist in private practice in Asheville, N.C. "I always say that the difference between someone who's a true workaholic and someone who's just a hard worker is that the workaholic is on the ski slopes dreaming about being back at work, and the hard worker is in the office dreaming about being on the ski slope."

Workaholism is remarkably similar to alcoholism in some ways. Just as an alcoholic will hide bottles around the house and drink furtively, for example, workaholics may try to sneak in work when they think no one is looking.

"It's something that I did in the throes of my own work addiction, and when I think about it now it sounds pretty sick," Robinson says. He once hid some work papers in his jeans after his family went through his suitcase looking for his secret stash while packing for a trip to the beach, he tells WebMD.

Other key signs of workaholism are:

• Trouble delegating work (workaholics tend to be control freaks and micro-managers)
• Neglecting other aspects of one's nonworking life (like the dad who never has time to attend Junior's school play)
• Incorporating other aspects of life into work (such as trying to turn a hobby into a new business)

Workaholics: All Work and No Play

A workaholic might seem to be every CEO's dream: an employee who comes in early, stays late, doesn't take vacations, and takes on mountains of work. But those very qualities may make the workaholic a poor candidate for employee of the month because they often have more work than they can handle effectively, don't delegate, aren't team players, and are often more disorganized than their less compulsive colleagues, Robinson says.

In addition, workaholics may refuse to take time off, even when their work performance is affected -- although here cultural expectations and financial realities may come into play.

"People are afraid to take vacations because they're afraid that with all the downsizing and the economy being what it is that they'd be the first to go," Robinson says.

"I train residents at McLean Hospital," Neuhaus says, "and I tell them, 'You have to take vacations. Go away. You're not going to be any good to me if you don't take vacations.'"

Are Workaholics Hurting Their Health?

Like other forms of addiction, workaholism can have significant health consequences, experts say, including significantly higher work-related stress and job burn-out rates, anger, depression, anxiety, and psychosomatic symptoms such as stomachaches and headaches.

Despite the symptoms, workaholics may be in deep denial about their addiction, like a severely emaciated teen with anorexia who looks in the mirror and sees herself as obese.

Montefiore's Rego tells WebMD that workaholics often need prodding from family and friends to seek help when "the seesaw of life is tilted too much toward work."

One highly effective treatment is cognitive behavioral therapy, a form of psychotherapy focused on identifying and modifying negative thoughts and thought patterns.

"The workaholic might have a set of beliefs about the value of work which are misguided," Rego says. "And if you can intervene cognitively -- not to correct or get rid of them, but just make them a little more rational -- you might see a change in the behavior and consequent stress reaction."

Robinson helps workaholics develop a self-care plan examining five aspects of their lives: work, relationships, play, self, and spiritual life.

"This helps them see in black and white where their lives are lacking," Robinson says.

He also helps patients understand that they don't have to go cold turkey or quit their jobs, but find a balance in their lives and identify what's most important to them, whether it's family, friendships, religion, or beliefs.

Workaholics Anonymous, a national support group modeled on Alcoholics Anonymous and other 12-step programs, publishes on its web site a list of questions that can help you determine whether you are a certified workaholic or just unusually diligent. Positive answers to three or more of the questions may signal the need for help. The group hosts meetings around the country where people with similar problems can share ideas anonymously and provide support and solutions that will help them balance their lives.

Comprehensive sex ed may cut teen pregnancies

By Amy Norton Mon Mar 24, 4:08 PM ET

NEW YORK (Reuters Health) - Comprehensive sex education that includes discussion of birth control may help reduce teen pregnancies, while abstinence-only programs seem to fall short, the results of a U.S. survey suggest.

Using data from a 2002 national survey, researchers found that among more than 1,700 unmarried, heterosexual teens between 15 and 19 years old, those who'd received comprehensive sex ed in school were 60 percent less likely to have been pregnant or gotten someone pregnant than teens who'd had no formal sex education.

Meanwhile, there was no clear benefit from abstinence-only education in preventing pregnancy or delaying sexual intercourse, the researchers report in the Journal of Adolescent Health.

The study found that teens who'd been through abstinence-only programs were less likely than those who'd received no sex ed to have been pregnant. However, the difference was not significant in statistical terms, which means the finding could have been due to chance.

In addition, there was no evidence that comprehensive sex education increased the likelihood of teen sex or boosted rates of sexually transmitted diseases (STDs) -- a concern of people who oppose teaching birth control in schools.

While comprehensive sex ed did not clearly reduce the STD risk, there was a modest, but statistically insignificant reduced risk of engaging in sex. The abstinence-only approach had no effect on either factor, the researchers found.

"The bottom line is that there is strong evidence that comprehensive sex education is more effective than abstinence-only education at preventing teen pregnancies," said lead researcher Pamela K. Kohler, of the Center for AIDS and STD at the University of Washington in Seattle.

She told Reuters Health the study "also solidly debunks the myth that teens who learn about birth control are more likely to have sex."

Currently, the federal government champions the abstinence-only approach, giving around $170 million each year to states and community groups to teach kids to say no to sex. This funding precludes mention of birth control and condoms, unless it is to emphasize their failure rates.

Critics have long pointed out that studies have failed to show that abstinence-only education delays sex or lowers rates of teen pregnancy.

The current study is the first to compare the effects of comprehensive sex ed and abstinence-only education in a national survey, Kohler noted.

Of the teens in the study, two thirds said they had received comprehensive sex education, while about one quarter had had abstinence-only courses. Just under 10 percent said they'd received no formal sex education.

There is now a body of evidence showing that the comprehensive approach may cut the odds of teen pregnancy, without increasing the likelihood of teens having sex, according to Kohler.

However, she added, "there seems to be a gap between scientific evidence and policy change."

SOURCE: Journal of Adolescent Health, April 2008.

Balance in Old Age Tied to Brain Changes

TUESDAY, March 18 (HealthDay News) -- The severity of age-related changes to white matter in the brain affects how well older people are able to move around and keep their balance, a new study says.

White matter changes -- called leukoaraiosis -- are common in older people.

The study participants included 639 women and men, ages 65 to 84, who underwent walking and balance tests, along with brains scans. The scans revealed that 284 of the volunteers had mild age-related changes to their brain's white matter, 197 had moderate changes, and 158 had severe changes.

Compared to those with mild changes, people with severe changes were twice as likely to score poorly on the walking and balance tests and twice as likely to have a history of falls. Participants with moderate changes were 1.5 times more likely than those with mild changes to have a history of falls.

The findings of the three-year study were published in the March 18 issue of the journal Neurology.

"Walking difficulties and falls are major symptoms of people with white matter changes and a significant cause of illness and death in the elderly," study author Dr. Hansjoerg Baezner, of the University of Heidelberg in Mannheim, Germany, said in a prepared statement.

"Exercise may have the potential to reduce the risk of these problems, since exercise is associated with improved walking and balance. We'll be testing whether exercise has such as protective effect in our long-term study of this group," said Baezner, who noted that mobility problems in older people often lead to hospitalization and nursing-home placement.

Monitoring white matter changes may assist early identification of walking problems, which have been linked to other health issues.

"Recently, gait abnormalities have been shown to predict non-Alzheimer's disease dementia, so recognition, early diagnosis and treatment of this disabling condition may be possible through early detection of walking and balance problems," Baezner said.

The causes of white matter changes and the reasons why it's worse in some people aren't fully understood. However, researchers have found evidence of a link to insufficiently treated high blood pressure.

Good marriage equals good blood pressure

By MALCOLM RITTER, AP Science Writer Thu Mar 20, 7:59 PM ET

NEW YORK - A happy marriage is good for your blood pressure, but a stressed one can be worse than being single, a preliminary study suggests.

That second finding is a surprise because prior studies have shown that married people tend to be healthier than singles, said researcher Julianne Holt-Lunstad.

It would take further study to sort out what the results mean for long-term health, said Holt-Lunstad, an assistant psychology professor at Brigham Young University. Her study was reported online Thursday by the Annals of Behavioral Medicine.

The study involved 204 married people and 99 single adults. Most were white, and it's not clear whether the same results would apply to other ethnic groups, Holt-Lunstad said.

Study volunteers wore devices that recorded their blood pressure at random times over 24 hours. Married participants also filled out questionnaires about their marriage.

Analysis found that the more marital satisfaction and adjustment spouses reported, the lower their average blood pressure was over the 24 hours and during the daytime.

But spouses who scored low in marital satisfaction had higher average blood pressure than single people did. During the daytime, their average was about five points higher, entering a range that's considered a warning sign. (That result is for the top number in a blood pressure reading).

"I think this (study) is worth some attention," said Karen Matthews, a professor of psychiatry, psychology and epidemiology at the University of Pittsburgh. She studies heart disease and high blood pressure but didn't participate in the new work.

Few studies of the risk for high blood pressure have looked at marital quality rather than just marital status, she said.

It makes sense that marital quality is more important than just being married when it comes to affecting blood pressure, said Dr. Brian Baker, an associate professor of psychiatry at the University of Toronto.

Anxiety Helps Elderly Women Live Longer

FRIDAY, March 14 (HealthDay News) -- Higher anxiety levels may help elderly women live longer, but may harm older men, U.S. research shows.

A team at the Cleveland Clinic and Case Western Reserve University followed 1,000 seniors in three Florida retirement communities for up to 15 years.

They found that women with higher levels of anxiety at the start of the study lived longer than others. Year-to-year changes in anxiety levels didn't appear to affect women's survival, either.

In contrast to women, men with higher anxiety levels at the start of the study were more likely to die earlier, the researchers said.

"Our research indicates that anxiety may have a protective effect on women, possibly causing them to seek medical attention more frequently than men," Dr. Jianping Zhang, of the department of psychiatry and psychology at the Cleveland Clinic, said in a prepared statement. "In contrast, increasing anxiety over time is more detrimental to men. Additional research is needed to better understand the mechanisms and effects of anxiety in men and women."

The study is noteworthy due to the large amount of data collected over a long period of time, noted co-researcher Dr. Leo Pozuelo, who is also in the department of psychiatry and psychology at the Cleveland Clinic.

"Baseline higher anxiety could have led the female study participants to be more active and health-conscious," Pozuelo said in a prepared statement. "We are not certain of the absolute connection between anxiety and mortality, but this data set shows there may be a gender difference."

The study was to be presented Thursday at the annual meeting of the American Psychosomatic Society.

1 in 4 US teenage girls have had a sexually-transmitted disease: study

Wed Mar 12, 4:44 AM ET

CHICAGO (AFP) - One in four teenage girls in the United States has been infected with at least one sexually transmitted disease, according to a study released Tuesday by the Centers for Disease Control and Prevention.

The first study to examine the combined national prevalence of common STDs among adolescent women in the United States estimates that at least 3.2 million teens aged 14 to 19 are currently infected.

Since the study only tested for the four most common sexually transmitted diseases, it is possible that the total prevalence among US teens is greater than the study's rate of 26 percent, the authors warned.

"Today's data demonstrate the significant health risk STDs pose to millions of young women in this country every year," said Kevin Fenton, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

"Given that the health effects of STDs for women -- from infertility to cervical cancer -- are particularly severe, STD screening, vaccination and other prevention strategies for sexually active women are among our highest public health priorities."

Half of the 838 girls who participated in the study reported ever having sex and of those, 40 percent were infected with an STD.

African American girls were particularly at risk: 48 percent of all African American girls were infected with an STD compared to 20 percent of white teens tested.

The most common STD overall was human papillomavirus, or HPV, with an infection rate of 18.3 percent.

Chlamydia was discovered in 3.9 percent of the teens, trichomoniasis in 2.5 percent and herpes in 1.9 percent.

Among teens who had an STD, 15 percent had more than one.

Infections rate rose to 50 percent among girls with three or more partners while 20 percent of those who had only had sex with one person had been infected.

"High STD infection rates among young women, particularly young African-American women, are clear signs that we must continue developing ways to reach those most at risk," said John Douglas, director of the CDC's Division of STD Prevention.

"STD screening and early treatment can prevent some of the most devastating effects of untreated STDs."

The CDC recommends HPV vaccination for all girls and women between the age of 11 and 26 and annual Chlamydia screening for sexually active women under the age of 25.

While most HPV infections will clear on their own, some will persist and can cause cervical cancer.

Two other studies released Tuesday found inadequate screening of high-risk teens.

The first found that just 27 percent of young women seeking emergency contraception were screened for chlamydia or gonorrhea.

The second found that only 38 percent of young women receiving contraceptive services associated with unprotected sex such as pregnancy tests were offered STD testing, counseling or treatment.

Are fat moms to blame for fat kids? Answer unclear

Tue Mar 11, 2:28 AM ET

WASHINGTON (Reuters) - British researchers who tried to show why overweight mothers tend to have overweight children said on Monday they had filled in one small piece of the puzzle.

Their reassuring finding: women who are too fat when pregnant are probably not somehow driving the obesity epidemic by programming their children to be fat.

But there is a strong link between overweight mothers and overweight children that still needs to be explained, Debbie Lawlor of Britain's University of Bristol and colleagues said.

Lawlor's team looked at the developmental overnutrition hypothesis -- the idea that if a woman is overweight during pregnancy, the higher levels of sugar and fatty acids in her blood would affect the developing fetus, dooming or at least predisposing the child to poor appetite control and a slower metabolism.

"The offspring of these mothers would be expected to be programmed to become more obese themselves," Lawlor's team wrote in their report, published in the Public Library of Science journal PLoS Medicine.

They studied 4,091 mothers, their children born in 1991-1992 and the fathers of these children. They also studied the DNA of everyone, height, weight and body mass index, which is a measurement of obesity, as well as smoking, education and other factors.

They did find that if a child became overweight by age 9 or 11, the mother was more likely to have been overweight or obese than was the father.

Then they looked at one gene that may explain this association -- the "fat mass and obesity associated," or FTO gene. FTO has been shown to predispose people to type 2 diabetes if they are overweight.

They found that people with certain variants of FTO are more likely to become overweight. Inheritance from the mother appeared to have a stronger effect, although why was not clear.

"At this stage, the exact mechanisms by which FTO results in increased BMI are not known. Consequently, we cannot discount it having an effect via dietary and physical activity behaviors," Lawlor's team wrote in the report, available online at http://medicine.plosjournals.org/perlserv/?request=get-document& doi=10.1371/journal.pmed.0050033.

What they did conclude was that obese mothers are unlikely to be driving a growing obesity epidemic by having babies who are metabolically programmed to get fat as they get older.

But mothers are somehow involved in other ways, they added.

In a commentary, Frank Hu of the Harvard School of Public Health said the study was unable to disprove the overnutrition hypothesis.

Hu said the obesity epidemic is clearly alarming and other researchers should be doing studies like Lawlor's to make sure that a "vicious cycle" of obese mothers, children and thus grandchildren is not somehow causing it.

(Reporting by Maggie Fox, Editing by Philip Barbara)

Ex-model Waris Dirie found in Belgium

AP Photo: Waris Dirie poses during a photocall at the 'Women's World Awards' in Hamburg, Germany,in...

By PAUL AMES, Associated Press Writer Mon Mar 10, 7:42 AM ET

BRUSSELS, Belgium - Police on Friday found Waris Dirie, three days after the Somali-born model who launched a worldwide campaign against female genital mutilation had vanished.

Dirie, 43, appeared to be in good health and was being questioned by police about the disappearance, said Estelle Arpigny, a spokeswoman for the prosecutor's office.

She declined to give further details, saying it was unclear what had happened since Dirie vanished early Wednesday. Belgian media reports said police found her Friday afternoon walking the Brussels' Grand Place square.

Hours earlier, police had announced they were launching a nationwide search for the former model, who had last been seen getting into a cab after a mix-up over a hotel.

Dirie gained international fame as a model posing in Chanel ads and acting in the 1987 James Bond movie "The Living Daylights" before launching her campaign against female genital mutilation in 1996.

She shocked the world with a best-selling book "Desert Flower" that described how her genitals were sliced off with a dirty razor blade without anesthesia, and then stitched together.

Now a U.N. goodwill ambassador, she was due to speak on genital mutilation in Brussels at two conferences on women's rights organized by the European Union, including one on Thursday attended by Secretary of State Condoleezza Rice.

News of Dirie's disappearance came a week after French police said they had found the body of another former model of African origin who had campaigned against female genital mutilation. Guinean-born Katoucha Niane was discovered floating in the River Seine in Paris.

The French police said an autopsy showed no signs of foul play, raising the possibility that she may have fallen accidentally into the river. However, Katoucha's family members say they suspect homicide.

Dirie's manager, Walter Lutschinger, said she had been involved in an altercation in a hotel reception area after a taxi driver took her to the wrong branch of the Sofitel hotel chain. The police were called and drove Dirie around Brussels looking for the correct hotel because she had apparently forgotten where she was staying.

At one hotel, while staff and police were checking for her name on a computer, Meilleur said Dirie stepped out saying she planned to buy cigarettes from an all-night kiosk, but instead climbed into a taxi and drove away.

An Austrian citizen, Dirie was attacked in her Vienna apartment in 2004 by a Portuguese handyman who had stalked her. The man was given a five-month suspended sentence by an Austrian court.

___

Associated Press writers Constant Brand and Aoife White in Brussels and George Jahn in Vienna contributed to this report.

___

On the Net:

Waris Dirie Foundation: http://www.waris-dirie-foundation.com

Ginkgo biloba may protect memory: study

NEW YORK (Reuters Health) - Taking the herbal supplement ginkgo biloba may help delay the onset of cognitive impairment in normal elderly adults, according to a study published online Wednesday.

However, the study also showed a higher incidence of strokes and "mini-strokes" in ginkgo users. The reasons for this are unclear and require confirmation in other studies, the investigators say.

Extracts of ginkgo biloba are among the most widely used dietary supplements. The herb is marketed as a memory enhancer, and some studies have suggested it may help improve memory and other mental functions in people with dementia.

"One of the most pressing public health problems facing our society is the rapidly growing number of people who, due to their age alone, are at high risk of developing dementia. The potential to delay or prevent this is of great importance," study chief Dr. Hiroko H. Dodge, from the Oregon State University in Corvallis, said in a statement.

The three-year study involved 118 people age 85 and older with no memory problems. Half of them took ginkgo biloba extract three times a day and half took a placebo.

During the study, 21 people developed mild memory problems, or questionable dementia: 14 of those took the placebo and 7 of those who took the ginkgo extract. Although there was a trend favoring ginkgo, the difference between those who took ginkgo and those who took placebo was not statistically significant.

However, when the researchers took into account whether people followed directions in taking the study pills, they found that people who reliably took ginkgo had a 68 percent lower risk of developing mild memory problems than those who took the placebo.

"These results need to be clarified with larger studies, but the findings are interesting because ginkgo biloba is already widely used, readily available, and relatively inexpensive," Dodge said.

As noted, more strokes and mini-strokes were seen in the ginkgo group. Seven people taking ginkgo had strokes, while none of those taking placebo did. "Ginkgo has been reported to cause bleeding-related complications, but the strokes in this case were due to blood clots, not excessive bleeding, and were generally not severe," Dodge noted in a statement.

"Further studies are needed to determine whether ginkgo biloba has any benefits in preventing cognitive decline and whether it is safe," he added.

SOURCE: Neurology, online February 27, 2008.

Your Brain on Creativity

To Get Your Creative Juices Flowing, Your Inner Critic Must Hush

By Miranda Hitti
WebMD Medical News

Reviewed by Louise Chang, MD

Feb. 29, 2008 -- For creativity to have a chance, the brain needs to get out of its own way and go with the flow.

That's the bottom line from a new study on creativity.

The study included six full-time professional jazz musicians. They got their brains scanned while playing a scale or a memorized jazz piece exactly as written and again when they were free to improvise, riffing off the assigned music.

When they improvised, the brain's dorsolateral prefrontal and lateral orbital regions were far less active -- and another brain area, the medial prefrontal cortex, was more active.

The brain regions that were quiet during improvisation are involved in consciously monitoring, evaluating, and correcting behaviors, write the researchers.

In contrast, the medial prefrontal cortex allows self-expression, in this case in the form of jazz improvisation, according to the study.

But creativity isn't just about self-expression. The brain's sensory regions were more active during improvisation.

"It's almost as if the brain ramps up its sensorimotor processing in order to be in a creative state," researcher Charles Limb, MD, says in a news release.

"One important thing we can conclude from this study is that there is no single creative area of the brain -- no focal activation of a single area," says Allen Braun, MD, in the news release. "You see a strong and consistent pattern of activity throughout the brain that enables creativity."

Limb, who wrote the jazz piece that the musicians memorized, worked on the study while he was a research fellow with the National Institute on Deafness and Other Communication Disorders (NIDCD). He's now an otolaryngologist at the Johns Hopkins University School of Medicine and a faculty member at Johns Hopkins' Peabody Conservatory of Music.

Braun, who worked with Limb on the study, is the chief of the language section in the NIDCD's intramural research division.

Why men lose interest in sex -- and 8 tips to rekindle desire.

By Susan Seliger
WebMD Feature

Men don’t like to talk about it; neither do their partners. But loss of libido in men or inhibited sexual desire stresses a marriage more than any other sexual dysfunction, according to Barry McCarthy, co-author of Rekindling Desire: A Step by Step Program to Help Low-Sex and No-Sex Marriages.

Losing interest in sex may not be as common an occurrence for men as it is for women: It affects about 15% to 16% of men, and at least double that many women. “But when men lose interest in sex it scares them more than women -- their masculinity is so linked to their sexuality that it is very threatening,” says Esther Perel, a couples therapist in New York city and author of Mating in Captivity.

Loss of libido also makes men more unhappy about the rest of their lives than it does women. Only 23% of men with loss of libido say they still feel very happy about life in general vs. 46% of women, says Edward Laumann, professor of sociology at the University of Chicago co-author of The Social Organization of Sexuality: Sexual Practices in the United States. “It bothers men more.”

But loss of libido is not something you have to live with. There is much you can do to regain your sex drive and your happy outlook on life.

How Do You Know if You have a Problem With Loss of Libido?

Libido loss doesn’t usually happen suddenly – it’s not like catching a cold where you wake up one morning and whoops, there it is. It can be a gradual process. Though difficult to define precisely, Laumann measures it as follows: “It is a lack of interest in sex for several months of the past year.”

Frequency of sexual activity is not the best measure of sexual interest – so many circumstances can get in the way of an encounter, even if the desire is there. But if you are in a committed relationship and having sex less often than the norm -- about once a week – you might ask yourself whether you are happy with things as they are.

If you’re not happy about your loss of libido, researchers agree that it is best to grapple with these issues before they become entrenched. To help identify the early warning signs, see whether you answer the following questions true or false:

1. Touching takes place only in the bedroom.
2. Sex does not give you feelings of connection and sharing.
3. One of you is always the initiator and the other feels pressured.
4. You no longer look forward to sex.
5. Sex is mechanical and routine.
6. You almost never have sexual thoughts or fantasies about your spouse.
7. You have sex once or twice a month at most.

“If you answered true to many or most of these questions, you may be on your way to losing sexual desire,” writes McCarthy. Understanding the various causes is the first step to finding the appropriate resolution.

What Accounts for Loss of Libido in Men?

The causes of this complex problem range from the physical and medical to the psychological and social. Quick fixes don’t solve everything.

• Erectile Dysfunction Causes Loss of Libido

Impotence, or ED, erectile dysfunction, is not the same as loss of libido, but when you experience one, sooner or later you are likely to feel the other as well. “Only 7% of young men report being unable to keep an erection,” Laumann says. Though ED does increase with age: “It’s 12% by age 40, 18% for ages 50-59; and then a sharp rise by age 60 to 25%to 30%,” says Laumann.

The good news: depending on the cause, “drugs can help that,” Laumann says. Vasodilators, such as Viagra, Cialis, and Levitra, enhance blood flow to the penis. It also helps to understand that it’s normal for erections to come and go during lovemaking -- "It can happen two to five times in a 45-minute sexual session,” McCarthy says.

• Performance Anxiety and Loss of Libido

Men report two major problems -- anxiety about performance and climaxing too early, according to Laumann. Almost one in three men report premature ejaculation, while under one in five are worried about performance, according to Laumann.

And the anxiety doesn’t stop there. Many modern, loving, and conscientious husbands feel they have not truly “performed” unless their partners climax during sex, too. And as Laumann’s statistics show, only 26% of women report that they always experience orgasm during sex, compared with 75% of men. No wonder men feel the pressure – and performing under pressure can cause loss of libido.

• Stress Leads to Loss of Libido

Job stress and self-esteem are also big factors. “If a man’s performance at work is challenged, and he doesn’t feel he is achieving or doesn’t feel self-worth, he often numbs himself sexually,” says Perel, “Desire is a healthy form of entitlement -- when you don’t feel deserving, you shut down.”

• Medical Conditions Can Cause Loss of Libido

A variety of medical problems and chronic physical conditions can diminish a man's sex drive. Serious illnesses, such as cancer and depression, can certainly dampen any thoughts of sex. Cardiovascular disease, hypertension, and diabetes can reduce blood flow to the body, including the genitals, wreaking havoc on libido as well. Chronic alcoholism and even occasional excessive alcohol consumption are notorious for inflaming desire but impeding performance. Conditions such as thyroid disorders and tumors of the pituitary gland (which controls most hormone production, including sex hormones) can also lower libido.

• Medications Can Interfere With Libido

The class of depression drugs called SSRIs can inhibit desire. So can tranquilizers and blood pressure medications. Illicit substances, such as heroin, cocaine, and marijuana, when used heavily and chronically, may also cause loss of libido. On the positive side, when you talk to your doctor about these issues, there are alternative drugs for depression and other conditions that may have less of an impact on sexual desire.

• The Quality of the Relationship Is an Important Part of Libido

It is not only women who respond – with sexiness or inhibited sexuality – to how happy they are in their relationship. Problems with sex can – but do not always – signal other problems in the relationship that need to be addressed. Anger and disappointment often carry over into the bedroom.

• Too Much Togetherness Can Sap Libido

The paradox of modern relationships is that greater intimacy may not make for better sex. “Sometimes too much closeness stifles desire; fire needs air,” says Perel.. “Separateness is a precondition for connection. When intimacy collapses into fusion, it is not lack of closeness but too much closeness that impedes desire.”

• The Wrong Kind of Respect Can Cause Loss of Libido

For some men, the very love and respect they have for their partners – especially after the birth of a baby – can become an obstacle to sexual desire. “A lot of men find it difficult to eroticize the mother of their children. It feels too regressive, too incestuous,” says Perel. And of course, if they are pulling their weight in the care of a baby or young children, the resulting exhaustion can sap libido for men as surely as it does for women.

Even where children are not involved, Perel reports that some men say things like, “I can’t do that with my wife.” Her advice? In the first instance, get some sleep. In the second, you never know until you try.

8 Tips for Rekindling Libido

The advice here is not so much about getting more, but getting better. Frequency is not the only measure of libido. Feelings count, too. If you look forward to sex, and feel good about it before, during, and after, that is the true measure of whether your libido is healthy. Here’s how to help combat loss of libido.

1. Get physical and Boost Libido

“When you have no desire you feel frozen. Juice is not flowing – so movement is important, figuratively as well as literally,” say Perel. “It gets people unstuck.” Take up a sport, go walking, with or without your partner. If you already walk or run or work out, try challenging yourself just a little bit further, so you feel a sense of accomplishment and vitality. That physical confidence will carry over into sexual confidence.

2. Keep Expectations Real

It may take the pressure off performance anxiety to bear in mind that not every sexual encounter has to be perfect. Probably only about 40% to 50% of sexual events can be mutually satisfying, McCarthy writes in his book. If you laugh off moments when things don’t work right, your partner will be more likely to want to experiment the next time around, since it takes some pressure and guilt off of her, too.

3. Use Imagination to Fight Loss of Libido

Yes, exploring your fantasies is now regarded by marriage therapists as a good thing. If you want your partner to share in the joy, you may want to both explore further some of the newer erotic literature and films that include female fantasies as well as male. After you’ve shared yours, ask your partner about her fantasies. If she says she doesn’t have any, don’t stop there. Instead, ask her to name just one thing she has ever wished a man would do to give her pleasure. (That’s a fantasy, but she may not call it that.)

4. Build Anticipation to Combat Loss of Libido

Sure, the idea of sex being utterly spontaneous -- no planning, just the heat of the moment -- sounds great. But for anyone with jobs, family, and real lives, there just may not be enough hours in the day to wait for the inclination to arise. Instead, turn planning into an opportunity to build anticipation, the way you look forward to going to a basketball game. Take pleasure in the details – get your partner a little gift, put on your favorite music from college days, turn off the phones and hire a babysitter to take the kids out to a long movie so there will be no interruptions.

5. Focus on the Whole Body to Boost Libido.

For men, sexuality tends to be focused disproportionately on the genitals. Focusing on the other erogenous zones can ease performance pressure – and add new pleasure. Where sexual satisfaction is concerned, the shortest distance between two points – from arousal to orgasm -- is not necessarily a straight line to the genitals. Take detours along the whole body, for yourself and your partner. Be pleasure oriented, not goal oriented. Tease and touch and take your time.

6. Talk About What You Want to Increase Libido

Talking is hard in the best of times, but even harder if you have been avoiding sex together and tension is high. So if you can’t talk, get one of the dozens of excellent sex books out there and point to a chapter. Cozy up and read it together. Look at the pictures, laugh – and let your partner know you’re open to making things better between you.

7. Go Out With Friends Together

Desire feeds on newness. When you go out to a dinner party with other people, you get the chance to see your partner in a fresh light. You remember how interesting and exciting she is – and she gets to see you shine as well. You remember why you were attracted to each other in the first place.

8. Specialists Can Help Combat Loss of Libido

When you have an electrical problem, you call an electrician, right? Sex and marital specialists can be just as helpful when it comes to loss of libido, so get over your resistance to asking for directions, and call one.

Check with your doctor or urologistto rule out any medical conditions that may be playing a part. If you are taking medication, such as an antidepressant, that may be causing loss of libido, discuss alternatives with your doctor.

Looking for a great simple supper? Whip up a hearty and filling soup.

By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column

Reviewed by Kathleen M. Zelman, MPH, RD, LD

One of the best "light" dinner options when the weather is cold is soup! Just pair a big bowl of soup with a wheat roll or some wheat crackers, and call it a meal. I always have some favorite canned soups in my pantry so anyone in the family can serve themselves some soup in l5 minutes. But there’s something to be said for slowly simmering a homemade pot of soup over the stove until the flavors meld together perfectly. From chicken matzo ball soup to hearty lentil soup, it can really hit the spot on a cold day or night. Read on for some healthy and low-fat soup recipes, as well as tips on how to make any soup recipe lighter.

Soup for Supper

Can soup suffice as supper? If you are accustomed to eating light at night -- or if this is something you're moving toward -- a bowl of soup can definitely work as a satisfying evening meal.

Here are three reasons why:

• It’s almost impossible to slam down a bowl of soup. You have to eat slowly and enjoy each spoonful.
• The high liquid content of most soups does a great job of filling your stomach.

If the soup or stew is high in fiber (from beans, vegetables, and/or whole grains), it will also help add bulk to your meal and thus help you feel full longer.

Light and Low-Fat Soups

As long as the soup you're slurping is broth- or tomato-based, you usually can't get into too much trouble, calorie-wise. A cup of broth, by itself, is about 25 calories with 1 to 2 grams of fat. A cup of tomato juice is about 40 calories and 1 gram of fat.

But with a cream-based soup, all bets are off. One cup of light whipping cream (in liquid form) is about 700 calories and 74 grams of fat, while 1 cup of half-and-half is 315 calories and 28 grams of fat. Wowza! Switching to whole milk in your creamy soup recipes is sounding a "whole" lot better now, isn't it?

One cup of whole milk is about 150 calories and 8 grams of fat. Using whole milk will usually give your soup the creamy taste and texture you desire, but without all the excess calories and fat. The lower-fat options for "cream" like whole milk, low-fat milk, and fat-free half-and-half are more sensitive to high heat, so avoid boiling and add them to the soup toward the end just to warm.

Here's a chart of the calories, fat, saturated fat, cholesterol, and fiber found in soup base ingredients so you can compare them for yourself:

Ingredient 1 (cup)	Calories	Fat (g)	Sat. Fat (g)	Cholesterol (mg)	Fiber (g)
Light whipping Cream, liquid	698	74	46	265	0
Half-and-half	315	28	17	89	0
Whole milk	150	8	5	33	0
Stewed tomatoes, Canned	66	0.4	0	0	4
Tomato juice	41	0.1	0	0	2
Chicken/beef broth	25	1	0.5	~2	0.5

4 More Tips for Low-Fat and Healthy Soups

Here are four more tips to help you keep your soup recipes low fat and healthy:

1. If your soup recipe calls for meat, choose leaner cuts whenever possible, like skinless chicken or turkey breast, pork tenderloin, or sirloin steak trimmed of visible fat. If the recipe calls for sausage, substitute a less-fat turkey sausage (such as turkey polska kielbasa links). Remember that you can usually get by with half as much as the recipe calls for.

2. When using fresh herbs, add them toward the end of cooking or stir them in right before serving. Some fresh herbs even work well sprinkled on as a garnish. Add dried herbs in the beginning or middle of cooking so they have plenty of time to rehydrate and give off their flavor.

3. If the soup recipe calls for stirring in butter at the end of the cooking process, just don’t go there. If it calls for sautéing vegetables in butter in the beginning, just use a tablespoon of olive oil or canola oil instead. If you need more moisture as the vegetables are browning, add in a couple of tablespoons of water, wine, or broth.

4. Pump up the fiber in your soups by adding beans when possible and use whole grains like barley, brown rice, wild rice, or whole wheat blend pastas instead of refined grains.

3 Healthy, Low-Fat Soup Recipes

Here are three new light and nutritious soup recipes to try this winter!

Moroccan Lentil Soup/Stew

WebMD Weight Loss Clinic members: Journal as 1 1/2 cups "hearty stew"

1 large onion, chopped (about 1 1/2 cups)

1 tablespoon minced garlic

1 teaspoon minced fresh ginger (or 1/2 teaspoon ground dried ginger)

1 tablespoon olive or canola oil

6 cups low-sodium chicken or beef broth (water can also be used)

1 1/2 cups red lentils, dried

15-ounce can garbanzo beans, rinsed and drained

14.5-ounce can diced tomatoes (tomatoes and any juice), low sodium if available

3/4 cup diced carrots

3/4 cup chopped celery (about 3 medium stalks)

1 teaspoon garam masala (a spice blend)

1 1/2 teaspoons ground cardamom

1/2 teaspoon ground cayenne pepper

1/2 teaspoon ground cumin

6 tablespoons fat-free sour cream (optional garnish)

• Add onions, garlic, ginger and olive to a large nonstick saucepan and cook over medium-high heat, stirring often (about 7 minutes). Add the broth, lentils, garbanzo beans, diced tomatoes, carrots, celery, garam masala, cardamom, cayenne pepper, and cumin.
• Bring stew to a boil, then lower heat to simmer, cover saucepan, and continue to cook until lentils are soft (about 1 to 1 1/2 hours.)
• Ladle about a third to a half of the soup into a large food processor or blender and pulse to briefly puree. Pour soup puree back into the pot and stir. Serve each bowl with a dollop of fat-free sour cream, if desired.

Yield: 6 large servings

Per serving: 321 calories, 21 g protein, 52 g carbohydrate, 5.5 g fat, 1.5 g saturated fat, 5 mg cholesterol, 11.4 g fiber, 323 mg sodium. Calories from fat: 15%.

Winter Chicken & Barley Soup

WebMD Weight Loss Clinic members: Journal as 1 cup "hearty stew"

1 tablespoon olive or canola oil

1/2 cup chopped onion

1 cup chopped celery

2 cups sliced mushrooms (about 6 ounces)

1 tablespoon minced garlic

1 cup chopped carrots

1 1/2 cups chopped, cooked skinless chicken breast (about 7 ounces cooked)

5 cups low-sodium chicken broth

2/3 cup pearl barley

1/4 cup chopped fresh parsley (or 1 tablespoon parsley flakes)

1/3 slivered almonds, toasted (toast by heating over medium heat in nonstick frying pan, stirring often, until golden brown)

Pepper to taste

Salt to taste (optional)

• Add oil to a large nonstick saucepan over medium heat. Stir in onions, celery, mushrooms and garlic and sauté until mushrooms are lightly browned (about 7 minutes).
• Stir in carrots, chicken, and broth and bring to boil. Stir in the barley, cover the saucepan, and reduce heat to simmer. Cook for about an hour or until barley is just tender.
• Turn off the heat and stir in parsley and almonds. Add pepper to taste and salt to taste if desired.

Yield: 6 servings

Per serving: 246 calories, 18 g protein, 26 g carbohydrate, 9.5 g fat, 2 g saturated fat, 32 mg cholesterol, 6 g fiber, 156 mg sodium. Calories from fat: 33%.

Light New England Clam Chowder

WebMD Weight Loss Clinic members: Journal as 1 1/2 cup of "cream based soup" OR 1 cup "hearty stews"

3 medium to large red potatoes, cubed

1/2 cup chopped or sliced celery (about 2 large stalks)

1 medium onion, chopped

1/4 cup flour

4 cups whole milk (low-fat milk can also be used)

2 tablespoons whipped butter or less fat margarine

1 teaspoon salt (optional)

1 teaspoon sugar

1 cup chopped clams (2, 6.5-ounce cans chopped clams, drained)

10 drops Tabasco sauce

1/4 cup shredded Parmesan cheese

Freshly ground pepper to taste

• Add potatoes, celery, and onion to a large, nonstick saucepan and add just enough water to cover. Bring to a boil and cook until tender (about 15 minutes).
• While vegetables are boiling, add flour and 1/4 cup milk to a 2-cup measure and stir to make a paste. Stir in another 1/4 cup of milk. Melt butter or margarine in a medium, nonstick saucepan over medium heat. Stir in the flour and milk mixture, then slowly whisk in the remaining 3 1/2 cups milk. Stir in the salt, if desired, and the sugar and continue cooking and stirring until soup is nicely thickened (about 5 minutes).
• Add the milk mixture to the potato mixture in large saucepan and stir in the clams and Tabasco sauce. Cover saucepan and simmer for 15 minutes.
• Stir in Parmesan and pepper to taste.

Yield: 8 servings