Sex Health Tips

Impact Of Obesity On Sex

2010-08-05T18:50:00.001-07:00

Obesity, and especially morbid obesity, has a huge range of physical effects. Those that suffer from obesity have an increased chance of developing other serious diseases, have less energy, and suffer from depression and low self esteem. They also tend to have problems in the bedroom.

When a person is obese, their sex life suffers. A report presented at a meeting of The North American Association for the Study of Obesity by Martin Binks, PhD, from Duke University Medical Center, shows that morbidly obese Americans are 25 times more likely than those of normal weight to report problems with their sex lives. It's a dramatic difference.

Why does this problem so widely affect the obese? There are a variety of reasons, both physical and emotional. The larger a person gets, the more problems he or she will report in the bedroom-- the desire for sex, sexual performance, and even sexual enjoyment fall dramatically. The physical restrictions placed on the obese by excess weight often make sexual activity too difficult or strenuous. In addition, a constant lack of energy and feeling of lethargy will tend to reduce the desire for sex.

Another impact obesity has on sexuality is a psychological one. Obesity brings along with it lowered self-esteem and often feelings of shame. These feelings lead to an unwillingness to display the body or make oneself vulnerable to their partner. The physical effects of obesity can also lead to performance anxiety, making partners unwilling to attempt to perform sexually. In a study of 928 obese men and women, of those seeking treatment for their obesity 50% had a decreased sex drive and trouble wanting sex, 42% felt they had problems performing sexually, and 41% said they avoided sex altogether.

Obesity also affects sexuality through its impact on marriages and relationships in and of themselves. Shame is a common consequence of obesity, and it often tends to cause an emotional imbalance within relationship. This happens where one partner feels "more worthless" than the other partner. Also, the partners of overweight persons can, at times, have problems finding their partner sexually attractive. This is especially common when the bulk of the weight gain occurred during the course of the relationship. When this happens in a relationship, it is hurtful and difficult to face for both partners, and communication about these issues is usually avoided. But in the end, avoidance of this topic only creates further problems in a relationship, as it cuts off lines of communication.

A large number of factors play into the sexual problems experienced by obese individuals. When physical problems are as severely compounded by psychological issues, as occurs with obesity, sexual dysfunction can seem an insurmountable obstacle. It's important, though, to seek help if you're experiencing problems with sexual performance or sex drive due to obesity. Simply taking the first steps to seek obesity treatment has a positive emotional impact, allowing obese persons to feel some level of control over their situation.

Sexual satisfaction is a basic human need, and it's just one more key reason to care for your health and try to find healthful solutions to the problem of obesity.

Women Versus Men

2010-07-12T19:08:00.000-07:00

Vaginas

Yes, your vagina can become loose, if you have frequent sex with "large" men. Generally speaking, your vagina will adapt to the size of your partners member and if you have frequent sex with large or larger than average men, then your vagina will adapt to their size. For example, the vagina of a 30 year old woman who is sexually active is probably not gonna be as tight as a 17 year old virgin.
Accept the one that SUITS U ..

    * The same applies for anal sex, frequent anal sex will loosen the muscles of the anus and make it easier to penetrate.

    * It probably will become looser, depending on how frequently you have intercourse, but there is a chance that it will most likely become tight if you stop for a little while. How long, it depends on the person.

    * It won't become "loose" as in flappy-loose. Sex may feel a little more comfortable, since your body is used to it, but don't worry about your vagina becoming "loose". The vagina is quite flexible, and is always repairing and cleaning itself, so it will always be "tight".

    * of course!!! having sex alot will definately make you become loose because if your partners are bigger than you, it will adapt to their size.But if you stop having sex for a while, it may reduce to being tight again.

    * I think all of you sound a little misguided. Yes, in some instances your vagina can become loose (child birth) but not usually. Having sex should actually tighten your vagina unless your letting someone TOO big stretch you out. When you have sex you should tighten your vaginal muscles, like you are holding in pee. This will exercise those (kegal) muscles, tightening them. Also it will make your vagina feel tighter to the man your with. I have been told that I have great control of those muscles and men love it. Also I have been with the same one man for four years. He is rather large and I have never "loosened" up. My vagina is the same size as when we got together, but during sex it loosens up for a little while then it goes back to normal a little later. You should also look into kegal exercises, it tightens your vaginal muscles without the sex.

    * There are muscles in your vagina just like the rest of your body, if you don't exercise them they will get flabby and soft just like the rest of your body. When you hold your pee you are using your vaginal muscles. If you act like you are holding your pee when you don't have to pee you are exercising your vaginal muscles. Just do it like any other exercise you hold and release. Don't over do it, you can make it so tight sex is uncomfortable. Also if you tighten during sex your partner can feel it, it feels tight and they like it. That is one reason men like anal sex, it is tighter.

    * The Vagina will become loose after a lot of sex?! That is not @ all true! Me and my husband have sex almost every day some times 2,3 times. We have been together for 5 years. His Penis Is very large, Sometimes it rips me a little just trying to get it in, sometimes we cant get it in, lol Anyway, I am not loose at all and we've had sex like 25349 million times. Its actually really really tight.....strange....

Men :
For most men, the foreskin rolls back when pushed against the opening of the vagina, exposing the head (glans) of the penis as it slides into the vagina. While thrusting into the vagina, the foreskin usually slides back and forth over the head so that when its in side of her sometimes the skin is over the head and sometimes it is back. On the part of the thrust where the man pulls his penis part way out of the vagina, the foreskin naturally slides up over the head due to its contact with the vaginal wall.

The foreskin functions as a sheath to protect the sensitive glans (head) of the penis from friction and dryness, maximizing the sensitivity of the glans and the man's pleasure during sexual activity. As the foreskin slides back with erection and penetration, the glans is left uncovered to come into direct contact with the soft, moist vaginal walls.

However for some men, the head of the penis remains covered during erection and during intercourse. In this situation the glans slides against the inner foreskin as the man thrusts, and this is a normal variation as long as it does not make intercourse uncomfortable.
Latex condoms should always be used during sex to prevent the transmission of sexually transmitted diseases, but they can restrict the movement of the foreskin during intercourse.

It is extremely common, and is caused by friction between the penis and the vaginal opening. This means there is too little lubrication, which is easily corrected by the use of some kind of lubricant - saliva or even better, water or silicon based lube. Water base is essential if a latex condom is used, since latex does not tolerate oils or greases.

The fact that there is too little lubrication is nothing to be ashamed of. Some women just become wetter than others. Also, the amount of foreplay

greatly affects the amount of natural lubricants in the vagina. The more turned on a woman is, the more her body produces fluids for easy penetration
The question is not, why does it burn during sex, the question is referring to "when the penis first enters the vagina". This could be caused by the female having a yeast infection due to the increase in acidity. this could also leave the male slightly itchy afterwards, not necessarily like jock itch but along the length of the penis.

Friction during entry of the penis can be caused by a lack of lubrication as noted in the first response. Another cause can be muscle tension. If the female is tense or not receptive then her vaginal muscle will be tense also. In some instances the tension can be so great as to resist penetration by the penis, causing pain to both partners, as a burning or bruising sensation. The use of synthetic and natural lubricants during foreplay aid in the relaxation of the vagina. If foreplay is performed long enough to cause the secretion of natural lubricants from specialized glands near the vaginal opening then the vaginal wall is not likely to be as tense and friction will be reduced to a pleasurable level. Lubricated condoms are available to minimize the friction burn during entry if natural secretions are insufficient.

The second answer has some value as well. A yeast infection in the female can cause a 'burn' sensation during penile entry and in some cases the male who contracts a serious yeast infection from his infected partner may have the similar symptoms. Usually signs of yeast infection are less obvious in the male than in the female. Going back to the idea of muscle tension, if a woman is aware she has something wrong , say a yeast infection, and she has not told her partner, it's possible she might be less relaxed than usual, and less receptive on a subconscious level.

Sex & Pomegranate Juice

2010-06-12T20:00:00.000-07:00

Pomegranate appears to be more than just a load of vitamin C. A new research comes to strengthen the results of other studies, showing that men wanting to make their partners happy in between the sheets should drink pomegranate juice on a daily basis.

"The juice is rich in antioxidants that increase the blood
supply to the genitals.

The new research incorporated 53 male subjects with libido problems. After a month, about 50 % of the subjects said that their sexual performances increased after consuming pomegranate juice. The fruit had been already connected to decreased risk of heart disease and prostate cancer.

A quarter of litter of pomegranate juice daily raised the stability period of prostate cancer by 4 times, with such a significant effect that it could enable men aged 60 to 75 to experience a full lifespan without experiencing malign prostate cancer.

The research was also made at the University of California on 50 subjects with prostate cancer who had undergone surgery or radiotherapy, and displayed a post-treatment rise of PSA (prostate specific antigen), showing that cancer had not been completely eliminated from of their organism.

The team monitored the men's PSA levels to determine how much time it took to become double. The average doubling time was 15 months and men with short doubling times were more likely to die from the disease. But drinking a quarter of litter of pomegranate juice daily prolonged the doubling period to 54 months, and the team also got evidence that the juice was in fact completely eliminating the prostate cancer cells.

"The improvements had been surprising and, though it was not a cure, scientists may now be able to stump prostate cancer growth."

Another research made at the University of Southern California in 2007 on ED (erectile dysfunction or impotence) patients revealed that 47 % of the men reported erections improved with pomegranate juice, while just 32% with the placebo.

It is believed that the potent antioxidant content of pomegranate juice can impede the harmful action of the free radicals in circulatory function. Many researches pointed that pomegranate juice improves blood flow and decreases or even reverses arterial plaque development. By decreasing arterial plaque and enhancing blood vessel dilation, the pomegranate antioxidants favor erection. 10 % of the men worldwide and about 20 million just in US alone are affected by impotence.

Pregnancy Test

2010-06-11T18:07:00.000-07:00

Am I pregnant?
Many women don't suspect they're pregnant until they've missed a period, but there may be other indications, sometimes even before that missed period, too.

    * Sickness and/or feelings of nausea
    * A strange, 'metallic' taste in your mouth
    * Breast tenderness, tingling and enlargement
    * The small bumps - 'Montgomery's tubercules' - on your nipples becoming more obvious
    * Stomach pains
    * Tiredness
    * Constipation
    * Needing to urinate more often
    * Going off certain things, such as coffee and fatty foods
    * Increased vaginal discharge
    * Some women experience very light bleeding (called 'spotting') that they mistake for their period

When should I do a test?

Home pregnancy tests can be used on the first day of your missed period, and some very sensitive tests can be used sooner than this.

The tests work by detecting the hormone human chorionic gonadotrophin (hCG) in your urine. A chemical in the stick changes colour when it comes into contact with this hormone, so the usual way of testing is to urinate on the end of the stick and watch for the result in the window of the stick.

Pregnancy tests are very accurate as long as you use them properly. It's possible to have a false negative, when the test says you aren't pregnant but you are. If your period still doesn't arrive, repeat the test or check with your GP.

You can buy home pregnancy tests online, in the supermarket or at your local chemist. Some GPs, family planning clinics and young people's services (such as Brook Centres) offer free tests, as do some pharmacies, the British Pregnancy Advisory Service and Marie S es International clinics.

When is my baby due?

The length of your pregnancy is dated from the first day of your last period, even though you actually conceive two weeks or so after this date (depending on the length of your cycle). Your baby is likely to be born two weeks either side of the due date.

Check your due date and what's happening within your body week by week with our pregnancy calendar. All you need to know is the first day of your last period.

Most women see their GP to arrange antenatal care, but you can book directly with a community midwife if you prefer. Call your doctor’s surgery, or your primary care trust, to find out how to do this.

Does a GP need to confirm my pregnancy?
If you've had a positive home test, you just need to tell your doctor. They're unlikely to test you again. You may be offered a 'dating' scan, even if you're sure of your dates. This is an ultrasound scan done in early pregnancy to find out the size of your uterus and the embryo, to help determine how many weeks pregnant you are.

What is Condom ?

2010-06-11T18:04:00.000-07:00

    * Myth: Condoms are restrictive and uncomfortable
    * Fact: Not true - condoms come in different textures, shapes and types. Find a brand that suits you
    * Myth: Condoms may have holes in them
    * Fact: Not true - all condoms are tested and carry the CE quality mark. Many brands also have a kite mark to show they're reliable

What are they?
Condoms are barrier methods that prevent sperm meeting an egg. There are male and female condoms. Condoms are made of latex (rubber) or polyurethane (plastic).

How reliable are they?
Effectiveness depends on how carefully they're used. Male condoms are 98 per cent effective when used according to instructions. This means that using this method, two women in 100 will get pregnant in a year. Female condoms are 95 per cent effective. This means five women in 100 will get pregnant in a year.

How are male condoms used?
Male condoms fit over a man's erect penis. They should be used before any close genital contact. Once the man has 'come' but before the penis goes soft, he must withdraw holding the condom firmly in place to avoid spilling any sperm. The condom is then removed and should be disposed of carefully.

How are female condoms used?
Female condoms are put into the vagina and line it loosely when in place. The closed end of the condom is inserted high into the vagina. The open, outer ring lies just outside the vagina. After sex the condom is removed by twisting the outer ring to keep the sperm inside and pulling it out. It should be disposed of carefully.

Advantages:
    * Very effective
    * Easily available (male condoms)
    * Only need to use them when you have sex
    * Help to protect against some sexually transmitted infections (STIs), including HIV
    * Male condoms come in many different varieties, shapes and sizes
    * Female condoms can be put in at any time before sex

Disadvantages:

    * Can interrupt sex
    * Male condoms can slip off or split if used incorrectly
    * When using the female condom care is needed to ensure the penis goes inside the condom and not down the side of the condom and the vagina
    * Some people are sensitive to the chemicals in latex condoms, although this is not common
    * Oil-based lubricants, such as body oils or lotions, should not be used with latex condoms

Condom allergy

Although in the past condom allergy was thought to be a poor excuse used by men when they didn't want to use a condom, it has become clear recently that the problem is real.

In many cases the problem seems to be an allergy to rubber. Hypoallergenic condoms are now available made from polyurethane instead of latex. Another possibility is a sensitivity to the spermicide that lubricates the condom. If you experience any rash or irritation after intercourse, try using a condom without nonoxynol-9 or 11 spermicide to see if that helps.

For many people, a lack of lubrication is the underlying cause of the irritation. The friction caused by dry skin surfaces makes sex uncomfortable. The solution is to use extra lubricant during foreplay and intercourse. This should be water-based. Oil-based lubricants react with the condom, breaking down and weakening the latex.

To avoid dryness and the friction it brings, 'jel-charge' the condom. Expel the air from the tip of the condom, put lubricant inside the   and massage it over the penis as you role the condom on. This not only solves the problem of dryness but also heightens the sensation experienced during intercourse.

Where can I get condoms?

    * They're free on the NHS
    * Male condoms are free and easily available from contraception clinics, sexual health clinics, genitourinary medicine clinics and some general practices. They can be bought from pharmacies, supermarkets, vending machines and via mail order
    * Female condoms are free from some contraception and sexual health clinics. They can be bought from some pharmacies and via mail order

SEx Positions - 11

2010-06-05T18:21:00.000-07:00

Sixty-nine
Women in the 69 position

Simultaneous oral sex between two people is called 69. It is called the congress of the crow in the Kama Sutra. Each partner may be male or female. They can be lying side-by-side, lying one on top of the other, or standing with one partner holding the other upside down.

Anilingus
Positions for anilingus, also known as butt licking, rimming, anal-oral sex, rimjob, or tossing the salad are often variants on those for genital-oral sex. Rimming-specific positions include:

    * The passive partner is on all fours. The active partner is behind them.

    * The passive partner is on their back with their legs up.

    * The passive partner on top in the Sixty-nine position.

    * The Rusty trombone, in which a male is standing while the active partner is both performing anilingus from behind, generally from a kneeling position, while also masturbating the standing partner, thus somewhat resembling someone playing the trombone.

Other positions
    * Fingering of the vagina or anus.

   * Shocker: simultaneous fingering of the vagina and anus using one hand. The index and middle finger are inserted in the vagina, and the pinky in the anus. A number of variations are possible by using different combinations of fingers in each orifice. This act figures prominently in the Story of O: shortly after O's arrival at the Chateau, a man grabs her in this way. O is shocked, but she learns to accept this and ruder intrusions. Sometimes referred to as "Two in the pink, one in the stink."

    * Female shocker: simultaneously fingering a man's anus with one's thumb while stimulating his scrotum with the other fingers. This is done by making a shape with the hands as though one were holding the bowl of a wine glass.

    * Fisting: inserting the entire hand into the vagina or anus. This usually requires large amounts of lubricant and relaxation. The hand is usually not actually made into a fist, but instead the thumb is placed between the middle and ring fingers. Anal fisting can be extremely dangerous and even fatal if the hand tears the lining of the intestine.[citation needed]

Group sex
Oral threesome with one male and two females
Threesome with three females

Double penetration.
Various assemblages of people may participate in group sex. While group sex does not imply that all participants must be in sexual contact with all others simultaneously, some positions are only possible with three or more people.

As with the positions listed above, more group sex positions become practical if erotic furniture is used.
With three participants

When three people have sex with each other, it is called a threesome. Possible ways of having all partners in sexual contact with each other include:

    * One person performs oral sex on either of the other two partners while they engage in anal or vaginal intercourse. Sometimes called a spit roast

* A man has vaginal or anal sex with one partner, while himself being anally penetrated by another (possibly with a strap-on dildo).

    * Three partners lie or stand in parallel, with one between the other two. Sometimes called a sandwich. This term may specifically refer to the double penetration of a woman, with one penis in her anus, and the other in her vagina.

    * A participant has vaginal or anal sex with one partner, and both give oral sex to a third.

    * Three people perform oral sex in a triangular configuration, commonly called a "daisy chain".

    * The slang term Lucky Pierre is sometimes used in reference to the person playing the "middle role" in a threesome.

With many participants
These positions can be expanded to accommodate any number of participants:

    * A group of males masturbating is called a circle jerk.

    * A group of males masturbating and ejaculating on one person's face, is known as bukkake.

    * A group of men, women, or both, each performing oral sex on the next, is called a daisy chain.

    * A group of men, penetrating each other in a row, with three to six participants, is called a trainfuck.

    * When one woman or man is given the serial or parallel attention of many, often involving a queue ("pulling a train"), it is often termed a gangbang (originally exclusively a rape term, but now used to include consensual group sex).

Multiple penetration
Multiple penetration refers to one person being sexually penetrated several times simultaneously. It generally involves between two and five participants. Penetration may be accomplished by fingers, toes, sex toys, or penises. These positions are popular in pornography, but it is difficult to say whether they enjoy any significant popularity outside of it.

If one person is penetrated by two objects, it is generically called double penetration (sometimes abbreviated dp). Given the vagina, anus and mouth, there are several ways in which this can be done. These include:

    * Simultaneous penetration of the anus by two penises or other objects. This is commonly called double anal or double stuffing.

* Simultaneous penetration of the vagina by two penises or other objects. This is commonly called double vaginal or double stuffing.

    * Simultaneous penetration of the vagina and anus. If this is done using penises and/or strap-on dildos, this is sometimes called the sandwich or BigMac. The shocker (see above) accomplishes this using several fingers of one hand.

    * Simultaneous penetration of the mouth and either the vagina or anus. If the penetrating objects are
penises, this is sometimes called the spit roast.

If one person is penetrated by three objects, it is generically called triple penetration. Possibilities include:

    * Two penises penetrating the vagina and one in the anus or vice versa. While possible, this position is very difficult.

    * One penis in the anus, one in the vagina, and one in the mouth simultaneously, sometimes called making her airtight or an airtight seal.

These variations of multiple penetration are commonly seen in pornography aimed at straight men. Some of these positions put two men in intimate contact with each other, either directly or indirectly.

SEx Positions - 10

2010-06-05T18:15:00.000-07:00

Genital-genital sex
Genital-genital sex, sometimes referred to as GG rubbing, is generally understood as sexual intercourse in a narrower sense, and among same sex partners. Sex by mutual genital rubbing is sometimes grouped with 'frottage'. However, other terms like 'non-penetrative' or 'outercourse' are heterosexist in reference and misleadingly assume a penile-vaginal context.

    * Frot or frottage: two males mutually rubbing penises together.

    * Tribadism or tribbing: two females mutually rubbing vulvae together.

    * Docking: mutual masturbation by inserting the glans penis into the foreskin of another male's uncircumcised penis.

Anal sex positions

Anal sex positions involve anal penetration. Most anal sex positions are adaptations of vaginal penetrative positions: Doggy style penetration maximizes the depth of penetration, but can pose the risk of pushing against the sigmoid colon. If the receiving partner is male, this increases the chances of stimulating the prostate. The penetrating partner controls the thrusting rhythm. A variation is the leapfrog position, in which the receiving partner angles their torso downward. The receiving partner may also lie flat and face down, with the penetrating partner straddling their thighs. In the missionary positions, to achieve optimal alignment, the receiving partner's legs should be in the air with the knees drawn towards their chest. Some sort of support (such as a pillow) under the receiving partner's hips can also be useful. The penetrating partner positions themselves between the receiving partner's legs. The penetrating partner controls the thrusting rhythm. This position is often cited as good for beginners, because it allows them to relax more fully than is usual in the doggy style position. The spoons position allows the receiving partner to control initial penetration and the depth, speed and force of subsequent thrusting. The receiving partner on top positions allow the receiving partner more control over the depth, rhythm and speed of penetration. More specifically, the receiving partner can slowly push their anus down on the penetrating partner, allowing time for their muscles to relax.

Oral sex positions

Oral sex is the term given to genital stimulation by the mouth. People may engage in oral sex as part of foreplay before intercourse, or during or following intercourse. It may also be performed for its own sake.

It can be performed simultaneously (e.g. one partner performs cunnilingus, while the other partner performs fellatio), or only one partner may perform upon the other; this creates a multitude of variations.[16]

Fellatio
Fellatio is oral sex involving a man's genitals. Possible positions include:

    * The man lies on his back while his partner kneels between his legs.

    * The man lies on his back while his partner lies off to the side of his legs.
    * The man sits in a chair and partner kneels in front of him between his legs.

    * The man stands while his partner either kneels in front of him or sits (in a chair or on the edge of a bed, etc.) and bends forward.

    * The man stands while his partner, also standing, bends forward at the waist.

    * While the active partner lies on their back, the man assumes the missionary position but adjusted forward so as to insert his penis in his partner's mouth.

    * The man stands or crouches at the edge of the bed, facing the bed. The active partner lies on the bed with their head hanging over the edge of the bed backward. The man inserts his penis into his partner's mouth, usually to achieve deep throat penetration, whereby the entire penis penetrates the mouth opening.

    * The man fellates his own penis; see autofellatio

    * The active partner (being female) lies on her back, and the man inserts his penis between her cleavage, and into her mouth.

Cunnilingus is oral sex involving a woman's genitals. Possible positions include:

    * The woman lies on her back as in the missionary position. The active partner lies on their front between her legs.

    * The active partner sits. The woman stands facing away and bends at the hips.

    * The active partner sits. The woman stands or squats facing towards partner and may arch her back, to create further stimulation.

    * The active partner lies on their back while the woman kneels with her legs at their sides and her genitals on their mouth. Humorously popularised in the Monty Python song "Sit On My Face" (1980).

    * The woman services her own genitals. Although rarer, some women still find this possible; see autofellatio

    * The woman stands, possibly bracing herself against a wall. The active partner kneels in front of her.

    * The woman sits on the bed with her legs open, the active partner kneels in front of her.

    * The woman is upside-down (standing on hands, held by partner, or using support, such as bondage or furniture), with the active partner standing or kneeling (depending on elevation) in front or behind. Such a position may be difficult to achieve, or maintain for extended time periods, but the rush of blood to the brain can alter stimulation's effect.

    * The woman stands on hands, resting each leg on either side of the active partner's head, with the active partner standing or kneeling facing them. Depending on which way up the woman is facing, different stimulation and levels of comfort may be available.

SEx Positions - 9

2010-06-05T18:11:00.000-07:00

Non-penetrative positions

Non-penetrative sex or frottage—the general term for rubbing one's genitals on one's partner. This may include the partner's genitals or buttocks.

    * Mutual Masturbation The stimulation of the penis in males and with the stimulation of the clitoris in females. Partners simultaneously stimulating both the male's penis and female's clitoris by mutual or simultaneous masturbation, rhythmic inter-genital contact friction or actual penetrative intercourse can lead to orgasm in one or both partners, sometimes simultaneously, known as simultaneous orgasm. Same gender partners can also stimulate each other's orgasm.

    * Orgasm control by self or by a partner managing the physical stimulation and sensation connected with the emotional and physiologic excitement levels. Through the practice of masturbation an individual can learn to develop control of their own body's orgasmic response and timing. In partnered stimulation either partner can control their own orgasmic response and timing. With mutual agreement either partner can similarly learn to control or enhance their partners orgasmic response and timing. Partner stimulation orgasm techniques referred to as Expanded Orgasm, Extended orgasm or Orgasm control can be learned and practiced for either partner to refine their control of the orgasmic response of the other. Partners mutually choose which is in control or in response to the other.

    * Orgasmic Meditation, is a mindfulness practice where the object of meditation is conscious finger to genital contact. "OMing" is practiced in pairs, with one partner, gently holding the genitals with both hands, and that partner's index finger gently, precisely, slowly stroking the female’s clitoris specifically and with both parties placing their complete awareness mindfully on that localized point of contact between them. Both practitioners focus their fullest attention on their sensitive nerve endings and on their finest muscle control in stroking movement to develop connective (limbic) resonance between practitioners. The outcome, is not simply orgasm but interpersonal connection.

Other forms of frottage—as part of foreplay or to avoid penetrative sex, people engage in a variety of other non-penetrative sexual behaviour, which may or may not lead to orgasm.

    * Dry humping: frottage while clothed. This act is common, although not essential, in the dance style known as "grinding".

    * Handjob: Manual stimulation of a partner's penis or clitoris

    * Footjob: using the feet to stimulate the penis.

    * Mammary intercourse: using the breasts together to stimulate the penis through the cleavage. (Should not be confused with a "boob job" meaning to have augmentive surgery done on the breasts.) Also called a titjob, titty-fucking, a tit-wank, or a muscle fuck. Several other slang terms exist.

    * Intercrural intercourse or interfemoral sex: with the penis between the partner's thighs, perhaps rubbing the vulva, scrotum or perineum.

    * Axillary intercourse: with the penis in the armpit.

The slang term humping may refer to masturbation—thrusting one's genitals against the surface of non-sexual objects, clothed or unclothed; or it may refer to penetrative sex.

SEx Positions - 8

2010-06-05T18:06:00.000-07:00

Less-common positions

The T-square position

These positions are more innovative, and perhaps not as widely known or practiced as the ones listed above.

    * The receiving partner lies on their back with knees up and legs apart. The penetrating partner lies on their side perpendicular to the receiver, with the penetrating partner's hips under the arch formed by receiver's legs. Sometimes called the T-square.

    * The receiving partner's legs are together turning to one side while looking up towards the penetrator, who has spread legs and is kneeing straight behind the other's hips. The penetrator's hands are on the other's hips. This position can be called the Modified T-square.

    * The Seventh Posture of Burton's translation of The Perfumed Garden is an unusual position not described in other classical sex manuals.[4] The receiving partner lies on his or her side. The penetrating partner faces the receiver, straddling the receiver's lower leg, and lifts the receiver's upper leg on either side of the body onto the crook of penetrating partner's elbow or onto the shoulder. While some references describe this position as being "for acrobats and not to be taken seriously,"others have found it very comfortable, especially during pregnancy.

The penetrator straddles one of the legs of the receiver, who is lying on their side.

    * The piledriver is a difficult position sometimes seen in porn videos. It is described in many ways by different sources. In a heterosexual context, the woman lies on her back, then raises her hips as high as possible, so that her partner, standing, can enter her vaginally or anally. The position places considerable strain on the woman's neck, so firm cushions should be used to support her.

The receiver lies face down legs spread on the edge of the bed and parallel to the floor, while the penetrator stands behind, holding both legs.

    * The Rusty Bike Pump is similar to a piledriver where penetration is achieved from above at a downward angle with the receiving partner bottom side up.

Others

    * The receiving partner is on the bottom. The penetrating partner lies on top perpendicularly to them.
    * The penetrating partner lies on their back, legs spread. The receiving partner is on their back on top of the penetrator, legs spread, facing the opposite direction.

    * The penetrator and the receiver lie on their backs, heads pointed away from one another. Each places one leg on the other's shoulder (as a brace) and the other leg out somewhat to the side.

    * The receiving partner lies on their back with the penetrating partner lying perpendicular. The receiving partner bends the knee closest to the penetrating partner's head enough so that there is room for the penetrating partner's waist to fit beneath it, while the penetrating partner's legs straddle the receiving partner's other leg. The in-and-out thrusting action will move more along a side-to-side rather than top-to-bottom axis. This is sometimes called the scissors position. This position allows for breast stimulation during sex, for partners to maintain eye contact if they wish, and for a good view of both partners as they reach orgasm.

    * The penetrating partner sits on edge of a bed or chair with feet spread wide on floor. The receiving partner lays on their back on the floor and drapes their legs and thighs over the legs of the penetrating partner. The penetrating partner holds the knees of the receiving partner and controls thrusts.

Using furniture or special apparatus
Using a table to allow a variant of the missionary position

Most sex acts are typically performed on a bed or other simple platform. As the range of supports available increases, so does the range of positions that are possible. Ordinary furniture can be used for this purpose. Also, various forms of erotic furniture and other apparatus such as fisting slings and trapezes have been used to facilitate even more exotic sexual positions.
Positions to promote or prevent conception

Pregnancy is a potential result of any form of sex where sperm comes in contact with the vaginal area (typically vaginal sex, but pregnancy can result from anal sex, digital sex with sperm fluids on the fingers, or even sperm that is on the body and is transferred to the vaginal area) between a fertile female and a fertile male. (Men and women are typically fertile by the time they reach puberty.) Oral sex itself can never result in pregnancy. However, if not careful, it can result in pregnancy if sperm on the hands or body comes in contact with the vaginal area. Though certain sexual positions are believed by some to produce more favorable results than others, none of these are effective means of contraception. See Birth control: Misconceptions.
Positions during pregnancy

The goal is to prevent excessive pressure on the belly and to restrict penetration as required by the particular partners. Some of the positions below are popular positions for sex during pregnancy.

    * Woman on top: takes the pressure off of the woman's abdomen and allows her to control the depth and frequency of thrusting.

    * Woman on back: like the missionary, but with less pressure on abdomen or uterus. The woman lies on her back and raises her knees up towards her chest. The partner kneels between her legs and enters from the front. Place a pillow under her bottom for added comfort.

    * Sideways: also keeps pressure off of her abdomen while supporting her uterus at the same time.

    * Spooning: very popular positions to use during the late stages of pregnancy; allowing only shallow penetration and relieves the pressure on the stomach.

    * Sitting: she mounts the sitting partner, relieving her stomach of pressure.

    * From behind: allowing her to support stomach and breasts.

SEx Positions - 7

2010-06-05T18:03:00.000-07:00

Anal sex positions

Anal sex positions involve anal penetration. Most anal sex positions are adaptations of vaginal penetrative positions:

    * Doggy style penetration maximizes the depth of penetration, but can pose the risk of pushing against the sigmoid colon. If the receiving partner is male, this increases the chances of stimulating the prostate. The penetrating partner controls the thrusting rhythm. A variation is the leapfrog position, in which the receiving partner angles their torso downward. The receiving partner may also lie flat and face down, with the penetrating partner straddling their thighs.
    * In the missionary positions, to achieve optimal alignment, the receiving partner's legs should be in the air with the knees drawn towards their chest. Some sort of support (such as a pillow) under the receiving partner's hips can also be useful. The penetrating partner positions themselves between the receiving partner's legs. The penetrating partner controls the thrusting rhythm. This position is often cited as good for beginners, because it allows them to relax more fully than is usual in the doggy style position.
    * The spoons position allows the receiving partner to control initial penetration and the depth, speed and force of subsequent thrusting.
    * The receiving partner on top positions allow the receiving partner more control over the depth, rhythm and speed of penetration. More specifically, the receiving partner can slowly push their anus down on the penetrating partner, allowing time for their muscles to relax.

SEx Positions - 6

2010-06-05T18:00:00.002-07:00

StandingOne partner stands while holding up the other without a support.

Most of these positions can be used for either vaginal or anal penetration. In the basic standing position, both partners stand facing each other. The following variations are possible:

    * In the basic standing position, both partners stand facing each other and engage in vaginal sex. In order to match heights, the shorter partner can, for instance, stand on a stair or wear high heels. It may be easier to maintain solid thrusts if the woman has her back to a wall. With such a support, the Kama Sutra calls this position the suspended congress. This position is most often used in upright places, such as a wall in a bedroom or a shower.
      * The penetrating partner stands, and the receiving partner wraps their arms around his neck, and their legs around his waist, thereby exposing either the vagina or anus to the man's penis. This position is made easier with the use of a solid object behind the receiver, as above.
    * Alternatively, the receiving partner can face away from the penetrating partner which allows for anal sex. This position is varied by having the receiving partner assume different semi-standing positions. For instance, they may bend at the waist, resting their hands or elbows on a table.

SEx Positions - 5

2010-06-05T18:00:00.000-07:00

Sitting and kneeling
Kneeling variant of the lotus position.
Most of these positions can be used for either vaginal or anal penetration.

    * The penetrating partner sits on an area surface, legs outstretched. The receiving partner sits on top and wraps their legs around the penetrating partner. Called pounding on the spot in the Burton translation of The Perfumed Garden. If the penetrator crosses their legs instead, it is called the lotus position. This position can be combined with fondling of both the breasts and buttocks of the receiving partner and the buttocks of the penetrating partner, increasing the chances of both pleasure and orgasm in both partners.
    * The penetrating partner sits in a chair. The receiving partner straddles penetrating partner and sits, facing the penetrating partner, feet on floor. This is sometimes known as the lap dance. Other receiver-on-top variants can be adapted in this way as well.
    * The penetrating partner sits on a couch or in a chair that has armrests. The receiving partner sits in the penetrating partner's lap, perpendicular to penetrating partner, with his or her back against the armrest.
    * The penetrating partner kneels while the receiving partner lies on his or her back, ankles on each side of penetrating partner's shoulders.

SEx Positions - 4

2010-06-05T17:58:00.000-07:00

Receiving partner on top The cowgirl position

These positions are sometimes called the woman on top, cowboy or cowgirl positions. Most of these positions can be used for either vaginal or anal penetration.

A feature of these positions is that the penetrating partner lies on his or her back with the receiving partner on top:

    * The receiving partner can kneel while straddling the penetrating partner, with the participants facing each other.
    * Alternatively, the receiving partner can face away from the penetrating partner. This position is sometimes called the reverse cowboy or reverse cowgirl position.
    * The receiving partner can arch back with hands on the ground.
    * The receiving partner can squat (instead of kneel) facing the penetrating partner.
    * The receiving partner can bring forward their knees against the ground.
    * The penetrating partner lies with their upper back on a low table, couch, chair or edge of bed, keeping their feet flat on the floor and back parallel to floor. The receiving partner straddles them, also keeping their feet on the floor. Receiving partner can assume any of various positions.
    * The lateral coital position was recommended by Masters and Johnson, and was preferred by three quarters of their heterosexual study participants after having tried it. The position involves the man on his back, with the woman rolled slightly to the side so that her pelvis is atop his, but her weight is beside his.[8]

    * This position should be used with caution as it is the leading cause of penile fracture.

SEx Positions - 3

2010-06-05T17:56:00.000-07:00

Penetrating from behind
A couple engaged in a rear-penetration position commonly referred to as doggy-style.

Most of these positions can be used for either vaginal or anal penetration.

        * Variants of the doggy style or doggy position include:

        * The receiving partner is on all fours with their torso horizontal. The penetrating partner inserts from behind.
        * In a variant on the doggy position, the receiving partner's torso is angled downwards. The penetrating partner can raise their own hips above those of the receiving partner for maximum penetration.
        * In another variant of the doggy position, the penetrating partner places their feet on each side of the receiving partner while keeping their knees bent and effectively raising up as high as possible while maintaining penetration. The penetrating partner's hands usually have to be placed on the receiving partner's back to keep from falling forward.[citation needed]
        * In a variant on the doggy position, the receiving partner kneels upright. The penetrating partner may gently pull the receiving partner's arms backwards at the wrists towards them.

    * In the spoons position both partners lie on their same side facing in the same direction.[6]
    * The receiving partner lies on their side. The penetrating partner kneels and penetrates from behind. Alternatively, the penetrating partner can stand if the receiving partner is on a raised surface.
    * The receiving partner lies facing down, possibly with their legs spread. The penetrating partner lies on top of them.[7] The placement of a pillow beneath the receiving partner's hips can help increase stimulation in this position.
    * The receiving partner lies face down, knees together. The penetrating partner lies on top with spread legs.
    * The receiving partner lies on their side with their uppermost leg forward. The penetrating partner kneels astride the receiver's lowermost leg.

SEx Positions - 2

2010-06-05T17:55:00.000-07:00

Penetrating partner on top with front entry Anal missionary between two males

The basic sex position is generally called the missionary position. In this position, the participants face each other. The receiving partner lies on his/her back with legs apart, while the penetrating partner lies on top. This position and the following variations are primarily used for vaginal intercourse, although some can also be used for anal sex.

    * The penetrating partner stands in front of the receiving partner, whose legs dangle over the edge of a bed or some other platform like a table. With the receiving partner's legs lifted towards the ceiling and resting against the penetrating partner, this is sometimes called the butterfly position. This can also be done as a kneeling position.
    * The receiving partner lies on his/her back. The penetrating partner stands and lifts the receiving partner's pelvis for penetration. A variant is for the receiving partner to rest his or her legs on the penetrating partner's shoulders.
    * The receiving partner lies on his/her back, legs pulled up straight and knees near to the head. The penetrating partner holds the receiving partner's legs and penetrates from above.
    * Similarly to the previous position, but the receiving partner's legs need not be straight and the penetrating partner wraps his or her arms around the receiving partner to push the legs as close as possible to the chest. Called the stopperage in Burton's translation of The Perfumed Garden.
    * The coital alignment technique, a position where a woman is penetrated vaginally: the penetrating partner enters vaginally in the missionary position and moves slightly forward so that the base of the phallus rubs the clitoris.
    * The receiving partner crosses his/her feet behind his/her head (or at least puts his/her feet next to his/her ears), while lying on his/her back. The penetrating partner then holds the receiving partner tightly around each instep or ankle and lies on the receiving partner full-length. A variation is to have the receiving partner cross his/her ankles on his/her stomach, knees to shoulders, and then have the penetrating partner lie on the receiving partner's crossed ankles with his/her full weight. Called the Viennese oyster by The Joy of Sex.

SEx Positions - 1

2010-06-05T17:52:00.000-07:00

Sex is actually a phenomenon comprising of three phases namely Foreplay, Coitus, Orgasm.
A sex positions is a position which people may adopt during or for the purpose of sexual intercourse or other sexual activities. Sexual acts are generally described by the positions the participants adopt in order to perform those acts. Though sexual intercourse generally involves the sexual penetration of the body of one person by another, or the stimulation of the sex organ of one by another, a sex position may not necessarily involve penetration or direct stimulation. Three categories of intercourse are commonly practiced: vaginal intercourse, involving vaginal penetration by the penis; oral intercourse, involving oral caress of the penis in a partner's mouth; and anal intercourse, involving insertion of the male's penis into a partner's anus. Sex acts may involve the use of fingers or hands or mutual masturbation such as grasping the mans penis or testicles and rubbing them around. There are numerous sex positions which the participants may adopt in any of these types of sexual intercourse or acts, creating an almost limitless number of sex positions.Two diversified classifications go as under - the penetrative and the n on penetrative positions.

Sex and desire

2010-06-01T08:38:00.000-07:00

Sex and desire have always been viewed to be a very important part of life, but it has emerged that most, in their pursuit for carnal satisfaction, ignore the safety and healthy bedroom rules.

Dr. Barry Buffman, a Board Certified urologist and the director of the Los Angeles Boston Medical Group, has given ten top sex myths that are most common among men, reports Askmen.com.

A woman will not get pregnant if a guy ''pulls out'' before ejaculation
Men do not always know when ejaculatory fluid begins to seep out and even ahead of a perceptible orgasm, pre-ejaculate (which includes sperm) is released and is enough to get a woman pregnant.

Thinking about someone else during the act is bad
A large part of the sexual experience starts with your brain, not your body, and sometimes your brain can wander. If you are committed to your lady, and your relationship is in a good place, it's ok to think about Angelina Jolie or Megan Fox every now and then.

Premature ejaculation only affects young men
Some men do find that premature ejaculation begins at the onset of sexual maturity, but plenty of men also find it to be an issue later in life. In fact, premature ejaculation affects 30 percent of men at sometime in their lives. Often, early ejaculation in men who are in their 30s or older is a co-symptom of erectile dysfunction or fatigue, poor cardiovascular conditioning, depression, anxiety, or neurological symptoms.

Oral sex is safer than vaginal sex
Oral sex seems to have the stigma of a "free pass" as far as sexual relationships go. Yes, it does count as sex, and yes, you can get a sexually transmitted disease from oral sex. There is still an exchange of fluids, meaning that diseases can enter your body through sores or small cuts in your mouth and throat.

How certain foods can be aphrodisiacs
While oysters, dark chocolate, strawberries, and tiger penis might make one feel l'amour, there is no scientific evidence to support the validity of aphrodisiacs.

Size matters
As anyone with sexual experience knows, true sexual enthusiasm far outweighs any gifted parts. And contrary to another popular sex myth, the size of ones member has nothing to do with the size of ones hands or feet.

Viagra and oral medications can treat erectile dysfunction
Oral medications are only a temporary fix to a problem that may have other underlying health causes that should be addressed by a qualified physician. In addition, many men with health conditions, including hypertension and diabetes, cannot take oral prescriptions due to serious potential side effects or contraindications with other medications. For men who cannot use oral meds, there are a number of other options including urethral suppositories and ICP, an injection that produces an erection within minutes.

After a certain age, sex is no longer important
Sex is an important aspect of physical and emotional health and well being for adults of all ages, even those in their golden years. While some people believe that a decrease in libido is a natural part of aging, a loss of sexual desire can be related to a number of other factors including hormone deficiencies, depression, anxiety disorders, side effects of medication, changes to a relationship, communication barriers, or loss of a spouse or partner.

Men have more sexual urges than women do
Though many men would have you believe they're ready to go 24 hours a day, 7 days a week, the truth is that men experience daily fluctuations in libido, as do women. A man's readiness to hop in the sack can be impacted by many of the same factors that impact a woman's level of desire, including diet, sleep, health, stress, medical conditions, self-confidence, and relationship disharmony.

Great sex will just happen naturally
The human body doesn't come with an instruction manual. The "tricks of the trade" that pleased a former partner do not always translate with someone new. Good communication is the key to good sex, as is a willingness to be open to trying new techniques and positions to find out what each partner finds pleasurable. It can be a little awkward at first to over-communicate during sex, but think about the outcome: a partner who knows how to do it right every time.

Condoms Types

2010-05-30T08:20:00.000-07:00

There are a lot of different kinds of condoms, but don't worry. Here are the different types you can get:

Material - Most condoms are made from latex or polyurethane. The latex ones are a little stronger, so they give slightly better protection from STDs and pregnancy. A very small amount of people are allergic to latex, though, so they use polyurethane ones.
Size - Condoms come in lots of different sizes. You can get longer or shorter or wider or narrower ones. If a packet of condoms says 'large' or 'small', this is usually talking about the width of the condom, not the length. Be honest! A condom that is too big may come off, and a condom that's too small might break. Most condoms that you buy in shops and vending machines will be a standard size.
Lubricated - Some condoms are not lubricated at all, some have silicone-based lubricants, some have water-based lubricants. Some condoms are lubricated with a spermicide (see below).
Spermicidal - Some condoms have a spermicidal lubricant, which can help to reduce the likelihood of pregnancy. One of the most common spermicides is something called nonoxynol-9. This is a chemical that some people are sensitive to, and if it's used regularly it can can cause irritation and increase the chance of HIV infection. Condoms lubricated with Nonoxynol 9 should not be used for anal sex.
Ribbed - These condoms have little ridges running around them. These can make sex more pleasurable for both partners, and if they're used correctly (see below) then they're just as safe as ordinary ones. Ribbed condoms are the answer for people who complain "But I can't feel anything if I put on a condom. . . "
Coloured - The natural colour of latex is a creamy white, so lots of condoms have different colours - some of them even glow in the dark. Again, if they're used properly, they're fine.
Flavoured - Some sexually transmitted infections can be passed on orally, so it's a good idea to put on a condom for oral sex. Sometimes, people don't like the smell and taste of latex, so they use flavoured condoms. These can taste of anything from strawberry to curry! Flavoured condoms shouldn't be used for vaginal or anal sex, though, unless they have the kite mark sign in the UK and Europe, or are FDA approved in the USA.
Resevoir tipped - Most condoms have a reservoir tip to catch semen, some have a plain tip. If they have a reservoir tip, be sure to pinch the end when putting them on - if they have air inside them, they can break when you're having sex.

Physiological cHhaNges During PUberty

2010-05-30T08:10:00.000-07:00

Puberty is the name given to the physical and emotional changes which take place in most boys and girls between the ages of 10 and 14. These changes occur so that the body is able to make a baby. This is called reproduction, and can only occur when a boy and girl are sexually mature.

One of the main physical changes of puberty is the growth and development of the sex organs – the parts of the body that are used to have sex and make babies. Sex organs that can be seen on the outside of the body are called ‘genitals’ while those that are inside the body are usually called ‘reproductive organs’.

Some more about a girl’s sex organs

All genitals naturally vary in appearance so not all will look like the genitals represented here.

Between a girl’s legs there are three small holes. At the front is the urethral opening which a girl urinates through, and at the back is the anus which she defecates from. In between these two holes is a third hole, her vaginal opening. From the vaginal opening there is a small passageway or tube, called the vagina, which leads to the reproductive organs inside the body.

When a girl has her period the blood comes out through her vagina. Inside the vagina there is a small piece of thin skin called the hymen. The hymen partly covers the vaginal opening, but there is still enough of a gap for blood to get through. Sometimes the hymen breaks and bleeds slightly when a girl has sex for the first time.

Some other important parts of a girl’s sex organs are:

* The clitoris, which is at the front of a girl’s outside sex organs and is about the size of a pea
* The outer lips (labia) of a girl’s sex organs

The labia, the clitoris and the vaginal opening are together known as the vulva.

Some more about a boy’s sex organs

A picture of a boy's sex organs including, Pubic Hair, Shaft, Scrotum, Glans and Penis

The boy’s sex organs outside his body are his penis and testicles (testes).

A boy’s penis hangs down between his legs at the front of his body. The main parts of a penis are:

    * The shaft - the main, long part of the penis
    * The glans - the tip or head of the penis
    * The foreskin - skin which covers the glans
The foreskin can usually be pulled back quite easily. If it is tight it can be stretched by gently pulling it over the glans. All boys are born with a foreskin, but some have it removed when they are a baby, or later in life. The removal of the foreskin is called circumcision.

Underneath the penis is the scrotum – a loose, wrinkly pouch of skin that hangs down behind a boy’s penis. It contains his testicles. As a boy goes through puberty his testicles move lower down his scrotum. One of the testicles usually hangs lower than the other.
Eggs and Sperm

Inside a girl’s body are two small organs called the ovaries. Contained in these ovaries are hundreds of tiny sex cells called eggs, each no bigger than the head of a pin. At some point during puberty, the ovaries will begin to release these eggs. Usually one egg is released every month. This process is called ovulation.

A boy’s sex cells are called sperm and they are even smaller than a girl’s eggs. At puberty a boy's testicles will start making sperm. Sperm leaves a boy's body through his penis when it is hard and erect. This is known as ejaculation and it happens when a boy reaches the height of sexual excitement and has an orgasm. When a boy ejaculates, millions of tiny sperm are sent from his testes, up through his penis and out through the end. The sperm are contained in a sticky white fluid called semen.

When a boy’s sperm meets with a girl’s egg they usually join together, and a baby will begin to grow.
How do egg and sperm meet? – Sexual intercourse

The most common way that sperm get inside a girl’s body is through sexual intercourse. Sexual intercourse is when a boy puts his hard penis inside a girl's vagina. It is also often called having sex or making love.

Having sex (which usually involves moving the penis in and out of the vagina) is usually very pleasurable for both a boy and a girl, and it will often result in an orgasm for one or both partners. If a boy ejaculates while his penis is inside the girl’s vagina (or if semen gets inside the vagina any other way) then the millions of tiny sperm in the semen will swim up the vagina, through the cervix (the entrance to the uterus) and into the uterus (also known as the womb). From there they will swim into the fallopian tubes. In one of the fallopian tubes the sperm may find an egg that has recently been released by the ovary. The sperm will surround this egg and try to get inside it. Eventually just one sperm cell will succeed, and the egg and sperm will join. This joining is also known as fertilisation or conception.

This joined sperm and egg then travel back down to the uterus, where they will settle in the thick, blood-rich lining and start to grow into a baby. It is at this point that we say a girl is pregnant.
What happens if the sperm and the egg don’t meet? - Periods

    On average, the whole menstrual cycle (from the first day of the period to the day before the next) will last 28 days.

Girls generally only release an egg once a month, and it will normally take a few days to travel down the fallopian tube. If the sperm and the egg don't meet during this time, then she won’t become pregnant.

Without a new baby to nourish, the thick lining of the uterus is no longer needed. So, approximately 14 days after a girl’s egg is released, the bloody lining of the uterus will begin to come away, and will flow down through the cervix and out of the vagina. This process is called menstruation, and this is the blood that a girl will notice when she has her period. During puberty, a girl’s first period is a sign that she has released her very first egg, and is now able to have children.

Periods will usually last somewhere between 3 and 10 days. Around 14 days after the start of her last period, a girl will ovulate (release an egg) again, and will once again have the chance to become pregnant. This process of period, then ovulation, then period, is known as the menstrual cycle. On average, the whole menstrual cycle (from the first day of the period to the day before the next) will last 28 days, although variations between 21 and 35 days are quite normal.

More about pregnancy

Though an egg is usually released about the same time each month, this doesn’t mean that a girl can predict exactly when she will (or won’t) become pregnant. This is because girls usually have no way of knowing exactly when they are ovulating. Not only can the day of ovulation vary from girl to girl, it can vary from month to month in an individual girl.

In addition, sperm can survive for several days within the body, so they can ‘hang around’ waiting for an egg to be released if there isn’t one there already.

All this means that if a girl wants to avoid pregnancy but still have sex, she and her partner will need to use contraception. Sexually transmitted diseases, which can be passed on from one person to another during sexual intercourse, are also something that both boys and girls need to consider if they decide to have sex. Condoms are widely used because they help to prevent both pregnancy and sexually transmitted diseases.

Using contraception every time you have sex is very important if you want to avoid pregnancy. It is also important to remember that a girl can become pregnant even if:

    * It is the first time she has sexual intercourse
    * She has sex before she has her first period (it could be that she is ovulating for the first time)
    * She has sex during her period (sperm can stay alive for several days)
    * A boy withdraws his penis before he ejaculates (pre-come, the fluid that leaks out the penis before a boy ejaculates, can sometimes contain sperm)
    * She has sex standing up (sperm can swim in any direction – up or down!)

Because periods stop during pregnancy, the first sign that a girl may be pregnant is usually a missing period. If a girl doesn’t start her period at the usual time, it is probably a good idea for her to talk to her doctor or another adult as soon as she can. Periods can come late for other reasons (for example when a girl is stressed, on a very strict diet or has been unwell), but if she has had sex in the past month, then it may be a good idea to take a pregnancy test to be sure.

Sexual feelings during puberty

It isn’t just the body that changes during puberty - our feelings can change too, and like the changes to the sexual organs, these feelings prepare us to have sex and make babies.

What are the main physical signs of sexual feelings?

When boys get sexually excited, the main sign is that they get an erection. The main sign for girls is that their vagina begins to get moist, and their clitoris gets bigger. For both boys and girls when they are sexually excited or "turned on", extra blood comes to the surface of the skin, particularly around the penis and vagina. This can cause areas of the body to feel more sensitive, and some people find they get a warm sensation.
Sexual feelings and masturbation

A person can have sexual feelings any time in their life, but these change around puberty. You might find some sexual feelings just seem to happen to you. But sexual feelings mostly come about from things you choose to do, either on your own or with someone else.

A main way that people express their sexual feelings is by touching their own genitals. Girls can get pleasure from touching their clitoris, and boys from touching their penis, particularly the tip. This is called masturbation. Some people masturbate very often, maybe every day. Some people do it less often, and some don't masturbate at all.

    Masturbation is a normal and natural activity and is not bad for you unless you masturbate so much that you make your genital area sore.

When a person is masturbating they become more and more sexually excited. They may then reach a peak of sexual excitement which is called having an orgasm or "coming". This is when all the tension and excitement that has built up is suddenly released. Boys ejaculate when they have an orgasm and their penis will then go limp. Everybody has their own way of masturbating that feels good for them. For many masturbation is their first sexual experience.

There are many myths about masturbation which make some people think it is wrong. However, masturbation is a normal and natural activity and is not bad for you unless you masturbate so much that you make your genital area sore. Masturbation does not damage you health: it cannot cause cancer, give you a sexually transmitted infection, affect your eyesight, or make you go mad. It does not cause hair to grow on your palms or any other part of your body, and it doesn't stunt your growth. If it did, the vast majority of people in the world would be very short and unhealthy!
Sexual feelings in relationships

When people have sexual feelings for each other they will usually want to do sexual things together. There is no set time or order in which to do these things.

People often enjoy kissing, cuddling and holding hands. 'French kissing' is when both people open their mouths when they are kissing and their tongues touch together.

Many people also like to stroke or rub each others bodies, particularly their genital areas. Some people like to touch each other directly, and some prefer to do it through their clothes.

There are a variety of other sexual activities that people will also do including sexual intercourse.

It can seem natural to bring sexual feelings into a relationship. You might want to do something because you feel curious about it. Or because you think it will make you feel good. And you might want to do it because you feel very close to someone.

But it can also change how people feel about each other and about themselves. It's important not to do any of these things because you feel under pressure. And it's important to think about the consequences and how you will feel afterwards.

Sex Problems & Solution

2010-05-30T07:53:00.000-07:00

What is the most common cause of sex problems among couples?

While they can take many forms, sex problems are defined as any physical or emotional issue that prevents a couple from achieving a mutually satisfying intimate relationship. Among the most common for men include prostate problems, a decrease in the blood supply to the penis due to diabetes, heart disease or other health concerns, nerve damage to the spinal cord, or a decrease in the hormone testosterone. In women common problems include a lack of desire caused by a decrease in the hormone estrogen, thyroid disorders (which can also affect some men), and pain during intercourse caused by any number of vaginal problems, including a lack of lubrication.

Some couples also find that the use of certain drugs can also cause sexual problems. These include alcohol, nicotine, narcotics, stimulants, some blood pressure drugs, antihistamines, and certain antidepressant medications.

What is the most common sexual condition affecting men?

Studies show it is premature ejaculation, which can affect up to 75% of men. Clinically it is defined as the release of the ejaculate from the penis either before intercourse can take place, or quickly after it starts, usually within less than 15 "thrusts." While every man will experience premature ejaculation at least once in their life, for some the problem is chronic. When this is the case causes can be linked to a highly sensitive and easily stimulated nervous system, obsessive compulsive disorder, or sometimes a lack of control over the body's response to excitement. A frequently overlooked cause of temporary premature ejaculation is an infection in the prostate gland known as prostatitis. When this is the case, a course of antibiotics often solves the problem. Temporary problems can also result from stress, or from the use of certain medications including some cold pills.

Treatments for chronic premature ejaculation include the antidepressant medication clomipramine (Anafranil) taken 12 hours before sex, and use of a condom to help reduce sensation. Sometimes a prescription lidocaine cream can also help by reducing sensation, but that can also impact the partner.

What is the true definition of erectile dysfunction -- and what are the most common causes?

Erectile dysfunction (ED), also known as impotence, has a far broader definition than many couples realize. It includes, of course, not being able to obtain an erection, but also the inability to sustain an erection sufficient for intercourse, as well as the inability to ejaculate on a consistent basis.

While once believed to be largely an emotional problem, today doctors know ED is most often the result of other health concerns including diabetes, high blood pressure, kidney failure, early heart disease, prostate problems, and depression. Additionally, alcohol abuse is a major contributing factor, and in some men, cigarette smoking. Chronic stress can also play a role. In some men certain drugs can result in erectile dysfunction, most notably some high blood pressure medications and some treatments for depression.

What causes sexual dysfunction in women?

Unlike men who require certain physiological events to have intercourse, women have no such restrictions. As such, the most common reasons for sexual dysfunction are often based in matters of desire, sexual arousal, or sometimes painful intercourse. Some women also report an inability to have an orgasm or experience pain when achieving one.

While a decrease in desire can be caused by many things, including a negative relationship with a partner, or other life stresses, physical causes are often traced to a decrease in the hormones estrogen and testosterone that occur during menopause. Not only can this put a damper on desire, it can also cause a decrease in vaginal lubrication making it more difficult to become aroused and causing intercourse to be painful (see question 6). In addition, certain illnesses, most notably a thyroid disorder or depression, can also impact a woman's desire. The inability to achieve orgasm is seldom caused by a physical problem, but more often the result of inadequate stimulation by a woman's partner.

What causes pain in the penis?

Like in any other part of the body, pain in the penis can be the result of many things, including infection, trauma, or disease. Excessive manipulation can sometimes lead to pain, as can simple things such as insect bites or pimples. At the same time, painful lesions or sores on the penis may be genital herpes or another infection. Additionally, prostate inflammation, urethritis (an infection of the urinary tube frequently caused by gonorrhea or chlamydia), and sometimes sickle cell anemia can also cause penile pain. A condition known as Peyronie's disease results in an abnormal bend in the penis that makes intercourse painful for a man. In rare instances, pain can be a sign of penile cancer, so always check with your doctor if discomfort is significant and does not subside within a few days.

Why is intercourse painful for some women?

Medically known as dyspareunia, in up to 80% of women the cause is physiological. This can be the result of a decrease in female hormones leading to vaginal dryness, the presence of yeast or other sexually transmitted infections, cystitis or urethritis (infections of the urinary tract), or certain orthopaedic problems. In some instances, even chronic constipation may play a role. A condition known as vulvar vestibulitis, an inflammation in a particular area of the vagina, is the most commonly overlooked cause of dyspareunia.

A specific type of dyspareunia known as vaginismus causes involuntary spasms of the muscles within the vagina. In some instances, they can be so strong, the vagina seals shut making penetration extremely painful or sometimes, impossible. It often has roots in psychological trauma.

What is retrograde ejaculation -- and how is it treated?

A form of male sexual dysfunction, retrograde ejaculation means the ejaculate fluid that normally leaves the penis during orgasm takes a wrong biological turn and ends up depositing in the bladder. Here it mixes with urine and eventually leaves the body as waste product. The problem isn't harmful unless the couple is trying to conceive. Retrograde ejaculation can occur either partially or completely. In either instance the cause is frequently linked to prior prostate or urethral surgery, diabetes, and the use of certain drugs including medications for high blood pressure. Controlling blood sugar can help improve the problem, as can some epinephrine-like medications. Sometimes switching blood pressure medications also works.

Is having an erection for an extended period of time dangerous?

A lot depends on your definition of "extended!" The condition itself is known as "priapism" and it's defined, in clinical terms, as an erection that lasts four hours or more without sexual stimulation. Normally, stimulation causes blood to flow into the penis, which in turn results in an erection. After ejaculation -- or if stimulation is discontinued -- the blood drains and the erection recedes. When priapism occurs, blood that is sent to fill the penis becomes trapped, causing the erection to remain without relief. Not only can this be extremely painful, if not treated early on it can result in scarring inside the penis, and sometimes, permanent erectile dysfunction. Priapism can occur in any male, even newborns, but most commonly develops between the ages of 5 and 10 years old, and 20 and 50 years old. Treatment can be as simple as applying ice packs, or may involve injecting the penis with medications, or aspirating blood to reduce pain and swelling. Occasionally surgery is necessary to restore proper blood flow and drainage.

Which medications commonly cause sex problems for men or women?

The most well-known are antidepressant drugs such as Prozac, or tranquilizers, such as Valium, both of which can impact desire in both men and women. For women, certain birth control pills can put a damper on desire, as can some formulations of HRT used to treat menopause symptoms. Drugs known to increase the risk of impotency in men include certain high blood pressure medications, antihistamines used for colds or allergies, some nonsteroidal anti-inflammatory drugs (NSAIDs) (like ibuprofen), heartburn drugs such as Tagamet, Zantac, and Pepcid, some lipid-lowering drugs for cholesterol, and certain medications used to treat Parkinson's disease or cancer.

Is it true that sex can actually give some people a headache?

Yes, it's true. Medically, the condition is known as coital cephalalgia, and surprisingly, it affects men more often than women -- surprising because in general women get more headaches than men. While no one is certain what's behind the problem, some say it may be related to the sudden change in blood flow and subsequent drop in blood pressure following orgasm. Others contend it may be the result of a release of adrenaline that floods the body during periods of intense sexual activity. While some folks can have sex headaches for several weeks followed by permanent remission, for others the problem may come and go indefinitely, or sometimes be present with every sexual encounter. Although you might not suffer from migraine headaches, sex headaches are thought to be chemically related and frequently respond to similar treatments. One word of caution: Don't assume that a headache you experience after sex is a sex headache. Experts say sometimes, benign lesions in the brain or aneurysms (a blood vessel disorder) can also cause headaches after sex. To rule out such problems, don't diagnose yourself -- see your doctor.

IMPROVING FERTILITY

2010-02-06T11:05:00.000-08:00

Common causes of female fertility include:

Ovulatory Dysfunction, which may be caused by aging, anovulatory cycles, amenorrhea, luteal phase defects, premature ovarian failure, and elevated prolactin. Ovulatory problems account for about 25% of all cases.

Polycystic Ovary Syndrome, affecting 6–10% of reproductive-age women.

Anatomical abnormalities, such as fallopian tube blockage (sometimes a sequelum of pelvic surgery), uterine fibromas, myomas and leiomyomas.

Endometriosis, found in 30–45% of infertile women.

Medications, including hormones, antidepressants, antibiotics, pain-relievers, aspirin and ibuprofen (when taken at mid-cycle).

Non-gynecological medical conditions, including diabetes, inflammatory bowel disease, celiac disease, epilepsy, and thyroid conditions.

Common causes of male infertility include:

Impaired spermatogenesis due to cryptorchidism (failure of one or both testes to descend); varicocele; high fevers, infections, kidney diseases, metabolic disorders; hormone dysfunction.

Ductal obstructions caused by sexually transmitted infections, inflammation, developmental disorders like cystic fibrosis, or retrograde ejaculation.

Systemic diseases including hemochromatosis (causing iron deposition in the testes); sickle cell anemia, which may cause hypogonadism; testicular cancer, which may cause testicular dysfunction; and testicular trauma.

Pharmaceuticals used to treat hypertension, arthritis, digestive diseases, and cancer. Recreational drugs can also impair fertility.

Environmental and Lifestyle Factors

Environmental factors such as chemical toxins, radiation, and infections affect fertility in both women and men, modulating the hormonal balance related to conception, implantation and development. Declining sperm counts, observed over the last 50 years in men in developed countries, may be due to exposure to estrogen-like compounds in the environment. One study showed that blood levels of organochlorines are inversely related to sperm count and motility.

Environmental exposures, especially past exposures, are difficult to rectify. But daily lifestyle factors profoundly affect fertility, and they are more easily changed.

In men, avoiding alcohol consumption improves fertility. Excessive alcohol intake may decrease sperm count, reduce sperm motility, and induce sperm morphologic abnormalities. Cigarettes are also bad news. Cadmium, a toxic metal found in cigarette smoke, negatively influences fertility. Smokers have lower sperm counts and reduced motility compared to non-smokers. Marijuana use adversely impacts fertility.

Heavy caffeine intake is also detrimental. Consumption of more than 2 cups of coffee per day may negatively affect fertility, particularly among women with endometriosis and fallopian tube disease.

In women, excessive physical activity and substantial weight loss can cause menstrual irregularities, amenorrhea, and anovulation. In fact, rapid weight loss is known to lower progesterone levels, slow follicular growth, and inhibit the luteinizing hormone surge, suppressing ovulation. Weight loss also mobilizes toxins stored in body fat, increasing systemic exposure. While it is generally healthy for overweight/obese women to shed pounds, it needs to be done carefully and not drastically, especially if a woman is trying to conceive.

Vitamins, Minerals, & Amino Acids

Nutritional status strongly influences fertility. There are a number of scientifically validated nutritional supplements that can assist in improving fertility. It is important to assess the nutritional status of both partners, and try to correct deficiencies and imbalances.

B Vitamins
B vitamin deficiency may predispose a person to altered hormone levels. Folic acid, in particular, is very important for preventing cellular oxidative damage and maintaining the health of the cervix.

Iron
Iron deficiency may cause amenorrhea, making it difficult to conceive. Supplementation in women with lower iron levels improves fertility. An important nutrient for erythropoiesis, pregnant women require substantial amounts of iron. Deficiency during pregnancy is associated with complications and increased perinatal maternal mortality.

Zinc
In men, low zinc concentrations negatively affect serum testosterone levels and seminal volume. Seminal plasma zinc level positively correlates with sperm density, which in turn affects spermatogenesis. Infertile males have lower concentrations of seminal plasma zinc, which correlates with reduced blood zinc levels. In one study, men with reduced sperm motility were supplemented with 250mg of zinc daily for 3 months. Within six months, they showed significantly higher sperm counts, better progressive motility, and improved fertilizing capacity, as well as a reduced presence of anti-sperm antibodies.

Vitamins C & E
Vitamin C, and other antioxidant vitamins promote fertility in both men and women. In men, low levels of vitamin C are associated with increased oxidative damage to spermatic DNA. In one study, vitamin C intake in normal healthy men was reduced from 250 mg to 5 mg per day. This dropped seminal vitamin C levels by 50% and induced a 91% increase in spermatic DNA damage.
Vitamin C is also important for female fertility. In animal models, supplementation with vitamins C and E decreased age-related reduction in ovulation rates. A human study found that women taking clomiphene with no results were able to have a menses and ovulate following the addition of 400 mg of vitamin C daily.
Vitamin E supplementation significantly decreases malondialdehyde (MDA), an indicator of lipid peroxidation, in seminal plasma and spermatozoa. It also improves sperm motility. Supplementation with vitamin E and selenium in men with low sperm counts and decreased motility improved both of these infertility factors after 6 months.

Selenium
Selenium is important for sperm motility. Infertile men were supplemented with selenium, selenium plus vitamins A, C, and E, or placebo for 3 months. The subjects in both selenium groups had significantly improved sperm motility, and 11% impregnated their partners during the 3-month study.

Amino Acids
Arginine is converted to several compounds believed to play a role in sperm motility. In one study, 74% of men supplemented with 4 grams arginine daily for 3 months showed improved sperm counts and motility. Carnitine is important for healthy sperm development. Studies of infertile men have shown a direct correlation between seminal carnitine content and sperm motility, and a positive correlation between carnitine supplementation, sperm counts and number of motile sperm.

Botanical Support for Fertility

Several medicinal herbs have proven useful in helping to promote healthy reproductive function in women and men. Here are three of the most effective:

Vitex agnus castus (Chasteberry)
Chasteberry has several hormone-normalizing effects. In women with hyperprolactinemia, 3 months of Vitex supplementation of 20mg per day resulted in suppressed prolactin release, a lengthened luteal phase, and improved progesterone synthesis. In another study, women with polymenorrhea, oligomenorrhea, and corpus luteum insufficiency were treated with a standardized extract of Vitex for 6 months. Vitex increased average progesterone levels, and normalized the menstrual cycle in 64% of the women; 29% of the women became pregnant.

Panax Ginseng (Asian ginseng)
Ginseng is an adaptogenic herb used traditionally to enhance libido. In one study, men supplemented with a Ginseng extract showed an increase in sperm number and motility, as well as total and free testosterone, dihydrotestosterone, LH, and FSH. Prolactin levels dropped.

Lepidium meyenii (Maca)
Maca, a tuberous root vegetable that is a staple food in the high Andes mountains, has been shown to improve seminal parameters without modulating hormone levels. In one study, 9 men supplemented with 1,500 or 3,000 mg of Maca per day for 4 months showed increases in seminal volume, sperm counts, motile sperm numbers, and sperm motility.

Natural Fertility Supplements

The following supplements were developed by leading ObGyn, Dr. Amos Grunebaum, a noted fertility expert and Director of Clinical Maternal-Fetal Medicine at one of the nation’s top university medical centers. Doctors often refer these products to patients as they supply comprehensive supplementation of the specific vitamins, minerals, and herbal ingredients recommended for trying-to-conceive couples. Further, these non-prescription supplements represent a significant savings when compared to purchasing the individual ingredients independently.

FertilAid for Women
FertilAid for Women is a natural fertility supplement designed to provide nutritional support and promote hormonal balance. FertilAid brings together complete prenatal vitamin support (including folic acid) with a select blend of herbal ingredients that have been shown to benefit trying-to-conceive women, including Vitex Agnus Castus.

FertilAid for Men
A male fertility enhancing supplement, FertilAid for Men has been shown to increase the total number of motile sperm according to a study presented at the 2009 American Society of Andrology annual meeting. FertilAid for Men contains a comprehensive blend of key sperm-enhancing vitamins (including 250 mg Vitamin C and 150 IU Vitamin E), minerals (including 50 mg Zinc and 70 mcg Selenium), and the amino acid L-Carnitine, which promotes sperm development.

FertileCM
FertileCM is a natural supplement designed to improve the quantity and quality of cervical mucus produced by trying-to-conceive women. Among other ingredients, FertileCM contains L-Arginine, an amino acid that promotes the synthesis of Nitric Oxide, which supports the production of endocervical secretions before and during ovulation. FertileCM also contains N-acetylcysteine, a natural mucolytic which helps thin overall mucus secretions.

Stress Reduction & Mind-Body Approaches

Generally speaking, stress interferes with fertility. A couple under constant, intense stress may have great difficulty conceiving, assuming they are even able to be intimate with one another. Yoga and acupuncture are both effective in reducing stress and may improve fertility. One study showed that adding acupuncture to conventional treatments for anovulation improved the pregnancy rate to 44% versus just 16% in the group on drug treatment alone. Targeted yoga practices, such as Dr. Anna Davis’ "Bend, Breathe, and Conceive" DVD, have been developed specifically for trying-to-conceive women.

Nutritional protocols, lifestyle change and stress reduction are relatively inexpensive and can benefit patients in many ways. In cases where they can help a couple conceive without pharmaceutical interventions, they provide a huge return on investment. Keep in mind that each cycle of in vitro fertilization costs approximately $12,000!

Natural, nutrition-based approaches are also safer, carrying little risk of harm. In contrast, ART interventions increase the risk of multiple births, which increases the risk of maternal complications, premature birth, low birth-weight babies, fetal growth restriction, infant death or disability, and health and developmental problems. Nutritional and lifestyle interventions may not help every infertile couple, but they can help some. When they work, they can spare couples the considerable risk and expense associated with more invasive treatments.

For couples seeking natural alternatives to prescription medications or invasive infertility treatments, Fairhaven Health offers a broad range of products to help couples conceive. Visit them to learn more about fertility supplements, ovulation predictors, and much more.

2010-02-06T10:59:00.000-08:00

Sex = babies, right? Actually, it's surprising as many people get pregnant as they do. If everything is in working order for both partners and the timing is just right, you still only have a 25% chance of egg + sperm = pregnancy. Many people believe that there are a few things you can do to improve your odds while trying.

Timing is Everything

When our mothers warned us it could happen the first time no matter when we had sex, they were mostly trying to scare us. Granted, it can happen, but the best time to get pregnant is when you're ovulating–usually somewhere between days 12 and 20 of your cycle. There's a whole science to determining when you're ovulating – you can pee on a stick, check your cervical mucus, or chart your temperature. Find out which fertility test and monitor works best for you and circle the day on your calendar.

Sex every day when you're ovulating is ideal if the sperm count is good; if not, aim for every other day instead. Men should refrain from unproductive ejaculation for 48 hours prior to the woman's fertile time.
Get an Oil Change

While sperm can be pretty hardy, it doesn't take much to slow them down. Unfortunately, using most kinds of oils, lubricants or similar products can keep sperm from getting where it wants to go.

Even if your lubricant doesn't contain a spermicide (such as nonoxynol-9), it may contain other ingredients that can be toxic to sperm. A product named ConceivEase, developed by gynecologists, is the most fertility-friendly lubricant on the market.

Some kinds of sex play need to wait until later in the month when you're not trying to have a baby. Since saliva can slow down sperm on the way to meet the eggs, oral sex should be kept to minimum when trying to conceive.

Get Natural

Natural treatments, such as vitamins and herbs, which are thought to restore a woman's ovulation cycles and improve a man's sperm count can also be an important aspect of helping a couple get pregnant.

Sex Positions

The issue of whether or not sex positions affect the chances of conception is controversial. There is no scientific evidence that coital poisitioning will improve your chances (ASRM). However, many people feel that, despite the fact that vaginal mucus is primarily responsible for moving sperm towards the egg, it's a good idea to give gravity a chance to aid the process.

Those who advocate optimizing sex positions to aid conception generally espouse the following:

Optimize your position

Any type of sex can result in conception, but if you're having trouble, woman on top may not be your best option. Toni Weschler, MS suggests that "if you have a tipped uterus, you may have better luck having intercourse from behind with the female on her hands and knees. Having intercourse in this position it allows the sperm better access to the cervix."

Post-coital Tilt

When you're done playing, stick a pillow under your hips and elevate them slightly for 15-20 minutes. You're increasing your odds and sperm swimming to the cervix. You don't have to put your legs in the air and you don't need an expensive "infertility pillow," either – just throw a towel over the pillow and get comfy. Again, this is more of a common sense measure that is not scientifically confirmed to produce results but it can't hurt.

Stay Out of the Water

Even if you're trying to jazz up the baby-making sex, nix the hot tub – for a couple of reasons. First, hot water decreases sperm production. And if you have sex in the water, there's a good chance that the sperm will end up swimming in the hot tub.

Was it Good for You?

Some folks believe the woman needs to have an orgasm on the theory that the contractions of her reproductive system may draw the sperm further toward the cervix and into the uterus, enhancing conception. There's no research to back that up, but it won't hurt, either. The male partner, however, should definitely ejaculate.

Good Sex keeps Doctors Away!!!

2010-02-06T10:54:00.000-08:00

You would have never thought that a kiss could help keeping dental worries at bay or a gratifying sexual act at night make you feel fit and fresh the next morning. But that's what studies across the web claim.

Healthy sex leads to a healthy life. You may have tried copious measures to get that extra glowing skin and shiny hair. You must have also worked out rigorously to achieve that perfect ten figure you've desired. But the key to your mind and heart is fulfilling sex. Even for those who lose their temper or are always in a depressed state of mind, 'sex' can be the solution.

A happy sexual life with your partner not only gets you in shape with better skin texture and silken tresses, it also burns extra calories, keeps you fit, combats asthma, relieves headache, reduces depression and tranquilises your mind. From make-up experts, hair stylists, sexologists and fitness connoisseurs – there's a common consensus that a vigourous sexual life leads to a healthy life – both physically and emotionally. We get them share more on this...

There have been several notions stating that 'sex' produces certain hormones that bring happiness, which lead to a fit body and a healthy mind. Shedding some light on this, Dr. Sanjay Chugh, specialist on sexual issues, states, "Sex contributes to general good health. Any sexual intimacy that is enjoyable and pleasurable promotes well being by providing several physical and psychological benefits. It is believed that sex boosts chemicals in the body that protects us against diseases. Research also suggests that sex and masturbation can help ease joint and muscle pain, combat depression, promote heart health and lengthen one's life span."

Dr. Samir Parikh, clinical physiatrist adds, "The basic fact is that a good sex life also means in a larger picture, a good relationship with one's partner and this makes the partner happier, less stressed and by virtue of that physically healthier."

Not just this, sex also accelerates blood circulation and one's basic metabolic rate, which further enhances the well-being of our mind and soul and helps us calm down.

On these emotional benefits, Dr Chugh adds, "A satisfying sexual relationship strengthens the bond between couples, making them feel secure and loved. The feeling of emotional connectedness adds to ones sense of belonging, which in totality helps them achieve a positive physical, psychological and spiritual state that is necessary for one's general health."

Elaborating further, on a scientific angle, Dr Avdesh Sharma, a consultant psychiatrist, and an expert on relationship issues shares, "Sex is a way of bonding at the physical, mental and emotional level and leads to health (including psychological) benefits. If it is used as a mechanical process, it may have limited benefits. There are physiological benefits of positive changes in parameters like pulse, heart rate, reduction in blood pressure (after an increase in B.P. specially if vigourous sex is tried), dilation of blood vessels and capillaries of the skin, leading to a 'glow', burning of a few calories (depending on the duration of the act and vigour), exercising of some of the muscles, thus improving lung capacity (during heavy breathing)."

However, we also need to understand that sexual acts work more in terms of improving resistance, but are not a safe guard or a treatment to illnesses. Any sexual act can neither be used as a treatment nor would it change your stresses of life, which one would need to resolve irrespective.

"The extra edge of sex may be due to the feeling of being wanted, an expression of emotions and certain hormonal and physiological changes that happen as an expression of love for another individual. Unfortunately, the benefits of sexuality are usually quoted out of context and people may look at this as a panacea for everything. But sexuality without emotions have limited value," concludes Dr Avdesh Sharma.

Have sex stay fit : Sex may seem like the safest sport you can take up. It de-stresses you, keeps you rejuvenated, elevates your moods and stretchs, tones and exercises your body muscles.

Expert opinion : Dr Ishi Khosla, clinical nutritionist, Director Whole Foods asserts, "Sexual acts certainly lead to a normal mental well-being and a healthy state of mind. This in turn creates a physically fit body. If there's an ill-health or manifestation of any problem, it would reflect on your outer body."

Dr Samir Parikh adds, "You would still need a balanced lifestyle, which means that if you compare two equals in terms of lifestyle age and other factors as a constant, then it's possible that a sexually active person feels better."

Sex burns extra calories : It is indeed a form of exercise and naturally burns one's calories too.

Expert Opinion : Dr Geetu Amarnani, wellness expert at Kolmet Hospital, opines, "While having sex, the BMP (basic metabolic rate) increases and that ultimately helps in burning the calories, so it's widely believed that one can shed that extra flab through sexual encounters."

Sex for glowing skin and hair : When women make love they produce the hormone oestrogen which makes their hair shine and their skin smooth.

Expert Opinion : Make-up expert Sylvie, also an expert on sexual issues asserts, "As sex helps releasing the extra level of frustration and stress on one's mind and body, so logically it leads to a glow on your face and your skin texture looks better too. Also, hormones in our body are activated at a faster rate than usual during sex, which helps in better blood circulation, adding that extra shine to one's skin and hair."

Sex brings relief from headaches, reduces depression and tranquilises your mind : A satisfying love-making session releases tension that restricts blood vessels in the brain. It brings you out of a depressed state of mind and acts as a tranquilliser.

Expert Opinion : Dr Sanjay Chugh, "The pleasure that is derived from a satisfying sexual act tends to relax one's mind, taking away headache. It releases endorphins into the bloodstream, producing a sense of euphoria and leaving you with a feeling of well-being. Good sex leaves the person feeling relaxed and satisfied thus acting like a tranquiliser."

A kiss to keep dental problems at bay : It is medically accepted that a kiss encourages saliva to wash food from the teeth and lowers the level of the acid that causes decay. It also prevents the build-up of plaque.

Expert Opinion : Dental expert, Dr. Vandana Jyoti opines, “Anything that increases salivation will help in bringing down the acid level, which causes damage to one’s teeth. It also prevents cavity. Other than a kiss, chewing gum and more of lemon intake also tend to act in the same manner. But one has to be extra careful, as it might act the other way round, in terms of spreading germs, if either of the two persons involved in a kiss is suffering from a tooth infection.

For a Mgical WEDDING NIGHT-10 Tips to follow

2010-02-06T10:49:00.001-08:00

There's a general national myth about wedding nights; supposedly, every bride and groom have the most intimate and wonderful sex of their lives on their wedding nights. In reality, while your wedding night may be a little different, it is an intimate moment, and an opportunity. Here are ten tips that can help make your wedding night one of the best evenings of your life.

1. Take things slowly
Savor this moment. While you may be a little too tired to have the most technically excellent sex of your lives, this is likely to be among your most romantic and intimate sexual experiences.

2. Lower your expectations
So this may not be the most amazing sex you've ever had. So what? Try to just enjoy whatever happens.

3. Read some sex books
Who couldn't use a little advice from the experts? Some to try: The Good Vibrations Guide to Sex, Sex Tips for Straight Women from a Gay Man and Lesbian Sex Secrets for Men.

4. Talk to each other
Spend some time relaxing, talking about the wedding, and about your love for each other. Let things get romantic and sappy. The sex that follows will be intimate and amazing.

5. Expand your idea of the "wedding night"
If you're too tired for foreplay, that sex isn't going to be so great. Couldn't it be better to wait until the morning?

6. Flirt with each other during the wedding
It can be easy to spend the whole wedding greeting Aunt Sally and Cousin Bob, cutting the cake, and attending to a thousand other details. Don't forget to stop, stare into each other's eyes, share a few extra kisses, and flirt with each other. It will also help build the excitement for your alone time later.

7. Don't have sex with each other for a couple of weeks before the wedding
Many couples try this to make the wedding night sex fresh and new again. Others go even further by giving up sex months before the wedding so that they may be virgin-like on the wedding night.

8. Try something new
Perhaps there's been something you've been wanting to try? Your wedding night can be a fun night to experiment,

9. Wear something special
Wedding night lingerie can really help the mood. Pick something a little different than what you usually wear to excite your partner. Make sure you feel confident in it, as a confident lover is almost always a better lover.

10. Set the stage
Help yourselves get into the mood by setting the stage. Light some candles, bring some CDs and a radio, scatter rosepetals, or do whatever helps you get in the mood. And don't be afraid to kick friends and family out early. While they may tease you a little, they'll certainly understand!

It's also a good idea to accept the fact that you may be too exhausted or tipsy to have sex. If one of you falls asleep, or isn't in the mood, remember, it's not a prediction of a doomed marriage. Spend the time relaxing and remembering how wonderful your wedding day was. And, if you'll be a virgin on your wedding night, don't forget to read Sex Tips for Virgins on Their Wedding Night

you should not ignore-10 sex tips

2010-02-06T10:47:00.000-08:00

Now that you are in a physical relationship you probably assume that you know all there is to know. But sex advice does not begin and end with protected sex. While it is important to have protected sex there are a few other things that you must know.

Make sure you and your partner get tested for HIV, AIDS and other STDs before you indulge in sex.

1. Even though you are free of any venereal disease, make sure you have protected sex. This will prevent the possibility of any sexual infection or unwanted pregnancy.

2. Remember, birth control pills are effective only if you take them a month before you start having sex and you need to continue taking them as long as you have sex. If you miss taking the pill for even a day and you have had unprotected sex, you could get pregnant.

3. Most couples believe that standing up or jumping immediately after unprotected sex will prevent unwanted pregnancies. This is a myth bacause if you have had unprotected sex, you can get pregnant or even get sexually transmitted diseases.

4. Most women in India get married early and are sexually active at an early age. Cervical cancer spreads because women are sexually active and bear children at an early age. So get a Pap smear test done just to be on the safe side.

5. If your body does not produce enough natural lubrication, you can use lubricants available in the market. Check with your gynaecologist about the brands available.

6. Stay monogamous. While being with several men may be the trend these days, remember that you are exposing yourself to a host of STDs. So stick to one man and stay safe.

7. Video recording sex sessions are not a good idea, especially if you are not married to the man. While it may be over-the-top to do it, it is also very risky. You never know where the tape may land up. So say no to video-recording.

8. If you are uncomfortable with having sex with your partner for whatever reason, it is okay for you to say no. Only do things that you are comfortable with. You do not have to be a 'Yes' woman.

9. Make sure that you get a complete medical test done annually once you are sexually active. Incase you suspect STDs, get yourself tested for it. There is nothing to be ashamed or scared about. Get yourself treated before it is too late.

And finally,

10. Are you bored of your sex life? Then experimenting with foreplay and sex always helps spice things up.

So go ahead girls, stay safe and stay protected.

Teens And Sex

2009-06-16T23:54:00.000-07:00

While many teens wish they could talk to their parents about sex, most feel uncomfortable asking questions. Instead, teens get most of their information about sex from friends, TV, and the movies. Unfortunately, much of what they learn is wrong!

So don't wait for your teen to start the conversation-it's up to you. If you've already begun talking to your child about sex, great! Keep talking.

Teens And Their Sex Mentality :

* Some parents believe that talking about sex will lead teens to have sex. In fact, research shows that teens who have talked with their parents about sex are more likely to postpone sex and to use birth control when they do begin.
* Teens who have high self-esteem are more likely to make responsible decisions about sex.
* Teens often believe that all their friends are having sex. This belief puts pressure on teens (especially boys) to have sex.
* Every hour 350 teens contact a sexually transmitted disease (STD).
* The United States has one of the highest birth rates among developed countries.
* Teens often overestimate the percentage of their peers who are sexually experienced

Parents Practicalism :

1. Teens need accurate information and decision-making skills to help protect them from pressure to have sex, unintended pregnancy, and HIV/AIDS and other sexually transmitted diseases.
2. If talking with your teen about sex is difficult for you, admit it. Keep a sense of humor.
3. Use TV, movies, articles, and real-life situations such as a friend's pregnancy to begin talking about sex.
4. Share your values regarding sex. If you believe a person should save having sex until marriage, say so. Accept that your teen may choose to have sex despite your values.
5. Don't assume that if your teen asks questions about sex, he or she is necessarily thinking about having sex.
6. Ask your teen what he or she wants to know about sex. If you don't know an answer, admit it. Find answers with your teen in books or other resources.
7. Talk with your teen about reasons to wait to have sex. Remind your teen that he or she can choose to wait (abstain) even if he or she has had sex before.
8. Reassure your teen that not everyone is having sex and that it is okay to be a virgin. The decision to become sexually active is too important to be based on what other people think or do.
9. Talk with your teen about ways to handle pressure from others to have sex. To feel comfortable talking openly with you, your teen needs to know that you will not punish him or her for being honest.
10. Leave age-appropriate articles or books about teenage sexuality around your home (see Resources). Teens will pick them up on their own and read them.
11. Your first talk with your teen about sex should not be your last! Talk with your teen about sex on an ongoing basis. Let your teen know that you are always willing to talk about any question or concern he or she may have about sex.

Topics to talk about with your teen :

* male and female reproductive systems
* sexual intercourse
* pregnancy
* abstinence/postponing sex
* ways to show affection without having sex
* birth control
* safer sex
* sexual orientation (heterosexual, homosexual, bisexual)
* HIV/AIDS and other STDs
* emotional consequences of having sex
* sexual assault, including date rape
* how alcohol and other drugs can affect decisions

[Its always good for a child parent relationship to have such descriptive talks.I personally have felt it so often that I just can't resist talking these to my child as and when need arises]

Sex During Pregnancy

2009-06-15T04:50:00.000-07:00

There are varied views regarding sex during pregnancy.

Some cultures believe that a woman becomes sacred during pregnancy and that her sexual organs should be left alone till the time she is breastfeeding. In others, men feel it their birthright to choose when to have sex with a woman irrespective of a woman's condition or her desires.

Regarding women, some feel it disgusting to have sex during pregnancy, while others enjoy their sexual relationship much more during these months.

Whatever one's viewpoint, after the confirmation of pregnancy, whether acknowledged or not, both man and woman develop an altered view of their sexuality from what it was. This, being a potential area of conflict, should be dealt with between the partners in an understanding and frank manner so as to avoid any future problems in the relationship.

One must be honest and have an open communication regarding their desires, comfort levels, changing attitudes and the woman's changing body. Whatever be the decision (whether to continue a sexual relation or not) must be approached in a meaningful way.

During pregnancy, menstruation and fertility is suspended. This reversal of function tends to support the belief that it is inappropriate to use the vagina & uterus for sex between conception and childbirth. So, those who intend practicing celibacy or diminished sex during pregnancy need to communicate this very openly. It is a time when the woman can pay close attention to her body and mind. She can internalize her sexual energy as extra sustenance for the growing child. This is a challenging situation or the man, so explaining why you are not interested in sex is a good option. However, you may continue to share sensuality in other ways without full intercourse.

If you wish to continue sex during pregnancy, it is important for the woman to have greater control over initiation and during sex. Lovemaking during sex can be an opportunity for a shared appreciation of each other - more so for the woman who may feel herself as awkward and bulky and not in the same manner as she felt before.

Besides the feel good factor, sex during pregnancy does have some benefits -

* Intercourse close to birth, helps to soften the cervix due to the hormones present in the semen.
* Pelvic movements are good for the uterus and the pelvic muscle and bone.
* Any lovemaking (need not be penetrative) leading to orgasm increases blood supply to the uterus and vagina thereby stimulating relaxation in that area.
* Keeps the woman connected to her sexuality and sexual organs in preparation for birth.
* Love is a time to transfer love and consciousness to the growing baby and along with it, all the 3 spirits to feel closely connected through the mother.

There are no known risks of sex during pregnancy except if there is a history of miscarriage or spotting. In either case, it is recommended that you take the advice of your doctor or home birther and take adequate rest while following abstinence.

In conclusion, attitudes towards sex in pregnancy can be quite varied due to emotional, psychological and physical reasons - it is perfectly normal and should be discussed between partners for a healthier relationship.

Talking With Kids Sex and Relationships

2009-06-10T03:58:00.000-07:00

Most parents want to do their best in talking with their kids about sex and sexuality, but we're often not sure how to begin. Here's our advice:

Explore your own attitudes

Studies show that kids who feel they can talk with their parents about sex -- because their moms and dads speak openly and listen carefully to them -- are less likely to engage in high-risk behavior as teens than kids who do not feel they can talk with their parents about the subject. So explore your feelings about sex. If you are very uncomfortable with the subject, read some books (see Readings for Parents) and discuss your feelings with a trusted friend, relative, physician, or clergy member. The more you examine the subject, the more confident you'll feel discussing it.

Even if you can't quite overcome your discomfort, don't worry about admitting it to your kids. It's okay to say something like, "You know, I'm uncomfortable talking about sex because my parents never talked with me about it. But I want us to be able to talk about anything -- including sex -- so please come to me if you have any questions. And if I don't know the answer, I'll find out."

Start early

Teaching your children about sex demands a gentle, continuous flow of information that should begin as early as possible -- for instance, when teaching your toddler where his nose and toes are, include "this is your penis" or "this is your vagina" in your talks. As your child grows, you can continue her education by adding more materials gradually until she understands the subject well.
Take the initiative

If your child hasn't started asking questions about sex, look for a good opportunity to bring it up. Say, for instance, the mother of an 8-year-old's best friend is pregnant. You can say, "Did you notice that David's mommy's tummy is getting bigger? That's because she's going to have a baby and she's carrying it inside her. Do you know how the baby got inside her?" then let the conversation move from there.
Talk about more than the "Birds and the Bees"

While our children need to know the biological facts about sex, they also need to understand that sexual relationships involve caring, concern and responsibility. By discussing the emotional aspect of a sexual relationship with your child, she will be better informed to make decisions later on and to resist peer pressure. If your child is a pre-teen, you need to include some message about the responsibilities and consequences of sexual activity. Conversations with 11 and 12-year-olds, for example, should include talks about unwanted pregnancy and how they can protect themselves.

One aspect that many parents overlook when discussing sex with their child is dating. As opposed to movies, where two people meet and later end up in bed together, in real life there is time to get to know each other -- time to hold hands, go bowling, see a movie, or just talk. Children need to know that this is an important part of a caring relationship.

Give accurate, age-appropriate information

Talk about sex in a way that fits the age and stage of your child. If your 8-year-old asks why boys and girls change so much physically as they grow, you can say something like, "The body has special chemicals called hormones that tell it whether to become a boy or a girl. A boy has a penis and testicles, and when he grows older his voice gets lower and he gets more hair on his body. A girl has a vulva and vagina, and when she gets older she grows breasts and her hips grow rounder."

Anticipate the next stage of development

Children can get frightened and confused by the sudden changes their bodies begin to go through as they reach puberty. To help stop any anxiety, talk with your kids not only about their current stage of development but about the next stage, too. An 8-year-old girl is old enough to learn about menstruation, just as a boy that age is ready to learn how his body will change.

Communicate your values

It's our responsibility to let our children know our values about sex. Although they may not adopt these values as they mature, at least they'll be aware of them as they struggle to figure out how they feel and want to behave.

Talk with your child of the opposite sex

Some parents feel uncomfortable talking with their child about topics like sex if the youngster is of the opposite gender. While that's certainly understandable, don't let it become an excuse to close off conversation. If you're a single mother of a son, for example, you can turn to books to help guide you or ask your doctor for some advice on how to bring up the topic with your child. You could also recruit an uncle or other close male friend or relative to discuss the subject with your child, provided there is already good, open communication between them. If there are two parents in the household, it might feel less awkward to have the dad talk with the boy and the mom with the girl. That's not a hard and fast rule, though. If you're comfortable talking with either sons or daughters, go right ahead. Just make sure that gender differences don't make subjects like sex taboo.

Relax

Don't worry about knowing all the answers to your children's questions; what you know is a lot less important than how you respond. If you can convey the message that no subject, including sex, is forbidden in your home, you'll be doing just fine.

What's safe sex?

If two people have sexual intercourse, and one of them has HIV or another sexually transmitted disease, he could give it to his partner(s). Doctors believe that if the man wears a latex condom whenever he has intercourse, it helps to protect him and his partner from giving each other HIV. That's why people call sexual intercourse with a latex condom "safe sex."

Is it true that you can't get pregnant the first time that you have sex?

No. You can get pregnant anytime you have sexual intercourse. Wearing a latex condom, taking birth control pills, or using other contraceptives are very effective at preventing pregnancy. However, the only absolute way to not get pregnant is to not have sex at all. You might also use this question as an opportunity to point out that not having sexual intercourse is a good idea for teens. Help them understand there are other ways to show affection.

Controlling Periods With Contraception

2009-06-10T03:43:00.000-07:00

Is your period supposed to start next week, at the same time as an upcoming event such as a wedding, holiday, sports competition, or exam? If you are using birth control methods such as the oral contraceptive pill, patch, or vaginal ring, you can delay your period until a more convenient time.

Birth Control Pills

Are you taking birth control pills in a 28-pill pack? To extend your cycle, finish taking the 21 active pills. Instead of taking the seven placebo (or sugar) pills, start a new pack immediately and continue on through the pack. This will have you taking six active pill weeks in a row. After the second pack of 21 active pills is done, continue to take the seven placebo pills and have a period that week.

Taking a 21-pill pack? After finishing the 21 pills, eliminate the pill-free week and start a new pack of pills right away. Finish this pack as well, making it six weeks of active pills. Once the second pack is done, take a pill-free week and have a period.

Contraceptive Patch or Vaginal ring

Using the patch or the vaginal ring? Once you have completed 21 days of either method (one ring or three patches), instead of having a week off and menstruating, continue immediately with another patch or ring. With the patch, you can add one, two, or three more extra weeks, depending on your schedule. For the vaginal ring, once the second three-week ring is done, remove it and have a ring-free week.

During the additional weeks of treatment, you may experience spotting or breakthrough bleeding. This is not harmful and the contraception effect will continue to work even if there is bleeding or spotting. Continue to take your contraceptive method according to the plan you and your health care provider have agreed upon.

Talk to Partner About Sex

2009-06-10T03:25:00.000-07:00

Sex has always been an essential part of life. Yet, after all this time, men and women still seem to speak different languages when it comes to sex. Men often focus on the physical act of sex - a nuts-and-bolts approach, so to speak. Women, however, tend to talk about sex from an emotional point of view - the caring, sharing and intimacy wrapped up in it.

But in spite of our differences, these days communication is more important than ever. With the advent of HIV/AIDS and the increased spread of dangerous STIs, talking about sex before you have sex could literally save your life. While the cold mechanics of safer sex may seem a bit unromantic, some of the alternatives - embarrassing trips to the clinic, unsightly diseases or even death - aren't exactly sexy either. In the end, whether you practice safer sex is your decision. But whatever you choice, it's a good idea to understand the benefits and risks associated with your decision. You may find this website a good place to find some of that information.

If you do decide to practice safer sex, you may want to bring up the subject with your partner before actually having sex. Usually, the best time to have this talk is before you both get worked up.

If you're a woman, you may want to say something like:

"You know that at some point we may become intimate." "This is what I expect from someone who loves and cares about me." "I want you to be honest about your sexual history - I will be honest about mine." "I want you to wear a condom when we make love."

HA HA HA...This conversation may be a little awkward, but most people will understand that you're only looking out for your health and theirs. Also, if you're sure you want to have sex with someone, you may want to use this conversation to initiate sex. Just be firm and prepared, and make sure that you leave yourself an opening to delay or call of sex if your partner is unwilling to meet your requests.

Tips:

* Make sure to express your needs from a personal perspective - this will help put your partner at ease
* Be clear, honest and open about your desires, your likes and dislikes
* Pay attention to your partner's responses, and take his/her feelings into consideration
* If you agree to have safe sex, don't get so caught up in passion that you forget about it later.

Remember, worrying about pregnancy or disease is one of the biggest desire killers, so let your partner know that taking precautions will only help you get into it more...which will almost certainly make it better for them too.

Sex And Circumcision

2009-06-05T02:14:00.000-07:00

Circumcision has been recommended as an efficient way to reduce HIV transmissions. However, fears that they will not be able to enjoy sex or that that their performance in bed is likely to be affected often stops men from undergoing the procedure. Now, a new study by researchers from Uganda and the USA puts these fears to rest.

Taking part in the study were 4, 456 sexually experienced Ugandan men aged from 15 to 49 who did not have the HIV virus. 2,210 of these men received circumcision while 2,246 had their circumcision delayed for 24 months. The majority of the men were Catholic, married, had one sexual partner and were educated to primary school level.

The researchers then checked for the levels of sexual desire, satisfaction and sexual performance for both groups of men over a period of six, 12 and 24 months.

A comparison of the results showed that circumcision doesn’t reduce sexual satisfaction and performance.

The results of the study showed that 98.6 per cent of the circumcised men reported no problems in penetration, compared with 99.4 per cent of the control group.

Also, 99.4 per cent of the circumcised men reported no pain on intercourse, compared with 98.8 per cent of the control group.

While at the six-month visit there was a small, but statistically significant, difference in problems with penetration and pain among the circumcised group, but this was temporary and was not reported at subsequent follow-up visits.

Sexual satisfaction was more or less constant in the circumcision group 98.5 per cent on enrolment and 98.4 per cent after two years but rose slightly from 98 per cent to 99.9 per cent in the control group. This difference was not felt to be clinically significant.

The results have prompted the researchers to conclude that circumcision does not have an adverse effect on men.

Our study clearly shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery said co-author Professor Ronald H Gray from the Bloomberg School of Health at Johns Hopkins University, Baltimore, USA.

Other studies have already shown that being able to reassure men that the procedure wont affect sexual satisfaction or performance makes them much more likely to be circumcised.

Our study clearly shows that being circumcised did not have an adverse effect on the men who underwent the procedure when we compared them with the men who had not yet received surgery concludes Professor Gray.

Other studies have already shown that being able to reassure men that the procedure wont affect sexual satisfaction or performance makes them much more likely to be circumcised.

These findings are very important as they can be used to support public health messages that promote circumcision as an effective way of reducing HIV transmission.

Enhancing Your Sexual Enjoyment

2009-06-05T02:12:00.000-07:00

There are many things you can to do make sex more enjoyable and fun. As always, only use what feels comfortable for you:

* Become more present in your body, and feel your body’s sensations.
You can do this by doing body awareness exercises, breathing awareness exercises, meditation, relaxing, walking, dancing, massage, etc. The more present you are overall, the more present you will be during sex.

* Let your body move the way it wants to.
There is no right or wrong way to move. In allowing yourself to move freely, you will find yourself feeling more pleasure. Your body knows what it wants and enjoys.

* Pay attention to your breathing while making love.
Learn to stay with or focus on the natural rhythm of your breath. Try letting your breath all the way out of your body. On your out-breath, let out a sound. Practice deep belly breathing.

* Make love to yourself without rushing or being mechanical.
Discover what is pleasurable to your whole body. Then ask for that when you make love.

* Focus on the feelings of pleasure in your body while you make love.

* Let go of any expectations you have about sex.
Just let yourself (and your partner) be. You don’t have to act or be any way. Just be the way that feels most right to you.

* Accept yourself where you are at — there are no “shoulds”
Pushing yourself to be where you're not won't get you there any quicker -- and may even make things harder for you.

* Touch each other in non-sexual ways:

o Explore each others' bodies.
With your partner, spend time touching each other all over except for explicitly sexual areas, only touch each other where you feel comfortable touching or being touched.

o Give and receive slow and luxurious massages with your partner.

o Hug each other, full body to body.
Close your eyes and really feel your partner against you. Feel their breath, the movement of their stomach. Smell their hair, their skin.

* Take the focus off your genitals or an orgasm when you make love; your whole body is an erogenous zone.

* Concentrate on the emotional connection you have with your partner when you make love.
Hold eye contact, talk lovingly with each other, talk sex-talk, stroke each others’ face and hair — do all the things that help you to feel safe and grounded with your lover.

* Take sex slowly, don’t rush it. Just enjoy yourself.

* Stop making love whenever you need to.
Stop when you feel scared, uncomfortable, spaced out, or numb. Talk about it. Start again if you want to and stop if it happens again. Stopping and starting not only help you to feel safe or in control, it can help you to increase your comfort with different levels of sexual arousal and pleasure.

* Talk about sex outside the bedroom.
Talk about what you enjoy, want, and fantasize about. Learn to make clear and direct sexual requests.

* Incorporate anything that helps you to feel good about yourself and your body, or that increases your sensual/sexual feelings, into sex.
Play music, wear comfortable clothes, dim the lighting, light candles, put on perfume, use massage oils, etc.

* Show your partner what makes you feel good.

o Guide your partner’s hand to areas of your body and show your partner the way you like to be touched.

o Pleasure your own body while your partner holds you or touches you elsewhere.

* Be emotionally and physically affectionate with each other in and outside the bedroom.

* Be playful with your partner.

o Read erotica together.

o Try sex toys on your own and with your partner.

o Laugh together. Sex doesn't have to be serious.

* Maintain an open and curious approach to sex.
Be willing to try new things -- as far as you're comfortable.

* Maintain open and honest communication in your relationship.
You'd be surprised at how much this can enhance your pleasure together.

* Take turns pleasuring each other the way you like to be pleasured.

* Try not to overreact to unsatisfying sexual experiences. Try laughing it off.

* Try to let go of thoughts that interfere with your sexual enjoyment.
Focus on the present moment.

* Ask for what you want.
Practice taking up space, asking for what you want, saying how you feel, asserting yourself, saying what feels uncomfortable to you, making sounds, dancing, and moving your body.

* Be gentle and compassionate with yourself and your lover.
If you're having a hard time with any aspect of sex, the best thing you can do for yourself is to be patient and understanding with where you are. The enjoyment will come.

CASE STUDY : Sex Talk With Varanasi Community

2009-05-29T00:56:00.000-07:00

Community Where Sex is Taboo: A Rural Experience
in North India
Jayant K* And Prashant P

MAMTA Health Institute for Mother and Child, New Delhi, India

Abstract

Talking sexuality in rural areas of Varanasi, where tradition is deep into their ethos, is challenging in itself. In the area where the working population is largely affected by the ill impact of return migration precipitating HIV/AIDS and young people are denied their basic ‘right to information’, the situation becomes graver. Gender discrimination is evident in every walk of life and sexual abuses are not uncommon. Despite these facts, strategically planned and consistent efforts made ensured that sexuality is being discussed within the community by engaging them in the process from the beginning.
Mamta, a NGO, took initiative to work with young people in the rural areas of Varanasi. Need assessment was done to get first hand information and develop specific need based intervention plans. It emerged that sexuality is the connecting thread to a number of concerns that young people have. Young people should have correct basic information regarding sexuality. Peer Educators among young people were identified and Youth Information Centers where young people can go and get information were initiated within the community. It was taken up at the level of individual, family, system and community as whole. With the support from the community and elected grass root leaders, it is not only feasible to talk on sexuality but also to integrate sexuality education with the formal education / school system. With the active participation of parents, teachers and young people, a local centric and culture specific curriculum on Sexuality Education is being designed on a pilot basis in partnership with RFSU of Sweden, which will be further up-scaled through local network of organisations and institutions. Challenges also came on the way. Apprehension in the mind of parents of young people and gatekeepers initially made the task more difficult. Culturally amphibious people from the community were the key for entry into the community on the issues. Now sexuality is being talked but there is a lot more to be done beyond talking and at a wider scale.

Introduction
Human sexuality is defined as a function of whole personality that begins at birth and ends at death. Sexuality is a ‘multi-faceted concept’. It starts with how we feel about ourselves as men and as women and it continues on through how we express that with other people. Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviour, practice, roles and relationship. While sexuality can include all these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economical, political, cultural, ethical, legal, historical and religious and spiritual factors http://www.who.int/reproductive-health/

Understanding sexuality is required in cultural context and a local centric approach is needed to address this issue in appropriate manner. In this endeavour, a need assessment was carried out in the identified areas and field realities mapped. These helped in making strategic plans for addressing the identified needs. Of various needs identified, addressing sexuality of young people emerged out as the links among majority of the concerns that young people have. This paper narrates steps that were taken to make it feasible to talk on sexuality where it is tabooed. It may be useful for those working on the issue — program people associated with intervention activities, researchers and policy makers in understanding the adopted strategies in less favourable circumstances.
The paper first presents an overview of sex and sexuality in Indian context from secondary sources and then about young people in India. Young people’s sexual behaviour and socio-cultural influences are also narrated subsequently. It gives an account of methodologies adopted for the need assessment that revealed the ground realities. Then follows the realities from the field that tells about the literacy level, perception of young people on sex and sexuality and also related facts like how do they express their sexuality and their health seeking behaviour. It then explains the strategic plan that was made to reach out to young people on culturally sensitive issue of sexuality. How discussion was initiated and what efforts were made at the level of individual, family and community is also explained along with integration of sexuality with the education system. It also gives the extent of reach in terms of number of young people and geographical coverage. It also narrates in brief about the challenges that came on the way and then summing up.
The paper emphasises the importance of engaging community in efforts that were difficult. Community engagement is the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well being of those people. It is a powerful vehicle for bringing about environmental and behavioural changes that will improve the health of the community and its members. It often involves partnerships and coalitions that help mobilise resources and influence systems, change relationships among partners, and serve as catalysts for changing policies, programs, and practices. From the social ecology perspective, the potential to change individual risk behaviour is considered within the social and cultural context in which it occurs. Interventions that are informed by this perspective are directed largely at social factors, such as community norms and the structure of community services including their comprehensiveness, coordination, and linkages, in addition to individual motivations and attitudes.
Social ecology theory as it informs health promotion suggests that community engagement efforts need to be focused at multiple levels — individuals; social network and support systems; the range of organisations that serve and influence individuals and the rules and regulations that these organisations apply; the community, including relationships among organisations, institutions, and informal networks; and public policy, regulations, ordinances and laws at the state and national levels.

Sexuality in India
India is land of contrasts. The basics of sex favourability are implicit in the Vedas and later Upanishads; eventually fairly explicit holy books were written about pleasure and particularly about sex, such as the KamaSutra of Vatsayana (Holmberg 1998).2 On one hand religion appears to be overt in its expression regarding sex and sexuality. The symbolism of Siva and Shakti cult along with various temple arts and existing Sanskrit literature are evidence of certain degree of transparency maintained regarding sex and sexuality. On the other hand in the mundane affair of the society, sex and sexuality in covert and strict codes governs the people.
In present India, however, sex and sexuality are still considered topics that are tabooed. Topics such as male libido and female orgasm do not trickle the bedroom of an average Indian. Precisely, a vernacular equivalent of orgasm is hard to find. In this context the question often surfaces that how can the women be expected to be knowledgeable about it. The subject of sexuality is neither approached clinically nor as a natural phenomenon. It is always been veiled behind stigma, taboo and mystique (Roy & Rizvi 1998).3
Sexuality remains a taboo in Indian society. Amongst most Indian families thus deny opportunities for open discussion. Such taboos and restrictions are accepted with no question asked. Some examples are
“The girl must be virgin”,
“Homosexuality is sin against nature,”
“Women are unclean during menstruation”,
“Men must be controlling partner in sex”,
“Sex with more than one partner is wrong”.
All these are just variations on familiar theme. Myths and misconceptions on menstruation, sexual intercourse, homosexuality, sexual identity information and psychological development are not often addressed at all. Existing gender bias puts young women at risk due to the high-risk behaviour of their partner.
Sexual experimentations are common amongst young people. Because of tremendous societal pressure, trying to define their own sexual identity is a problem for both the sexes. On one hand girls grow up with the idea of “having to fulfill male sexual desire in specific way”. Women are seen primarily as being responsible for producing children and are not expected to express sexual enjoyment. Women are not expected to express sex within the ‘desire’ and ‘pleasure’ perspective. (Verma et al. 2004).
4 On the other hand, the “macho” image of masculinity as “the person always in control” puts a lot of pressure on boys to conform to it and “prove their masculinity”. Social pressure severely limits men’s ability to speak about their need for more information or about their doubts and fear. Besides, both sexes believe the myths of men’s uncontrolled sexual drive, which cannot be interrupted or diverted. This idea implies that women must take the responsibility for moral standards and contraception. Sexual abuse and risk behaviour are not uncommon. Unmarried men describe instances when their friends not only justified but supported coercive sex with a unwilling women partner. (Verma et al. 2004).
5 Indian youth are torn between cross currents of reality, fantasy and dream. A strict moral code at home and the selection of a life partner are in contrast to the visuals a youth is exposed to in day-to-day activities. (Roy and Rizvi 1998).
6 Moral standards set by societal norms through socialisation process and prevailing situation in which they live in is putting young people at the crossroad.

Young people in India
India was never so young as is now. “There are 300 million young people age 10–24 years in India, comprising thirty per cent of India’s total population. Health-related experiences, attitude and behaviour of these youth are intimately linked to their social, educational and economic aspirations and options, which will have a strong impact on the future India. Unfortunately, the unique developmental, sexual and reproductive health needs of this segment of the Indian population are poorly understood and under-served” (ICRW Information Bulletin, Feb 2001).
7
Sexual behaviour and reproductive health among young people in India
While international attention tends to focus on premarital sexual activity among young people, for young women in India, sexual relations occur overwhelmingly within the context of marriage (Pelto, Joshi and Verma 20008). Despite the rising age at marriage and laws prohibiting early marriage (Child Marriage Restraint Act of 1929 and its amendment in 1978), half of all women aged 20 to 24 were married by 18 years and a quarter by 15 years (IIPS and ORC Macro 20009; Santhya and Jejeebhoy 200310). Among females aged 15 to 19, one-third were already married. In contrast, boys rarely marry in adolescence — only six per cent of those aged 15 to 19 were married at the time of the survey (IIPS and ORC Macro 200011; Kulkarni 200312).
The prevailing family system in India is based on premarital chastity and monogamous marital sex, particularly for women. However, a number of small-scale studies, despite limitations in their designs and methodologies, have found a more permissive attitude towards sexual pleasure and higher-than-expected levels of premarital and extramarital sexual activity among men and women in India (Sarah Hawkes K. G. Santhya, 200113). Younger age at sexual debut is associated with a higher number of lifetime sexual partners, greater risk for unintended pregnancy, and higher risk for STDs. Other studies find that for the majority of people, first sexual experience occurs within marriage. A population-based survey of urban and rural men found that only 25 per cent had sex before marriage, and the overall mean age at first sex was 23 years (Collumbien, M., Das, B., Bohidar, N. and Pelto, P., 200014). Even studies among college boys (where social constraints may be relaxed) have found that less than one third report sex before marriage (Jejeebhoy 199815). Reports (often from qualitative studies) of premarital sexual contacts of men have found a wide variety of partners: sex workers; friends; relatives; and future spouses (Sarah Hawkes K. G. Santhya 200116). Among girls, reported premarital sexual contact is mainly with future spouses, friends and relatives (Sarah Hawkes K. G. Santhya 200117). Large-scale country surveys highlight initiation in sexual activity among males at as early as 11 years (NACO 200118), with a median age of 20 for males in rural areas and 21 for urban areas, whereas, for females it is 18 years in both areas. For one-third of males, the first sexual partners are commercial sex workers.
Premarital sexual activity is clearly more common among men than women, although some difference may reflect over-reporting among males and under-reporting among females. Typically, fewer than 10 per cent of young women reported premarital sexual experience, while a higher range (15–30 per cent) was observed among young males (Abraham and Kumar 199919; Awasthi et al. 200020; Bang et al. 198921; Bansal 199222; Bhende 199523; Goparaju 199324; IMRB 199325; Jejeebhoy 200026; Kaur et al. 199627; Mehra et al. 200228; Savara and Sridhar 199329; 199430; Sehgal et al. 199231; Sharma and Sharma 199532; Watsa 199333).
According to a report on knowledge, attitudes and practice of youth drawn from the National AIDS Control Organisation (NACO), National Behavioural Surveillance Survey, some ten per cent and eight per cent of rural and urban young men aged 15 to 19, respectively, reported a casual sex encounter in the 12 months preceding the survey compared to two per cent of sexually active 5
young rural and urban females (NACO and UNICEF 200234). Furthermore, age appears to be associated with increased casual sex experiences, particularly among young males; for females, there is no corresponding variation.
The incidence of homosexuality at initiation is reportedly low (1.5 per cent) (NACO 200135) Over all ages homosexuality is reported to be between three and seven per cent (Naz Foundation International36). Open discussion of men having sex with men (MSM) is not well tolerated in Indian society, which continues to place extremely high values on the family and lineage. Recent research has concentrated on describing the practices, lifestyles and cultures of MSM in India, but not on hypothesising the extent of the practice among men. In part this may be a result of the often hidden nature of MSM in India. Data show that Indian populations are not as chaste and monogamous as has been claimed (Ravi Verma et al. 200437).
The environment
Young people are poorly informed about their own bodies and matters related to sexuality and health. The information they have is often incomplete and they remain confused. Low rates and levels of schooling, attitudes that prohibit discussion of sex and sexuality thus limiting access to sex education. It furthers their ignorance. As gatekeepers who should play a pivotal role in enabling adolescents to protect their sexual and reproductive health, parents often obstruct rather than facilitate informed choice. Young people commonly report that discussions with parents about sex or reproduction are taboo. Parents and family members say that boys and girls prefer to talk to peers rather than parents. They describe feeling acutely embarrassed at the thought of discussing sexual matters with their children. They also lack the vocabulary and the basic information about sexuality that would help them talk about these matters with their adolescent children. Furthermore, they express concern that discussing such matters might appear to give tacit “permission” to engage in sex. They associate knowledge of sexual matters with promiscuity and a loss of parental control. They are generally concerned for sexual security of their daughters, but indifferent about their sons’ behaviour. (Masilamani 2003)38 In both rural areas and urban slums, parents often want and expect their young children, particularly daughters, to remain uninformed about sex. The situation is such that neither parents nor young people feel comfortable talking about sexuality and are just trying to provide excuse for not talking. Education systems also tend to be ambivalent about sex or sexuality education, though this has begun to change in the wake of the HIV/AIDS pandemic. In many cases, sex education continues to put emphasis on biological and scientific information over broader issues of sexuality. Teachers often find the topic embarrassing, shameful, and avoid such issues, even in schools that supposedly teach a family life/sex education curriculum. As a result of adults’ reluctance to address these issues, young people tend to rely on peers and mass media for information about sex, reproduction and STIs including HIV/AIDS (Bott and Jejeeboy 200339).
At the cross roads of sexual maturation and reproductive capability on the one hand and lack of information on the other, adolescents are vulnerable to sexual experimentation and risk of early and unintended pregnancy, RTI and STI. Awareness about sexual and physiological changes in adolescence eludes large number of adolescents. Articles on adolescent sexuality and fertility emphasise the lack of information that both girls and boys have on their anatomy and reproductive physiology; but do not make the link between this fact and the unfortunate circumstances of some girls’ early sexual encounters. There is little appeal for young couples to delay the birth of the first child or space out their children. The first child must arrive soon after marriage to establish a girl in her in-laws’ home, and if that child is not a boy, then there is additional pressure to produce the second (Greene 199740). Awareness about contraception is very vague among married as well as unmarried adolescents.

Socio-cultural influences
The transition from childhood to adulthood is sudden in India, especially for young girls, and more so in rural areas, where the majority of these girls live. Sometimes withdrawal from school and marriage follow the onset of puberty directly, especially among girls in rural India (Greene 1997)41 In Indian societies on the other hand, particularly in rural areas, decisions like when to marry, whom to marry, how many children to have, etc. go by cultural dictates and are usually decided by elders in the family. Any activity, even talking in public, in a mixed gender setting (other than with family members) has partial sanction for a boy/man but not for a girl/ woman. She is invariably labeled as of ‘loose character’. This gender discrimination has the sanction of the society. There is great need to look at sexuality and sexual behaviour in affirmative, accepting manners, to recognise sexuality as integral part of health and well being (Verma et al. 2004).

MAMTA’s role
Very little information is available about young people (10 to 24 years) as a distinct group in India. MAMTA, a Non-Governmental Organisation (NGO), is working with young people since 1990. It recognises the urgent need to identify effective approach to address concerns of young people. It took the initiative to work with the young people of Pindra block of Varanasi district. It has the proven capacity to work with the young people on Sexual and Reproductive Health and Rights. MAMTA in twin partnership with RFSU, an organisation from Sweden, planned to work with young people in that area. RFSU has over seventy years of experience of working on sexuality issues in diverse conditions. Technical inputs from RFSU with MAMTA’s strength of working with young people paved the way forward. Need assessment was planned. The assessment was
done in 33 villages of Pindra block in Varanasi district, in the month of March 2003 and subsequently intervention was planned that initiated in July 2003 to create an enabling environment.

Methods
Participatory Rural Appraisal (PRA) method was used to assess needs of the community, especially target population. Young people (10 to 24 years of age), their parents, key community workers and service providers are mainly targeted. Both quantitative and qualitative data were collected. Questionnaire was used for quantitative data collection. For qualitative data collection, resource mapping, body mapping, focused group discussion (FGD) and in-depth interviews were conducted. Data on 511 young people (10 to 24 years) were drawn as sample from 33 villages of Pindra Block, District Varanasi, Uttar Pradesh. Total 85 FGDs were conducted. 50 FGDs with young people, 25 with their parents and 10 with key community people. In depth interviews were conducted with 54 service providers. The need assessment was done in March 2003 before the intervention started in July 2003. An assessment was done after 18 months of intervention to review the project in December 2004.

Ground Realities About the area
Intervention area in Pindra Block, District Varanasi, represents a typical rural setting of eastern Uttar Pradesh, with few channels of information. Agriculture is the main source of livelihood. There are large numbers of landless labourers. Women work in agricultural fields and work also as maids. Some sections of the population practice traditional occupations of pottery making, carpet, saree weaving, carpentry, sheep and goat rearing, dairy and tailoring. Very few people are employed in government or private jobs. With small land holdings and large family size, the area is experiencing bulk out migration of males for better job opportunities. Income level of general household is low. More than 33 per cent of the households have monthly income below Rs. 2000.

Literacy
The literate population among the young people (10 to 24 years) of the area is 52 per cent, among which 57 per cent are males and 43 per cent are females. Girls are discouraged to attend schools. There are high percentages of school dropouts, especially among girls, after age of 13 as they attain puberty by this age. Nearly 16 per cent of young people have never been to school. As people live in poverty conditions, they are not ready to invest years in schooling.

Perception of young people on sex and sexuality
Getting “attraction to opposite sex“ along with the urge to indulge in sexual activity is widely accepted by boys. There is prevalence of sexual activities through various manifestations, including masturbation, visits to prostitutes, and sex with girls in school and neighbourhood and homosexuality. Fantasising and day dreaming are common feature among young people. Girls do experience attraction to boys but were not really forthcoming about it. The socialisation process plays an important role here, where girls are made to think of, and interact with, only the husbands, apart from other male members of her family. Also there are too many restrictions imposed on their movement and socialising. Girls said these restrictions leave them depressed. Some of them did talk about fantasising on film heroes. Only in co-educational schools girls found an opportunity to talk to boys, as in most other environment it was prohibited. The girls found it hard to share their experience of sexual urges. For some of these girls who belonged to the lower caste and lower socio economic strata, marriage and motherhood coincides with menstruation. Parents are too concerned about their girls respect when the latter attain sexual maturity.

Bodily changes and awareness
Growing of beard and moustaches, changes in voice and rebellious nature marks the sign of maturity for boys. And for girls, maturity come with menarche, growth of pubic hair and when breast start developing. Boys consider themselves grown up when the length of the penis increases, height increases, and hair growth is seen in private parts. Turning shy and seriousness characterises girls’ maturity. Also there is increase in breast-size and mensuration starts. With maturity, unmarried girls are restricted from certain activities like mixing with boys. But, so much restriction is not applied to boys. Not many unmarried youths have accepted having friendship with members of the opposite sex. They make indirect references to others having such relationships. The common notion among elders is when a boy and girl is matured enough to reproduce then they should be married off as soon as possible. Not much awareness exists among the young people regarding sexual health. Lack of information, incorrect and incomplete information regarding menarche along with myths and misconceptions were found among girls. The common age of onset of menstruation is 13 to 14 years: 44.7 per cent of the girls have undergone menarche in that age group and another 11 per cent had their menses at below 13 years. It is noteworthy that about 85 per cent girls had no knowledge about menarche before it occurred. More than 80 pe rcent girls commonly use old used cloth for menstrual management and only about 2.2 per cent use fresh cloths or napkins. During Focussed Group Discussions, most of the girls said that they suffered pain and discomfort during periods. Girls are not aware of the processes underlying menstruation.

Discussing sexuality in public is objectionable to young people (15 to 19 years) as it is considered as ‘something dirty’. Parental interaction regarding growth and development, especially concerning menarche, is negligible and sources of information are brother’s wife, friends and siblings/relatives. Some sort of parental communication was found in the case of girls who were studying and had educated mothers.
Among boys also, there are various misconceptions on sexual health issues. Like, nightfall is perceived as a problem/illness. Boys are taking medicine for nightfall to get cured. The myth associated with masturbation among boys is that it brings weakness and adversely affects the sexual prowess and performance. Young people are aware of homosexuality and oral sex.
Sexual interests have varied outlet apart from the intercourse method in the form of masturbation, sex with animals, and anal sex. There are cases of sexual relations developing between father and daughter, between father-in-law and daughter-in-law, brother-in-law and sister-in-law and between male teacher and female students. Forced sex under the influence of alcohol is common. Though there are some incidents of sexual violence and coercion within the conjugal relationships. It was observed that sexual harassment in the public sphere is not easily tolerated. The FGDs also revealed that sex during menstrual periods is common within the marital relationship. The women in the area admitted that they could never question or refuse men in the matter of sex.

Sexual health
Sexual health is not attended and addressed within the community due to unawareness, embarrassment and unavailability of proper services of information. During menses, vomiting, dizziness, itching, RTI infection affects the women’s sexual relations with their husbands. Back pain is common and old cloth is used during menarche. White discharge is considered as ‘normal’ post marriage phenomenon. Social and religious taboos are attached with menarche like not visiting temple, not entering the kitchen, not to eat hot and sour things, etc. Women believe that eyesight is affected when period stops. It has been learnt that many understand ‘unprotected sex’ as those having sex with multiple partners. Community members revealed their ignorance about RT’s and ST’s, though young people, as well as their mothers, have talked about white discharge, rashes, and pain during menses, irregular menses and pain after intercourse. Out migration of male working population from the area brings in additional risk of STD and HIV infection to both the male and in turn to the females. Young people, especially girls and women do not seek treatment for STI due to embarrassment. Some of the health professionals cite cases of STI for which their advice has been sought. They estimated that the prevalence rates of STI must be much more than the reported cases.

Cultural influences
Early marriage and early pregnancy are common. More than 85 per cent of females and more than 60 per cent males get married before eighteen years of age. Among these, 36.55 per cent of females get married between 13 and15 years of age. In case of males, more than 50 per cent get married in the age group of 16 to 18 years. Forty-seven per cent had their first child by the age of 18 years; 12 per cent have the first child at the age of 19 years and the rest at the age of 20 to 23 years. The low age of first pregnancy is primarily the resultt of early age at marriage. There continues to be familial and social pressure on couples to have the child soon after marriage.

Age at Menarche
0
10
20
30
40
No response
At 12
At 13
At 14
At 15
At 16
At 17
Age
% responses

Age at Menarche
Most of the deliveries are done at home. Unsafe abortion is widely prevalent in the community. The women told about some home preparations that are widely used in the area. Abortion is done mostly when the pregnancy takes place out of wedlock. Girls (15 to 16 years) revealed the incidences of abortions primarily in case of relationship not having societal sanction. Women who cannot conceive take the help of Ojha (spiritual healer) as infertility treatment in hospitals is expensive. Couples who are unable to have children have little scope for appropriate medical care. Infertility is not often disclosed.

Concerns
A common expression of young people has been 'control and restrictions' on them by parents and the elders in the family. It is leading to anger, depression and irritability among them, more so in 11 case of girls. Mothers accepted that there is a communication gap between them and their daughters. There are many common needs such as 'poor knowledge on contraceptives', 'incomplete information and misconceptions related to menarche management', 'gender bias' etc. The concerns expressed by women are the 'management of menarche', 'premarital sex', 'lack of appreciation for the many chores that women perform', 'lack of awareness for earning livelihood' and 'income generation programs'. Parents were worried about poor knowledge of adolescents and their parents on sex and sexuality and misconceptions related to it. Elders have expressed grave concern about their young ones being rebellious and communication gap between them and their children.
There have been 14 reported cases of HIV/AIDS. The HIV infection seemed to be coming through the people who have migrated to large cities and who regularly visit the native villages. Only 7.4 per cent of young people surveyed have heard about HIV. While awareness regarding HIV/AIDS is very low among the young people, but among those who have heard about it most of them have cited unprotected sex as the major reason for the spread of HIV/AIDS. Television and radio are also the most common source of information for the community and the young people about HIV/AIDS. For girls, mother and peer are source of information.

Health-seeking behaviour
Young people cope up with illness in a wide variety of ways. In the event of falling sick, the options available to them are no treatment but rest. Block Hospital, Quacks (unqualified private practitioners), Ojha (spiritual healer), qualified doctor, household remedies and District Hospital are the source of services. Experience is reportedly not favourable in the case of government-run hospitals, which is used only in emergency and as a last resort. Quacks (unqualified private practitioners) are easily accessible and people have faith in them. Ojha (Spiritual healers) also thrive on people’s trust and they are easily accessible, although people go to them in desperation.
People tend to use home remedies for most illnesses not perceived as severe. Only when an illness persists or aggravates over several days then they seek help. The quacks (unqualified private practitioners) are most preferred because they are locally available, less expensive, have trust on them and people perceive that they provide good treatment. Only in case of any acute illness do they go to government health centers because they are not easily accessible. Table 1 depicts the health care seeking behaviour of the young people. It shows that the private unqualified doctor is the most preferred practitioner among young people. If the problem aggravates further, they go to a hospital in Pindra or Varanasi. The first choice here too, is a private hospital. The government hospital comes only as a last resort. Only 2.5 per cent (both married and unmarried) of young people visit government hospitals.
12
Table 1. Health-seeking behaviour of young people (10-24 years)
Health services
Unmarried (%)
Married (%)
None /no response/don’t know
1.9
1.3
Sub-centre
2.5
2.5
PHC/CHC
2.5
2.5
Private Unqualified Doctor
80.9
58.0
MBBS
4.9
4.2
Private hospital
7.4
2.5
Ojha/ other traditional practitioner
-
29
Total
100
100
Around one-third of the total pregnant women are below 19 years of age. Nearly 58 per cent married and 80.9 per cent unmarried young people go to private unqualified practitioners for treatment. Though the unqualified medical practitioners are the most preferred for giving treatments but they have stated that they do not handle cases related to sexual and reproductive health, as they are not qualified for it. The ANM provides the necessary service and in some cases, which are complicated like high-risk pregnancies, they refer the patient to either PHC at Varanasi or to private hospitals.
Reaching out to young people
Strategic planning

Multi strategic planning was done to address the concerns of young people. After series of brain storming sessions with experts and professionals in the field, key persons from the community and community workers, a holistic plan was developed.
Key stakeholders were identified and activities were planned to address the concerns of young people including the issue of Sexuality. To begin the activities in the community, issues that concern the community most were identified. These identified issues acted like entry point to the communities. Specific activities were planned to suit the stakeholders and also it was made very explicit in the plan document that how different activities feed into each other to make holistic impact. It was evident from the assessment that environment in the community was not conducive to talk on sensitive issues of sexuality. The community, as a whole, was not comfortable with the issue. Culturally amphibious people were identified from the community and were sensitised first on the issue to facilitate the entry into community. These people often play the role of advocates for the issue in the community. Particular emphasis was on the gatekeepers of the communities viz. elected members of the local bodies, influential persons in the communities and service providers to the young people like doctors, teachers and barbers. Simultaneously young people were sought out by community workers for direct interventions to make them aware about the issues that concern them. Some of them volunteered as Peer Educators who were educated in programd manner on the issues over a period of six months. These peer educators were to be the carrier of the issue and are responsible to sustain the effort within the community. Peer Educators participated in the different activities at community level as well as state and national level and helped the community workers in carrying out these activities. This was planned with the objective to make peer educators understand the issue in operational ways. Space within the community was identified as Youth Information Center (YIC) where young people will come and discuss their concerns in free atmosphere. It was also planned that the links will be established with the existing health and educational establishments. These establishments in future hoped to act as place for dissemination of information on issues. And as these centers are integral part of the community, taking up of sexuality by them would lead to its sustainability.
Apart from these strategic plans, consistent effort with elected local body members were made to make them participate from program planning to its carrying out in the community. This would lead to further realising the importance of young people by them and also their importance in electoral politics, as they would be the future vote banks. The need for these programs for young people to be the integral part of the planned activities of local bodies would be the ultimate outcome where young people will feel free to discuss their concerns with the concerned.

Talking sexuality within the community
As it was felt from the Need Assessment, Sexuality needs to be talked not only with young people but also with their parents, gatekeepers in the community and also with the service providers that includes doctors and teachers. Talking on the issues, which is taboo in the community and attracts bad name and disrepute for those involved in these talks, need to be dealt very carefully and cautiously. Strategic planning helped to deal with the issue at different levels.
At family level, parents are targeted to make them understand the need of talking sexuality for their children. Specific activities with parents are planned and designed in which they are being contacted in person individually as well as in groups. Trained community workers are there to facilitate these planned activities and communicate with them in cultural sensitive language. These community workers visit their houses at the time of their convenience and discuss the issue and share their concerns. Also at times, these community workers act as communicator between parents and their children on the issues/matters that parents are not able to
communicate but feel that they must tell their children. Community workers visit the houses of parents of young people and talk to them about the concerns of young people and ways to tackle them in friendly manner. Parents do share their concerns about their children and express their helplessness in addressing them.
Parents are specially called at the Mass Meeting for awareness to develop and refine their understanding of the issue of Sexuality. Such occasions also provide an opportunity for the parents to talk and discuss about their concerns pertaining to their children, including sexuality, with other parents, community workers and other project staff. During such activities they get a chance to see IEC materials on the related issues including those made by young people from the area itself in local dialects. These local centric IEC materials developed by young people are very helpful in communicating the young people’s feeling to their parents in very subtle ways which otherwise young people need not dare to communicate to their parents. At times parents are surprised to see the IEC materials prepared by their children. Parents confess that they would not have known all these if these types of activities were not there.

At the level of community, the gatekeepers are mainly targeted. Panchayati Raj Members (PRI Members), elected people’s representative from a group of villages (Panchayat) and local leaders are sensitised in planned manner and made aware about the young people’s needs and concerns. Meetings are organised with these PRI members and local leaders. During these meetings apart from sharing of views and opinion, parents concerns are also communicated to them to make them feel the need and importance of sexuality in their lives. This also helps in building their opinion to support the cause and the initiatives. Special sessions are planned with PRI members for their better understanding of the project as well issues of sexuality. Now they are integral part of the project planning. They acts as ‘watch-dog’ for all activities and started coming up with valuable suggestions to improvise and improve project activities to suit local needs. Good rapport with the gatekeepers not only eased the operation of the project but also their proactive role reduced the effort load of community workers. With their cooperation and support, project is heading towards sustainability.
To sensitise and orient service providers on the issues of sexuality and develop better understanding of young people, workshops are planned in which experts on these issues are called. This has not only helped in developing perspective amongst service providers but also provided a platform for developing better understanding between project staff and service providers. Apart from these, special events are planed at strategic locations such as school premises, Panchayat Building and health centers. To establish good rapport with the health service providers, community workers provide support to doctors working at government dispensaries during public health campaign. These community workers help them by collecting people from the community to seek and utilise services available with the government setups (like polio drops). This has proved very fruitful. It also helped doctors to understand young people and respond to their problems in friendlier manner. And also at the same time young people get more chance to interact with doctors and paramedical people.

Sexuality education
Integrating sexuality into the existing system was a challenge. Though it was the felt need to initiate Sexuality Education, initiating it was a mammoth task. Sensitisation of community about the issue and gradual increase in their participation in community based activities halped in taking the steps forward. Concerned authorities in school as well as with education department were contacted and convinced about the need of starting sexuality education. After lots of pusuation and consistant effort it became possible to initiate the sexuality education in school. School authorities have given permission to conduct sessions on Sexuality Eduaction. Simultenously local centric and culture specific curriculum is developed in participatory manner. Community workers who understands the community and young people very well were the key in developing Sexuality Education Session Plan. RFSU, a Swedish organisation, provided the technical support.
The Sexuality Education Curriculum takes a holistic approach to young people’s health, covering reproductive health topics as well as broader health and other issues relate to transition to adulthood. This approach tries to put sensitive reproductive health information into a positive, non-threatening context, by emphasising the effect on adolescents’ overall health. Specifically, the project addresses topics such as human body and physical changes, female and male reproductive parts, sexually transmitted infections (STI), contraception, pregnancy, gender roles, self-esteem, hygiene, disease prevention and healthy relationship. MAMTA uses a participatory, interactive training methodology, both for adult trainers (community workers and teachers) as well as for adolescent peer educators. The approach emphasise on ‘experiential learning’ or ‘learning by doing’. Participants work in small groups and learn by taking part in activities rather than passively receiving information through lecture or reading. Such activities include dance, role-play, skits and games.
Project staff reached out to all 33 villages at least twice during the project period. In various activities 5618 young people participated; 6131 members from the community along with 183 PRI Members and 58 Service providers were sensitised. Initially the turnout rate was as low as 45 to 50 in a Mass Meeting which rose to above 500 over a period of eighteen months of intervention. In the beginning getting a place in the community was not easy whereas now community people 16
themselves are making places available. Girls participation in the program was almost ‘nil’ when community workers started the project. But now parents ask community workers about the program schedule. Where boys and girls were not allowed to talk earlier, now both are participating together in even sports activities. There has been occasions when community members took the role of community worker in meetings.

Challenges
Initially opening the channel of communication was really tough. Parents, as expected, were initially not comfortable with the issues of sexuality. Bringing boys and girls together on these issues was a big challenge. There was lot of apprehension in the mind of parents and gatekeepers that discussing Sexuality would deteriorate the family and community enviornment. Working conditions are tough as there is poor infrastructural support. Community workers need to travel long distances in hot summers and chilling winters. Changes in the project staff also at times hampers the progress of the project. Despite these challenges, with people’s support it is now possible to talk on sexuality.

Conclusion
Sexuality is taboo in Indian society despite the fact that it was rooted into their way of life since prehistoric time, as depicted in literature and monuments. The fact cannot be denied that there is need to talk about it in light of the prevailing situation. Young people are poorly informed about their bodies and matters related to sexuality. There is opposition iin norms and practices. Societal norms preache to be faithful to sexual partner, but the prevalent behaviour shows extra and premarital relationships. Substancial number of young people experiences first sexual intercourse in mid-teens. Homosexuality though not tolerated in society but are in practice. There is growing trend of RTI/STI including HIV/AIDS, consequence of conservative approach toward life. There is prevalence of myths and misconception concerning sexual and reproductive health of young people. Young people do not have knowledge to make informed choice and correct decisions. They are guided more by traditional value than scientific knowledge.Teachers in school who has been entrusted with the responsibility of providing information and impart knowledge on sexuality and related matters to young people feel handicapped in dealing with it.

Despite social conditions not very condusive to talk and discuss sexuality in family and with community members, strategic planning, consistant and pragmatic approach resulted into a situation where sexuality is discussed by and among them. Steps taken over four and half years have resulted into a situation where discussing sexuality is a reality. The gatekeepers of the community has sensed the need of hour and allowed the discussion. It has been accepted by society and only after support from the community it become possible for initiating it with school system.
It may be relevant to mention here that issues related to sexuality are to be looked at beyond the talking point. It has wide connotation, particularly in culture which is less open and more rigid. Being cultuarly sensitive is key, but the need is to address the issue at larger level.

Losing Your Virginity And The First Sexual Experience :

2009-05-29T00:03:00.000-07:00

Losing Your Virginity And The First Sexual Experience

First Time Lovers

It is very important that the first time someone has sex everything should be done to make it a satisfying and exciting experience. Plan ahead regarding contraception, safe sex and any other vital facts you need to know, so you will not feel anxious afterwards about getting her pregnant or catching an STD.

You and your partner should have sex when you are both ready and comfortable with the idea. Allow lots of time to have sex the first time, like a whole weekend.

What To Do

* Eat light, and avoid eating a heavy meal as this can make you sleepy.
* Avoid drinking too much alcohol

Alcohol helps if you are inhibited but it can cause a male to lose an erection or have difficulty achieving an erection.

Location

It is important that you make love in a place that is very comfortable to you both. It is not really suitable for exquisite lovemaking to use a car.

Sex in the outdoors has:

* less privacy
* bugs
* sand
* pine needles, etc.

You really need a place that has:

* a bed (still the best thing to make love in)
* heat
* comfort
* space
* a bathroom

You might like to bring along:

* some form of contraception, (condoms, etc.)
* favorite pillow
* favorite bathrobe

Taking a shower together before sex is a wonderful, intimate experience and can be very arousing. Get to know each other's bodies. Take your time. That's what lovemaking is about.

Female advice :

It is very important to show your partner what you like by telling him or showing him by taking his hands and placing them where they make you feel good. He may very nervous if it is his first time so go slow, his penis may not respond at first. Patience, gentleness, and understanding are required.

Losing your virginity may hurt but with the right touch and the right partner, you should be able to take his penis into your body without pain.

What To Do

* Use a commercial lubricant like KY Jelly if you feel the need
* Have him take his time to press his fingers into you, opening you up slowly.
* Tell him when it feels good and when it hurts.

Sexual Position

The position you use depends on many factors, mainly what feels comfortable for the both of you. Choose what is best for you. Just go slow and take your time.

* Some women prefer to have sex the first time being on top where they can control the initial penetration.
* Others want to be on the bottom and give their lovers that control.

Orgasm

The first time do not worry whether you orgasm together or orgasm at all. All will improve with practice and patience.

Some women do not orgasm during intercourse and may need to be masturbated or have oral sex to orgasm.

Just enjoy yourself.

Back to the top

Male advice:

The biggest anxiety with men is that they will not be able to get an erection. Nervousness and lack of confidence can cause all sorts of problems. Take a deep breath. Do something else for a while with your hands, your lips and your tongue. Try to forget about your anxiety, and your penis will respond.

What To Do

If you are a virgin and she is not, tell her before making love and she will be able to guide you. This is very sexually stimulating for a woman to be able to guide a man for the first time.

If it is the first time for both of you it may be an awkward fumbling experience. Being a good lover does not happen automatically.

If you have:

* the right partner
* time
* care
* practice

you have all that is required to become a great lover.

Sexual Position

Sex can be performed in any number of positions. The penis and vagina can be matched in many different ways, and each new position can bring new pleasures to you and your partner.

Orgasm

Men have anxiety about premature ejaculation. If you actually orgasm too soon, take your time, relax, and try again. The second time you should be much more relaxed and ready to take your time.

Size and Shape

One of the major anxiety problems with men is the size and shape of their penis.

The average penis is slightly more than 51/2 inches in length when erect. The vagina is capable of stretching to take a large penis, or shape itself to pleasure a small one. Size has very little to do with your ability as a lover.

Another common issue is shape. Some men become concerned because their penis bends downwards, or to the left. Others worry that a downward bend will make sex difficult or painful. It is claimed a downward-bending penis is much easier to perform oral sex upon.

In the interest of Minimizing the Risks of Disease, providing Information about STD Transmission, Prevention and Safe Sex Practices, as well as Information about Pregnancy, Birth Control and Sexual Relationships.

Sex Tips for a Wedding Night :

2009-05-26T04:02:00.000-07:00

There's a general international,inter-racial and myriads of inter-bla bla bla myth about wedding nights; supposedly, every bride and groom have the most intimate and wonderful sex of their lives on their wedding nights. In reality, while your wedding night may be a little different, it is an intimate moment, and an opportunity. Here are ten tips that can help make your wedding night one of the best evenings of your life.

1. Take things slowly
Savor this moment. While you may be a little too tired to have the most technically excellent sex of your lives, this is likely to be among your most romantic and intimate sexual experiences.

2. Lower your expectations
So this may not be the most amazing sex you've ever had. So what? Try to just enjoy whatever happens.

3. Read some sex books
Who couldn't use a little advice from the experts? Some to try: The Good Vibrations Guide to Sex, Sex Tips for Straight Women from a Gay Man and Lesbian Sex Secrets for Men.

4. Talk to each other
Spend some time relaxing, talking about the wedding, and about your love for each other. Let things get romantic and sappy. The sex that follows will be intimate and amazing.

5. Expand your idea of the "wedding night"
If you're too tired for foreplay, that sex isn't going to be so great. Couldn't it be better to wait until the morning?

6. Flirt with each other during the wedding
It can be easy to spend the whole wedding greeting Aunt Sally and Cousin Bob, cutting the cake, and attending to a thousand other details. Don't forget to stop, stare into each other's eyes, share a few extra kisses, and flirt with each other. It will also help build the excitement for your alone time later.

7. Don't have sex with each other for a couple of weeks before the wedding
Many couples try this to make the wedding night sex fresh and new again. Others go even further by giving up sex months before the wedding so that they may be virgin-like on the wedding night.

8. Try something new
Perhaps there's been something you've been wanting to try? Your wedding night can be a fun night to experiment,

9. Wear something special
Wedding night lingerie can really help the mood. Pick something a little different than what you usually wear to excite your partner. Make sure you feel confident in it, as a confident lover is almost always a better lover.

10. Set the stage
Help yourselves get into the mood by setting the stage. Light some candles, bring some CDs and a radio, scatter rosepetals, or do whatever helps you get in the mood. And don't be afraid to kick friends and family out early. While they may tease you a little, they'll certainly understand!

It's also a good idea to accept the fact that you may be too exhausted or tipsy to have sex. If one of you falls asleep, or isn't in the mood, remember, it's not a prediction of a doomed marriage. Spend the time relaxing and remembering how wonderful your wedding day was.

How to Communicate BEFORE the wedding night
Pick a quiet moment to ask your soon-to-be-spouse "are you feeling nervous at all about our wedding night?" Odds are, he or she will be relieved to have the opportunity to talk about it. Talk about what your hopes and fears are. You may want to visit a counselor, or talk about sex during your pre-wedding counseling. If you are too nervous to bring up the subject of sex, consider leaving a magazine open, or even forwarding this article in an email.

Will she bleed? Will it be painful?
When a woman loses her virginity, it is possible for it to be a little bloody or painful. However, it shouldn't last for too long, and it is almost never very serious. To make things easier, make sure there's plenty of foreplay before you try penetration. You'll also want to have a good lubricant. I recommend a brand called "Slippery Stuff" because it is safe to use with latex, and it's glycerin-free. (Glycerin can cause yeast infections.) Even if you use a lubricated condom, you'll want to use extra lube. And, if you're afraid of bleeding on the hotel sheets, bring a towel with you, or your own sheets.

Will he be able to maintain an erection? What happens if he can't?
The pressure of the wedding night can be too much for many men. If things aren't "working," try to change up the mood. Spend some time kissing, and fondling each other. Perhaps make a game out of how many different body parts you can kiss, or be a little more serious by talking about the wedding, your love for each other, and milestones ahead of you.

Will I be any good? How can I wow my new husband or wife?
Sex, like most things, takes practice. You are likely to be a little clumsy and to feel a little goofy. Take things slowly, and try to listen to your partner. Find out what feels good, and what doesn't. Don't be afraid to ask! But don't concentrate on how mind-blowing (or not!) the physical feelings are. Instead try to be gentle with one another, and focus on how amazing it is to finally be in each others arms as a married couple.

At the beginning of most sexual relationships the sex part is so new and exciting, that not much talk is required. This seems reasonable, but it isn’t really sustainable. If you find yourself in a long term committed relationship, eventually something is going to happen sexually that you aren’t happy with. Maybe it’s not enough sex, or too much of one kind of sex, or you just want the sexual relationship to go in a different direction. All these things require you to start talking with your partner.

Because we don’t always talk about sex openly with our partners, thoughts and feelings can build up and knowing where to start, or what to say, can feel like too much. If the relationship is loving, and you feel mostly satisfied, you may decide just to ignore the sex part.

This sex tip offers a way to begin opening up about your sexual feelings, thoughts, dreams, etc…

Pick one week where you and your partner commit to doing two things:

1. Don’t have sex that week. Intimacy is okay, touching, hugging, kissing, but whatever kind of sex you regularly have, take a week off.
2. Everyday have a five minute conversation about sex. It doesn’t have to be heavy, or deeply confessional, it doesn’t even have to be about you, but you commit to talking about sex for five minutes in private every day.

The idea is to put sex on the rotation in your regular conversations. We’re so used to talking about every other aspect of our relationships except the sex, and that, in part, is what makes talking about sex so difficult. If it becomes a daily topic of conversation eventually everyone has a better chance of speaking and being heard.

Have fun!

Talking with Partners About Sex

Viral Fever :

2009-05-25T01:04:00.000-07:00

What is viral fever ?

Viral fever refers to a broad spectrum of conditions where viral infections are associated with elevation of body temperature. In medical terms, any fever caused as a result of viral infection is a viral fever. These viral infections may show generalised symptoms, but may target specific organs. The course and duration of the fever does not follow any set pattern and is frequently accompanied by, though not always by all of them, generalised body ache, running nose, cough, shivering, skin rash and irritability. Viral infections may affect any age group, and are seen worldwide. They require only symptomatic treatment. Some are highly contagious. Most of them are not dangerous and are self-limited, but some can progress rapidly leading to death.

What is the cause ?

Most viral infections are spread by the intake of contaminated water or food, or by direct contact. The infection then spreads locally and, thereafter, enters into the blood stream or lymph channels. Some of the viral infections can be transmitted sexually or by direct inoculation into the blood stream. The duration of the primary infection may vary from days to several weeks. Manifestation of the disease is usually a consequence of the virus multiplying at a specific site.

What are the symptoms ?

Once the virus enters the body, there is an incubation period when the virus multiplies to a level high enough to cause infection. This is followed by a phase of fatigue and body and muscle aches that may lead to the onset of fever. The fever may be low grade or high grade. Inflammation of the throat, a running nose, nasal congestion, headache, redness of the eyes, cough, muscle and joint pains and a skin rash could be present. Fatigue and body pain could be disproportionate to the level of fever, and lymph glands in the neck may swell up. The illness is usually self-limited but the fatigue and cough may persist for a few weeks. Sometimes pneumonia, vomiting and diarrhoea, jaundice or arthritis (joint swelling) may complicate the initial viral fever. Some viral fevers are spread by insects, for example, arbovirus, and can cause a bleeding tendency, which results in bleeding from the skin and several other internal organs and can be fatal.

How is it diagnosed ?

The diagnosis and management of viral fevers is based on the clinical presentation rather than on laboratory investigations. The diagnosis is made by the typical history of fever with severe muscle and joint pains. Skin rash and lymph gland swellings have to be specifically looked for. Laboratory investigations are undertaken to rule out other bacterial infections rather than to confirm viral fever. Blood tests will not show any increase in the white blood cells, which typically occurs with bacterial infections. The numbers of lymphocytes may be increased. The erythrocyte sedimentation rate (ESR) may be elevated. Confirmation of the fever is done by a culture of virus from the relevant specimens such as nasal swabs, and skin rash or by increase in antibody levels in serial blood samples.

What is the treatment and prognosis ?

Treatment of viral fever is purely symptomatic. Medicines are given to lower temperature and relieve body aches. Bed rest and adequate fluid intake is advised. Nasal decongestants may be beneficial. Specific antiviral therapy is not routinely recommended. Steroids are not advised as it may lead to bacterial super-infection. Complications of viral infections like pneumonia need to be addressed specifically. Symptoms of gastroenteritis should be managed with anti-motility agents. Most viral fevers recover completely in a week although fatigue may persist for a few weeks.

How to prevent the fever ?

Viral fevers are difficult to prevent. They occur as epidemics of infection depending on their mode of spread. Vaccines have been tried targeting the respiratory and gastrointestinal viruses with little success due to the presence of several sub-groups of viruses, all of which cannot be covered with a single vaccine. Fortunately, since most infections are mild and self-limited, one can be assured of a full recovery.

Vaginitis :

2009-05-25T01:02:00.000-07:00

What is vaginitis ?

Vaginitis is the swelling or discomfort caused by vaginal infections in females. It is commonly caused by certain microorganisms – parasites like trichomonas, yeasts like candida or certain bacteria. Some vaginal infections are transmitted through sexual contact, but not others such as candidiasis (yeast infections). They are a frequent cause of distress and discomfort in adult women.

What are the symptoms ?

Vaginitis is characterised by a yellowish-white discharge from the vagina, irritating and sometimes itching. The character of the discharge or pain differs according to the causative agent. In case of bacterial vaginosis, the discharge is thin and has a fishy smell. Trichomoniasis is characterised by heavy yellow or grey discharge, discomfort during intercourse, vaginal smell and painful urination. Yeast or candida infection has a thick curdy white discharge, which stick to the vagina.

How is the diagnosis of vaginitis made ?

The cause of vaginitis cannot be determined solely on the basis of symptoms or a physical examination. Laboratory tests that allow a microscopic examination of the vaginal discharge are required for a correct diagnosis.

What is the treatment ?

Vaginitis should be treated with an appropriate course of antibiotics. It is very important to treat the male partner even if he does not have symptoms, otherwise the infection keeps recurring in the woman. If the full treatment is not taken, the infection can recur. In case of trichomoniasis, it is preferable to eliminate the parasite. Metronidazole is the best drug for the treatment of trichomoniasis. People taking this drug should avoid taking alcohol as a severe reaction with nausea and vomiting can occur. For candida infection, the doctor may prescribe tablets that may need to be placed in the vagina (pessaries).

How can it be prevented ?

Condoms and diaphragms may be helpful in preventing the spread of trichomoniasis. Spermicides or medicines that kill sperms are not very effective in reducing the risk of these diseases. In fact the frequent use of the spermicides (more than three times a week) may cause vaginal inflammation (chemical vaginitis). Maintaining good personal hygiene is important. In case of diabetics, who are prone to the vaginal yeast infection, the control of blood sugar is important.

Syphilis :

2009-05-25T00:59:00.000-07:00

What is syphilis ?

Syphilis is a sexually transmitted disease caused by Treponema pallidum. It is spread from one person to another through vaginal, anal or oral sex. The syphilis bacterium is passed through direct contact with a syphilis sore. Sores mainly occur on the external genitals, vagina, and anus or in the rectum. Sores also occur on the lips and in the mouth. An infected woman can also pass the disease on to her baby during pregnancy or childbirth. This kind of disease is called congenital syphilis.

What are the causes ?

Treponema pallidum is the bacterium that cause syphilis. This organism penetrates broken skin or mucous membranes. Unprotected sexual intercourse increases the chance of acquiring syphilis.

Syphilis cannot be spread by toilet seats, doorknobs, swimming pools, bathtubs, shared clothing, or utensils.

What are the signs and symptoms ?

The time between contacting the infection and the occurence of the first symptom can range from 10 to 90 days (average 21 days). If untreated, syphilis passes through three stages: primary, secondary, and latent or tertiary. The symptoms vary in the three stages:

Primary symptoms:

* Painless ulcers or open sores on the genitals, rectum, mouth, or fingers
* Enlarged lymph nodes in the area near the sores
* Sores that heal in 4 to 8 weeks

Secondary symptoms:

* Skin rash
* Enlargement of the lymph nodes
* Painless silvery ulcerations of the mucous membranes
* Headache
* Pain in the bones
* Loss of appetite
* Fever
* Fatigue
* Sore throat
* Weight loss

The secondary stage may persist for a year. Sometimes people can develop meningitis, which is inflammation of the membrane that surrounds the brain and spinal cord.

Tertiary symptoms: Tertiary stage syphilis can involve any organ of the body. When the brain is involved it is called neurosyphilis. This can cause many problems, including:

* Weakness or paralysis
* Loss of speech
* Deafness
* Blindness
* Mental disturbances

Other tertiary symptoms are:

* Tumours of the skin, bones, or liver
* Cardiovascular syphilis, which affects the aorta causing valve disease
* Central nervous system disorders

Other symptoms that may be associated with syphilis are:

* Vaginal bleeding between periods
* Swallowing difficulty
* Nose bleed
* Mouth sores
* Groin lump
* Genital lesions in females

In congenital syphilis, there may be no symptoms at all or very severe symptoms may be present. The usual symptoms of syphilis include:

* Enlarged lymph nodes
* Rash
* Enlarged liver and spleen
* Bone abnormalities
* Low blood cell count

If left untreated, the late signs of congenital syphilis include bone malformations, malformed teeth, and eye and brain problems. It can even cause death.

How is it diagnosed ?

Syphilis can be diagnosed by testing the blood sample for the presence of antibodies (proteins produced by the body to fight germs and other foreign substances) to Treponema pallidum. The doctor can also detect the presence of this organism in a sample of genital secretion. Various tests used to diagnose syphilis are:

* VDRL (veneral diseases research laboratory test)
* FTA-ABS fluorescent treponemal antibody test
* Dark field examination of primary lesion
* Donath-Landsteiner test
* T. pallidum hemagglutination assay (TPHA)

What is the treatment ?

The objective of the treatment is to eliminate the infection with antibiotic therapy. Penicillin is the best choice for all types of syphilis. A test dose should be given to check the hypersensitivity for penicillin. Oral tetracycline can be given to those sensitive to penicillin. A baby born with the disease needs daily penicillin treatment for 10 days. This treatment will kill the bacteria causing syphilis and prevent further damage, but it will not repair any damage already done. Persons who are under treatment for syphilis must abstain from sexual contact with new partners until the syphilis sores are completely healed.

How can it be prevented ?

To prevent syphilis, one should use a barrier method such as latex or plastic condom or a female condom when having sex. Some male condoms are made with the spermicidal nonoxynol-9, which helps kill some organisms that cause sexually transmitted diseases.

Anyone diagnosed as having syphilis should encourage his or her sex partner to be screened and treated. Also, people infected with the AIDS virus, as well as certain another STDs, should be tested for syphilis. To prevent congenital syphilis, all women should be screened for the disease and treated if detected positive.

Sexually transmitted infections :

2009-05-25T00:56:00.000-07:00

What are sexually transmitted infections ?

STIs are infections that one gets by having sexual intercourse (vaginal, oral or anal) with someone who already has an STI. There are more than 30 different sexually transmissible bacteria, viruses and parasites. Several, in particular HIV and syphilis, can also be transmitted from mother to child during pregnancy and childbirth, and through blood products and tissue transfer.

What causes STIs ?

Bacteria and viruses cause STIs. Those caused by bacteria include chlamydia, gonorrhoea, trichomoniasis and syphilis. These can be treated and cured with antibiotics. STIs caused by viruses include HIV/AIDS, genital herpes, genital warts and cytomegalovirus. These STIs can be controlled but not cured.

What are the various types of STIs ?

HIV Infection and AIDS

AIDS (Acquired Immune Deficiency Syndrome) is a disease that weakens the body's ability to protect itself from getting sick. The virus that causes it is HIV (Human Immunodeficiency Virus), which is found mainly in blood but occurs in other body fluids such as semen, vaginal secretions and breast milk. The main sources of infection are shared needles and syringes, unsafe sex, and mother-to-child transmission during pregnancy.People with HIV infections may not have symptoms for years. When however, they develop certain infections because of their depressed immunity they are said to have AIDS. Symptoms include fever for a long duration, weight loss without a cause, extreme fatigue and prolonged diarrhoea and the symptoms associated with opportunistic infections.A blood test is usually used to detect the HIV virus. Although there is no cure for HIV infections, a combination of drug therapy, healthy diet, exercise, stress reduction and prompt treatment of opportunistic infections can delay the onset of AIDS.

Gonorrhoea

This is an infection easily transmitted by sexual contact. The causative organism can infect the throat, producing severe soreness; the urethra, causing burning, painful urination and it may also infect the anus and the rectum. Untreated gonorrhoea may lead to urinary tract infections and ultimately kidney failure.The most common initial symptom is a thick discharge from the urethra, which may be white or yellow. There may be painful urination. Gonorrhoea is often associated with the presence of other sexually transmitted diseases. Safer sex behaviour may reduce the risk. The affected person should be given adequate treatment with antibiotics. It is also important to locate and test all the other sexual contacts and treat them to prevent re-infection of the primary patient and further spread of the disease.

Syphilis

Syphilis is an infectious disease caused by the bacterium Treponema pallidum, which penetrates broken skin or mucous membranes. It can also be transmitted to the foetus via the placenta. It infects the genital area, lips, mouth, or anus of both men and women. One gets syphilis from sexual contact with someone who has it. It can also pass from mother to baby during pregnancy.Syphilis is easy to cure with antibiotics if caught early. In the initial stages, skin rashes may appear which are very infectious. If the disease is not treated, bacteria continue to invade the body and infect the internal organs, the bones, the heart and the brain. Safer sexual practices need to be adopted to curb the spread of STIs.

Chlamydia

It is one of the most common sexually transmitted diseases. The majority of genital chlamydia infections are without symptoms until complications appear. Infection with chlamydia leads to pelvic inflammatory disease, which can cause scarring of the fallopian tubes and sterility. The symptoms include burning with urination, discharge from the end of the penis, tenderness or pain in the testicles, fever and chills. Chlamydia infection is often found in conjunction with gonorrhoea.The use of condoms during sex and limiting the number of sex partners may help in reducing the risk of developing the infection. It can be treated and cured with antibiotics.

Herpes

This is an infection caused by the Herpes simplex virus type 1 (HSV-l) which is associated with infections of the lips, mouth and face. HSV-2 is associated with genital lesions and is transmitted by sexual contact. HSV-2 can be transmitted to a newborn during vaginal delivery if the mother is actively infected.Infection occurs after exposure to the virus through a break in the skin, or through mucous membranes. The virus spreads to nerve cells within the body and then to other skin surfaces. The symptoms include genital lesions, fever, vaginal discharge, sore throat and in some cases memory loss. Avoiding direct contact with an open lesion will lower the risk of infection. Safer sex behaviours including the use of condoms may further lower the risk of infection.

Genital warts

Genital warts are caused by the Human papilloma virus (HPV) which causes small growths on the skin and mucous membranes. They grow best in moist genital areas and are flesh-coloured tumours appearing singly or in clusters. In women, HPV can invade the vagina and cervix and may lead to cancerous changes in the cervix.

Symptoms include “warty” tumours on the genitals, genital sores, itching of the genital areas and increased vaginal discharge.

Topical treatments to eradicate the lesions include trichloroacetic acid and podophyllum. Sex abstinence or use of condoms should be practiced until both partners are free of the disease.

Trichomoniasis

Trichomoniasis is caused by a parasite. It affects both women and men, but symptoms are more common in women. Symptoms include a green or yellow discharge from the vagina, itching in or near the vagina and discomfort with urination. Most men with trichomoniasis don't have any symptoms, but it can cause irritation inside the penis.

Trichomoniasis can be cured with antibiotics. In men, the infection usually goes away on its own without causing symptoms. But an infected man can continue to infect or reinfect a woman until he gets treated. So it's important that both partners get treated at the same time. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading trichomoniasis.

What can be done to prevent STIS ?

* Having a mutually monogamous sexual relationship with an uninfected partner.
* Correctly and consistently using a condom greatly reduces the chance of acquiring an STI.
* Using clean needles if injecting intravenous drugs.
* Having regular check ups for STIs even in the absence of symptoms.

Anyone diagnosed as having an STI should:

* Be treated to reduce the risk of transmitting an STI, especially a pregnant woman to an infant.
* Follow the full course of medicine.
* Avoid sexual activity while being treated for an STI.
* Ensure that the partner is also diagnosed and treated.

Sildenafil :

2009-05-25T00:54:00.000-07:00

Sildenafil has recently been introduced for the treatment of impotence or erectile dysfunction. Although it has been on the world market since March 1998, it has only recently become available in India.

What is Sildenafil ?

Sildenafil is a drug that has helped many men suffering from the problem of erection of the penis (erectile dysfunction). Erectile dysfunction refers to the inability to get an erection, sufficient for satisfactory sexual activity. Taking this drug helps a man who is sexually aroused to get and maintain an erection by increasing the blood flow to the penis. If however, a man takes Sildenafil but is not sexually stimulated he will not get an erection.

Sildenafil is not a hormone or an aphrodisiac (a drug that arouses sexual desire). It is a prescription medicine, which aims at improving the problems of erection in men. Its use for the treatment of sexual dysfunction in women is still being investigated.

How well does Sildenafil work ?

Sildenafil improves erections in 4 out of 5 men who take it, regardless of how long they have had erectile dysfunction and what caused it. It is to be taken about 1 hour before engaging in sexual activity. In most cases, it helps get an erection in 30 minutes that lasts for around 4 hours if a man is sexually excited. If sexual stimulation is absent then nothing will happen.

What is the frequency and dosage of the drug ?

Sildenafil comes in different doses of 25mg, 50mg and 100mg. The recommended dosage is one tablet a day. For most people it should not be taken more than once a day. It is advisable to go by the doctor’s prescription regarding the dose to be taken as it will vary from person to person.

Who should not take Sildenafil ?

It should never be taken by men who are using nitrate drugs, like nitroglycerine that is used for the treatment of chest pains due to heart disease. This could lead to a sudden drop in the blood pressure to unsafe levels. This includes the use of nitroglycerines in any form such as sprays, ointments and chewable tablets.

There are additional warnings about the use of the drug by individuals with cardiovascular disease. Caution is specifically advised for men who have had a stroke or heart attack or life-threatening arrhythmia in the past 6 months, those with low or high blood pressure or those suffering from a disease causing degeneration of the retina.

What has been the success rate of Sildenafi l?

It has been found that 82% of the men who have taken Sildenafil, have experienced an improvement in their erections. It has helped men having mild erectile dysfunction. Those who have severe impotence problems have had less success with the drug. Men who have undergone surgery for prostate removal have also not experienced significant success.

Are there any side effects of Sildenafil ?

The drug has some side effects, which last for a few minutes to a few hours after taking the drug. These include dilation of the blood vessels in other parts of the body, causing headaches and fainting. Other side effects such as facial flushing, upset stomach, blurred vision and sensitivity to light usually occur with high doses.

What care should be taken while taking the drug for effective results ?

* Drinking alcohol may temporarily impair the ability to get an erection. It is therefore advisable not to drink large amounts of alcohol before taking Sildenafil.
* Taking Sildenafil after a meal rich in fats may cause the drug to take a longer time to start working. It is best to have a balanced meal before the drug is taken for increased effectiveness.
* The tablet should be stored at room temperature; away from heat, moisture and direct light.

Sexual Intercourse :

2009-05-25T00:52:00.000-07:00

Sexual intercourse is not merely a physical act with your partner. It is important that both of you are ready for it and enjoy it for fulfilment. It is, therefore, necessary that the mood be right and both partners be adequately aroused sexually. Arousal can be heightened by foreplay, which is an important part of intercourse.

In foreplay, the partners fondle and kiss each other, and stroke each other's genitals. This increases the sexual urges and also lubricates the sex organs to facilitate a pain-free intercourse. As a result of the sexual arousal during foreplay, the man’s penis becomes filled with blood, causing it to become erect. This process is called an erection.

Sexual intercourse involves the male inserting his erect penis into the vagina of the woman. This must be done slowly and gently so as not to cause much discomfort to the woman. In a virgin, the initial insertion can be extremely painful, and this discomfort may be reduced with the help of lubricating creams. After this, the penis is moved forward and backwards in the vagina without withdrawing it completely. This rhythmic motion is continued till both partners reach their orgasm. An orgasm is a feeling of extreme pleasure that starts from the genital region and washes over the whole body. It ends in a climax, which is a state of heightened pleasure for both the partners.

In the male, the orgasm is usually reached with the discharge of semen. In the female, there is a white discharge from the vagina. After an orgasm is reached, the male’s penis becomes deflated again and comes out of the vagina easily.

Safe sex

Newly weds must be aware of the contraceptive devices that are available. Unwanted pregnancy may be avoided with the help of condoms or contraceptive pills for, which a doctor must be consulted. Safe sex also means taking precautions during sex that can keep you from getting a sexually transmitted disease (STD), or from giving an STD to your partner. These diseases include genital herpes, genital warts, HIV, Chlamydia, gonorrhea, syphilis, hepatitis B and C, and others.

Abstinence is an absolute answer to preventing STDs. However, abstinence is not always a practical or desirable option. Next to abstinence, the least risky approach is to have a monogamous sexual relationship with someone free of any STD. Ideally, before having sex with a new partner, one should get screened for STDs, especially HIV and hepatitis B, and share the test results with one another.

While using condoms you must be careful of the following:
# The condom must be rolled onto a fully erect penis and should be in place from the beginning to end of sexual activity
# While rolling the condom care must be taken to press out all the air that may collect inside
# After the act, the condom must be carefully taken out of the vagina along with the erect penis
# The condom must never be reused.

Here are some additional safe-sex steps:
# Know your partner: before having sex, establish a committed relationship that allows trust and open communication. You should be able to discuss past sexual histories, any previous STDs or IV drug use. You should not feel coerced or forced into having sex.
# Stay sober: alcohol and drugs impair your judgment, communication abilities, and ability to properly use condoms or lubricants.
# Be responsible: if you have an STD, like HIV or herpes, advise any prospective sexual partner. Allow him or her to decide what to do. If you mutually agree on engaging in sexual activity, use latex condoms and other measures to protect the partner.

Safe sex requires prior planning and good communication between partners. Given that, couples can enjoy the pleasures of a sexual relationship while reducing the potential risks involved.

Sex And Heart :

2009-05-25T00:39:00.000-07:00

Sexual activity is a normal human instinct, which protects men and women against feelings of isolation. It offers them an opportunity to be free of mental stress and tension by gestures such as touching, hugging, caressing and fantasy. Intercourse is the ultimate expression of sexuality.

Heart patients and their spouses frequently perceive sexual intimacy as stressful or even life threatening. Their fears and doubts are often not clarified by physicians and other health care providers, who may also feel inhibited while discussing sexual matters with their patients. Majority of the patients, therefore receive little or no instructions about resuming sex after a heart attack or heart surgery. Those who are instructed frequently don’t receive adequate information. Often the spouse is excluded from counselling. Without proper guidance, both patient and spouse rely on their own knowledge, myths and misconception to cope up with their unfounded fears of sexual inadequacy, impotence and death during intercourse.

Sexual problems in heart disease

Male heart patients frequently report a reduction in frequency and satisfaction of intercourse after heart attack or heart surgery. Sexual desire may decrease, leading to inhibition of feelings and failure of erection. Some men also experience premature ejaculation. Yet, such problems do occur in as many as 40% of happily married normal couples too. A strong emotional relationship between spouses lessens the occurrence of sexual dissatisfaction after a hart attack. Relatively few studies have been carried out regarding sexual activities of female patients with heart disease.

Psychological basis of sexual problems

Two primary psychological reactions interfere with resumption of normal sex after a heart attack:

1. Anxiety: Anxiety results from fear of angina or recurrence of heart attack during sexual intercourse. These fears are frequently based on ignorance about physical demands of sexual activity, when to resume sex and ways to prevent to treat the symptoms. Another contributory factor is patient’s perceived change in body image, leading to a feeling of being less of a man or a woman.

2. Depression: After a heart attack, many people experience a moderate to severe depression. It prevents the patient from resuming normal; emotional ties with the spouse and may also lead to a decrease in libido. Occasionally, it may cause impotence.

Spouses’ responses

Forced dependency in hospital setting during a hear attack or surgery may lead to erosion of feeling of self worth and sexual attractiveness for a while. During this time, the spouse can provide much needed support. In reality, many spouses themselves undergo considerable psychological trauma during this period. They wish to reassure their spouse of their love and affection, yet feat the worst. This naturally comes in way of resuming normal sex. Wives of heart patients tend to treat their husbands of heart patients like Humpty-Dumpty, who might break at the slightest provocation. Even if the husband wants to make any advance, wife is generally so scared that she would not be able to respond with real conviction. The overprotective attitude of the male spouses also makes them feel that they are protecting their wives by with-holding sex. Lack of communication or covert communication only helps to reinforce the anxiety of both the partners. The matters may be complicated when the spouse also begins to grudge his/her continued responsibility.

Physical effort of sexual intercourse with spouse is comparable to climbing a flight of stairs or walking briskly. Therefore, most of the people should be able to return to their previous level of sexual activity after recovering from a heart attack or CABG. Here are some practical tips to regain a normal sex life.

* Communication with your spouse

This is the first and most important step in resuming a normal relationship. Heart attack or major heart surgery is a stressful experience for both the partners. Recuperation after home coming is the right time to pick up the threads of life once again. An open discussion about apprehensions and anticipations may be more important than the act of sexual intercourse itself at this stage.

* Getting started

Cuddling for a while without worrying about performance is desirable. Hugging, touching and caressing without penetrative sex and orgasm require very little energy. These may be resumed soon after reaching home. An affectionate gesture this time is good way to express your love before moving on to sexual intercourse.

* Time to resume sexual intercourse

Sexual intercourse is like any other physical activity. A general rule of the thumb is that sex may be resumed when it is possible to climb 1 0r 2 flights to stairs with angina or breathlessness. This generally means 4-6 weeks following an uncomplicated heart attack, and a little later after heart surgery.

* The environment

Sexual intercourse should be resumed in familiar surroundings, in a relaxed and restful environment. Room temperature should be comfortable. Extreme temperatures place more stress on the heart.

* Don’t skip the foreplay

While it is never a good idea to cut short the foreplay, it is especially important during convalescence. Besides enhancing enjoyment, foreplay also allows a gradual rise in heart rate, preparing for sex in the same way as warm up stretching exercises prepare for aerobic training.

* Desirable positions

Whatever the position adopted during sexual intercourse, it should be comfortable and permit free breathing. It was previously thought that when the patient was in bottom or lies side to side rather than the top, the rise in blood pressure during intercourse is less. Little isometric effort is involved in these positions. What should be avoided is supporting the body on hands, when on top.

* Things to avoid

Digestion of food increases heart rate for a while. Therefore, sexual intercourse should be avoided for 2 hours after a heavy meal to minimise strain on heart. Sex should be avoided when either of the partners is extremely tired, tense, angry or under time pressure.

Normal responses and warning signals

Fast and deep breathing, sweating and palpitation are normal features of arousal during sexual intercourse. Even though they are often misinterpreted as symptoms of heart disease, there is nothing alarming amount them.

Severe breathless or palpitation persisting beyond a few minutes of orgasm, or their recurrence after some time may be a cause for concern. To be certain of the nature of the problem, it is worthwhile to contact personal physician. If symptoms are related to heart problem, a small change in medication may be all that is needed. Extreme fatigue on the morning after sexual intercourse should be also reported.

Rarely, angina may occur during sexual intercourse. It can be controlled by taking sublingual (under the tongue) nitoglycerine. Regular occurrence of angina during sexual intercourse may be controlled by taking g it 15 minutes before sexual activity. Some physicians advice routine use of nitoglycerine before attempting sexual intercourse for the first time after a heart attack.

When sexual intercourse is not advisable

If sexual intercourse precipitates severe angina or breathlessness on more than 1 occasion, or when even modest physical exertion precipitates irregular or missed heart beats or ECG changes, it is desirable to resume sexual intercourse after optimization of medical therapy.

If there is a problem: Problems in resuming normal sex life after an acute heart problem may be due to several reasons.

For physically deconditioned people, supervised exercise training is an excellent way of improving the safety of sexual intercourse. Less increase in heart rate during sexual intercourse in the physically conditioned impose less strain on the heart.

Causes of sexual problems in heart disease

* Anxiety
* Depression
* Preexisting sexual problem
* Concomitant stroke during acute heart ailment or heart surgery
* Atherosclerosis of aorta or its branches supplying blood to penis
* Physical deconditioning
* Alcohol and tobacco abuse
* Some therapeutic drugs

Sometimes sexual problems encountered in heart disease are caused or aggravated by certain medicines. Some medicines known to cause sexual difficulties are spironolactone, beta blockers, thiazide diuretics, statins, anti-depressants and sedatives and anti-anxiety drugs. Personal physician is the best guide to assess whether particular medicine is responsible for sexual problems. If identifies with reasonable certainty, the offending medicine may be withdrawn. When a medicine is absolutely essential, sex may be scheduled when blood levels of the problem medication are low, that is, about 6-8 hours after dose of the medicine.

Conclusion

Sexual intercourse after a heart attack is not a risky Endeavour. To the contrary, it is normal, also to be desirable and healthy provided it is undertaken with a familiar partner. If someone can walk on a treadmill, climb 2 flights of stairs at a good pace without breathlessness, palpitations or chest pain, his physical condition is good enough to resume normal sex.

Abuse in Child :

2009-05-25T00:37:00.000-07:00

What is sexual abuse ?

Sexual abuse in children is a term used when the offender, who may or may not be a member of the family, uses a child for his sexual gratification. Very young children as well as older teenagers may be victimized.

What does sexual abuse include ?

Sexual abuse can be physical, verbal or emotional and includes:

* Touching and fondling with sexual intent.
* Exposing children to adult sexual activity or pornographic material.
* Having children pose, undress or perform in a sexual fashion on film or in person.
* “Peeping” into bathrooms or bedrooms to spy on a child.
* Rape or attempted rape.

The perpetrator may use force, tricks, bribes or threats to involve a child into sexual activity. But the use of physical force is rarely necessary because children, who wish to seek adults love and approval, believe that they are always right and thus become vulnerable at the hands of such people.

What are the signs of sexual abuse ?

Children generally do not tell if they are being sexually abused because they may be afraid of the perpetrator. The abuser may threaten to harm the child or any member of her family if she told them. In cases, where the abuser is known to the child, he may ask her not to divulge “their little secret” to anyone else.

Parents or guardians must be vigilant towards their children since there are certain general behaviour changes that may occur in children if they are experiencing such a problem.

* Sleep disturbances.
* School problems.
* Withdrawal from family, friends or usual activities.
* Other problems may include depression, anxiety, discipline problems, drug or alcohol problems, hostility or aggression and in some cases running away.

Children who have been sexually abused frequently have more specific symptoms like displaying sexual knowledge or behaviour that is beyond what is normal for their age; copying adult sexual behaviour; unexplained pain, swelling, bleeding or irritation of the mouth; urinary infections and sexually transmitted diseases.

How does a sexually abused child feel ?

A sexually abused child may feel different emotions like fear of the abuser or of being different; anger at other adults around her who did not protect her; isolation, sadness, guilt, confusion and shame.

What should parents do ?

As concerned adults, parents should teach the children:

* that they are loved, valued and are most precious for them.
* the difference between safe and unsafe touches.
* that their bodies belong to them and nobody has the right to touch or hurt them.
* to tell anything about which they might feel uncomfortable to their parents.

If a child trusts the parents and tells them about the incident, they should help by providing positive support.

Some dos:

* Keep calm.
* Believe the child.
* Give positive messages such as “I know you could not help it”, “I’m proud that you trusted me”.
* Respect the child’s privacy and never discuss the topic in front of others.
* Take the child for a medical check up to make sure that no permanent damage has occurred.

Some don’ts:

* Never panic or overreact as the child needs help and support to make it through this difficult time.
* Never confront the offender in the child’s presence.
* Do not blame the child because sexual abuse is never the child’s fault.

Rape :

2009-05-25T00:35:00.000-07:00

What is rape ?

Rape is a crime in which a person is forced to have sexual intercourse without giving consent. It is not known if the number of rapes has increased or if more victims are now willing to report the crime. Shame, fear of revenge or rejection, and the trauma of a court trial are common reasons for failure to report a sexual offence.

Rape is most often motivated by extreme anger toward the victim or a need to overpower the victim. The motive is rarely sexual and violence is not always involved. Forced sex is intended to abuse, humiliate, and dehumanise the victim. Fifty percent of all rapists are under the age of 25 and most rapists average ten rapes before they are caught. Studies indicate that rape occurs most frequently with someone the victim already knows. Drug and alcohol abuse are frequently related to sexual offences.

What are the effects ?

The effects of rape are both physical and psychological.

Physical effects on the victim may include:

* injuries from beating or choking, such as bruises, scratches, cuts, and broken bones
* swelling around the genital area
* bruising around the vagina
* injury to the rectal-vaginal area (for example, tearing of the tissue that bridges between the anus and the vagina)
* sexually transmitted diseases (such as, herpes, gonorrhoea, AIDS, and syphilis)
* possible pregnancy, in a regularly menstruating female

Psychological effects on the victim may include:

* severe anxiety
* depression
* difficulty concentrating or sleeping
* dreaming about what happened
* inappropriate guilt feelings
* emotional numbness or irritability
* flashbacks
* nightmares
* extreme fear

How is it treated ?

If there has been a assault, the police must be called to report the incident. The victim must be taken to a hospital. The doctor will conduct a thorough physical exam, including a pelvic exam, to determine the extent of the injuries. The doctor will make special note of any cuts, bruises, or other injuries, especially in the genital area and prepare a medico-legal report.

To collect potential evidence to use against the assailant, the doctor will look for specimens such as patches of torn clothing, blood, semen and strands of hair from the attacker. These specimens can be tested against body fluid or skin samples from suspects.

After the examination the doctor may recommend the following:

* Professional crisis counselling.
* antibiotics or other medicine for sexually transmitted diseases such as gonorrhoea, chlamydial infection, or pubic lice.
* Help the resources available to help the victim deal with the emotional and physical effects of sexual assault.
* A support group for rape victims.
* Medications to prevent pregnancy.

Child victims need to be evaluated by a doctor immediately. It is generally recommended that the child see a special counsellor trained to work with cases of abused children.

How long will the effects last ?

The physical effects of rape may last from a day to a few months, depending on the extent of the injuries involved. The mental and emotional effects are less predictable. The effects may last a lifetime, but crisis counselling and rape support groups can help reduce long-term effects and help the victim cope with feelings of isolation, guilt, depression, or anxiety.

Children are especially vulnerable to long-lasting mental and emotional effects. They frequently need special counselling and care.

The victim must not isolate herself. She must allow family members to provide emotional support. There are family counselling programmes for family members who need help dealing with their concerns and increasing their ability to provide emotional support.

For child victims, find a counsellor who specializes in working with child abuse and incest cases.

What can be done to help prevent rape ?

* Girls must learn about characteristics or typical behaviour patterns of potential attackers.
* Children must be taught what to do if approached by a stranger, what behaviour to look out for, and what places or situations to avoid.
* Educate oneself about aspects of one’s appearance and behaviour that might make one vulnerable to attack.
* Girls must learn self-defence techniques to help them defend against an attacker.

Proctitis :

2009-05-25T00:33:00.001-07:00

What is proctitis ?

Proctitis is an inflammation of the lining of the rectum causing discomfort, bleeding, and occasionally, a discharge of mucous or pus.

What are the causes ?

There are many causes of proctitis but they can be broken down into several small groups:

* sexually-transmitted diseases
* non-sexually transmitted infection
* autoimmune disease
* noxious agents

Sexual disease related proctitis occurs with high frequency among homosexual men and women who engage in anal intercourse. Sexually-transmitted diseases which can cause proctitis include gonorrhoea, herpes, chlamydia etc. Amoebiasis is another disease which can cause proctitis and can be transmitted by ano-oral sex.

Non-sexually transmitted infections causing proctitis are seen less frequently than STD proctitis. Non-sexually transmitted infection occurs in children and the proctitis is caused by beta-haemolytic streptococcus, the same organism which causes strep throat. Autoimmune proctitis is associated with diseases such as ulcerative colitis or Crohn's disease.

Proctitis may also be caused by physical agents including chemicals inserted into the rectum, medications and radiation. Radiation proctitis is seen in association with radiotherapy as part of cancer treatment.

Risk factors include high-risk sexual practices, homosexuality, and autoimmune disorders. In ulcerative proctitis, a common form of proctitis, ulcers appear in the inflamed rectal lining. The condition may affect 1 to 4 inches of the lower rectum.

What are the symptoms ?

Proctitis typically causes painless bleeding or the passage of mucous from the rectum. When the cause is gonorrhoea, herpes simplex, or cytomegalovirus, the anus and rectum may be intensely painful.

* pain, discomfort
* rectal bleeding
* rectal discharge, pus
* bloody stools
* constipation

How is it diagnosed ?

To make the diagnosis, a doctor looks inside the rectum with a proctoscope or sigmoidoscope and takes a tissue sample of the rectal lining for examination. The laboratory then can identify bacteria, fungi, or viruses that may be causing the proctitis. A doctor also may examine other areas of the intestine using a colonoscope or barium x-rays.

What is the treatment ?

Successful treatment of the underlying cause usually cures the problem. Proctitis caused by infection is treated with antibiotics specific for the causative organism. Corticosteroid or mesalamine suppositories may relieve symptoms in Crohn's disease or ulcerative colitis. When the cause is radiation therapy or is not known, the person may get relief from a corticosteroid, such as hydrocortisone, and mesalamine, another anti-inflammatory drug. Both can be taken as an enema or as a suppository. Sulfasalazine or a similar drug may be taken orally at the same time. If these forms of therapy do not relieve the inflammation, oral corticosteroids may help.

What is the prevention ?

Safer sex behaviours may prevent the disease from being spread by sexual transmission.

Prevention than cure :

2009-05-25T00:32:00.000-07:00

We have all grown up hearing the adage 'Prevention is better than cure' since our very childhood — brush your teeth twice to protect them from decaying; wash your hands before eating food to avoid a stomach upset; do not eat uncovered street food; get vaccinated against diseases like polio; get rid of stagnant water to stay clear of malaria and dengue; exercise to stay fit; and so on and so forth. No one wants to argue with these time-tested measures, which if followed can reduce one’s chances of contracting a disease; forget about trying to find a cure later.

But when we talk about an issue such as AIDS, Acquired Immunodeficiency Syndrome, the whole prevention angle seems to be misconstrued. People have been warned about AIDS and the virus causing it, HIV (Human Immnuodeficiency Virus) for over 20 years now. But has it been enough? AIDS has already killed millions of people, millions more continue to become infected with HIV. But still the point is far from being driven home — There is neither a vaccine nor a cure for AIDS; the only way to remain safe is by not getting infected.

To this end, the ABC (abstinence, be faithful and use a condom) campaign to prevent HIV infection needs to be seen in new light. With more and more people indulging in unprotected sex, especially youngsters, the mystery and confusion surrounding it needs to be cleared, and this can be best achieved by imparting sex education.

Sex education, both from the family perspective and the government in general, has become a hot topic of debate, with very less being done to clarify the doubts nesting in the boggled young minds. We have to go beyond showing a ‘single’ documentary at school, which only leaves the minds more baffled and curious. Family discussions need to be more focused emphasising on the fact that it can happen to anyone and so the need to understand the facts correctly to help members make an informed decision.

According to a survey, 51 per cent of the people in India feel that AIDS has a cure, 65 per cent do not use condoms while having sex with ‘unknown’ partners and only 73 per cent practice abstinence before marriage. About 95 per cent people believe that it can never happen to them. This is a telling picture of the crude information engulfing our society.

The idea of prevention can only be realised when people are informed about how they can protect themselves and their partner, and if infected how they can take care of themselves and prevent from spreading the infection. If the government takes a firm step to inform and educate the masses how to prevent from getting HIV/AIDS, it will also help to bring down the cost of health care required at a later stage after one gets infected.

In 2007, the number of people worldwide living with HIV is estimated to be 33.2 million, 2.5 million people became newly infected and 2.1 million people died of AIDS. The brutal truth is that this number includes 2.5 million children who get infected with HIV much before they actually get to know about prevention. The transmission of the virus from HIV-positive mothers pushes 3,80,000 children to the jaws of death every year.

These statistics only reinforce the need for prevention — by drugs so that the virus is not transmitted from HIV-positive mothers to their infants and thereafter by proper sex education so that people can make an informed choice.

Ignorance may be bliss sometimes, but definitely this does not apply to AIDS. Preventing ignorance is the first step, and it should happen not only on the World AIDS Day, but should be an ongoing process.

Premature ejaculation :

2009-05-25T00:31:00.001-07:00

What is premature ejaculation ?

Premature ejaculation is the inability to delay ejaculation till the man wishes or when ejaculation occurs too early in the sexual act to satisfy both partners. The time to reach the stage of ejaculation is subjective and varies form one man to another. Some men may ejaculate immediately after copulation begins while another may not ejaculate even after 10 minutes. Thus, time is not a criterion for ascertaining whether the ejaculation is premature or not; mutual satisfaction is the benchmark against which this condition is measured.

What is the cause ?

Premature ejaculation primarily has a physiological basis. Biologically, men have an orgasm approximately 2-3 minutes after penetrating the vagina. Women, on the other hand, typically take more time to reach the climax. Since in most cases, the partners may not climax together, they are not satisfied and the ejaculation is termed premature.

However, premature ejaculation may be caused by a variety of psychological and social reasons. It is seen that it occurs frequently when the man is under mental stress or anxiety. Anxiety may be due to the fear of non-performance, the fear of being discovered (as during premarital or extramarital sex in our society) or anxiety related to contraction of sexually transmitted diseases or an unwanted pregnancy.

Though men of all ages may experience the condition, it is more common in adolescents, young adults and inexperienced men. However, it is also true that almost all men experience it at some point in their lives. Premature ejaculation is one of the most common sexual problems for which couples seek advice. The result of treatment is often successful.

What are the symptoms ?

Since premature ejaculation is not a disease, it does not have the classic "symptoms". An individual realizes that he is suffering from it when sexual intercourse ends before either partner is completely satisfied. It is diagnosed by a physical examination, in addition to interviews with the couple regarding their relationship.

What is the treatment ?

In some cases, the problem can be solved simply by educating an individual about the condition and reassuring him. Counselling is provided by psychologists that helps a man to deal with his fears and anxieties and, thus, eliminate the psychological causes of the condition. The following techniques may be beneficial in delaying ejaculation:

1. The "stop and start" method – in this method, the man learns to recognise the stage after which he cannot control ejaculation. The treatment method trains the person to remove the stimulus just before that stage is reached so that the urge to ejaculate is controlled. For example, when during masturbation, the man reaches a point just before ejaculating, he stops the stimulus until he starts losing the erection. Once the stage is past, he can resume the activity. This process is repeated again and again until the individual is able to delay ejaculation till the time he wishes. This method called the 'Masters and Johnson method', is most effective when the help of the partner is sought during actual intercourse.
2. The squeeze technique – in this method, the partner gently squeezes the tip or base of the penis just before the point of ejaculation thereby "cancelling" the orgasm. This process can be continued until the couple decides mutually to reach the climax.
3. Desensitising creams and gels are available in the market that reduce the sensitivity of the penis and help men reach climax later. Some men also feel that condoms reduce the sensations and, in addition to providing safer sex, help them last longer.
4. The couple can also experiment with sexual positions as some positions offer more control than others and may help to delay ejaculation.

Postpartum :

2009-05-25T00:29:00.000-07:00

Postpartum is the period of time after the birth of a baby when the body is changing back to normal. It lasts about 6 weeks or until the uterus returns to its normal size.

What care is needed after delivery ?

The following are important components of postpartum care:

Rest : You need rest. However, with caring for and feeding a new baby, there is not much time to rest. You can get help from friends and family and have extra time to care for the baby and yourself. Because you must feed the baby day and night, you may need to change your sleeping schedule to get enough rest. Try to sleep while the baby sleeps. Morning and afternoon naps can be very helpful.

Pain relief : If you delivered the baby normally through the birth canal, pain in the area between the rectum and vagina is common. To relieve the pain and prevent infection, you can sit in a warm bath, put cold packs on the area, or put warm water on the area with a squirt bottle or sponge. It is also important to wipe yourself from the front to back after a bowel movement to prevent infection.

Bleeding and discharge : You will have vaginal discharge for 2 to 6 weeks after delivery. Sometimes it may last longer. It may come out in gushes or more evenly like a menstrual period. The discharge will start out red and slowly change to pink and finally a yellow-white color.

Constipation and haemorrhoids : It is common to be constipated or have discomfort from haemorrhoids after delivery. Ointments and sprays can be used to help reduce swelling in the area of the rectum. For constipation try eating foods rich in fiber and drinking lots of liquids.

Breast soreness : Milk will come in about 2 to 4 days after the child is born. This may make breasts very large, hard, and sore. This will get better once you start a breast-feeding routine. If you are not breast-feeding, your breasts may become large or painful while you are waiting for your milk to dry up. To help with pain and discomfort, wear a well-fitting support bra and put ice packs on your breasts.

When can normal activities be resumed ?

If you had a normal delivery without any problems, you can get back to doing most of your normal activities right away. You should still take it easy and avoid heavy lifting, and a lot of stair climbing for the first couple of weeks. If you have had a caesarean section (C-section), you will need to avoid heavy lifting for 6 weeks.

Exercise is one of the best ways to lose weight, get more energy, relieve stress, and build strength. Unless you had a C-section, difficult birth, or other pregnancy problem, you can usually start exercising as soon as you feel up to it. If you have had a C-section, you can usually start exercising in 6 weeks.

How to return to pre-pregnancy weight ?

During birth, one loses about 12 to 14 pounds. However, this may still leave some weight to lose, depending on how much weight you gained during pregnancy. Losing this weight takes time. It takes most women 8 to 12 months to return to their normal weight. Losing the weight slowly is healthy and natural. The key is to eat healthy and exercise. After the first few months of eating right and exercising, you can begin a healthy weight-loss programme if necessary. If you are breast-feeding, you should make sure you are still eating at least 1800 calories a day. Because breast-feeding uses a lot of calories, it usually helps women lose their pregnancy weight.

When can I have sex again ?

The number of weeks you should wait before having sex depends on your specific situation. If you had an episiotomy, you should wait at least 3 to 4 weeks for it to heal. If you had a C-section you should wait at least 4 weeks so your cuts can heal. Because it takes approximately 6 weeks for your uterus to return to normal size, many recommend that all new mothers wait a full 6 weeks. It is normal to feel uncomfortable at first when you start having sex again after childbirth.

Talk to your doctor about methods of birth control to be sued after the birth of your baby. The method that may be best for you depends on the type of delivery you had, how you are recovering, and if you are breast-feeding.

When does the menstrual cycle resume ?

If you are not breast-feeding, you may start having menstrual periods 3 to 10 weeks after delivery. If you are breast-feeding, there is no specific time when your periods will start again. It may not happen until after the first 6 months of breast-feeding, but it could happen earlier. Some women do not get their period again until they stop breast-feeding.

What are the postpartum blues ?

Many physical and emotional changes occur during pregnancy and after you give birth. These changes can leave you feeling sad, anxious, afraid, or confused. These feelings are called the baby blues and usually start right after the baby is born and go away within a week. However, for some women, these feelings do not go away and they may get worse. When this happens it is called postpartum depression. Postpartum depression can start right after the baby is born or begin weeks later. It can be a serious problem and needs treatment.

Pap smear :

2009-05-25T00:27:00.000-07:00

What is a Pap smear ?

A Pap smear is a test that checks for changes in the cells of the cervix. The cervix is the lower part of the uterus that opens into the vagina. Other terms for Pap smear are Papanicolaou smear, Pap test, and cervical smear. The main purpose of the Pap test is to find abnormal cell changes that may arise from cervical cancer or before cancer develops.

What is a pelvic exam ?

In a pelvic exam, the uterus, vagina, ovaries, fallopian tubes, bladder and rectum are felt to find any abnormality in their shape or size. During a pelvic exam, an instrument called a speculum is used to widen the vagina so that the upper portion of the vagina and the cervix can be seen.

Why is a Pap smear important ?

A Pap smear and pelvic exam are important parts of a woman’s routine health care because they can detect abnormalities that may lead to invasive cancer of the cervix. These abnormalities can be treated before cancer develops. Also, as with many types of cancer, cancer of the cervix is more likely to be treated successfully if it is detected early. The Pap smear tests for abnormal changes in the cervical cells. A precancerous change in the cells, called cervical dysplasia, can be detected by a Pap smear. The abnormal cells can develop into cancer if the dysplasia is not discovered and treated. The Pap smear may also detect viral infections of the cervix, such as genital warts and herpes. It may detect vaginal infections such as infections with yeast or trichomonas. Sometimes the Pap smear can give information about the hormones, especially progesterone and estrogen. Most women should get a Pap smear at least every year, especially if they are sexually active.

You are at an increased risk for cervical cancer if :

* You have had an abnormal Pap smear.
* You began to have sexual intercourse in your teens or earlier.
* You have a history of many sexual partners.
* You or your sexual partner has had genital wart virus infection.
* You have had vulvar or vaginal cancer.
* Your sexual partner has or had cancer of the penis.
* You smoke cigarettes.
* Your immune system is weakened; for example, because you have had a transplant, you are taking immunosuppressive drugs, or you have AIDS.

Pap smears can detect precancerous and cancerous conditions. If these conditions are discovered, there is a good chance that simple treatment will prevent the development or spread of cancer.

How to prepare for a Pap smear ?

Do not use vaginal creams during the 2 days before the test. Do not have intercourse within 24 hours before the Pap smear because it can cause inaccurate test results. You should get this test done when you are not menstruating; the best time is between 10 and 20 days after the first day of the last menstrual period.

How is a Pap test done ?

A Pap test is simple, quick, and painless; it can be done in a doctor’s office, a clinic, or a hospital. While a woman lies on an exam table, the clinician inserts a speculum into her vagina to widen it. A sample of cells is taken from the cervix with a wooden scraper and/or a small cervical brush. The specimen (or smear) is placed on a glass slide and preserved with a fixative, or is rinsed in a vial of fixative, and is sent to a laboratory for examination.

What happens after the procedure ?

If the cells look normal, no treatment is necessary. The Pap test may show that you have an infection. The doctor may treat you for the infection and suggest that you have another Pap test in several months. If the cells look abnormal, more tests may be necessary. Discuss with the doctor when you should return for any tests or a follow-up exam. A Pap test is not 100% accurate. There are newer methods used now for Pap testing, including computer-assisted testing, which are more accurate. However, these newer methods cost more.

Peyronie’s disease :

2009-05-25T00:25:00.000-07:00

What is it ?

Peyronie’s disease is characterised by the formation of hard, fibrous lumps on the penis. The lumps or plaques are first evident as swellings on the upper or lower portion of the penis, which later develop into hard scars that may cause curvature of the shaft of the penis. In most cases, these scars may not be painful and heal by themselves in a few months. In severe cases, they become painful and prevent full erection of the penis due to reduced flexibility.

If the plaque forms on the upper portion of the shaft, the penis bends upwards and if the lump is on the lower portion, the curvature is downwards. The disease occurs more commonly in middle aged men, but can occur at all ages.

How is it caused ?

The exact cause of the disease is not known. Sometimes it occurs due to an infection. In most cases, it is caused by injury to the penis. The soft erectile tissue of the penis may be injured because of which internal bleeding takes place. This results in scarring over a period of time to form the plaque. Repeated injury to the penis may worsen the condition.

What are the symptoms ?

Men with Peyronie’s disease usually seek medical help because of painful erections and difficulty in sexual intercourse. There may be associated symptoms like:

# Lumps in the penis which may be felt while it is soft and flaccid.
# Mild discomfort or a dull pain may be felt in some parts of the penis before any lump is detected. This is when the infection or trauma has already taken place, but the hardening has not occurred.
# Bending or curvature of the penis when erect.

How is it diagnosed ?

The disease is detected first by the patient himself. The doctor confirms the diagnosis by a thorough physical examination. All the predisposing symptoms are taken into account while making the diagnosis.

What is the treatment ?

Sometimes the lumps may dissolve on their own or with other treatments like vitamin supplements (which help to dissolve the lump) may be given. The patient may be given painkillers to reduce discomfort. However, these treatments may not be effective. Surgery is the only long term and the most effective treatment for the condition.

In this, the hardened plaque is removed and the area is covered by a patch of skin graft. In another procedure, called the Nesbit procedure, some tissue from the side of the penis opposite to the side with the plaque, is removed. This helps in balancing out the curvature of the penis.

Paedophilia :

2009-05-23T00:13:00.000-07:00

What is paedophilia ?

Paedophilia is a form of sexual abuse of children. It is an aberration of sexual behaviour in which the preferred sexual objects are children, usually under the age of 13.

Who are paedophiles ?

Paedophiles are persons who practice paedophilia. They are present at every social and economic level and are very often respected members of the community. They can be close relatives or friends of the victim. They are the people who seem content to fantasize in the safety of their homes and find a sense of fulfilment in sexual activities with pre-pubescent children (children in the age group of 6-12 years).

Many of these offenders have extensive collections of child pornography or child erotic materials that feeds their fantasy. This may consist of photographs, toys, slides or video tapes. The paedophile collector can either be one who builds and views his collection in a very secretive manner or one who displays such material to others to make a profit.

He may use such collections:

* to lower the inhibitions in a victim and introduce him to the possibilities of sex with an adult.
* for his own gratification.
* to blackmail his victims into further sexual activity.

What are the characteristics of a paedophile ?

A paedophile exhibits certain characteristics common to all such offenders:

* These people often have failed marriages due to their sexual interests. The wife prefers to keep quiet to avoid social stigma and disgrace.
* He displays a fascination or unusual interest in children.
* He may use inappropriate and exaggerated terms for children such as “pure”, “God sent” or “blissful”.
* His hobbies commonly belong to the child’s world such as toy collecting, building models of cars and planes and his room may be decorated in a child’s theme.
* He is generally single and has few or no friends of his age.
* He has systematic and prolonged access to children. Jobs such as that of school teachers, photographers, school counsellors and sports coaches serves his need well.
* Paedophiles are very adept at locating troubled or withdrawn children and lavish gifts upon the target and take him for activities in which they are left alone with no parental supervision.
* If the target is a troubled child, the paedophile will comfort and sympathize with him or her and often, over a period of time, the child will develop feelings for the offender even though he is being actively abused, a phenomenon called “Stockholm syndrome”.

What is the role of the internet in boosting such sexual acts ?

The internet and computer have been the most important exchange medium for child pornography. Cheap, user-friendly encryption software is often deployed by child pornographers to make decoding of the files extremely difficult for clients and especially law enforcement agencies to identify them. Images showing sexual abuse of children can be uploaded and downloaded with relative ease and anonymity.

Thus, the world over, parents, schools and society in general are concerned to ensure a safe environment for their children before the TV screen and the computer.

What efforts are needed to regulate paedophilia ?

* Strict law enforcement is needed against child abuse, child pornography and paedophilia. The erring sites need to be identified and removed from the web.
* Agencies like UNESCO have an ethical interest to safeguard freedom of expression and they are working towards protecting children from the dangers of the internet without destroying the new communication and information tool.
* More research, information, monitoring and sensitizing of the public is required in the direction of sexual abuse of children.
* Parents need to educate their children about this and take care that their innocent children do not become victims in the hands of paedophilic offenders.

Masturbation :

2009-05-23T00:05:00.000-07:00

What is it ?

Masturbation is the stimulation of the sexual organs usually by a person himself, to obtain an orgasm. Though masturbation can be done by partners on one another, the term is more commonly used when sexual satisfaction is provided by self. Most people use their hands to masturbate, but instruments like vibrators and dildoes may also be used. These imitate the movements of the hand and provide sexual pleasure.

Masturbation is a way of releasing pent up sexual energy. Most people start masturbating at the time of puberty. With changes in an individual's hormonal profile during puberty, there is a surge of sexual energy which can be released with the help of masturbation. Masturbation is reported more in males than in females. More than a physiological difference in libido, this may be due to sociological taboos on females. Females also tend to discontinue or reduce masturbation when they form sexual relationships.

Is masturbation harmful ?

This is the biggest myth surrounding masturbation. If indulged in moderation, masturbation, on the contrary, is a healthy practice that releases sexual energy. According to certain religious practices and beliefs, masturbation is harmful since it results in the loss of a man's "seeds" and makes him weak. Masturbation in women has largely been ignored in the religious texts. Other myths surrounding the act are that it reduces virility by making the semen less thick thereby reducing the chances of a man to bear children. This is totally untrue. Masturbation does not cause any loss of strength or virility in a person.

What are the other myths surrounding masturbation ?

1. Only males masturbate – this is not true. Females masturbate as much as males do. However, they tend to report it less than males due to the social stigma attached to it. Also it has been observed that females tend to reduce or discontinue masturbation once they get into meaningful sexual relationships.
2. Masturbation is unhealthy – masturbation per se does not cause any health hazards. It is not an unhealthy habit. However, it may be mentally unhealthy if it assumes obsessive proportions and the individual is unable to think of anything else. It may also have physical repercussions if the instrument used to masturbate is dirty or infected.
3. Only adolescents masturbate – though the practice usually begins during adolescence, almost all adults practise it at some time or the other.
4. Masturbation does not provide as much satisfaction as sexual intercourse – sometimes masturbation is more satisfying than the sex act. This is because, during masturbation, an individual is in control of his own movements and can maximize the pleasure according to his or her needs. During sexual intercourse, the degree of satisfaction may, to some extent, lie with the partner.
5. People masturbate only if they have unfulfilling sexual relationships – people also masturbate for self satisfaction, even when they have fully satisfying sexual relationships.

Can one stop masturbating?

One can stop masturbating if one wants to. Just as one can live without indulging in sex, one can also stop masturbating with some will power. However, since the activity has nothing to be ashamed of and most people do it, there is no scientific reason to discontinue it. If one still wishes to discontinue, then the sexual energy may need to be channelised into alternative physical activities.

Lesbianism :

2009-05-23T00:03:00.000-07:00

What is meant by lesbianism ?

Lesbianism is a term, which describes women whose primary sexual and emotional attractions are fulfilled by other women. Many myths exist concerning lesbianism. It is believed that women become lesbians because of bad experiences with men. It is also said that the lesbians are very masculine.

Are lesbians different people ?

Like heterosexuals, lesbians also range in size, shape and appearance and have been found to be no different from them in relationships with parents and friends, drinking, self-esteem and many other issues. Lesbianism is simply the way a minority of our population expresses human love and sexuality. Studies on the mental health of lesbians show that they function like heterosexuals as far as their judgement, stability and adaptiveness are concerned.

What is the basic cause for lesbianism ?

Research suggests that the homosexual orientation is decided very early in life. It is therefore unethical to change a person’s sexual orientation through therapy. Psychological techniques like psychotherapy may only help them in becoming comfortable with their sexual orientation.

What is homophobia and heterosexism ?

Within our society, there is an irrational fear of homosexuality. This aversion to gay or lesbian people is called homophobia. Heterosexism is a term used to define prejudice and discrimination against gays and lesbians.

Homophobia can be called a health hazard because the prejudice from society may cause an individual to turn inward and become depressed. The fear of stigma from the society may lead to a refusal to seek medical attention when needed, ultimately resulting in poor health for the lesbian.

What could be done to help this important minority ?

An attitudinal and behavioural change is required towards this group as a whole. Lesbianism says loving another woman is good, exciting and healthy. Therefore, the people need to be more informed in order to encourage a healthy approach.

An open forum is required where such people can meet, exchange their feelings and become more vocal with regard to issues that affect them.

Laparoscopic Hysterectomy :

2009-05-23T00:01:00.000-07:00

What is laparoscopic hysterectomy ?

It is a procedure by which the uterus is removed laparoscopically. This is done with the aid of a telescope and very fine instruments, without making a big incision in the abdomen.

What are the advantages of laparoscopic hysterectomy ?

The advantages over the conventional hysterectomy are that there is minimal tissue handling resulting in much less pain and lesser chances of adhesion formation after the operation. 2-3 very small incisions of 0.5-1.0 cm (as compared to 10-15cms in conventional procedure) are given on the abdomen resulting in less blood loss and lesser chances of wound infection with decreased hospital stay and early recovery as compared to conventional surgery.

Who can undergo laparoscopic hysterectomy ?

Usually all the patients who have been advised for conventional hysterectomy can undergo laparoscopic hysterectomy, provided the size of uterus is not very big (that is bigger than 20 cm).

A person with diabetes or hypertension can also undergo this procedure after the conditions are under control, and in fact the advantages of lesser chances of infection and early recovery are very beneficial for them.

A patient who has undergone operations in the past can also undergo this procedure and if there are adhesions because of previous operations, they can be removed along with the laparoscopic hysterectomy, in the same sitting.

It is also possible to treat or remove the ovaries and tubes while carrying out laparoscopic hysterectomy.

What preparation is needed before the procedure ?

The usual routine tests are required as for any other operative procedure and no special investigation is required for laparoscopic hysterectomy.

To make the operation easier, the recovery after the operation faster and resumption of normal work or activity earlier, some medicines along with diet restriction is started 2-3 days before the operation.

If the patient is fully investigated and has undergone an anaesthetic check up, she can get admitted on the morning of the operation.

How is the surgery performed ?

This procedure is carried out under general anaesthesia. A small incision (about 1 cm) is made at the lower end of the navel. Through this a laparoscope is introduced inside the abdomen. It is a tube having lenses inside and a special camera attached to the outside end. This is then connected to a television monitor and allows the surgeon to see everything inside. After that two small half to one cm incisions are made on either side of the abdomen, to allow the introduction of thin long instruments, with which the operation is carried out.

What happens after the procedure ?

The total hospital stay is usually for two days, after which one can go back home.

On an average, two hours after lunch and eight hours rest after dinner is what is usually recommended. The patient can climb stairs slowly, walk half to one km slowly and carry out sedentary work at home without much difficulty. One can bathe as the stitch dressing is usually waterproof.

Routinely, the patient is called seven days after the operation for the removal of stitches and then after six weeks for an internal check up.

When can one resume normal activity or go back to work ?

Once the stitches are removed, the patient can resume normal activity like walking, jogging, cooking, driving, sitting in front of the computers for 4-6 hrs etc. Sexual intercourse, strenuous exercise, lifting of heavy weights and swimming. has to be avoided for six weeks.

Menstrual cycles :

2009-05-22T23:57:00.000-07:00

Irregularity in the menstrual cycle

Menstrual cycles vary in length from one woman to another. They may occur at the same time each month or be irregular. Typically, a cycle occurs about once a month, but can be as short as 21 days or as long as 35 days and still be considered normal. Menstrual flow lasts about 3 to 7 days. A menstrual period is considered late if it is 5 or more days overdue according to the usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.

What is the cause ?

A late or missed period could be because of any of the following:

1. Pregnancy
This is the most common cause of missed periods. If you have had unprotected sex even once in the past several months, see your doctor for a pregnancy test before you consider any of the other possible causes.
2. Stress
Stress is the second most common cause of late or missed periods in teenagers. It may be emotional stress or depression. Or it may be physical stress, such as a severe illness, a sexually transmitted infection, rapid weight loss or gain, or strenuous exercise. Dieting or binging and purging may interrupt menstrual cycles. Changes in your usual routine, for example, going on a vacation may also cause your period to be late or missed.
3. Normal development
During the first couple of years of menstruation many teenagers have irregular periods. During this time the body's hormones are not yet finely tuned, so the ovaries may not release an egg once every month. As a result, your cycles may be irregular, occurring as close together as 2 weeks or as far apart as 3 months.
4. Hormone imbalance
Hormone imbalance is rarely the cause of missed periods. In teenagers, polycystic ovary syndrome is the most common type of hormone imbalance that affects the menstrual cycle. Polycystic ovaries may cause irregular cycles, increased body hair, acne, and weight gain. Sometimes when you stop taking birth control pills you may have a temporary hormone imbalance and loss of periods. If you are having sex, be sure to use another reliable method of birth control because you could still become pregnant. Problems of the thyroid gland, pituitary gland, adrenal glands, or ovaries can be rare causes of irregular periods.

How to know what the cause is?

Pregnancy: A positive pregnancy test is the only way to be certain of pregnancy. It is best to see your doctor for a pregnancy test.

Stress: Some stress is a normal part of daily life. Only you can know if you are under too much stress.

Normal development: If your doctor finds nothing abnormal during your physical examination and you've been having periods for 2 years or less, your irregular periods may be part of your normal development. If you have had sexual intercourse, go to your doctor's office for a pregnancy test when your period is late for you, even if you normally have irregular cycles.

Hormone imbalance: If you have missed several periods without an explanation, your doctor can check your ovaries and look for any signs of hormone imbalance. Blood tests can be done to measure hormone levels.

When will periods return to normal ?

It is important to identify pregnancy early so that you can discuss the options available to you and start prenatal care. Early prenatal care helps ensure a healthy baby. If the irregularity is due to stress then your periods should return when the activities or situations that are stressing you are eliminated or changed. As part of normal development, most girls' menstrual cycles become fairly regular as their hormone levels become mature and synchronized. A few women will continue to have irregular cycles as their normal pattern. Most often the doctor can treat a hormone imbalance, once the cause is discovered.

Incest :

2009-05-22T23:55:00.000-07:00

What is incest?

Incest is sexual intercourse that takes place between individuals related by blood. The act may be committed by a father with his daughter, between a grandparent and a grandchild and between a brother and a sister. Though children of the same sex as the perpetrator may also be victims of molestation, it is not termed as incest because penetration does not take place.

Incest is different from child sexual abuse, since the latter consists of any "sexual" act with the child. This does not necessarily include penetration. Child abuse may include fondling, exhibitionism, masturbation, sexual intercourse or showing of explicitly sexual material. Child pornography (involving children in the production of pornographic material) is also a form of child sexual abuse.

Why does incest occur?

There is no cause for incestuous relations to develop between members of a family. In most cases, incest occurs when a young child is threatened by an older and more powerful member of the family. The older member of the family usually wants to exert and express his power on the child when he is unable to do so under normal circumstances. In a minority of cases, incest may be with mutual consent of both the individuals involved.

There are certain conditions under which the risk is increased. Some of them are:

* When the individuals involved have mental defects so that they are unable to comprehend the prohibition associated with the act
* When the individuals involved, get into an incestuous relationship with consent and are unable to control their feelings
* When alcohol removes the sense of prohibition
* When related individuals are separated early in their lives and meet later as strangers, e.g., a brother and sister who meet as adults after being separated during childhood and are unaware of their relationship
* Where close relatives live in proximity which gives rise to physical intimacy.
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What are the feelings that a child may experience after incest?

A child who has been molested by a trusted member of the family may go through a multitude of emotions after the act. The first feeling that most children feel is denial. The child may believe it to be a bad dream. Fear is another emotion that is experienced almost simultaneously. The child, in most cases, is afraid of the authority of the perpetrator and has usually been sworn to secrecy by the adult. Because of this reason, the child may not be able to share his feelings with anyone.

Children may become withdrawn after being molested. This is worse when the molester is someone the child knows and trusts. She may start having nightmares and may suddenly become very fearful. She may become moody and may have fits of incessant crying. The child usually refuses to discus the problem with anyone for fear of rebuke or harm.

An adolescent may become depressed and may avoid the company of the molester. Some youngsters may develop personality disorders like schizophrenia and obsessive compulsive disorder. They may subconsciously blame the other parent for not saving them. Some children grow up to hate their bodies while others may believe that they can be "used" by anybody at any time.

How can an individual be helped later?

Talking with a professional helps most people who have undergone this trauma. This helps to purge hidden feelings of guilt, fear and anger. The victim can join a support group working in the area of rehabilitation of incest victims. A warm and supportive family atmosphere goes a long way towards rehabilitating a victim. Most important is that she should not be blamed for the act and not be made to feel guilty.

What is the legal status for incest in India?

In India, incest, is not an offence. Indian law does not recognize incest as a punishable crime, unless the child is a minor, in which case it is treated as child sexual abuse. Section 90 of the Indian Penal Code deals with sexual abuse of children. According to the IPC, "there is no specific provision in the Indian law as regards to sexual abuse of children by parents or teachers. Such acts are covered by the general provisions relating to sexual abuse of children by their custodian, in whatever capacity they may be.

Impotence :

2009-05-22T23:53:00.000-07:00

A man who cannot develop or sustain an erection to perform satisfactory sexual intercourse is termed 'impotent'. Unfortunately, this term has serious social consequences and should be used with caution and after due consideration of the complex process of male sexual function.

Besides the inability to sustain erection other factors like loss of desire or libido, inability to ejaculate at the right time, difficulty in achieving orgasms, all coexist in some individuals and contribute to the patient's loss of confidence and inadequacy. Erectile dysfunction occurs in 5% of all males above 40 years of age and this percentage increases with advancing age.

What happens during erection?

The penis consists of large open spaces confined within a tight capsule. These spaces contain blood. Erection is brought about by a complex method of influences that travel from the brain, originating in the hormonal system and acting through the peripheral nerves. These result in the filling up of the spaces with blood, and this blood cannot flow out. This engorgement of the spaces with blood makes the penis rigid. Once the influences are withdrawn, as after orgasm and ejaculation, blood drains out from the spaces making the penis flaccid.

What are the causes of erectile dysfunction?

The causes are most often psychological and may include performance anxiety, guilt, depression or a fear of failure. It is important to rule out the physical causes. Besides progressing age, other factors include diseases like diabetes, high blood pressure and obesity. Smoking, excessive intake of alcohol and lack of physical activity can aggravate the problem. Persons with depression, anxiety, chronic stress and difficult relationships have a higher chance of having erectile dysfunction.

Other diseases that predispose to the condition include decreased thyroid function and kidney failure. Some drugs like anti-depressants, tranquillisers and medicines for high blood pressure may also lead to impotence.

How is it diagnosed?

The doctor will take a detailed medical history to determine whether impotence is due to an physical illness or due to psychological problems. Similarly, a detailed examination of the body including examination of the sexual organs will be done. Blood tests may be done to exclude diabetes or high cholesterol. Specialised tests may be done in specific instances to locate a problem in the structure and function of the penis.

How is it treated?

Erectile dysfunction due to a psychological problem is treated with much care. Usually the problem is due to performance anxiety, guilt, depression or a fear of failure. The patient is explained that this only worsens the problem. Sex education helps correct misinformation and ignorance about normal sexual practice. In married couples, discussing the problem with both partners may help the doctor to arrive at the root cause of anxiety or performance failure. These treatment sessions are usually time-consuming and slow.

The psychological treatment can be supplemented with the help of medicines that stimulate erection. These can be taken orally like sildenafil (viagra) or others that can be injected into the penis like papaverine or alprostadil, a synthetic prostaglandin. For men with low levels of male sex hormone, testosterone, this hormone may need to be supplemented. In some cases that do not satisfactorily respond to medicines, erections can be achieved with the help of appliances like vacuum devices or the insertion of implants into the penis by an operation.

Homosexuality :

2009-05-22T23:50:00.000-07:00

What is homosexuality?

Sexual orientation is a component of adult sexuality characterised by attraction towards members of a particular gender. Homosexuality is a sexual preference wherein a person feels sexually attracted to another person of the same sex. It is not a sexual perversion, nor is it a disease. Just like most people are attracted to members of the opposite sex and are called heterosexuals, a minority is attracted to members of the same sex and are called homosexuals.

In colloquial usage, a homosexual is also called 'gay'. 'Lesbian' is a specific term for homosexual women while homosexual men are usually called gay. Homosexuals experience similar feelings of love, attraction and romance like heterosexual individuals, the difference being that the feelings are felt towards a same-sex person.

All individuals have basic sexual rights which should not be violated. Some of them are:
# Freedom of sexual thought, fantasy or desire.
# Right to sexual entertainment.
# Right NOT to be exposed to sexual material or behaviour.
# Right to engage in consensual sexual activity.

What causes homosexuality?

The exact nature of the development of sexual orientation and preferences is still not known. It is not clear whether sexual preferences result from genetic causes or are moulded by the environment in which a child grows up. Though some research studies have suggested that homosexuality is genetic and is present at birth, there is no conclusive evidence to prove it. Studies conducted on twins have shown that if one of the twins is homosexual, there is a more than 50% chance that the other twin will also be gay. Some studies have also shown that there is a difference in the brains of homosexuals and heterosexuals.

There have been other studies to prove that homosexuality develops as a result of complex interactions between a child's social, psychological and physiological environment. The realisation whether an individual is homosexual or not, usually dawns after puberty. Just like heterosexuality, homosexuality is also an alternative way of life.

Is it a mental or emotional illness?

Homosexuality, historically had been considered a sin and a sexual abnormality. Till the 1970's it was considered a mental aberration and homosexuals were shunned in public life. Thus most homosexuals were afraid to reveal their sexual preference and were called 'closet homosexuals'. In 1973, the American Psychiatric Association removed homosexuality from the list of mental disorders.

Homophobia is the hatred or disgust that some people feel towards homosexuals. Homophobics refuse to be associated with homosexuals and have very rigid negative feelings for them. Homosexuals on the other hand may harbour anger towards heterosexuals for marginalizing them.

Do homosexuals have different feelings?

Homosexuals are not different human beings and do not have feelings any different from heterosexuals. However, since they are in a minority, they may develop a low self esteem because of the constant shunning by society. Most homosexuals in India, have still not been able to come out in the open with their sexuality because of the fear of societal censure. A long period of forced secretiveness about their sexuality may also have a negative impact on their psyche. Some gay men and lesbians may start dressing differently in order to make a statement to those around them, but this is most often a defence mechanism. When in a relationship, homosexuals are known to experience the same feelings as heterosexuals.

What are some of the myths surrounding homosexuality?

1. "Homosexuality is a deviation"
Homosexuality is not a deviation, it is an alternate sexual lifestyle. Just like heterosexuality is a way of life, so is homosexuality.
2. "Homosexuals have gender confusion"
This is not true. Most homosexuals dress, walk, talk and live like regular people. Any masculinity or feminity are individual personality traits and have nothing to do with one's sexual preference.
3. "Homosexuals are always artistic"
Since most homosexuals lead sexually repressed lives, they may be more prone to expressing themselves by means of art and music. However, there is no scientific proof that homosexuals are more artistic than others.
4. "Homosexuals are promiscuous"
Though not promiscuous per se, homosexuals may go through a period of promiscuity in an effort to assert their sexuality. However, once they realise their sexual orientation, homosexuals are faithful and monogamous with their partners, like heterosexuals.

What is the legal status of homosexuality in India?

According to the Indian Penal Code, homosexuality is "against the order of nature" and is thus a crime. Under section 377 of the IPC, homosexuality can be a punishable offence with an imprisonment for life. Alternatively, the offender can be imprisoned for ten years with imposition of a fine. However, the act of unnatural intercourse has to be proven to make a case. Penetration of a man by a man is termed unnatural by the Indian law.

HIV AIDS :

2009-05-22T03:48:00.000-07:00

What is HIV infection and AIDS?

The Human Immuno-deficiency Virus or HIV is the organism that ultimately causes AIDS. Soon after first getting the HIV infection the person has a short, self limiting ‘flue-like disease. This only lasts a few days and is so mild that many persons do not even know it. The virus slowly destroys the ability of the body to resist common communicable diseases. When tha resistance of the body is so reduced that infections can no longer be resisted, the person is said to have AIDS. The mean period between getting the HIV infection and developing AIDS is 9.8 years. In other words, in 9.8 years half the HIV infected persons can be expected to develop AIDS and conversely it must be emphasized that half the persons will still be well and healthy at this time.

Once a person has lost the ability to resist common infections and has developed AIDS, the prognosis is poor and death usually comes in 12 to 18 months unless anti-retroviral treatment is initiated. On anti-retrovirals a person can be expected to be sustained for long time. The infection is not cured and treatment must continue life-long.

It must be stressed again that in the early stages of HIV infection, the person feels well and is able to function normally. Examination by a doctor will not reveal any illness and the only detected abnormality is a positive blood test. Such persons should be encouraged to live normally and continue their normal occupation.

AIDS is a serious illness caused by infection with the human immunodeficiency virus (HIV). HIV breaks down the body's immune system, so the person with AIDS can no longer fight off disease successfully. As a result, secondary infections, cancers can more easily take root in the body.

It takes from 6 weeks to several months for the body to form sufficient antibodies (proteins produced in response to infection to show a positive test). When these antibodies can be detected in the blood, the patient is said to be HIV-positive. AIDS is a much later stage when the ability to fight off serious infections is lost.

How does it occur?

HIV is spread by unprotected penetrative sexual contact with an infected person. It can also be acquired when infected blood enters the persons’ blood by sharing needles or the transfusion of infected blood and organ transplants. Infection can also be transmitted from an infected mother to her child in the uterus, during delivery or while breastfeeding.

The virus is also found in smaller amounts in tears, saliva, brain, spinal fluid, urine, and faeces although contact with these bodily fluids is not likely to transmit the virus. Casual contact such as by shaking hands, social kisses, touching an infected person, touching something that the person has handled, using public toilets or telephones, or using swimming pools does NOT spread HIV. The available information also bears out that HIV is not spread by mosquito or other insect bites.

What are the symptoms?

The symptoms of AIDS are the symptoms of the diseases that attack the body because of a weakened immune system. One should never, therefore, attempt to diagnose HIV infection on the basis of symptom or signs only. Patients with HIV/AIDS may present with a variety of manifestations which include:

* Fever, sweats, chills
* Fatigue
* Loss of appetite, weight loss
* nausea, vomiting
* Sore throat
* Diarrhoea
* Cough
* Shortness of breath
* Body rash
* Skin problems

It is important to always keep in mind that all the above symptoms are non-specific and commonly occur in a variety of conditions. To establish a diagnosis of HIV/AIDS a blood test that has been confirmed is essential. A physical examination and other tests are necessary to rule out other illnesses.

How is a test for HIV infection done?

Most of the blood tests used to detect HIV infection work by detecting the presence of HIV antibodies. Keep in mind that early in infection there may not be sufficient antibodies present in the blood to give a positive reaction even though the person has HIV infection. This period is known as the “Window Period” and is dangerous as though the person has a negative test, infection can be spread through sex or blood.
The commonest test used is the ELISA test. The result of a single ELISA (or Rapid / Spot tests) should never be taken to indicate infection but merely as an indication for repeated tests to confirm the result. The WHO recommends that ERS (ELISA, Rapid or Spot) always be repeated to confirm the diagnosis, preferably using a different make of test kit. The Western Blot test is no longer recommended as a mandatory confirmatory test. A single positive test does not indicate infection and must always be confirmed. A negative test does not guarantee that a person is not infected where the risk exposure has occurred recently. If the person has only recently been infected, the antibodies may not yet have been formed (window phase). It may take up to 3 to even 6 months for someone to develop adequate antibodies after exposure to the virus. A confirmed positive test indicates that the person has been exposed to the virus and has developed antibodies but may not necessarily progress to full-blown AIDS.

Who is at high risk for HIV infection?

* Men and women with more than one partner who have oral, anal, or vaginal sex without a condom
* Sexual partners of people who are infected
* People who receive regular blood transfusions (haemophiliaand thalassaemia) or who received blood transfusion prior to the time screening of blood for HIV was made mandatory
* Babies born to infected mothers
* People who share needles (for IV drugs, tattooing or piercing) and their sexual partners
* People who receive injections with recycled disposable syringes or needles
* Prostitutes and their sex partners

How can exposure to HIV be avoided?

The best way of self-protection is to learn as much as possible about HIV infection, avoid risky behaviour, and follow guidelines for protection. Abstinence, non-penetrative sex or a stable relationship between mutually faithful partners is optimal. Where this is not possible, risk can be substantially reduced by the following:

* Use latex condoms correctly and consistently. Keep in mind that condoms offer protection but risk is not totally eliminated by using condoms
* Do not share needles and syringes for injecting drugs, preferably avoid intravenous drug abuse
* Ensure the use of single use disposable needles and syringes for injection
* Insist on sterile disposable syringes and needles for injections
* Never use a paid blood donor
* Get all sexually transmitted infections treated by a qualified doctor as soon as possible, also get your partner checked/treated
* Do not visit prostitutes
* Avoid casual sex

At this time, there is no cure or vaccination that will prevent HIV infection, though a lot of research is being done for a vaccine. Anyone engaging in high-risk behaviour should contact a physician to arrange for a complete physical examination and blood tests.

Instructions for using latex condoms:

* Use a latex condom during intercourse or other acts involving contact with a man's penis
* Put the condom on after the penis is erect but before intimate contact. Sores, any secretions from the penis (including semen), vaginal secretions, urine, faeces, and possibly saliva can contain sexually transmitted disease organisms
* Put the condom on the head of the penis and unroll it all the way to the base
* Leave an empty space at the end of the condom to collect semen.
* Squeeze the tip of the condom before rolling it on to the penis to ensure that no air is trapped in the bulb of the condom. Air if present can cause the condom to burst or rupture during use and thus expose the person to infection.
* If a lubricant is desired, use one that is water-based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream, because these may damage the condom
* After ejaculation, carefully withdraw the penis before it is completely limp and draw off the condom carefully to avoid spilling.
* The used condom should be disposed of safely, preferably after tying a knot in it to avoid spilling of semen.
* Store condoms in a cool, dark, dry place.
* Do not use a condom which is sticky, brittle, discoloured, or obviously damaged
* Use each condom only once

ELISA and Western Blot Tests

The most common test for AIDS is the ELISA (Enzyme-Linked Immuno-Sorbent Assay), which is performed on a blood sample. This test is very sensitive and detects almost all persons infected with the human immunodeficiency virus (HIV) except during the first few weeks of infection. The ELISA test detects the body's immune response to HIV.

Single tests must not be used to diagnose HIV infection. False positive test results are not infrequent with the ELIA and similar tests. Before making a diagnosis that a specimen is HIV positive, the test result must be confirmed by one or even two repeat tests, even on the same specimen if sufficient sample is available. The confirmatory repeat tests can be ELISA or Rapid / Spot tests. It is preferable to use test kits that are different when doing a confirmatory tests. Confirmation by the Western Blot test is no longer the recommended procedure.

Anyone with a positive test for HIV infection should seek follow-up medical evaluation, interpretation of the results, counselling, and advice for possible lifestyle changes. A negative HIV antibody test implies either the person has not been infected with the HIV virus or does not have a detectable level of HIV antibodies. If the results of the same test done six months later are still negative for HIV antibodies, AIDS infection is highly unlikely, assuming there have been no high-risk activities in those six months.

Hirsutism :

2009-05-22T03:47:00.000-07:00

What is Hirsutism?

Hirsutism is the term for excess body or facial hair in women. It can be described as a male pattern of hair growth or distribution on a female body i.e. in the moustache and beard areas, or occurring more thickly than usual on the limbs. It may be the result of a serious hormonal disorder.

What are the causes?

The complaint of hirsutism is common and often accompanied by severe anxiety and social stress. Hirsutism is caused by an increased production of a group of hormones called androgens (male hormones). These hormones stimulate the development of male secondary sexual characteristics. The increased sensitivity of the skin to these hormones leads to hirsutism. Androgen disorders affect between 5% to 10% of all women. For most women the tendency towards hirsutism is inherited.

Although some women with hirsutism have increased amounts of male hormone, most have normal levels. The problem in these women is that the hairs are more sensitive than normal to small amounts of hormone. The hairs grow more quickly and thicker in response to it. The increased hair growth is usually first noted in late teenage years and tends to gradually get more severe as the woman gets older.
It can also be caused by other factors like:

* Drugs (like cyclosporin, corticosteroids, diazoxide, streptomycin, interferon and acetazolamide.)
* Birth control pills
* Chemicals
* Injury
* Pressure
* Allergy and infections
* Cancer
* Genetic conditions

What are the symptoms?

Patients with hirsutism due to hormonal causes will also have some
disturbances of menstruation, lack of ovulation, acne, deepening of voice, balding and overweight. It is more prominent on the areas of the face, which are androgen dependent.

What is the treatment?

Hirsutism may require a long-term treatment, as the problem tends to recur when the treatment is discontinued. Anti-androgens help control the male hormones that cause hirsutism. Anti-androgens usually take at least 3 to 6 months to work. They can decrease the amount of new hair growth, but are less likely to change the amount of hair one already has.
The agents used in the treatment include oestrogens (as oral contraceptives), cyproterone acetate, spironalactone as they all have anti-androgen activity. Other agents like bromocriptine, cimetidine and new agents like finasteride and flutamide can also be used. Eflornithine hydrochloride is used topically by women as a cream to remove unwanted facial hair. Losing weight reduces the amount of hormones in your body that cause increased hair growth. The local treatment like plucking, shaving, bleaching, creams or waxes may all help and are often used.

When should the doctor be consulted?

The doctor must be consulted if there is a sudden increase in the facial or body hair. Also, if the periods have become irregular or if the voice has become deeper, a specialist must be consulted.

Hepatitis C :

2009-05-22T03:45:00.001-07:00

What is hepatitis C?

Hepatitis C virus causes an inflammation of the liver. The hepatitis C virus (HCV) is found in the blood of persons who have this disease. HCV is spread by contact with the blood of an infected person.

What are the causes?

Hepatitis C infection is caused by the hepatitis C virus (HCV). Persons who may be at risk for hepatitis C are those who:

* received blood, blood products, or solid organs from a donor who has hepatitis C
* have injected street drugs or shared a needle with someone who has hepatitis C
* have been on long-term dialysis for kidney failure
* have frequent contact with blood on the job such as doctors
* have sexual intercourse with multiple partners
* have sex with a person who has hepatitis C
* share personal items, such as toothbrushes and razors, with someone who has hepatitis C
* are born to hepatitis C infected mothers .

What are the symptoms?

Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. The following symptoms could occur:

* jaundice
* abdominal pain in the right upper abdomen
* fatigue
* loss of appetite
* nausea and vomiting
* low-grade fever
* pale or clay-coloured stools
* dark urine
* generalised itching

How is it diagnosed?

There are several blood tests that can be done to determine if one has been infected with HCV. Your doctor may order one or a combination of these tests.

a) Anti-HCV (antibody to HCV)

* EIA (enzyme immunoassay): This test is usually done first. If positive, it should be confirmed

* RIBA (recombinant immunoblot assay): A supplemental test used to confirm a positive EIA test

Anti-HCV does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.

b) Qualitative tests to detect presence or absence of virus (HCV RNA)
c) Quantitative tests to detect amount (titre) of virus (HCV RNA)

* Hepatitis virus serology with negative antibody to hepatitis A and hepatitis B
* ELISA assay to detect hepatitis C antibody
* Hepatitis C PCR test
* Elevated liver enzymes
* Liver biopsy showing acute or resolving hepatitis

What is the treatment?

Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin.

Interferon alpha is given by injection just under the skin and has a number of side effects, including flu-like symptoms, headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets.

Ribavirin is a capsule taken twice daily, and the major side effects are severe anaemia (low red blood cells) and birth defects. Women should, therefore, avoid pregnancy during and for 6 months following treatment.

Recently, a version of interferon alpha with a longer half-life (pegylated interferon alpha) has been introduced, and the longer half-life means the injections are taken weekly instead of the three times a week with standard interferon alpha. Pegylated interferon alpha and ribavirin lead to a sustained response in approximately 50% of patients. A sustained response means that the patient remains free of hepatitis C virus 6 months after stopping therapy. People with hepatitis C should avoid any substances toxic to the liver (hepatotoxic). All patients with hepatitis C should be immunised against hepatitis A and B also.

People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their doctor. Patients with hepatitis C should avoid alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of the treatment.

What are the complications?

* chronic hepatitis
* cirrhosis

What is the prevention?

One should avoid contact with blood or blood products whenever possible. Health care workers should practice universal precautions when handling blood and body fluids.

One should not inject drugs of abuse, and especially not share needles with anyone. One should be cautious when getting tattoos and body piercings done.

Sexual transmission is low among stable, monogamous couples. A partner should be screened for hepatitis C. If the partner is negative, the current recommendations are to make no changes in sexual practices. Individuals having sex outside of a monogamous relationship should practice safer sex behaviours to avoid hepatitis C as well as sexually transmitted diseases, including HIV and hepatitis B. Currently there is no vaccine for hepatitis C.

Frigidity :

2009-05-22T03:43:00.000-07:00

What is frigidity?

Frigidity is a condition in which a woman is unable to achieve or sustain sexual arousal. She may not be able to exhibit adequate sexual desire, arousal, orgasm or desire for intercourse.

What are its causes?

* Unskilled or uncaring partner.
* Communication problems with the partner.
* Anxiety, depression, fear of pregnancy, feelings of guilt and shame about sex.
* Fear of pain or infection.
* A physical cause that inflicts pain during intercourse.
* Reduction in oestrogen levels in menopause.
* Deep-seated psychological problems.
* Previous surgery, such as removal of the uterus, may also lead to the inability to perform sexually.

How is it treated?

Treatment consists of psychological and physical examination that would help to identify the underlying cause for the problem. Questions related to relationships, attitudes towards sex and any physical symptoms if present may be asked. A pelvic examination may be done if needed.
In some cases counseling sessions by a trained psychologist may help to cure the people.

Fetishism :

2009-05-22T03:42:00.002-07:00

What is fetishism?

Fetishism describes intense sexual fantasies, urges or behaviour involving the use of nonliving objects. In this, the person experiences sexual excitement leading to orgasm from contact with a part of the body of a woman or some article belonging to her that normally has no sexual influence. This condition occurs almost exclusively among men.

What are the common fetishes?

Common fetishes are feet, shoes and articles of intimate female dress like a brassiere, or they may be erotic fascination with common latex balloons and inflatable toys. In some cases the mere picture of the fetish object provides sufficient stimulus while at times stealing the article affords adequate sexual satisfaction.

How old is the concept of fetishism?

The term dates back to very early societies in which trees and icons were deemed to possess a soul. Supernatural attributes were ascribed to material and inanimate objects known as fetishes. They consisted of fur, feathers, hair, bone, or teeth of an animal. In some cases the belief was so definitely crystallized about the object that it merged into idolatry.

Female orgasm :

2009-05-22T03:42:00.001-07:00

What is it?

Female orgasmic disorder is the inability to achieve orgasm by some women despite adequate sexual arousal. Women have individual differences in the amount of stimulation needed for them to achieve an orgasm. However, when the doctor feels that the woman’s orgasmic capacity is less than what would be expected of a woman of her age and sexual experience, the disorder is diagnosed.

Women having the disorder fall on a scale describing the intensity of the disorder. There are some women who never reach a climax. Then are women who achieve an orgasm only during masturbation, but never with their partners. In the middle range fall women who need stimulation of the clitoris in addition to vaginal stimulation, but are able to climax with their partners. Near the upper range are women who do not need much stimulation to achieve an orgasm.

The disorder can be life long or situational. In the former, the woman has never had an orgasm, either through masturbation or with a partner. In the latter, the disorder is temporary and may be caused due to unconducive situations.

What are the causes?

Science does not clearly understand the brain mechanisms behind the achievement of an orgasm. It is for this reason that the causes for the disorder are not known. More than physiological reasons, psychological reasons have been held responsible for the inability to achieve an orgasm. It most commonly occurs when a woman tries hard to achieve it. When achieving an orgasm becomes a goal for sexual intercourse, the increased pressure works against its achievement.

The mood of the partners during intercourse is also an important determinant of whether they are able to climax or not. If the woman is tensed during the act or the partners have other problems on their mind, achieving an orgasm may become difficult.

What is the treatment?

There is no specific treatment for the disorder. If it is because of dryness of the vagina, lubricants are given which help to make intercourse easier. If psychological help is sought, the partners are asked to relax during the act and enjoy it rather than work towards the achievemtn of an orgasm. The partners should know each other’s preferences and work towards maximizing the pleasure.

Partners are advised to communicate with each other and spend more time in foreplay. This helps to induce adequate lubrication. Other techniques of lovemaking like oral sex and mutual masturbation are advised. The best way to achieve orgasm is to remain positive and relax during sexual intercourse.

Erectile dysfunction :

2009-05-22T03:38:00.000-07:00

What is erectile dysfunction?

The term erectile dysfunction covers a range of disorders, but usually refers to the inability to obtain an adequate erection for satisfactory sexual activity.

Although erectile dysfunction, formerly called impotence, is more common in men older than 65, it can occur at any age. An occasional episode of erectile dysfunction happens to most men and is normal. As men age, it's also normal to experience changes in erectile function. Erections may take longer to develop, may not be as rigid or may require more direct stimulation to be achieved. Men may also notice that orgasms are less intense, the volume of ejaculate is reduced and recovery time increases between erections.

Such problems contribute to loss of confidence and inadequacy. Erectile dysfunction occurs in 5% of all males above 40 years of age and this percentage increases with advancing age. When erectile dysfunction proves to be a pattern or a persistent problem, it can interfere with a man's self-image as well as his and his partner's sexual life. Erectile dysfunction may also be a sign of a physical or emotional problem that requires treatment.

What is the cause?

The penis consists of large open spaces confined within a tight capsule. These spaces contain blood. Erection is brought about by a complex method of influences that travel from the brain, originating in the hormonal system and acting through the peripheral nerves. These result in the filling up of the spaces with blood, and this blood cannot flow out. This engorgement of the spaces with blood makes the penis rigid. Once the influences are withdrawn, as after orgasm and ejaculation, blood drains out from the spaces making the penis flaccid.

1. Nonphysical causes
Nonphysical causes may account for impotence. They may include:

* Psychological problems. The most common nonphysical causes are stress, anxiety and fatigue. Impotence is also an occasional side effect of psychological problems such as depression.

* Negative feelings. Feelings that you express toward your sexual partner — or that are expressed by your sexual partner — such as resentment, hostility or lack of interest also can be a factor in erectile dysfunction.

2. Physical causes

Physical causes account for many cases of erectile dysfunction and may include:
* Nerve damage from longstanding diabetes (diabetic neuropathy)
* Cardiovascular disorders affecting the blood supply to the pelvis
* Certain prescription medications
* Operations for cancer of the prostate
* Fractures that injure the spinal cord
* Multiple sclerosis
* Hormonal disorders
* Alcoholism and other forms of drug abuse

How is it diagnosed?

It's normal to experience erectile dysfunction on occasion. But if erectile dysfunction lasts longer than two months or is a recurring problem, one needs to see the doctor for a physical examination.

Although erectile dysfunction is seen as a personal or embarrassing problem, it's important to seek treatment. In many cases, erectile dysfunction can be successfully treated. The doctor will take a detailed medical history to determine whether this is due to an physical illness or due to psychological problems. Similarly, a detailed examination of the body including examination of the sexual organs will be done. Blood tests may be done to exclude diabetes or high cholesterol. Specialised tests may be done in specific instances to locate a problem in the structure and function of the penis.

How is it treated?

A wide variety of options exist for treating erectile dysfunction. They include everything from medications and simple mechanical devices to surgery and psychological counselling. The cause and severity of the condition are important factors in determining the best treatment or combination of treatments.

Erectile dysfunction due to a psychological problem is treated with much care. Usually the problem is due to performance anxiety, guilt, depression or a fear of failure. The patient is explained that this only worsens the problem. Sex education helps correct misinformation and ignorance about normal sexual practice. In married couples, discussing the problem with both partners may help the doctor to arrive at the root cause of anxiety or performance failure. These treatment sessions are usually time-consuming and slow.
The psychological treatment can be supplemented with the help of medicines that stimulate erection. These can be taken orally like sildenafil (viagra) or others that can be injected into the penis like papaverine or alprostadil, a synthetic prostaglandin. For men with low levels of male sex hormone, testosterone, this hormone may need to be supplemented. Surgery may also be used to correct erectile dysfunction caused by vascular blockages. In some cases that do not satisfactorily respond to medicines, erections can be achieved with the help of appliances like vacuum devices or the insertion of implants into the penis by an operation.

What is the prevention?

Although most men experience episodes of erectile dysfunction from time to time, one can take the following steps to decrease the likelihood of occurrences:

* Limit or avoid the use of alcohol and other similar drugs
* Stop smoking
* Exercise regularly
* Reduce stress
* Get enough sleep
* Deal with anxiety or depression
* See the doctor for regular checkups and medical screening tests

Epididymitis :

2009-05-22T03:37:00.000-07:00

What is epididymitis?

Epididymitis is an inflammation of the epididymis (the structure that is the first part of the duct draining the testis). This can occur as the result of injury or infection.

What are the causes?

Epididymitis is caused by bacterial organisms associated with urinary tract infection, sexually-transmitted diseases (such as chlamydia and gonorrhoea), prostatitis (infection of the prostate), or prostatectomy (removal of the prostate).

The risk is higher in sexually active men who are not monogamous and do not use condoms. Men who have recently had surgery or have a history of structural problems involving the genitals or urinary tract are also at increased risk regardless of their sexual behaviours.

What are the symptoms?

Epididymitis may begin with a low-grade fever and chills and a heavy sensation in the testicle. The testicle becomes increasingly sensitive to pressure.

The symptoms of epididymitis include scrotal pain and swelling. The pain or swelling may be mild or severe. At times the epididymis may become so inflamed that the patient is unable to walk due to pain. There may be lower abdominal discomfort or pelvic discomfort, and urination may be associated with burning or pain. On occasion, there may be a discharge from the urethra, blood in the semen, or pain on ejaculation. The testicle may enlarge significantly.

How is it diagnosed?

Physical examination shows a tender and sometimes swollen testicle on the affected side. Tenderness can usually be localised to a small area of the testicle where the epididymis is attached. Enlarged lymph nodes in the groin area may be present. There may be a discharge from urinary meatus. A rectal internal examination may reveal an enlarged or tender prostate.The following tests may be performed:

* A urinalysis and culture
* Tests to screen for chlamydia and gonorrhoea
* A complete blood count may show leukocytosis, or increased white blood cells
* Gram stain of urethral discharge

What is the treatment?

Medications to treat infection are prescribed. Sexually transmitted infections require special antibiotics and the patient's sexual partners should also be simultaneously treated. Pain relieving medications may be required and anti-inflammatory drugs are often prescribed.

Bedrest, with elevation of the scrotum and ice packs applied to the area, is recommended. It is very important to have a follow-up visit with the doctor to evaluate if the infection has completely resolved.

* Antibiotic therapy
* Analgesics for pain control
* Supportive care
* Scrotal elevation and support
* Ice pack

Epididymitis usually resolves with appropriate antibiotic therapy, without any damage to sexual or reproductive abilities. Recurrence of the infection is fairly common.

Infrequently, chronic epididymitis may develop and surgery may be necessary. Although uncommon, infertility may result from chronic epididymitis.

How is it prevented?

Complications from epididymitis may be prevented by early diagnosis and adequate treatment of the infection. Preventive antibiotics are frequently given at the time of operation in which the patient is at increased risk for epididymitis. Safer sexual practices (monogamous relationships, use of barriers such as condoms) may be helpful in preventing those cases of epididymis associated with sexually-transmitted diseases.

Education :

2009-05-22T03:35:00.000-07:00

The growth of your child into adolescence may put your parenting and communication skills to the test. Sex education varies according to the beliefs of a particular community. It depends on many factors – religious, cultural, economic and social.

Many consider that sex is something private and personal and should not be discussed in public. But these days, growing awareness on the prevention of AIDS and the use of condoms, has brought the discussion of sex into each household. You cannot avoid telling your child about sex these days. Even for the mental health and adjustment of your child, it is necessary to frankly tell him the facts of life when he asks questions about sex.

How to deal with children between the ages two and four?

In this period the child asks questions about the world around him and he will also ask about matters relating to differences between a boy and a girl. His genitalia are the same to him as his nose or fingers. He does not attribute any special function to them. Do not dodge his questions or refuse to answer, for then he will think there is something secretive about it. In any case he will find out as he grows older, so it is much better for him to hear about it from his parents.

A question like “where do babies come from?” should obviously be answered in different ways to a four-year-old and a fourteen-year-old. Answer his questions simply and say only as much as he can understand. Always tell the truth. However you should not try to cover the whole field of sex in your answer, but just enough to satisfy his curiosity at that time. The process of birth is complicated enough for a child, so do not confuse him further. Having a pet in the house helps; you can discuss the question of puppies and kittens with him.

Sometimes he may ask the same question twice. Parents may think he is getting obsessed with sex. The simple reason is that he has forgotten the answers and he wants to ask the question again. When he is satisfied with your answers, he may come back later with more questions.

When does he become aware about himself ?

Around the age of three, a child becomes aware that he is a boy or she is a girl. He becomes aware that he has something extra, which his sister does not have. Similarly, a girl is aware that she lacks the appendage, which her brother has. Tell them that there is a difference, and to reassure them, tell them the boy will grow up like his father and the girl like her mother.

How can you help them deal with sexuality?

From two or three years onwards, the child will explore his genitals just as he explores his mouth, nose and other parts of his body. Many parents get embarrassed and concerned about this. Do not threaten the child or slap him or laugh. This can be very disturbing to a child. It arouses fear and guilt and may make him feel that in some way, that part of his body is dirty.

Some parents think that excessive handling of the male organs is, perhaps, due to his prepuce (skin covering the penis) irritating the child and they have him circumcised. The exploration of sex parts is normal for a child and nothing to be alarmed about. You can, however, give him plenty to do with his hands. Give him toys to play with and direct his attention elsewhere. Everytime a child is naked, do not tease him. This attitude makes him terribly conscious of his sex. Privacy should be respected. These attitude carry on in adult life and may create psycho-sexual problems.

In fact, you need to worry if the child does not ask questions about sex. It may mean that his normal curiosity has, somehow been curbed and he is resorting to friends, relatives, books, or advertisements for information. He may, in the process, pick up information, that is incorrect. In a few schools, sex education is part of the curriculum. It is best that matters of sex are discussed with the child by parents or some senior member of the family with whom the child relates comfortably.

Your adolescent child needs to be given correct information about sex. Tell your daughter about menstruation before it happens. Similarly, tell your son about nocturnal emissions (wet dreams). Explain to the boy that nature provides an excess of seminal fluid and that it is perfectly normal, and to the girl that menstruation is nature’s way of disposing off the unfertilised eggs.

You need to realise the importance of talking to your children. There may be very few teenagers who will directly ask their parents questions about sex. Emotional maturity at this age is rare and hardly expected of adolescent. Weaving discussions of sexual topics into everyday conversations – television shows, articles in books – may help your child consider sex as a normal part of life.

What is masturbation?

Sometimes small children of two to four years of age rub their thighs or play with their sex organs and find a pleasurable sensation accompanied by flushing of the face. This is known as masturbation. Like thumb sucking, this will also stop as the child develops other interests. Distract him, but do not scold him or beat him. Masturbation is also common among adolescents. It is not the physical act itself that is unhealthy but the guilt which accompanies it. Give your child plenty of affection, make him feel wanted and needed, and once he is well occupied he may stop masturbating. The more satisfaction he gets from activities within and outside the home, the less will he want to masturbate.

Parents as well as children need to know that masturbation is a natural and harmless way of feeling sexual pleasure and of relieving sexual tension. You should try to answer your child’s direct or indirect questions helping your child develop informed and positive attitudes towards sex and sexuality.

Diabetic neuropathies :

2009-05-22T03:31:00.000-07:00

What is diabetic neuropathy?

Diabetic neuropathies are nerve disorders caused by diabetes. People with diabetes can, over time, damage their nerves throughout their body. Neuropathies lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Problems may also occur in other organ systems, including the digestive tract, heart, and sex organs. People with diabetes may develop nerve problems at any time, but the longer a person has diabetes, the greater the risk. Diabetic neuropathy appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40. The most common type is peripheral neuropathy, which affects nerves of the arms and legs.

What are the causes?

The causes are different for different varieties of diabetic neuropathy. Nerve damage is likely due to a combination of factors:

* metabolic factors, such as high blood glucose, long duration of diabetes, low levels of insulin, and abnormal blood fat levels
* neurovascular factors, leading to damage to the blood vessels that carry oxygen and nutrients to the nerves
* autoimmune factors that cause inflammation in nerves
* mechanical injury to nerves, such as carpal tunnel syndrome
* inherited traits that increase susceptibility to nerve disease
* lifestyle factors such as smoking or alcohol use

What are the symptoms?

Symptoms depend on the type of neuropathy and the nerves affected. Some people have no symptoms at all. For others, numbness, tingling, or pain in the feet is often the first sign. A person may experience both pain and numbness. Often, symptoms are minor at first, and since most nerve damage occurs over several years, mild cases may go unnoticed for a long time.

Symptoms may include:

* numbness, tingling, or pain in the toes, feet, legs, hands, arms, and fingers
* wasting of the muscles of the feet or hands
* indigestion, nausea, or vomiting
* diarrhoea or constipation
* dizziness or faintness due to a fall in blood pressure on standing
* problems with urination
* erectile dysfunction (impotence) or vaginal dryness
* weakness

What are the types of diabetes neuropathy?

Diabetic neuropathies may be classified as peripheral, autonomic, proximal, and focal. Each affects different parts of the body in different ways.

* Peripheral neuropathy causes either pain or loss of feeling in the toes, feet, legs, hands, and arms.
* Autonomic neuropathy causes changes in digestion, bowel and bladder function, sexual response, and perspiration. It may also affect the nerves that serve the heart and control blood pressure. Autonomic neuropathy may also cause hypoglycaemia (low blood sugar) unawareness, a condition in which people no longer experience the warning signs of hypoglycaemia.
* Proximal neuropathy causes pain in the thighs, hips, or buttocks and leads to weakness in the legs.
* Focal neuropathy results in the sudden weakness of one nerve, or a group of nerves, causing muscle weakness or pain. Any nerve in the body may be affected.

How is the diagnosis made?

Neuropathy is diagnosed on the basis of symptoms and a physical examination. During the examination, the doctor may check the blood pressure and heart rate, muscle strength, reflexes, and sensitivity to position, vibration, temperature, or a light touch. The doctor may also do other tests to help determine the type and extent of nerve damage.

What is the treatment?

The first step is to bring the blood glucose levels within the normal range to prevent further nerve damage. Blood glucose monitoring, meal planning, exercise, and oral drugs or insulin injections are needed to control blood glucose levels. Although symptoms may get worse when blood glucose is first brought under control, over time, maintaining lower blood glucose levels helps lessen neuropathic symptoms.

Foot care

People with neuropathy need to take special care of their feet. The nerves to the feet are the longest in the body and are the ones most often affected by neuropathy. Loss of sensation in the feet means that sores or injuries may not be noticed and may become ulcerated or infected. Circulation problems also increase the risk of foot ulcers.
Here are the steps to follow:

* Clean your feet daily, using warm and not hot water and a mild soap. Avoid soaking your feet. Dry them with a soft towel; dry carefully between your toes.
* Inspect your feet and toes every day for cuts, blisters, redness, swelling, calluses, or other problems.
* Moisturize your feet with lotion, but avoid getting it between your toes.
* After a bath or shower, file corns and calluses gently with a pumice stone.
* Each week or when needed, cut your toenails to the shape of your toes.
* Always wear shoes or slippers to protect your feet from injuries. Prevent skin irritation by wearing thick, soft, seamless socks.
* Wear shoes that fit well and allow your toes to move.
* Before putting your shoes on, look them over carefully and feel the insides with your hand to make sure they have no tears, sharp edges, or objects in them that might injure your feet.

Pain relief

To relieve pain, burning, tingling, or numbness, the doctor may suggest aspirin, acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs). Topical creams and antidepressant medications or anticonvulsant medications may relieve pain in some people.

Gastrointestinal problems

To relieve mild symptoms of gastroparesis, indigestion, belching, nausea, or vomiting, doctors suggest eating small, frequent meals, avoiding fats, and eating less fibre. When symptoms are severe, the doctor may prescribe medication to speed digestion and help relieve nausea.

Dizziness and weakness

Sitting or standing slowly may help prevent dizziness or fainting associated with blood pressure and circulation problems. Some people may benefit from increased salt in the diet and treatment with salt-retaining hormones.

Urinary and sexual problems

To clear up a urinary tract infection, the doctor will probably prescribe an antibiotic. Drinking plenty of fluids will help prevent another infection. People who have incontinence should try to urinate at regular intervals (every 3 hours, for example) since they may not be able to tell when their bladder is full.

To treat erectile dysfunction in men, the doctor will first do tests to rule out a hormonal cause. Several methods are available to treat erectile dysfunction caused by neuropathy, including taking oral drugs, using a mechanical vacuum device, or injecting a drug called a vasodilator into the penis before sex. The vacuum and vasodilator raise blood flow to the penis, making it easier to have and maintain an erection. Another option is to surgically implant an inflatable or semirigid device in the penis. A constriction ring or penile sling may be helpful.
Vaginal lubricants may be useful for women when neuropathy causes vaginal dryness. To treat problems with arousal and orgasm, the doctor may refer the woman to a gynaecologist.

What is the prevention?

The best way to prevent neuropathy is to keep the blood glucose levels as close to the normal range as possible. Maintaining safe blood glucose levels protects nerves throughout the body.

Delayed ejaculation :

2009-05-22T03:30:00.000-07:00

What is delayed ejaculation?

Delayed ejaculation refers to an inhibition of ejaculation. The man is unable to ejaculate, either during intercourse, or with manual stimulation in the presence of a partner.

What is the cause?

Most men ejaculate within 2 to 4 minutes after onset of active thrusting in intercourse. Men with retarded ejaculation may be entirely unable to ejaculate in some circumstances (for example, during intercourse), or may only be able to ejaculate with great effort and after prolonged intercourse (for example 30 to 45 minutes). The most common causes are psychological. Common psychological causes include:

* A strict religious background causing the person to view sex as sinful
* Lack of attraction for a partner
* Conditioning caused by unique or atypical masturbation patterns
* Traumatic events (for example learning that one's partner is having an affair)
* Organic causes are also possible; a variety of drugs may sometimes impair ejaculation.
* Neurological diseases may also cause delayed or an inability to ejaculate such as strokes and nerve damage to the spinal cord or back.

How is it diagnosed?

If the man is unable to ejaculate in a reasonable length of time with some form of stimulation (as with masturbation), it is a good indicator that organic factors are likely to play a role in the problem. Stimulation of the penis may determine if an underlying physical often neurological problem exists. A neurological examination may uncover other neurological defects associated with delayed ejaculation.

What is the treatment?

If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse) in his life, a urologist should be consulted to determine if there is a congenital or physical abnormality. If, however, he is able to ejaculate in a reasonable period of time by some form of stimulation, he should seek sex therapy from a therapist specialising in this area. Treatment usually includes both partners. This includes educating the couple about the fundamentals of sexual response and how to communicate and guide the partner to provide ideal stimulation, rather than trying to force a sexual response to occur.

Therapy then commonly involves a series of homework assignments wherein the couple, in the privacy of their home, engage in sexual activities that minimise performance pressure and maximise focusing on pleasure. Typically, sexual intercourse will be prohibited for a limited period of time, while the couple gradually enhance their ability to enjoy ejaculation through other types of stimulation.

In cases where there is a problematic relationship or an inhibition of sexual desire between the couple, therapy to enhance the relationship and emotional intimacy may be required as a preliminary step.

Self-treatment of this problem will probably be unsuccessful in most cases. If a medication is believed to be the cause of the problem, the man's physician should review other medication options. This may be difficult in certain instances, especially when the medication is working appropriately to solve a pre-existing medical or a psychological problem.

What is the prognosis?

Outpatient treatment generally requires about 12 to 18 sessions with an average success rate in the range of 70 to 80%. A more positive outcome is associated with having a previous history of satisfying sexual experiences, a short duration of the problem, feelings of sexual desire, feelings of love toward one's sexual partner, motivation for treatment, and absence of serious psychological problems.

If medications are the source of the problem, a full recovery should be expected if the physician is able to switch or discontinue the medication.

Can it be prevented?

Healthy attitudes toward sexuality and one's own genitals helps prevent delayed ejaculation. It is also vitally important to realise that one cannot always control a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder one tries to have a certain sexual response, the more it becomes inhibited.

To minimise the pressure, a man should absorb himself in the pleasure of the moment, without worrying about whether or when he will ejaculate. The partner should create a relaxed atmosphere, free of pressure. Finally, any fears or anxieties, such as fear of pregnancy or disease, should be openly discussed.