Psychology

Why Play is essential for Child?

2011-11-01T19:05:00.002+05:30

Play consists of those activities performed for self amusement that have behavioral,social, and psycho-motor rewards. Play is important to childhood development as well as children learn about shapes, colors, cause and effect and themselves. In cognitive thinking, play helps the child learn social and psycho-motor skills. It is a way of communicating joy, fear , sorrow, and anxiety . Early 2000s children of all ages and from every socioeconomic background often prefer television, computers, and battery-operated toys to self-directed, imaginative, and creative play. This tendency leaves children developmentally deprived, because imaginative and fantasy play allows children to explore their world and express their inner thoughts and feelings, hopes and fears, likes and dislikes. Through play, decisions are made without penalty or fear of fail. Play allows children to gain control of their thoughts, feelings, actions, and helps them achieve self-confidence.Play takes different forms for different children, and its definition entails many aspects. Play is the direct opposite of work; it is frivolous. It provides freedom and invites the impulse to engage in foolishness. Yet it provides a means for ego development and a process by which social skills and physical skills develop as well.Play with imagination and fantasy is the child's natural medium of self-expression and one that gives cues about the child's conscious and unconscious states. In play therapy, clinicians employ various techniques designed to reveal the child's psychological and social development. Clinician-directed play therapy is, therefore, not naturally self-directed play, but play designed by a professional to facilitate understanding of the child and the child's healing process.

Categories of play

Some specific categories of play are as follows:

Physical play: When children run, jump, and play games such as chase, hide-and-seek, and tag, they engage in physical play. This play has a social nature because it involves other children. It also provides exercise , which is essential for normal development.
Expressive play: Certain forms of play give children opportunities to express feelings by engaging with materials. Materials used in expressive play include tempera paints, fingerpaints, watercolors, crayons, colored pencils and markers, and drawing paper; clay, water, and sponges; beanbags, pounding benches, punching bags, and rhythm instruments; and shaving cream, pudding, and gelatin. Parents can take an active role in expressive play by using the materials alongside the child.
Dramatic play: Children act out situations they suspect may happen to them, that they are fearful will happen, or that they have witnessed. Dramatic play can be either spontaneous or guided and may be therapeutic for children in the hospital.

Functions of play

PHYSICAL DEVELOPMENT Play aids in developing both fine and gross motor skills . Children repeat certain body movements purely for pleasure, and these movements develop body control. For example, an infant will first hit at a toy, then will try to grasp it, and eventually will be able to pick it up. Next, the infant will shake the rattle or perhaps bring it to the mouth. In these ways, the infant moves from simple to more complex gestures. Because play often involves physical activity, it is closely related to the development and refinement of children's gross and fine motor skills and their body awareness. As children vigorously and joyfully use their bodies in physical exercise, they simultaneously refine and develop skills that enable them to feel confident, secure, and self-assured. In societies where children experience pressure to succeed in all areas, confidence and competence are essential (Berk, 2002; Fromberg, 2002; Frost et al., 2001; Holmes & Geiger, 2002; McCune & Zanes, 2001; Murata & Maeda, 2002; Santrock, 2003).

EMOTIONAL DEVELOPMENT Children who are anxious may be helped by role playing. Role playing is a way of coping with emotional conflict. Children may escape through play into a fantasy world in order to make sense out of the real one. Also, a child's self-awareness deepens as he explores an event through role-playing or symbolic play.When a parent or sibling plays a board game with a child, shares a bike ride, plays baseball, or reads a story, the child learns self-importance. The child's self-esteem gets a boost. Parents send positive messages to their child when they communicate pleasure in providing him or her with daily care. From these early interactions, children develop a vision of the world and gain a sense of their place in it.

COGNITIVE DEVELOPMENT Children gain knowledge through their play. They exercise their abilities to think, remember, and solve problems. They develop cognitively as they have a chance to test their beliefs about the world.Children increase their problem-solving abilities through games and puzzles. Children involved in make-believe play can stimulate several types of learning. Language is strengthened as the children model others and organize their thoughts to communicate. Children playing house create elaborate narratives concerning their roles and the nature of daily living.Evidence also suggests a strong relationship between play and cognitive development. Studies indicate a positive relationship between play and student learning (Kumar & Harizuka, 1998; Lieberman, 1977). They identify improvements to attention, planning skills, and attitudes (McCune & Zanes, 2001; Smilansky & Shefatya, 1990; Sylva, Bruner, & Genova, 1976); creativity and divergent thinking (Dansky, 1980; Holmes & Geiger, 2002; Pepler, 1982; Sutton-Smith, 1997); perspective-taking (Burns & Brainerd, 1979); memory (Jensen, 1999, 2000; Saltz, Dixon, & Johnson, 1977); and language development (Clawson, 2002; Creasey, Jarvis, & Berk, 1998; Gardner, 1993; Howes, Droege, & Matheson, 1994).Children also increase their understanding of size, shape, and texture through play. They begin to understand relationships as they try to put a square object in a round opening or a large object in a small space. Books, videos, and educational toys that show pictures and matching words also increase a child's vocabulary while increasing the child's concept of the world.

SOCIAL DEVELOPMENT A newborn cannot distinguish itself from others and is completely self-absorbed. As the infant begins to play with others and with objects, a realization of self as separate from others begins to develop. The infant begins to experience joy from contact with others and engages in behavior that involves others. The infant discovers that when he coos or laughs, mother coos back. The child soon expects this response and repeats it for fun, playing with his mother.Social skills are learned in the give and take of play. Verbal communication and body language, safety and danger, freedom and boundaries, cooperation and teamwork: all are discovered and practiced repeatedly during infant and childhood play. We continue to refine these skills in adulthood through play and playful communication.As children grow, they enjoy playful interaction with other children. Children learn about boundaries, taking turns, teamwork, and competition. Children also learn to negotiate with different personalities and the feelings associated with winning and losing. They learn to share, wait, and be patient.As social organisms, humans have a basic need to belong to and feel part of a group and to learn how to live and work in groups with different compositions and for different purposes. Play serves several functions in satisfying these needs and developing these social and emotional life skills. For example, children of all ages need to be socialized as contributing members of their respective cultures. Numerous studies (Creasey, Jarvis, & Berk, 1998; Erikson, 1963; Goleman, 1995; Piaget, 1962; Rubin & Howe, 1986; Rubin, Maioni, & Hormung, 1976; Rubin, Watson, & Jambor, 1978; Sutton-Smith, 1997; Vygotsky, 1978) indicate that play with others gives children the opportunity to match their behavior with others and to take into account viewpoints that differ from their own. Thus, play provides the rich experience children need to learn social skills;

MORAL DEVELOPMENT When children engage in play with their peers and families, they begin to learn some behaviors are acceptable while others are unacceptable. Parents start these lessons early in the child's life by teaching the child to control aggressive behavior . Parents can develop morals while reading to children by stressing the moral implications in stories. Children can identify with the moral fictional characters without assuming their roles. With peers they quickly learn that taking turns is rewarding and cheating is not. Group play helps the child appreciate teamwork and share and respect others' feelings. The child learns how to be kind and charitable to others.

Kind of Love

2011-10-26T18:30:00.002+05:30

Sternberg conceptualized love in terms of three basic components that form the vertices of a triangle: intimacy, passion, and decision/commitment. The intimacy component is primarily emotional or affective in nature and involves feelings of warmth, closeness, connection, and bondedness in the love relationship. The passion

component is motivational and consists of the drives that are involved in physical attraction, sexual consummation, and related phenomena. The commitment component is largely cognitive and represents both the short-term decision that one individual loves another and the longer term commitment to maintain that love.

According to Sternberg, these three love components differ with respect to a number of properties, including stability, conscious controllability, and experiential salience. For example, the elements of intimacy and decision/commitment are usually quite stable in close relationships (once they occur and become characteristic of a relationship, they tend to endure), whereas passion tends to be less stable and predictable.

In addition, whereas people possess a great deal of conscious control over the commitment that they make to relationships and possess at least some degree of control over their feelings of intimacy, they actually have very little conscious control over the amount of passion that they experience for their partners. The three components also differ in terms of their experiential salience. Specifically, an individual is usually quite aware of the passion component, but awareness of the intimacy and decision/commitment components can be extremely variable. That is, a person may experience feelings of intimacy (e.g., closeness, connection, warmth) without explicitly being aware of those feelings or even being able to identify what he or she is feeling. Similarly, a person might not consciously realize the full extent of his or her commitment to the relationship and the partner.

Types of Love Relationship

The three basic components of love combine to produce eight different love types, summarized in Table. Nonlove (no intimacy, passion, or decision/commitment) describes casual interactions that are characterized by the absence of all three love components. Most of our personal relationships (which are essentially casual associations) can be defined as nonlove. Liking (intimacy alone) relationships are essentially friendship. They contain warmth, intimacy, closeness, and other positive emotional experiences but lack both passion and commitment. Infatuation (passion alone) is an intense, “love at first sight” experience that is characterized by extreme attraction and arousal in the absence of any intimacy and decision/ commitment. In empty love (commitment alone) relationships, the partners are committed to each other and the relationship but lack an intimate emotional connection and passionate attraction. This type of love is often seen at the end of long-term relationships (or at the beginning of arranged marriages). Romantic love (intimacy + passion) consists of feelings of closeness and connection coupled with strong physical attraction. Companionate love (intimacy + commitment) is essentially a long-term, stable, and committed friendship that is characterized by high amounts of emotional intimacy, the decision to love the partner, and the commitment to remain in the relationship. This type of love is often seen in “best friendships” that are nonsexual or in long-term marriages in which sexual attraction has faded. Couples who experience fatuous love (passion + commitment) base their commitment to each other on passion rather than on deep emotional intimacy. These “whirlwind” relationships are typically unstable and at risk for termination. Finally, consummate love (intimacy + passion + commitment) results from the combination of all three components. According to Sternberg, this is the type of “complete” love that many individuals strive to attain, particularly in their romantic relationships. Because the three basic components of love occur in varying degrees within a relationship, most love relationships will not fit cleanly into one particular category but will reflect some combination of categories.

1 in 5 kids has mental illness

2011-10-17T22:53:00.000+05:30

Only 1 In 50 Gets Treatment In India While Ratio Is 1:3 In West:
Study
Kounteya Sinha TNN

New Delhi: One in 5 children in developing countries like India has a mental health problem. Globally, mental health problems affect 10–20% of children and adolescents. However, while 1 in 3 people with a mental health problem in wealthy nations receive treatment, in developing countries, it is as few as 1 in 50.
One of the main reasons for this is that there is an overall shortage of 2.39 lakh mental health workers (17.3 workers per one lakh population in lowincome countries and 14.9 per lakh population in middle-income countries). For young people, neuropsychiatric disorders are a leading cause of health-related burden, accounting for 15–30% of the disability-adjusted life-years (DALYs) lost during the first three decades of life.
Children and adolescents constitute almost a third (2.2 billion individuals) of the world’s population and almost 90% live in low-income and middle-income countries (LMIC), where they form up to 50% of the population. These are some of the findings of the four studies on mental health to be published in the Lancet on Monday.
Only 10% of trials of mental health interventions come from LMIC, and most of these are for drug-based interventions not psychosocial strategies.
Dr Vikram Patel, lead editor of the Lancet series and professor at the London School of Hygiene and Tropical Medicine, UK told TOI from Cape Town, “The main problem in countries like India is that services for mental health are fragmented and are being provided by different organisations. There is no real connection between the services. Shortage of skilled human resources particularly specialists besides lack of good leadership is a major problem.”
According to Dr Patel, despite their relevance as a leading cause of health-related disability in the age group and their long-lasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries.
Progress is hampered by lack of government policy, inadequate funding and a dearth of trained clinicians. That less than a third of countries have an entity in charge of mental health programmes for children and adolescents illustrates the chronic neglect in this area.
A survey of 87 mostly developing countries has, encouragingly, shown some improvement in awareness of mental health issues among leaders during the past three years, with more than half of respondents reporting “more” or “much more” awareness. Many countries are also updating their mental health policy or legislation.
Yet, about 40% of respondents, from 26 (44%) of the countries surveyed, identified continuing poor awareness and low priority or poor commitment by political leaders as major barriers to development of mental health services.

By: Times of india

More Loneliness, Anxiety Experienced By Overweight Kids, MU Study Finds

2009-07-04T19:50:00.000+05:30

As childhood obesity rates continue to increase, experts agree that more information is needed about the implications of being overweight as a step toward reversing current trends. Now, a new University of Missouri study has found that overweight children, especially girls, show signs of the negative consequences of being overweight as early as kindergarten.
"We found that both boys and girls who were overweight from kindergarten through third grade displayed more depression, anxiety and loneliness than kids who were never overweight, and those negative feelings worsened over time," said Sara Gable, associate professor of human development and family studies in the MU College of Human Environmental Sciences. "Overweight is widely considered a stigmatizing condition and overweight individuals are typically blamed for their situation. The experience of being stigmatized often leads to negative feelings, even in children."

MU researchers used the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) to examine the social and behavioral development of 8,000 school-age children from kindergarten entry through third grade. The researchers evaluated factors that have not been studied previously: age at becoming overweight and length of time being overweight.

"Girls who were consistently overweight, from kindergarten through third grade, and girls who were approaching being overweight were viewed less favorably than girls who were never overweight," said Gable, an MU State Extension Specialist. "Teachers reported that these girls had less positive social relations and displayed less self-control and more acting out than never-overweight girls."

The results indicate that larger than average children, especially girls, experience social and behavioral challenges before they reach the 95th percentile of the Body Mass Index and are classified as being overweight. More research is needed to develop alternative approaches for categorizing children's weight and creating effective intervention programs, Gable said.

"Most appearance-based social pressure likely originates in the eye of the beholder," Gable said. "Therefore, intervention and prevention efforts should be designed for everyone. All kids should learn what constitutes a healthy weight and healthy lifestyle."

MU researchers will continue to use the ECLS-K to study the implications of being overweight for children's development. The study, "Implications of Overweight Onset and Persistence for Social and Behavioral Development between Kindergarten Entry and Third Grade," was published in Applied Developmental Science, and was funded by the United States Department of Agriculture, Food Assistance and Nutrition Research Programs.

Source:
Emily Smith
University of Missouri-Columbia

by: http://www.medicalnewstoday.com/

Schizophrenia And Bipolar Disorder Share Many Common Genetic Variants Says International Research Consortium

2009-07-02T18:07:00.000+05:30

A new study by a large international consortium found that many common genetic variants contribute up to a third of a person's risk of inheriting schizophrenia and many of the same DNA variations are also involved in bipolar disorder. While the study helps to explain the complexity of the genetic make up of these diseases it also suggests that developing a test to predict these diseases will take some time.

The study, which provides the first molecular evidence of this form of genetic variation in schizophrenia and shows a new way of thinking about the genetic origins of psychiatric diseases, was the work of the International Schizophrenia Consortium whose members are drawn from 26 different research centers in the US, Europe and Australia. The findings are published as an advance access paper on 1 July in the journal Nature.

Dr Thomas Insel, director of the National Institute for Mental Health, which partially funded the study, said:

"These new results recommend a fresh look at our diagnostic categories."

"If some of the same genetic risks underlie schizophrenia and bipolar disorder, perhaps these disorders originate from some common vulnerability in brain development," he added.

The researchers found that not only are rare variants involved, but also a significant number of common ones.

Dr Pamela Sklar, of the Massachusetts General Hospital (MGH) Department of Psychiatry and Center for Human Genetic Research (CHGR), and a senior associate member of the Broad Institute of MIT and Harvard, is a corresponding author of the paper. She said that:

"While our study finds a surprising number of genetic effects, we fully expect that future work will assemble them into meaningful pathways that will teach us about the biology of schizophrenia and bipolar disorder."

Dr Shaun Purcell is also a corresponding author of the paper and with MGH Psychiatry and the CHGR, and an associate member of the Broad Institute. He said that while they now know the variants, they don't know how they translate into into schizophrenia or bipolar disorder for a given patient.

However, while the results are remarkable and robust, both Sklar and Purcell point out that they are not enough from which to develop a diagnostic test to predict a particular person's risk of inheriting these diseases.

For this study, the researchers examined hundreds of thousands of single nucleotide polymorphisms (SNPs, discrete sections of DNA that contain the genetic variants) from over 3,300 individuals with schizophrenia and 3,600 individuals without the disorder. They used new analytical methods developed by consortium members from the Queensland Institute of Medical Research in Brisbane, Australia: Drs Naomi Wray and Peter Visscher.

To their surprise, and perhaps the most critical finding of the study, was the discovery that the same large group of SNPs was common to all the samples from schizophrenia patients, even though these had been collected by different researchers and tested in different labs.

Another striking discovery was the fact these schizophrenia-related variants were also common in people with bipolar disorder but not to several non-psychiatric diseases. The two disorders are considered distinct but related conditions, the researchers said.

The authors wrote that this study provides:

"Molecular genetic evidence for a substantial polygenic component to the risk of schizophrenia involving thousands of common alleles of very small effect."

The International Schizophrenia Consortium was set up in 2006 and much of the funding comes from the Broad Institute's Stanley Center for Psychiatric Research. The success of the project relies on the willingness of its members to share DNA samples taken from thousands of patients over many years.

Director of the Stanley Center for Psychiatric Research at the Broad Institute, Dr Edward Scolnick, said:

"The consortium has taken important steps towards unearthing the complex genomic architecture of schizophrenia and other psychotic disorders, and this paper is another example of that critical work."

"To fulfill the promise of these early studies, we as a community will need to continue to fully define the genetic basis of these disorders and ensure that our insights help improve the diagnostic and therapeutic options for patients and their families," he added.

The Brain and Mind Research Institute at the University of Sydney is another consortium member in Australia. Their executive director, Professor Ian Hickie said this research:

"Reveals striking evidence for the common genetic risk factors behind the major psychiatric disorders".

"The race will now focus on identification of the key neurodevelopmental genes that underpin these disabling conditions," he added.

Schizophrenia is a chronic, severe, and disabling brain disorder that affects about 1 in 100 people and usually starts in late adolescence or early adulthood. People with schizophrenia experience persistent delusions and hallucinations for instance hearing voices other people don't hear or believing others are reading their minds, controlling their thoughts, or plotting to hurt them.

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. The symptoms are severe and very different from the normal ups and downs that everyone goes through from time to time.

"Common polygenic variation contributes to risk of schizophrenia and bipolar disorder."
Shaun M. Purcell, Naomi R. Wray, Jennifer L. Stone, Peter M. Visscher, Michael C. O'Donovan, Patrick F. Sullivan, Pamela Sklar and other members of the The International Schizophrenia Consortium.
Nature Advance online publication 1 July 2009.
DOI:10.1038/nature08185

By: http://www.medicalnewstoday.com/

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release ,Lover admits to kinky sex killing ,MSPs pass major sex crime reforms ,Size of egg influences lizard sex ,Challenging Sex Taboos, With Help From the Koran ,Sir David Attenborough: I want to come back as 'animal with wild sex life',"Sex pats" discover Ukraine's alluring women ,Poor Sleep Is Associated With Lower Relationship Satisfaction In Both Women And Men ,Neural Mechanism Supports Survival In An Uncertain World ,Brain Energy Use Key To Understanding Consciousness

Brain Scans Of The Future

2009-06-21T17:03:00.000+05:30

Psychologists Use fMRI To Understand Ties Between Memories And The Imagination

Psychologists have found that thought patterns used to recall the past and imagine the future are strikingly similar. Using functional magnetic resonance imaging to show the brain at work, they have observed the same regions activated in a similar pattern whenever a person remembers an event from the past or imagines himself in a future situation. This challenges long-standing beliefs that thoughts about the future develop exclusively in the frontal lobe.
Psychologists have found that thought patterns used to recall the past and imagine the future are strikingly similar. Using functional magnetic resonance imaging to show the brain at work, they have observed the same regions activated in a similar pattern whenever a person remembers an event from the past or imagines himself in a future situation. This challenges long-standing beliefs that thoughts about the future develop exclusively in the frontal lobe.

Remembering your past may go hand-in-hand with envisioning your future! It's an important link researchers found using high-tech brain scans. It's answering questions and may one day help those with memory loss.

For some, the best hope of 'seeing' the future leads them to seek guidance -- perhaps from an astrologist. But it's not very scientific. Now, psychologists at Washington University are finding that your ability to envision the future does in fact goes hand-in-hand with remembering the past. Both processes spark similar neural activity in the brain.

"You might look at it as mental time travel--the ability to take thoughts about ourselves and project them either into the past or into the future," says Kathleen McDermott, Ph.D. and Washington University psychology professor. The team used "functional magnetic resonance imaging" -- or fMRI -- to "see" brain activity. They asked college students to recall past events and then envision themselves experiencing such an event in their future. The results? Similar areas of the brain "lit up" in both scenarios.

"We're taking these images from our memories and projecting them into novel future scenarios," says psychology professor Karl Szpunar.

Most scientists believed thinking about the future was a process occurring solely in the brain's frontal lobe. But the fMRI data showed a variety of brain areas were activated when subjects dreamt of the future.

"All the regions that we know are important for memory are just as important when we imagine our future," Szpunar says.

Researchers say besides furthering their understanding of the brain -- the findings may help research into amnesia, a curious psychiatric phenomenon. In addition to not being able to remember the past, most people who suffer from amnesia cannot envision or visualize what they'll be doing in the future -- even the next day.

BACKGROUND: Researchers from Washington University in St. Louis have used advanced brain imaging techniques to show that remembering the past and envisioning the future may go hand-in-hand, with each process showing strikingly similar patterns of activity within precisely the same broad network of brain regions. This suggests that envisioning the future may be a critical prerequisite for many higher-level planning processes in the brain.

WHAT IS fMRI: Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field rather than X-rays to take clear and detailed pictures of internal organs and tissues. fMRI uses this technology to identify regions of the brain where blood vessels are expanding, chemical changes are taking place, or extra oxygen is being delivered. These are indications that a particular part of the brain is processing information and giving commands to the body. As a patient performs a particular task, the metabolism will increase in the brain area responsible for that task, changing the signal in the MRI image. So by performing specific tasks that correspond to different functions, scientists can locate the part of the brain that governs that function.

ABOUT THE STUDY: The researchers relied on fMRI to capture patterns of brain activation as college students were given 10 seconds to develop a vivid mental image of themselves or a famous celebrity participating in a range of common life experiences. Presented with a series of memory cues -- such as getting lost, spending time with a friend, or attending a birthday party -- participants were asked to recall a related event from their own past; to envision themselves experiencing such an event in their future life; or to picture a famous celebrity (specifically, former U.S. president Bill Clinton) participating in such an event.

WHAT THEY FOUND: Comparing images of brain activity in response to the 'self-remember' and 'self future' event cues, researchers found a surprisingly complete overlap among regions of the brain used for remembering the past and those used for envisioning the future. The study clearly demonstrates that the neural network underlying future thoughts is not only happening in the brain's frontal cortex. Although the frontal lobes play an important role in carrying out future-oriented operations -- such as anticipation, planning and monitoring -- the spark for these activities may be the process of envisioning yourself in a specific future event. And that's an activity based on the same brain network used to remember memories about our own lives. Also, patterns of activity suggest that the visual and spatial context for our imagined future is often pieced together using our past experiences, including memories of specific body movements: data our brain has stored as we navigated through similar settings in the past.

By: http://www.sciencedaily.com/

Early and Easy Detection Of Alzheimer's Disease?

2009-06-17T13:00:00.000+05:30

ScienceDaily — A new diagnostic technique which may greatly simplify the detection of Alzheimer's disease has been discovered by researchers at McGill University and the affiliated Lady Davis Institute for Medical Research at Montreal's Jewish General Hospital (JGH).

There is currently no accepted blood test for Alzheimer's, and the diagnosis is usually based on expensive and labour-intensive neurological, neuropsychological and neuroimaging evaluations.
Dr. Hyman Schipper and colleagues at the Lady Davis Institute and McGill University utilized a new minimally-invasive technique called near-infrared (NIR) biospectroscopy to identify changes in the blood plasma of Alzheimer's patients, changes which can be detected very early after onset, and possibly in pre-clinical stages of the disease.
Biospectroscopy is the medical form of spectroscopy, the science of detecting the composition of substances using light or other forms of energy. In NIR spectroscopy, different substances emit or reflect light at specific, detectable wavelengths.
In this study, Schipper and his colleague Dr. David Burns – head of McGill's Biomedical Laboratory for Informatics, Imaging and Spectroscopy at the department of chemistry – applied near-infrared light to blood plasma samples taken from patients with early Alzheimer's dementia, mild cognitive impairment (MCI) == an intermediate state between normal cognition and dementia -- and healthy elderly control subjects at the JGH/McGill Memory Clinic. Using this technique, the researchers were able to distinguish Alzheimer's from healthy controls with 80 per cent sensitivity (correct identification of patients with the disease) and 77 per cent specificity (correct identification of persons without the disease). A significant number of subjects with MCI tested positively with the Alzheimer group, indicating that the test may be capable of detecting Alzheimer disease even before patients' symptoms meet clinical criteria for dementia.
"We are very encouraged by these data and look forward to testing this potential diagnostic tool in larger-scale studies", said Schipper, Director of the Centre for Neurotranslational Research at the JGH and professor of neurology and medicine at McGill. Researchers have been searching for a minimally-invasive biological marker that differentiates Alzheimer's disease from normal aging and other neurodegenerative conditions for decades.
"The advent of a simple blood test for the diagnosis of early Alzheimer's", remarked Schipper, "would represent a major achievement in the management of this common disorder".
by: http://www.sciencedaily.com/

Brain Energy Use Key To Understanding Consciousness

2009-06-16T13:23:00.000+05:30

ScienceDaily — High levels of brain energy are required to maintain consciousness, a finding which suggests a new way to understand the properties of this still mysterious state of being, Yale University researchers report.

At its simplest, consciousness can be defined as the ability to respond meaningfully to external stimuli. Most studies of consciousness have used imaging technology to try to pinpoint areas of brain activity during tasks such as memorization or problem solving.

There are two problems with such an approach, said Robert G. Shulman, Sterling Professor Emeritus of molecular biophysics and biochemistry at Yale and lead author of the paper, to be published this week in the online edition of the journal Proceedings of the National Academy of Sciences. First, functional magnetic resonance imaging has shown that many areas of the brain, not just one or two, are recruited during tasks such as memory tests and are scant help in studying the state of being conscious. Second, the amount of energy used in such tasks is minute, about one percent of baseline energy available to the brain.

"Neuroimaging has been looking at the tip of the iceberg," Shulman said. "We looked at the rest of the iceberg."

What is the other 99 percent of energy consumption doing?

Shulman and colleagues have proposed that it is needed to maintain a person in a state of consciousness. Heavily anesthetized people are known to show approximately 50 percent reductions in cerebral energy consumption. When the paws of lightly anesthetized rats with rather high baseline energy levels were stroked, fMRI signals were received in the sensory cortex and in many other areas of the brain. In heavily anesthetized rats the signal stopped at the sensory cortex. Both the total energy and the fMRI signals changed when the person or animal lost consciousness.

"What we propose is that a conscious person requires a high level of brain energy," Shulman said.

The finding has profound implications for our understanding of the connection between the brain and consciousness, Shulman said. "You can think of consciousness not as a property of the brain, but of the person."

Anesthesiologists consider a person to be in a behavioral state of consciousness when he or she can respond to simple stimuli. Properties of this state, such as the high energy and the delocalized fMRI signals, allow the person to perform the interconnected activities that make up our everyday lives. Shulman suggests that these more energetic properties of the brain support human behavior and should be considered when interpreting the much weaker signals that are typically recorded during fMRI studies.

Other Yale researchers involved in the study are professors Fahmeed Hyder and Douglas L. Rothman.
The study was funded by the National Institutes of Health.

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release ,Lover admits to kinky sex killing ,MSPs pass major sex crime reforms ,Size of egg influences lizard sex ,Challenging Sex Taboos, With Help From the Koran ,Sir David Attenborough: I want to come back as 'animal with wild sex life',"Sex pats" discover Ukraine's alluring women ,Poor Sleep Is Associated With Lower Relationship Satisfaction In Both Women And Men ,Neural Mechanism Supports Survival In An Uncertain World

Neural Mechanism Supports Survival In An Uncertain World

2009-06-16T11:19:00.000+05:30

ScienceDaily (June 16, 2009) — A new study uncovers a pivotal role for the human frontal lobe in the promotion of behavioral flexibility during voluntary choice. The work, published by Cell Press in the June 11th issue of the journal Neuron, presents a critical new neural mechanism that supports the decision to adapt or maintain behavior when change is not explicitly instructed by the external environment.

Previous work has shown that the frontopolar cortex (FPC) is involved in memory and multitasking and is active when human subjects switch between tasks. "Typically such experiments provide participants with explicit instructions about when to switch from one task to another," explains senior study author Erie D. Boorman from the Department of Experimental Psychology at the University of Oxford. "However, in everyday life organisms must often determine what to do in the absence of explicit cues. It is not clear whether or how the FPC contributes to the control of behavior when humans freely select between tasks."
Boorman and colleagues examined activity in the FPC while human subjects voluntarily selected between two actions during a simple decision making task. Specifically, subjects switched between one of two possible actions on the basis of the expected values of reward associated with the actions. Importantly, the subjects did not receive any instructions that signaled a behavioral change. The expected value of each action was based on the probability that it would yield rewards if chosen, which subjects estimated based on recent outcomes.
The researchers observed that the FPC kept track of evidence in favor of switching to the alternative course of action. Further, immediately prior to a switch in behavior, the FPC exhibited a distinct pattern of connectivity with the parietal cortex, an area of the brain that is known to be active during cued behavior switching. "This suggests that when the FPC has recruited sufficient evidence to support a behavioral switch, it engages the parietal cortex to implement the switch," offers Dr. Boorman.
This study provides the first evidence that the human FPC performs specific computations that support decision making and behavioral flexibility during voluntary choice. "Our findings illustrate that the FPC is not just active when a change in behavior occurs but continually tracks the long-term evidence accrued to support a switch in behavior during decisions and intervals between trials," says Boorman. "Essentially, the FPC tracks how green the grass is on the other side."
The researchers include Erie D. Boorman, University of Oxford, Oxford, UK; Timothy E.J. Behrens, University of Oxford, Oxford, UK; Mark W. Woolrich, University of Oxford, Oxford, UK; and Matthew F.S. Rushworth, University of Oxford, Oxford, UK.
Journal reference:
Erie D. Boorman, Timothy E.J. Behrens, Mark W. Woolrich, Matthew F.S. Rushworth. How Green Is the Grass on the Other Side? Frontopolar Cortex and the Evidence in Favor of Alternative Courses of Action. Neuron, 2009; DOI: 10.1016/j.neuron.2009.05.014
Adapted from materials provided by Cell Press, via EurekAlert!, a service of AAAS.by: http://www.sciencedaily.com/

Poor Sleep Is Associated With Lower Relationship Satisfaction In Both Women And Men

2009-06-15T16:08:00.000+05:30

ScienceDaily (June 15, 2009) — A bidirectional association exists between couples' sleep quality and the quality of their relationship, according to a research abstract that will be presented on Wednesday, June 10, at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.
Results indicate that on a day to day basis, couples' relationship quality affects their sleep, and their sleep also affects their subsequent relationship functioning. For men, better sleep (as indicated by diary–based sleep efficiency) was associated with more positive ratings of relationship quality the next day. For women, negative partner interactions during the day were associated with poorer sleep efficiency for both themselves and their partner that night.

"When we look at the data on a day-by-day basis, there seems to be a vicious cycle in which sleep affects next day relationship functioning, and relationship functioning affects the subsequent night's sleep," said principal investigator Brant Hasler, clinical psychology doctoral candidate at the University of Arizona. "In this cycle, conflict with one's partner during the day leads to worse sleep that night, which leads to more conflict the following day. Although these results are preliminary due to the relatively small sample size and a subjective measure of sleep quality, the woman's perception of the relationship seems particularly important, as it impacts both her own and her partner's subjective sleep quality that night."

The study involved data from 29 heterosexual, co-sleeping couples who did not have children. Each completed sleep diaries for seven days. Each partner was asked to record the quality of interactions with their partner six times a day.
Hasler said that interventions directed at improving either quality of sleep or relationships may provide overall benefits, as the two directly impact each other. Hasler recommends that couples should resolve disputes before going to bed and avoid confrontational discussions on a day when one or both of them had a bad night's sleep.

--------------------------------------------------------------------------------

Adapted from materials provided by American Academy of Sleep Medicine, via EurekAlert!, a service of AAAS.

"Sex pats" discover Ukraine's alluring women

2009-06-12T17:09:00.000+05:30

Foreigners flock to Kiev in search of wives, girlfriends or just plain sex.

KIEV, Ukraine — In the early summer evenings you see them individually and in groups: foreign men, of all ages and nationalities — ex-Soviet, European, North American, Middle Eastern and African. They sit in the outdoor cafes that adorn Kiev’s winding central streets, or patrol about the main Independence Square like guerrilla squads. At night they pack the discos and restaurants and bars.
Some of them study and work here. Others have come to take in the architecture, history and museums of this breathtaking Eastern European capital, or are on their way to a vacation in one of the picturesque outlying towns.
Many, however, have a less exalted purpose in mind: to meet women. And the more the better.
It’s called sex tourism, and the practitioners “sex pats” — a play on the word expat or expatriate. The phenomenon is all-too-common throughout the world, including in South America, Asia and Africa.
Now it seems that it has arrived in the former Eastern Bloc with a vengeance.
Riga, Prague and Krakow have been overrun by the planeload, aided by budget airlines like Ireland’s RyanAir. The men are lured by perceptions that the pickings are easier than at home, whether because of reported liberal attitudes, a possible preference for foreigners or difficult economic circumstances among the local population. And that thanks to their anonymity, they can behave as boorishly as they want.
Ukraine, where the women pride themselves on their beauty and femininity, has become one of the most popular destinations. (“What country has the most alluring women?” is a favorite and legitimate conversation topic here — pondered by men and women alike. Any answer other than “Ukraine” usually elicits disappointment or even outrage.)
The stag parties that have blighted other Eastern European cities — drunken, rowdy and often British hordes who accost locals and regularly expose themselves — thankfully have not arrived here. But a multitude of other parties have.
For many, the purpose is straightforward enough: find a girlfriend or even a wife. (Western Internet introduction and marriage sites, with names like “Ukrainian Brides,” are a worldwide business that rakes in the millions, if not billions.) This often bleeds into a quest simply for easy sex — often among the marriage agencies, where men abuse the service, trying to meet and bed as many women in their short stay here as possible.
Unsurprisingly, prostitution has by all appearances metasized, and with it a host of other ills. According to the International HIV/AIDS Alliance in Ukraine, the country has the one of the highest HIV rates in Europe, and for the first time last year, infections through sex exceeded those from drug injection. Human trafficking for the sex trade also remains a chronic tragedy, though no official figures exist to pinpoint whether it is actually rising or remaining constant.
Anna Hutsol of the organization “FEMEN” wants to change all this. For a year, she and her group of activists have carried out a series of eye-catching demonstrations — for example, parading around the city in skimpy and provocative clothing to attract attention, and then handing out fliers to expatriate men, informing them that, among other things, prostitution is illegal in Ukraine.

“We are certain that the aim of your visit to our country is absolutely decent,” one flier says. “Unfortunately ... your compatriots come to Ukraine to get easy sex using the fact that Ukraine girls are poor, unprotected and naive.”
FEMEN strives to add teeth to laws against prostitution. At the moment, sex workers and pimps pay a a fine (although very small), while clients are left alone. The organization would like to see sex tourism defined in the legal code and clients punished as well, and possibly deported from the country. Recent anti-prostitution legislation was introduced at the beginning of the year, but so far has languished, Hutsol said.
Ultimately, FEMEN wants to change how all foreigners regard Ukrainian women, who suffer from an association with the sex trade throughout Europe, as well as how Ukrainian women view themselves.
“The basic problem is that we lack emancipation,” Hutsol said. “Men take care of us economically — men provide everything. Very few women see any kind of independent future.”
On a recent Friday night, Hutsol and her cohorts conducted a major action under Kiev’s central monument. German electronic-music celebrity DJ Hell provided the sounds for a mini rave, while dozens of college students paraded in avant garde fashion from local designers. At the end, a group of protesters, dressed only in bikinis, held up a banner and shouted, “Ukraine is not a bordello!”
Many young women among the hundreds of onlookers supported FEMEN’s message that foreign men should also appreciate Ukrainian culture and history, and that it was insulting when they spent their days simply chasing introductions.
The majority of those questioned, however, said that the foreigners were in general very respectful, and in many cases better behaved than their own male population. Many said that they had foreign friends and boyfriends, and that men would not come here if local women were not themselves interested in meeting non-Ukrainians.
“We love you all very much,” said Yana Pashchits, 19, a student, who was participating in the fashion show. “We want you to come here.”
Nevertheless, FEMEN’s message was lost on some of the crowd.
Three Danish 30-year-old professionals happened upon the action, just three hours after arriving in Kiev for a long-weekend. “This is what it’s all about,” pointing to one of their number’s T-shirt, which read, bluntly, “I Love Ukrainian Girls,” and staring at the half-dressed beauties parading around him. However, when told what the demo was actually for, and that they were in fact being interviewed for a Western publication, they insisted that they had not come just to meet women.
But Rasmus Anderson, a product manager, added, almost as an afterthought: “You have to agree that there are some very pretty girls here.”

by: http://www.telegraph.co.uk/

Sir David Attenborough: I want to come back as 'animal with wild sex life'

2009-06-12T16:40:00.001+05:30

Sir David Attenborough: I want to come back as 'animal with wild sex life'

Sir David Attenborough, 82, is preparing to visit the Arctic and Antarctic to film The Frozen Planet for the BBC. Photo: EDDIE MULHOLLAND

The 82-year-old disclosed in a radio programme that he wished he could come back as a creature that mates in an unusual way.
Sir David made the admission during a show to be broadcast on BBC Radio 4 Friday night, according to a report in The Sun.

He said: “People often say, 'What would you like to be if you came back to Earth as an animal?' Well the answer I give depends on the company I'm with. If it's a bit racy, I daresay my mind would wander over a range of animals remarkable for the extravagance of their reproductive techniques.”
He added that he would often tone down his answer. "In more sober company, I normally find a safer answer. A sloth, I say. It spends most of its time hanging upside from a branch in a tropical rainforest, dozing."
His comments are made in the first of a series of short radio shows called Life Stories, in which he talks about different subjects close to his heart.
He also talks about his first ever pet, a salamander, and his favourite animal - the bird of paradise.
The wildlife expert, whose wife died ten years ago, has completed his Life On... television series but says he will not retire until "I'm in a bathchair".
Sir David is preparing to visit the Arctic and Antarctic to film The Frozen Planet for the BBC.
The Life Stories programme will be broadcast on BBC Radio Four at 8.50pm on Friday 5 June and repeated at 8.50am on Sunday 7 June.

by: www.telegraph.co.uk

Challenging Sex Taboos, With Help From the Koran

2009-06-12T12:38:00.000+05:30

DUBAI, United Arab Emirates

WEDAD LOOTAH does not look like a sexual activist. A Muslim and a native Emirati, she wears a full-length black niqab — with only her brown eyes showing through narrow slits — and sprinkles her conversation with quotes from the Koran.
Yet she is also the author of what for the Middle East is an amazingly frank new book of erotic advice in which she celebrates the female orgasm, confronts taboo topics like homosexuality and urges Arabs to transcend the backward traditions that limit their sexual happiness.
The book, “Top Secret: Sexual Guidance for Married Couples,” is packed with vivid anecdotes from Ms. Lootah’s eight years as a marital counselor in Dubai’s main courthouse. It became an instant scandal after it was published in Arabic in the Emirates in January, drawing praise from some liberals and death threats from conservatives, who say she is guilty of blasphemy or worse.
Ms. Lootah, a strong-willed and talkative 45-year-old, is one of a small but growing number of Arabs pushing for more openness and education about sex. Unlike earlier generations of women who often couched their criticism in a Western language of female emancipation, Ms. Lootah and her peers are hard to dismiss as outsiders because they tend to be religious Muslims who root their message in the Koran.
Ms. Lootah, for instance, studied Islamic jurisprudence in college, not Western psychology, and her book is studded with religious references. She submitted the text to the Mufti of Dubai before publishing it, and he gave his approval (though he warned her that Arab audiences might not be ready for such a book, especially by a woman).
“People have said I was crazy, that I was straying from Islam, that I should be killed,” Ms. Lootah said. “Even my family ask why I must talk about this. I say: ‘These problems happen every day and should not be ignored. This is the reality we are living.’ ”
She is not a liberal by Western standards. One of the themes of her book is the danger of anal sex and homosexuality generally, not because of AIDS but because they are banned by the Koran. But her openness about the issue was itself a shock to many here.
In Saudi Arabia and other countries where the genders are rigorously separated, many men have their first sexual experiences with other men, which affects their attitudes toward sex in marriage, Ms. Lootah said.
“Many men who had anal sex with men before marriage want the same thing with their wives, because they don’t know anything else,” Ms. Lootah said. “This is one reason we need sex education in our schools.”
She is also emphatic about the importance of female sexual pleasure, and the inequity of many Arab marriages in that respect. One of the cases that impelled her to write the book, she said, was a 52-year-old client who had grandchildren but had never known sexual pleasure with her husband.
“Finally, she discovered orgasm!” Ms. Lootah said. “Imagine, all that time she did not know.”
Another important theme of the book is infidelity. The prevalence of foreign women in Dubai and the ease of e-mail and text-message communication has made cheating easier (and easier to detect), Ms. Lootah said, helping push the divorce rate to 30 percent.
The Gulf’s oil-fueled modernization in recent decades has also shattered some old Arab social structures. At the same time, the rise of political Islam has undermined traditional authorities, leaving many Arabs confused about moral issues.
“Before, people lived in one place and the community was like one big family,” Ms. Lootah said. “Now, people have spread to different areas, everything’s mixed up and traditions have changed.”
ONE result is the Family Guidance section in the Dubai Courthouse, which opened in 2001 with Ms. Lootah as its first counselor (there are now six others, all men). Kuwait’s government has had a similar social-services wing since the 1990s, and other Persian Gulf countries are following suit. Private psychologists and marriage counselors also exist throughout the Arab world, though they are still rare.
“We’re making a lot of progress,” said Heba Kotb, who runs an Islam-oriented sex therapy clinic in Cairo, and ran a satellite television talk show on sexual and marital issues from 2006 until 2008. “Ten years ago we were unable to even mention the subject, and now people are getting used to hearing it.”

There are still formidable obstacles. In a region where “honor killings” of women who have sex outside marriage remain fairly common, sex education is widely viewed as a portal to sin. Genital cutting of women still takes place in Egypt, though it is now illegal. Arab writers and artists have begun to tackle these subjects.
Thirty years ago the Egyptian director Saleh Abu Seif wrote a screenplay called “Sex School,” but the censorship bureau had yet to approve it when he died in 1996. His son was finally allowed to direct a modified version of the film, about a sexually dissatisfied couple who go to see a therapist, and it was released in 2002 under the title “The Ostrich and the Peacock.”
Ms. Lootah never expected to become part of this debate. One of nine children born to an illiterate water-seller in Dubai, she married early and taught elementary school for years. Later, she took a job working for an Islamic endowment, where her efforts to introduce education and family-reunion days in prison earned her two government-service awards. When Dubai introduced the Family Guidance section of its courthouse, Dubai’s ruler, Sheik Muhammed bin Rashid al-Maktoum, asked her to be the first counselor.
THE family guidance section was established in part to comply with Islamic precepts calling for couples who want a divorce to try to work out their problems first. In practice, it has become an all-purpose therapy destination for people with marital problems.
Ms. Lootah sees about seven cases a day, individuals and couples. Most of them are native Emiratis, but in the multicultural world of Dubai — where about 90 percent of the population is foreign — she has also counseled some Europeans and Asians. As in the criminal courts next door, a translator sits in on the session, and sometimes even offers advice to bridge cultural gaps.
“Some people are amazed I can work with people with only my eyes showing,” Ms. Lootah said, with a ripple of laughter. “Maybe it’s because of the way I move my hands! But I can tell you that people come here, and they speak very frankly with me.”
She reels off stories from her practice in rapid fire: the Emirati military officer whose wife had an affair because he was away from home too much; the woman who thought fellatio was against Islam (not true at all, Ms. Lootah notes); the wife who discovered her husband dressing up as a woman and going out to gay bars. She seems bent on showing that there is a whole world of sexual confusion that would benefit from open discussion.
Publishing the book, she notes, was a difficult choice. Her father supported her, but other family members sometimes wondered why she had to be so public about it all. After it was published a man called her office phone and threatened to kill her. Other threats appeared on the Internet.
She brushes them off, saying she has declined an offer of protection from the government. Besides, she adds, educating the public is worth the risk.
“A few days ago a woman came in and asked me if it is O.K. to kiss the man all over his body,” she said. “I told her, ‘Read my book!’ ”

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release ,Lover admits to kinky sex killing ,MSPs pass major sex crime reforms ,Size of egg influences lizard sex

Size of egg influences lizard sex

2009-06-12T12:27:00.000+05:30

Sydney (IANS): A lizard's egg size shows whether it's going to be a boy or girl, says a new study.
"We were astonished," said Richard Shine of the University of Sydney (U-S). "Our studies on small alpine lizards have revealed another influence on lizard sex: the size of the egg.
Big eggs tend to give girls, and small eggs tend to give boys. And if you remove some of the yolk just after the egg is laid, it's likely to switch to being a boy, even if it has female sex chromosomes; and if you inject a bit of extra yolk, the egg will produce a girl, even if it has male sex chromosomes."
In many animals, the sex of offspring depends on specialized sex chromosomes. In mammals and many reptiles, for instance, males carry one X and one Y chromosome, while females have a pair of X chromosomes.
Conversely, animals like alligators depend on environmental cues like temperature to set the sex of future generations.
The new findings add to evidence that when it comes to genetic versus environmental factors influencing sex determination, it doesn't have to be an either/or proposition.
Shine's group also noticed something else: large lizard eggs were more likely to produce daughters and small eggs were likely to produce sons, said a U-S release.
Despite the correlation, Shine said he had assumed that the association was indirect. In fact, his colleague R Radder conducted studies in which he removed some yolk from larger eggs, more likely to produce daughters, to confirm that assumption.
"We were confident that there would be no effect on hatchling sex whatsoever," Shine said. "When those baby boy lizards started hatching out, we were gob-smacked."
These findings were published online in the Thursday edition of Current Biology.

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release ,Lover admits to kinky sex killing ,MSPs pass major sex crime reforms

MSPs pass major sex crime reforms

2009-06-11T18:25:00.000+05:30

A major shake-up of the law on sexual offences, including a toughening up of rape legislation, has been passed by the Scottish Parliament.
The Sexual Offences Bill will define consent to sex in law, creating a broader statutory offence, including male rape, for the first time.
MSPs also moved to close a loophole in the bill, over Labour fears it could create a "get-out clause for rapists".
The laws won wide cross-party backing at the final parliamentary hurdle.
The bill aims to tighten up current laws by giving a broader definition of rape and consent based on free agreement.
It sets out a list of circumstances where there can be no free agreement - including a victim being incapable through alcohol.

The new laws came at a time when women's organisations have branded figures showing only 3% of rape allegations in Scotland end in conviction as a "national disgrace".
Hailing the legislation, Justice Secretary Kenny MacAskill said: "Challenging myths, assumptions and unacceptable attitudes is vital if the legislative reforms and the changes being made to the prosecution of these offences are to be fully effective.
"This is a journey, not simply in terms of legislation, but in terms of Scotland becoming a modern, progressive country, recognising the position of women and treating them with the respect they are entitled to."
Parliament backed an amendment from Labour MSP Margaret Curran, who said the bill as it stood would allow a rapist to claim a victim had given prior consent, for example, before getting drunk.

She said the law had to provide protection to women who were targeted by predatory men, even when they were very drunk.
The legislation also brings in tougher laws on sexually offensive e-mails and texts, and the use of date rape drugs.
The laws were passed by 121 votes to zero, although Green MSP Patrick Harvie abstained.
Labour community safety spokesman Paul Martin said there were "many positive aspects" to the bill, but raised concern it could allow a person convicted of sexually assaulting a child to be fined.
Backing the reforms, Tory justice spokesman Bill Aitken, said: "Sometimes people behave foolishly, sometimes people behave even irresponsibly. But it is our duty to see they are protected."
The Lib Dems' Robert Brown added: "As a whole, it provides what we hope will be a modern statute, fit for purpose in the 21st century, playing its part in deterring crime and securing justice for the victims of serious crimes of a sexual nature."

by: bbc

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release ,Lover admits to kinky sex killing

Lover admits to kinky sex killing

2009-06-11T18:20:00.000+05:30

The lover of one of the most influential bankers in Europe has broken down in court and admitted killing him after kinky sex.
Cecile Brossard, 40, shot French investment banker Edouard Stern, 50, in his luxury apartment in Geneva in 2005.
Mr Stern, a friend of French President Nicolas Sarkozy, was found in a latex body suit with four bullet wounds.
Defence lawyers say during a sex game he told her: "A million dollars is a lot of money to pay for a whore."
Ms Brossard told the court in Geneva at the start of her trial she would "try to explain the truth".

Mr Stern was an investment banker and the 38th richest man in France.
His death was at first rumoured to be linked to the Russian mafia, before his lover confessed.
Lawyers for the Stern family claim she wanted money and planned to kill Stern when she realised she would not get it - a premeditated killing which would carry a sentence of up to 20 years.
Ms Brossard's lawyers, however, say Mr Stern had humiliated and abused her, and that the shooting was an unpremeditated crime of passion - which has a maximum sentence of only 10 years.

Sex game
After the court heard testimony from Mr Stern's former wife Beatrice, and their two adult children, Ms Brossard said: "I would like to ask for forgiveness, but we cannot seek forgiveness for something so abominable. The only thing that I can do is to try to explain the truth."
Ms Brossard described Mr Stern as "an intelligent man, refined, extraordinary in every way".
Mr Stern's lawyers say he was killed in a row over $1m, which he had transferred to his lover's account but then blocked.
Her lawyers say that during the course of a sado-masochistic sex game he provoked her by saying: "A million dollars is a lot of money to pay for a whore."
According to them, his words led Ms Brossard to seize his gun, that was in the bedroom, and to shoot him - twice in the body and twice in the head.
The trial is expected to last 10 days.

by: bbc

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women , Concern over sex offender release

Concern over sex offender release

2009-06-11T18:15:00.000+05:30

Scotland's chief prisons inspector has warned that sex offenders receive the worst preparation before their release.
Andrew McLellan said there was a lack of sex offender treatment programmes in jails - and little evidence they made a difference.
In his annual report, Dr McLellan also said prison overcrowding remained a "real evil".
But he said jail living conditions had been transformed for the better, and paid tribute to prison staff.
Opposition parties said the report showed the Scottish Government was failing to cope with problems in prisons - but Justice Secretary Kenny MacAskill said ministers were taking action to address the concerns.
In his final annual report after seven years in the job, Dr McLellan said that, despite the efforts of the Scottish Prison Service, sex offenders received "the worst preparation for release", despite being the type of prisoner which caused the most public concern.
He said the treatment programme was too small, while the most serious sex offenders who refused to admit their crimes failed to sign up for it.
"Equally disturbing is the fact that there is very little statistical evidence in the UK that the sex offender treatment programme makes a difference," added Dr McLellan.
"It is surely time that research evidence was produced to support a programme which remains the principal resource for addressing the offending behaviour of sex offenders in Scottish prisons."
The chief prisons inspector said many problems were long-standing ones, with no solutions in sight.
He said: "The damage done by overcrowding has already been emphasised - but it cannot be emphasised too often.
"Prisons do not improve more quickly because the best efforts of all the most imaginative and caring staff are completely frustrated by the evil of overcrowding."
Dr McLellan raised concern that under-16s were still being held in prison, and that remand prisoners were still spending too long locked up in cells.
But he also paid tribute to the "patience, humanity and fundamental decency" of all prison staff.
And he said the last seven years had seen a transformation which had produced first class prison buildings - although Dr McLellan said it was "with despondency" he had to report that the practice of slopping out still existed in one jail, Peterhead.

Scottish Conservative justice spokesman Bill Aitken accused ministers of wanting to empty Scotland's jails through the use of community sentences.

"The proper use of prison will eventually lead to a reduction in prisoner numbers, but that will only happen when more police are in our communities, we properly end the scandal of automatic early release, we adopt a zero-tolerance approach to drugs and put in place effective rehabilitation services," he said.

Richard Baker, the Labour justice spokesman said: "Kenny MacAskill's handling of Scottish prisons has been nothing short of disastrous.

'Protecting the public'

"Mr MacAskill's answer to prison overcrowding is to attempt to empty jails by scrapping six-month sentences," he said. "This is a move that will not save the taxpayer a penny but will seriously damage public safety."

The Lib Dems' Robert Brown added: "This report is yet another reminder that the justice secretary hasn't got to grips with overcrowding in our prisons.

"We know that our prisons are getting more dangerous and the rates of re-offending remain high. Prison has an important role to play in our justice system and time spent in prison should be about more than just punishment."

Mr MacAskill said the prison estate was in far better shape than seven years ago, adding that a record £120m was being invested in Scotland's jails.

But he said of Dr McLellan's report: "He is also entirely right to point out that much more needs to be done to deal with overcrowding and other inherited problems such as high reoffending rates.

"This government is committed to protecting the public and prison will always be the right place for serious and dangerous offenders - but modern and proportionate offender management is about more than simply building more and more jails."
by: bbc

some other posts: Pupil sex teacher ruling delayed , Sex seminar aiming to help women

Sex seminar aiming to help women

2009-06-10T12:24:00.000+05:30

A "pioneering" seminar aimed at allowing women to get out of the sex industry is taking place in Aberdeen.
Grampian Police and other organisations are taking part in the event which will focus on their exploitation.
The Violence Against Women Fund event is said to be the first of its kind in the north east of Scotland.
Luan Grugeon, a member of the Aberdeen-based Sex Industry Forum, said: "Women involved in street prostitution are extremely vulnerable."

'Difficulties faced'
She added: "Services need to develop new ways of working in order to attract and retain women in order to support them to adopt healthier, safer and more fulfilling lives.
"The response to this event has been overwhelming and we have a really wide range of organisations signed up to attend.
"We hope this will enable a range of services involved in this area to work more closely together to help women involved in street prostitution address their problems."
Insp John Soutar, of Grampian Police, said: "The police have to strike a balance between enforcement and understanding the requirements of a victim-based approach which will hopefully, in the long term, see women exit this lifestyle.
"From a policing perspective, I welcome the opportunity this brings to discuss the difficulties women engaged in this type of activity face."
In November, BBC Scotland reported claims prostitution in Aberdeen had spread into the city centre since a tolerance zone was abandoned because of a change in the law.
The introduction of kerb crawling laws meant police were unable to continue the managed area, carried out on streets around the harbour.
Convictions for soliciting in the city centre tripled in the six months after the tolerance zone was scrapped.

by: bbc

some other posts: Pupil sex teacher ruling delayed

Pupil sex teacher ruling delayed

2009-06-10T12:17:00.000+05:30

A former Aberdeen teacher placed on probation for having sex with a 15-year-old pupil has had her disciplinary hearing delayed.
Alison Smith, who was a teacher at the city's Bankhead Academy, confessed the incident to church associates and her parents before going to the police.
Smith was placed on probation and given 200 hours community service in January.
The General Teaching Council for Scotland had to delay her hearing due to an administrative error.
Smith had been charged in July last year over the allegations of an inappropriate relationship.
The incident happened last June when Smith was visited at her home by the pupil.

'Human weakness'
There she had, what she described as, consensual sex, with the boy.
In a written testimonial to Aberdeen Sheriff Court, one of the boy's parents said it had not had any long-term psychological affect on him.
Sheriff Kieran McLernan told Smith: "On the face of it, this offence is normally regarded with considerable seriousness because it's one form of a significant abuse of trust.
"It was an effect of your own conscience which brought this matter to light.
"Human weakness is not often best dealt with by public punishment but it is a matter of public interest where there is a breach of trust."
Smith had been placed on the sex offenders register at an earlier hearing.
The GTCS said the conviction hearing came before the disciplinary committee on Tuesday.
Smith did not attend and did not send a representative.
A GTCS spokeswoman told the BBC Scotland news website that Smith had been sent the wrong form to fill in, which she had returned, and she would be re-served with the correct documents.
Smith will then have 28 days to respond.
The GTCS said it was not responsible for sending the forms out, but that this fell under the remit of the council solicitor.

By: bbc

2009-01-08T12:55:00.001+05:30

Libido

Libido is the term that the noted founder of psychoanalysis, Sigmund Freud, used to label the sexual drive or sexual instinct. He noted that the sexual drive is characterized by a gradual buildup to a peak of intensity, followed by a sudden decrease of excitement.
As he studied this process in his patients, Freud concluded that various activities like eating and drinking, as well as urination and defecation share this common pattern. Consequently, he regarded these behaviors as sexual or libidinous as well.

Freud also became interested in the development of the libido, which he saw as the basic and most powerful human drive. He believed that the development of the libido involved several distinct and identifiable stages.

Freud's Theory on How Libido Develops
During infancy, he noted, sexual drive is focused on the mouth, primarily manifested in sucking. He labeled this the oral stage of libidinous development. During the second and third years of a child's life, as the child is undergoing toilet training, focus and erotically tinged pleasure shifts to rectal functions. Freud labeled this the anal stage.

Later, during puberty, focus shifts again to the sex organs, a period of development he labeled the phallic stage in the maturation of the libido.

During the later stage of development, libidinal drives focus at first on the parent of the opposite sex and add an erotic coloring to the child's experience of his/her parents. Parental disapproval of uncontrolled libidinal drive, Freud believed,leads to the development of a human psyche that is made up of three components; the id, the ego and the superego. He concluded that the id, or basic set of instincts and drives (including the libido but also other drives like aggression), provides the psychic energy needed to initiate activities.

The ego, an executive function, directs the day-to-day fulfillment of libidinous and other desires in socially acceptable and achievable ways.

The superego labels the learned and internalized social standards of behavior, including an awareness of banned or punishable behaviors. During wakeful periods, strong boundaries separate these three arenas, but during sleep and fantasy the boundaries weaken, giving rise to open expression of otherwise controlled libidinous desires. Conscious awareness of these unrestrained desires and fantasies can cause the person to feel sexual guilt or shame.

Freud believed that an individual's personality is established early on in life and is determined by the ways in which basic drives and impulses such as libido are satisfied. Failure to satisfy libidinal and other drives leads to their repression with resulting consequences for the development of an individual's personality and psychological health.

>>>next

2009-01-08T12:51:00.000+05:30

Libido

Subsequent generations of psychoanalysts questioned Freud's work on the libido. Several stressed the point that Freud had overemphasized biological development and underemphasized the impact of cultural and social factors on sexual attitudes and practices.
An Alternative Theory on Libido
Carl Jung, a Swiss psychiatrist and psychoanalyst, broke with Freud's view of the libido by rejecting the idea that sexual experiences during infancy are the principal determinants of adult emotional problems.

Jung developed an alternative theory of the libido that viewed the will to live rather than sexual desire as the strongest drive. Jung emphasized the distinction between introverted and extroverted personality types.

Extroversion typifies individuals whose attention is strongly directed (but not exclusively) outward from themselves to other people and to the world around them.

Extroverts tend to feel comfortable in social situations and tend to be gregarious.

Introversion labels the opposite characteristics, including directing attention inward toward internal processes and thoughts. Introverts tend to be self-reliant, introspective, thoughtful and comparatively uncomfortable in large social groups. Jung used the term libido to label the mental energy responsible for creating and sustaining introversion/extroversion. He did not believe individuals were strictly introverted or extroverted, but tended to mix these qualities in varying amounts.

Many contemporary psychologists view libido as a basic human potential that, while rooted in human biology (e.g., hormones), is shaped largely by culture and experience.

<<< prev

2009-01-07T18:56:00.001+05:30

Marriage and Sex

If you're married or thinking about getting married, at some point or another you've wondered what better sex in marriage would be like or how sex in marriage could be improved.
Keeping the sexual spark alive in a marriage or in a long-term relationship is easier said than done. However, couples who take time to cultivate and maintain healthy and satisfying sexual relations tend to be more connected with each other and do not suffer from depression, heart problems and other health maladies, experts say.

The daily routines of life — whether careers, children or financial responsibilities — challenge couples to keep alive that flame that initially brought them together. From a practical standpoint, there's less time for sex and intimacy as relationships develop and individual partners take on more responsibilities.

Furthermore, aging brings on a host of physical conditions that can affect life in the bedroom. These include sexual dysfunction, cardiovascular conditions, arthritis and rheumatism, and a host of other problems.

Whatever the reasons for brewing trouble in the bedroom — whether emotional or physical in nature — the good news is that many such problems are easily treated. Moreover, troubles in a couple's sexual relationship are often signs of other problems, and can serve as a warning sign for still bigger troubles ahead.

"A good sex life is an important part of an individual's overall health," says Mark Schoen, Ph.D., director of sex education for the Sinclair Intimacy Institute. "People who have a good sex life feel better [mentally and physically]."

"Sex can be a wonderful cementer or a terrible wedge" for relationships, says Dr. Linda Banner, Ph.D., a licensed sex therapist specializing in marriage and relationship counseling and a researcher associated with Stanford University Medical School.

Adults Have Sex 61 Times a Year
Adults, on average, have sex about 61 times per year, or slightly more than once a week, according to University of Chicago's National Opinion Research Center. Marital status and age are key influences in sexual activity.

Sexual activity is 25 percent to 300 percent greater for married couples versus the non-married, depending on age. The 1998 University of Chicago report that compiled available sex research also concluded that intercourse is more frequent among couples in happier marriages.

As people age, they tend to have sex less, regardless of whether they are in marriages or not. Married couples between ages 18 and 29 have sexual relations an average of nearly 112 times per year. That rate steadily decreases as people age, so that married couples aged 70 and older have sex 16 times a year on average.

But that fact shouldn't be misconstrued as meaning that older people are less satisfied with their sex life. An AARP survey released last year showed that most mid-life and older adults surveyed were either extremely satisfied or somewhat satisfied with their sex life, and felt it was an important quality-of-life factor.

Renowned sex researcher John McKinley, Ph.D., director of the New England Research Institutes in Watertown, Mass., says as people age, particularly men, their expectations about sex aren't as high.

Overcoming Emotional Barriers
"The worst thing that can happen to a relationship is that a sex life becomes routine and boredom sets in," Schoen says. But in today's fast-paced life, filled with dueling responsibilities, a sub-par or absent sex life is a common problem.

When physical problems are not the root cause of a diminished sex life, many remedies exist to rekindle the flame of passion. Much of the fix is grounded in communication and reprioritizing one's life to make time for love and sex, says Jan Sinatra, a Manchester, Conn., psychotherapist and co-author of "Heart Sense for Women."

Sinatra usually asks couples initially coming to her about their love life how they communicate. "It's a barometer of the relationship."

Sometimes couples need to focus on addressing unresolved conflicts between them, while other spouses just need to remember to have fun when the weight of life's responsibilities drags them and their sex life down. Still others may just need to build time into their schedules to be together and let nature takes its course. Simply setting aside date nights can jump-start one's love life.

Through communication—both verbal and non-verbal — and listening, couples come to understand what ignites that spark in the other partner. That might be cuddling, leaving love notes for your partner to find, meeting at a motel for a tryst, trying out new sex techniques, introducing a vibrator or dozens of other potential turn-ons.

>>>next

2009-01-07T18:52:00.000+05:30

Marriage and Sex

Sex therapist Banner conducted a research study that included 65 couples who were having sexual problems because either one or both partners were diagnosed with sexual dysfunction or arousal problems. The average length of time these couples had been together was 24 years.

The study examined what it would take for these couples to resume normal sexual relations. For 65 percent of the couples, the introduction of educational sex videos was all that was needed to jump-start stagnant sex lives, Banner discovered.

Overcoming Physical Barriers
Sexual dysfunction, however, is not necessarily something that is in one's head, and is a major reason sexual relationships suffer. Erectile dysfunction among men aged 65 and older is usually related to physical problems, says Dr. Michael Werner, a New York urologist, whereas most cases of erectile dysfunction for men under 65 are more psychological.
That's not to say there isn't a mental aspect to erectile dysfunction in older men. As with any medical condition, psychological issues also come into play. For men, much of their self-esteem emanates from how they feel sexually. Erectile dysfunction (ED) affects 25 percent of men either completely or moderately by age 40, McKinlay says. By age 70, that increases to one out of two men.

More important, research in the last three to five years shows that impotence or sexual dysfunction is largely a physical problem, not an emotional problem. "Nearly everything we assumed in the last 95 years was totally wrong," says McKinlay. "E.D. is a circulatory problem, it's part of vascular disease…E.D. is an early warning sign of a heart attack."

In addition to cardiovascular conditions, depression, anxiety and prostate disease can also be factors in sexual dysfunction or sexual problems. And the bad news is that medications for these conditions negatively affect sexual functioning, creating a vicious cycle and making it harder to jump-start one's sex life, and possibly affecting a couple's overall relationship.

Viagra has replaced traditionally invasive treatments for men's sexual dysfunction, and McKinlay says new medications more effective than Viagra will soon hit the market. These will be easier to take, quicker acting and will not pose a cardiovascular threat as Viagra has shown to, he says.

However, what works even better than Viagra for many men with erectile dysfunction, McKinlay says, is increasing one's physical activity, kicking the smoking habit, and watching one's weight and cholesterol. As erectile dysfunction is related to cardiovascular disease, such changes can also reduce the risk of the biggest killer of men in the world.

If that doesn't do it, then McKinlay suggests men work with their doctors to change medications before trying medication specifically for erectile dysfunction. As a last resort, a number of invasive treatments are available.

Meanwhile, older women experience reduced vaginal lubrication and reduced blood flow to sex organs, and the intensity of muscle spasms during an orgasm are diminished. These and other issues can be addressed through estrogen replacement therapy and something as simple as using lubricants.

Although some recommend and swear by such alternative therapies as ginkgo biloba or an amino acid called L-arginine for libido and erection problems, McKinlay says there's no scientific data that shows hormone supplements, herbs or dietary supplements work to address erectile dysfunction. However, that's not to say alternative medicine won't work, he adds.

Strategies for Keeping the Spark Alive

Treat your partner as if you're dating
Romance your spouse outside the bedroom
Plan a date night
Talk with your partner
Listen to your partner
Understand your partner's sexual needs and desires
Keep physically fit and attractive for your partner
Maintain perspective on sex as life ebbs and flows
Resolve any underlying conflicts as they will spillover to the bedroom
Have fun and engage in foreplay, whether that's kissing, sexual banter or anything else
Be adventurous and creative in and outside the bedroom
Exercise, preferably together
Stop smoking and get your partner to quit
Watch your weight and cholesterol
Consider seeking specialized treatment from a specialist if behavioral changes don't work

<<< prev

2009-01-07T18:48:00.001+05:30

Orgasm

Orgasm is the sudden discharge of accumulated sexual tension resulting in rhythmic muscular contractions in the pelvic region that produce intensely pleasurable sensations followed by rapid relaxation. Orgasm is also in part a psychological experience of pleasure and abandon, when the mind is focused solely on the personal experience. It is sometimes called climaxing or coming.
In Masters and Johnson's original research of the human sexual response cycle, orgasm is the third of four stages, occurring after the plateau phase and before the resolution phase. Another widely accepted model of the sexual response cycle, developed by Helen Singer Kaplan, M.D., PhD., involves just three stages: desire, excitement and orgasm.

Orgasms vary from person to person and for each individual at different times. Sometimes orgasm is an explosive, amazing rush of sensations, while others are milder, subtler, and less intense. The differences in intensity of orgasms can be attributed to physical factors, such as fatigue and length of time since last orgasm, as well as to a wide range of psychosocial factors, including mood, relation to partner, activity, expectations, and feelings about the experience.

Orgasm — A Total Body Response
There are several physiological components of orgasm. First, orgasm is a total body response, not just a pelvic event. Brain wave patterns have shown distinct changes during orgasm, and muscles in many different areas of the body contract during this phase of sexual response. Some people experience the involuntary contraction of facial muscles resulting in what looks like a grimace or an expression of discomfort or displeasure, but it is actually an indication of high sexual arousal.

The most characteristic physical feature of orgasm is the sensation produced by the simultaneous rhythmic contractions of the pubococcygeus muscle (pc muscle). Along with contractions of the anal sphincter, rectum and perineum, the uterus and outer third of the vagina (the orgasmic platform) for women, and the ejaculatory ducts and muscles around the penis for men, this constitutes the reflex of orgasm.

The first few contractions are intense and close together, occurring at about 0.8-second intervals. As orgasm continues, the contractions diminish in intensity and duration and occur at less frequent intervals.

Orgasm Differences Between Men and Women
Despite the anatomical differences between male and female genitals, orgasms in men and women are physiologically and psychologically, or subjectively, very similar.

In fact, studies have been done in which "experts" could not reliably determine gender when reading descriptions of orgasms with all anatomical references removed.
Women have described the sensations of orgasm as beginning with a sense of suspension, quickly followed by an intensely pleasurable feeling that usually begins at the clitoris and spreads throughout the pelvis. The genitals are often described as becoming warm, electric or tingly, and these physical sensations usually spread through some portion of the body. Most women also feel muscle contractions in their vagina or lower pelvis, often described as "pelvic throbbing".

The subjective feeling of orgasm in men has been described quite consistently as beginning with the sensation of deep warmth or pressure that corresponds to ejaculatory inevitability, the point when ejaculation cannot be stopped. It is then felt as sharp, intensely pleasurable contractions involving the pc muscles, anal sphincter, rectum, perineum and genitals. Some men describe this part as a sensation of pumping. Finally, a warm rush of fluid or a shooting sensation describes the actual process of semen travelling through the urethra during ejaculation.

It is important to note that orgasm and ejaculation are not one in the same event. Although they typically occur together, a man may have an orgasm without ejaculating.

A major difference between the female and the male orgasmic phase is that far more women than men have the physical capability to have one or more additional orgasms within a short time without dropping below the plateau of sexual arousal.

Being multi-orgasmic depends on both continued stimulation and sexual interest. Because neither of these is present every time for most women, multiple orgasms do not occur with every sexual encounter.

On the other hand, upon ejaculation, men enter a recovery phase called the refractory period. During this time, further orgasm or ejaculation is physiologically impossible. However, some men can learn to have an orgasm without ejaculating, thereby making it possible to experience multiple orgasms.

2009-01-07T18:22:00.001+05:30

Has Your Sex Drive Pulled a Disappearing Act?

Women — if your sex drive has taken a turn for the worse, and your one-time turn-ons aren’t doing the trick, consider asking your health professional the following questions, based on recommendations from the National Women’s Health Resource Center. They could provide some keys for diagnosing the problem and giving you back your sexual zest.

Could bodily changes related to menopause be causing my sexual problem? If so, what can be done to minimize these sexual effects?

Could my sexual problem be related to a different medical condition, and is there a way to manage my medical problem that might help resolve my sexual dysfunction?

Could any medications I am taking be causing sexual side effects? Can my prescription be changed to minimize these effects?

What are my estrogen and androgen hormone levels, and are they possibly related to my sexual problem?

What treatments are available for my sexual problem? Should I consider hormonal therapy for my sexual problem, and if so, what hormones might work best for me?

2009-01-07T18:20:00.000+05:30

When a couple's sex life has turned sour, physical problems may not be the only factor. There's often an emotional component too, says human sexuality expert Barnaby Barratt, Ph.D., president of the American Association of Sex Educators, Counselors and Therapists.

"From 30 years of clinical experience, I can tell you that all people — even those who think they're very cool about sex — have conflicts that create shame, guilt and anxiety."

As a rule, too, both people in a relationship contribute to the sexual problems. "Finger-pointing and blaming are never productive for improving a couple's sexual life, because inevitably in this context it takes two to tango," Barratt says.

Putting yourself in each other's position can be a helpful first step in recapturing the sexual spark, and for that, it helps to know about the following Mars-Venus differences between the sexes.

Women React Differently Than Men to ...

An X-rated video
It's what they see that arouses most men. While some women find it sexy to see erotic pictures or scenes in magazines or on videos, others are totally turned off by them. Words ("I love you" are three to try) and touch (a gentle caress in a nonsexual way, for starters, or a back or foot rub) are better-bet approaches to melting your female partner's heart and preparing her for a passionate rendezvous.
A touch on the cheek
Nonsexual touch can be exciting for women, though it's seen by many men as a needless delay on the way to sex play. A soft, nongenital touch is a romantic way to convey affection, women tend to feel, so men might be better off skipping the sex video in favor of an affectionate cuddle and caress.

Watching sports while making whoopie
Women want their man to be present in the moment while making love. Forget watching football players making a great play; keep your eye on the ball in your own bedroom if you want a chance to get lucky tonight. Men can wreck the romance even with the TV turned off, by focusing too much on their erection and disconnecting from the sexual moment.

Women's Work
Women, make an effort to understand his sexual preferences. Leaving the TV on while making love might be a lot to ask, but understand when he views a "nongenital" touch as just a waste of time. Once in a while, skip the romantic steps and get right down to the sexual stuff. For foreplay, consider this for a compromise: a pornographic video that actually has a plot!

Has your desire for sex tanked?

2009-01-07T18:18:00.001+05:30

Has your desire for sex tanked?
Have you stopped fantasizing, having erotic thoughts?
Do you no longer feel aroused and excited during sex?
Are you actually having pain during intercourse?
Worst of all, do you think: "It's all my fault?"
If you answered "yes" to any of these questions, you are not unlike the scores of women who flock to Drs. Jennifer and Laura Berman's clinic in Los Angeles in search of solutions to their sexual problems. The Berman sisters are leading experts in sexual health and well-being.

Happily, the Bermans' patients usually find both psychological relief and a course of treatment that works. You can too, because chances are that your sexual problems are "not in your head," say the Bermans, but rooted in one or more of four sexual disorders specific to women:

hypoactive sexual desire disorder
sexual arousal disorder
orgasmic disorder
sexual pain disorders

Female Sexual Dissatisfaction
Officially, these four conditions have been grouped under the label "female sexual dysfunction," but the Bermans prefer the term "female sexual dissatisfaction" (FSD). The last thing women need is another stigma "when so many of them suffer from these complaints," they write in their book, For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life.

Straight Talk About Sex
So let's talk straight about female sexual dissatisfaction with the goal of figuring out why your sex life may be less satisfying than you'd like—and exactly what you can do to improve it.

"Our goal," says Jennifer Berman, one of the few female urologists in the country, "is to heighten public awareness of female sexuality and sexual problems to provide not only information but resources for women, so they can seek help for their problems, if they exist, and to let them know there is help out there and that they're not alone."

hypoactive sexual desire disorder

2009-01-07T18:16:00.001+05:30

Learn more about the most common type of female sexual dysfunction, a hypoactive sexual desire disorder also known as HSDD. HSDD affects women's sexual desire and has many contributing factors that contribute to a woman's sexual dysfunction.
Hypoactive sexual desire disorder (HSDD) is the most common form of female sexual dissatisfaction (FSD) and occurs when there is a persistent lack of desire or absence of sexual fantasies. In other words, you're rarely in the mood; you neither initiate sex nor seek stimulation.

Lack of desire often occurs as a result of relationship conflicts, say Drs. Jennifer and Laura Berman, two of the nation's top experts on sexual health for women.

"Communications problems, anger, a lack of trust, a lack of connection and a lack of intimacy can all adversely affect a woman's sexual response and interest," they write in their book: For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life.

If this sounds like you, counseling and therapy with your partner is probably your No. 1 treatment option to overcome HSDD, the sisters say.

Medical Causes of HSDD
Obviously, lifestyle factors also influence the desire for sex. A single working mom who is overwhelmed by family needs may feel too exhausted to relax, kick back and fantasize about sex — let alone engage in it! However, sometimes a medical condition is the underlying cause of low libido, including:

Medication Use: Many commonly prescribed drugs, such as antihypertensives, antidepressants and birth control pills, interfere with sex drive, arousal and orgasm by affecting the balance of sexual hormones and the transmission of chemical messengers. For instance, antidepressants known as selective serotonin reuptake inhibitors combat depression by increasing the production of serotonin in the brain. Unfortunately, serotonin dampens sexual desire.
Menopause: The onset of menopause, either surgical or natural, is characterized by a gradual decline of the hormones estrogen, progesterone and testosterone. Reduced testosterone levels, in particular, say the Bermans, can lead to a "sudden or gradual" decline in libido. Ironically, the conventional hormone replacement regimen of estrogen and progesterone given to relieve menopausal symptoms can make matters worse, because estrogen increases a protein (called steroid hormone-binding globulin) in the blood that binds to testosterone, causing it to become less available to the body.
Hypoactive Sexual Desire Disorder (cont'd)

Depression: A common symptom of depression is diminished sex drive, which, in turn, can exacerbate depression. Studies indicate that 12 percent of all women will experience clinical depression at some point in their lives. As mentioned, one of the side effects of the popular antidepressants Prozac, Paxil and Zoloft is loss of libido. Dysthymia is a lower-grade form of depression that is not easily diagnosed because you can function with it, note the Bermans. A woman with dysthymia may feel isolated and overwhelmed and withdraw from sex and social activities.
Overcoming Libido Loss
If you're suffering from loss of libido and think there is a medical basis for your problem, here are some solutions to consider:

Talk to your doctor about testosterone, especially if you have had your ovaries removed, are taking estrogen or under severe stress. Get your testosterone level evaluated and if it is below 20 nanograms per deciliter, consider starting testosterone therapy. "To us, testosterone is so central to a woman's sexual function, that no lover and no amount of sexual stimulation can make up for its absence," write the Bermans, who report enormous success in treating low-libido patients with supplemental testosterone. Testosterone to treat FSD has not been approved by the FDA, notes Dr. Jennifer Berman, so you'll need to find a physician open to prescribing it to treat lack of sexual desire. If you are already on hormone replacement therapy for menopausal symptoms, ask your doctor to add testosterone to your regimen.
Switch to medications known to have less effect on sexual function or lower dosages. The antidepressants Prozac, Zoloft and Paxil, of which women are major consumers, cause loss of libido in as many as 60 percent of patients. "We generally switch to one that has less of a sexual side effect," like Celexa, Wellbutrin, BuSpar, Serzone or Effexor, says Jennifer.
Viagra, the little blue pill may help jump-start your sex life as long as "you have the desire to engage in sex and have been stimulated enough for it to take effect," say the Bermans. It's especially helpful if your lack of desire is related to hysterectomy or menopause. Physicians aren't exactly sure how Viagra helps rekindle lust — the Bermans are investigating how it works in their clinic — but they know it helps women achieve arousal, which is the phase that comes after desire, by increasing blood flow to the vagina, clitoris and labia.

sexual arousal disorder

2009-01-07T18:14:00.001+05:30

Think of sexual arousal as the second phase of lovemaking. First, you want to have sex and then, through foreplay and intimacy, you become aroused. But if your mind is saying "yes" and your body isn't listening, you could be suffering from sexual arousal disorder (SAD).
Medically speaking, SAD is defined as the persistent or recurring inability to maintain adequate genital lubrication, swelling or other responses, such as nipple sensitivity, during the excitement stage of sexual activity.

Vaginal lubrication is dependent on the swelling of blood vessels in the genital region, so any impediment to blood flow could potentially cause SAD, including:

Pelvic surgery like hysterectomy of which 600,000 are performed each year. Drs. Jennifer and Laura Berman report that the research on hysterectomy is contradictory: Some studies indicate sex improves after surgery, and some show negative results, such as decreased vaginal lubrication and a loss of genital sensation. Even if the surgery spares your ovaries, you can still experience these symptoms. The Bermans say removal of the cervix and injury to the nerves during surgery can severely compromise blood flow, thereby setting the stage for SAD.
Childbirth trauma (vaginal tearing) from suction or forceps sometimes causes nerve and vascular damage to the vagina, resulting in problems with vaginal and clitoral sensation. Decreased lubrication can also occur during breast-feeding; it is not uncommon in postpartum women due to an elevation of the hormone prolactin.
Blood flow diseases: Coronory heart disease, high blood pressure, diabetes, and high cholesterol all can impede blood flow to the pelvic region and reduce a woman's ability to become aroused. Ironically, some drugs used to treat high blood pressure, known as beta-blockers, actually cause sexual dysfunction; calcium channel blockers, also used in the treatment of heart disease, have become more popular, say the Bermans, because of their reduced impact on sexual function.
Hormonal changes: Fluctuations can be instigated by the onset of menopause, childbirth or medications. For instance, some women who take progestin-dominant birth control pills complain of a loss of libido and vaginal dryness. Medications to prevent recurrence of breast cancer, such as Tamoxifen, also can cause vaginal dryness. But by far, the most dramatic change is the drop in estrogen, which occurs with menopause and causes decreased vaginal lubrication as well as many other unpleasant symptoms.
Overcoming Sexual Arousal Disorder
Until the Bermans and other advocates of women's sexual health arrived on the scene, all women had to combat SAD were vaginal lubricants like KY-jelly, which eases symptoms but does not address the underlying problem.

Sexual Arousal Disorder (cont'd)

Now, clinical trials are underway to evaluate the efficacy of medications like Viagra to successfully treat SAD and some other types of female sexual dysfunction. The Bermans have worked tirelessly to help determine the best candidates for the trial.

Notes Dr. Jennifer Berman: "In the studies, probably 80 to 90 percent of women with arousal problems noted enhanced sensation, lubrication and engorgement" with Viagra.

Two Approaches to Sexual Arousal Disorder
Basically, there are two approaches to treating SAD: hormone replacement therapy (HRT) and increasing blood flow to the pelvic tissues.

HRT: Conventional hormone replacement therapy—estrogen combined with a synthetic version of the hormone progesterone—is typically used to treat decreased estrogen levels associated with dryness, thinning and irritation of the vagina. You don't have to take Premarin, the best-selling drug in the United States for estrogen; in fact, for SAD you may want an estradiol vaginal ring (Estring), which is placed in the vagina for 90 days at a time. Another local vaginal delivery system is Vagifem, a tablet that you insert into your vagina daily for two weeks, followed by twice a week thereafter. These two options are easiest to use and less messy than vaginal creams, note the Bermans.
Increasing blood flow:
To help increase blood flow and improve genital sensation, the Bermans often prescribe 2 percent testosterone cream, which you apply at least three times a week at bedtime to the clitoris and inner labia. (Libido problems associated with hypoactive sexual disorder are better treated with oral testosterone.) The Bermans also often recommend the prescription drug Viagra. Viagra helps to engorge the vagina with blood, causing it to become properly lubricated, much the same way it causes the blood vessels in a man's penis to become engorged, which produces an erection.
The Story of Lucy
In their book For Women Only: A Revolutionary Guide to Reclaiming Your Sex Life, the Bermans tell the story of Lucy, a 43-year-old mom with very low genital sensation and lubrication. The Bermans suspected that Lucy's vaginal nerves and arteries had been injured during her hysterectomy 13 years earlier. They prescribed Viagra and sexual counseling. With the help of Viagra, Lucy was able to experience powerful orgasms for the first time in years.

In addition to Viagra, there are number of other medications that enhance arousal by causing blood vessels to expand, thereby increasing blood flow to the genitals. You'll have to work closely with your doctor if you want to try any one of the following medical treatments. Currently, there is no FDA-approved pharmaceutical product for treating any form of female sexual dysfunction.

Phentolamine, marketed as Vasomax for men and Vasotem for women, has been shown to improve arousal, lubrication and sensation in post-menopausal women with SAD.
The Eros-CTD(clitoral therapy device): Approved in May 2000 by the FDA for treatment of FSD, the CTD is a small cup with a pump that fits over the clitoris. When it is turned on, a gentle vacuum is created, increasing blood flow to the genital area. The device is designed not unlike the penile pump that was created for men many years ago. Says Jennifer Berman: "It can be used as part of foreplay. It can be used on its own. It's recommended to be used as sort of an exercise to maintain the health of your genital area...It's sort of a variation of a vibrator." What's the advantage of the CTD over a stimulator or vibrator? The CTD is intended for women who typically have problems becoming sexually aroused with manual and/or vibratory stimulation. If you find that you can become aroused with other kinds of stimulation (e.g. manually or with a vibrator), then your arterial system is indeed functioning and enough blood is traveling to the genital area to create engorgement, lubrication, and sensation, and you probably don't need this device, says Jennifer.
Other Alternatives: The Bermans say results are promising for L-arginine, an amino acid sold in health food stores and yohimbe, a West African herb used for centuries to enhance libido. L-arginine is essential for the formation of nitric oxide, which relaxes smooth muscles and widens blood vessels, leading to better circulation. You can take L-arginine orally, and some companies offer nonprescription topical creams that, when applied to the clitoris, may increase blood flow by dilating clitoral blood vessels. The standard dose is 1,500 mg per day.
Given the size of the market, many new drugs are likely to emerge in coming years to treat SAD, hypoactive sexual disorder, orgasmic disorder and sexual pain disorder. The Bermans are keeping a watch on the development of topical genital creams based on prostaglandin E-I, a factor that helps enlarge blood vessels, and the drug apomorphine. A new tablet form of apomorphine is being developed by Tap Pharmaceuticals. It could be the first medication to target the brain for improved sexual arousal.

Female Orgasmic Disorder

2009-01-07T18:08:00.001+05:30

In the final phase of lovemaking — after desire and sufficient arousal — a woman often achieves orgasm. But a persistent delay in, or complete absence of, orgasm that causes the woman marked distress has been labeled "female orgasmic disorder" (FOD).
The condition can be primary, meaning that the woman has never reached an orgasm, or secondary — the woman can no longer achieve orgasm.

Primary FOD is the most challenging of all female sexual dissatisfactions to treat, says Jennifer Berman, M.D., a urologist and one of the nation's leading experts on sexual health.

Both primary and secondary FOD can be caused by:

Emotional trauma or sexual or physical abuse: There is no doubt that women with a history of abuse are at greater risk for all sorts of emotional and physical problems — especially depression and anxiety — that can ruin their sex lives. "Feelings of guilt, shame, anger, fear anxiety, and isolation" are quite common for these women, write the Bermans in their book, For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life. For some, the feelings manifest in an inability to be present or connected while making love. Other women report being on the verge of orgasm and then hitting a wall.
Medications and surgery can contribute to FOD: Excessive amounts of alcohol, drugs that reduce blood pressure, the class of antidepressants know as selective serotonin reuptake inhibitors (Prozac, Zoloft, Paxil) and anti-anxiety drugs like Xanax and sedatives such as Halcion can delay or impede orgasm. Severed pelvic nerves as a result of surgery can inhibit the engorgement of the genitals — a precondition for building to a climax.
Inadequate Sex: You simply can't talk about orgasm without mentioning sexual techniques. Making love is not something we are born knowing; we have to learn how to give and receive sexual stimulation and satisfaction. Due to a variety of reasons — cultural, religious and personal — some women are uncomfortable discussing and exploring the sexual techniques that might bring on or intensify an orgasm.
Pelvic floor prolapse: This condition occurs with the loosening of the muscles that support internal pelvic organs. Prolapse can result from childbirth, aging, surgery and spinal cord injury. Women suffering from prolapse often experience an urge to urinate and complain of pressure in the vagina or rectum, report the Bermans.
Overcoming Female Orgasmic Disorder
We are conditioned to believe in sex = intercourse = orgasm. Such high-pressure expectation alone can prevent orgasm from occurring. Furthermore, as the Bermans frequently acknowledge, there is much more to sex than orgasm.

Female Orgasmic Disorder (cont'd)

"For many couples, the intimacy, exploration, sensuality and connection of sex can be lost when it becomes goal-oriented, focusing on orgasm as the ultimate experience," they write. Nonetheless, there is no need to "grin and bear" sex without orgasm if you can do something about it. Possible solutions include:

Counseling: The Bermans prescribe counseling for victims of sexual abuse. The treatment process is long and arduous, but it can help an abused woman reclaim her sexuality. "The first step is acknowledging what happened, the second is acknowledging that it wasn't your fault and the third is purging the shame," they write. All three steps are crucial to recovery.
Changing meds: You may need to switch or even eliminate prescription drugs that have a negative impact on sexual function. Of course, you must work with your doctor before making any changes to your medication regimen. Depending on a woman's history, the Bermans generally advise taking antidepressants known to have less sexual side effects, including the medications marketed as Celexa, Wellbutrin, BuSpar, Serzone or Effexor. Sometimes, you can also change the way you take the drug to reduce side effects. For instance, there is now a version of Prozac that can be taken weekly instead of daily.
Communication: To have satisfying sex, you and your partner have to become experts in arousing each other, which requires honest communication. "Every woman is different," say the Bermans, and as such, it is every woman's "responsibility to tell a partner what she likes." If you feel uncomfortable talking about you want, the Bermans suggest introducing erotic books or videos to start the conversation. Stay on a positive track with statements like: "I would really love it if you would do more ________."
Kegel exercises: Toning your pelvic muscles with Kegel exercises can help you achieve more intense orgasms. To strengthen these muscles, start and stop your stream of urine several times. The Bermans recommend working up to five sets of 10 contractions a day. The longer you hold the contractions, the stronger your muscles will become. Think of all the fun you can have at boring meetings and standing in line at the grocery store!
Hormones: In their book, the Bermans describe a 38-year-old patient whose ability to reach orgasm improved after she began taking methyltestosterone, a synthetic form of testosterone sold by drug companies. The patient did not have any medical problems, but she did have very low levels of testosterone available for use by her body.
How do the Bermans comfort a woman who has never been able to have an orgasm? Because "there is no orgasm pill at this time," says Jennifer Berman, you have to be "sensitive and supportive and explain the limitations of what is available now. We also explain our working knowledge of anatomy and attempt to provide alternatives toward sexual fulfillment."

sexual pain disorders

2009-01-07T18:05:00.001+05:30

Perhaps the most extreme symptoms of female sexual dissatisfaction are those associated with sexual pain disorders. The two most common pain disorders, say Drs. Laura and Jennifer Berman, are:
Dyspareunia: recurrent or persistent genital pain related to attempted penetration during sex. The pain can be within the vagina or deep in the pelvis. Dyspareunia can emerge following a vaginal infection or vaginal and vulvular surgery, or result from vaginal thinning during menopause. Infections of the vagina, in particular, cause redness, itching, burning or stinging of the vulva — a condition known as vulvitis.
Vaginismus: recurrent or persistent involuntary contraction of the muscles of the outer one-third of the vagina that interferes with vaginal penetration.
A third subcategory of sexual pain disorder is genital pain caused by any type of sexual stimulation besides intercourse.

Treating Sexual Pain Disorders
"A lot of women experience pain for a variety of different reasons," says Jennifer, a urologist, who adds that — as with most female sexual dissatisfactions — the causes are often a blend of physical and emotional factors. When the problem is medical and can be identified, treatment tends to be fairly straightforward. Among the most common solutions:

Hormone replacement therapy (estrogen + progestin) to alleviate the vaginal dryness, thinning and urinary urgency that may cause dyspareunia. A vaginal estradiol ring (Estring) that delivers low-dose estrogen is an increasingly popular alternative to oral or transdermal estrogen, note the Bermans. If the woman is menopausal, the doctors have found that adding testosterone to the therapy provides additional benefits.
Antibiotics for vaginal or urinary tract infections due to yeast, bacteria or parasites. Once the painful symptoms of these conditions clear, dyspareunia goes away. Chronic bladder infections, also a cause of dyspareunia, do not respond to antibiotics.
Dilation Exercises: Commonly prescribed to treat vaginismus, these exercises involve stretching the opening of the vagina. The idea is to help the body accept penetration by conditioning the vagina muscles to relax. The exercise is done with manual objects like a finger, dilator or dildo. Once the woman can accept the object without pain, she can usually handle penile penetration.
Putting Sexual Dissatisfaction in Perspective
Desiring sex less often than your partner, failing to become excited, not achieving orgasm — all of these occurrences are perfectly normal. Daily stressors — financial concerns, demanding jobs, busy parenting schedules — can take a toll on our sex lives.
It's when the lack of or unsatisfying sex becomes the norm that we need to ask whether we could be suffering from one or more of the sexual disorders specific to women. And if we are, the physical or psychological causes or combination of both can be identified and successfully treated.

What Is Female Sexual Dysfunction?

2009-01-07T18:02:00.001+05:30

Female sexual dysfunction is a general term for anything "wrong" with a woman's sex life. It includes lack of libido (sex drive), problems having sexual intercourse and lack of orgasms.
It is very difficult to know what constitutes "normal" sexual function for women, which makes defining sexual dysfunction very difficult.

Here are some of the different manifestations of female sexual dysfunction, with some pointers on the possible causes and remedies.

Loss of Sex Drive
Possible causes include:

Relationship problems. If this is the case, you may find that you are attracted to others but not to your partner. If you can resolve the problems in your relationship, you may find the sexual side of things improves too.
Stress/anxiety. Reducing your stress levels may stop anxiety from interfering with your natural urges.
Depression. If you suffer from depression, you may well lose interest in all aspects of sex, as well as other things you used to enjoy. Consider talking to your doctor about whether you need counseling or antidepressants.
Having a baby. It's natural not to have sex for a few weeks after you have a baby. If your loss of sex drive persists, it may signal post-natal depression or a problem with your relationship.
Getting older. Age-related loss of sex drive tends to be gradual, although it may become more marked when you reach the menopause.
Contraception. Certain forms of contraception can reduce your sex drive—look in the booklet that comes with your tablets, or talk to your doctor.
Medications Some medicines, especially certain antidepressants, can reduce your sex drive.
Alcohol. It's well documented that alcohol can inhibit sexual response.
Pain with Intercourse
Possible causes include:
Lack of lubrication. This may be due to lack of arousal or lack of estrogen after the menopause, or while you are breastfeeding. It can be more marked at certain times of your cycle. It tends to make intercourse painful right from the start of penetration. Try and find out what the cause is, if possible. Otherwise try a lubricant—a water-based one if you're using a barrier method of contraception.
Vaginismus. This is a spasm of the muscles around the opening of the vagina that makes penetration pretty much impossible. It almost always has a psychological cause, and is more common if you have had major sexual trauma such as sexual abuse or rape. Get yourself referred to a sexual dysfunction clinic with your partner.
Vaginal infection. Common infections such as thrush can make intercourse painful all the way up your vagina. Other infections, such as pelvic inflammatory disease may cause deep pain, more marked in certain positions. If you are fairly sure you have thrush, buy treatment from your chemist. If not, consult your doctor.
Endometriosis. This can cause deep pain on intercourse as well as painful periods.
Painful episiotomy scar after childbirth. These scars are always painful at first, but the pain should settle within a couple of months. If it doesn't, talk to your doctor.
Lack of Orgasm
Not having an orgasm usually has a psychological cause, causing lack of arousal. This may be because of relationship problems; anxiety; past sexual trauma; deeply ingrained negative feelings about sex (such as being taught from an early age that sex is dirty); or inadequate stimulation from your partner.

Lack of orgasm may mean that you have never had an orgasm, or that you have never had one from penetrative sex but can masturbate to orgasm.

If lack of orgasm doesn't concern you, there is no reason to seek help. If it does, you may want to get help before it damages your relationship. There are plenty of self-help books around, but referral to a psychosexual clinic with your partner may be the best option.

Potency Assessment for Men

2009-01-07T17:58:00.001+05:30

Men, this five-question quiz will help you determine whether you should consult your doctor for erectile dysfunction, a condition in which you can't get or keep an erection long enough to have sexual intercourse.

1. How do you rate your confidence that you could get and keep an erection?
1: Very low
2: Low
3: Moderate
4: High
5: Very high
2. When you had erections with stimulation, how often were your erections hard enough for penetration (entering your partner)?
0: No sexual activity
1: Almost never or never
2: A few times (much less than half the time)
3: Sometimes (about half the time)
4: Most times (much more than half the time)
5: Almost always or always
3. During sexual intercourse, how often were you able to maintain your erection after you had penetrated (entered) your partner?
0: Did not attempt intercourse
1: Almost never or never
2: A few times (much less than half the time)
3: Sometimes (about half the time)
4: Most times (much more than half the time)
5: Almost always or always
4. During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?
0: Did not attempt intercourse
1: Extremely difficult
2: Very difficult
3: Difficult
4: Slightly difficult
5: Not difficult
5. When you attempted sexual intercourse, how often was it satisfactory for you?
0: Did not attempt intercourse
1: Almost never or never
2: A few times (much less than half the time)
3: Sometimes (about half the time)
4: Most times (much more than half the time)
5: Almost always or always

What’s your score?
Add the numbers associated with your five answers. If your score is 21 or lower, consider speaking with your doctor.

The Little Blue Pill ... Plus Other Impotence Options

2009-01-07T17:54:00.001+05:30

Their sex drive might hold steady, but as men get older, their erection is less likely to always rise to the occasion when called upon.

More than half of all men over 40 — an estimated 30 million American men — suffer to some extent from erectile dysfunction (ED), the consistent or recurrent inability to get or keep a penile erection sufficient for sexual intercourse. To determine whether you suffer from ED, see Sexual Health Inventory for Men.

The Food and Drug Administration has approved three drugs to bring on an erection when a man is sexually stimulated: Viagra, Levitra and Cialis.

Three in Stiff Competition
Viagra (generic name sildenafil) made its sexual splash in 1998 and has become popularly known as the "little blue pill." The first-ever erectile dysfunction drug and its 2003-approved competitor Levitra (vardenafil) take effect in about 30 minutes and can last about four and five hours, respectively.

A pill for impotence is a dream-come-true for so many men, says Irwin Goldstein, professor of urology and gynecology at Boston University School of Medicine's Institute for Sexual Medicine. "Through the millennia it has been man's dream: take a pill and get a better erection."

Cialis (tadalafil), approved like Levitra in 2003, stays in the bloodstream much longer than the others, between 24 and 36 hours. The makers call its longer-lasting effects a major advantage, touting the spontaneity factor that its shorter-window competitors don't allow.

Right for You?
Clinical studies have shown Viagra, Levitra and Cialis to be similar in effectiveness — about 75 percent of men can expect to be helped, by one estimate, though the drugs often fail to help those whose impotence is caused by prostatectomy surgery to remove all or part of their prostate. Viagra absorption may be slowed by consumption of food, especially fatty food.

Before taking any of these drugs, men should tell their doctor about:

Allergies to any drugs
Any medical conditions they have and medications they are taking, including prescription, nonprescription and dietary supplements. One drug of particular concern is nitroglycerin or a long-acting nitrate for angina (chest pain), which can cause dangerously low blood pressure in combination with Viagra or Levitra
Plans to have dental or any other kind of surgery
It's possible that all or none of these three options will work for a particular man. Side effects aren't common but can include headache, upset stomach, flushing, nasal congestion, back pain in the case of Cialis, and blue color-distorted vision from Viagra. Call your doctor for severe or long-lasting forms of these symptoms, or if you experience rash, painful erection, prolonged erection, fainting, chest pain, or itching or burning during urination.

The popular conception that Viagra-type drugs cause heart attack is not supported by the evidence. Older men suffering from impotence, though, may be susceptible to heart attack from physical activity — including sexual activity — that causes extra strain on the body.

Self-Test for Diagnosing Erectile Dysfunction

2009-01-07T17:49:00.001+05:30

Men, if you have problems getting an erection, the cause may not be a physical one, or due to any medication you may be taking; it could be psychological, particularly if you still have nighttime erections.

A good way to pin down the reason is to take a simple at-home test that involves the use of four to six postage stamps.

How To Do the Test
Pick three nights for the experiment when you can get uninterrupted sleep. (Don't drink alcohol or take a sleep-inducing medication for at least two days prior.)

Each night wear briefs to bed, bringing your penis through the fly with as little pubic hair as possible.

Wrap a strip of four to six stamps snugly around the shaft of your penis, overlapping the stamps and moistening the end of one to seal the ring.

Once the seal has dried, carefully re-place your penis inside the briefs, keeping the underwear on to protect the stamps from falling off.

Check in the morning: Has the stamp ring been broken at the perforations? (If you're awakened at night by the tearing of the stamps, check for an erection and how rigid it is.)

What the Stamp Test Tells You
For most people taking the test, the ring of stamps will be broken at the perforations at least one of the three nights, meaning that erection problems may have a psychological cause. If the stamps are not broken during the three nights of testing, the erection problem is more likely related to a physical condition or impotence-causing medication.

Tell your health professional — doctor or psychologist — about the results of your stamp test. It could be a helpful first clue in diagnosing and treating an erectile problem.

Sexual-Desire Skin Patch Looks Promising

2009-01-07T17:32:00.001+05:30

There's a patch to help people stop smoking on the market and one to prevent pregnancy, as well. But the patch to enhance a woman's sexual desire (Intrinsa) may not be approved anytime soon. An expert panel has recommended that the Food and Drug Administration wait for additional data proving the safety of this women's version of Viagra.

It's by clinical studies that experimental products such as the Intrinsa passion patch must prove their safety and effectiveness to earn the FDA's approval for marketing.

Female Aphrodisiac: Not Far Behind
One product is worth keeping a hopeful eye on, though it is still in preliminary trials: PT-141, a synthetic form of a brain hormone, which is right behind Intrinsa in the race to become the first bona fide female aphrodisiac. The drug, which is being studied, too, for use in men to promote erections, has completed its first-phase trials in women. So far, it has aroused female rats, causing them to chase after males to feed their spiked sexual appetite. Other products to promote sexual health are in various stages of clinical trials.

Other products to promote sexual health are in various stages of clinical trials. Showing promise against impotence:

Uprima. Two forms — a tablet dissolved under the tongue and a nasal spray — both stimulate the brain chemical dopamine to intensify sexual sensations. Clinical trials continue in the United States for this drug, already available in Europe, which has been associated with fainting in a small number of people who have taken it.
Topiglan. Topiglan, a version of the drug alprostadil that is already used in injection and suppository forms, is applied to the penis as a gel or cream and could become the first topical drug to treat erectile dysfunction.
Alibra. This version of alprostadil under review by the FDA contains a painkiller and is longer lasting than its approved predecessor.
And under study for women: Tibolone, already approved in Europe and Australia, may increase vaginal lubrication, arousal level and sexual desire. On the disappointing side, the makers of the male blockbuster drug Viagra recently gave up seeking approval of the drug for female sexual dysfunction because results weren't strong enough to prove it works in women.

Making Love Again: When a Medical Problem Imperils Your Sexual Life

2009-01-07T17:30:00.001+05:30

An interview with sexual survivors and authors Virginia and Keith Laken
"If a guy's impotent, he's powerless!" Keith Laken recalls his one-time mind-set in the book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy (Ant Hill Press, 2002), which he cowrote with his wife of more than three decades, Virginia.

After being diagnosed with prostate cancer in his 40s, Keith wrestled with the knowledge that the prostate surgery that could save his life could also deal a deathblow to his sex life as he knew it. Fearful, too, that the prostatectomy surgery and its side effects would lead to lost respect professionally, Keith was torn about whether to even go ahead with the procedure.

In Making Love Again, Keith and Virginia recount the story of their fight to regain physical intimacy after Keith chose to undergo radical prostatectomy. Discovery Health spoke with the Lakens about the sexual dysfunction that tested their relationship and about their multifaceted approach to restoring their treasured intimate bond, still standing strong as the Lakens approach the 10-year anniversary of Keith's surgery.

Q: Rather than risk impotence, Keith initially considered not having surgery at all for his prostate cancer: "If my choice is to live longer and be half a man, or to live a shorter life with all my capabilities, you'd better believe I'd rather live a shorter, more fulfilling life!" he said. Why did Keith feel at one point that sexual impotence translated into lack of power and fulfillment in life generally?

A: Keith:
I felt at the most basic level that I would not be able to perform sexually as a man and satisfy my partner. And, at the same time, I had risen in my job to a point where there were hundreds and hundreds of people depending on my ability to maintain leadership in the presence of an unknown future. Envisioning myself as a leader, I was concerned because the word impotence is almost always used in the public domain to describe someone who can't get the job done — like a lame duck politician — or as the brunt of a joke.
As a sexual partner on one hand and a person trying to be effective in my job on the other, I drew the conclusion that I would just as soon have a shorter life that has not been tampered with than a longer life in which I am no longer effective and am a prisoner in my own body.

Virginia:
I was the person who couldn't quite get this, how he would make the bargain for a shorter life as long as he felt more "empowered." Now, after hearing the same theme repeated over and over by many, many men, I'm certainly a believer.

--------------------------------------------------------------------------------

Q: You speak in the book of your "new rules of lovemaking" — what is your redefined approach to intimacy that saved your sexual life?

A: Keith:
Once I had this traumatic surgical intervention, there was a period of time spent establishing a new norm. It opened up our minds to redefining intimacy. Intimacy is what two people agree to do to provide pleasure to each other. That doesn't have to be penetration. Prior to the surgery, our sexual menu had several different facets — oral sex and other things — and we allowed ourselves to go back there again and find new degrees of satisfaction. It opened up a whole new world, and it's an ongoing, ever-changing process. I don't have an urgency now to arrive at orgasm, but instead I have an overriding desire to please my partner.
Virginia:
Keith and I have a very satisfying sexual relationship right now, but it was an evolutionary process for Keith. And I actually felt impotent for a while, when Keith rejected me and seemed to be no longer attracted to me. I had a sense of that feeling of powerlessness. People need to know that can be a temporary condition between partners.
I could live without having intercourse with Keith, but I couldn't live without having him touch me, hold me, caress me, hold my hand. That's what women are saying to their partners: "Yes, I need to be held." Many women will tell us that their partners are much better lovers now, when they take time and their goal is to give pleasure to their partner without rushing through or feeling pressure.

--------------------------------------------------------------------------------

Q: What restored a feeling of sexual wholeness after the physical and psychological traumas associated with your illness, and what do you want others who have been struggling with illness-associated sexual dysfunction to learn from your experience?

A: Keith:
In the process of life, the first thing we try to do is go back and get what we lost. Part of the process of healing is to reestablish a new baseline that defines what is meaningful to us.
At what point did I start feeling whole again? Probably about four to five years after surgery, I started feeling pretty comfortable with our relationship and our intimacy. I was no longer judging each contact relative to prior to the surgery. I stopped recording each intimate encounter on a Richter scale.

Our seminar is billed as hope for couples. Men have a sense of feeling inadequate, traumatized, injured and hurt. They think "she will expect more of me than I will be able to provide." When they transition to "this is about us as a couple, not me as an individual," it opens up communication and is a real breakthrough for them and their relationship.

Virginia:
In any change, we have to first mourn what we lost. I think we began the healing process the night we cried over the fact that we would never be the same as we were. We realized that people's physical intimacy is always becoming — it changes dramatically when a first baby comes, the second baby, a move, a job change, a death in the family. And the aging factor is a part of this that affects every couple.
Our definition of intimacy — giving pleasure to each other with our bodies in ways on which we both agree — allows the freedom to increase the pleasure within the physical limitations we have now.

Our message to people is, don't stop being intimate. Sometimes the medical community approaches sexual dysfunction purely as a physical dysfunction — for example, focusing only on helping the man achieve an erection. But to redefine a relationship, sometimes we need to take more initiative for our own health and look beyond medical procedures to the psychological. That may mean a couple needs to seek help from a person who deals specifically with sexual dysfunction, such as a sexual therapist.

Suffering From Sexual Dysfunction?

2009-01-07T17:27:00.001+05:30

Options That Are Out There for Men and for Women

Live long enough and your sex life is likely to be stalled by some dysfunction, but seek treatment and your odds are good — 70 percent, to put a number on it — to be restored to healthy sexual function, says Irwin Goldstein, M.D., professor of urology and gynecology with Boston University's Institute for Sexual Medicine. "Men and women who have sexual health concerns shouldn't need to live with them," Goldstein says. "If a sexual problem is causing distress, it's time to seek help."

Men's Multiple Options
The elusive erection is a top sexual trouble point for men. Popular options for impotence include:

PDE-5 Inhibitors. Popularly known as Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil), the phosphodiesterase-5 inhibitors are proven effective in promoting erection and restoring satisfactory intercourse. They support an erection by helping the arteries in the penis to dilate and blood flow to increase when a man is sexually stimulated. One of the three might work better for you, so see a doctor to discuss the best choice. (See "The Little Blue Pill ... Plus Other Impotence Options.")
Penile Self-Injection. Injection therapy with alprostadil (Caverject), papaverine, or alprostadil with papaverine and phentolamine (Tri-Mix) can take a penis from flaccid to full readiness within a few minutes by engorging the penis with blood. With proper training in use of the injecting syringe, the success rate is relatively high, but pain from the injections causes many men to stop using them. Other side effects are possible, including dangerous prolonged erection, known as priapism.
Vacuum-Assisted Erection Devices. The device, which uses vacuum pressure to draw blood to the penis and rings to help keep the blood there, can create erections in most men.
Options That Are Out There for Men and for Women

Live long enough and your sex life is likely to be stalled by some dysfunction, but seek treatment and your odds are good — 70 percent, to put a number on it — to be restored to healthy sexual function, says Irwin Goldstein, M.D., professor of urology and gynecology with Boston University's Institute for Sexual Medicine. "Men and women who have sexual health concerns shouldn't need to live with them," Goldstein says. "If a sexual problem is causing distress, it's time to seek help."

Men's Multiple Options
The elusive erection is a top sexual trouble point for men. Popular options for impotence include:

PDE-5 Inhibitors. Popularly known as Viagra (sildenafil), Levitra (vardenafil) and Cialis (tadalafil), the phosphodiesterase-5 inhibitors are proven effective in promoting erection and restoring satisfactory intercourse. They support an erection by helping the arteries in the penis to dilate and blood flow to increase when a man is sexually stimulated. One of the three might work better for you, so see a doctor to discuss the best choice. (See "The Little Blue Pill ... Plus Other Impotence Options.")
Penile Self-Injection. Injection therapy with alprostadil (Caverject), papaverine, or alprostadil with papaverine and phentolamine (Tri-Mix) can take a penis from flaccid to full readiness within a few minutes by engorging the penis with blood. With proper training in use of the injecting syringe, the success rate is relatively high, but pain from the injections causes many men to stop using them. Other side effects are possible, including dangerous prolonged erection, known as priapism.
Vacuum-Assisted Erection Devices. The device, which uses vacuum pressure to draw blood to the penis and rings to help keep the blood there, can create erections in most men.
(cont'd)

Premature ejaculation (the inability to wait with ejaculation for both partners' enjoyment) is another major troublemaker for men. In addition to the "squeeze technique" — in which pressure is applied to the penis, where the glans meets the shaft, on the brink of ejaculation — some drug therapies have been used successfully, such as:

Selective Serotonin Reuptake Inhibitor. This class of antidepressants is blamed for negative sexual side effects, but sometimes the problem can be turned into a positive by delaying ejaculation until it's desired.
Tricyclic antidepressant. The drug clomipramine has been shown to be effective in delaying ejaculation, but side effects including dry mouth can occur.
Ways to Treat Women's Dysfunction
Non-drug treatments are often effective for women suffering from sexual dysfunction. According to Alan Altman, M.D., author of UpToDate.com's "Treatment of Sexual Dysfunction in Women," these steps might return sex that's a pain into a pleasure again:

Have More Sex. "Use it or lose it" also applies to sex — with a partner or alone, sexual activity can increase blood flow and improve vaginal health.
Communicate Sexual Preferences. Respectfully communicating with your partner about personal sexual turn-ons and turn-offs can work wonders for mutual sexual satisfaction, as can changing up the routine once in awhile in terms of time, location or sexual position.
Add More Pre-Sex Stimulation. More stimulation by hand or mouth can help the female's sexual response (as well as helping with the male's erection). Ask your partner honestly if you want a greater fix of foreplay.
Make Healthy Lifestyle Adjustments. Stay hydrated, quit smoking, and undertake strength training and aerobic exercise to up stamina and improve sexual satisfaction.
Strengthen the Pelvis Floor Muscles. Vaginal weights, inserted and held in the vagina to improve muscle tone, can help some women with orgasmic disorders by helping awareness of sexual response and, in some women, stopping bothersome urine leakage during intercourse.
If focusing on psychological, intimacy and relationship issues isn't the hoped-for fix, medical treatment options are available to compensate for hormonal imbalances and increase genital blood flow. These include:

Artificial Lubrication. Over-the-counter vaginal lubricating creams, gels or suppositories, such as Replens, Astroglide or K-Y Jelly, may make sex more comfortable and enjoyable.
Topical Estrogens. Menopausal women who are uncomfortable during sex might want to try estrogen creams such as Estrace or Premarin or a vaginal insert such as Estring. Another option, the Vagifem vaginal tablet, can combat vaginal dryness.
Hormone Therapy. For menopausal women, an estrogen-progestin combination therapy or estrogen alone can improve clitoris sensitivity, ease pain from vaginal thinning and dryness, and improve blood flow. Hormone use should be carefully considered, though, according to the Food and Drug Administration (FDA), because of potentially increased risks for heart disease, stroke and breast cancer.
Androgen Therapy. Supplementation with the sex hormone androgen may help with sexual arousal. Testosterone, a type of androgen, is sometimes prescribed to counter reduced desire after hysterectomy, but it is unclear whether androgen supplementation can increase desire in all menopausal women. The risks from this type of therapy include increased facial hair, enlargement of the clitoris, and for the oral form, liver damage, blood cholesterol changes and acne.
DHEA. Dehydroepiandrosterone, produced by the adrenal glands, may benefit women with diminished sexual interest and arousal problems caused by low levels of naturally produced DHEA. The supplement form is available over the counter, but medical guidance is suggested based on its risks, such as acne, hair growth and possibly, according to the National Women's Health Resource Center, an increased risk of breast cancer.
Clitorial Therapy Device. The FDA-cleared Eros device for female sexual arousal disorder has a suction cup that is placed over the clitoris before sex, and a battery-operated vacuum pump that draws blood into the clitoris.
Think About Sex Therapy
If a man's impotence could be caused by performance anxiety or a woman's desire has dropped off without a physical explanation, sex therapy can sometimes work wonders. A common technique emphasizes sensate focus exercises — concentrating on the pleasure of touch with your partner without engaging in intercourse.

Your sexual relationship with your partner deserves work just like every other aspect of your life, emphasizes Barnaby Barratt, Ph.D., president of the American Association of Sex Educators, Counselors and Therapists. "In this culture, couples often assume that their sexual relationship should run by itself. But every couple needs to work on keeping their sexual life alive and well."

Are Supplements the Solution for a Sex Life Gone South?

2009-01-07T13:34:00.001+05:30

Men whose sex life has gone from gangbusters to game-over commonly turn to herbal supplements to find their erections again.

But what evidence exists that these "Viagra alternatives" will get you back in the game without risks to your health?

The fact is, it's largely "buyer beware" with therapies like these, which are not approved and are only loosely regulated by the Food and Drug Administration.

Even so, many healthcare providers believe they can help with sexual dysfunction. According to Marc Bonnard, M.D., author of The Viagra Alternative (Healing Arts Press, 1999), certain herbs may actually have an advantage over pharmaceutical alternatives. Writes Bonnard, a psychiatrist specializing in sex therapy: "Herbs work in a more leisurely fashion," replacing the mind-body balance that is "so important for a positive sexual experience."

Some alternative treatments may affect the physiological functions that contribute to sexual dysfunction, such as hormonal imbalances and slowed circulation. But take care when trying these supposed sex boosters — Bonnard, like other experts, emphasizes that even "all-natural" over-the-counter herbal products are potentially potent and can have toxic side effects.

The following are among the herbal ingredients in the most popular sexual supplements:

Damiana. Popular as an aphrodisiac in Mexico, the plant-derived leaves and stems are available in tablet form, or the dried leaves can be prepared in a tea. But, advise Mayo Clinic experts, know that the product has not been tested in humans.

DHEA (dehydroepiandrosterone). The hormone produced by the adrenal glands is necessary for the production of testosterone as well as estrogen. Some small scientific studies have shown promise in helping men with low testosterone, but only a small minority of impotence problems can be blamed on low levels of the hormone.
Are Supplements the Solution? (cont'd)

Ginkgo. Bonnard's point: Ginkgo seeds and leaves can get a rise out of many men by getting "the blood flowing to the right spots." The Mayo Clinic's counterpoint: No solid evidence exists to indicate that ginkgo is an effective impotence remedy. Both camps agree that in some cases ginkgo can be dangerous. Because it can affect blood clotting, supplements containing ginkgo should be avoided by people taking prescription blood thinners.

Ginseng. Found as a dried root and available in a powder or liquid form, ginseng can also be prepared as a tea to be sipped slowly. The aromatic root is used as an aphrodisiac in Asia and has been shown to have some energy-boosting properties, but it is unknown whether impotence is directly affected by the herb.

Kava. It could be the root's mood-altering effects that help to resolve sexual troubles, such as low libido, caused by tension and anxiety. Kava probably won't do the trick for cases of "true ED," Bonnard says.

L-Arginine. This amino acid found naturally in fish, peanuts and beans increases the amounts of nitric oxide in the bloodstream, which increases blood flow. Because an erection requires blood flow to the penis, L-arginine should theoretically work against impotence, but little scientific research has been undertaken, according to the Mayo Clinic.

Maca Root. Though not tested in humans, the Peruvian herb has been shown to improve the penis power in male lab rats. And some men swear it has jump-started their sexual systems.

Muira Puama. Many Brazilians rely on the bush extract as an aphrodisiac — "potency wood" and "tree of verility" are among its nicknames — and some studies have suggested it can bring a man's member to life. Beware its side effects: Chills and allergies are among the most common ones.

Yohimbe. The yohimbe evergreen tree's dried bark is used in herbal remedies, but the bark has been listed as an unsafe herb by the U.S. Department of Agriculture. The safer alternative: a strictly regulated prescription form of yohimbine, which is approved by the FDA as an impotence treatment.

What About Women?
There is no lack of over-the-counter alternatives sold as remedies for women's sexual complaints. What is lacking, in many cases, is scientific evidence to support the sex-saving claims. None of the herbal products promoted for female sexual dysfunction — not ginkgo, kava, saw palmetto — has been scientifically proven, so an approved drug prescribed by your doctor is usually the better bet.

A recent University of Pennsylvania School of Medicine study in a very narrowly defined population of women — those whose adrenal gland had been removed or was not functioning properly — showed that DHEA therapy can improve sexual quality of life (and learning efficiency and general feeling of health, as well). But the study found, too, that too much DHEA could be dangerous and possibly fatal in some older women.

There are external over-the-counter products that can make sex more pleasurable. A simple solution for many women who have lost that lubricated feeling as they have aged: a drugstore lubricant such as K-Y Jelly or Astroglide.

The Real Risks
Risks can be high from so-called alternative therapies because dietary supplements and other such non-drug remedies (technically, those that don't claim to affect "the structure or function" of the body) can be sold without being approved by the Food and Drug Administration based on safety and effectiveness. Recently, the two dietary supplement products Vinarol and Viga tablets, promoted for enhancing sexual desire and improving performance, had to be recalled because they could pose life-threatening health risks to some consumers. To minimize risks, purchase supplements from a reliable outlet and take them according to labeled directions, including recommended doses. To stay safest while trying these types of treatments, work with a doctor to choose the best ones for you.

Sufficient sleep, meditation and yoga are some risk-free recommendations for "balancing your life" and fighting back against sexual problems such as low libido, says integrative medicine physician Janine Blackman, M.D., Ph.D. Based on common sense—no clinical studies needed—the doctor with University of Maryland's Center for Integrative Medicine recommends a holistic mind-body approach for anyone trying to resuscitate a sinking sex life.

(STDs)

2009-01-07T13:31:00.001+05:30

While it is normal and healthy for people to enjoy active sex lives, it is important to realize that there are more than 30 sexually transmitted diseases that have the potential to turn sexual contact into an unpleasant, and in some cases deadly, activity.
Many people, when they think of STDs, think of AIDS (acquired immunodeficiency syndrome), a presently incurable disease, first identified in 1981.

Currently there is no medical treatment to prevent the spread of the AIDS virus. There are effective treatments for reducing the severity of some AIDS symptoms and for preventing or treating the opportunistic infections which occur when the body's normal immune system is compromised as a result of the AIDS virus.

Millions Affected by STDs
Some of the other STDs that effect millions of people around the world each year include chancroid, chlamydia, genital pediculosis, gonorrhea, hepatitis B, herpes, syphilis, trichomoniasis, and venereal warts.

Although contracting one of these diseases is not as life threatening as contracting AIDS, the impact they can have on your lifestyle, relationships, and psychological well-being is enormous.

All STDs are contracted by having sexual contact with someone, who in many cases may be unaware that they are carrying a sexually transmittable disease.

Practicing Safe Sex
Practicing safe sex is the single most important step anyone can take to prevent contracting or spreading STDs. However, there are no 'safe sex' methods that are 100 percent effective.The only 100 percent 'safe sex' method is sexual abstinence!

'Safer sex' methods can, however, prevent or lower the risk of contracting an STD infection, including AIDS. These methods include masturbation of yourself or your partner without exchanging semen or vaginal fluids. Touching and kissing of nipples, back, feet, hands, legs, face and ears can be a safe and enjoyable intimate experience.

Any vaginal or rectal intercourse should occur only with the use of a latex condom. Safer oral sex should include the use of a condom, or dental dam. Fingering of the penis, vagina, or anus is safest from risk of STDs when using a condom, dam, or finger cot.

With the exception of AIDS and Hepatitis B, STDs can usually be treated easily if diagnosed early. Therefore, it is imperative that anyone who thinks they may have been exposed to someone with an STD contact a health professional immediately for diagnosis and treatment. Women could see their gynecologist and men their urologist or their primary care physician or nurse practitioner. Dermatologists are also adept at identifying and treating STDs, since many of the symptoms include skin lesions, rashes, and warts.

safer sex

2009-01-07T13:29:00.001+05:30

Overview
Safer sex practices are sexual practices that lower (but do not completely reduce) the risk of catching or giving a sexually transmitted infection (STI), sexually transmitted disease (STD) or becoming pregnant.

What is the information for this topic?
Sex is designed to be an enjoyable, life-enhancing experience. Everyone must recognize, though, that many sexual activities carry potential consequences, such as:

• unwanted pregnancy
• STDs
• emotional and psychological trauma

Abstinence for sexual activity is the only sure way to prevent pregnancy, STIs and STDs. Some sexual activities are much safer than others, though. These include:

• hugging
• kissing
• touching
• holding hands
• intimate conversations

Other types of sex are more risky. Touching the genitals of another person, mutual masturbation, and vaginal, anal or oral sex are all sexual activities that can spread viruses, bacteria and parasites present on the skin, in the genital hair or in bodily fluids.

Some activities may cause tiny tears in genital or rectal tissues. This allows bacteria and other organisms to penetrate the skin and cause infections.

Pregnancy is a consequence, too, of heterosexual intercourse—whether protected or unprotected.

According to the CDC, practicing safer sex by using a male latex condom 100% of the time, can lessen, but not eliminate the risk of getting an STI, such as:

• herpes
• chlamydia
• gonorrhea
• syphilis
• chancroid
• human immunodeficiency virus (HIV), the virus that causes AIDS
• trichomoniasis

There is no evidence that practicing safer sex can lessen the risk of getting:

• hepatitis B,
• pelvic inflammatory disease (PID),
• pubic lice,
• scabies, or
• human papilloma virus, also known as HPV or genital warts. Some types of HPV increase a woman's risk of cervical cancer or precancerous changes of the cervix, called cervical dysplasia. Even so, correct and consistent condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.

So, safer sex only reduces and does not eliminate the risk of STIs and STDs. For example, the CDC reports that condoms can reduce the risk of contracting HIV by 85%, but only if correctly and consistently used. Unfortunately, this is less likely to be the case when teenagers or individuals who are high on drugs are involved.

Women who have unprotected sexual intercourse are more likely to have recurrent yeast infections. They are also at higher risk for bacterial vaginosis, which is an overgrowth of bacteria in the vagina.

Although unwanted pregnancies often can be prevented by using birth control with modern, natural family planning, hormonal birth control, cervical caps, intrauterine devices (IUDs) or diaphragms, none of these methods protects against STDs.

Latex and probably plastic male and female condoms provide some protection against some STD. But no condom can offer complete protection.

With male condoms, for example, skin surfaces like the scrotum and labia, or outer lips of the vagina may still touch. And any condom may break or slip during sexual activity.

To use a male condom correctly:

• Hold the condom at the tip to squeeze out air. Roll it all the way down to the base of the erect penis.
• After intercourse, withdraw while the penis is still erect. Hold onto the condom while doing so to prevent leaks.
• Use only water-based lubricants, such as K-Y Jelly, with latex condoms. Oil-based lubricants like petroleum jelly or solid vegetable shortenings can weaken these condoms and make them break.
• Refer to the manufacturer's instructions to use the female condom correctly.

Other important safer sex practices:

• Limit the number of sexual partners. Monogamy, or an exclusive one-to-one relationship with a noninfected partner for life, helps lower the risk of catching an STD.
• Do not have sex when either partner has sores on the penis or vulva, genital warts or unusual discharge.
• Avoid partners who use IV drugs or have had many other sexual partners, an STD, or unprotected homosexual intercourse.
• Do not mix sex with alcohol or illegal substances. Doing so lessens the ability to practice safer sex.
• Seek healthcare right away if an STD or exposure to an STD is suspected.

Do not hesitate to call a healthcare professional:

• if an STD or exposure to an STD is a possibility
• if unprotected sex occurred and pregnancy or an STD is suspected
• if sexual activity causes emotional or psychological stress

Premature Ejaculation (early discharge)

2009-01-07T13:19:00.001+05:30

What is Premature Ejaculation?

Premature ejaculation (also known as early discharge or quick orgasm, early fall, Shigra-patan) is one of the most frequent, of sexual disorders in the male and is characterized by sudden ejaculation of the semen, just prior to or immediately after vaginal penetration during intercourse (before one wishes or before he could satisfy the female partner). Approximately 10% to 30% people of all age group suffer with quick semen discharge. Premature or 'before time' in other words, is a condition where the man has no voluntary control over his ejaculation. He is quick on the trigger once he starts the coitus. This is a very frustrating disorders of male sexual function in which man feels totally helpless. This leads to bitterness in husbands & wife relationships. For the man, lack of control of his body functioning leaves him feeling unsure of himself. His pleasure is often decreased by the abrupt early discharge. Eventually his preoccupation with trying to postpone ejaculation will hinder his ability enjoy himself to sexual pleasure. When a man is, feeling inadequate, and ejaculating fast, the woman will probably be left unsatisfied. Her frustration will only increase the negative pattern. This is an easily treatable condition.

What is normal time of discharge: In one scientific study European males took approximately ten minutes in discharge whereas Americans took fourteen minutes in getting orgasm.

How common is pre mature ejaculation due to some well-defined internal causes?
Many of recent studies have proved that, most cases of quick ejaculation are Psychogenic is not correct (which was old belief). In one study by Schwartz & Pirke & colleague found that in many patient of pme male hormones were deranged. Similarly Colpi et all found that evoked sacral potentials & Bulbocavernosal reflex were hyper-excitable in many patients.
Thus psychogenic cause should never be labeled unless Hormonal & other causes have been excluded, by thorough examination, hormones & other tests as mentioned below.

Causes of Premature Ejaculation:

There are number of possible causes have been propounded about the causes of premature ejaculation.

(1) Hormone disorder
(2) Urogenital Infections
(3) Neurogenic causes
(4) Increased penile sensitivity to touch.
(5) Sex Centre disorder i.e. hyper excitability of sex centre
(6) Drug induced: many drug cause PME
(7) Psychogenic i.e. psychiatric illness

In following section we'll discuss these causes in detail:

(1) Hormone disorder: In recent studies it have been seen that many hormone disorder directly causes premature ejaculation. Additionally hormone disorder may cause other sexual dysfunction, which may secondarily cause early discharge. These hormones are important for normal control on your ejaculation.

(2) Deficiency of neuro-transmitters as serotonin & others have been found to be one of the significant causes of early semen fall.

(3) Urogenital Infections: Any infection of urethra, prostate, epidididymis, seminal vesicle, Orchitis, epididimo-orchitis etc. Leads to irritability of sacro-coccigeal nerves, which govern the function of all these sex organs. This irritability leads to lowers threshold for ejaculation. Thus infections are one of the significant causes of early orgasm.

(3) Neurogenic causes: Among nervous system disorder, any disorder involving sex centre area in brain as multiple sclerosis, hyper-excitable focus or any organic lesion will lead to very fast semen discharge. Any lesion of conus medullaris of spinal cord leads to premature ejaculation.

(4) Increased penile sensitivity to touch: In many patients there is excess of certain neurotransmitters in the penile skin which makes it highly erogenous at time of sexual excitation leading to reaching peak of excitation & climax fast. In various studies it has been found that bulbo-cvernous reflex is hyperactive.

(5) Psychogenic i.e. many psychiatric illnesses as anxiety, anxiety neurosis, schizophrenia, MDP etc. leads to early climax.

(6) Sex Centre disorder: There are certain conditions in which sex centre, which is situated in brain, becomes hyper excitable so that peak of orgasmic threshold reaches very quickly. This is a disorder of function, which occurs due to various reasons. Sex centre is a part of brain, which is situated in hippocampal part of forebrain. It controls the time taken for orgasm i.e. ejaculatory discharge during sexual activity. In early orgasm disorders the sex centre is extremely sensitive to sexual stimulation so that sex centre reaches peak of excitation with in few moments after penetration in vagina so that the orgasmic threshold reaches with in seconds of sexual intercourse or even before coitus. The causes of sex centre induced premature ejaculation can be divided into two groups: (1) immediate cause, and (2) remote cause. Such a classification is helpful in the treatment of fast climax. If the early discharge is due to immediate causes, a removal of these factors results in adequate sexual functioning. When premature ejaculation is due to remote causes, detailed sex therapy may be necessary for a more lasting cure. Sex centre also controls the other component of sex cycle namely desire & erection. Thus beside premature ejaculation, patient may also suffer with low desire or erectile dysfunction.

They could be physical body disorders as mentioned above or psychological. It is therefore necessary to rule out the internal organic causes first before commencing treatment. These causes are diagnosed by detailed history and a thorough physical check-up, sexual counseling including penile sensory tests for penile hypersensitivity, blood tests for biochemistry & various hormone tests, central nervous system tests should be done to rule out any internal causes, before starting treatment.

Thus premature ejaculation causes a man to focus more and more on his own sexual response pattern, thus getting away from the freedom and naturalness of allowing the response to occur by itself. As he concentrates on controlling his ejaculation, this concentration may begin to get in the way of maintaining the erection. This then can bring about the loss of erection. After some time this may even completely inhibit the erection from occurring. Often a problem that might begin with premature ejaculation gets joined to a problem of impotence, and then both issue have to be dealt with.

After a time the couple will begin to withdraw from each other, not wanting to enter an experience that is going to end up frustrating them. The man doubts his masculinity, and the wife later experiences a lessening of confidence in her, along with anger toward her partner. The anxiety about performing, and the tendency to move into the spectator role and watch how one is doing.

Diagnosis of Cause

1) We take detail history
2) Detailed general & systemic examination
3) Investigation & Diagnostic tests
For accurate diagnosis of the cause patient's blood is tested following tests:
Complete Male Hormone Profile tests
Biochemistry tests
Urine is tested for pus cells
Penile Nerve conduction tests & central nervous system is if required.
Scrotum, epididydmus, prostate is examined for infection.
Semen is examined for pus & semen culture sensitivity.
Ultrasonography of scrotum & prostate may be required.
Various antibodies are tested against relevant microbial agent
Detail sex counseling is done for knowing the cause of PME.

Treatment:

(1) Oral Medicines: After the finding out the cause of premature ejaculation. Various drugs to treat sex centre & other causes are prescribed along with sex therapy. These medicines are not costly & have no side effects & patient has to purchase from market. Response comes with in two week & patients are cured in two-month time. Medicines can be
a) Hormone pills when hormone disorder found
b) Medicines to cure the urogenital infections when infection as the cause confirmed
c) Neurotransmitter serotonin level increasing drugs as Anafranil, Paxil, prozac, & Zoloft, Luvox, Celexa, & others are used in those patients having low serotonin is very effective
d) Specific treatment of central nervous disorder need to be done when that is the cause.
e) Other medicines which h may be effective in selective patients are Propranolol & Alpha adrenergic blockers as phenoybenzamine, Alphuzosin, Terazosin, Tamsulosin

(2) INJECTION THEREPY: Rarely injection therapy is advised which is very effective in treating premature ejaculation. It is used only when oral drug therapy has failed. Sometime we also use it as temporary method to build confidence of those patients who are highly demoralized due to their previous failures. Patient is advised various Vasoactive injections by which penis becomes hard in three minutes & remains hard at least for 30 minutes thus almost all patient do the satisfactory sex with injection therapy without any fear. After few weeks of injection therapy & concurrent sex therapy patient develops capacity to control his ejaculation & he may stop injection after sometime.

3) TOPICAL THERAPY is effective but it is only a temporary treatment. By these creams sensitivity of penis to sexual excitation & time of discharge increases. It has no side effects.

4) Phytoterapy: extract of saliva haeamatodes & some other natural products are effective in pre mature ejaculation.

(2) Sex Therapy:
In sex therapy two exercises are taught to patient along with medicines. These are:
Stop-start technique
Kegel exercises
Squeeze Therapy
& certain behavioral therapy exercises

These sex therapy exercises when practiced by patient for four weeks then patient is able to sustain erection without ejaculation for at least 8 to 10 minutes. After the full course of treatment once you have reached the point where you can chose when you will ejaculate, you may find it helpful to continue using the sex therapy exercises on various occasions to help lengthen the lovemaking period. This would be particularly true if it has been some time since the last ejaculation, because then you are more likely to ejaculate more quickly. The use of this should be incorporated into love making and used at any point along the way for the rest of your life.

If premature ejaculation has evolved into impotence, then that should be given attention first. Then impotence must be treated before the premature ejaculation.

2009-01-07T12:15:00.001+05:30

Female Sex Fantasies Exposed

We've all been there – a gorgeous, scantilly-clad french maid walks into your hotel room and is immediately smitten. She pushes you to the bed and orders you to rip off her clothes. In your dreams, right? Ours too, but we're told it doesn't have to be that way. In fact, after a long conversation with the girls on the Debonair Sex Panel, we're practically convinced that girls have a more warped imagination than we do. So what exactly are women thinking of when you see them staring off into the distance at a café, stealing a glipse of you walking down the street?Dirty Talk Sarah, Sales Assistant in Midtown, 23 years old - "Dirty talk is best as a whisper in public – like if we're shopping or in a restaurant sometimes I'll lean in and say what I'm going to do to him when we get home or what I want him to do to me. Seeing how he reacts is fun, but what I really love is building up the anticipation all day. When we get home we practically attack each other we both want it so bad."
Emily, Store Manager in the East Village, 29 years old - "Getting really explicit and erotic is such a release – when you're in the middle of all that physical stimulation, talking dirty sets off fireworks in my head and gets me totally immersed in the moment." Bondage Laura, Paralegal in Midtown, 26 years old - "Being the 'good girl' gets old – sometimes I just want to leave that part of my personality on the floor and let my inner animal out. When he's clawing at me, spanking me, pulling my hair, it just unleashes a different kind of passion between us." Kim, Graduate Student in Tribeca, 25 years old - "Most guys I've been with expect to be in control when we hit the sack, but that's just not how I like it. There's nothing I like more than to tie him up, tease him, and dominate the night. He's definitely going to get what he wants, but I get the added rush of being in power – is this how men feel all the time? I could get used to it!"
Having a ThreesomeJulie, Stage Actress in Hell's Kitchen, 28 years old - "I've had one threesome in my life, where I was the other girl, and it was the most exciting thing I've ever done. I mean, it's such a different kind of sex – limbs everwhere, kissing, groping, having permission to be sexual with another women – it was just primal. I'm not sure I'd do it again because of the fallout afterwards, but that doesn't mean thinking about it doesn't get my juices going." Angela, Dancer in Greenwich Village, 26 years old - "Oh, threesomes, definitely, and the fact that my boyfriend has a whole mess of sexy, gorgeous friends just makes me think about it more! It's not really about just one way either; sometimes I like the idea of being overwhelmed and filled up, you know, a rough, used experience, but other times it's more about being pampered and lavished over – it's not just guys that like the idea of having more than one person to please them." Videotape Kayla, Set Designer in Times Square, 26 years old - "My boyfriend and I have made a few tapes, mostly on vacation actually, and we watch them to get in the mood, and keep it on while we have sex to keep things intense. When you make a tape you're always a bit more theatrical and in the mood to do stuff outside your comfort zone, so I like being able to relive that part of it." Adrianne, Marketing Manager in Soho, 29 years old - "I used to be pretty apprehesive about being taped, but as long as I get to keep the tape, I'm fine. Just having a camera running while you do it makes things more exciting because it feels like a performance, like there's someone watching you off in another room. [Laughs] When I end up as that person I love seeing what I can do to my partner and for the lonely nights it's so much better than what's on the internet. Know what I mean?" Role-playing Jane, Bartender in the East Village, 28 years old - "I've done all kinds of stuff, from teachers and school girls to the requisite french maid and nurse. I know it sounds silly to get into a costume for sex, but it's not just a costume, you know, it's getting to be a whole other person and imagine yourself in a spontaneous encounter. I'd never just jump a guy on the street, but I can imagine I would by playing dress up. [Laughs] And a side benefit is I guess I never have to worry about Halloween!"
AJ, Executive Assistant in Chelsea, 29 years old - "With role-playing you're just re-enacting bad porn films, but you know what? Bad porn films are kinda hot - at least I think so. I actually feel pretty silly doing it, but anything that makes you laugh during sex is usually a good thing. It's easy to get stuck in a rut with that part of the relationship, so being able to do something goofy while you're naked can do wonders to strengthen a relationship."

<<< BAACK

2009-01-07T12:12:00.001+05:30

Oral Sex Confessions

Oral Sex Confession
Ever wonder if you know what you're doing when you give a girl head? Sure she seems to enjoy it, but those tricky women are known for being convincing fakers. To put the insecurities to rest we called up our Debonair Sex Panel to ask a few dirty questions and see what women really want down there.

How often do you expect oral sex from your partner?
"At least everytime we have sex, so for us, that's like three or four times a week. Just getting head by itself is great too, but once we get into it we usually end up circling the bases." - Grace, Graduate Student on the Upper West Side, 26 years old
"Expect is such a dirty word, and not the good kind. But, that said, I think I'd be a little upset if it didn't happen at least once a week. That's usually not a problem for my boyfriend, who gives it to me about three times a week during foreplay." - Sarah, Sales Assistant in Midtown, 23 years old
"It really depends if they guy I happen to be seeing is any good at it. If he is, I tend to want it more often, so really everytime we have sex. If he's no good I suppose I should want to help him practice, but it's not as much fun so I don't care as much." - Kendra, Marketing Manager in Soho, 24 years old
"When I'm in a relationship, all the time - but I will say that I get a bit wary of a guy that wants to eat me out on the first sexual experience. I get the feeling he's got some strange fetish about it or something." - Nicci, Fashion Designer in Hell's Kitchen, 29 years old

Do you want oral sex as foreplay or as an event in itself?
"Well both, obviously, but it really helps warm things up for me, so it's definitely part of the foreplay routine." - Grace, Graduate Student on the Upper West Side, 26 years old
"Both. I can't finish with regular sex, so oral is the only way I can get off. Don't tell my boyfriend, but I'd be just fine if we just had oral sex." - Sarah, Sales Assistant in Midtown, 23 years old
"It's more a foreplay thing for us. Not surprisingly, he tends to put a little more effort into it when he knows we're going to have sex, so it just works better that way for me." - Nicci, Fashion Designer in Hell's Kitchen, 29 years old

What are the most overrated techniques?
"I know that everyone says to lick the alphabet, but for me it just doesn't cut it. I need a constant, slow rhythm to come and if his tongue is darting all over the place it just feels random and frustrating." - Kendra, Marketing Manager in Soho, 24 years old
"I can't believe guys believe that humming actually works. Uh, just so you know, there's a reason they call vibrators power tools and there's no way your tongue can compete." - Grace, Graduate Student on the Upper West Side, 26 years old
"It's not the technique most guys struggle with, it's that they need a map to find the clit. Once you get your tongue in the right spot, slow and steady flicks is all the information you really need to know." - Sarah, Sales Assistant in Midtown, 23 years old

Afterwards, do you make a guy wash out his mouth before he kisses you?
"I don't know if it's just me, but it's a really big turn-on to taste myself on my man's breath. With most guys they seem to expect that I won't like it, but for me, that's not true at all." - Sarah, Sales Assistant in Midtown, 23 years old
"Well, my boyfriend certainly doesn't want me to kiss him after I give him a blowjob, so it's basically inferred that he won't kiss me after giving me head. I've had other relationships where it happened though, and it wasn't a big deal. I wouldn't mind it if he did." - Kendra, Marketing Manager in Soho, 24 years old
"It's funny you ask because my girlfriends and I just talked about this – and I have to be honest, I don't really want to be kissed the second after he's done. I know some women enjoy it, and hey, I keep things very clean down there, but personally I don't like it." - Nicci, Fashion Designer in Hell's Kitchen, 29 years old
"Oral sex is the ultimate foreplay before sex and since I like to be kissed during sex and don't want to interrupt things by waiting for him to brush his teeth, I don't really see a way around it." - Grace, Graduate Student on the Upper West Side, 26 years old

Do you want your guy to finger you at the same time?
"Honestly, it's too much for me to have both at the same time, and it seems to distract him. I don't need both to get off, so I'd rather he didn't." - Kendra, Marketing Manager in Soho, 24 years old
"Sometimes, but usually not. It's too much stimulation and makes it harder to get off. I think my body gets confused." - Sarah, Sales Assistant in Midtown, 23 years old
"If a guy can slowly go in and out and hits the right place while stroking me gently with his tongue it can be really satisfying. In my experience though, most guys seem to think of it like a video game or have seen too much porn to do it that way. I'm just not in the mood to deal with it very often." - Nicci, Fashion Designer in Hell's Kitchen, 29 years old

<<< BACK

2009-01-07T12:06:00.001+05:30

9 Sex Moves Women Crave

We went to the streets of New York to interview young, sexy women about what they want from their men in bed. After many slaps (and a few phone numbers) we compiled the best nine tips to help our fellow mankind in the sack. Just remember guys, with great knowledge comes great responsibility.

A Little Kinky

Think all women want it nice and slow? Think again. These women want it hot and heavy on the kitchen table, the bedroom floor, or just about anywhere else you can send them over the edge. They like moves that show a guy's strong, masculine side, just look at the advice below:
Kendra, Marketing Manager in Soho, 24 years old - "I love it when a guy tosses me around a little. I mean, nothing crazy, but it's a huge turn-on to know he's strong and likes being the boss."
Nicci, Fashion Designer in Hell's Kitchen, 29 years old - "I'm a sucker for biting. Oh, and sucking is good too! (Laughs) A gentle bite me on the neck and I'm yours. I like it when a guy rolls with my reactions too, the anticipation makes my heart race when he makes his way to my ears, nipples, toes and anything else he finds appetizing!"
Kim, Investment Banker in the Financial District, 32 years old - "Think you're busy? I eat sissy analysts for lunch and I don't have time for your trial and error in bed. Want to know how to please me? Here it is - the difference between a boy and a man is a man knows how to make me come. If you want this to last more than tonight I orgasm first, then you - or together. Got it?"

The Pressure Cooker
New York women have their schedules packed, so when they finally have time for some all night sex, they want the ecstasy to last for hours. Don't move right in to the main event, tease them with foreplay and build the anticipation to the boiling point.
Julia, Freelance Graphic Designer in Greenwich Village, 30 years old - "That spot right between my middle and lower back, that's the jackpot. If you can work that, you're set. Lick me there, kiss me there or just move your whole body against it. And, you know, you're not too far away from my butt, so if you want to sneak a spank or two in there, go for it, just don't get distracted from the area I want you to focus on."
Sarah, Sales Assistant in Midtown, 23 years old - The back of my neck is magical. I like it massaged, kissed, and licked. Work the whole combination from my neck, down my shoulders and then my whole back. Tiny gentle kisses, (laughs) I'm giving myself goosebumps just thinking about it! I love a guy that can give me the chills with his kiss and his reaction to seeing me squirm and smile keeps things fun."
Grace, Graduate Student on the Upper West Side, 26 years old - "I don't need anything fancy from a guy - I just want a him to tease me a bit. Touch me, caress my body and slowly move to the sensitive points. Rub my legs, my stomach, kiss my legs up and down and plenty of attention to my inner thighs. I said slowly! I want a guy to spend time with my body, it makes me feel important - but after 30 minutes, if you're doing it right at least, I'll be more than ready to take it to the next step."

Back To Basics
Apparently men, we're not faring so well on some of the fundamentals - if a decade of mistakes from junior high to college graduation didn't teach you how to kiss or hold a girl, well, none of the tips above are going to save you. We didn't expect how much of a firestarter some of the straightforward moves can be - maybe there's not a big secret to great sex after all! AJ, Executive Assistant in Chelsea, 29 years old - "I love it when a guy uses his hands softly. Squeezing, grabbing, touching - it's all magnified 500 times if it's done softly and slowly. Turn off the lights, shut your mouth, and let your hands tell me everything you want."
Adina, Med Student in the East Village, 27 years old - "Great sex is about more than going in and out. Ever heard of um, a little foreplay? Chase me around, undress me slowly, find a creative use for your hands and stop repeating your old moves! I want to be surprised so get over your nervousness and don't afraid to be silly with me."
Jamie, Lawyer in Midtown, 32 years old - "Kissing is key. If he can't kiss, he probably can't do much else. Kiss all over my face, suck on my tongue, just keep it playful - when I guy spends alot of time kissing me I know he's completely into me, and that's the starting point for my inner-animal."

<<< BACK

9 Sex Moves Women Crave

2008-12-20T17:50:00.000+05:30

9 Sex Moves Women Crave

A Little Kinky

<<< back

2008-12-20T17:44:00.000+05:30

Oral Sex Confessions

<<< BACK

2008-12-20T17:29:00.000+05:30

Female Sex Fantasies Exposed

<<< BAACK

Dryness of Vagina During Intercourse

2008-12-14T15:59:00.000+05:30

Dryness of vagina during intercourse

The various causes of dryness of vagina during sexual intercourse are as follows:
Lack of enjoyment during intercourse

Dryness of vagina during coitus is also called female sexual excitation & arousal disorder, it is characterized by minimal vaginal lubrication or no lubrication et all during sexual excitation along with absence of feeling of excitation. In one study many women complained of lack of sexual arousal so that they get very little lubrication & vagina does not relaxes so that sexual intercourse is painful. In population many women complain of difficulty in getting excited. Many of such women complain of absence of orgasm & sex may be even be painful. It can be from beginning of sexual life or may start later in life. In some arousal may be absent with one partner whereas it is normal with other partner.

Causes of Dryness of vagina during coitus

(1) Hormones Disorder:
Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia,
Ovarian Dysfunctions
Hypothyroidisms
Untreated endocrinopathies & Diabetics
Glucorticoids excess, Cushings disease, Addisons disease

21) Excess asthenia i.e. chronic asthenia is a also a significant cause of low sexual excitation & arousal.

22) chronic vulvo-vaginitis, and chronic urethritis.

23) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.

24) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics, anti -hypertensives, many other drugs.

25) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.

26) Any kind of sexual dysfunction in man leading to non-enjoyment of sexual act by female may lead to absent arousal & excitement.
27) Any cause of painful sexual intercourse (as due to vaginismus or dyspaerunia) will also lead to secondary loss of excitation in women whether married or unmarried.

32.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication, pain during intercourse
25.) Infections: in genital tract or vulvae vestibule, vulvo-vaginitis
26.) Less lubrication due to various reasons as hormone deficiency

27.) Connective tissue diseases leading to dryness
28.) Psychological problems: as depression & other psychiatry disorders
29.) Sicca syndrome
30.) Idiopathic

33.) Any ulcerative lesions of vagina as chronic lichen planus, herpese genitals, Pemphigus vulgaris of vagina
34.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication, pain during intercourse
35.) Vulvar vestibulitis
36.) Restrictive upbringing, Inadequate sexual information, early insecurity in psychosexual role,
37.) Obstructive vaginal lesions: Vaginal stenosis, vaginal scarring, post surgical problems, retroverted uterus, organic diseases of uterus, endometriosis, adenomyosis, tubes or ovaries, chronic pelvic inflammatory diseases, urethral diverticulum
38.) Idiopathic vulvodynia

9) Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the desire of sex. Sex center has some well-defined portion, which control different component of normal sexuality These are as follows as one part of sex center controls sexual desire other parts controls excitation i.e. lubrication in response to sexual excitation, time taken in orgasm & enjoyment of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to dryness of vagina during intercourse
in response to sexual stimuli. This occurs due to arousal & excitation-controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient does not gets sexually excited. Beside absent excitation patient may be sexually otherwise be fit or may be suffering with some other sexual disorder.
The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of absent excitation. If the absent excitation & arousal is due to immediate causes, a removal of these factors results in adequate excitation & lubrication & enjoyment by women. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.

DIAGNOSIS OF CAUSE

First step in proper treatment of absence of sexual excitation & arousal is accurate diagnosis of cause of her absence of sexual excitation & arousal. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY:

Onset: We take detailed history, as for duration of absence of sexual excitation & arousal whether it is from the beginning or of recent onset, whether it is mild, moderate or severe. Then we decide whether it occurs all the time or only occasionally. How is the response of previous treatment? Response to previous therapy, pain during sex, Stress (physical or mental), History of precipitation by some drugs any past history of sexual abuse or painful sex.

EXAMINATION OF GENITALS:

We examine whether any Sexual Development defect is present or not. The vagina is examined for some local problem. If the vaginal examination is very painful with accompanied spasm is proof of the some local cause. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of vagina is assessed by, palpating texture of vaginal wall. Nerves supplying the female genitals examined by sensation testing & Deep Tendon reflexes.
Then other systems of body are also examined.

Diagnostic tests:At our centre we have all the facility for complete investigation of cause of dryness of vagina during intercourse& other difficulties. So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -

Complete sex hormones profile as Estradiol, SHBG etc.
Thyroids test
Serum prolactins
Androgen levels
Investigation for systemic diseases
Other tests which may be required depending on likelihood of the any of above causes.
Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, talking in detail resulting in detection of primary cause leading to absence of sexual excitation & arousal.
In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of absence of sexual excitation & arousal confirmed.

Treatment:

After the diagnosis of cause of dryness of vagina during intercourse
is made, treatment includes medicines to cure the basic cause.
(1) Hormone therapy:When female sex hormone deficiency is found or disorder of other glands the correction of hormone dysfunction is done. Hormone therapy is very effective in curing dryness of vagina during intercourse, when hormone is the cause for absence of sexual excitation & arousal. It is given in the form of oral tablets. Skin cream, local application of gels. These medicines are given in well tested prescribed doses as described in authentic textbooks. Some hormone precursors have also been used for increasing sexual excitation in many patients in whom no hormone disorder is found,

(3) Sex therapy is offered in which we teach the patient about the various techniques in such a way that it increase the enjoyment of body touch better excitation & arousal in female. This leads to good lubrication of vagina thus women enjoys the sex more pleasurable. Due to this more enjoyment of sex leads to women getting orgasm more often. All this improves the dryness of vagina during intercourse
as well as enjoyment of sex.
(4) Treatment of chronic asthenia is done by replacement of antiasthenic drug with good results.
(5) Treatment of Urogenital infection balanitis, prostatitis, and epididymitis gives immediate relief & very dramatic increase in sexual excitation & arousal.
(6) Stop Offending drugs which patients is consuming is identified after detailed history & drug challenge is discontinued with permanent cure of the absence of sexual excitation & arousal
(7) Treatment of psychiatric disorder are diagnosed & treated.
(8) Oral supplement of DHEAS is also effective.
(9) Treatment of sex center disorder: In cases of absence of sexual excitation & arousal due to sex center disorder there are many drugs, which improve the sexual excitation & arousal like hormone precursors, sex center stimulator drugs. These drugs act on sex center & correct the biochemical defect in sex center, leading return of the libido.

(10) Treat other systemic disease when they are detected.

Response of treatment:When treated is started after the diagnosis of cause. After appropriate drug therapy, sex education & sex therapy patient recover in two months time. The dryness of vagina during intercourse of patient recovers. After return of dryness of vagina during intercourse to normal her family relationship also normalizes.

Lack of Enjoyment During Intercourse

2008-12-14T15:56:00.000+05:30

Lack of Enjoyment During Intercourse

This is also called female arousal disorder, it is characterized by minimal vaginal lubrication or no lubrication et all during sexual excitation along with absence of feeling of excitation. In one study many women complained of lack of sexual arousal so that they get very little lubrication & vagina does not relaxes so that sexual intercourse is painful. In population many women complain of difficulty in getting excited. Many of such women complain of absence of orgasm & sex may be even be painful. It can be from beginning of sexual life or may start later in life. In some arousal may be absent with one partner whereas it is normal with other partner.

Causes of Lack of enjoyment during intercourse

(1) Hormones Disorder:

Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia,
Ovarian Dysfunctions
Hypothyroidisms
Untreated endocrinopathies & Diabetics
Glucorticoids excess, Cushings disease, Addisons disease

2) Excess asthenia i.e. chronic asthenia is a also a significant cause of low sexual excitation & arousal.

3) chronic vulvo-vaginitis, and chronic urethritis.

4) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.

5) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics,
anti-hypertensives, many other drugs.

6) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.

7) Any kind of sexual dysfunction in man leading to non-enjoyment of sexual act by female may lead to
absent arousal & excitement.

8) Any cause of painful sexual intercourse (as due to vaginismus or dyspaerunia) will also lead to secondary loss
of excitation in women whether married or unmarried.

9) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication,
pain during intercourse

10.) Infections: In genital tract or vulvae vestibule, vulvo-vaginitis

11.) Less lubrication due to various reasons as hormone deficiency

12.) Connective tissue diseases leading to dryness

13.) Psychological problems: as depression & other psychiatry disorders

14.) Sicca syndrome

15.) Idiopathic

16.) Any ulcerative lesions of vagina as chronic lichen planus, herpese genitals, Pemphigus vulgaris of vagina

17.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal
lubrication, pain during intercourse

18.) Vulvar vestibulitis

19.) Restrictive upbringing, Inadequate sexual information, early insecurity in psychosexual role.

20.) Obstructive vaginal lesions: Vaginal stenosis, vaginal scarring, post surgical problems, retroverted
uterus, organic diseases of uterus, endometriosis, adenomyosis, tubes or ovaries, chronic pelvic
inflammatory diseases, urethral diverticulum

21.) Idiopathic vulvodynia

Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the desire of sex. Sex center has some well-defined portion, which control different component of normal sexuality These are as follows as one part of sex center controls sexual desire other parts controls excitation i.e. lubrication in response to sexual excitation, time taken in orgasm & enjoyment of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to less excitation in response to sexual stimuli. This occurs due to arousal & excitation-controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient does not gets sexually excited. Beside absent excitation patient may be sexually otherwise be fit or may be suffering with some other sexual disorder.
The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of absent excitation. If the absent excitation & arousal is due to immediate causes, a removal of these factors results in adequate excitation & lubrication & enjoyment by women. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.

DIAGNOSIS OF CAUSE

First step in proper treatment of absence of sexual excitation & arousal is accurate diagnosis of cause of her absence of sexual excitation & arousal. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY

Onset: We take detailed history, as for duration of absence of sexual excitation & arousal whether it is from the beginning or of recent onset, whether it is mild, moderate or severe. Then we decide whether it occurs all the time or only occasionally. How is the response of previous treatment? Response to previous therapy, pain during sex, Stress (physical or mental), History of precipitation by some drugs any past history of sexual abuse or painful sex.

EXAMINATION OF GENITALS

We examine whether any Sexual Development defect is present or not. The vagina is examined for some local problem. If the vaginal examination is very painful with accompanied spasm is proof of the some local cause. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of vagina is assessed by, palpating texture of vaginal wall. Nerves supplying the female genitals examined by sensation testing & Deep Tendon reflexes.
Then other systems of body are also examined.

Diagnostic Tests:At our centre we have all the facility for complete investigation of cause of absence of sexual excitation & arousal & other difficulties. So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -

Complete sex hormones profile as Estradiol, SHBG etc.
1.Thyroids test
2.Serum prolactins
3.Androgen levels
4.Investigation for systemic diseases
5.Other tests which may be required depending on likelihood of the any of above causes.
6.Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, talking in detail resulting in detection of primary cause leading to absence of sexual excitation & arousal.
7.In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of absence of sexual excitation & arousal confirmed.

Treatment : After the diagnosis of cause of absence of sexual excitation & arousal is made, treatment includes medicines to cure the basic cause.

(1) Hormone Therapy :When female sex hormone deficiency is found or disorder of other glands the correction of hormone dysfunction is done. Hormone therapy is very effective in curing absence of sexual excitation & arousal, when hormone is the cause for absence of sexual excitation & arousal. It is given in the form of oral tablets. Skin cream, local application of gels. These medicines are given in well tested prescribed doses as described in authentic textbooks. Some hormone precursors have also been used for increasing sexual excitation in many patients in whom no hormone disorder is found.

(2) Sex therapy is offered in which we teach the patient about the various techniques in such a way that it increase the enjoyment of body touch better excitation & arousal in female. This leads to good lubrication of vagina thus women enjoys the sex more pleasurable. Due to this more enjoyment of sex leads to women getting orgasm more often. All this improves the desire of sex as well as enjoyment of sex.

(3) Treatment of chronic asthenia is done by replacement of antiasthenic drug with good results.

(4) Treatment of Urogenital infection balanitis, prostatitis, and epididymitis gives immediate relief & very dramatic increase in absence of sexual excitation & arousal.

(5) Stop Offending drugs which patients is consuming is identified after detailed history & drug challenge is discontinued with permanent cure of the absence of sexual excitation & arousal.

(6) Treatment of psychiatric disorder are diagnosed & treated.

(7) Oral supplement of DHEAS is also effective.

(8) Treatment of sex center disorder: In cases of absence of sexual excitation & arousal due to sex center disorder there are many drugs, which improve the sexual excitation & arousal like hormone precursors, sex center stimulator drugs. These drugs act on sex center & correct the biochemical defect in sex center, leading return of the sexual excitation & arousal.

(9) Treat other systemic disease when they are detected.

Response of Treatment : When treated is started after the diagnosis of cause. After appropriate drug therapy, sex education & sex therapy patient recover in two months time. The sexual excitation & arousal of patient recovers. After return of libido to normal her family relationship also normalizes.

Absent Orgasm

2008-12-14T15:37:00.000+05:30

Absent Orgasm

It is a condition in which women does not gets orgasm even after prolong sexual intercourse &when she gets orgasm after prolong sex then it is called inhibited orgasm. In some women even after normal sex desire, excitation & enjoyment, they do not achieve peak o sexual enjoyment i.e. orgasm. As against many women get multiple orgasm during same sexual act. Some women get orgasm during clitoral stimulation during manual stimulation or masturbation, but do not orgasm during vaginal sex. The orgasm is divided into clitoral orgasm & vaginal orgasm. In one study approximately 10% never experienced the orgasm in their lifetime & rest few percent women achieve the orgasm occasionally. The absence of orgasm is classified as either primary means she has never experienced the orgasm. Secondary or acquired anorgasmia is called when inhibited orgasm develops later in life. Due to absence of orgasm coitus is not very pleasurable for such ladies.
But luckily this problem is very easily amenable to treatment with newer drugs & advent of modern sex therapy techniques. It may be generalized i.e. absence orgasm with masturbation as well as no coital orgasm also. It can be situational also in which she gets orgasm with masturbation not during sex. In some women orgasm occurs only after very prolong stimulation to wife so that couple is always under pressure to achieve orgasm rather than enjoying the sexual act. This kind of inhibited orgasm is very frustrating for the couple

Absence of orgasm is most common sexual dysfunction in women whether married or unmarried.

Causes of Lack of Orgasm Are

(1) Hormones Disorder : Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia,
Ovarian Dysfunctions
Hypothyroidisms
Untreated endocrinopathies & Diabetics
Glucorticoids excess, Cushings disease, Addisons disease
2) Absence of proper excitation of G. spot by her partner
3) Weak P. C. Muscles
4) Wrong techniques of jerks & other sex techniques.
5) Due to fears due to various sexual myths
6) Any guilt or negative thinking about her sexuality
7) Excess asthenia i.e. chronic asthenia is a also a significant cause of absent orgasm.
8) Defect of spinal cord
9) After an abdominal or uterine disorder requiring surgical procedure
10) Any radiation exposure
11) Any major surgery on genitals
12) Multiple sclerosis

13)Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.
14) Due to Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and
anti-psychotics, anti -hypertensives, alprazolam, diazepam, many other drugs.
15) Due to Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.
16) Any kind of sexual dysfunction in man leading to non-enjoyment of sexual act by female may lead to low desire
in women.
17) Any cause of painful sexual intercourse (as due to vaginismus or dyspaerunia) will also lead to secondary loss of interest in sex in females whether married or unmarried.

Disorders of Sex Centre

n the brain there is a particular center in the hippocampus part of fore brain, which regulates the enjoyment achieved during sex. When this peak excitation reaches a particular threshold, the muscles around vagina starts contracting. This phenomenon is called orgasm. Sex center has some well-defined portion, which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls excitation i.e. lubrication in response to sexual excitation, time taken in orgasm & enjoyment of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to absent orgasm in females. This occurs due to orgasm controlling portions of sex center does not achieves the peak of sexual excitation & final orgasm so that in spite of \not having any physical or mental disorders the patient either does not getting orgasm or getting it after long delay. Beside absent orgasm patient may be sexually otherwise fit or patient may be suffering with low desire or some other sexual dysfunctions.

The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of decreased libido. If the loss of desire is due to immediate causes, a removal of these factors results in adequate sexual desire. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.

2) Sexual Performance anxiety means development of anxiety before sex. Patient develops obsessive concern for her orgasm i.e. whether or not She'll get orgasm. Due to this anxiety She tries to concentrate more on getting it & contracting the pelvic & leg muscles rather than allow it to occur in natural response to erotic pleasure. But unluckily most ladies do not know that orgasm occurs spontaneously & automatically in response to more & more enjoyment she gets in touching & loving by her partner. Thus the more she tries to get orgasm, but the just opposite happens i.e. she never gets it. Thus this anxiety to get orgasm every time where as it really further worsens the prospects of getting orgasm. This performance anxiety can be cured by sex therapy in few sittings.

3) Spectator Attitude: Those women who suffer with absent orgasm, whenever She goes for sexual activity though engaged love making, her brain is always thinking and involuntarily (unconsciously) trying hard to achieve the vaginal orgasm. This is called spying for her own orgasm. Thus her mind is always preoccupied about whether she'll get the orgasm or not. Thus in place of enjoying the sexual experience , She remains concerned for orgasm, thus sex centre does not reaches the peak & orgasm never occurs. She loses confidence in her capability to achieve the orgasm, and instead of relaxing & enjoying She starts watching her own sexual responses like 'spectators', rather than being involved in what is going on. So that in place of enjoying the partner's touch, She always keeps spying her own sexual response leading to lack of enjoyment of sexual activity thus\leading to repeated failures in getting orgasm.

These all above problems contributes to repeated absent orgasm. So that in all cases of absent orgasmic patients, after proper diagnosis & treatment of primary cause, these secondary problems also need to be tackled by sex therapy then only patient can get permanent cure. So by sex therapy, the patient is taught how to avoid spectator role and become free of performance anxiety.So these problems hinder her in getting orgasm
Thus the anxiety of failure into getting into orgasm and spectatoring (the patient watching all the time to see if She'll get orgasm or not) are also the important cause. After correcting these causes the normal orgasm starts occurring. If these factors are removed by sex therapy, orgasm starts occurring. The new, intensive team treatment of sexual dysfunction has revolutionized sex therapy. 'In most cases, for cure of absent orgasm detailed sex counseling & sex therapy is necessary.

DIAGNOSIS OF CAUSE

First step in proper treatment of low sex desire is accurate diagnosis of cause of her absent orgasm during sex. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY

For diagnosis of cause of absent orgasm, detailed history is taken. After which thorough physical examination is done for relevant causes.
Onset: We take detailed history, as for duration of absent or delayed orgasm whether it is from the beginning or of recent onset, whether it is mild, moderate or severe. Then we decide whether it occurs all the time or only occasionally. How is the response of previous treatment? Response to previous therapy, any pain during sex, Stress (physical or mental), History of precipitation by some drugs any past history of sexual abuse or painful sex.

EXAMINATION OF GENITALS:
We examine whether any Sexual Development defect is present or not. The vagina is examined for some local problem. If the vaginal examination is painful with accompanied spasm is proof of the some local cause. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of vagina is assessed by, palpating texture of vaginal wall. Nerves supplying the female genitals examined by sensation testing & Deep Tendon reflexes.
Then other systems of body are also examined.

Diagnostic Tests:
For diagnosis of cause of investigation following tests are required. These tests include
Complete sex hormones profile as Estradiol, SHBG etc.
Thyroids test
Serum prolactins
Androgen levels
Investigation for systemic diseases
Other tests which may be required depending on likelihood of the any of above causes.
Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, talking in detail resulting in detection of primary cause leading to low sex desire.
In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of absence of orgasm confirmed.

TREATMENT OF ABSENT ORGASM
Once the diagnosis of lack of orgasm is confirmed after detailed history, examination, relevant investigations, we start the treatment. It involves giving the sex therapy session, which is focused on eliminating the anxiety & spectatoring for achieving orgasm & hormone therapy or other treatment as indicated.
The various treatment options are:
1) Sex Therapy
2) Hormone Therapy
3) Treatment of any secondary cause found as infection, or local cause or any psychiatric disorder.
4) Sex Therapy: The various sex therapy is offered by sex therapist are structured directed sex therapy sessions leading to elimination of the anxiety that whether She'll achieve the orgasm or not & She becomes confident of her ability. By these exercises she starts getting orgasm regularly. Along with we tell the partner about the various sexually very sensitive areas of her body including G. spot, stimulating which in proper way makes women get a very intense orgasm. Then various vibrators are used which leads to quick discharge. Sex therapy begins with detail sex education about the anatomy of male & female genitals. Then we give the patients specific exercises, which, the couple has to do at their home. After every exercise session lady becomes more confident in her ability to achieve the orgasm. Along with these exercise various orgasmic tools are also used. With these exercises along with behavioral therapy, hypnotherapy, & couple's therapy leads to cure in approximately two months. Certain pelvic exercises also help in getting orgasm quickly. We teach patient how to eliminate excessive focusing on having an orgasm.
Even some women fake the orgasm to please her partner & hide her inadequacy.
4) Hormones Therapy: Hormones therapy is given to cure the hormone problem whenever hormone disorder is found. Estrogen treatment is given when deficiency of hormones are found. Hormones therapy helps n fast cure of this problem & do not have any adverse effects as they given to only those patients in whom some hormone disorder is found.
5) Other drugs found effective are anti-inflammatory, serotonin reuptake inhibitors etc are used when indicated.
Response of Treatment: As we have fully dedicated team of highly qualified, experienced, doctors, sex counselors, sex therapist, who are expert in the treatment of female sexual problems, we get cure in almost all cases. It is cured in most patients by two months treatment.

Low Sex Desire (Low Libido)

2008-12-14T15:34:00.000+05:30

The low sex desire is called when the desire for sex is lower than average. This decreased libido leads to un-satisfaction in opposite partner. Even the person who suffers with less i.e. diminished sexual desire & low frequency of sex suffers with various psychological depression disorders. Even the relation between the couples deteriorates.

Causes of Low libido i.e. diminished sex desire are: -

(1) Hormones Disorder:

(a) Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis)
Autoimmune hypophysitis, drug-induced hyperprolactinemia, untreated endocrinopathies, Diabetics Glucorticoid excess, Hypopituitarisms, Cushings disease, Addisons disease.
Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic
Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Following inflammation, Infiltrative or destructive processes (autoimmune, hemosiderosis),
Fertile eunuch syndrome, Idiopathic hypopituitarism,
(b) hypogonadism: testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy, Primary testicular defect-disorders of testicular differentiation or inborn errors of testosterone synthesis, Klinefelter syndrome, Other X polysomies (i.e. XXXXY, XXXY)
Rainbow syndrome
(d) Hypothyroidisms
(e) Untreated endocrinopathies & Diabetics
(f) Glucorticoids excess, Cushings disease, Addisons disease

2) Excess asthenia i.e. chronic asthenia is a also a significant cause of low sex desire.

3) Sickle cell disease, chronic cardiac disease, chronic renal disorder, chronic pulmonary dysfunction, chronic hepatic disease, Infections mono-nucleosis, hepatitis, chronic balanitis, chronic prostatitis, and chronic urethritis.

4) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.

5) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics, anti -hypertensives, many other drugs.

6) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.

6) Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the desire of sex. Sex center has some well-defined portion, which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls erection, time taken in orgasm enjoy of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to less desire. This occurs due to desire controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient desire for sex is low. Beside low sex desire patient may be sexually otherwise for or patient may be suffering with impotence, premature ejaculation.

The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of decreased libido. If the loss of desire is due to immediate causes, a removal of these factors results in adequate sexual desire. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.
It can cause less sexual desire alone or patient may have associated erectile disorder, premature ejaculation, or lack of enjoyment of sex.

Diagnostic Tests:

For diagnosis of cause of low libido (sex desire) detailed history is taken. After which thorough physical examination is done for relevant causes.
For diagnosis of cause of low libido following tests are required. These tests include
Complete male hormone profile (do not bold).

Thyroids test
Serum prolactin
SHBG
DHT Level
Investigation for systemic diseases
Other tests which may be required depending on likelihood of the any of above causes.

Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, trying to found out if there is any likelihood of sex centre disorder or other disorder as the cause of low sex desire.
In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of low sex desire confirmed.

Treatment:

Once the diagnosis of cause of low sex desire is made, treatment includes medicines & sex therapy sessions to cure the basic cause. The various treatments offered are:

(a) Hormone therapy:

Like in case of hormone deficiency or disorder of other glands the correction of hormone dysfunction is done. Hormone therapy is given in the form of oral tablets. Skin cream, gels or scrotal patches. These medicines are given in well tested prescribed doses as described in authentic textbooks. Some hormone precursors have also been used for increasing sex drive in many patients in whom no hormone disorder is found,

1) Male hormone testosterone replacement: The replacement of male hormone testosterone is one of the common treatments for decreased sex desire. The various preparation of testosterone is :

a) Oral preparation, which is available in capsule form. It needs to be given one to three capsules daily. These have no side effects.

b)Transdermal gel preparation are available which are applied on the any part of body once daily. This is absolutely safe with no side effects, economical & easy to use.

c)Tran dermal Testosterone given as scrotal patch. It is very effective & has no side effects.

i) Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective in curing low libido.
j) Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective for increasing penile size, & in cases of cure of breast development in boys.

k) Injection Testosterone esters: These include Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.

l) Long acting testosterone as testosterone bucilate given once in 4 months.

m) Testosterones implants are now available which once injected remain effective for up to six months.

n) New human androgen receptor modulators they increase the effect of male hormone over androgens.

2) Growths Hormones Therapy; is given when somatotropin deficiency is found.

3) IGF-1 therapy; is given when somatomedin c is subnormal.

4) DHT Therapy is given in many patients. It is very effective in most patients. This treatment is also effective in many patients when all above treatment has failed. The other good thing about this is that it is available as skin gel so taking this is simple & has no side effects. This treatment is very effective in those in whom male hormone is unable to work due to inability to generate the final end product for testosterone efficacy due to 5 alpha reductase defects. In such patient replacement of final target hormone is replaced leading to good sexual feelings & desire. In such situation even male hormone can be used in higher than usual doses leading to achievement normal sex desire.

5) Gonadotropin therapy is also very effective in normalizing low desire.Gonadotropin releasing hormone therapy is effective in many cases of low libido.

(b) Treat other systemic disease when they are detected.

(c) Treatment of chronic asthenia is done by replacement of antiasthenic drug with good results.

(d) Treatment of Urogenital infection balanitis, prostatitis, and epididymitis gives immediate relief & very dramatic increase in sex desire.

(e) Stop Offending drugs which patients is consuming is identified after detailed history & drug challenge is discontinued with permanent cure of the low libido disorder (f)Treatment of psychiatric disorder are diagnosed & treated.

(g)Treatment of sex center disorder: In cases of low libido due to sex center disorder there are many drugs, which improve the libido like hormone precursors, sex center stimulator drugs. These drugs act on sex center & correct the biochemical defect in sex center, leading return of the libido.

(h)Sex therapy is offered in which we teach the patient about the various techniques in such a way that it increase the enjoyment of body touch sex centre starts functioning normally & patient develops normal sex desire in addition males get better hardness of penis & sustained penile erection & takes longer time in discharge. All this improves the desire of sex as well as enjoyment of sex.

Response of treatment:

Person gets completely cured in two months time when treatment is started after the diagnosis of cause. After appropriate medicine therapy, sex education & sex therapy patient recover in two months time. The sexual desire of patient recovers. After return of libido to normal his family relationship also normalizes.

Side Effects:

The above mentioned drug treatment It has no side effects if given in proper disease and in-patients when it is really indicated. This it is absolutely safe when it is given by qualified doctor in proper doses.

Vaginismus ( Pain with spasm at time of entry)

2008-12-14T15:32:00.000+05:30

Vaginismus

In vaginismus involuntary painful contraction of vaginal entry muscles (i.e. vaginal opening) is so painful that entry is virtually impossible. So that due to spasm of introitus muscles there occurs virtual closure of the vaginal opening with significant pain. Vaginismus is one of the causes of Dyspareunia. This is one of the common cause of coital pain & even this one of the important cause for non-consummation of marriage. This can be classified as lifelong or situational. Similarly it may be classified as primary from beginning or secondary means started later in life. It is found in approximately one percent of women.
In some women there may be mild degree of vaginismus in which sexual intercourse is possible but with pain. In one study approximately 10% housewife had some degree of vaginismus pain.
In vaginismus pain felt by girl or female is so much that next time she starts avoiding the sexual contact of any kind because of fear that it will give her pain. Thus in most cases husband is unable to penetrate her successfully also called as non-consummation of marriage.
But the fore play & sexual desire excitation & lubrication may be absolutely normal in vaginismus women. In many women they do sex between their abducted thighies. With this technique even many vaginismic women may get enough arousal & even orgasm.
Due to any of the various below-mentioned causes the vaginal penetration or intercourse may be painful. This leads to development of a conditioned response in the body, so that the moment penis or even finger comes closure to vagina for penetration there occurs painful spasm of all the pelvic muscles at vaginal opening with associated fear of penetration. Thus nothing can enter. In future She starts avoiding sex.

The causes of vaginismus are

1)Disorder of sex centre: So that vagina & muscles around it goes into painful spasm at the point of penis entry rather than relaxing.
1.) It may also occur following any previous painful penetration of penis i.e. painful sexual intercourse or painful entry of some other object as painful examination of vagina by doctor with some instrument or by some traumatic experience in the past.
2.) Sexual aversion disorder & female sexual arousal disorder
3.) Hormone disorder:In which female hormones are less some other sex stimulating hormone are disturbed.
These hormone disorders may be due to any of the following causes:
Hypothalmic idiopathic hypogonadotropic hypogonadism,
Prolactinomas, Empty sella, Sheehan syndrome, Panhypopituitarism, Inflammatory /infiltrative
Ovarian lesions : Granulosa-theca cell, Brenner, mucinous/serous cystadenomas, Krukenberg. mumps oophoritis, Resistant ovary (Savage syndrome), Autoimmune disease
1.) Defect in uterus or vagina : Narrow vaginal openings or small vagina,Labial agglutination/fusion, transverse
vaginal septum, Complete androgen resistance (testicular feminization),
2.) Infections: in genital tract or vulvae vestibule, vulvo-vaginitis
3.) Less lubrication due to various reasons as hormone deficiency
4.) Connective tissue diseases leading to dryness
5.) Psychological problems: as depression & other psychiatry disorders
6.) Sicca syndrome
7.) Idiopathic
8.) Any ulcerative lesions of vagina as chronic lichen planus, herpese genitals, Pemphigus vulgaris of vagina
9.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication,
pain during intercourse
10.) Vulvar vestibulitis
11.) Restrictive upbringing, Inadequate sexual information, early insecurity in psychosexual role,
12.) Obstructive vaginal lesions: Vaginal stenosis, vaginal scarring, post surgical problems, retroverted uterus,
organic diseases of uterus, endometriosis, adenomyosis, tubes or ovaries, chronic pelvic inflammatory
diseases, urethral diverticulum
13.) Idiopathic vulvodynia

DIAGNOSIS OF CAUSE Of PAIN DURING SEX

First step in proper treatment of pain during sex is accurate diagnosis of cause of her pain during sex. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY

Onset: We take detailed history, as for quality of pain whether is at the introitus, superficial or deep inside, whether it is mild, moderate or severe pain. Then we decide whether it occurs all the time only during sexual activity. How is the response of previous treatment? Response to previous therapy, Libido, Stress (physical or mental), History of precipitation by some drugs any past history of sexual abuse or painful sex.

EXAMINATION OF GENITALS

We examine whether any Sexual Development defect is present or not. For this vaginal size is measured by vaginometer or Genitometer (if patient is outstation then by radiological tests). The vagina is examined for some local problem. In many cases vaginal examination may or may not elicit the spasm & pain. If the vaginal examination is very painful with accompanied spasm is another proof of the diagnosis as vaginismus. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of vagina is assessed, by assessing the texture of vaginal wall. Nerves supplying the female genitals examined by sensation testing & Deep Tendon reflexes.
Then other systems of body are also examined.

INVESTIGATIONS i.e. DIAGNOSTIC TESTS

At our centre we have all the facility for complete investigation of cause of pain during coitus & other difficulties. So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -
Step I : Hormone Testing: Various Female sex hormones & other associated Hormones are tested by latest-immunoassay techniques. These hormones includes total Estradiol, Estriol, Prolactin, LH, FSH, T3, T4, TSH others as Cortical, E2, Free testosterone SHBG etc. Among above tests relevant hormones are tested in that particular patient. Results are available in 36 hours. When we find out any of above hormones disorder correction of these hormone disorder helps a lot in eliminating pain.
Blood glucose & other relevant tests are also done.
Step II : ULTRASOUND SCANNING : Ultrasound scanning is done to decide whether any type of local problem is present or not, accordingly treatment is prescribed.
Step III :. SEX COUNSELING : After detail discussion with our female sex therapist, we try to finds out the root cause of pain problem then we treat accordingly. For counseling we take detail history of sexual development, her thoughts, her misconception about sex, her old experience in sex, her unconscious fears about sex. This counseling session unravels all the hidden psychological causes of sexual pain disorder.
Step IV : OTHER TESTS (If required)
1) Pelvic Nerve Testing: By conduction and sensory testing (NCV, EMG).
2) Psychoanalysis: To find different factor leading to psychogenic pain disorder.
3) Detailed Sex Counseling

TREATMENT OF VAGINISMUS

Once the diagnosis of vaginismus is confirmed after detailed history, examination, relevant investigations, we start the treatment. It involves giving the sex therapy session, which is focused on eliminating the painful vasospasm of pelvic muscles & associated fear of entry of penis into vagina.
The various treatment options are:
1) Sex Therapy
2) Hormone Therapy
3) Treatment of any secondary cause found as infection, or local cause or any psychiatric disorder.

1) Sex Therapy: The various sex therapy is offered by sex therapist leading to elimination of the pelvi-vaginal muscular spasm & fear of penis entering vagina. Sex therapy begins with detail sex education about the anatomy of male & female genitals. Then we give the patients specific exercises, which, the couple has to do at their home. After every exercise session fear of penetration decreases. Along with these exercise vaginal dilators of increasing sizes are given. These vaginal dilators, along with S focus exercise sex therapy is designed to gradually expose the women to vaginal penetration with increasing sizes. With these exercises along with behavioural therapy,hypnotherapy,& couple's therapy leads to cure in few months.
2) Anti-in-effective drugs: The anti-microbial treatment is indicated whenever the infection is found.
3) Hormones Therapy: Hormones therapy is given to cure the hormone problem whenever hormone disorder is found. Estrogen treatment is given when deficiency of hormones are found. Hormones therapy helps n fast cure of this problem & do not have any adverse effects as they given to only those patients in whom some hormone disorder is found.
4) Other drugs found effective are anti-inflammatory, serotonin reuptake inhibitors.

Pain During Intercourse (Dyspareunia)

2008-12-14T15:31:00.000+05:30

The causes of Pain during intercourse may be due to:

Dyspaerunia

Vaginismus

Dyspaerunia

The pain due to Dyspaerunia may occur repeatedly either before, during, or after sexual intercourse. It is one of the common problems in women. It can be primary or secondary, it may also be classified superficial or deep, or as diffuse with every partner or situational i.e. with particular partner. In one study approximately 9% women suffer with pain during sex. In many cases it disturbs the family life also. This vaginal/ genital pain may occur due to various below mentioned causes.

Causes may be:
1.) Hormone disorder: In which female hormones are less some other sex stimulating hormone are disturbed. These hormone disorders may be due to any of the following causes:
Hypothalmic idiopathic hypogonadotropic hypogonadism,
Prolactinomas, Empty sella, Sheehan syndrome, Panhypopituitarism, Inflammatory /infiltrative

Ovarian lesions : Granulosa-theca cell, Brenner, mucinous/serous cystadenomas, Krukenberg. mumps oophoritis, Resistant ovary (Savage syndrome), Autoimmune disease.

2.) Defect in uterus or vagina : Narrow vaginal openings or small vagina,Labial agglutination/fusion, transverse
vaginal septum, Complete androgen resistance (testicular feminization).

3.) Infections: in genital tract or vulvae vestibule, vulvo-vaginitis.

4.) Less lubrication due to various reasons as hormone deficiency.

5.) Vaginismus: i.e. painful involuntary contraction of vaginal introitus i.e. opening & vaginal all.

6.) Sexual aversion disorder

7.) Connective tissue diseases leading to dryness

8.) Psychological problems: as depression & other psychiatry disorders

9.) Sex centre disorders so that proper signal of sexual excitation does not comes from the sex centres so that pre
sex secretion does not occurs.

10.) Sicca syndrome

11.) Idiopathic

12.) Neoplasm's of vagina.

13.) Any ulcerative lesions of vagina as chronic lichen planus, herpese genitals.

14.) Pemphigus vulgaris of vagina.

15.) Decreased blood supply to vagina due to various medical conditions can lead to diminish vaginal lubrication,
pain during intercourse

16.) Vulvar vestibulitis.

17.) Restrictive upbringing, Inadequate sexual information, early insecurity in psychosexual role.

18.) Vaginal stenosis, vaginal scarring, post surgical problems, retroverted uterus, organic diseases of uterus,
endometriosis, adenomyosis, tubes or ovaries, chronic pelvic inflammatory diseases, urethral diverticulum

19.) Idiopathic vulvodynia.

20.) Atrophic vaginal mucosal atrophy.

21.) Sexual aversion disorder & female sexual arousal disorder

Primary Cause of pain during sexual intercourse: Due to any of the above causes patient may first time feel pain during sexual act. Once a women get pain due to any of the above causes as hormone disorder or decreased pelvic blood supply or any other cause virtually all woman develop following three things, these three factors further worsen the pain during sexual activity, and these are called secondary factors.

These secondary factors are as follows:

1) Fear of pain: In this the moment lady thinks of going for sex, She starts fearing that, I may get pain again thus she start getting anxious about pain during sex. This fear decreases her confidence leading to further worsening of the pain. Many times due to this fear patient starts avoiding sex & his desire for intercourse decreases.
2) Anxiety due to anticipation of pain: Woman develops severe anxiety before real sex. Patient develops obsessive concern for pain during sex i.e. whether or not She can do the sexual activity without pain & can keep his partner satisfied. This performance anxiety can be cured by sex therapy in few sittings.
3)So by sex therapy, the patient is taught how to avoid fearing and become free of fear of failure & performance anxiety.
4)So above secondary problems hinder into normal recovery of sexual function even if the original cause may have been cured.

After correcting primary cause also sometimes pain during se does not disappears, because these secondary factors interfere with normal sexual functioning. If these factors are also removed by sex therapy, sexual functioning soon becomes normal. The new, intensive team treatment of sexual dysfunction has revolutionized sex therapy. In most cases, for cure of pain during sexual intercourse detailed sex counseling & sex therapy is necessary.

DIAGNOSIS OF CAUSE Of PAIN DURING SEX

First step in proper treatment of pain during sex is accurate diagnosis of cause of her pain during sex. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination by female doctor, examination genitals. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY:

Onset: We take detailed history, as for quality of pain whether is at the introitus, superficial or deep inside, whether it is mild, moderate or severe pain. Then we decide whether it occurs all the time only during sexual activity. How is the response of previous treatment. Response to previous therapy, Libido, Stress (physical or mental), History of precipitation by some drugs.

Presence of hypertension, heart problems, claudication, trauma, diabetes, Secondary. Sexual Characters, Hypothyroidisms / Hyperthyroidisms & Galactorrhoeas, Symptoms of sensory loss.

EXAMINATION OF GENITALS:
We examine whether any Sexual Development defect is present or not. For this vaginal size is measured by vaginometer or Genitometer (if patient is outstation then by radiological tests). The vagina is examined for some local problem. Status of female hormone is assessed by examination of various estrogenic signs. Galactorrhoeas & features of other hormones disorders are checked up. Blood supply of penis is assessed by, palpating dorsal penile artery of penis. Nerves supplying the female genitals examined by sensation testing, Deep Tendon reflexes.
Then other systems are examined.

INVESTIGATIONS i.e. DIAGNOSTIC TESTS:
At our centre we have all the facility for complete investigation of cause of pain during coitus & other difficulties. So we perform following tests, step by step depending on their need based on history & examination.

The various diagnostic tests needed/performed are as follows: -
Step 1 - HORMONE TESTING
Various Female sex hormones & other associated Hormones are tested by latest-immunoassay techniques. These hormones includes total Estradiol, Estriol, Prolactin, LH, FSH, T3, T4, TSH others as Cortical, E2, Free testosterone SHBG etc. Among above tests relevant hormones are tested in that particular patient. Results are available in 36 hours. When we find out any of above hormones disorder simply correction of these hormone disorder corrects the pain problems in two months time. Blood glucose & other systemic tests are also done.

Step 2 - ULTRASOUND SCANNING
Ultrasound scanning is done to decide whether any type of local problem is present or not, accordingly treatment is prescribed.

Step 3 - SEX COUNSELING
After detail discussion with our female sex therapist, we try to finds out the root cause of pain problem then we treat accordingly. For counseling we take detail history of sexual development, her thoughts, her misconception about sex, her old experience in sex, her unconscious fears about sex. This counseling session unravels all the hidden psychological causes of sexual pain disorder.

Step 4 - OTHER TESTS (If required)
1) Pelvic Nerve Testing: By conduction and sensory testing (NCV, EMG).
2) Psychoanalysis: To find different factor leading to psychogenic pain disorder.
3) Detailed Sex Counseling

TREATMENT OF PAINFUL INTERCOURSE
After diagnosing the cause of pain during sexual intercourse, we prescribe medicines that patient has to purchase herself from any medical store & give the sex therapy session. The success of various drugs we use depends on accurate diagnosis of cause.

The various treatment options for patient with impotence are:
1) Hormone Therapy
2) Anti-in-effective drugs
3) Sex Therapy

Hormones Therapy:
Hormones therapy is given to cure the hormone problem.
1)Hormones Therapy: Estrogen treatment is given when deficiency of hormones are found. Hormone therapy usually cures the Hormone problem in 2 to 3 months time and they do not have any adverse effects as they given to only those patients in whom some hormone disorder is found.
2) Anti-in-effective drugs: The anti-microbial treatment is indicated whenever the infection is found.
3) Sex Therapy: The various sex therapy is offered by sex therapist leading to permanent sex therapy.
4) Other drugs found effective are anti-inflammatory, serotonin reuptake inhibitors.

Sexually Transmitted Diseases

2008-12-14T15:00:00.000+05:30

AIDS / HIV

The full form of AIDS is Acquired Immune Deficiency Syndrome, and the disease is caused by the human immune-deficiency virus, also known as HIV.

HIV virus attacks the body’s defence immune system.. Once it is inside the body, this virus invades the white blood cells, which normally fight off disease, then it multiplies and destroys them. It also breeds inside the brain. Three to four years normally elapse between infection with HIV and any subsequent development of the symptoms associated with AIDS.

AS AIDS develops the body's natural defenses become depleted, and the AIDS patient is increasingly likely to contract diseases that a healthy body would normally ward off, and so rare forms of cancer and pneumonia develop. Sometimes AIDS patients are attacked by several infections at once, such as Candida, herpes and TB. At the same time, the brain may succumb to increasingly severe dementia. Somewhere between one in ten and one in three of those infected with HIV are likely to develop AIDS. As yet there is no cure for AIDS. AIDS usually progresses through various infections and stages of increasing debility to the eventual death of the sufferer.

That crushes your immune power and leads to opportunistic diseases, like pneumonia, tuberculosis or Kaposi’s sarcoma, a rare from of cancer.
High-risk sex includes unprotected sex with strangers, sex with many partners, unprotected oral sex and just about any other activity where you swap bodily fluids.

Chlamydia

Chlamydia is a common STD all over world. It’s a bacterial infection.Symptoms consist of urethral discharge, a burning sensation during urination and, occasionally, swelling of the testicles. Complication of this can be epididymitis, and inflammation in the scrotum that may leave the man sterile.

Genital Warts

Warts are viral infection acquired during sexual intercourse.When the warts grow, they look like raised or flat bumps and are usually located along the penis or anal region.

Gonorrhea (Gonococcal Urethritis)

It is caused by the bacterium Nesseria gonorrhoea.
Symptoms include pus discharge from urethra, burning & pain during urination and sometimes swelling of the penile head. It spreads through sexual contact.

Herpes (Genital herpes)

The herpes virus is a very common sexually transmitted disease.
Symptoms are tingling and itching at the site of infection & a painful ulcer appears on penis at exposed area. After initial healing it may recur again.

Syphilis

Syphilis is a bacterial infection spreads through sex or kissing. Initial symptom is a firm nodule at penis followed by ulcer formation. It is of following types Primary syphilis Secondary Syphilis, Latent syphilis, Teritiary syphilis, Congenital syphilis, Endemic syphilis

Non-Specific urethritis or NSU (Non-gonococcal Urethritis) it also spreads through sex. There is discharge from the vagina or penis. It is caused by any of the following causative agent Chlamydia trachomatis, Ureaplasma urelyticum, Mycoplasma genitalium

Candioda species, Anaerobes, Trichomonas vaginalis, Herpes genitalis, Unidentified / idiopathic. Some times it may be Persistent/recurrent non-gonococcal urethritis or Prolonged urethritis.

Candidal Balanitis (Thrush) is a fungal infection that may also spread through sexual intercourse
Trichomoniasis is one of the most common STD having symtom similar to other kind of urethritis

Diagnostic tests
Urine may show threads or ‘beads of pus’ positive leycocyte esterase test.
Gram Stain
Culture
Molecular identification
Methelyne blue stain
Antigen detection techniques
Poly merase chain reaction
Trichomonas vaginalis
Fungi detection test
Herpes simplex virus antibodies
Anti-T. pallidum immunoglobulin M (IgM)
Veneral Disease Research Laboratory (VDRL)
T.pallidum haemagglutination assay (TPHA) enzymelinked immunosorbend essay
T. pallidum immoblization (TPI) test or fluroscent treponemal antibody absorption

TREATMENT of Various Sexually Transmitted Diseaes are:
Spectinomycin
Ceftriaxone
Co-trimoxazole
Doxycycline 100 mg
Amoxoxycillin
Ceftriaxone
Erythromycin
Azithromycin
Doxycycline
Ofloxacin
Penicillin
Doxycycline
Minocycline
Flurouracil
Podophylline

Weakness After Sex or Masturbation

2008-12-14T14:51:00.000+05:30

Weakness after sex or masturbation. (Post ejaculatory asthenia)

Many people feel weak, tired fatigued, tense, lack of memory after sex. This may occur in young boys after masturbation or after marriage after coitus. This disturbs the family life of couple.

The various causes of such problems are as follows:
1) Hormones disorders are one of the common causes of weakness after intercourse or masturbation. There are many male hormones in the body as serum testosterones, free testosterones, DHEAS, Androstenidiones, thyroids & other tests. So we have to test hormones to finds out hormones disorders. Once the diagnosis is made they are easily treatable in approximately two months time. Causes of hormone disorder may be Hypogonadisms (Testosterone deficiency), Hyperprolactinemias, Hypothyroidisms or Hyperthyroidisms, Cushing syndrome, Endocrines dysfunction Secondary to drugs/toxin & systemic diseases, Hypothalamic - pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Hypothalamic deficiency,drug-induced hyperprolactinemias, Untreated endocrinopathies , Diabetics , Glucorticoid excess, Hypopituitarisms, Addison disease. Isolated gonadotropin deficiency, Idiopathic hypopituitarism,

(A) Other Systemic diseases (liver disorder, renal disorder, cardiac disorder or other system disorder, hypocalcemia, osteomalacia, anemia, asthenia etc.)
(B) Drugs & Toxins various drugs cause weakness. So detailed drug history taking is must.
Antiandrogens (Spironolactone & Ketoconazole)
Antidepressants (Tricyclic antidepressants, Major Tranquillizers & Antipsychotics & Addictions of (Alcohol, Smoking, Heroine, methadone, Cannabis, opiates & marijuana)
2) Excess asthenia i.e. chronic asthenia is a also a significant cause of weakness after sex.
3) Sickle cell disease, chronic cardiac disease, chronic renal disorder, chronic pulmonary dysfunction, chronic hepatic disease, Infections mono-nucleosis, hepatitis, chronic balanitis, chronic prostatitis, and chronic urethritis.
4) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.
5) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics, anti -hypertensives, many other drugs.
6) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.
7) Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the feeling of freshness after sex . Sex center has some well-defined portion, which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls erection, time taken in orgasm, enjoyment of sexual act including enjoyment of orgasm & feeling of freshness energetic feeling after intercourse. So any disorder of sex center due to various causes can lead to weakness after sex. This occurs due to feeling of energetiveness after sex controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient feels weak after sex. Beside low & tired feeling after sex patient may be sexually otherwise fit.
(c) Psychogenic: Many psychiatric disorders as obsessive-compulsive disorder, Neurosis, schizophrenia, depression can cause weakness after sex
Treatment : after proper investigation & making diagnosis, it can be cured in two months time.

Watery Sticky Secretion From Penis

2008-12-14T14:50:00.000+05:30

Small Penis / Penis Enlargement

CAUSES OF STICKY WATERY SECRETION PROBLEM

There are many patients in whom whitish semen like or water like secretions are discharged from penis /urethraat time of thinking of sex,during foreplay or during urination or other time. This type complaint has been found in many boys or men. The various causes of such problems are:
1) Dhat secretion in urine
1.) Spermatorrhoea
2.) Retrograde Ejaculation: In this semen goes in bladder in place of, coming out through penile opening. The cause of retrograde ejaculation can be due to diabetics, some psychiatric drugs & pelvic surgeries. Thus for treatment the cause should be tried to find out by detail history, investigation. Once diagnosis is made treatment can be possible.
3.) Pyuria
4.) Crystalluria
5.) Leucocytouria
6.) Cowper's gland over activity / or infections
7.) Prostatitis
8.) Significant proteinuria
9.) Chylliuria
10.) Nephrotic syndrome
11.) Candidal balanitis
12.) Non gonococcal urethritis
13.) Idiopathic
14.) Venereophobia
15.) After play secretions

DIAGNOSIS OF CAUSE OF STICKY WATERY SECRETION PROBLEM

First step in proper treatment of watery like secretions from penis is accurate diagnosis of cause of his problem. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 24 hours. So if you are from out of Delhi, you may come here for two days for proper diagnosis of your problem.

DETAILED HISTORY

Onset: Sudden/gradual, Response to previous therapy, Libido, Stress (physical or mental), H/O precipitation by some infection or unprotected sexual intercourse, Sec. Sexual Characters, Other symptoms suggestive of any infections.

EXAMINATION OF GENITALS

We examine whether Sexual Development is adequate or subnormal. For this testis size is measured by orchidometer (if patient is outstation then by ultrasound of testis). Then other systems are examined. Signs of urinary tract infection, any sexually transmitted diseases are examined.

INVESTIGATIONS i.e. DIAGNOSTIC TESTS

At our centre we have all the facility for complete investigation of cause of difficulties & other sex problems. So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -
Biochemistry tests, phosphorus, Usg., C/S, & other relevant tests.

TREATMENT

After diagnosing the cause of watery like secretions we prescribe medicines that patient has to purchase himself from any medical store The success of various drugs we use in watery like secretions depends on accurate diagnosis of cause. If empirical treatment is prescribed as most doctors do, it often does not achieves permanent cure. These sex tonics & ayurvedic medicines can improve you watery like secretions temporarily but they cannot give permanent cure. Thus please get yourself fully investigated before starting treatment.

Response of Treatment: As we have fully dedicated team of highly qualified, experienced, doctors, who are expert in field of sexology. After finding the cause of watery like secretions by above tests it is cured in most patients by two months treatment.

Passing of Semen in Urine

2008-12-14T14:32:00.000+05:30

Night Falls / Nocturnal Emission
(Semen discharge during sleep).

We discuss in detail about the detail physiology and causes of night falls & what one should do for it.
Multiple growths on penis: which occurs on base of glans in one or two row. They are pearl like small asymptomatic growth. They can be due to warts, benign growths, & pearly penile papule. We diagnose the cause of such problems & then treat accordingly.
Semen passing in urine: The various causes of passing semen in urine is discussed & managed by us.
Swelling on penis after sex or masturbation: The various causes of swelling on penis is discussed & managed by us.
Burning in urine after sex: The various causes of burning in urine after sex is discussed & managed by us.
Ulcer on penis after sex: The various causes of Ulcer on penis after sex is discussed & managed by us.
Difficulty in pulling the foreskin over the glans when penis is full tight: The various causes of difficulty in pulling the foreskin over the glans when penis is full tight is discussed & managed by us.
Phimosis & paraphimosis: Difficulty in pulling the foreskin over the glans when penis is full tight is called Phimosis. When foreskin is pulled back but it is unable to go to it original position is called paraphimosis. T his sometimes produces a kind of constriction band over the glans penis leading t a kind of pressure band. This results into swelling of the glans penis. The various causes of Phimosis & paraphimosis is discussed & managed by us.
Pain in penis during or after sex: The various causes of Pain in penis during or after sex is discussed & managed by us.
Pain in testicles: The various causes of pain in testicles is discussed & managed by us.
Prominent blue veins on penis: The various causes of prominent blue veins on penis is discussed & managed by us.
Abnormal shape of penis like thin at one place & thick at other. The various causes of abnormal shape of penis like thin at one place & thick at other is discussed & managed by us.
Hidden penis: The various causes of hidden penis is discussed & managed by us.
Lifeless (like dead & soft) penis. The various causes of lifeless (like dead & soft) penis is discussed & managed by us. The various causes of prominent
Shrunken Penis: The various causes of shrunken Penis is discussed & managed by us.
(1) Loosely hanging scrotum/Loose scrotum: The various causes of loosely hanging scrotum/Loose scrotum is discussed & managed by us.
(2) Thin semen, yellow semen: The various causes of thin semen, yellow semen is discussed & managed by us.
(3) Pain in testis & scrotum: The various causes of pain in testis & scrotum is discussed & managed by us.
(4) Oral sex (Cunnilingus & Annilingus): The various aspects of Oral sex (Cunnilingus & Annilingus) is discussed.
(5) Knowledge about clitoris & its role in female sexual satisfaction is given by us.
(6) Discussion about normal anatomy, physiology of vulva, vagina, uterus is given by us.
(7) Discussion about frequency of intercourse & orgasm in female is given by us.
(8) Discussion about various postures & techniques of intercourse is told by us.
(9) Discussion about uses of sex toys.
(10) Discussion about fantasies during sexual intercourse.
(11) Other Sex related queries.

Dhat (whitish/semen like in urine)

2008-12-14T14:29:00.000+05:30

Dhat

There are many patients in whom whitish or yellow semen like or water like secretions are discharged in urine during defecation, urination or other time. This type complaint has been found in many boys or men. The various causes of such problems are:
1) Dhat secretion in urine
1.) Spermatorrhoea
2.) Retrograde Ejaculation: In this semen goes in bladder in place of, coming out through penile opening. The cause of retrograde ejaculation can be due to diabetics, some psychiatric drugs & pelvic surgeries. Thus for treatment the cause should be tried to find out by detail history, investigation. Once diagnosis is made treatment can be possible.
3.) Pyuria
4.) Crystalluria
5.) Leucocytouria
6.) Cowper's gland over activity / or infections
7.) Prostatitis
8.) Significant proteinuria
9.) Chylliuria
10.) Nephrotic syndrome
11.) Candidal balanitis
12.) Non gonococcal urethritis
13.) Idiopathic
14.) Venereophobia

DIAGNOSIS OF CAUSE OF DHAT PROBLEM:
First step in proper treatment of Dhat like secretions is accurate diagnosis of cause of his problem. So we first try to find out cause. We take detailed history, thorough sex counseling and physical examination. After that depending on likelihood of particular, cause relevant tests are done at our centre. Thus you may consult us at our centre & at same time you may get all test done also. The time taken in getting all the reports ready is 24 hours. So if you are from out of Delhi, you may come here for two days for proper diagnosis of your problem.

DETAILED HISTORY:
Onset: Sudden/gradual, Response to previous therapy, Libido, Stress (physical or mental), H/O precipitation by some infection or unprotected sexual intercourse, Sec. Sexual Characters, Other symptoms suggestive of any infections.

EXAMINATION OF GENITALS:
We examine whether Sexual Development is adequate or subnormal. For this testis size is measured by orchidometer (if patient is outstation then by ultrasound of testis). Then other systems are examined. Signs of urinary tract infection, any sexually transmitted diseases are examined.

INVESTIGATIONS i.e. DIAGNOSTIC TESTS:
At our centre we have all the facility for complete investigation of cause of Dhat problem . So we perform following tests, step by step depending on their need based on history & examination.
The various diagnostic tests needed/performed are as follows: -
Biochemistry tests, phosphorus, Usg., C/S, & other relevant tests.

TREATMENT:
After diagnosing the cause of Dhat like secretions we prescribe medicines that patient has to purchase himself from any medical store The success of various drugs we use in Dhat like secretions depends on accurate diagnosis of cause. If empirical treatment is prescribed as most doctors do, it often does not achieves permanent cure. These sex tonics & ayurvedic medicines can improve you Dhat like secretions temporarily but they cannot give permanent cure. Thus please get yourself fully investigated before starting treatment.
Response of Treatment: As we have fully dedicated team of highly qualified, experienced, doctors, who are expert in field of sexology. After finding the cause of Dhat like secretions by above tests it is cured in most patients by two months treatment.

Absent Ejaculation / Orgasm

2008-12-14T14:28:00.000+05:30

Absent ejaculation in which patient does not gets orgasm & semen discharge even after prolong sexual activity

3. Delayed ejaculation: In this disorder orgasm & semen discharge occurs after abnormally prolonged sexual activity.

4. Retrograde ejaculation: In which patient gets orgasm at normal time but semen in place of coming out through penile opening goes into bladder.

(4) Absent Ejaculation or Orgasm: There are certain conditions in which patient does not get orgasm even after prolonged sexual activity. the cause of this can be primary, Psychogenic or due to certain medication, neurological diseases, surgeries etc. Treatment needs diagnosis of cause & then treatment.

Delayed Ejaculation (Orgasm)

2008-12-14T14:26:00.000+05:30

There are certain conditions in which ejaculation occurs but it takes long time (delayed ejaculation). Retarded ejaculation is a disorder where the male wants to ejaculate but is unable to do so. It was believed to be a rare condition but we frequently come across patients suffering from this disorder. Sex therapists in USA and Europe have also noted an increase in its incidence. Individuals complaining of retarded ejaculation get aroused; have a normal erection, which persists, but cannot ejaculate in the vagina, though eagerly desiring orgasmic release. But sometimes they can easily ejaculate during masturbation or oral coitus with a partner. The causes of retarded ejaculation are some hormonal disorders, drugs, C.N.S. abnormalities & psychiatric illnesses.

In order to understand the paradox of a man being able to have a good erection without ejaculation, it is necessary to remember that the sexual response is biphasic. Erection is mediated by the parasympathetic division of the autonomic nervous system, while ejaculation is dependent on the sympathetic division of central nervous system.
The impotent male is unable to achieve an erection while the male with retarded ejaculation cannot come, although his erection is normal. In severe cases of retarded ejaculation, the extreme frustration of being unable to experience orgasm makes such men dislike intercourse and resort to masturbation alone for orgasmic release. One would think that the female partner would welcome the delayed orgasmic response of the male, but it is not so, she considers it a rejection of herself.

Homosexuality

2008-12-13T00:39:00.000+05:30

Homosexuality

A) Homosexual Male :

Homosexuals are those male who feel excited seeing & imagining about male body & like to make sexual relationship with male. The causes of homosexuality are mainly psychology development disorder in which boys are brought up by dominant mother or who are brought in company of females. Sometime it can be due to decreased male sex hormone.

Treatment : Those who are desirous of changing there sexual behavior they may some times become normal with sex therapy.

B) Homosexual Female : They are also called lesbian (lesbianism). Some times if they wish they may be cured with the help of sex therapy.

Inability to consummate after marriage

2008-12-13T00:36:00.000+05:30

Many couples are unable to do successful vaginal intercourse after marriage due to various reasons. The cause may be in man or women. Each of these below mentioned causes for non-consummation of marriage are investigated & treated scientifically.
Thus first of all you find out your likely cause then from home age read that disorder in detail i.e.
The male cause leading, to inability to vaginal penetration are as follows:

1) Erectile dysfunction: i.e. due to less penile hardness due to various causes.
I t may occur due to complete erectile failure: i.e. some men achieve no erection et all. For others, an erection may occur in the regular manner, but as the love play continues the erection is lost (we call it maintenance failure). For still others, the erection may be maintained very adequately up to the point of entry. As soon as entry is either contemplated or attempted, the erection disappears (this is called entry failure). For some, erection may be maintained beyond the point of entry, and then wanes after a period of activity inside the vagina (this is called mid-act failure). No matter when the erection goes away, its loss is always troublesome. Erectile dysfunctions though a benign disorder has a great impact on the affected individual. Patient feels frustrated, depressed, and ashamed, has lowered self-esteem & may even disturb his family relationship. There has been an explosion in the interest in male sexual dysfunction with the development in techniques of modern scientific diagnosis & treatment of male sexual disorders with very good treatment outcomes. Now majority patients are cured by proper diagnosis & correction of the defect. Thus consult us at our centre & get rid of this problem for always. For detail read the diagnosis & treatment of this disorder Erectile Dysfunction (Impotence)

2) Premature ejaculation:Premature ejaculation (also known as early discharge or quick orgasm, early fall, Shigra-patan) is one of the important cause of non-consummation of marriage and is characterized by sudden ejaculation of the semen, just prior to or immediately after vaginal penetration during intercourse (before one wishes or before he could satisfy the female partner). Premature or 'before time' in other words, is a condition where the man has no voluntary control over his ejaculation. He is quick on the trigger once he starts the coitus. This is a very frustrating disorders of male sexual function in which man feels totally helpless. This leads to bitterness in husbands & wife relationships. For the man, lack of control of his body functioning leaves him feeling unsure of himself. His pleasure is often decreased by the abrupt early discharge. When a man is, feeling inadequate, and ejaculating fast, the woman will probably be left unsatisfied. This is an easily treatable condition. For details of diagnosis of its cause & treatment click
Premature Ejaculation (i.e. early discharge)

The various Female cause leading, to inability to vaginal penetration are as follows:

1) Vaginismus:In vaginismus involuntary painful contraction of vaginal entry muscles (i.e. vaginal opening) is so painful that entry is virtually impossible. So that due to spasm of introitus muscles there occurs virtual closure of the vaginal opening with significant pain. Vaginismus is one of the significant female causes for inability of penis entry into the vaginal opening. Thus this is one of the common causes of for non-consummation of marriage.
In vaginismus pain felt by girl or female is so much that next time she starts avoiding the sexual contact of any kind because of fear that it will give her pain.
But the fore play & sexual desire excitation & lubrication may be absolutely normal in vaginismus women. For details of diagnosis of its cause & treatment click
Vaginismus ( Pain with spasm at time of entry)

2) Defect in uterus or vagina: Narrow vaginal openings or small vagina, Labial agglutination/fusion, transverse vaginal septum, Complete androgen resistance (testicular feminization), Vaginal stenosis, vaginal scarring, post surgical problems
3) Any ulcerative lesions of vagina as chronic lichen planus, herpes genitals, Pemphigus vulgaris of vagina

Low Sex Desire (Decreased Libido)

2008-12-08T23:02:00.000+05:30

Low Sex Desire (Libido)
The low sex desire is called when the desire for sex is lower than average. This decreased libido leads to un-satisfaction in opposite partner. Even the person who suffers with less i.e. diminished sexual desire & low frequency of sex suffers with various psychological depression disorders. Even the relation between the couples deteriorates.

Causes of Low libido i.e. diminished sex desire are: -

(1) Hormones Disorder:

(a) Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis)
Autoimmune hypophysitis, drug-induced hyperprolactinemia, untreated endocrinopathies, Diabetics Glucorticoid excess, Hypopituitarisms, Cushings disease, Addisons disease.
Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic
Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Following inflammation, Infiltrative or destructive processes (autoimmune, hemosiderosis),
Fertile eunuch syndrome, Idiopathic hypopituitarism,
(b) hypogonadism: testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy, Primary testicular defect-disorders of testicular differentiation or inborn errors of testosterone synthesis, Klinefelter syndrome, Other X polysomies (i.e. XXXXY, XXXY)
Rainbow syndrome
(d) Hypothyroidisms
(e) Untreated endocrinopathies & Diabetics
(f) Glucorticoids excess, Cushings disease, Addisons disease

2) Excess asthenia i.e. chronic asthenia is a also a significant cause of low sex desire.

3) Sickle cell disease, chronic cardiac disease, chronic renal disorder, chronic pulmonary dysfunction, chronic hepatic disease, Infections mono-nucleosis, hepatitis, chronic balanitis, chronic prostatitis, and chronic urethritis.

4) Addiction as chronic alcoholism, chronic smoker, heroin or cannabis use.

5) Drugs: Sedative: Narcotics, tranquillizers, amphetamine, cocaine, many antidepressant, and anti-psychotics, anti -hypertensives, many other drugs.

6) Psychiatric disorder as depression, neurosis, & many other psychiatric disorders.

6) Disorders of sex centre: In the brain there is a particular center in the hippocampus part of fore brain, which regulates the desire of sex. Sex center has some well-defined portion, which control different component of normal sexuality. These are as follows as one part of sex center controls sexual desire other parts controls erection, time taken in orgasm enjoy of sexual act including enjoyment of orgasm. So any disorder of sex center due to various causes can lead to less desire. This occurs due to desire controlling portions of sex center does not work properly so that inspite of \not having any physical or mental disorders the patient desire for sex is low. Beside low sex desire patient may be sexually otherwise for or patient may be suffering with impotence, premature ejaculation.

The causes of sex centre dysfunction can be divided into two groups: (1) immediate cause, and (2) remote causes. Such a classification is helpful in the treatment of decreased libido. If the loss of desire is due to immediate causes, a removal of these factors results in adequate sexual desire. If it is due to remote causes, then detailed sex therapy may be necessary for a more lasting cure.
It can cause less sexual desire alone or patient may have associated erectile disorder, premature ejaculation, or lack of enjoyment of sex.

Diagnostic Tests:

For diagnosis of cause of low libido (sex desire) detailed history is taken. After which thorough physical examination is done for relevant causes.
For diagnosis of cause of low libido following tests are required. These tests include
Complete male hormone profile (do not bold).

Thyroids test
Serum prolactin
SHBG
DHT Level
Investigation for systemic diseases
Other tests which may be required depending on likelihood of the any of above causes.

Detailed Sex Counseling: detailed sex counseling session, in which our male & female sex counselors meet with respective patient, trying to found out if there is any likelihood of sex centre disorder or other disorder as the cause of low sex desire.
In biochemistry Tests as liver function or kidney function tests are done.
These tests confirm the diagnosis of low sex desire confirmed.

Treatment:

Once the diagnosis of cause of low sex desire is made, treatment includes medicines & sex therapy sessions to cure the basic cause. The various treatments offered are:

(a) Hormone therapy:

Like in case of hormone deficiency or disorder of other glands the correction of hormone dysfunction is done. Hormone therapy is given in the form of oral tablets. Skin cream, gels or scrotal patches. These medicines are given in well tested prescribed doses as described in authentic textbooks. Some hormone precursors have also been used for increasing sex drive in many patients in whom no hormone disorder is found,

1) Male hormone testosterone replacement: The replacement of male hormone testosterone is one of the common treatments for decreased sex desire. The various preparation of testosterone is :

a) Oral preparation, which is available in capsule form. It needs to be given one to three capsules daily. These have no side effects.

b)Transdermal gel preparation are available which are applied on the any part of body once daily. This is absolutely safe with no side effects, economical & easy to use.

c)Tran dermal Testosterone given as scrotal patch. It is very effective & has no side effects.

i) Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective in curing low libido.
j) Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective for increasing penile size, & in cases of cure of breast development in boys.

k) Injection Testosterone esters: These include Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.

l) Long acting testosterone as testosterone bucilate given once in 4 months.

m) Testosterones implants are now available which once injected remain effective for up to six months.

n) New human androgen receptor modulators they increase the effect of male hormone over androgens.

2) Growths Hormones Therapy; is given when somatotropin deficiency is found.

3) IGF-1 therapy; is given when somatomedin c is subnormal.

4) DHT Therapy is given in many patients. It is very effective in most patients. This treatment is also effective in many patients when all above treatment has failed. The other good thing about this is that it is available as skin gel so taking this is simple & has no side effects. This treatment is very effective in those in whom male hormone is unable to work due to inability to generate the final end product for testosterone efficacy due to 5 alpha reductase defects. In such patient replacement of final target hormone is replaced leading to good sexual feelings & desire. In such situation even male hormone can be used in higher than usual doses leading to achievement normal sex desire.

5) Gonadotropin therapy is also very effective in normalizing low desire.Gonadotropin releasing hormone therapy is effective in many cases of low libido.

(b) Treat other systemic disease when they are detected.

(c) Treatment of chronic asthenia is done by replacement of antiasthenic drug with good results.

(d) Treatment of Urogenital infection balanitis, prostatitis, and epididymitis gives immediate relief & very dramatic increase in sex desire.

(e) Stop Offending drugs which patients is consuming is identified after detailed history & drug challenge is discontinued with permanent cure of the low libido disorder (f)Treatment of psychiatric disorder are diagnosed & treated.

(g)Treatment of sex center disorder: In cases of low libido due to sex center disorder there are many drugs, which improve the libido like hormone precursors, sex center stimulator drugs. These drugs act on sex center & correct the biochemical defect in sex center, leading return of the libido.

(h)Sex therapy is offered in which we teach the patient about the various techniques in such a way that it increase the enjoyment of body touch sex centre starts functioning normally & patient develops normal sex desire in addition males get better hardness of penis & sustained penile erection & takes longer time in discharge. All this improves the desire of sex as well as enjoyment of sex.

Response of treatment:

Person gets completely cured in two months time when treatment is started after the diagnosis of cause. After appropriate medicine therapy, sex education & sex therapy patient recover in two months time. The sexual desire of patient recovers. After return of libido to normal his family relationship also normalizes.

Side Effects:
The above mentioned drug treatment It has no side effects if given in proper disease and in-patients when it is really indicated. This it is absolutely safe when it is given by qualified doctor in proper doses.

Thin Penis / Girth Enhancement

2008-12-08T16:23:00.000+05:30

What is Thin penis: - When penis is somewhat thinner than average, is called thin penis. This thin penis is found in approximately two percent of males .The thin penis may occur as single disorder or in some persons it may be associated with small penis. In some persons penis is so thin that as in children. It makes them sexually unsure of his sexuality and decreases their confidence. They feel inferiority complex in exposing themselves in public places as in swimming pools & sea beaches etc. Thus it must be consulted urgently, so that diagnosis and treatment is done by team of hormone specialist & micro vascular surgeon. For this you consult at our sex n hormone center for complete diagnosis & treatment. In majority cases proper diagnosis & hormone therapy of about one year duration leads to penis growth in girth and normalization of penis in length & thickness. Thus you come to our center where doctor have experience of treating such problems. In very-2 rare cases surgical intervention is needed in which case by microsurgery technique the penis girth enhancement is achieved in length as well as in thickness (i.e. girth) if required.

Causes Of Thin Penis

The following are the major cause of thin penis & small Penis

It may occur due to

Male Hormones Disorder:

Hypogonadotropic hypogonadism (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis)
Autoimmune hypophysitis, drug-induced hyperprolactinemia, untreated endocrinopathies, Diabetics Glucorticoid excess, Hypopituitarisms, Cushings disease, Addisons disease.
Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic
Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Following inflammation, Infiltrative or destructive processes (autoimmune, hemosiderosis),
Fertile eunuch syndrome, Idiopathic hypopituitarism,

Hyperogonadotropic hypogonadism: testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy, Primary testicular defect-disorders of testicular differentiation or inborn errors of testosterone synthesis, Klinefelter syndrome, Other X polysomies (i.e. XXXXY, XXXY)
Rainbow syndrome,
Partial androgen insensitivity
Growths Hormones Deficiency
Thyroids hormones deficiency
Idiopathic thin phallus: In many patients all the hormone growth factor & every thing else is normal, still they have small genitalia. This occurs due to Decreased capacity of penile tissue to grow. This occurs due to defective morphogenesis of the penis in utero so that its growing capacity decreases later in life. This is also one of the common causes of small & thin penis.

Diagnostic Test:

For diagnosis of cause of investigation following tests are required. These tests include
Complete male hormone profile.
Thyroids test
Serum prolactin
SHBG
Ultrasound of testis
Growth Hormone analysis
DHT Level
Other tests which may be required depending on likelihood of the any of above causes.
In biochemistry liver function or kidney function tests are done.
Dynamic test to judge functional capacity of testis whether testis has the capacity to function normally or not. In this test we inject single injection of gonadotropin as intramuscular injection then three day later the rise in concentration of male hormone is seen to asses whether testis has capacity to function normally or not.
Chromosomal analysis is done to see the genetic structure of testis, because there are many chromosome disorders, which lead to small penis.

Capacity of generation of active testosterone i.e. DHT is tested. This DHT generation test is abnormal in some cases of small penis / thin penis /underdeveloped penis.

Tests to locate testis as ultrasonography or C.T. Scan abdomen is needed if testis is not palpable.
MRI / CT SCAN head if suspecting hypogonadotropic hypogonadism.

Serum inhibin is tested which tells that whether testis is functioning or not.

Serum Iron, T.I.B.C. & ferritin concentration tested for hypogonadism due to hemochromatosis.

Combined Pituitary hormone tests are performed when suspecting pituitary disorder.

Molecular genetic studies done in some special cases.

Serum estrogen increased whenever testicular function is decreased.

Serum DHT is low in some conditions when generation of dihydrotestosterone is decreased.

Assessment of androgen receptor is done when needed,
Dynamic tests as HCG test, response to antiestrogen & gonadotropin releasing hormone tests.
Interpretation of all above tests one need to be expert of hormone diseases with good experience. Based on above test result diagnosis of cause of small /or thin penis is made. Once the cause is found then treatment becomes very easy with good results.

Before starting treatment for enlargement of penis all above causes are investigated and proper diagnosis is made. Once male hormone deficiency or other cause found treatment becomes easy. Various options of penis girth enhancement therapy are available for thin penis is:
Medical treatment i.e. by hormone therapy available as pills, hormonal skin patches or injections

Surgical therapy: Penis girth enhancement surgeries

First We Test: Whether Penis Enlargement Is Possible Or Not.

For this hormone therapy given for three months in form of male hormone injection, skin patches, or oral tablets. If penis enlarges in size i.e. it grows in size by more than 1.25 cm in length & significant growth in girth in these three months, it means penis of that patient has potential for further growth. Once it is decided by above test that penis has potential for further growth, in such patient further courses of hormone therapy is given. By few courses of hormone treatment penis enlarges by three to four inches. By this therapy penis girth also increases besides increase in length. This penis girth increasing treatment is very effective in those entire patients in whom initial penis increasing potential test shows that penis has capability for further penis growth. Thus all patients achieve fully normal penis i.e. good penis length & thick penis. As penis increases in size patients confidence increases and feeling of well-being is achieved.

Treatment: Treatment can be either

Hormone treatment i.e. by oral drugs, hormone skin patches or injections
Surgical therapy

Hormone Treatment:

We start medical treatment only when above tests shows that penis has capacity to enlarge in girth as well as in length. It is given in the form replacement of male hormone testosterone & other hormones as growth hormone, DHT hormone & growth factor replacement. These hormones can be given in the form of oral tablets, skin patches, ointments, gel or injections.
As this treatment has no side effects, is economical and easy to take either as oral tablets, skin patches, or as gel or sometimes as injection of hormone.

The various Treatment options are:

1) Male hormone testosterone replacement: The replacement of male hormone testosterone is one of the common treatments for penis enlargement. The various preparation of testosterone is:

a) Oral preparation, which is available in capsule form. It needs to be given one to three capsules daily. These have no side effects.

b) Tran dermal Testosterone given as scrotal patch. It is very effective & has no side effects. It can be also given as Testosterone gel, which can be applied on any part of the skin.

d) Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective in inducing better sex organ & secondary sexual character development.

e) Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective for increasing penile thickness.

f) Injection Testosterone esters: These include Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.

g) Long acting testosterone as testosterone bucilate given once in 4 months.

h) Testosterones implants are now available which once injected remain effective for up to six months.

i) New human androgen receptor modulators they increase the effect of male hormone over androgens.

2) Growths Hormones Therapy: is given when somatotropin deficiency is found.

3) IGF-1 therapy: is given when somatomedin c is subnormal.

4) DHT Therapy is given in many patients. It is very effective in most patients. This treatment is also effective in many patients when all above treatment has failed. The other good thing about this is that it is available as skin gel so taking this is simple & has no side effects. This treatment is very effective in those in whom male hormone is unable to work due to inability to generate the final end product for testosterone efficacy due to 5 alpha reductase defects. In such patient replacement of final target hormone is replaced leading to good penile growth. In such situation even male hormone can be used in higher than usual doses leading to achievement of good penile enlargement.

5) Gonadotropin therapy is also very effective in penis enlargement.

2) Gonadotropin releasing hormone therapy is effective in many cases of underdeveloped genitalia.

How this treatment works:

When we give above-mentioned hormone by any of the above-mentioned routes. The concentration of these hormones in blood circulation rises. This leads to binding of more hormones on androgen receptors of penis. After binding with receptors these hormones leads to certain changes in the penis tissue. This leads to multiplication of penile tissue leading to further growth in girth as well as in length. This continued multiplication of penile tissue leads to further penis growth. This continued multiplication of penis tissue under the effect of above mentioned hormone treatment continues till penis girth & length normalizes.

Response of treatment: When any of above treatment is started the response is very good & has no side effects. In one study when the above hormone started, penis girth increases as well as length increases by 1.0 cm in first month & then 0.3 cm every month in later months. After few courses of above treatment penis enlarges by three to four inches in length & also in girth i.e. thickness. Thus the trial of treatment should be given to all adults with small penis before asking them to go for surgery.
But unluckily many doctors do not take the problem seriously leading to patient not given proper treatment. Thus many patients remain having small size of penis & associated lifelong inferiority complex.

Side Effects: It has no side effects if given in proper disease and in patient's when it is really indicated. This it is absolutely safe.

Penis Girth Enhancing Surgeries:

Surgical Treatment is required when medicine are not effective then there are various surgical procedures are there which can lead to long & thick penis. At our centre our micro surgeon performs all penis enlarging or girth increasing surgery.

These surgeries are performed by specialist surgeon (microscopic surgery) when penis is significantly small medicines have failed. Sometimes it is performed to improve the performance & satisfaction of man.
This surgery is called Penis Girth increasing surgeries.

Small Penis / Penis Enlargement

2008-12-08T16:10:00.000+05:30

What is small Penis?

As we know average penile length is six inches (i.e. fifteen centimeter). When penis is somewhat smaller than this, is called small penis. And when it is too small than normal is called micropenis. This small penis size is found in approximately one percent of men .The small penis may occur as single disorder or in some persons it may be associated with thin penis. In some persons penis is very thin as in children. It makes them sexually unsure of himself and decreases their confidence. They feel inferiority complex in exposing themselves in public places as in swimming pools & sea beaches etc. Thus it must be consulted urgently, so that diagnosis and treatment can be started as soon as possible. For this you may consult at our sex n hormone center for complete diagnosis & treatment. In majority cases proper diagnosis & hormone therapy of about one year duration leads to penis growth in size and normalization of penis in length & thickness. Thus you consult at our center where doctor have experience of treating such problems. In very-2 rare cases surgical intervention is needed in which case by microsurgery technique the penis enlargement is achieved in length (as well as in thickness i.e. girth if required).

Causes of small penis:
The following are the major causes of small penis & Thin Penis:

Male Hormones Disorder:
(1) Hypogonadotropic hypogonadism: (hypothalamic or pituitary deficiencies)
Hypogonadisms, Hypothyroidisms, Testosterone deficiency, hyperprolactinemias,
Hypogonadotropics states: Hypothalamic - pituitary deficiencies: Idiopathic GnRH deficiency, Kallman syndromes, Prader-Willi syndromes, Laurence-Moon-Biedl syndromes, pituitary hypoplasia, Trauma, post surgical, postiradiation, Tumour (Adenoma, craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis)
Autoimmune hypophysitis, drug-induced hyperprolactinemia, untreated endocrinopathies, Diabetics Glucorticoid excess, Hypopituitarisms, Cushings disease, Addisons disease.
Isolated gonadotropin deficiency (non acquired): Pituitary, Hypothalamic
Associated with multiple pituitary hormone deficiencies: Idiopathic pan hypo pituitarism (hypothalamic defects), Pituitary dysgenesis, Following inflammation, Infiltrative or destructive processes (autoimmune, hemosiderosis),
Fertile eunuch syndrome, Idiopathic hypopituitarism,
(2) Hyperogonadotropic hypogonadism: testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy, Primary testicular defect-disorders of testicular differentiation or inborn errors of testosterone synthesis, Klinefelter syndrome, Other X polysomies (i.e. XXXXY, XXXY)
Rainbow syndrome,
(3) Partial androgen insensitivity
(4) Growths Hormones Deficiency
(5) Thyroids hormones deficiency
(6) Idiopathic small phallus: In many patients all the hormone growth factor & every thing else is normal, still they have small genitalia. This occurs due to Decreased capacity of penile tissue to grow. This occurs due to defective morphogenesis of the penis in utero so that its growing capacity decreases later in life. This is also one of the common causes of small & thin penis.

Diagnostic tests for diagnosing cause of small penis

First of all we take detailed history then do thorough examination of whole body system including genitalia. On history & examination we get certain clue for likelihood of some of the above causes. Then we perform those relevant tests in that particular patient. Thus by doing some of below mentioned tests diagnosis of cause of small penis is made.
The following are the list of investigations; need to be done in the cases of underdeveloped small/ or thin penis

These tests includes:

Complete male hormone profile.
Thyroids test
Serum prolactins
SHBG
Ultrasound of testis
Growths Hormones analysis
DHT Level
Other tests which may be required depending on likelihood of the any of above causes.

In biochemistry liver function or kidney function tests are done.

Dynamic test: To judge functional capacity of testis whether testis has the capacity to function normally or not. In this test we inject single injection of gonadotropin as intramuscular injection then three day later the rise in concentration of male hormone is seen to assess whether testis has capacity to function normally or not.

Chromosomal analysis is done to see the genetic structure of testis, because there are many chromosome disorders, which lead to small penis.

Capacity of generation of active testosterone i.e. DHT is tested. This DHT generation test is abnormal in some cases of small penis / thin penis /underdeveloped penis.

Tests to locate testis as ultrasonography or C.T. Scan abdomen is needed if testis is not palpable.
MRI / CT SCAN head: if suspecting hypogonadotropic hypogonadism.

Serum inhibin is tested which tells that whether testis is functioning or not.

Serum Iron, T.I.B.C. & ferritin concentration tested for hypogonadism due to hemochromatosis.

Combined Pituitary hormone tests are performed when suspecting pituitary disorder.

Molecular genetic studies done in some special cases.

Serum estrogen increased whenever testicular function is decreased.

Serum DHT is low in some conditions when generation of dihydrotestosterone is decreased.

Assessment of androgen receptor is done when needed
Dynamic tests as:
HCG test,
Response to antiestrogen clomiphene
LH, FSH rise in response to gonadotropin releasing hormone tests.
All above tests need to be interpreted by expert of hormone diseases with good experience. Based on above test results diagnosis of cause of small /or thin penis is made. Once the cause is found then treatment becomes very easy with good results.

TREATMENT OPTIONS FOR PENIS ENLARGEMENT

Penis enlargement by Hormone Therapy:

Before starting treatment for enlargement of penis all above causes are investigated and proper diagnosis is made. Then we test whether penis enlargement is possible or not..

First We Test Whether Penis Enlargement Is Possible Or Not.

For this hormone therapy given for three months in form of male hormone injection, skin patches, or oral tablets. If penis enlarges in size i.e. it grows in size by more than 1.25 cm in these three months, it means penis of that patient has potential for further growth. Once it is decided by above test that penis has potential for further growth, in such patient further courses of hormone therapy is given. By few courses of hormone treatment penis enlarges by three to four inches. By this therapy penis girth also increases besides increase in length. This penis lengthening treatment is very effective in those patients's in whom initial penis increasing potential test shows that penis has capability for further penis growth. Thus all patients achieve fully normal penis i.e. good penis length & thick penis. As penis increases in size patient's confidence increases and feeling of well-being is achieved.

How this treatment works:

When we give below-mentioned hormones by any of the below-mentioned routes. The concentration of these hormones in blood circulation rises. This leads to binding of more hormones on androgen receptors of penis. After binding with receptors these hormones leads to certain changes in the penis tissue. This leads to multiplication of penile tissue leading to further growth. This continued multiplication of penile tissue leads to further penis growth. This continued multiplication of penis tissue under the effect of above mentioned hormone treatment continues till penis size normalizes. Usually in one-year time penis size as well as penis thickness i.e. girth normalizes. Unluckily most doctors have less knowledge about hormone treatment so that they neither investigate the patient nor give hormone or other medical therapy for penile growth.

Treatment of Small Penis

Various options of penis enlargement therapy are available for micropenis & small penis.

This treatment can be either:

Hormone Therapy: availalable as pills, hormonal skin patches or injections

Surgical therapy: Penis enlargement surgeries

HORMONE TREATMENT

We start medical treatment only when above tests shows that penis has capacity to enlarge. It is given in the form replacement of male hormone testosterone & other hormone as growth hormone, DHT hormone & growth factor replacement. These hormones can be given in the form of oral tablets, skin patches, ointments, gel or injections.
As this treatment has no side effects, is economical and easy to take either as oral tablets, skin patches, or as gel or sometimes as injection of hormone.

The various Treatment options are:

1) Male hormone testosterone replacement: The replacement of male hormone testosterone is one of the common treatments for penis enlargement. The various preparation of testosterone is:

a) Oral preparation, which is available in capsule form. It needs to be given one to three capsules daily. These have no side effects.

b) Tran dermal Testosterone given as scrotal patch. It is very effective & has no side effects. It can be also given as Testosterone gel, which can be applied on any part of the skin.

c) Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective is fast & better sex organ & secondary sexual character development.

d) Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective for increasing penile size, & in cases of cure of underdeveloped penis size in boys.

e) Injections of Testosterone esters: These include Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.

f) Long acting testosterone as testosterone bucilate given once in 4 months.

g) Testosterones implants are now available which once injected remain effective for up to six months.

h) New human androgen receptor modulators they increase the effect of male hormone over androgens.

2) Growths Hormones Therapy: Growth hormone is given when somatotropin deficiency is found.

3) IGF-1 therapy: is given when somatomedin-c is subnormal.

4) DHT Therapy: is given in many patients. It is very effective in most patients. This treatment is also effective in many patients when all above treatment has failed. The other good thing about this is that it is available as skin gel so taking this is simple & has no side effects. This treatment is very effective in those in whom male hormone is unable to work due to inability to generate the final end product for testosterone efficacy due to 5 alpha reductase defects. In such patient replacement of final target hormone is replaced leading to good penile growth. In such situation even male hormone can be used in higher than usual doses leading to achievement of good penile enlargement.

5) Gonadotropin therapy is also very effective in penis enlargement.

6) Gonadotropin Releasing hormone therapy is effective in many cases of under develop genitalia.

But unluckily many doctors do not take the problem seriously leading to patient not given proper treatment. Thus many patients remain having small size of penis & associated lifelong inferiority complex.

Response of Treatment:

When any of above treatment is started the response is very good & has no side effects. In one study when the above hormone started, penis size increases by 1.0 cm in first month & then 0.3 cm every month in later months. After few courses of above treatment penis enlarges by three to four inches in length & also in girth i.e. thickness. Thus the trial of treatment should be given to all adults with small penis before asking them to go for surgery.

Side Effects:

It has no side effects if given in proper disease and in-patients when it is really indicated. This it is absolutely safe in young patients below 50 years.

PENIS ENLARGEMENT SURGERY

Surgical Treatment is required when medicine are not effective then there are various surgical procedures are there which can lead to long & thick penis. At our centre our micro surgeon performs all penis enlarging or girth increasing surgery.

Penis lengthening surgeries are performed by specialist surgeon (microscopic surgery) when penis is significantly small medicines have failed. Sometimes it is performed to improve the performance & satisfaction of man.

Three types of surgeries are performed.

(i) Penis Lengthening Surgeries
(ii) Penis Girth increasing surgeries.
(iii) Chordee correction

Response of Treatment

When any of above treatment is started the response is very good & has no side effects. In one study when the above hormone started, penis size increases by 1.0 cm in first month & then 0.3 cm every month in later months. After few courses of above treatment penis enlarges by three to four inches in length & also in girth i.e. thickness. Thus the trial of treatment should be given to all adults with small penis before asking them to go for surgery.

Side Effects: It has no side effects if given in proper disease and in-patients when it is really indicated. This it is absolutely safe.

Premature Ejaculation (early discharge)

2008-12-08T16:06:00.000+05:30