What is vaginitis?
Vaginitis is the swelling or discomfort caused by vaginal infections in females. It is commonly caused by certain microorganisms – parasites like trichomonas, yeasts like candida or certain bacteria. Some vaginal infections are transmitted through sexual contact, but not others such as candidiasis (yeast infections). They are a frequent cause of distress and discomfort in adult women.
What are the symptoms?
Vaginitis is characterised by a yellowish-white discharge from the vagina, irritating and sometimes itching. The character of the discharge or pain differs according to the causative agent. In case of bacterial vaginosis, the discharge is thin and has a fishy smell. Trichomoniasis is characterised by heavy yellow or grey discharge, discomfort during intercourse, vaginal smell and painful urination. Yeast or candida infection has a thick curdy white discharge, which stick to the vagina.
How is the diagnosis of vaginitis made?
The cause of vaginitis cannot be determined solely on the basis of symptoms or a physical examination. Laboratory tests that allow a microscopic examination of the vaginal discharge are required for a correct diagnosis.
What is the treatment?
Vaginitis should be treated with an appropriate course of antibiotics. It is very important to treat the male partner even if he does not have symptoms, otherwise the infection keeps recurring in the woman. If the full treatment is not taken, the infection can recur. In case of trichomoniasis, it is preferable to eliminate the parasite. Metronidazole is the best drug for the treatment of trichomoniasis. People taking this drug should avoid taking alcohol as a severe reaction with nausea and vomiting can occur. For candida infection, the doctor may prescribe tablets that may need to be placed in the vagina (pessaries).
How can it be prevented?
Condoms and diaphragms may be helpful in preventing the spread of trichomoniasis. Spermicides or medicines that kill sperms are not very effective in reducing the risk of these diseases. In fact the frequent use of the spermicides (more than three times a week) may cause vaginal inflammation (chemical vaginitis). Maintaining good personal hygiene is important. In case of diabetics, who are prone to the vaginal yeast infection, the control of blood sugar is important
Showing posts with label sex. Show all posts
Showing posts with label sex. Show all posts
Sildenafil (Viagra)
Sildenafil has recently been introduced for the treatment of impotence or erectile dysfunction. Although it has been on the world market since March 1998, it has only recently become available in India.
What is Sildenafil?
Sildenafil is a drug that has helped many men suffering from the problem of erection of the penis (erectile dysfunction). Erectile dysfunction refers to the inability to get an erection, sufficient for satisfactory sexual activity. Taking this drug helps a man who is sexually aroused to get and maintain an erection by increasing the blood flow to the penis. If however, a man takes Sildenafil but is not sexually stimulated he will not get an erection.
Sildenafil is not a hormone or an aphrodisiac (a drug that arouses sexual desire). It is a prescription medicine, which aims at improving the problems of erection in men. Its use for the treatment of sexual dysfunction in women is still being investigated.
How well does Sildenafil work?
Sildenafil improves erections in 4 out of 5 men who take it, regardless of how long they have had erectile dysfunction and what caused it. It is to be taken about 1 hour before engaging in sexual activity. In most cases, it helps get an erection in 30 minutes that lasts for around 4 hours if a man is sexually excited. If sexual stimulation is absent then nothing will happen.
What is the frequency and dosage of the drug?
Sildenafil comes in different doses of 25mg, 50mg and 100mg. The recommended dosage is one tablet a day. For most people it should not be taken more than once a day. It is advisable to go by the doctor’s prescription regarding the dose to be taken as it will vary from person to person.
Who should not take Sildenafil?
It should never be taken by men who are using nitrate drugs, like nitroglycerine that is used for the treatment of chest pains due to heart disease. This could lead to a sudden drop in the blood pressure to unsafe levels. This includes the use of nitroglycerines in any form such as sprays, ointments and chewable tablets.
There are additional warnings about the use of the drug by individuals with cardiovascular disease. Caution is specifically advised for men who have had a stroke or heart attack or life-threatening arrhythmia in the past 6 months, those with low or high blood pressure or those suffering from a disease causing degeneration of the retina.
What has been the success rate of Sildenafil?
It has been found that 82% of the men who have taken Sildenafil, have experienced an improvement in their erections. It has helped men having mild erectile dysfunction. Those who have severe impotence problems have had less success with the drug. Men who have undergone surgery for prostate removal have also not experienced significant success.
Are there any side effects of Sildenafil?
The drug has some side effects, which last for a few minutes to a few hours after taking the drug. These include dilation of the blood vessels in other parts of the body, causing headaches and fainting. Other side effects such as facial flushing, upset stomach, blurred vision and sensitivity to light usually occur with high doses.
What care should be taken while taking the drug for effective results?
Drinking alcohol may temporarily impair the ability to get an erection. It is therefore advisable not to drink large amounts of alcohol before taking Sildenafil.
Taking Sildenafil after a meal rich in fats may cause the drug to take a longer time to start working. It is best to have a balanced meal before the drug is taken for increased effectiveness.
The tablet should be stored at room temperature; away from heat, moisture and direct light.
What is Sildenafil?
Sildenafil is a drug that has helped many men suffering from the problem of erection of the penis (erectile dysfunction). Erectile dysfunction refers to the inability to get an erection, sufficient for satisfactory sexual activity. Taking this drug helps a man who is sexually aroused to get and maintain an erection by increasing the blood flow to the penis. If however, a man takes Sildenafil but is not sexually stimulated he will not get an erection.
Sildenafil is not a hormone or an aphrodisiac (a drug that arouses sexual desire). It is a prescription medicine, which aims at improving the problems of erection in men. Its use for the treatment of sexual dysfunction in women is still being investigated.
How well does Sildenafil work?
Sildenafil improves erections in 4 out of 5 men who take it, regardless of how long they have had erectile dysfunction and what caused it. It is to be taken about 1 hour before engaging in sexual activity. In most cases, it helps get an erection in 30 minutes that lasts for around 4 hours if a man is sexually excited. If sexual stimulation is absent then nothing will happen.
What is the frequency and dosage of the drug?
Sildenafil comes in different doses of 25mg, 50mg and 100mg. The recommended dosage is one tablet a day. For most people it should not be taken more than once a day. It is advisable to go by the doctor’s prescription regarding the dose to be taken as it will vary from person to person.
Who should not take Sildenafil?
It should never be taken by men who are using nitrate drugs, like nitroglycerine that is used for the treatment of chest pains due to heart disease. This could lead to a sudden drop in the blood pressure to unsafe levels. This includes the use of nitroglycerines in any form such as sprays, ointments and chewable tablets.
There are additional warnings about the use of the drug by individuals with cardiovascular disease. Caution is specifically advised for men who have had a stroke or heart attack or life-threatening arrhythmia in the past 6 months, those with low or high blood pressure or those suffering from a disease causing degeneration of the retina.
What has been the success rate of Sildenafil?
It has been found that 82% of the men who have taken Sildenafil, have experienced an improvement in their erections. It has helped men having mild erectile dysfunction. Those who have severe impotence problems have had less success with the drug. Men who have undergone surgery for prostate removal have also not experienced significant success.
Are there any side effects of Sildenafil?
The drug has some side effects, which last for a few minutes to a few hours after taking the drug. These include dilation of the blood vessels in other parts of the body, causing headaches and fainting. Other side effects such as facial flushing, upset stomach, blurred vision and sensitivity to light usually occur with high doses.
What care should be taken while taking the drug for effective results?
Drinking alcohol may temporarily impair the ability to get an erection. It is therefore advisable not to drink large amounts of alcohol before taking Sildenafil.
Taking Sildenafil after a meal rich in fats may cause the drug to take a longer time to start working. It is best to have a balanced meal before the drug is taken for increased effectiveness.
The tablet should be stored at room temperature; away from heat, moisture and direct light.
Sexually transmitted infections
What are sexually transmitted infections?
STIs are diseases that you get by having sexual intercourse (vaginal, oral or anal) with someone who already has an STI. There are more than 20 kinds of STIs that affect both men and women.
What causes STIs?
Bacteria and viruses cause STIs. Those caused by bacteria include chlamydia, gonorrhoea, trichomoniasis and syphilis. These can be treated and cured with antibiotics.
STIs caused by viruses include HIV/AIDS, genital herpes, genital warts and cytomegalovirus. These STIs can be controlled but not cured.
What are the various types of STIs?
HIV Infection and AIDS
AIDS (Acquired Immune Deficiency Syndrome) is a disease that weakens the body's ability to protect itself from getting sick. The virus that causes it is HIV (Human Immunodeficiency Virus), which is found mainly in blood but occurs in other body fluids such as semen, vaginal secretions and breast milk. The main sources of infection are shared needles and syringes, unsafe sex, and mother-to-child transmission during pregnancy.
People with HIV infections may not have symptoms for years. When however, they develop certain infections because of their depressed immunity they are said to have AIDS. Symptoms include fever for a long duration, weight loss without a cause, extreme fatigue and prolonged diarrhoea and the symptoms associated with opportunistic infections.
A blood test is usually used to detect the HIV virus. Although there is no cure for HIV infections, a combination of drug therapy, healthy diet, exercise, stress reduction and prompt treatment of opportunistic infections can delay the onset of AIDS.
Gonorrhoea
This is an infection easily transmitted by sexual contact. The causative organism can infect the throat, producing severe soreness; the urethra, causing burning, painful urination and it may also infect the anus and the rectum. Untreated gonorrhoea may lead to urinary tract infections and ultimately kidney failure.
The most common initial symptom is a thick discharge from the urethra which may be white or yellow. There may be painful urination. Gonorrhoea is often associated with the presence of other sexually transmitted diseases.
Safer sex behaviour may reduce the risk. The affected person should be given adequate treatment with antibiotics. It is also important to locate and test all the other sexual contacts and treat them to prevent re-infection of the primary patient and further spread of the disease.
Syphilis
Syphilis is an infectious disease caused by the bacterium Treponema pallidum, which penetrates broken skin or mucous membranes. It can also be transmitted to the foetus via the placenta.
In the initial stages, skin rashes may appear which are very infectious. If the disease is not treated, bacteria continue to invade the body and infect the internal organs, the bones, the heart and the brain.
Safer sexual practices need to be adopted to curb the spread of STIs.
Chlamydia
It is one of the most common sexually transmitted diseases. The majority of genital chlamydia infections are without symptoms until complications appear.
Infection with chlamydia leads to pelvic inflammatory disease which can cause scarring of the fallopian tubes and sterility. The symptoms include burning with urination, discharge from the end of the penis, tenderness or pain in the testicles, fever and chills. Chlamydia infection is often found in conjunction with gonorrhoea.
The use of condoms during sex and limiting the number of sex partners may help in reducing the risk of developing the infection. It can be treated and cured with antibiotics.
Herpes
This is an infection caused by the Herpes simplex virus type 1 (HSV-l) which is associated with infections of the lips, mouth and face. HSV-2 is associated with genital lesions and is transmitted by sexual contact. HSV-2 can be transmitted to a newborn during vaginal delivery if the mother is actively infected.
Infection occurs after exposure to the virus through a break in the skin, or through mucous membranes. The virus spreads to nerve cells within the body and then to other skin surfaces. The symptoms include genital lesions, fever, vaginal discharge, sore throat and in some cases memory loss.
Avoiding direct contact with an open lesion will lower the risk of infection. Safer sex behaviours including the use of condoms may further lower the risk of infection.
Genital warts
Genital warts are caused by the Human papilloma virus (HPV) which causes small growths on the skin and mucous membranes. They grow best in moist genital areas and are flesh-coloured tumours appearing singly or in clusters. In women, HPV can invade the vagina and cervix and may lead to cancerous changes in the cervix.
Symptoms include “warty” tumours on the genitals, genital sores, itching of the genital areas and increased vaginal discharge.
Topical treatments to eradicate the lesions include trichloroacetic acid and podophyllum. Sex abstinence or use of condoms should be practiced until both partners are free of the disease.
What can be done to prevent STIS?
Having a mutually monogamous sexual relationship with an uninfected partner.
Correctly and consistently using a condom greatly reduces the chance of acquiring an STI.
Using clean needles if injecting intravenous drugs.
Having regular check ups for STIs even in the absence of symptoms.
Anyone diagnosed as having an STI should:
Be treated to reduce the risk of transmitting an STI, especially a pregnant woman to an infant.
Follow the full course of medicine.
Avoid sexual activity while being treated for an STI.
Ensure that the partner is also diagnosed and treated.
STIs are diseases that you get by having sexual intercourse (vaginal, oral or anal) with someone who already has an STI. There are more than 20 kinds of STIs that affect both men and women.
What causes STIs?
Bacteria and viruses cause STIs. Those caused by bacteria include chlamydia, gonorrhoea, trichomoniasis and syphilis. These can be treated and cured with antibiotics.
STIs caused by viruses include HIV/AIDS, genital herpes, genital warts and cytomegalovirus. These STIs can be controlled but not cured.
What are the various types of STIs?
HIV Infection and AIDS
AIDS (Acquired Immune Deficiency Syndrome) is a disease that weakens the body's ability to protect itself from getting sick. The virus that causes it is HIV (Human Immunodeficiency Virus), which is found mainly in blood but occurs in other body fluids such as semen, vaginal secretions and breast milk. The main sources of infection are shared needles and syringes, unsafe sex, and mother-to-child transmission during pregnancy.
People with HIV infections may not have symptoms for years. When however, they develop certain infections because of their depressed immunity they are said to have AIDS. Symptoms include fever for a long duration, weight loss without a cause, extreme fatigue and prolonged diarrhoea and the symptoms associated with opportunistic infections.
A blood test is usually used to detect the HIV virus. Although there is no cure for HIV infections, a combination of drug therapy, healthy diet, exercise, stress reduction and prompt treatment of opportunistic infections can delay the onset of AIDS.
Gonorrhoea
This is an infection easily transmitted by sexual contact. The causative organism can infect the throat, producing severe soreness; the urethra, causing burning, painful urination and it may also infect the anus and the rectum. Untreated gonorrhoea may lead to urinary tract infections and ultimately kidney failure.
The most common initial symptom is a thick discharge from the urethra which may be white or yellow. There may be painful urination. Gonorrhoea is often associated with the presence of other sexually transmitted diseases.
Safer sex behaviour may reduce the risk. The affected person should be given adequate treatment with antibiotics. It is also important to locate and test all the other sexual contacts and treat them to prevent re-infection of the primary patient and further spread of the disease.
Syphilis
Syphilis is an infectious disease caused by the bacterium Treponema pallidum, which penetrates broken skin or mucous membranes. It can also be transmitted to the foetus via the placenta.
In the initial stages, skin rashes may appear which are very infectious. If the disease is not treated, bacteria continue to invade the body and infect the internal organs, the bones, the heart and the brain.
Safer sexual practices need to be adopted to curb the spread of STIs.
Chlamydia
It is one of the most common sexually transmitted diseases. The majority of genital chlamydia infections are without symptoms until complications appear.
Infection with chlamydia leads to pelvic inflammatory disease which can cause scarring of the fallopian tubes and sterility. The symptoms include burning with urination, discharge from the end of the penis, tenderness or pain in the testicles, fever and chills. Chlamydia infection is often found in conjunction with gonorrhoea.
The use of condoms during sex and limiting the number of sex partners may help in reducing the risk of developing the infection. It can be treated and cured with antibiotics.
Herpes
This is an infection caused by the Herpes simplex virus type 1 (HSV-l) which is associated with infections of the lips, mouth and face. HSV-2 is associated with genital lesions and is transmitted by sexual contact. HSV-2 can be transmitted to a newborn during vaginal delivery if the mother is actively infected.
Infection occurs after exposure to the virus through a break in the skin, or through mucous membranes. The virus spreads to nerve cells within the body and then to other skin surfaces. The symptoms include genital lesions, fever, vaginal discharge, sore throat and in some cases memory loss.
Avoiding direct contact with an open lesion will lower the risk of infection. Safer sex behaviours including the use of condoms may further lower the risk of infection.
Genital warts
Genital warts are caused by the Human papilloma virus (HPV) which causes small growths on the skin and mucous membranes. They grow best in moist genital areas and are flesh-coloured tumours appearing singly or in clusters. In women, HPV can invade the vagina and cervix and may lead to cancerous changes in the cervix.
Symptoms include “warty” tumours on the genitals, genital sores, itching of the genital areas and increased vaginal discharge.
Topical treatments to eradicate the lesions include trichloroacetic acid and podophyllum. Sex abstinence or use of condoms should be practiced until both partners are free of the disease.
What can be done to prevent STIS?
Having a mutually monogamous sexual relationship with an uninfected partner.
Correctly and consistently using a condom greatly reduces the chance of acquiring an STI.
Using clean needles if injecting intravenous drugs.
Having regular check ups for STIs even in the absence of symptoms.
Anyone diagnosed as having an STI should:
Be treated to reduce the risk of transmitting an STI, especially a pregnant woman to an infant.
Follow the full course of medicine.
Avoid sexual activity while being treated for an STI.
Ensure that the partner is also diagnosed and treated.
Sexual abuse in children
What is sexual abuse?
Sexual abuse in children is a term used when the offender, who may or may not be a member of the family, uses a child for his sexual gratification. Very young children as well as older teenagers may be victimized.
What does sexual abuse include?
Sexual abuse can be physical, verbal or emotional and includes:
Touching and fondling with sexual intent.
Exposing children to adult sexual activity or pornographic material.
Having children pose, undress or perform in a sexual fashion on film or in person.
“Peeping” into bathrooms or bedrooms to spy on a child.
Rape or attempted rape.
The perpetrator may use force, tricks, bribes or threats to involve a child into sexual activity. But the use of physical force is rarely necessary because children, who wish to seek adults love and approval, believe that they are always right and thus become vulnerable at the hands of such people.
What are the signs of sexual abuse?
Children generally do not tell if they are being sexually abused because they may be afraid of the perpetrator. The abuser may threaten to harm the child or any member of her family if she told them. In cases, where the abuser is known to the child, he may ask her not to divulge “their little secret” to anyone else.
Parents or guardians must be vigilant towards their children since there are certain general behaviour changes that may occur in children if they are experiencing such a problem.
Sleep disturbances.
School problems.
Withdrawal from family, friends or usual activities.
Other problems may include depression, anxiety, discipline problems, drug or alcohol problems, hostility or aggression and in some cases running away.
Children who have been sexually abused frequently have more specific symptoms like displaying sexual knowledge or behaviour that is beyond what is normal for their age; copying adult sexual behaviour; unexplained pain, swelling, bleeding or irritation of the mouth; urinary infections and sexually transmitted diseases.
How does a sexually abused child feel?
A sexually abused child may feel different emotions like fear of the abuser or of being different; anger at other adults around her who did not protect her; isolation, sadness, guilt, confusion and shame.
What should parents do?
As concerned adults, parents should teach the children:
that they are loved, valued and are most precious for them.
the difference between safe and unsafe touches.
that their bodies belong to them and nobody has the right to touch or hurt them.
to tell anything about which they might feel uncomfortable to their parents.
If a child trusts the parents and tells them about the incident, they should help by providing positive support.
Some dos:
Keep calm.
Believe the child.
Give positive messages such as “I know you could not help it”, “I’m proud that you trusted me”.
Respect the child’s privacy and never discuss the topic in front of others.
Take the child for a medical check up to make sure that no permanent damage has occurred.
Some don’ts:
Never panic or overreact as the child needs help and support to make it through this difficult time.
Never confront the offender in the child’s presence.
Do not blame the child because sexual abuse is never the child’s fault.
Sexual abuse in children is a term used when the offender, who may or may not be a member of the family, uses a child for his sexual gratification. Very young children as well as older teenagers may be victimized.
What does sexual abuse include?
Sexual abuse can be physical, verbal or emotional and includes:
Touching and fondling with sexual intent.
Exposing children to adult sexual activity or pornographic material.
Having children pose, undress or perform in a sexual fashion on film or in person.
“Peeping” into bathrooms or bedrooms to spy on a child.
Rape or attempted rape.
The perpetrator may use force, tricks, bribes or threats to involve a child into sexual activity. But the use of physical force is rarely necessary because children, who wish to seek adults love and approval, believe that they are always right and thus become vulnerable at the hands of such people.
What are the signs of sexual abuse?
Children generally do not tell if they are being sexually abused because they may be afraid of the perpetrator. The abuser may threaten to harm the child or any member of her family if she told them. In cases, where the abuser is known to the child, he may ask her not to divulge “their little secret” to anyone else.
Parents or guardians must be vigilant towards their children since there are certain general behaviour changes that may occur in children if they are experiencing such a problem.
Sleep disturbances.
School problems.
Withdrawal from family, friends or usual activities.
Other problems may include depression, anxiety, discipline problems, drug or alcohol problems, hostility or aggression and in some cases running away.
Children who have been sexually abused frequently have more specific symptoms like displaying sexual knowledge or behaviour that is beyond what is normal for their age; copying adult sexual behaviour; unexplained pain, swelling, bleeding or irritation of the mouth; urinary infections and sexually transmitted diseases.
How does a sexually abused child feel?
A sexually abused child may feel different emotions like fear of the abuser or of being different; anger at other adults around her who did not protect her; isolation, sadness, guilt, confusion and shame.
What should parents do?
As concerned adults, parents should teach the children:
that they are loved, valued and are most precious for them.
the difference between safe and unsafe touches.
that their bodies belong to them and nobody has the right to touch or hurt them.
to tell anything about which they might feel uncomfortable to their parents.
If a child trusts the parents and tells them about the incident, they should help by providing positive support.
Some dos:
Keep calm.
Believe the child.
Give positive messages such as “I know you could not help it”, “I’m proud that you trusted me”.
Respect the child’s privacy and never discuss the topic in front of others.
Take the child for a medical check up to make sure that no permanent damage has occurred.
Some don’ts:
Never panic or overreact as the child needs help and support to make it through this difficult time.
Never confront the offender in the child’s presence.
Do not blame the child because sexual abuse is never the child’s fault.
Sexual intercourse
Sexual intercourse is not merely a physical act with your partner. It is important that both of you are ready for it and enjoy it for fulfilment. It is, therefore, necessary that the mood be right and both partners be adequately aroused sexually. Arousal can be heightened by foreplay, which is an important part of intercourse.
In foreplay, the partners fondle and kiss each other, and stroke each other's genitals. This increases the sexual urges and also lubricates the sex organs to facilitate a pain-free intercourse. As a result of the sexual arousal during foreplay, the man’s penis becomes filled with blood, causing it to become erect. This process is called an erection.
Sexual intercourse involves the male inserting his erect penis into the vagina of the woman. This must be done slowly and gently so as not to cause much discomfort to the woman. In a virgin, the initial insertion can be extremely painful, and this discomfort may be reduced with the help of lubricating creams. After this, the penis is moved forward and backwards in the vagina without withdrawing it completely. This rhythmic motion is continued till both partners reach their orgasm. An orgasm is a feeling of extreme pleasure that starts from the genital region and washes over the whole body. It ends in a climax, which is a state of heightened pleasure for both the partners.
In the male, the orgasm is usually reached with the discharge of semen. In the female, there is a white discharge from the vagina. After an orgasm is reached, the male’s penis becomes deflated again and comes out of the vagina easily.
Newly weds must be aware of the contraceptive devices that are available. Unwanted pregnancy may be avoided with the help of condoms or contraceptive pills for which a doctor must be consulted. Condoms are also extremely important to reduce the chances of contracting sexually transmitted diseases including AIDS. While using condoms you must be careful of the following:
The condom must be rolled onto a fully erect penis
While rolling the condom care must be taken to press out all the air that may collect inside
After the act, the condom must be carefully taken out of the vagina along with the erect penis
The condom must never be reused.
In foreplay, the partners fondle and kiss each other, and stroke each other's genitals. This increases the sexual urges and also lubricates the sex organs to facilitate a pain-free intercourse. As a result of the sexual arousal during foreplay, the man’s penis becomes filled with blood, causing it to become erect. This process is called an erection.
Sexual intercourse involves the male inserting his erect penis into the vagina of the woman. This must be done slowly and gently so as not to cause much discomfort to the woman. In a virgin, the initial insertion can be extremely painful, and this discomfort may be reduced with the help of lubricating creams. After this, the penis is moved forward and backwards in the vagina without withdrawing it completely. This rhythmic motion is continued till both partners reach their orgasm. An orgasm is a feeling of extreme pleasure that starts from the genital region and washes over the whole body. It ends in a climax, which is a state of heightened pleasure for both the partners.
In the male, the orgasm is usually reached with the discharge of semen. In the female, there is a white discharge from the vagina. After an orgasm is reached, the male’s penis becomes deflated again and comes out of the vagina easily.
Newly weds must be aware of the contraceptive devices that are available. Unwanted pregnancy may be avoided with the help of condoms or contraceptive pills for which a doctor must be consulted. Condoms are also extremely important to reduce the chances of contracting sexually transmitted diseases including AIDS. While using condoms you must be careful of the following:
The condom must be rolled onto a fully erect penis
While rolling the condom care must be taken to press out all the air that may collect inside
After the act, the condom must be carefully taken out of the vagina along with the erect penis
The condom must never be reused.
Lesbianism
What is meant by lesbianism?
Lesbianism is a term, which describes women whose primary sexual and emotional attractions are fulfilled by other women. Many myths exist concerning lesbianism. It is believed that women become lesbians because of bad experiences with men. It is also said that the lesbians are very masculine.
Are lesbians different people?
Like heterosexuals, lesbians also range in size, shape and appearance and have been found to be no different from them in relationships with parents and friends, drinking, self-esteem and many other issues. Lesbianism is simply the way a minority of our population expresses human love and sexuality. Studies on the mental health of lesbians show that they function like heterosexuals as far as their judgement, stability and adaptiveness are concerned.
What is the basic cause for lesbianism?
Research suggests that the homosexual orientation is decided very early in life. It is therefore unethical to change a person’s sexual orientation through therapy. Psychological techniques like psychotherapy may only help them in becoming comfortable with their sexual orientation.
What is homophobia and heterosexism?
Within our society, there is an irrational fear of homosexuality. This aversion to gay or lesbian people is called homophobia. Heterosexism is a term used to define prejudice and discrimination against gays and lesbians.
Homophobia can be called a health hazard because the prejudice from society may cause an individual to turn inward and become depressed. The fear of stigma from the society may lead to a refusal to seek medical attention when needed, ultimately resulting in poor health for the lesbian.
What could be done to help this important minority?
An attitudinal and behavioural change is required towards this group as a whole. Lesbianism says loving another woman is good, exciting and healthy. Therefore, the people need to be more informed in order to encourage a healthy approach.
An open forum is required where such people can meet, exchange their feelings and become more vocal with regard to issues that affect them.
Lesbianism is a term, which describes women whose primary sexual and emotional attractions are fulfilled by other women. Many myths exist concerning lesbianism. It is believed that women become lesbians because of bad experiences with men. It is also said that the lesbians are very masculine.
Are lesbians different people?
Like heterosexuals, lesbians also range in size, shape and appearance and have been found to be no different from them in relationships with parents and friends, drinking, self-esteem and many other issues. Lesbianism is simply the way a minority of our population expresses human love and sexuality. Studies on the mental health of lesbians show that they function like heterosexuals as far as their judgement, stability and adaptiveness are concerned.
What is the basic cause for lesbianism?
Research suggests that the homosexual orientation is decided very early in life. It is therefore unethical to change a person’s sexual orientation through therapy. Psychological techniques like psychotherapy may only help them in becoming comfortable with their sexual orientation.
What is homophobia and heterosexism?
Within our society, there is an irrational fear of homosexuality. This aversion to gay or lesbian people is called homophobia. Heterosexism is a term used to define prejudice and discrimination against gays and lesbians.
Homophobia can be called a health hazard because the prejudice from society may cause an individual to turn inward and become depressed. The fear of stigma from the society may lead to a refusal to seek medical attention when needed, ultimately resulting in poor health for the lesbian.
What could be done to help this important minority?
An attitudinal and behavioural change is required towards this group as a whole. Lesbianism says loving another woman is good, exciting and healthy. Therefore, the people need to be more informed in order to encourage a healthy approach.
An open forum is required where such people can meet, exchange their feelings and become more vocal with regard to issues that affect them.
Premature ejaculation
What is premature ejaculation?
Premature ejaculation is the inability to delay ejaculation till the man wishes or when ejaculation occurs too early in the sexual act to satisfy both partners. The time to reach the stage of ejaculation is subjective and varies form one man to another. Some men may ejaculate immediately after copulation begins while another may not ejaculate even after 10 minutes. Thus, time is not a criterion for ascertaining whether the ejaculation is premature or not; mutual satisfaction is the benchmark against which this condition is measured.
What is the cause?
Premature ejaculation primarily has a physiological basis. Biologically, men have an orgasm approximately 2-3 minutes after penetrating the vagina. Women, on the other hand, typically take more time to reach the climax. Since in most cases, the partners may not climax together, they are not satisfied and the ejaculation is termed premature.
However, premature ejaculation may be caused by a variety of psychological and social reasons. It is seen that it occurs frequently when the man is under mental stress or anxiety. Anxiety may be due to the fear of non-performance, the fear of being discovered (as during premarital or extramarital sex in our society) or anxiety related to contraction of sexually transmitted diseases or an unwanted pregnancy.
Though men of all ages may experience the condition, it is more common in adolescents, young adults and inexperienced men. However, it is also true that almost all men experience it at some point in their lives. Premature ejaculation is one of the most common sexual problems for which couples seek advice. The result of treatment is often successful.
What are the symptoms?
Since premature ejaculation is not a disease, it does not have the classic "symptoms". An individual realizes that he is suffering from it when sexual intercourse ends before either partner is completely satisfied. It is diagnosed by a physical examination, in addition to interviews with the couple regarding their relationship.
What is the treatment?
In some cases, the problem can be solved simply by educating an individual about the condition and reassuring him. Counselling is provided by psychologists that helps a man to deal with his fears and anxieties and, thus, eliminate the psychological causes of the condition. The following techniques may be beneficial in delaying ejaculation:
The "stop and start" method – in this method, the man learns to recognise the stage after which he cannot control ejaculation. The treatment method trains the person to remove the stimulus just before that stage is reached so that the urge to ejaculate is controlled. For example, when during masturbation, the man reaches a point just before ejaculating, he stops the stimulus until he starts losing the erection. Once the stage is past, he can resume the activity. This process is repeated again and again until the individual is able to delay ejaculation till the time he wishes. This method called the 'Masters and Johnson method', is most effective when the help of the partner is sought during actual intercourse.
The squeeze technique – in this method, the partner gently squeezes the tip or base of the penis just before the point of ejaculation thereby "cancelling" the orgasm. This process can be continued until the couple decides mutually to reach the climax.
Desensitising creams and gels are available in the market that reduce the sensitivity of the penis and help men reach climax later. Some men also feel that condoms reduce the sensations and, in addition to providing safer sex, help them last longer.
The couple can also experiment with sexual positions as some positions offer more control than others and may help to delay ejaculation.
Premature ejaculation is the inability to delay ejaculation till the man wishes or when ejaculation occurs too early in the sexual act to satisfy both partners. The time to reach the stage of ejaculation is subjective and varies form one man to another. Some men may ejaculate immediately after copulation begins while another may not ejaculate even after 10 minutes. Thus, time is not a criterion for ascertaining whether the ejaculation is premature or not; mutual satisfaction is the benchmark against which this condition is measured.
What is the cause?
Premature ejaculation primarily has a physiological basis. Biologically, men have an orgasm approximately 2-3 minutes after penetrating the vagina. Women, on the other hand, typically take more time to reach the climax. Since in most cases, the partners may not climax together, they are not satisfied and the ejaculation is termed premature.
However, premature ejaculation may be caused by a variety of psychological and social reasons. It is seen that it occurs frequently when the man is under mental stress or anxiety. Anxiety may be due to the fear of non-performance, the fear of being discovered (as during premarital or extramarital sex in our society) or anxiety related to contraction of sexually transmitted diseases or an unwanted pregnancy.
Though men of all ages may experience the condition, it is more common in adolescents, young adults and inexperienced men. However, it is also true that almost all men experience it at some point in their lives. Premature ejaculation is one of the most common sexual problems for which couples seek advice. The result of treatment is often successful.
What are the symptoms?
Since premature ejaculation is not a disease, it does not have the classic "symptoms". An individual realizes that he is suffering from it when sexual intercourse ends before either partner is completely satisfied. It is diagnosed by a physical examination, in addition to interviews with the couple regarding their relationship.
What is the treatment?
In some cases, the problem can be solved simply by educating an individual about the condition and reassuring him. Counselling is provided by psychologists that helps a man to deal with his fears and anxieties and, thus, eliminate the psychological causes of the condition. The following techniques may be beneficial in delaying ejaculation:
The "stop and start" method – in this method, the man learns to recognise the stage after which he cannot control ejaculation. The treatment method trains the person to remove the stimulus just before that stage is reached so that the urge to ejaculate is controlled. For example, when during masturbation, the man reaches a point just before ejaculating, he stops the stimulus until he starts losing the erection. Once the stage is past, he can resume the activity. This process is repeated again and again until the individual is able to delay ejaculation till the time he wishes. This method called the 'Masters and Johnson method', is most effective when the help of the partner is sought during actual intercourse.
The squeeze technique – in this method, the partner gently squeezes the tip or base of the penis just before the point of ejaculation thereby "cancelling" the orgasm. This process can be continued until the couple decides mutually to reach the climax.
Desensitising creams and gels are available in the market that reduce the sensitivity of the penis and help men reach climax later. Some men also feel that condoms reduce the sensations and, in addition to providing safer sex, help them last longer.
The couple can also experiment with sexual positions as some positions offer more control than others and may help to delay ejaculation.
Impotence
A man who cannot develop or sustain an erection to perform satisfactory sexual intercourse is termed 'impotent'. Unfortunately, this term has serious social consequences and should be used with caution and after due consideration of the complex process of male sexual function.
Besides the inability to sustain erection other factors like loss of desire or libido, inability to ejaculate at the right time, difficulty in achieving orgasms, all coexist in some individuals and contribute to the patient's loss of confidence and inadequacy. Erectile dysfunction occurs in 5% of all males above 40 years of age and this percentage increases with advancing age.
What happens during erection?
The penis consists of large open spaces confined within a tight capsule. These spaces contain blood. Erection is brought about by a complex method of influences that travel from the brain, originating in the hormonal system and acting through the peripheral nerves. These result in the filling up of the spaces with blood, and this blood cannot flow out. This engorgement of the spaces with blood makes the penis rigid. Once the influences are withdrawn, as after orgasm and ejaculation, blood drains out from the spaces making the penis flaccid.
What are the causes of erectile dysfunction?
The causes are most often psychological and may include performance anxiety, guilt, depression or a fear of failure. It is important to rule out the physical causes. Besides progressing age, other factors include diseases like diabetes, high blood pressure and obesity. Smoking, excessive intake of alcohol and lack of physical activity can aggravate the problem. Persons with depression, anxiety, chronic stress and difficult relationships have a higher chance of having erectile dysfunction.
Other diseases that predispose to the condition include decreased thyroid function and kidney failure. Some drugs like anti-depressants, tranquillisers and medicines for high blood pressure may also lead to impotence.
How is it diagnosed?
The doctor will take a detailed medical history to determine whether impotence is due to an physical illness or due to psychological problems. Similarly, a detailed examination of the body including examination of the sexual organs will be done. Blood tests may be done to exclude diabetes or high cholesterol. Specialised tests may be done in specific instances to locate a problem in the structure and function of the penis.
How is it treated?
Erectile dysfunction due to a psychological problem is treated with much care. Usually the problem is due to performance anxiety, guilt, depression or a fear of failure. The patient is explained that this only worsens the problem. Sex education helps correct misinformation and ignorance about normal sexual practice. In married couples, discussing the problem with both partners may help the doctor to arrive at the root cause of anxiety or performance failure. These treatment sessions are usually time-consuming and slow.
The psychological treatment can be supplemented with the help of medicines that stimulate erection. These can be taken orally like sildenafil (viagra) or others that can be injected into the penis like papaverine or alprostadil, a synthetic prostaglandin. For men with low levels of male sex hormone, testosterone, this hormone may need to be supplemented. In some cases that do not satisfactorily respond to medicines, erections can be achieved with the help of appliances like vacuum devices or the insertion of implants into the penis by an operation.
Besides the inability to sustain erection other factors like loss of desire or libido, inability to ejaculate at the right time, difficulty in achieving orgasms, all coexist in some individuals and contribute to the patient's loss of confidence and inadequacy. Erectile dysfunction occurs in 5% of all males above 40 years of age and this percentage increases with advancing age.
What happens during erection?
The penis consists of large open spaces confined within a tight capsule. These spaces contain blood. Erection is brought about by a complex method of influences that travel from the brain, originating in the hormonal system and acting through the peripheral nerves. These result in the filling up of the spaces with blood, and this blood cannot flow out. This engorgement of the spaces with blood makes the penis rigid. Once the influences are withdrawn, as after orgasm and ejaculation, blood drains out from the spaces making the penis flaccid.
What are the causes of erectile dysfunction?
The causes are most often psychological and may include performance anxiety, guilt, depression or a fear of failure. It is important to rule out the physical causes. Besides progressing age, other factors include diseases like diabetes, high blood pressure and obesity. Smoking, excessive intake of alcohol and lack of physical activity can aggravate the problem. Persons with depression, anxiety, chronic stress and difficult relationships have a higher chance of having erectile dysfunction.
Other diseases that predispose to the condition include decreased thyroid function and kidney failure. Some drugs like anti-depressants, tranquillisers and medicines for high blood pressure may also lead to impotence.
How is it diagnosed?
The doctor will take a detailed medical history to determine whether impotence is due to an physical illness or due to psychological problems. Similarly, a detailed examination of the body including examination of the sexual organs will be done. Blood tests may be done to exclude diabetes or high cholesterol. Specialised tests may be done in specific instances to locate a problem in the structure and function of the penis.
How is it treated?
Erectile dysfunction due to a psychological problem is treated with much care. Usually the problem is due to performance anxiety, guilt, depression or a fear of failure. The patient is explained that this only worsens the problem. Sex education helps correct misinformation and ignorance about normal sexual practice. In married couples, discussing the problem with both partners may help the doctor to arrive at the root cause of anxiety or performance failure. These treatment sessions are usually time-consuming and slow.
The psychological treatment can be supplemented with the help of medicines that stimulate erection. These can be taken orally like sildenafil (viagra) or others that can be injected into the penis like papaverine or alprostadil, a synthetic prostaglandin. For men with low levels of male sex hormone, testosterone, this hormone may need to be supplemented. In some cases that do not satisfactorily respond to medicines, erections can be achieved with the help of appliances like vacuum devices or the insertion of implants into the penis by an operation.
Irregular periods
Irregularity in the menstrual cycle
Menstrual cycles vary in length from one woman to another. They may occur at the same time each month or be irregular. Typically, a cycle occurs about once a month, but can be as short as 21 days or as long as 35 days and still be considered normal. Menstrual flow lasts about 3 to 7 days. A menstrual period is considered late if it is 5 or more days overdue according to the usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
What is the cause?
A late or missed period could be because of any of the following:
Pregnancy
This is the most common cause of missed periods. If you have had unprotected sex even once in the past several months, see your doctor for a pregnancy test before you consider any of the other possible causes.
Stress
Stress is the second most common cause of late or missed periods in teenagers. It may be emotional stress or depression. Or it may be physical stress, such as a severe illness, a sexually transmitted infection, rapid weight loss or gain, or strenuous exercise. Dieting or binging and purging may interrupt menstrual cycles. Changes in your usual routine, for example, going on a vacation may also cause your period to be late or missed.
Normal development
During the first couple of years of menstruation many teenagers have irregular periods. During this time the body's hormones are not yet finely tuned, so the ovaries may not release an egg once every month. As a result, your cycles may be irregular, occurring as close together as 2 weeks or as far apart as 3 months.
Hormone imbalance
Hormone imbalance is rarely the cause of missed periods. In teenagers, polycystic ovary syndrome is the most common type of hormone imbalance that affects the menstrual cycle. Polycystic ovaries may cause irregular cycles, increased body hair, acne, and weight gain. Sometimes when you stop taking birth control pills you may have a temporary hormone imbalance and loss of periods. If you are having sex, be sure to use another reliable method of birth control because you could still become pregnant. Problems of the thyroid gland, pituitary gland, adrenal glands, or ovaries can be rare causes of irregular periods.
How to know what the cause is?
Pregnancy: A positive pregnancy test is the only way to be certain of pregnancy. It is best to see your doctor for a pregnancy test.
Stress: Some stress is a normal part of daily life. Only you can know if you are under too much stress.
Normal development: If your doctor finds nothing abnormal during your physical examination and you've been having periods for 2 years or less, your irregular periods may be part of your normal development. If you have had sexual intercourse, go to your doctor's office for a pregnancy test when your period is late for you, even if you normally have irregular cycles.
Hormone imbalance: If you have missed several periods without an explanation, your doctor can check your ovaries and look for any signs of hormone imbalance. Blood tests can be done to measure hormone levels.
When will periods return to normal?
It is important to identify pregnancy early so that you can discuss the options available to you and start prenatal care. Early prenatal care helps ensure a healthy baby. If the irregularity is due to stress then your periods should return when the activities or situations that are stressing you are eliminated or changed. As part of normal development, most girls' menstrual cycles become fairly regular as their hormone levels become mature and synchronized. A few women will continue to have irregular cycles as their normal pattern. Most often the doctor can treat a hormone imbalance, once the cause is discovered.
Menstrual cycles vary in length from one woman to another. They may occur at the same time each month or be irregular. Typically, a cycle occurs about once a month, but can be as short as 21 days or as long as 35 days and still be considered normal. Menstrual flow lasts about 3 to 7 days. A menstrual period is considered late if it is 5 or more days overdue according to the usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
What is the cause?
A late or missed period could be because of any of the following:
Pregnancy
This is the most common cause of missed periods. If you have had unprotected sex even once in the past several months, see your doctor for a pregnancy test before you consider any of the other possible causes.
Stress
Stress is the second most common cause of late or missed periods in teenagers. It may be emotional stress or depression. Or it may be physical stress, such as a severe illness, a sexually transmitted infection, rapid weight loss or gain, or strenuous exercise. Dieting or binging and purging may interrupt menstrual cycles. Changes in your usual routine, for example, going on a vacation may also cause your period to be late or missed.
Normal development
During the first couple of years of menstruation many teenagers have irregular periods. During this time the body's hormones are not yet finely tuned, so the ovaries may not release an egg once every month. As a result, your cycles may be irregular, occurring as close together as 2 weeks or as far apart as 3 months.
Hormone imbalance
Hormone imbalance is rarely the cause of missed periods. In teenagers, polycystic ovary syndrome is the most common type of hormone imbalance that affects the menstrual cycle. Polycystic ovaries may cause irregular cycles, increased body hair, acne, and weight gain. Sometimes when you stop taking birth control pills you may have a temporary hormone imbalance and loss of periods. If you are having sex, be sure to use another reliable method of birth control because you could still become pregnant. Problems of the thyroid gland, pituitary gland, adrenal glands, or ovaries can be rare causes of irregular periods.
How to know what the cause is?
Pregnancy: A positive pregnancy test is the only way to be certain of pregnancy. It is best to see your doctor for a pregnancy test.
Stress: Some stress is a normal part of daily life. Only you can know if you are under too much stress.
Normal development: If your doctor finds nothing abnormal during your physical examination and you've been having periods for 2 years or less, your irregular periods may be part of your normal development. If you have had sexual intercourse, go to your doctor's office for a pregnancy test when your period is late for you, even if you normally have irregular cycles.
Hormone imbalance: If you have missed several periods without an explanation, your doctor can check your ovaries and look for any signs of hormone imbalance. Blood tests can be done to measure hormone levels.
When will periods return to normal?
It is important to identify pregnancy early so that you can discuss the options available to you and start prenatal care. Early prenatal care helps ensure a healthy baby. If the irregularity is due to stress then your periods should return when the activities or situations that are stressing you are eliminated or changed. As part of normal development, most girls' menstrual cycles become fairly regular as their hormone levels become mature and synchronized. A few women will continue to have irregular cycles as their normal pattern. Most often the doctor can treat a hormone imbalance, once the cause is discovered.
Irregular periods
Irregularity in the menstrual cycle
Menstrual cycles vary in length from one woman to another. They may occur at the same time each month or be irregular. Typically, a cycle occurs about once a month, but can be as short as 21 days or as long as 35 days and still be considered normal. Menstrual flow lasts about 3 to 7 days. A menstrual period is considered late if it is 5 or more days overdue according to the usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
What is the cause?
A late or missed period could be because of any of the following:
Pregnancy
This is the most common cause of missed periods. If you have had unprotected sex even once in the past several months, see your doctor for a pregnancy test before you consider any of the other possible causes.
Stress
Stress is the second most common cause of late or missed periods in teenagers. It may be emotional stress or depression. Or it may be physical stress, such as a severe illness, a sexually transmitted infection, rapid weight loss or gain, or strenuous exercise. Dieting or binging and purging may interrupt menstrual cycles. Changes in your usual routine, for example, going on a vacation may also cause your period to be late or missed.
Normal development
During the first couple of years of menstruation many teenagers have irregular periods. During this time the body's hormones are not yet finely tuned, so the ovaries may not release an egg once every month. As a result, your cycles may be irregular, occurring as close together as 2 weeks or as far apart as 3 months.
Hormone imbalance
Hormone imbalance is rarely the cause of missed periods. In teenagers, polycystic ovary syndrome is the most common type of hormone imbalance that affects the menstrual cycle. Polycystic ovaries may cause irregular cycles, increased body hair, acne, and weight gain. Sometimes when you stop taking birth control pills you may have a temporary hormone imbalance and loss of periods. If you are having sex, be sure to use another reliable method of birth control because you could still become pregnant. Problems of the thyroid gland, pituitary gland, adrenal glands, or ovaries can be rare causes of irregular periods.
How to know what the cause is?
Pregnancy: A positive pregnancy test is the only way to be certain of pregnancy. It is best to see your doctor for a pregnancy test.
Stress: Some stress is a normal part of daily life. Only you can know if you are under too much stress.
Normal development: If your doctor finds nothing abnormal during your physical examination and you've been having periods for 2 years or less, your irregular periods may be part of your normal development. If you have had sexual intercourse, go to your doctor's office for a pregnancy test when your period is late for you, even if you normally have irregular cycles.
Hormone imbalance: If you have missed several periods without an explanation, your doctor can check your ovaries and look for any signs of hormone imbalance. Blood tests can be done to measure hormone levels.
When will periods return to normal?
It is important to identify pregnancy early so that you can discuss the options available to you and start prenatal care. Early prenatal care helps ensure a healthy baby. If the irregularity is due to stress then your periods should return when the activities or situations that are stressing you are eliminated or changed. As part of normal development, most girls' menstrual cycles become fairly regular as their hormone levels become mature and synchronized. A few women will continue to have irregular cycles as their normal pattern. Most often the doctor can treat a hormone imbalance, once the cause is discovered.
Menstrual cycles vary in length from one woman to another. They may occur at the same time each month or be irregular. Typically, a cycle occurs about once a month, but can be as short as 21 days or as long as 35 days and still be considered normal. Menstrual flow lasts about 3 to 7 days. A menstrual period is considered late if it is 5 or more days overdue according to the usual pattern of periods. A period is considered missed if there is no menstrual flow for 6 or more weeks.
What is the cause?
A late or missed period could be because of any of the following:
Pregnancy
This is the most common cause of missed periods. If you have had unprotected sex even once in the past several months, see your doctor for a pregnancy test before you consider any of the other possible causes.
Stress
Stress is the second most common cause of late or missed periods in teenagers. It may be emotional stress or depression. Or it may be physical stress, such as a severe illness, a sexually transmitted infection, rapid weight loss or gain, or strenuous exercise. Dieting or binging and purging may interrupt menstrual cycles. Changes in your usual routine, for example, going on a vacation may also cause your period to be late or missed.
Normal development
During the first couple of years of menstruation many teenagers have irregular periods. During this time the body's hormones are not yet finely tuned, so the ovaries may not release an egg once every month. As a result, your cycles may be irregular, occurring as close together as 2 weeks or as far apart as 3 months.
Hormone imbalance
Hormone imbalance is rarely the cause of missed periods. In teenagers, polycystic ovary syndrome is the most common type of hormone imbalance that affects the menstrual cycle. Polycystic ovaries may cause irregular cycles, increased body hair, acne, and weight gain. Sometimes when you stop taking birth control pills you may have a temporary hormone imbalance and loss of periods. If you are having sex, be sure to use another reliable method of birth control because you could still become pregnant. Problems of the thyroid gland, pituitary gland, adrenal glands, or ovaries can be rare causes of irregular periods.
How to know what the cause is?
Pregnancy: A positive pregnancy test is the only way to be certain of pregnancy. It is best to see your doctor for a pregnancy test.
Stress: Some stress is a normal part of daily life. Only you can know if you are under too much stress.
Normal development: If your doctor finds nothing abnormal during your physical examination and you've been having periods for 2 years or less, your irregular periods may be part of your normal development. If you have had sexual intercourse, go to your doctor's office for a pregnancy test when your period is late for you, even if you normally have irregular cycles.
Hormone imbalance: If you have missed several periods without an explanation, your doctor can check your ovaries and look for any signs of hormone imbalance. Blood tests can be done to measure hormone levels.
When will periods return to normal?
It is important to identify pregnancy early so that you can discuss the options available to you and start prenatal care. Early prenatal care helps ensure a healthy baby. If the irregularity is due to stress then your periods should return when the activities or situations that are stressing you are eliminated or changed. As part of normal development, most girls' menstrual cycles become fairly regular as their hormone levels become mature and synchronized. A few women will continue to have irregular cycles as their normal pattern. Most often the doctor can treat a hormone imbalance, once the cause is discovered.
Incest
What is incest?
Incest is sexual intercourse that takes place between individuals related by blood. The act may be committed by a father with his daughter, between a grandparent and a grandchild and between a brother and a sister. Though children of the same sex as the perpetrator may also be victims of molestation, it is not termed as incest because penetration does not take place.
Incest is different from child sexual abuse, since the latter consists of any "sexual" act with the child. This does not necessarily include penetration. Child abuse may include fondling, exhibitionism, masturbation, sexual intercourse or showing of explicitly sexual material. Child pornography (involving children in the production of pornographic material) is also a form of child sexual abuse.
Why does incest occur?
There is no cause for incestuous relations to develop between members of a family. In most cases, incest occurs when a young child is threatened by an older and more powerful member of the family. The older member of the family usually wants to exert and express his power on the child when he is unable to do so under normal circumstances. In a minority of cases, incest may be with mutual consent of both the individuals involved.
There are certain conditions under which the risk is increased. Some of them are:
When the individuals involved have mental defects so that they are unable to comprehend the prohibition associated with the act
When the individuals involved, get into an incestuous relationship with consent and are unable to control their feelings
When alcohol removes the sense of prohibition
When related individuals are separated early in their lives and meet later as strangers, e.g., a brother and sister who meet as adults after being separated during childhood and are unaware of their relationship
Where close relatives live in proximity which gives rise to physical intimacy.
What are the feelings that a child may experience after incest?
A child who has been molested by a trusted member of the family may go through a multitude of emotions after the act. The first feeling that most children feel is denial. The child may believe it to be a bad dream. Fear is another emotion that is experienced almost simultaneously. The child, in most cases, is afraid of the authority of the perpetrator and has usually been sworn to secrecy by the adult. Because of this reason, the child may not be able to share his feelings with anyone.
Children may become withdrawn after being molested. This is worse when the molester is someone the child knows and trusts. She may start having nightmares and may suddenly become very fearful. She may become moody and may have fits of incessant crying. The child usually refuses to discus the problem with anyone for fear of rebuke or harm.
An adolescent may become depressed and may avoid the company of the molester. Some youngsters may develop personality disorders like schizophrenia and obsessive compulsive disorder. They may subconsciously blame the other parent for not saving them. Some children grow up to hate their bodies while others may believe that they can be "used" by anybody at any time.
How can an individual be helped later?
Talking with a professional helps most people who have undergone this trauma. This helps to purge hidden feelings of guilt, fear and anger. The victim can join a support group working in the area of rehabilitation of incest victims. A warm and supportive family atmosphere goes a long way towards rehabilitating a victim. Most important is that she should not be blamed for the act and not be made to feel guilty.
What is the legal status for incest in India?
In India, incest, is not an offence. Indian law does not recognize incest as a punishable crime, unless the child is a minor, in which case it is treated as child sexual abuse. Section 90 of the Indian Penal Code deals with sexual abuse of children. According to the IPC, "there is no specific provision in the Indian law as regards to sexual abuse of children by parents or teachers. Such acts are covered by the general provisions relating to sexual abuse of children by their custodian, in whatever capacity they may be.
Incest is sexual intercourse that takes place between individuals related by blood. The act may be committed by a father with his daughter, between a grandparent and a grandchild and between a brother and a sister. Though children of the same sex as the perpetrator may also be victims of molestation, it is not termed as incest because penetration does not take place.
Incest is different from child sexual abuse, since the latter consists of any "sexual" act with the child. This does not necessarily include penetration. Child abuse may include fondling, exhibitionism, masturbation, sexual intercourse or showing of explicitly sexual material. Child pornography (involving children in the production of pornographic material) is also a form of child sexual abuse.
Why does incest occur?
There is no cause for incestuous relations to develop between members of a family. In most cases, incest occurs when a young child is threatened by an older and more powerful member of the family. The older member of the family usually wants to exert and express his power on the child when he is unable to do so under normal circumstances. In a minority of cases, incest may be with mutual consent of both the individuals involved.
There are certain conditions under which the risk is increased. Some of them are:
When the individuals involved have mental defects so that they are unable to comprehend the prohibition associated with the act
When the individuals involved, get into an incestuous relationship with consent and are unable to control their feelings
When alcohol removes the sense of prohibition
When related individuals are separated early in their lives and meet later as strangers, e.g., a brother and sister who meet as adults after being separated during childhood and are unaware of their relationship
Where close relatives live in proximity which gives rise to physical intimacy.
What are the feelings that a child may experience after incest?
A child who has been molested by a trusted member of the family may go through a multitude of emotions after the act. The first feeling that most children feel is denial. The child may believe it to be a bad dream. Fear is another emotion that is experienced almost simultaneously. The child, in most cases, is afraid of the authority of the perpetrator and has usually been sworn to secrecy by the adult. Because of this reason, the child may not be able to share his feelings with anyone.
Children may become withdrawn after being molested. This is worse when the molester is someone the child knows and trusts. She may start having nightmares and may suddenly become very fearful. She may become moody and may have fits of incessant crying. The child usually refuses to discus the problem with anyone for fear of rebuke or harm.
An adolescent may become depressed and may avoid the company of the molester. Some youngsters may develop personality disorders like schizophrenia and obsessive compulsive disorder. They may subconsciously blame the other parent for not saving them. Some children grow up to hate their bodies while others may believe that they can be "used" by anybody at any time.
How can an individual be helped later?
Talking with a professional helps most people who have undergone this trauma. This helps to purge hidden feelings of guilt, fear and anger. The victim can join a support group working in the area of rehabilitation of incest victims. A warm and supportive family atmosphere goes a long way towards rehabilitating a victim. Most important is that she should not be blamed for the act and not be made to feel guilty.
What is the legal status for incest in India?
In India, incest, is not an offence. Indian law does not recognize incest as a punishable crime, unless the child is a minor, in which case it is treated as child sexual abuse. Section 90 of the Indian Penal Code deals with sexual abuse of children. According to the IPC, "there is no specific provision in the Indian law as regards to sexual abuse of children by parents or teachers. Such acts are covered by the general provisions relating to sexual abuse of children by their custodian, in whatever capacity they may be.
Sex during pregnancy
Pregnancy is the time when most women experience a change in their hormonal profile to such a degree that they may have to alter a lot of their regular activities to suit their mood at that time. Sex is one of those activities which might be the most affected. Many women do not enjoy sex at all during their pregnancy while others obtain maximum pleasure.
Is it safe to have sex during pregnancy?
Sex during pregnancy is totally safe if not otherwise advised by the doctor. Most women can have sex right until the last month of their pregnancy if they do not feel uncomfortable. It is safe to have intercourse since the baby is protected by a thick mucous plug that seals the cervix and guards against infection.
Some of the medical reasons which require abstaining from sex are:
Recent vaginal bleeding
Preterm labour
Ruptured membranes (broken water bag)
Placenta praevia
Infection with STDs
Does the sexual urge diminish during pregnancy?
Sexual urge is idiosyncratic and may increase or decrease when a woman is pregnant. Most women however, feel a decreased urge to have sexual intercourse, which may be more due to the presence of other symptoms during pregnancy like nausea and abdominal heaviness than due to actual decrease in sexual desire. Increased sexual desire may be due to increased blood flow to the pelvic area during pregnancy. There are changes in the hormonal profile also which may cause an increase in libido. Some women enjoy unrestrained sex since the fear of an unwanted pregnancy is removed.
The first trimester is usually the worst time for a woman to think about sex since most women experience breast tenderness and morning sickness during the first three months. They may also be tired both physically and emotionally due to the novelty of the situation. By the second trimester the situation eases considerably and couples are more likely to resume their normal sexual relations. However, these preferences are purely individual and may vary from one couple to another.
By the third trimester, physical discomfort is usually increased to a large extent. This may prompt couples to adopt alternate sexual positions so that the discomfort is alleviated. The "woman on top" position may be more suitable and enjoyable than the conventional "man on top" one. The rear entry position may also be tried out.
Is oral sex safe?
Oral sex, especially during the later months can be a very feasible alternative to intercourse. It may satisfy both partners without any potential discomfort. However, care should be taken that the male partner does not blow air into the vagina since it may cause blockage of a blood vessel which could be potentially dangerous. Oral sex should also be avoided if either of the partners has a sexually transmitted disease.
Is it safe to have sex during pregnancy?
Sex during pregnancy is totally safe if not otherwise advised by the doctor. Most women can have sex right until the last month of their pregnancy if they do not feel uncomfortable. It is safe to have intercourse since the baby is protected by a thick mucous plug that seals the cervix and guards against infection.
Some of the medical reasons which require abstaining from sex are:
Recent vaginal bleeding
Preterm labour
Ruptured membranes (broken water bag)
Placenta praevia
Infection with STDs
Does the sexual urge diminish during pregnancy?
Sexual urge is idiosyncratic and may increase or decrease when a woman is pregnant. Most women however, feel a decreased urge to have sexual intercourse, which may be more due to the presence of other symptoms during pregnancy like nausea and abdominal heaviness than due to actual decrease in sexual desire. Increased sexual desire may be due to increased blood flow to the pelvic area during pregnancy. There are changes in the hormonal profile also which may cause an increase in libido. Some women enjoy unrestrained sex since the fear of an unwanted pregnancy is removed.
The first trimester is usually the worst time for a woman to think about sex since most women experience breast tenderness and morning sickness during the first three months. They may also be tired both physically and emotionally due to the novelty of the situation. By the second trimester the situation eases considerably and couples are more likely to resume their normal sexual relations. However, these preferences are purely individual and may vary from one couple to another.
By the third trimester, physical discomfort is usually increased to a large extent. This may prompt couples to adopt alternate sexual positions so that the discomfort is alleviated. The "woman on top" position may be more suitable and enjoyable than the conventional "man on top" one. The rear entry position may also be tried out.
Is oral sex safe?
Oral sex, especially during the later months can be a very feasible alternative to intercourse. It may satisfy both partners without any potential discomfort. However, care should be taken that the male partner does not blow air into the vagina since it may cause blockage of a blood vessel which could be potentially dangerous. Oral sex should also be avoided if either of the partners has a sexually transmitted disease.
Homosexuality
What is homosexuality?
Sexual orientation is a component of adult sexuality characterised by attraction towards members of a particular gender. Homosexuality is a sexual preference wherein a person feels sexually attracted to another person of the same sex. It is not a sexual perversion, nor is it a disease. Just like most people are attracted to members of the opposite sex and are called heterosexuals, a minority is attracted to members of the same sex and are called homosexuals.
In colloquial usage, a homosexual is also called 'gay'. 'Lesbian' is a specific term for homosexual women while homosexual men are usually called gay. Homosexuals experience similar feelings of love, attraction and romance like heterosexual individuals, the difference being that the feelings are felt towards a same-sex person.
All individuals have basic sexual rights which should not be violated. Some of them are:
Freedom of sexual thought, fantasy or desire.
Right to sexual entertainment.
Right NOT to be exposed to sexual material or behaviour.
Right to engage in consensual sexual activity.
What causes homosexuality?
The exact nature of the development of sexual orientation and preferences is still not known. It is not clear whether sexual preferences result from genetic causes or are moulded by the environment in which a child grows up. Though some research studies have suggested that homosexuality is genetic and is present at birth, there is no conclusive evidence to prove it. Studies conducted on twins have shown that if one of the twins is homosexual, there is a more than 50% chance that the other twin will also be gay. Some studies have also shown that there is a difference in the brains of homosexuals and heterosexuals.
There have been other studies to prove that homosexuality develops as a result of complex interactions between a child's social, psychological and physiological environment. The realisation whether an individual is homosexual or not, usually dawns after puberty. Just like heterosexuality, homosexuality is also an alternative way of life.
Is it a mental or emotional illness?
Homosexuality, historically had been considered a sin and a sexual abnormality. Till the 1970's it was considered a mental aberration and homosexuals were shunned in public life. Thus most homosexuals were afraid to reveal their sexual preference and were called 'closet homosexuals'. In 1973, the American Psychiatric Association removed homosexuality from the list of mental disorders.
Homophobia is the hatred or disgust that some people feel towards homosexuals. Homophobics refuse to be associated with homosexuals and have very rigid negative feelings for them. Homosexuals on the other hand may harbour anger towards heterosexuals for marginalizing them.
Do homosexuals have different feelings?
Homosexuals are not different human beings and do not have feelings any different from heterosexuals. However, since they are in a minority, they may develop a low self esteem because of the constant shunning by society. Most homosexuals in India, have still not been able to come out in the open with their sexuality because of the fear of societal censure. A long period of forced secretiveness about their sexuality may also have a negative impact on their psyche. Some gay men and lesbians may start dressing differently in order to make a statement to those around them, but this is most often a defence mechanism. When in a relationship, homosexuals are known to experience the same feelings as heterosexuals.
What are some of the myths surrounding homosexuality?
"Homosexuality is a deviation"
Homosexuality is not a deviation, it is an alternate sexual lifestyle. Just like heterosexuality is a way of life, so is homosexuality.
"Homosexuals have gender confusion"
This is not true. Most homosexuals dress, walk, talk and live like regular people. Any masculinity or feminity are individual personality traits and have nothing to do with one's sexual preference.
"Homosexuals are always artistic"
Since most homosexuals lead sexually repressed lives, they may be more prone to expressing themselves by means of art and music. However, there is no scientific proof that homosexuals are more artistic than others.
"Homosexuals are promiscuous"
Though not promiscuous per se, homosexuals may go through a period of promiscuity in an effort to assert their sexuality. However, once they realise their sexual orientation, homosexuals are faithful and monogamous with their partners, like heterosexuals.
What is the legal status of homosexuality in India?
According to the Indian Penal Code, homosexuality is "against the order of nature" and is thus a crime. Under section 377 of the IPC, homosexuality can be a punishable offence with an imprisonment for life. Alternatively, the offender can be imprisoned for ten years with imposition of a fine. However, the act of unnatural intercourse has to be proven to make a case. Penetration of a man by a man is termed unnatural by the Indian law.
Sexual orientation is a component of adult sexuality characterised by attraction towards members of a particular gender. Homosexuality is a sexual preference wherein a person feels sexually attracted to another person of the same sex. It is not a sexual perversion, nor is it a disease. Just like most people are attracted to members of the opposite sex and are called heterosexuals, a minority is attracted to members of the same sex and are called homosexuals.
In colloquial usage, a homosexual is also called 'gay'. 'Lesbian' is a specific term for homosexual women while homosexual men are usually called gay. Homosexuals experience similar feelings of love, attraction and romance like heterosexual individuals, the difference being that the feelings are felt towards a same-sex person.
All individuals have basic sexual rights which should not be violated. Some of them are:
Freedom of sexual thought, fantasy or desire.
Right to sexual entertainment.
Right NOT to be exposed to sexual material or behaviour.
Right to engage in consensual sexual activity.
What causes homosexuality?
The exact nature of the development of sexual orientation and preferences is still not known. It is not clear whether sexual preferences result from genetic causes or are moulded by the environment in which a child grows up. Though some research studies have suggested that homosexuality is genetic and is present at birth, there is no conclusive evidence to prove it. Studies conducted on twins have shown that if one of the twins is homosexual, there is a more than 50% chance that the other twin will also be gay. Some studies have also shown that there is a difference in the brains of homosexuals and heterosexuals.
There have been other studies to prove that homosexuality develops as a result of complex interactions between a child's social, psychological and physiological environment. The realisation whether an individual is homosexual or not, usually dawns after puberty. Just like heterosexuality, homosexuality is also an alternative way of life.
Is it a mental or emotional illness?
Homosexuality, historically had been considered a sin and a sexual abnormality. Till the 1970's it was considered a mental aberration and homosexuals were shunned in public life. Thus most homosexuals were afraid to reveal their sexual preference and were called 'closet homosexuals'. In 1973, the American Psychiatric Association removed homosexuality from the list of mental disorders.
Homophobia is the hatred or disgust that some people feel towards homosexuals. Homophobics refuse to be associated with homosexuals and have very rigid negative feelings for them. Homosexuals on the other hand may harbour anger towards heterosexuals for marginalizing them.
Do homosexuals have different feelings?
Homosexuals are not different human beings and do not have feelings any different from heterosexuals. However, since they are in a minority, they may develop a low self esteem because of the constant shunning by society. Most homosexuals in India, have still not been able to come out in the open with their sexuality because of the fear of societal censure. A long period of forced secretiveness about their sexuality may also have a negative impact on their psyche. Some gay men and lesbians may start dressing differently in order to make a statement to those around them, but this is most often a defence mechanism. When in a relationship, homosexuals are known to experience the same feelings as heterosexuals.
What are some of the myths surrounding homosexuality?
"Homosexuality is a deviation"
Homosexuality is not a deviation, it is an alternate sexual lifestyle. Just like heterosexuality is a way of life, so is homosexuality.
"Homosexuals have gender confusion"
This is not true. Most homosexuals dress, walk, talk and live like regular people. Any masculinity or feminity are individual personality traits and have nothing to do with one's sexual preference.
"Homosexuals are always artistic"
Since most homosexuals lead sexually repressed lives, they may be more prone to expressing themselves by means of art and music. However, there is no scientific proof that homosexuals are more artistic than others.
"Homosexuals are promiscuous"
Though not promiscuous per se, homosexuals may go through a period of promiscuity in an effort to assert their sexuality. However, once they realise their sexual orientation, homosexuals are faithful and monogamous with their partners, like heterosexuals.
What is the legal status of homosexuality in India?
According to the Indian Penal Code, homosexuality is "against the order of nature" and is thus a crime. Under section 377 of the IPC, homosexuality can be a punishable offence with an imprisonment for life. Alternatively, the offender can be imprisoned for ten years with imposition of a fine. However, the act of unnatural intercourse has to be proven to make a case. Penetration of a man by a man is termed unnatural by the Indian law.
Hirsutism
What is Hirsutism?
Hirsutism is the term for excess body or facial hair in women. It can be described as a male pattern of hair growth or distribution on a female body i.e. in the moustache and beard areas, or occurring more thickly than usual on the limbs. It may be the result of a serious hormonal disorder.
What are the causes?
The complaint of hirsutism is common and often accompanied by severe anxiety and social stress. Hirsutism is caused by an increased production of a group of hormones called androgens (male hormones). These hormones stimulate the development of male secondary sexual characteristics. The increased sensitivity of the skin to these hormones leads to hirsutism. Androgen disorders affect between 5% to 10% of all women. For most women the tendency towards hirsutism is inherited.
Although some women with hirsutism have increased amounts of male hormone, most have normal levels. The problem in these women is that the hairs are more sensitive than normal to small amounts of hormone. The hairs grow more quickly and thicker in response to it. The increased hair growth is usually first noted in late teenage years and tends to gradually get more severe as the woman gets older.
It can also be caused by other factors like:
Drugs (like cyclosporin, corticosteroids, diazoxide, streptomycin, interferon and acetazolamide.)
Birth control pills
Chemicals
Injury
Pressure
Allergy and infections
Cancer
Genetic conditions
What are the symptoms?
Patients with hirsutism due to hormonal causes will also have some
disturbances of menstruation, lack of ovulation, acne, deepening of voice, balding and overweight. It is more prominent on the areas of the face, which are androgen dependent.
What is the treatment?
Hirsutism may require a long-term treatment, as the problem tends to recur when the treatment is discontinued. Anti-androgens help control the male hormones that cause hirsutism. Anti-androgens usually take at least 3 to 6 months to work. They can decrease the amount of new hair growth, but are less likely to change the amount of hair one already has.
The agents used in the treatment include oestrogens (as oral contraceptives), cyproterone acetate, spironalactone as they all have anti-androgen activity. Other agents like bromocriptine, cimetidine and new agents like finasteride and flutamide can also be used. Eflornithine hydrochloride is used topically by women as a cream to remove unwanted facial hair. Losing weight reduces the amount of hormones in your body that cause increased hair growth. The local treatment like plucking, shaving, bleaching, creams or waxes may all help and are often used.
When should the doctor be consulted?
The doctor must be consulted if there is a sudden increase in the facial or body hair. Also, if the periods have become irregular or if the voice has become deeper, a specialist must be consulted.
Hirsutism is the term for excess body or facial hair in women. It can be described as a male pattern of hair growth or distribution on a female body i.e. in the moustache and beard areas, or occurring more thickly than usual on the limbs. It may be the result of a serious hormonal disorder.
What are the causes?
The complaint of hirsutism is common and often accompanied by severe anxiety and social stress. Hirsutism is caused by an increased production of a group of hormones called androgens (male hormones). These hormones stimulate the development of male secondary sexual characteristics. The increased sensitivity of the skin to these hormones leads to hirsutism. Androgen disorders affect between 5% to 10% of all women. For most women the tendency towards hirsutism is inherited.
Although some women with hirsutism have increased amounts of male hormone, most have normal levels. The problem in these women is that the hairs are more sensitive than normal to small amounts of hormone. The hairs grow more quickly and thicker in response to it. The increased hair growth is usually first noted in late teenage years and tends to gradually get more severe as the woman gets older.
It can also be caused by other factors like:
Drugs (like cyclosporin, corticosteroids, diazoxide, streptomycin, interferon and acetazolamide.)
Birth control pills
Chemicals
Injury
Pressure
Allergy and infections
Cancer
Genetic conditions
What are the symptoms?
Patients with hirsutism due to hormonal causes will also have some
disturbances of menstruation, lack of ovulation, acne, deepening of voice, balding and overweight. It is more prominent on the areas of the face, which are androgen dependent.
What is the treatment?
Hirsutism may require a long-term treatment, as the problem tends to recur when the treatment is discontinued. Anti-androgens help control the male hormones that cause hirsutism. Anti-androgens usually take at least 3 to 6 months to work. They can decrease the amount of new hair growth, but are less likely to change the amount of hair one already has.
The agents used in the treatment include oestrogens (as oral contraceptives), cyproterone acetate, spironalactone as they all have anti-androgen activity. Other agents like bromocriptine, cimetidine and new agents like finasteride and flutamide can also be used. Eflornithine hydrochloride is used topically by women as a cream to remove unwanted facial hair. Losing weight reduces the amount of hormones in your body that cause increased hair growth. The local treatment like plucking, shaving, bleaching, creams or waxes may all help and are often used.
When should the doctor be consulted?
The doctor must be consulted if there is a sudden increase in the facial or body hair. Also, if the periods have become irregular or if the voice has become deeper, a specialist must be consulted.
Aphrodisiacs
What are aphrodisiacs?
The word “Aphrodisiac” is derived from Aphrodite, the name of the ancient Greek goddess of love. It refers to drugs that arouse or increase sexual desire or excitement. These agents enhance the sexual drive, performance and lead to greater sexual satisfaction. They cause an increase in libido and sexual interest. They are sometimes used in the treatment of impotence.
Which drugs are used as aphrodisiacs?
A number of prescription drugs may act as sex stimulants. These include levodopa (l-dopa), bromociptine, amantadine, naloxone, pergolide, and imipramine.
For men, sildenafil citrate, better known as Viagra, is approved for the treatment of impotence. Clinical studies have shown that sildenafil citrate corrects erectile dysfunction problems in 60 to 70 percent of men. Viagra is a commonly used drug to facilitate a male erection in conjunction with sexual stimuli.
Arginine is also taken by men and women to enhance sex organ sensation and performance. Arginine works as well in women as it does in men. Prostaglandins have also been used as a local aphrodisiac agent. The role of oxytocin as a potential aphrodisiac in women is also being investigated.
How do they act?
These drugs act by enhancing the sex organ sensation and performance. They improve the blood flow to the male sex organs, thus improving the male libido. A similar response in women may also produce an increased sexual stimulation. Arginine works directly in the area of the genitals, whereas the other supplements act on the brain. Prostaglandins can be directly applied to the penis by injection or by a small solid insertion into the urethra. This is the most effective locally active aphrodisiac.
What are their uses?
Aphrodisiacs are primarily used to help men and women suffering from sexual dysfunctions. For men, the most common problems are impotence and premature ejaculation. It was previously thought that these were caused primarily by psychological conditions, but more recent research has shown that there is a range of physical problems, such as heart disease, stress and hormone imbalance, which can cause sexual dysfunction. Androgens (male hormones) can be prescribed for men with low libido or poor performance.
For women, low hormone levels can result in a lack of sexual interest or an inability to achieve orgasm. This happens mostly during menopause. Hormone Replacement Therapy (HRT) is now being accepted for its favourable effects in improving sexual desire, performance and pleasure in some women. Hormones in the modern context can be an aphrodisiac.
Aphrodisiacs serve the following purposes:
To increase low libido.
To improve sexual performance.
In the treatment of impotence
To treat physiological problems that affect sexual activity
What are their side effects?
The side effects of these aphrodisiacs include irregularities of the rhythm of the heart, suicidal tendencies, mental disorders and tremors. These medications must be used under medical advice.
The drug Sildenafil citrate has some side effects, which last for a few minutes to a few hours after taking the drug. These include dilation of blood vessels in other parts of the body, causing headaches and fainting. Other side effects such as facial flushing, upset stomach, blurred vision and sensitivity to light usually occur with high doses.
Who should not take Sildenafil?
It should never be taken by men who are using nitrate drugs, like nitroglycerine that is used for the treatment of chest pains due to heart disease. This could lead to a sudden drop in the blood pressure to unsafe levels.
There are additional warnings about use of the drug by individuals with cardiovascular disease. Caution is specifically advised for men who have had a stroke or heart attack or life-threatening arrhythmia in the past 6 months, those with significant low or high blood pressure or those suffering from a disease causing degeneration of the retina.
The word “Aphrodisiac” is derived from Aphrodite, the name of the ancient Greek goddess of love. It refers to drugs that arouse or increase sexual desire or excitement. These agents enhance the sexual drive, performance and lead to greater sexual satisfaction. They cause an increase in libido and sexual interest. They are sometimes used in the treatment of impotence.
Which drugs are used as aphrodisiacs?
A number of prescription drugs may act as sex stimulants. These include levodopa (l-dopa), bromociptine, amantadine, naloxone, pergolide, and imipramine.
For men, sildenafil citrate, better known as Viagra, is approved for the treatment of impotence. Clinical studies have shown that sildenafil citrate corrects erectile dysfunction problems in 60 to 70 percent of men. Viagra is a commonly used drug to facilitate a male erection in conjunction with sexual stimuli.
Arginine is also taken by men and women to enhance sex organ sensation and performance. Arginine works as well in women as it does in men. Prostaglandins have also been used as a local aphrodisiac agent. The role of oxytocin as a potential aphrodisiac in women is also being investigated.
How do they act?
These drugs act by enhancing the sex organ sensation and performance. They improve the blood flow to the male sex organs, thus improving the male libido. A similar response in women may also produce an increased sexual stimulation. Arginine works directly in the area of the genitals, whereas the other supplements act on the brain. Prostaglandins can be directly applied to the penis by injection or by a small solid insertion into the urethra. This is the most effective locally active aphrodisiac.
What are their uses?
Aphrodisiacs are primarily used to help men and women suffering from sexual dysfunctions. For men, the most common problems are impotence and premature ejaculation. It was previously thought that these were caused primarily by psychological conditions, but more recent research has shown that there is a range of physical problems, such as heart disease, stress and hormone imbalance, which can cause sexual dysfunction. Androgens (male hormones) can be prescribed for men with low libido or poor performance.
For women, low hormone levels can result in a lack of sexual interest or an inability to achieve orgasm. This happens mostly during menopause. Hormone Replacement Therapy (HRT) is now being accepted for its favourable effects in improving sexual desire, performance and pleasure in some women. Hormones in the modern context can be an aphrodisiac.
Aphrodisiacs serve the following purposes:
To increase low libido.
To improve sexual performance.
In the treatment of impotence
To treat physiological problems that affect sexual activity
What are their side effects?
The side effects of these aphrodisiacs include irregularities of the rhythm of the heart, suicidal tendencies, mental disorders and tremors. These medications must be used under medical advice.
The drug Sildenafil citrate has some side effects, which last for a few minutes to a few hours after taking the drug. These include dilation of blood vessels in other parts of the body, causing headaches and fainting. Other side effects such as facial flushing, upset stomach, blurred vision and sensitivity to light usually occur with high doses.
Who should not take Sildenafil?
It should never be taken by men who are using nitrate drugs, like nitroglycerine that is used for the treatment of chest pains due to heart disease. This could lead to a sudden drop in the blood pressure to unsafe levels.
There are additional warnings about use of the drug by individuals with cardiovascular disease. Caution is specifically advised for men who have had a stroke or heart attack or life-threatening arrhythmia in the past 6 months, those with significant low or high blood pressure or those suffering from a disease causing degeneration of the retina.
Circumcision
What is circumcision?
Circumcision is the surgical removal of the sleeve of skin and mucosal tissue that normally covers the glans (head) of the penis. This double layer, sometimes called the prepuce, is more commonly known as the foreskin.
What are the functions of the foreskin?
The foreskin serves three functions: protective, sensory, and sexual. In most cases, the foreskin is still fused to the glans at birth and will separate over a variable period of time over the first few years. During the diaper period, the foreskin protects against abrasion from diapers and faeces. Throughout life, the foreskin keeps the glans soft and moist and protects it from trauma and injury. Parts of the foreskin, such as the mucosa (inner foreskin) and frenulum, are particularly sensitive and contribute to sexual pleasure. Specialised nerve endings enhance sexual pleasure and control. The inner foreskin (mucosa) is the skin directly against the glans. The foreskin provides ample loose skin for the penis to occupy when erect. It is a movable skin sheath for the penis during intercourse, reducing chafing and the need for artificial lubricants, and allowing the glans and foreskin to naturally stimulate each other.
What are some reasons that circumcision is performed?
Phimosis is the inability to retract the foreskin fully. In babies and young boys this is normal. As the baby grows older, the foreskin separates from the underlying glans penis. In some individuals, this separation does not happen fully or due to repeated infection in that area the skin becomes scarred. It might also happen later in life. When the foreskin does not retract, it predisposes to repeated infection in that area. Also, sexual intercourse may become painful and result in bleeding. The only treatment at that stage is a minor operation called circumcision, in which the foreskin is surgically removed.
Is circumcision painful?
When done without pain medicine, circumcision is painful. There are pain medicines available that are safe and effective. It is recommended that they be used to reduce pain from circumcision. Local anaesthetics can be injected into the penis to lower pain and stress in infants. There are also topical creams that can help. Problems with using pain medicine are rare and usually not serious.
What to expect after the procedure?
After the circumcision, the tip of the penis may seem raw or yellowish. If there is a bandage, it should be changed with each diapering to reduce the risk of the penis becoming infected. The plastic ring that is left on the tip of the penis usually drops off within five to eight days. For both newborns and older children, circumcision is considered a very safe procedure with complete healing expected.
What are the health benefits?
Possible benefits of circumcision include:
Circumcision prevents infection and inflammation of the foreskin. And it may decrease the risk of penile cancer.
It might play a role in reducing the risk of sexually transmitted diseases. Practicing safe sex, however, is a far more important factor in preventing these diseases than whether a man is circumcised.
Infants who are not circumcised may be more likely to develop urinary tract infections. These infections early in life may lead to kidney problems later in life. Infants who have kidney or bladder abnormalities are at higher risk of urinary tract infections, so circumcision may be advised for these babies.
In rare circumstances problems can occur with the uncircumcised penis that may require circumcision at an older age. These problems include inflammation of the foreskin or adherence of the foreskin to the tip of the penis. Circumcision during infancy eliminates the possible need for the procedure at an older age.
Circumcision makes it easy to keep the end of the penis clean. However, the shedding skin cells that naturally accumulate on the glans of an uncircumcised boy are not harmful. Do not try to force the foreskin back to clean the penis of an infant or young boy. Washing externally with mild soap and water is all that is necessary.
Possible risks:
Like any minor surgery, circumcision poses some risk to the newborn:
Circumcision may cause excessive bleeding or infection, but this is rare.
Circumcision does cause pain. Local anaesthesia is frequently used. If you decide to have your son circumcised, you should to talk to your doctor about whether local anaesthesia will be used.
Circumcision is a preventive measure but is by no means a guarantee that medical issues will not develop later in life at the tip of the penis.
Circumcision is the surgical removal of the sleeve of skin and mucosal tissue that normally covers the glans (head) of the penis. This double layer, sometimes called the prepuce, is more commonly known as the foreskin.
What are the functions of the foreskin?
The foreskin serves three functions: protective, sensory, and sexual. In most cases, the foreskin is still fused to the glans at birth and will separate over a variable period of time over the first few years. During the diaper period, the foreskin protects against abrasion from diapers and faeces. Throughout life, the foreskin keeps the glans soft and moist and protects it from trauma and injury. Parts of the foreskin, such as the mucosa (inner foreskin) and frenulum, are particularly sensitive and contribute to sexual pleasure. Specialised nerve endings enhance sexual pleasure and control. The inner foreskin (mucosa) is the skin directly against the glans. The foreskin provides ample loose skin for the penis to occupy when erect. It is a movable skin sheath for the penis during intercourse, reducing chafing and the need for artificial lubricants, and allowing the glans and foreskin to naturally stimulate each other.
What are some reasons that circumcision is performed?
Phimosis is the inability to retract the foreskin fully. In babies and young boys this is normal. As the baby grows older, the foreskin separates from the underlying glans penis. In some individuals, this separation does not happen fully or due to repeated infection in that area the skin becomes scarred. It might also happen later in life. When the foreskin does not retract, it predisposes to repeated infection in that area. Also, sexual intercourse may become painful and result in bleeding. The only treatment at that stage is a minor operation called circumcision, in which the foreskin is surgically removed.
Is circumcision painful?
When done without pain medicine, circumcision is painful. There are pain medicines available that are safe and effective. It is recommended that they be used to reduce pain from circumcision. Local anaesthetics can be injected into the penis to lower pain and stress in infants. There are also topical creams that can help. Problems with using pain medicine are rare and usually not serious.
What to expect after the procedure?
After the circumcision, the tip of the penis may seem raw or yellowish. If there is a bandage, it should be changed with each diapering to reduce the risk of the penis becoming infected. The plastic ring that is left on the tip of the penis usually drops off within five to eight days. For both newborns and older children, circumcision is considered a very safe procedure with complete healing expected.
What are the health benefits?
Possible benefits of circumcision include:
Circumcision prevents infection and inflammation of the foreskin. And it may decrease the risk of penile cancer.
It might play a role in reducing the risk of sexually transmitted diseases. Practicing safe sex, however, is a far more important factor in preventing these diseases than whether a man is circumcised.
Infants who are not circumcised may be more likely to develop urinary tract infections. These infections early in life may lead to kidney problems later in life. Infants who have kidney or bladder abnormalities are at higher risk of urinary tract infections, so circumcision may be advised for these babies.
In rare circumstances problems can occur with the uncircumcised penis that may require circumcision at an older age. These problems include inflammation of the foreskin or adherence of the foreskin to the tip of the penis. Circumcision during infancy eliminates the possible need for the procedure at an older age.
Circumcision makes it easy to keep the end of the penis clean. However, the shedding skin cells that naturally accumulate on the glans of an uncircumcised boy are not harmful. Do not try to force the foreskin back to clean the penis of an infant or young boy. Washing externally with mild soap and water is all that is necessary.
Possible risks:
Like any minor surgery, circumcision poses some risk to the newborn:
Circumcision may cause excessive bleeding or infection, but this is rare.
Circumcision does cause pain. Local anaesthesia is frequently used. If you decide to have your son circumcised, you should to talk to your doctor about whether local anaesthesia will be used.
Circumcision is a preventive measure but is by no means a guarantee that medical issues will not develop later in life at the tip of the penis.
Hepatitis C
What is hepatitis C?
Hepatitis C virus causes an inflammation of the liver. The hepatitis C virus (HCV) is found in the blood of persons who have this disease. HCV is spread by contact with the blood of an infected person.
What are the causes?
Hepatitis C infection is caused by the hepatitis C virus (HCV). Persons who may be at risk for hepatitis C are those who:
received blood, blood products, or solid organs from a donor who has hepatitis C
have injected street drugs or shared a needle with someone who has hepatitis C
have been on long-term dialysis for kidney failure
have frequent contact with blood on the job such as doctors
have sexual intercourse with multiple partners
have sex with a person who has hepatitis C
share personal items, such as toothbrushes and razors, with someone who has hepatitis C
are born to hepatitis C infected mothers
What are the symptoms?
Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. The following symptoms could occur:
jaundice
abdominal pain in the right upper abdomen
fatigue
loss of appetite
nausea and vomiting
low-grade fever
pale or clay-coloured stools
dark urine
generalised itching
How is it diagnosed?
There are several blood tests that can be done to determine if one has been infected with HCV. Your doctor may order one or a combination of these tests.
a) Anti-HCV (antibody to HCV)
EIA (enzyme immunoassay): This test is usually done first. If positive, it should be confirmed
RIBA (recombinant immunoblot assay): A supplemental test used to confirm a positive EIA test
Anti-HCV does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.
b) Qualitative tests to detect presence or absence of virus (HCV RNA)
c) Quantitative tests to detect amount (titre) of virus (HCV RNA)
Hepatitis virus serology with negative antibody to hepatitis A and hepatitis B
ELISA assay to detect hepatitis C antibody
Hepatitis C PCR test
Elevated liver enzymes
Liver biopsy showing acute or resolving hepatitis
What is the treatment?
Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin.
Interferon alpha is given by injection just under the skin and has a number of side effects, including flu-like symptoms, headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets.
Ribavirin is a capsule taken twice daily, and the major side effects are severe anaemia (low red blood cells) and birth defects. Women should, therefore, avoid pregnancy during and for 6 months following treatment.
Recently, a version of interferon alpha with a longer half-life (pegylated interferon alpha) has been introduced, and the longer half-life means the injections are taken weekly instead of the three times a week with standard interferon alpha. Pegylated interferon alpha and ribavirin lead to a sustained response in approximately 50% of patients. A sustained response means that the patient remains free of hepatitis C virus 6 months after stopping therapy. People with hepatitis C should avoid any substances toxic to the liver (hepatotoxic). All patients with hepatitis C should be immunised against hepatitis A and B also.
People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their doctor. Patients with hepatitis C should avoid alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of the treatment.
What are the complications?
chronic hepatitis
cirrhosis
What is the prevention?
One should avoid contact with blood or blood products whenever possible. Health care workers should practice universal precautions when handling blood and body fluids.
One should not inject drugs of abuse, and especially not share needles with anyone. One should be cautious when getting tattoos and body piercings done.
Sexual transmission is low among stable, monogamous couples. A partner should be screened for hepatitis C. If the partner is negative, the current recommendations are to make no changes in sexual practices. Individuals having sex outside of a monogamous relationship should practice safer sex behaviours to avoid hepatitis C as well as sexually transmitted diseases, including HIV and hepatitis B. Currently there is no vaccine for hepatitis C.
Hepatitis C virus causes an inflammation of the liver. The hepatitis C virus (HCV) is found in the blood of persons who have this disease. HCV is spread by contact with the blood of an infected person.
What are the causes?
Hepatitis C infection is caused by the hepatitis C virus (HCV). Persons who may be at risk for hepatitis C are those who:
received blood, blood products, or solid organs from a donor who has hepatitis C
have injected street drugs or shared a needle with someone who has hepatitis C
have been on long-term dialysis for kidney failure
have frequent contact with blood on the job such as doctors
have sexual intercourse with multiple partners
have sex with a person who has hepatitis C
share personal items, such as toothbrushes and razors, with someone who has hepatitis C
are born to hepatitis C infected mothers
What are the symptoms?
Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. The following symptoms could occur:
jaundice
abdominal pain in the right upper abdomen
fatigue
loss of appetite
nausea and vomiting
low-grade fever
pale or clay-coloured stools
dark urine
generalised itching
How is it diagnosed?
There are several blood tests that can be done to determine if one has been infected with HCV. Your doctor may order one or a combination of these tests.
a) Anti-HCV (antibody to HCV)
EIA (enzyme immunoassay): This test is usually done first. If positive, it should be confirmed
RIBA (recombinant immunoblot assay): A supplemental test used to confirm a positive EIA test
Anti-HCV does not tell whether the infection is new (acute), chronic (long-term) or is no longer present.
b) Qualitative tests to detect presence or absence of virus (HCV RNA)
c) Quantitative tests to detect amount (titre) of virus (HCV RNA)
Hepatitis virus serology with negative antibody to hepatitis A and hepatitis B
ELISA assay to detect hepatitis C antibody
Hepatitis C PCR test
Elevated liver enzymes
Liver biopsy showing acute or resolving hepatitis
What is the treatment?
Some patients with hepatitis C benefit from treatment with interferon alpha or a combination of interferon alpha and ribavirin.
Interferon alpha is given by injection just under the skin and has a number of side effects, including flu-like symptoms, headaches, fever, fatigue, loss of appetite, nausea, vomiting, depression, and thinning of hair. Treatment with interferon alpha may also interfere with the production of white blood cells and platelets.
Ribavirin is a capsule taken twice daily, and the major side effects are severe anaemia (low red blood cells) and birth defects. Women should, therefore, avoid pregnancy during and for 6 months following treatment.
Recently, a version of interferon alpha with a longer half-life (pegylated interferon alpha) has been introduced, and the longer half-life means the injections are taken weekly instead of the three times a week with standard interferon alpha. Pegylated interferon alpha and ribavirin lead to a sustained response in approximately 50% of patients. A sustained response means that the patient remains free of hepatitis C virus 6 months after stopping therapy. People with hepatitis C should avoid any substances toxic to the liver (hepatotoxic). All patients with hepatitis C should be immunised against hepatitis A and B also.
People with hepatitis C should also be careful not to take vitamins, nutritional supplements, or new over-the-counter medications without first discussing it with their doctor. Patients with hepatitis C should avoid alcohol. Even moderate amounts of alcohol speed up the progression of hepatitis C, and alcohol reduces the effectiveness of the treatment.
What are the complications?
chronic hepatitis
cirrhosis
What is the prevention?
One should avoid contact with blood or blood products whenever possible. Health care workers should practice universal precautions when handling blood and body fluids.
One should not inject drugs of abuse, and especially not share needles with anyone. One should be cautious when getting tattoos and body piercings done.
Sexual transmission is low among stable, monogamous couples. A partner should be screened for hepatitis C. If the partner is negative, the current recommendations are to make no changes in sexual practices. Individuals having sex outside of a monogamous relationship should practice safer sex behaviours to avoid hepatitis C as well as sexually transmitted diseases, including HIV and hepatitis B. Currently there is no vaccine for hepatitis C.
HIV infection and AIDS
What is HIV infection and AIDS?
The Human Immuno-deficiency Virus or HIV is the organism that ultimately causes AIDS. Soon after first getting the HIV infection the person has a short, self limiting ‘flue-like disease. This only lasts a few days and is so mild that many persons do not even know it. The virus slowly destroys the ability of the body to resist common communicable diseases. When tha resistance of the body is so reduced that infections can no longer be resisted, the person is said to have AIDS. The mean period between getting the HIV infection and developing AIDS is 9.8 years. In other words, in 9.8 years half the HIV infected persons can be expected to develop AIDS and conversely it must be emphasized that half the persons will still be well and healthy at this time.
Once a person has lost the ability to resist common infections and has developed AIDS, the prognosis is poor and death usually comes in 12 to 18 months unless anti-retroviral treatment is initiated. On anti-retrovirals a person can be expected to be sustained for long time. The infection is not cured and treatment must continue life-long.
It must be stressed again that in the early stages of HIV infection, the person feels well and is able to function normally. Examination by a doctor will not reveal any illness and the only detected abnormality is a positive blood test. Such persons should be encouraged to live normally and continue their normal occupation.
AIDS is a serious illness caused by infection with the human immunodeficiency virus (HIV). HIV breaks down the body's immune system, so the person with AIDS can no longer fight off disease successfully. As a result, secondary infections, cancers can more easily take root in the body.
It takes from 6 weeks to several months for the body to form sufficient antibodies (proteins produced in response to infection to show a positive test). When these antibodies can be detected in the blood, the patient is said to be HIV-positive. AIDS is a much later stage when the ability to fight off serious infections is lost.
How does it occur?
HIV is spread by unprotected penetrative sexual contact with an infected person. It can also be acquired when infected blood enters the persons’ blood by sharing needles or the transfusion of infected blood and organ transplants. Infection can also be transmitted from an infected mother to her child in the uterus, during delivery or while breastfeeding.
The virus is also found in smaller amounts in tears, saliva, brain, spinal fluid, urine, and faeces although contact with these bodily fluids is not likely to transmit the virus. Casual contact such as by shaking hands, social kisses, touching an infected person, touching something that the person has handled, using public toilets or telephones, or using swimming pools does NOT spread HIV. The available information also bears out that HIV is not spread by mosquito or other insect bites.
What are the symptoms?
The symptoms of AIDS are the symptoms of the diseases that attack the body because of a weakened immune system. One should never, therefore, attempt to diagnose HIV infection on the basis of symptom or signs only. Patients with HIV/AIDS may present with a variety of manifestations which include:
Fever, sweats, chills
Fatigue
Loss of appetite, weight loss
nausea, vomiting
Sore throat
Diarrhoea
Cough
Shortness of breath
Body rash
Skin problems
It is important to always keep in mind that all the above symptoms are non-specific and commonly occur in a variety of conditions. To establish a diagnosis of HIV/AIDS a blood test that has been confirmed is essential. A physical examination and other tests are necessary to rule out other illnesses.
How is a test for HIV infection done?
Most of the blood tests used to detect HIV infection work by detecting the presence of HIV antibodies. Keep in mind that early in infection there may not be sufficient antibodies present in the blood to give a positive reaction even though the person has HIV infection. This period is known as the “Window Period” and is dangerous as though the person has a negative test, infection can be spread through sex or blood.
The commonest test used is the ELISA test. The result of a single ELISA (or Rapid / Spot tests) should never be taken to indicate infection but merely as an indication for repeated tests to confirm the result. The WHO recommends that ERS (ELISA, Rapid or Spot) always be repeated to confirm the diagnosis, preferably using a different make of test kit. The Western Blot test is no longer recommended as a mandatory confirmatory test. A single positive test does not indicate infection and must always be confirmed. A negative test does not guarantee that a person is not infected where the risk exposure has occurred recently. If the person has only recently been infected, the antibodies may not yet have been formed (window phase). It may take up to 3 to even 6 months for someone to develop adequate antibodies after exposure to the virus. A confirmed positive test indicates that the person has been exposed to the virus and has developed antibodies but may not necessarily progress to full-blown AIDS.
Who is at high risk for HIV infection?
Men and women with more than one partner who have oral, anal, or vaginal sex without a condom
Sexual partners of people who are infected
People who receive regular blood transfusions (haemophiliaand thalassaemia) or who received blood transfusion prior to the time screening of blood for HIV was made mandatory
Babies born to infected mothers
People who share needles (for IV drugs, tattooing or piercing) and their sexual partners
People who receive injections with recycled disposable syringes or needles
Prostitutes and their sex partners
How can exposure to HIV be avoided?
The best way of self-protection is to learn as much as possible about HIV infection, avoid risky behaviour, and follow guidelines for protection. Abstinence, non-penetrative sex or a stable relationship between mutually faithful partners is optimal. Where this is not possible, risk can be substantially reduced by the following:
Use latex condoms correctly and consistently. Keep in mind that condoms offer protection but risk is not totally eliminated by using condoms
Do not share needles and syringes for injecting drugs, preferably avoid intravenous drug abuse
Ensure the use of single use disposable needles and syringes for injection
Insist on sterile disposable syringes and needles for injections
Never use a paid blood donor
Get all sexually transmitted infections treated by a qualified doctor as soon as possible, also get your partner checked/treated
Do not visit prostitutes
Avoid casual sex
At this time, there is no cure or vaccination that will prevent HIV infection, though a lot of research is being done for a vaccine. Anyone engaging in high-risk behaviour should contact a physician to arrange for a complete physical examination and blood tests.
Instructions for using latex condoms:
Use a latex condom during intercourse or other acts involving contact with a man's penis
Put the condom on after the penis is erect but before intimate contact. Sores, any secretions from the penis (including semen), vaginal secretions, urine, faeces, and possibly saliva can contain sexually transmitted disease organisms
Put the condom on the head of the penis and unroll it all the way to the base
Leave an empty space at the end of the condom to collect semen.
Sqeeze the tip of the condom before rolling it on to the penis to ensure that no air is trapped in the bulb of the condom. Air if present can cause the condom to burst or rupture during use and thus expose the person to infection.
If a lubricant is desired, use one that is water-based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream, because these may damage the condom
After ejaculation, carefully withdraw the penis before it is completely limp and draw off the condom carefully to avoid spilling.
The used condom should be disposed of safely, preferably after tying a knot in it to avoid spilling of semen.
Store condoms in a cool, dark, dry place.
Do not use a condom which is sticky, brittle, discoloured, or obviously damaged
Use each condom only once
ELISA and Western Blot Tests
The most common test for AIDS is the ELISA (Enzyme-Linked Immuno-Sorbent Assay), which is performed on a blood sample. This test is very sensitive and detects almost all persons infected with the human immunodeficiency virus (HIV) except during the first few weeks of infection. The ELISA test detects the body's immune response to HIV.
Single tests must not be used to diagnose HIV infection. False positive test results are not infrequent with the ELIA and similar tests. Before making a diagnosis that a specimen is HIV positive, the test result must be confirmed by one or even two repeat tests, even on the same specimen if sufficient sample is available. The confirmatory repeat tests can be ELISA or Rapid / Spot tests. It is preferable to use test kits that are different when doing a confirmatory tests. Confirmation by the Western Blot test is no longer the recommended procedure.
Anyone with a positive test for HIV infection should seek follow-up medical evaluation, interpretation of the results, counselling, and advice for possible lifestyle changes. A negative HIV antibody test implies either the person has not been infected with the HIV virus or does not have a detectable level of HIV antibodies. If the results of the same test done six months later are still negative for HIV antibodies, AIDS infection is highly unlikely, assuming there have been no high-risk activities in those six months.
The Human Immuno-deficiency Virus or HIV is the organism that ultimately causes AIDS. Soon after first getting the HIV infection the person has a short, self limiting ‘flue-like disease. This only lasts a few days and is so mild that many persons do not even know it. The virus slowly destroys the ability of the body to resist common communicable diseases. When tha resistance of the body is so reduced that infections can no longer be resisted, the person is said to have AIDS. The mean period between getting the HIV infection and developing AIDS is 9.8 years. In other words, in 9.8 years half the HIV infected persons can be expected to develop AIDS and conversely it must be emphasized that half the persons will still be well and healthy at this time.
Once a person has lost the ability to resist common infections and has developed AIDS, the prognosis is poor and death usually comes in 12 to 18 months unless anti-retroviral treatment is initiated. On anti-retrovirals a person can be expected to be sustained for long time. The infection is not cured and treatment must continue life-long.
It must be stressed again that in the early stages of HIV infection, the person feels well and is able to function normally. Examination by a doctor will not reveal any illness and the only detected abnormality is a positive blood test. Such persons should be encouraged to live normally and continue their normal occupation.
AIDS is a serious illness caused by infection with the human immunodeficiency virus (HIV). HIV breaks down the body's immune system, so the person with AIDS can no longer fight off disease successfully. As a result, secondary infections, cancers can more easily take root in the body.
It takes from 6 weeks to several months for the body to form sufficient antibodies (proteins produced in response to infection to show a positive test). When these antibodies can be detected in the blood, the patient is said to be HIV-positive. AIDS is a much later stage when the ability to fight off serious infections is lost.
How does it occur?
HIV is spread by unprotected penetrative sexual contact with an infected person. It can also be acquired when infected blood enters the persons’ blood by sharing needles or the transfusion of infected blood and organ transplants. Infection can also be transmitted from an infected mother to her child in the uterus, during delivery or while breastfeeding.
The virus is also found in smaller amounts in tears, saliva, brain, spinal fluid, urine, and faeces although contact with these bodily fluids is not likely to transmit the virus. Casual contact such as by shaking hands, social kisses, touching an infected person, touching something that the person has handled, using public toilets or telephones, or using swimming pools does NOT spread HIV. The available information also bears out that HIV is not spread by mosquito or other insect bites.
What are the symptoms?
The symptoms of AIDS are the symptoms of the diseases that attack the body because of a weakened immune system. One should never, therefore, attempt to diagnose HIV infection on the basis of symptom or signs only. Patients with HIV/AIDS may present with a variety of manifestations which include:
Fever, sweats, chills
Fatigue
Loss of appetite, weight loss
nausea, vomiting
Sore throat
Diarrhoea
Cough
Shortness of breath
Body rash
Skin problems
It is important to always keep in mind that all the above symptoms are non-specific and commonly occur in a variety of conditions. To establish a diagnosis of HIV/AIDS a blood test that has been confirmed is essential. A physical examination and other tests are necessary to rule out other illnesses.
How is a test for HIV infection done?
Most of the blood tests used to detect HIV infection work by detecting the presence of HIV antibodies. Keep in mind that early in infection there may not be sufficient antibodies present in the blood to give a positive reaction even though the person has HIV infection. This period is known as the “Window Period” and is dangerous as though the person has a negative test, infection can be spread through sex or blood.
The commonest test used is the ELISA test. The result of a single ELISA (or Rapid / Spot tests) should never be taken to indicate infection but merely as an indication for repeated tests to confirm the result. The WHO recommends that ERS (ELISA, Rapid or Spot) always be repeated to confirm the diagnosis, preferably using a different make of test kit. The Western Blot test is no longer recommended as a mandatory confirmatory test. A single positive test does not indicate infection and must always be confirmed. A negative test does not guarantee that a person is not infected where the risk exposure has occurred recently. If the person has only recently been infected, the antibodies may not yet have been formed (window phase). It may take up to 3 to even 6 months for someone to develop adequate antibodies after exposure to the virus. A confirmed positive test indicates that the person has been exposed to the virus and has developed antibodies but may not necessarily progress to full-blown AIDS.
Who is at high risk for HIV infection?
Men and women with more than one partner who have oral, anal, or vaginal sex without a condom
Sexual partners of people who are infected
People who receive regular blood transfusions (haemophiliaand thalassaemia) or who received blood transfusion prior to the time screening of blood for HIV was made mandatory
Babies born to infected mothers
People who share needles (for IV drugs, tattooing or piercing) and their sexual partners
People who receive injections with recycled disposable syringes or needles
Prostitutes and their sex partners
How can exposure to HIV be avoided?
The best way of self-protection is to learn as much as possible about HIV infection, avoid risky behaviour, and follow guidelines for protection. Abstinence, non-penetrative sex or a stable relationship between mutually faithful partners is optimal. Where this is not possible, risk can be substantially reduced by the following:
Use latex condoms correctly and consistently. Keep in mind that condoms offer protection but risk is not totally eliminated by using condoms
Do not share needles and syringes for injecting drugs, preferably avoid intravenous drug abuse
Ensure the use of single use disposable needles and syringes for injection
Insist on sterile disposable syringes and needles for injections
Never use a paid blood donor
Get all sexually transmitted infections treated by a qualified doctor as soon as possible, also get your partner checked/treated
Do not visit prostitutes
Avoid casual sex
At this time, there is no cure or vaccination that will prevent HIV infection, though a lot of research is being done for a vaccine. Anyone engaging in high-risk behaviour should contact a physician to arrange for a complete physical examination and blood tests.
Instructions for using latex condoms:
Use a latex condom during intercourse or other acts involving contact with a man's penis
Put the condom on after the penis is erect but before intimate contact. Sores, any secretions from the penis (including semen), vaginal secretions, urine, faeces, and possibly saliva can contain sexually transmitted disease organisms
Put the condom on the head of the penis and unroll it all the way to the base
Leave an empty space at the end of the condom to collect semen.
Sqeeze the tip of the condom before rolling it on to the penis to ensure that no air is trapped in the bulb of the condom. Air if present can cause the condom to burst or rupture during use and thus expose the person to infection.
If a lubricant is desired, use one that is water-based. Do not use oil-based lubricants made with petroleum jelly, mineral oil, vegetable oil, or cold cream, because these may damage the condom
After ejaculation, carefully withdraw the penis before it is completely limp and draw off the condom carefully to avoid spilling.
The used condom should be disposed of safely, preferably after tying a knot in it to avoid spilling of semen.
Store condoms in a cool, dark, dry place.
Do not use a condom which is sticky, brittle, discoloured, or obviously damaged
Use each condom only once
ELISA and Western Blot Tests
The most common test for AIDS is the ELISA (Enzyme-Linked Immuno-Sorbent Assay), which is performed on a blood sample. This test is very sensitive and detects almost all persons infected with the human immunodeficiency virus (HIV) except during the first few weeks of infection. The ELISA test detects the body's immune response to HIV.
Single tests must not be used to diagnose HIV infection. False positive test results are not infrequent with the ELIA and similar tests. Before making a diagnosis that a specimen is HIV positive, the test result must be confirmed by one or even two repeat tests, even on the same specimen if sufficient sample is available. The confirmatory repeat tests can be ELISA or Rapid / Spot tests. It is preferable to use test kits that are different when doing a confirmatory tests. Confirmation by the Western Blot test is no longer the recommended procedure.
Anyone with a positive test for HIV infection should seek follow-up medical evaluation, interpretation of the results, counselling, and advice for possible lifestyle changes. A negative HIV antibody test implies either the person has not been infected with the HIV virus or does not have a detectable level of HIV antibodies. If the results of the same test done six months later are still negative for HIV antibodies, AIDS infection is highly unlikely, assuming there have been no high-risk activities in those six months.
Rape
What is rape?
Rape is a crime in which a person is forced to have sexual intercourse without giving consent. It is not known if the number of rapes has increased or if more victims are now willing to report the crime. Shame, fear of revenge or rejection, and the trauma of a court trial are common reasons for failure to report a sexual offence.
Rape is most often motivated by extreme anger toward the victim or a need to overpower the victim. The motive is rarely sexual and violence is not always involved. Forced sex is intended to abuse, humiliate, and dehumanise the victim. Fifty percent of all rapists are under the age of 25 and most rapists average ten rapes before they are caught. Studies indicate that rape occurs most frequently with someone the victim already knows. Drug and alcohol abuse are frequently related to sexual offences.
What are the effects?
The effects of rape are both physical and psychological.
Physical effects on the victim may include:
injuries from beating or choking, such as bruises, scratches, cuts, and broken bones
swelling around the genital area
bruising around the vagina
injury to the rectal-vaginal area (for example, tearing of the tissue that bridges between the anus and the vagina)
sexually transmitted diseases (such as, herpes, gonorrhoea, AIDS, and syphilis)
possible pregnancy, in a regularly menstruating female
Psychological effects on the victim may include:
severe anxiety
depression
difficulty concentrating or sleeping
dreaming about what happened
inappropriate guilt feelings
emotional numbness or irritability
flashbacks
nightmares
extreme fear
How is it treated?
If there has been a assault, the police must be called to report the incident. The victim must be taken to a hospital. The doctor will conduct a thorough physical exam, including a pelvic exam, to determine the extent of the injuries. The doctor will make special note of any cuts, bruises, or other injuries, especially in the genital area and prepare a medico-legal report.
To collect potential evidence to use against the assailant, the doctor will look for specimens such as patches of torn clothing, blood, semen and strands of hair from the attacker. These specimens can be tested against body fluid or skin samples from suspects.
After the examination the doctor may recommend the following:
Professional crisis counselling.
antibiotics or other medicine for sexually transmitted diseases such as gonorrhoea, chlamydial infection, or pubic lice.
Help the resources available to help the victim deal with the emotional and physical effects of sexual assault.
A support group for rape victims.
Medications to prevent pregnancy.
Child victims need to be evaluated by a doctor immediately. It is generally recommended that the child see a special counsellor trained to work with cases of abused children.
How long will the effects last?
The physical effects of rape may last from a day to a few months, depending on the extent of the injuries involved. The mental and emotional effects are less predictable. The effects may last a lifetime, but crisis counselling and rape support groups can help reduce long-term effects and help the victim cope with feelings of isolation, guilt, depression, or anxiety.
Children are especially vulnerable to long-lasting mental and emotional effects. They frequently need special counselling and care.
The victim must not isolate herself. She must allow family members to provide emotional support. There are family counselling programmes for family members who need help dealing with their concerns and increasing their ability to provide emotional support.
For child victims, find a counsellor who specializes in working with child abuse and incest cases.
What can be done to help prevent rape?
Girls must learn about characteristics or typical behaviour patterns of potential attackers.
Children must be taught what to do if approached by a stranger, what behaviour to look out for, and what places or situations to avoid.
Educate oneself about aspects of one’s appearance and behaviour that might make one vulnerable to attack.
Girls must learn self-defence techniques to help them defend against an attacker.
Rape is a crime in which a person is forced to have sexual intercourse without giving consent. It is not known if the number of rapes has increased or if more victims are now willing to report the crime. Shame, fear of revenge or rejection, and the trauma of a court trial are common reasons for failure to report a sexual offence.
Rape is most often motivated by extreme anger toward the victim or a need to overpower the victim. The motive is rarely sexual and violence is not always involved. Forced sex is intended to abuse, humiliate, and dehumanise the victim. Fifty percent of all rapists are under the age of 25 and most rapists average ten rapes before they are caught. Studies indicate that rape occurs most frequently with someone the victim already knows. Drug and alcohol abuse are frequently related to sexual offences.
What are the effects?
The effects of rape are both physical and psychological.
Physical effects on the victim may include:
injuries from beating or choking, such as bruises, scratches, cuts, and broken bones
swelling around the genital area
bruising around the vagina
injury to the rectal-vaginal area (for example, tearing of the tissue that bridges between the anus and the vagina)
sexually transmitted diseases (such as, herpes, gonorrhoea, AIDS, and syphilis)
possible pregnancy, in a regularly menstruating female
Psychological effects on the victim may include:
severe anxiety
depression
difficulty concentrating or sleeping
dreaming about what happened
inappropriate guilt feelings
emotional numbness or irritability
flashbacks
nightmares
extreme fear
How is it treated?
If there has been a assault, the police must be called to report the incident. The victim must be taken to a hospital. The doctor will conduct a thorough physical exam, including a pelvic exam, to determine the extent of the injuries. The doctor will make special note of any cuts, bruises, or other injuries, especially in the genital area and prepare a medico-legal report.
To collect potential evidence to use against the assailant, the doctor will look for specimens such as patches of torn clothing, blood, semen and strands of hair from the attacker. These specimens can be tested against body fluid or skin samples from suspects.
After the examination the doctor may recommend the following:
Professional crisis counselling.
antibiotics or other medicine for sexually transmitted diseases such as gonorrhoea, chlamydial infection, or pubic lice.
Help the resources available to help the victim deal with the emotional and physical effects of sexual assault.
A support group for rape victims.
Medications to prevent pregnancy.
Child victims need to be evaluated by a doctor immediately. It is generally recommended that the child see a special counsellor trained to work with cases of abused children.
How long will the effects last?
The physical effects of rape may last from a day to a few months, depending on the extent of the injuries involved. The mental and emotional effects are less predictable. The effects may last a lifetime, but crisis counselling and rape support groups can help reduce long-term effects and help the victim cope with feelings of isolation, guilt, depression, or anxiety.
Children are especially vulnerable to long-lasting mental and emotional effects. They frequently need special counselling and care.
The victim must not isolate herself. She must allow family members to provide emotional support. There are family counselling programmes for family members who need help dealing with their concerns and increasing their ability to provide emotional support.
For child victims, find a counsellor who specializes in working with child abuse and incest cases.
What can be done to help prevent rape?
Girls must learn about characteristics or typical behaviour patterns of potential attackers.
Children must be taught what to do if approached by a stranger, what behaviour to look out for, and what places or situations to avoid.
Educate oneself about aspects of one’s appearance and behaviour that might make one vulnerable to attack.
Girls must learn self-defence techniques to help them defend against an attacker.
Female orgasmic disorder
What is it?
Female orgasmic disorder is the inability to achieve orgasm by some women despite adequate sexual arousal. Women have individual differences in the amount of stimulation needed for them to achieve an orgasm. However, according to the Diagnostic and Statistical Manual (IV), when the doctor feels that the woman’s orgasmic capacity is less than what would be expected of a woman of her age and sexual experience, the disorder is diagnosed.
Women having the disorder fall on a scale describing the intensity of the disorder. There are some women who never reach a climax. Then are women who achieve an orgasm only during masturbation, but never with their partners. In the middle range fall women who need stimulation of the clitoris in addition to vaginal stimulation, but are able to climax with their partners. Near the upper range are women who do not need much stimulation to achieve an orgasm.
The disorder can be life long or situational. In the former, the woman has never had an orgasm, either through masturbation or with a partner. In the latter, the disorder is temporary and may be caused due to unconducive situations.
What are the causes?
Science does not clearly understand the brain mechanisms behind the achievement of an orgasm. It is for this reason that the causes for the disorder are not known. More than physiological reasons, psychological reasons have been held responsible for the inability to achieve an orgasm. It most commonly occurs when a woman tries hard to achieve it. When achieving an orgasm becomes a goal for sexual intercourse, the increased pressure works against its achievement.
The mood of the partners during intercourse is also an important determinant of whether they are able to climax or not. If the woman is tensed during the act or the partners have other problems on their mind, achieving an orgasm may become difficult.
What is the treatment?
There is no specific treatment for the disorder. If it is because of dryness of the vagina, lubricants are given which help to make intercourse easier. If psychological help is sought, the partners are asked to relax during the act and enjoy it rather than work towards the achievemtn of an orgasm. The partners should know each other’s preferences and work towards maximizing the pleasure.
Partners are advised to communicate with each other and spend more time in foreplay. This helps to induce adequate lubrication. Other techniques of lovemaking like oral sex and mutual masturbation are advised. The best way to achieve orgasm is to remain positive and relax during sexual intercourse.
Female orgasmic disorder is the inability to achieve orgasm by some women despite adequate sexual arousal. Women have individual differences in the amount of stimulation needed for them to achieve an orgasm. However, according to the Diagnostic and Statistical Manual (IV), when the doctor feels that the woman’s orgasmic capacity is less than what would be expected of a woman of her age and sexual experience, the disorder is diagnosed.
Women having the disorder fall on a scale describing the intensity of the disorder. There are some women who never reach a climax. Then are women who achieve an orgasm only during masturbation, but never with their partners. In the middle range fall women who need stimulation of the clitoris in addition to vaginal stimulation, but are able to climax with their partners. Near the upper range are women who do not need much stimulation to achieve an orgasm.
The disorder can be life long or situational. In the former, the woman has never had an orgasm, either through masturbation or with a partner. In the latter, the disorder is temporary and may be caused due to unconducive situations.
What are the causes?
Science does not clearly understand the brain mechanisms behind the achievement of an orgasm. It is for this reason that the causes for the disorder are not known. More than physiological reasons, psychological reasons have been held responsible for the inability to achieve an orgasm. It most commonly occurs when a woman tries hard to achieve it. When achieving an orgasm becomes a goal for sexual intercourse, the increased pressure works against its achievement.
The mood of the partners during intercourse is also an important determinant of whether they are able to climax or not. If the woman is tensed during the act or the partners have other problems on their mind, achieving an orgasm may become difficult.
What is the treatment?
There is no specific treatment for the disorder. If it is because of dryness of the vagina, lubricants are given which help to make intercourse easier. If psychological help is sought, the partners are asked to relax during the act and enjoy it rather than work towards the achievemtn of an orgasm. The partners should know each other’s preferences and work towards maximizing the pleasure.
Partners are advised to communicate with each other and spend more time in foreplay. This helps to induce adequate lubrication. Other techniques of lovemaking like oral sex and mutual masturbation are advised. The best way to achieve orgasm is to remain positive and relax during sexual intercourse.
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