youthsession

Three Indian children to attend J8 summit in Rome

2009-07-04T06:51:00.001-07:00

New Delhi, July 4 (ANI): The United Nations Children’s Fund (UNICEF) has picked three children to represent India at the J8 summit, a confluence of young people from countries participating in the G8 summit.
Sanjukta Pangi, a 16-year-old girl from Orissa, Samuel Venkatesen, 17-year-old boy from Tamil Nadu and Narendra Kumar, 15-year-old boy from Rae Bareli have been selected for the youth summit called Junior8 (J8) to be held in Rome from July 5-12.
‘I’m very excited and feel wonderful that I’m going to Rome. I always dreamt of such an opportunity. This gives me a chance to look into the problems I have gone through,’ said, Pangi, who is a tribal girl from Orissa.
‘What I have achieved today is all because of the help of UNICEF and my school teacher. There are many children like me who need attention,’ said Venkatesen.
These young Indian representatives will get a chance to share their experiences with other young people from 14 country teams. They will also get a chance to exchange their views amongst themselves and with the ‘extended summit’ leaders on issues like climate change, global meltdown and poverty reduction.

‘It’s a really fantastic opportunity to have the voices of the Indian young people heard. And not only among their peers but also by the world leaders who will be at the J8 summit as well,’ said Angela Walker, UNICEF India’s spokesperson.
The J8, now in its fifth year, brings together 56 young people, aged 14 to 17, from each of the G8 countries and four from the extra-G8 countries from July 4-10 to discuss contemporary issues.
The G8 comprises the developed countries, – Canada, France, Germany, Italy, Japan, Russia, UK and the US, while the extended summit includes leaders of developing economies, – Brazil, China, Egypt, India, Mexico and South Africa.

One representative each from the 14 country delegations at the J8 summit will have an opportunity to engage their respective leaders on the concerns identified by the entire group. (ANI)
[NF]

By:http://www.sindhtoday.net/

India's politicians keep it in the family

2009-07-04T01:35:00.000-07:00

As India's new cabinet was sworn in, the biggest applause was reserved for one of its youngest members, Agatha Sangma, who is all of 28.
She was among several young faces who were brought into government by the Congress party to inject a sense of freshness and energy after its resounding poll victory.
But every single one of them belongs to political families.
Political nepotism appears to be a trend that isn't abating but seemingly spreading beyond the influential Nehru-Gandhi dynasty to a handful of clans across India.
So the formation of the new cabinet was held up because the chief of the southern Dravida Munnetra Khazagam (DMK) party wanted posts for his children and members of his extended family.
Even the smaller parties are often family fiefdoms with parents handing over the reins to their children.

'Subverting democracy'

Jiten Jain who runs Youth For Equality, a political advocacy group, says increasingly politics is being seen as a lucrative business.
"Sons, daughters, relatives are becoming MPs. This is disturbing. You are moving towards a monarchy where one constituency is ruled by one family and 500 families will rule India."
Youth for Equality put up a candidate in the election but she was routed by her better-funded opponent from a well-known political family.
"There are three to four political families that have five to six ministers in the cabinet. Except for one or two, none of them have worked in the social domain, none of them have any political experience. They have just come with the name of their fathers and grandfathers and got elected," he says.
It's not the voters who are at fault.
Vir Sanghvi, editor of the Hindustan Times newspaper says the parties are simply subverting democracy and freezing out the people.
"Often the voters are given two or three choices and all of those choices are dynasts. The internal democracy that we should be seeing in parties is almost entirely missing.
"So while there may be democracy when it comes to elections there is no democracy within parties. It's almost always the dynasts who get nominated," he says.

The young political beneficiaries of this trend argue that they have earned the right to be here.
Agatha Sangma, who is the daughter of a former Speaker of parliament, accepts that a political background, especially at a young age, is a huge advantage but it's not enough to succeed.
"It's not a guarantee that just because you have a political background things will be easy for you. It gives you an initial advantage but after that you have to be able to perform and only that will determine your political future," she says.

Family business
So at a time when India is emerging as a major international player, the world's largest democracy and an economic giant whose companies are at the forefront of global buy-outs - what can explain this apparently regressive step?

It's an extremely profitable business, people who become ministers tend to make a lot of money," says Vir Sangvi.
"There's also a sense, particularly in the smaller parties, that if you allow proper succession you lose control of the party. It's much more tempting to run it like a family business."
Then there's the tradition in India of children, usually male but increasingly female, going into the family profession.
Sociologist Dipankar Gupta says that unlike their Western counterparts, middle-class Indians feel that they cannot afford to leave the family profession, be it medicine, law, or increasingly, politics.
"The gap between the rich and the poor is so large that nobody wants to risk sliding to the bottom of the social scale. And because of a shortage of avenues you need your parental help otherwise you'll be at the bottom of the social rung."
So why do the parties select people from political families?
Mr Gupta says it has to do with a vast system of patronage between the politicians and the parties where they both end up favouring each other often at the cost of ordinary people.
But for many, this is extremely worrying for Indian democracy.
"If this continues, you will have the emergence of a political caste - a sort of Brahminical caste. Indian democracy will cease to be participatory, it will cease to be a way of empowering people. To get elected to parliament you will have to be born into political families," says Mr Sanghvi.
"The whole point of democracy in India is that poor people should be able to enter politics and change their lives.
"If there's just going to be a class of new Brahmins who get elected because the peasants vote them into power, the consequences for India will be devastating."

By Sanjoy Majumder

Indian sex workers learn karate

2009-07-04T01:34:00.002-07:00

Prostitutes in the southern Indian state of Tamil Nadu have begun taking karate lessons to protect themselves from violent customers and pimps.
The women say they were so fed up with abuse that they approached a local community group for help.
The organisers hope the course in the ancient self-defence technique sends a message that violence against sex workers must stop.
India is thought to have nearly three million sex workers.
Most live on the fringes of society and have few legal rights.
Correspondents say that means they often have little or no choice but to put up with violence and harassment.
'I will kick him'
Dressed in white and wearing masks, the first 75 women to take the karate course in the coastal city of Madras (Chennai) had to brave intense heat as they practised their moves.

They trained together for nearly five hours a day, mostly learning how to fight. Now the women say they feel more able to protect themselves.
"Even though I may not be able to attack a group of five men when they attack me, I am fully confident now that I can escape," one sex worker, Santhi (not her real name), told the BBC Tamil service.
"I think I can easily handle one man at any given time. I face physical abuse on a daily basis and have been abused and been beaten up by my clients many times.
"A thug once stripped me of my clothes and told me to run naked. From now on, I think nobody can do that to me. I will kick him."
The Indian Community Welfare Organisation is providing the training free of charge. Its founder secretary, AJ Hariharan, said Tamil Nadu state alone was thought to have about 90,000 commercial sex workers.
"Many of them, particularly those who operate individually on the streets face physical abuse on a daily basis - not only from their customers, but also from local thugs and policemen," he told the BBC Tamil service.
"They attack these commercial sex workers, rob their money and force them into having unprotected sex. We want to train them in karate so that they can protect themselves from these violent attacks."
Mr Hariharan said the aim was to build the self esteem and self confidence of the women.
"We are going to train 300 sex workers in the second phase and 500 sex workers after that.
"We are trying to send a loud and clear message to those who abuse these sex workers that they cannot abuse them any more.

Some other posts:Early warning clue for dementia , Strikes 'kill 27 Afghan Taleban' , Israel reopens crossings into Gaza , Indian Republic Day , India's crown prince vs 'messiah of hate ', Rahul Gandhi vs Varun Gandhi , ELECTION EYE - Congress-Left could come together after polls , Some Interesting Factoids and Trivia About the Indian General Elections 2009 , BharatMatrimony conducts survey on "Marriage & its Values" among singles & .... , India's election campaigns get Net-savvy , The World's Most Important Election , Nigeria: Youth urged to drop gun for ICT , High security in India ahead of national elections: New Gandhi touted as future prime minister , Ohio prison director demoted for handcuffing youth , Murkowski Calls on HHS to Address Native Youth Suicide , Arvind Singhal: Dividends from human capital , 'Hot bhabhi' turns India on , Occupied Kashmir:World asked to take note of troops’ use of force ,India's politicians keep it in the family ,Indians in Australia warned over revenge violence

Hinduism and India Cool

2009-07-04T01:34:00.001-07:00

Indian youth has a new relationship with religion. As the BBC programme, What the World Thinks of God explores the modern world's relationship with God, Bachia Karkaria writes about contemporary attitudes to faith and in particular Hinduism.
God has a new incarnation in India - cool, user-friendly, results-oriented, upwardly mobile, and probably carrying one too. Seriously. Cell-phone ring-tones come in the tunes of popular Hindu hymns.
Atheism may be universally endemic to the young, especially male, but India is the exception to the dictum that "Everyone is a Marxist in his youth".
For the record, young Indians remained equally immune to communism's mystic alternative - the hippie movement of the 60s.
Today's New Age cults are nothing more than flower-power Gen-etically modified.
Like the sitar, guru shirts and transcendental meditation in the Beatles-era, India Cool has discovered nirvana, yoga, joss-sticks and Vastu Shastra, the Hindu equivalent of Feng Shui, via the West.

Ordinary, middle-class 20-somethings have an equation all their own with God.
They have been influenced by the political tsunami of Hindutva, the political incarnation of Hinduism.
The ruling Bharatiya Janata Party, which started it all, has displayed an increasing ambivalence towards militant Hinduism, first to appease its more secular allies, and now to advance their new 21st century globalised image.
Young Hindus are woven out of these contrary strands, but the result is a seamless breed with varying levels of religious involvement.
Pretty young things genuflect to patriarchy by fasting for the long-life of future husbands, even as they invoke the goddess, "Shakti", which literally means `power', to fight their social battles.
The computer geek is quite likely to decorate his desktop with stickers of both Garfield and Ganesha, the phenomenally popular god of auspicious beginnings.
His home probably boasts a stylised idol sculpted by a best-seller Indian artist in collaboration with Murano glass.
The mystic word `Om' once had an exclusively religious context. But it has acquired a dubious universality courtesy of Madonna mantras and Sunset Boulevard spiritualism.
There is a new Om-ni presence even among those who never chanced upon the Time story on yoga featuring Christy Thornton sitting in the lotus position on the cover.
Fashion accessory

Young Indian men and women sport Hinduism's most potent symbol as a fashion accessory.
Designer "Om" pendants dangle from throats and jangle on charm bracelets, alongside little Ganeshas - and yin-and-yang medallions.
They rock to the souped-up Om beat of a Grammy wannabe. The spiritual O-Word seeps into them from almost every episode of popular TV soaps.
In the blockbuster "Kuchh Kuchh Hota Hai", a Britain-returned heroine in a micro-mini belted out the hymn, "Om Jagdish" to prove that she remained uncorruptedly Indian.
Rituals, surprisingly, are still important to young Hindus. In fast-paced, commuting-harried urbania, the temple comes to the worshippers' drawing room via the tele-puja and even a votive tele-viewing of the deity.
Conditional faith
Where the young differ from their parents is their attitude to faith. If faith wants to keep them, it has to work for it.
It's a commercial relationship. You can have my prayers, provided you get me my girlfriend back.
But it's not all sanitised sanctity. A regressive fundamentalism is clearly evident in sections of the young of all religions, including such traditionally liberal ones as Zoroastrianism.
Its disturbing manifestation is an obdurate intolerance, communal exclusivity, and the demonising of the Other.
They don't want to hear that dying for your belief is quite different from killing for it.

Bachi Karkaria

Associate Editor, The Times of India

You can do it, Kalam tells youth

2009-07-04T01:33:00.000-07:00

LONDON: The former President, A.P.J. Abdul Kalam, has been awarded an honorary Doctorate of Laws by Queen’s University, Belfast, for distinction in public service.
The degree was conferred on him at a special ceremony on Wednesday. Queen’s Vice-Chancellor Professor Peter Gregson described Mr. Kalam as an “outstanding world statesman, scientist, educator and visionary” who had “inspired millions” in India and around the world.
“It is a significant honour for Queen’s to host this visit from the former leader of one of the world’s most thriving and exciting countries. A number of distinguished Indian institutions hold a special place within the Queen’s family of academic partners and Mr. Kalam’s visit is a tangible example of the educational, research, business and cultural links between India and Northern Ireland,” he said.
Sir Reg Empey, Northern Ireland’s Minister for Employment and Learning, said the decision reflected Queen’s University’s close links with India.
Mr. Kalam called for pooling global resources for common good. He said that in today’s “borderless world,” countries could not afford to remain isolated as problems affecting one country had implications for others.

Imaginative leadership
Mr. Kalam said he had noticed “anxiety” among youth on how to deal with a world “devastated” by conflict. But he said: “Youth can do it,” He called for “imaginative leadership” to bring people together and build a peaceful world.

Some other posts:Early warning clue for dementia , Strikes 'kill 27 Afghan Taleban' , Israel reopens crossings into Gaza , Indian Republic Day , India's crown prince vs 'messiah of hate ', Rahul Gandhi vs Varun Gandhi , ELECTION EYE - Congress-Left could come together after polls , Some Interesting Factoids and Trivia About the Indian General Elections 2009 , BharatMatrimony conducts survey on "Marriage & its Values" among singles & .... , India's election campaigns get Net-savvy , The World's Most Important Election , Nigeria: Youth urged to drop gun for ICT , High security in India ahead of national elections: New Gandhi touted as future prime minister , Ohio prison director demoted for handcuffing youth , Murkowski Calls on HHS to Address Native Youth Suicide , Arvind Singhal: Dividends from human capital , 'Hot bhabhi' turns India on , Occupied Kashmir:World asked to take note of troops’ use of force ,India's politicians keep it in the family ,Indians in Australia warned over revenge violence ,Indian sex workers learn karate , Hinduism and India Cool

‘Hot Bipasha real reason for global warming’

2009-07-04T01:32:00.002-07:00

MACAU - Bipasha Basu should be India’s environment minister because she was “the real reason for global warming all over the world.”
This was the choice of International Indian Film Academy (IIFA) Awards hosts Boman Irani and Riteish Deshmukh who unveiled their dream cabinet before a packed auditorium at the Chinese resort here as the annual event marked its 10th anniversary.
The comic duo announced their choice that they said should have been appointed by Bollywood after the recent elections, much to the delight of the 15,000 strong crowd here Saturday night.
Director Ashutosh Gowariker should be agriculture minister for what he had done for the rural community with his hit film “Lagaan”; Raakesh Roshan, the coal minister because his successful film “Koyla” had shown that he knows everything there is to know about the black product; and Katrina Kaif should be the youth affairs minister because every youth wanted to talk to her, the pair added.
Aamir Khan should be home minister because all he did for eleven months in every year was sit at home and then just release a single film in the last month.
Akshay Kumar, shown on screen with his face on a Rs1,000 note, should be the finance minister because with the money he makes he could finance almost the entire population.
“Slumdog Millionaire” star Freida Pinto would do well in the post of minister for
overseas and foreign affairs because she knew exactly how to start an affair abroad, Irani jested.
Always on the defensive, Salman Khan would make the ideal defence minister and Malika Sherawat could occupy the new position of minister for the upliftment of the downtrodden.
Others in the Irani/Deshmukh cabinet would be Sunny Deol as law and transport minister ; Yash and Aditya Chopra of ‘Punjab Power’ fame for their film “Rab Ne Bana Di Jodi” as joint power ministers; and Viveik Oberoi as telecommunications minister because he knew how to make calls quickly when necessary.

No sex education for us. We’re Indian.

2009-07-04T01:32:00.001-07:00

By Amodini Sharma

India is a populous country, and I’m pretty sure the citizens of India have something to do with it. I don’t think the storks are delivering all those babies, or that they are gifts of the Gods a la Kunti. Thus the move to squash teaching of basic sex education in schools is quite surprising. A few months back, the Committee on Petitions, comprising Rajya Sabha members and headed by BJP’s Venkaiah Naidu, said “there should be no sex education in schools” since “our country’s social and cultural ethos are such that sex education has absolutely no place in it”. ”Let’s trot out that pony again — India’s glorious cultural ethos. Let’s hide behind it again. We won’t do it because it’s against our cultural ethos. Let’s all burrow our heads in the sand and ignore the problem, because it’s “against the Indian cultural ethos”.
Watch Indian TV nowadays, and if it isn’t Ekta Kapoor’s sindoor-anointed, scheming pativrata naris in backless cholis, it’s pretty young things in short-short skirts swinging to some very suggestive lyrics. Sexy is the new buzzword. Looking pretty is not good enough — you’ve got to look sexy. Most advertisements use women to sell their products. These are mostly pretty women, and they sell soaps, shampoos, refrigerators, hair dyes and even car tyres (Ceat tyres had an animated cartoony advertisement featuring a well-endowed woman in a low-cut blouse and shorts and you can’t see the face of the woman). A lot of these ads feature women in little clothing, mouthing suggestive dialogues.
Watch Bollywood films, and you will realise that most feature women in secondary roles, playing second-fiddle to the men and assumming subservient roles. There are also those, which pandering to the NRI, portray foreign-bred women who are all too happy to trade-in autonomous life to smilingly melt into the arms of our handsome, chauvinistic hero. Women as depicted in such media are shown as having little independence.
Many rural women marry young, conceive early and die in child-birth. Knowledge of contraceptives is limited. There are few people “progressive” enough to go to a doctor for such advice, leave alone uneducated women who have no agency of their own. Attitudes in the country still remain vastly chauvinistic — you’ll read about it in the newspapers (foeticide, infanticide and child marriage) and you’ll see it in the street molestation everyday. The youth remains uninformed about sexual choices and we shy away from educating them because it’s against the “cultural ethos” ?
“The committee ruled that children must be given the message that sex before marriage is “immoral, unethical and unhealthy” ”The young people of this country are being bombarded by suggestive messages on the one hand and being denied basic sex education on the other. Pativrata nari vs. oomph-laden, skirt-suited pretty woman — guess who wins the image war these days ? Mr Naidu and his Committee might think pre-marital sex is “immoral”, but it’s happening anyway. And if the folk having pre-marital sex don’t know about basic safety, it’s probably adding to the AIDS numbers, if not creating unwanted children.
The urban youth has access to the net and other media. If you don’t give them information straight up, they will find it, and it might be pretty warped depending upon the source. Apart from that, what about curiosity ? If a girl starts menstruating early, she might be a little curious as to what’s going on. Mr Venkaiah Naidu might be blind, but most young folk are not.
“Advocating “instinct control” and “dignity of restraint”, the committee called for a new curriculum to include material on lives and teaching of saints, spiritual leaders, freedom fighters and national heroes.”While I do think kids should have knowledge of saints, freedom fighters etc, I doubt that learning about Bhagat Singh will help the cause of abstinence any. The cultural invasion has already come. And it’s a little worrying to hear statements like the above from eminently sane people with good vision, and one assumes, satifisfactory hearing. Are they actually living in modern-day India ? Do they actually not see Govinda (now an MP) cavort on screen and thrust his pelvis or have they missed out on all those little gems of fine Indian film-making ? Do they think he is hinting at “instinct control”?
The Committee had better realise that the day for preaching the “dignity of restraint” has come and gone. In other words, that boat sailed. Long ago. And Mr Naidu wasn’t on it. And if at all applicable in this context, there is “dignity” only in not treating our youth as if they were pea-brained. As for restraint, Mr Naidu might apply it to avoid placing his foot in his mouth.
The committee said chapters on Naturopathy, Ayurveda, Unani and Yoga and moral values should be made integral parts of the syllabus to enable “total development of the child”. Chapters like “Physical and Mental Development in Adolescents” and “HIV/AIDS and other Sexually Transmitted Diseases” and related topics should be removed from the curriculum and incorporated in biology books only at the 10+2 stage.
When I was in school, some 20 years back, education on puberty and bodily changes was dealt with in the 9th standard. Much too late, I have always thought. I cannot imagine it being pushed out even further. At that time, a child is already 14-15 years of age, well into the age of puberty. And whether you like it or not, they are noticing these changes. It is high time for adults to acknowledge the elephant in the room.
There is a case to be made for considering the subject essential to proper growth and a balanced viewpoint. And for starting this education earlier. The more we consider this taboo and hide information, the more mystique is built around it. And the more alluring it gets.
It is all very well to talk about the high road and moral values, but it is another to assume that problems will dissappear once we try to inculcate our moral values in young folk, without first answering their pertinent questions. And as much as I am a fan of Yoga, I do think that the Committee is a tad out of touch with the youth’s mindset to think that it would do any good in this respect.
Ignoring sex education for young adults has done enough damage already. From a burgeoning AIDS crisis to exponential population growth, and young folk with repressed sexualities and stunted mentalities, it is bad enough already. It should not be allowed to get any worse.
***
Amodini Sharma is a software programmer based in the US. She believes that society is still chauvinistic and immune to indignities against women, and that speaking up and writing about this is an important first step towards changing attitudes. Among other things, she is passionate about films and a keen reader. She blogs at Amodini’s Movie Reviews and the Review Room.

Child Labour: A Demon in the Indian Society

2009-07-04T01:31:00.001-07:00

Anshul Tewari

Raju wakes up at 6 every morning. After preparing rice for his 5 sisters, who are 4 to 5 years each, Raju leaves for a nearby construction site to continue his work. Raju's mother, however, goes to a few houses to help clean the households, and his father is usually drunk, thus, does nothing. After 10 hours of continuos work, Raju returns home, with a soar stomach and rugged hands.
His mother prepares rice for them and each member of the family has not more than 5 tea spoons of rice, enough to help them survive the night.

Raju is only 8 years old and is a child labourer working in a residential area of Delhi. He misses his childhood, all he knows is that he has to earn enough to get his sisters married off.
India has been talking about child labour more often than not, at seminars, in the parliament, by NGO's and at many more places and by many more people. At a time when India is witnessing an abnormal high in the number of children associated with this problem, Youth Ki Awaaz brings forth a report which will help us understand better, the solutions for this problem. Why are we facing this problem? How did it emerge? What are the areas of concern and how can we solve them? We present to you an analysis of child labour in India focussing on its various aspects.
In India, officially there are around 16 million child labourers, but if we trust the unofficial sources, the number crosses 60 million. A country where 70% of the population lives in rural areas, around 50-60% children are being forced into child labour. Let's understand this evil and try to curb it.
Usually, when we think of child labour, the first thing that comes to our mind is a child working in a factory. But this is not it, child labour ranges from factories to mines, to construction areas to small tea stalls and every other work. Children, who are at the receiving end, end up with ruined lives, bleak and a misty future and physical as well as psychological disorders.
Child labourers are divided in a number of sectors. Namely, I. Cultivation, II. Agricultural Labour, III. Livestock, Forestry, Fishing, Plantation, IV. Mining and Quarrying, V. Manufacturing, Processing, Servicing and Repairs, VI. Construction, VII. Trade and Commerce, VIII. Transport, Storage and Communication, and IX. Other Services (Census of India 1981 cited in Nangia 1987, 72).
Labour by children is an outcome of many reasons other than the well known poverty, unemployment, lack of education. They are either in debt bondage or pledged for advances contracted by parents. Some of them are victims of illusory promises made by procurers about bright prospects after undergoing training in certain trades. People say that the points stated above are the reasons behind child labour. But we argue the other way. Our experience and the various studies conducted by researchers corroborate the fact that child labour is equally, if not solely responsible for causing and perpetuating unemployment, poverty, population growth and illiteracy.

Looking at the states which have the highest number of child labourers, Andhra Pradesh tops the list with over 18 million child labourers, followed by Bihar, Gujarat, Karnataka, Madhya Pradesh, Maharashtra, Orissa, Rajasthan, Tamil Nadu, Uttar Pradesh and West Bengal.

The industries in which children are employed are:

Matches, Fireworks and Explosives- Sivakasi
Glass and Bangles- Ferozabad
Beedi Making- Nizamabad, North Arcot District
Carpet Making- Bhadoi, Varanasi , Mirzapur , Jammu and Kashmir
Lock-making- Aligarh
Brassware- Moradabad
Export Oriented Garment Industry- Tiruppur
Gem Polishing Export Industry- Jaipur, Rajasthan
Slate Mines and Manufacturing Units- Markkapur
Leather Units- Agra , Kanpur , Durg, Rajasthan
Diamond Industry- Surat

India has the dubious distinction of being the nation with the largest number of child laborers in the world. The child labors endure miserable and difficult lives. They earn little and struggle to make enough to feed themselves and their families. They do not go to school; more than half of them are unable to learn the barest skills of literacy. The environmental degradation and lack of employment avenues in the rural areas also cause people to migrate to big cities. On arrival in overcrowded cities the disintegration of family units takes place through alcoholism, unemployment or disillusionment of better life etc. This in turn leads to emergence of street children and child workers who are forced by their circumstances to work from the early age. The girls are forced to work as sex -workers or beggars. A large number of girls end up working as domestic workers on low wages and unhealthy living conditions.
Some times children are abandoned by their parents or sold to factory owners. The last two decades have seen tremendous growth of export based industries and mass production factories utilizing low technologies. They try to maintain competitive positions through low wages and low labor standards. The child laborers exactly suit their requirements. They use all means to lure the parents into giving their children on pretext of providing education and good life.
People come here, read the articles, get the point, but rarely do they implement stuff in their daily lives. When asked for solutions, various NGO's told YKA the following:

-Stop eating at dhabas and restaurants which promote child labour.
-Condemn the business and industries which preach child labour
-Do not employ a child to work at your place or at your workplace.

These points are common and heard of. But Youth Ki Awaaz completely differs from these illogical points. Yes, we are being radical. These points are illogical, excpet for the last one.

And the reason behind them being illogical is simple. Consider this, if you stop going to a restaurant which preaches child labour, stop buying clothes of a brand which preaches child labour, condemn a corporate who preaches child labour or an industry which preaches child labour, you are just killing the child. He would have no money, thus, no food, thus, empty stomach (both the child and the family), and no place to live, thus, the child would die. Right?

So what is the solution? Let's understand this by the easiest way possible. What is the prime reason for child labour? Poverty. What is the prime reason for poverty? Unemployment. What is the prime reason for unemployment? Education.
This might sound cliche, but yes, EDUCATION is the solution. Some argue that there is a lack of opportunity, but we say, what good would opportunity be if there is no education. Right?
The need of the hour is to make education available to each and every child, especially in the rural areas.
Youth Ki Awaaz asked a few children who were working as labourers, aged around 15 to 16 years, about the reforms that they would want. The reason behind asking this age group was the fact that they have a better understanding in terms of work and the problems that they face. Their list was as follows, we have modified a bit to make it look more realistic and we have added a few points as well:

1. Enforce existing laws on child labour.
2. Every child should enjoy a free and compulsory education till they complete 18 years.
3. Develop alternative education options and training schemes for child labourers.
4. Enhance economic security and resilience of household of all child labourers.
5. Ensure participation of child labourers in decisions that affect them.
6. Right to Education Bill, 2008 should be passed in the Parliament at the earliest.
7. Allocate over 5% of GDP for education.

"There is no trust more sacred than the one the world holds with children. There is no duty more important than ensuring that their rights are respected, that their welfare is protected, that their lives are free from fear and want and that they can grow up in peace."-- Kofi Annan

Muslim youth: The road ahead

2009-07-04T01:30:00.002-07:00

By Dr Malik Rashid Faisal,

What an average Indian Muslim youth thinks of the issues concerning the Muslim society at large? This is no small question, the answer of which builds a world where a whole lot of generation can not only survive but move towards a prosperous living. When I was a child, for me the world was nothing more than a game where everyone is playing a role of one’s own choice. There are, perhaps, still no clearly drawn out objectives of Muslim youth, although the earth has been steadily rotating to demonstrate the bitter lessons they could learn.
I used to go to a maktab on the bicycle gifted by my maternal uncle. Some boys of my village traveled to the school on foot. They used the tactic of pushing and pulling my moving cycle to irritate and annoy me. Like wise, Mulsims today are two steps forward and one step back. Unfortunately, today I do not find those boys in any prestigious position. I am told that some of them completed Intermediate with difficulties and some ended up in scraps business in Mumbai. They all are struggling to survive.
A Muslim youth is blamed for pursuing a conservative, fanatic and fundamentalist course of action. They are alleged to be terrorists. I can say without any doubt that their survival is at stake and they can not afford to be a terrorist. They have no energy to think beyond their survival. Had I not studied in Madrasa, I could never have known the actual situation a big population of Muslims is trapped into. A Madrasa student lives like a frog in a well. They do not know the contemporary issues of importance. They read books which do not have any relevance to sufferings of Muslims. The old and irrelevant issues of Islamic jurisprudence are still taught in Madrasas. I remember the day when Babri Masjid was demolished. This sad news was announced in a trembling and emotion laden voice by one of our Maulana after Namaz-e-Asr in the Masjid located in the fore walls of the Madrasa Jamiatul Falah and then a sudden silence enveloped amongst all the students and teachers.
The next day, in the weekly cultural programme of my class, I delivered an emotionally laden high pitched speech raising the slogan ‘Allahu Akbar’ as if I was going to wage a war against the demolishers. The teacher laughed. But it is a fact that the same teachers taught me the way I registered my protest against the demolition. On the other hand, I admit that Madrasas inculcate in students the basic understanding of religion. A Madrasa student at later stage of his growth knows how to deal with religious issues and practices.
But then only 4% of Muslims go to Madrasas. What about the rest of the Indian Muslim youth? Ironically, most of them live a battered life. They have no clear cut thinking about the interests of the society at large. One of many reasons is of course, illiteracy. Many of them are school drop outs. Some get trapped into family business and some join underpaid jobs. They get married and are forced to take care of the well being of the family.
Naturally, if a large section of the society is cut to size and made vulnerable, how would its people join the mainstream and think high for the betterment of society? Today we observe that Indian Muslim youths have no new organizations of their own that works for improving the deteriorating conditions of the Muslims. It may be because of the fear of failure.
The endeavor to start an organization for overall development of the community is something which should be taken seriously. In fact, many Muslim NGOs do exist but they are not performing well and therefore often alleged to be nothing but ill fated. Many of them are purposefully collecting funds for self interests. At this hour of crisis, the energetic Muslim youth could play an important role in promoting the organizations for the development of the community. Unfortunately, they are not showing interest in such an endeavor.
The pathetic attitude of Indian Muslim youths is maligning the whole community. For instance, about 15,000 Muslim students study in Aligarh Muslim University but it is very unfortunate to say that very few of them do something good for the society after completing their education. Most of the Muslim youth join underpaid jobs and live the whole life in conformity. Some of them become burden on their parents. They lack will power to do something great. This is, in my view, on account of inferiority complex and no proper guidance from the parents or the elders of the community.
That is no wonder then, economic, political and social conditions of Muslims are very bad. However, Muslim youths through establishing NGOs and coordinating with each other could do a great job for overall development of the community in all aspects. They need to understand the severity of the problems being faced by themselves and the community. NGOs can play an important role in raising the standard of community in all aspects. Therefore, to think positive and move forward is the only solution of many problems. Youths in any society play important roles and the Muslim community is no exception.
--------------------------------------------------
Malik Rashid Faisal is the Senior Editor of The Sunday Indian (Urdu). He may be contacted at malikrfaisal@gmail.com
article from: http://www.twocircles.net/

Rahul Gandhi and the New Politics of India

2009-07-04T01:30:00.001-07:00

The Quiet Revolutionary: Rahul Gandhi
by Sudip Mazumdar
NEWSWEEKFrom the magazine issue dated Jun 8, 2009

A revolution is underway in India. The man leading the charge is neither a fiery ideologue nor a gun-toting guerrilla. Instead, he is the scion of one of the world’s most famous political families. But Rahul Gandhi, 38, has set out to disrupt the very system that created his power. At first glance, he is simply trying to restore the 125-year-old Indian National Congress—a party once led by his great-grandfather Jawaharlal Nehru, his grandmother Indira Gandhi and his father, Rajiv Gandhi, and now run by his mother, Sonia Gandhi—to its once lofty position as India’s dominant political group.
But his tactics are game-changing: insisting on grassroots activism, building deep connections to rural India and trying to democratize the hierarchical Congress party itself. If he succeeds—a big “if”—India could soon undergo a kind of political big bang, ushering in a new model for developing countries: combining a well-functioning democracy with good government and economic growth. And if that works, Rahul will probably also ensure his own political future as the head of the nation.
Already Rahul, as he is known throughout the country, has been widely credited with Congress’s big win in last month’s elections. Not only was he, as Congress’ general-secretary, the party’s main campaigner—he spoke at 125 rallies across the country in six weeks, compared with 75 for his mother and 50 for Prime Minister Manmohan Singh. He was also its master strategist.
His approach—fully endorsed by his mother, the party’s president—was risky, presenting Congress as a national party that stood for secularism, good governance and growth. Such tactics were in sharp contrast to the mainstream of Indian politics for the last 20 years, in which parties based on caste, ethnicity and religion had flourished. During those decades, Congress officials had made alliances with these regional groups in order to maintain their access to power, privileges, perks and money. But this strategy had also ensured the slow decline of Congress as a national force, ceding ground to parties based on identity politics.
Rahul was convinced that to regain Congress’s old strength, it must contest elections alone as much as possible—especially in Uttar Pradesh and Bihar. These two states, which together send 120 members to the 543-seat lower house of the Indian Parliament, are crucial to any party’s chances in New Delhi, and Congress had virtually become nonexistent in those areas.
Before the election, the conventional wisdom had it that Rahul’s choice to go it alone would be a huge blunder. But it paid off—spectacularly. Congress more than doubled its tally in Uttar Pradesh, from nine seats (out of 80) to 21. And the party made serious inroads into several other constituencies. In Bihar, even if it only ended up with two seats, it managed to take away big chunks of votes from caste-based parties and reduced powerful regional satraps and minor coalition partners to insignificance. Elsewhere Congress swept the polls. The result? “This is Rahul Gandhi’s moment,” says Pratap Bhanu Mehta, President of the Center for Policy Research, a New Delhi think tank. “He rose above the narrow identity politics of his opponents and showed that Indians long for inclusiveness and tolerance. He has changed the rules of politics.”
Rahul also broke ground by pushing forward a slate of young candidates—a rare move in a country where age is venerated and 80-year-old politicians are a common sight. He bet that with 70 percent of the country under the age of 40 and half under 25, youth politics had reached a tipping point. And again he was vindicated. Most of his fresh faces won. Just as significantly, many of these newcomers had emerged through an open and democratic selection process in the party—and were thus seen as more connected to the grassroots than usual Congress hacks.
One such winner was Rahul’s close aide, Meenakshi Natarajan, a biochemistry graduate from a small town called Ratlam in Madhya Pradesh. Natarajan couldn’t have been more different from a typical Indian politician. Nobody in her family had ever served in politics. She traveled in crowded public transport, lived in a small rented apartment in Delhi and devoted her time to energizing students and young people to join the party. All this was unheard of in India, where candidates typically travel in 20-car convoys with hundreds of hangers-on.
“The world missed the significance of our baby steps in democratizing Congress’s youth organizations,” says Natarajan. But the voters didn’t. Rahul is “creating space for fresh ideas, competence and youthful energy,” says political analyst Rajiv Desai. “If he can pull it off, this will eventually make the old timers and power brokers irrelevant in the party.”
Since the election, calls have grown within Congress for Rahul to take a seat in cabinet or become prime minister himself; even Singh has said that he would try to persuade Gandhi to join the government. But Rahul has politely declined the offers so far, saying his focus remains the party. This has only enhanced his public image. According to Sam Pitroda, who was an aide to Rajiv Gandhi and is considered the father of India’s telecom revolution, and now heads the country’s National Knowledge Commission, “Rahul is not here for any short-term goals. He has a long-term vision. He is methodical, analytical, hardworking and humble.”
Rahul’s makeover couldn’t have come at a better time. Apart from regional players and corrupt special interests, the Congress Party had come to rely on vast amounts of black money to run its campaigns in recent years. Other parties were even worse, dominated by people who used fear and hatred to widen caste, religious and ethnic differences. Campaign slogans were often divisive and negative.
Politicians became notorious for siphoning government resources and filling their coffers with kickbacks and bribes. While India now has some of the richest citizens in the world, it also has huge areas wracked by destitution, and more than half of its 1.2 billion people still live on less than 20 cents a day. Over the past two decades the Congress Party, which has ruled India for 45 out of its 62 years of independence, had gradually lost ground to its major rival, the anti-Muslim Hindu nationalist Bharatiya Janata Party, and smaller caste-based and sectarian parties. Forced to cobble together coalition governments, Congress had fallen hostage to pressure and blackmail from its junior partners.
Rahul observed this decline from a front-row seat. His was a life of both privilege and tragedy. He was barely 14 when his grandmother, Prime Minister Indira Gandhi, was killed by her Sikh bodyguards in 1984. Suddenly, Rahul and his younger sister, Priyanka, found themselves enveloped in a security cocoon and lost whatever vestiges of normal teenage life they’d once enjoyed. Then, less than seven years later, the children also lost their father, Rajiv, who had catapulted into politics from his job as an airline pilot after Indira’s death. Rajiv was killed by a Tamil suicide bomber at an election rally in 1991 in southern India.
After being shuttled from one school to another for safety reasons, Rahul was eventually sent to the United States, starting university at Harvard and eventually graduating from Rollins College in Florida. He then received an M.Phil. in development studies from Cambridge University. It was an academic career marked less by dramatic achievement than a desire for privacy. After graduating, he spent the next three years with the Monitor Group in London, a consulting firm founded by the management guru Michael Porter, before returning to India in 2002. Colleagues at the firm had no idea who they were working with—Rahul was using an assumed name—which meant Gandhi got no special treatment. His reputation within the company was “very impressive,” in the words of one senior partner. And he’d go on to apply the training he got with Monitor in the careful, methodical way he would study the Indian electorate.
During Rahul’s period abroad, the BJP, taking advantage of the rudderless Congress, had captured power with a coalition of a few other sectarian parties, and Congress had been reduced to a worn-out shell of its former self. Party leaders were dejected and desperately wanted another member of the storied Nehru-Gandhi line to rescue them. They ultimately managed to rope in Rahul’s reclusive, Italian-born mother, Sonia. And she soon managed to save her husband’s party from virtual extinction. Her tireless campaigning, political acumen and hands-on leadership revived Congress and helped return it to power in 2004.
Although Sonia tried to reform the party, she remained surrounded by elderly time servers and family retainers with no connections to the grassroots. Though the Congress Party had traditionally held the middle ground of Indian politics by appealing to all sections of society, factionalism and lack of ideas had drained its strength. Many advisers began pushing Sonia to let the articulate and savvy Priyanka become Congress’ new face. But she was married and focused on raising her children, and was not inclined to join active politics.
Meanwhile, away from the public gaze, Rahul—often seen as shy and reclusive—began closely studying the Indian system and the way its parties were run. He began visiting his mother’s parliamentary constituency in Amethi in Uttar Pradesh, India’s largest state and a place where Congress had become a nonentity. When the general elections were called in 2004, Rahul made his move: he ran for a seat from Amethi. He and his mother campaigned vigorously around the country and their efforts paid off: Rahul won his seat and nationally Congress managed to overthrow the BJP-led coalition. Declining the office of the prime minister, Sonia installed Singh—a former finance minister and an economist with sterling credentials—in the top job, signaling a break from the party’s corrupt power brokers.
Sonia’s critics saw her renunciation of power as nothing more than a clever move to keep the seat warm for her son by letting a loyal follower take the job till Rahul was ready for it. But Rahul had different plans. He stayed away from the media and devoted his time to studying ways to advance development—and Congress—focusing on his own constituency and the divisive, caste-based politics of Uttar Pradesh.
Over the past three years he has worked hard to acquaint himself with poor, rural India by making numerous visits to remote, neglected villages, where he would listen to locals’ complaints while sitting cross-legged on their dirt floors, sharing their meals and sometimes even sleeping in their homes. On occasion he would lead villagers to government officials to demand better services or organize sit-ins in dusty towns to highlight the plight of the poor. His “discovery of India” tour (a riff on Nehru’s book of the same name) was dismissed by the media and scorned by his opponents, one of whom referred to Rahul as an “aquarium fish.” Yet Rahul persisted, often making unnoticed trips to remote tribes, panicking his security detail. Calculated or not, such moves are extremely rare for a politician of Gandhi’s stature in India, where most leaders prefer to travel in air-conditioned comfort.
Rahul’s current views on the economy seem to owe to these tours. Broadly speaking, he is pro-market, owing in part to his time at Monitor, but he insists that growth should provide opportunities for the poor. “What is the difference between a rich man and a poor man?” he liked to ask at campaign rallies. “Opportunity!” Rahul argues that the human talent in India’s poorest states is as good as anywhere else and that it’s the government’s fault that these regions remain impoverished. He also believes in economic reform.
Rahul has said that the current global financial crisis is a “short-term disruption” and large countries like India and China can benefit in the long run if they position themselves properly. But he wants “inclusive growth,” and has supported job guarantees for the rural poor and loan waivers to farmers—measures derided by market reformers but that appear to have had strong political benefits for Congress and to have shielded India’s rural sector from the worst of the current crisis. Rahul is also known to support the growing U.S.-India alliance and is said to speak well of George W. Bush in private for pushing it through.
Those who know Rahul say he is levelheaded and unruffled, draws inspiration from Mahatma Gandhi (no relation) and, like his sister, Priyanka, takes an interest in Buddhism and has attended teachings by the Dalai Lama. He meticulously seeks out different points of view before coming to a decision. He is a teetotaler who once favored fast cars but whose only apparent vice now is a fondness for Indian sweets. The siblings are close (”There is no one closer to me than my sister [Priyanka],” he recently told a questioner). For a while, he was known to be dating an attractive Spanish architect, but he is now India’s most eligible bachelor and appears in no hurry to change that status.
In a sense, given the magnitude of the job he’s assigned himself, it’s no wonder that Rahul turned down a cabinet post. The work he has in mind involves enlisting 10 million young people into the party’s youth wing and holding democratic elections to produce new leaders from among them. He has already managed to sign up some 1.5 million youngsters in three opposition-ruled states—Punjab, Gujarat and Uttarakhand—to join the Youth Congress. All this has helped Rahul construct himself as an agent of radical change. “His strategy of positioning himself as an outsider seems a masterstroke,” says Mehta, the New Delhi analyst.
The irony, of course, is that in seeking to make the Congress Party more democratic, Rahul is working against the legacy of his own grandmother, who suspended internal party elections in the mid-1970s, allowing her to chose the party’s regional leaders herself—a process most experts believe helped turn Congress from a grassroots, vibrant party into a court full of fawning retainers.
Still, the seductions of power remain strong—indeed, this may be the biggest obstacle Gandhi will face. “Rahul has a unique role to play in defining India’s political destiny over the coming decades,” says Ramesh Ramanathan, a former Citibank senior manager who gave up a flourishing career in Europe in his mid-30s to start a Bangalore nonprofit that promotes government accountability and who now works as an adviser to the government on urban renewal.
“Thousands of ambitious people will gather around him like moths around a lamp to feed their own careers.” Rahul’s success will depend on how well he avoids the trap of hubris, so common among Congress leaders, and how well he handles the inevitable flatterers and hangers-on. “So far he has been careful not to let any [such clique] grow around him,” says Mehta. “He seems to allow only those around him who have no ax to grind.”
There are other obstacles. Congress remains extremely resistant to any moves that would weaken its party grandees. Regional governments will not eagerly make room for newcomers at the expense of favored castes and clients. The Indian bureaucracy has a long way to go before it begins actually serving the people rather than obstructing their path. Big business will also be happy to slow down certain reforms—in order to slow down competition—or guide them in ways that let it game the market.
Still, the process Rahul Gandhi has unleashed has the potential to turn India into a shining example of how to manage a successful economy and a successful democracy in a large, heterogeneous country. It’s true that he faces enormous challenges. Yet he also enjoys enormous advantages—especially his family name and his rising popularity. This stature will only grow if Rahul manages to remain uncorrupted. Of course, it will be all too easy for him to succumb to the status quo, to do just well enough to achieve high office and then to stop fighting. But that would be a tragic waste of India’s greatest hope in a very long time.
URL: http://www.newsweek.com/id/200051

Another Indian Student Racially Assaulted In Australia | Inside story

2009-07-04T01:29:00.001-07:00

Filed under: Issues
Author: micky

Racial attacks on Indians in Australia continued unabated with a 20-year-old Delhi youth becoming the 14th victim of a spate of assaults on the community in less than a month when he was punched and abused here, leaving him with a fractured finger and a bloody nose.Mr Sunny Bajaj, a Deakin University student, was attacked by two men in Melbourne’s eastern suburb on Friday night as he was about to get into his car. “They came up to me and asked me for money, I told them I had none and then they attacked me,” Mr Bajaj said. Mr Bajaj was verbally abused and then punched by the two men, in their 20s one white and the other apparently of African descent.
The student said the attackers slammed his car door and punched him in head and stomach and then racially abused him. “They called me a ——ing Indian c—- why would they do that? I said nothing to them,” Mr Bajaj said, adding he suffered a fractured finger, bruising to his back and a bloody nose.Mr Bajaj, who was supposed to sit for an accounts exam, had to miss out on it because of the broken finger. Meanwhile, Mr Sravan Kumar, the 25-year old student, whose comatose pictures had sent shock waves across the Indian diaspora, will be moved to a rehabilitation centre to help him recuperate from the brutal attack.Mr Kumar, the first victim of a series of alleged racist attacks will move to the rehab centre on Tuesday.

by: http://www.zorsebol.com

NPYC to continue AAKS programmes

2009-07-04T01:28:00.002-07:00

The Indian Youth Congress has launched Aam Aadmi ka Sipahi, Soldier of common people (AKKS) a nationwide movement to confront the problems of the common man.
The Aam Aadmi or the Common Man has been at the centre of the Congress Party’s and UPA’s policies and programs. Indeed, the National Rural Employment Guarantee Act (NREGA), the Right to Information Act (RTI), Sarva Siksha Abhiyaan, Bharat Nirman Yojana, Rajiv Gandhi Grameen Vidyutikaran Yojana, National Rural Health Misson etc were all initiated not only to renew the historical bonds that exist between the common people and the Congress party but also to empower the common people to take his rightful place as an active participant in the Nation-building process.
Kuputo Shohe, President, NPYC and Dokiu Kecham, State Level Co-ordinator, AAKS states in a press release, “It is being observed that the implementation of NREGA in Nagaland has a long way to go to fulfill its intended purpose. In compliance with the direction of Indian Youth Congress, the NPYC will continue to carry out the activities of AAKS with special reference to NREGA, NRHM, SSA, RTI, Bharat Nerman, Rajiv Gandhi Grameen Vidyutikaran Yojana etc. and carry forward the message of the people friendly policies and programmes of Congress led UPA government to the door steps of the people living in the rural villages.”
“It is also true that despite these historic steps taken by the UPA, the benefits of these schemes more often than not, do not reach their intended beneficiaries, more so in non-Congress ruled states. At the historic Centennial Session of the AICC at Mumbai, Rajivji had famously lamented that of every rupee sent by the Government of India for the poor; only a fraction reaches to those it was intended for. Not much has changed since then,” the NPYC also said.
By working alongside the common people at the grassroots, the AAKS will ensure that this is no longer so. In this sense, the AAKS is as much a social movement as it is a political one. Needless to say, it is the youth who plays the most significant role in any social movement. It is only fitting then that the IYC has taken the leadership in the movement to empower the common people who had hitherto been left out of India’s march towards taking its rightful place in the 21st century at the forefront of Nations.
“We wish AAKS all the very best in their efforts to fight for the rights of the Common Man,” the release further stated.

By: http://www.morungexpress.com/

Now… Gay sex is legal !!

2009-07-04T01:28:00.001-07:00

Giving its landmark judgement, the high court said that section 377 should be amended and any sex between consenting adults should be legalised.

New Delhi, July 2: The Delhi High Court Thursday decriminalised gay sex by striking down section 377 of the Indian Penal Code (IPC), quoting Jawaharlal Nehru to emphasise that the Constitution guaranteed homosexuals rights equal to what other citizens enjoy.
A bench of Chief Justice Ajit Prakash Shah and Justice S. Muralidhar said that if not amended, section 377 of the IPC would violate Article 21 of the Indian Constitution, which states that every citizen has equal opportunity of life and is equal before law.
"Equality and inconclusiveness are the tenets of the Constitution," the court quoted India's first prime minister Nehru as having said.
Section 377, a law from the British Raj era, says homosexuality and "unnatural sex" is a criminal act.
Giving its landmark judgement, the high court said that section 377 should be amended and any sex between consenting adults should be legalised.
In plain terms, what this judgement means is that police will no longer be able to intrude upon or arrest adult homosexuals having consensual sex.
Advocate Tripti of the Naz foundation, which had filed the petition, said: "It is very clear now that sex between consenting adults would no longer be an offence."
Anjali Gopalan of the Naz Foundation added: "We had asked that section 377 be read down. This, however, does not hold good for minors below the age of 18. Also, the fact the adults have to be consenting is important."
In 2004, the high court had dismissed the same petition, saying that it was an academic challenge to the constitutionality of a legislative provision which could not be entertained.

Content from:http://www.indianewsupdates.com/

Over 80 percent Pakistanis see Taliban a threat : Poll

2009-07-04T01:27:00.000-07:00

The survey, which was conducted between May 17 and 28 and randomly interviewed some 1,000 people across Pakistan, showed that about 70 percent of respondents support the government in its decision to launch the military offensive in the Swat valley.

Washington, July 2: Most Pakistanis believe that the Taliban fighters are a "critical threat" to their country and support the ongoing offensive in the Swat valley, according to a survey. An overwhelming 87 percent of Pakistanis think that the Taliban, who are fighting to overthrow the Afghan government, should not be allowed to have bases in Pakistan, showed the poll by the World Public Opinon (WPO), a US-based organisation working on public opinion on international issues.
The survey, which was conducted between May 17 and 28 and randomly interviewed some 1,000 people across Pakistan, showed that about 70 percent of respondents support the government in its decision to launch the military offensive in the Swat valley.
About 45 percent of respondents also said the government was right in trying to resolve the situation through dialogue with the militants. They believe that the Taliban breached the agreement by not putting down their weapons, forcing the government to deal with them militarily.
The army has been battling the militants since April 26 after the Taliban reneged on a controversial peace deal with the North West Frontier Province (NWFP) government and instead moved south from their Swat headquarters and occupied Buner, which is just 100 km from Islamabad.
The operations had begun in Lower Dir, the home district of Taliban-backed radical cleric Sufi Mohammad, who had brokered the peace deal and who is the father-in-law of Swat Taliban commander Maulana Fazlullah. They later spread to Buner and Swat - and to South Waziristan earlier this month.
The military operations have displaced 3.8 million civilians from the three districts of NWFP.
"A sea change has occurred in Pakistani public opinion. The tactics and undemocratic bent of militant groups--in tribal areas as well as Swat--have brought widespread revulsion and turned Pakistanis against them," said Clay Ramsay, the organisation's research director.
However, he adds: "It's crucial to understand that the US is resented just as much as before, despite the US having a new president."
This striking new public willingness to see the government directly oppose Taliban groups and Al Qaeda owes little or nothing to an "Obama effect", the WPO poll said.
About 62 percent of respondents said US President Barack Obama's policies on Pakistan would be the same like his predecessor George W. Bush.
Similarly, 69 percent expressed unfavourably for the current US government, while more than 80 percent said they believe US is trying to weaken and divide the Muslim world.

Content from:http://www.indianewsupdates.com/

Gurdwara Bangla Sahib

2009-07-02T09:44:00.000-07:00

Gurudwara Bangla Sahib is situated in the heart of New Delhi's Cannaught Place area. It is loacted on the east side intersection of Ashok Road and Baba Kharag Singh Marg. Originally this place was the Bungalow(haveli) of Mirza Raja Jai Singh, hence the name Bangla Sahib. It's original name was Jaisinghpura Palace. Mirza Raja Jai Singh was an important military leader of Mughal emperor Aurangzeb.

After the passing away of Guru Har Rai the seventh Sikh Guru, Ram Rai and his masands(masand is derived from Arabic word masnad, meaning delegating authorotiy of the sovereign) instigated Mughal Emperor Aurangzeb to issue a decree summoning Guru Harkrishan to his court. Ram Rai was elder brother of Guru Harkrishan. Guru Harkrishan decided to go to Delhi since he felt that the "sangat", his followers had been misguided and he saw an oppurtunity in this to clear their misunderstandings. Meanwhile Sikhs of Delhi approached Mirza Raja Jai Singh, a strong devotee of Sikh Gurus to prevent any harm coming to Guru Harkrishan either by Aurangzeb or by the masands of Ram Rai.

Ram Rai when learned that Guru Harkrishan had accepted the summons to appear before Aurangzeb in his court at Delhi, started rejoicing since Guru Harkrishan had taken a vow not to appear before Aurangzeb. If Guru Harkrishan Comes to Delhi and refuses to meet Aurangzeb then definitely he will be arrested and suffer humiliation. Now Ram Rai felt that this act of Guru Harkrishan will surely lower his prestige among his followers and will pave the way for Ram Rai to declare himself as the true successor of Guru Har Rai.

Mirza Raja Jai Singh had made elaborate arrangements to receive Guru Harkrishan. Guru Harkrishan was received on the outskirts of Delhi like a royal guest of honor. Guru Harkrishan was accompanied by prominent Sikhs from his darbar and his mother Sulakhni.
Information From:http://banglasahib.org/

India Gate

2009-06-10T23:54:00.000-07:00

The India Gate (Hindi: इंडिया गेट) is one of the largest war memorials in India. Situated in the heart of New Delhi, India Gate was designed by Sir Edwin Lutyens. Originally known as All India War Memorial, it is a prominent landmark in Delhi and commemorates the 90,000 soldiers of the erstwhile British Indian Army who lost their lives fighting for the Indian Empire in World War I and the Afghan Wars.
Originally, a Statue of King George V had stood under the now-vacant canopy in front of the India Gate, and was removed to Coronation Park with other statues. Following India's independence, India Gate became the site of the Indian Army's Tomb of the Unknown Soldier, known as the Amar Jawan Jyoti (Immortal Soldier).

Amar Jawan Jyoti
Burning in a shrine under the arch of India Gate since 1971 is the Amar Jawan Jyoti (the flame of the immortal warrior), which marks the Tomb of the Unknown Soldier. The shrine itself is a black marble cenotaph with a rifle placed on its barrel, crested by a soldier's helmet. Each face of the cenotaph has inscribed in gold the words "Amar Jawan" (Immortal Warrior).
This cenotaph is itself placed on an edifice which has on its four corners four torches that are perpetually kept alive. It was unveiled on January 26, 1972 by the then Prime Minister Indira Gandhi, in the wake of the Indo-Pakistani War of 1971.
The Canopy near India Gate, New DelhiToday, it is customary for the President and the Prime Minister, as well as visiting Guests of State, to pay homage at the site on occasions of State ceremonies, and each Republic Day, 26th January, the Prime Minister pays homage to the soldiers along with Heads of Armed Forces, before joining the annual parade at the Rajpath.

The canopy
Standing right behind the gate is an empty canopy, also designed by Lutyens, and inspired by a 18th century Mahabalipuram pavilion, that till Independence of India in 1947 had the statue of King George V, which now stands in the Coronation Park, Delhi.

Site
The 42-metre tall India Gate is situated such that many important roads spread out from it. Traffic passing around India Gate used to be continuous till the roads were closed to the public due to terrorist threats.
The lawns around Rajpath are thronged by people during the night, when the India Gate is lit up.

इण्डिया गेट

2009-06-10T23:52:00.000-07:00

इण्डिया गेट (भारत द्वार) नई दिल्ली के राजपथ पर स्थित ४३ मीटर ऊँचा द्वार है। इस द्वार का निर्माण प्रथम विश्वयुद्ध और अफ़ग़ान युद्धों में शहीद हुए सैनिकों की स्मृति में किया गया था। सैनिकों की स्मृति में यहाँ एक राइफ़ल के ऊपर सैनिक की टोपी सजाई गई है जिसके चार कोनों पर सदैव अमर जवान ज्योति जलती रहती है। इसकी दीवारों पर हजारों शहीद सैनिकों के नाम खुदे हैं। इसके सबसे ऊपर अंग्रेजी में लिखा हैः

भारतीय सेनाओं के मृतकों के लिए, जो फ्रांस और फ्लैंडर्स मेसोपोटामिया फारस पूर्वी अफ्रीका गैलीपोली और निकटपूर्व एवं सुदूरपूर्व की अन्य जगहों पर शहीद हुए, और उनकी पवित्र स्मृति में भी जिनके नाम दर्ज़ हैं और जो तीसरे अफ़ग़ान युद्ध में भारत में या उत्तर-पश्चिमी सीमा पर मृतक हुए।
दिल्ली की कई महत्वपूर्ण सड़कें इण्डिया गेट के कोनों से निकलती हैं। रात के समय यहाँ मेले जैसा माहौल होता है।

2009-01-07T23:24:00.001-08:00

Libido (cont'd)

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

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

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

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

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

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

<<< prev

2009-01-07T23:23:00.001-08:00

Libido

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

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

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

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

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

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

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

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

>>>next

2009-01-07T05:25:00.001-08:00

Marriage and Sex

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

>>>next

2009-01-07T05:23:00.000-08:00

Marriage and Sex1

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

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

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

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

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

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

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

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

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

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

Strategies for Keeping the Spark Alive

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

<<< prev

2009-01-07T05:18:00.001-08:00

Orgasm

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

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

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

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

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

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

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

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

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

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

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

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

2009-01-07T04:53:00.001-08:00

Has Your Sex Drive Pulled a Disappearing Act?

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

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

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

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

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

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

2009-01-07T04:50:00.001-08:00

What Women Want ...

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

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

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

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

Women React Differently Than Men to ...

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

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

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

2009-01-07T04:49:00.001-08:00

It's Not "All in Your Head", the Bermans Tell Women

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

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

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

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

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

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

2009-01-07T04:45:00.002-08:00

hypoactive sexual desire disorder

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

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

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

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

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

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

Hypoactive Sexual Desire Disorder (cont'd)

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

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

2009-01-07T04:45:00.001-08:00

sexual arousal disorder

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

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

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

Sexual Arousal Disorder (cont'd)

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

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

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

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

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

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

2009-01-07T04:38:00.001-08:00

Female Orgasmic Disorder

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

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

Both primary and secondary FOD can be caused by:

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

Female Orgasmic Disorder (cont'd)

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

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

2009-01-07T04:36:00.001-08:00

sexual pain disorders

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

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

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

2009-01-07T04:32:00.001-08:00

What Is Female Sexual Dysfunction?

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

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

Loss of Sex Drive
Possible causes include:

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

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

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

2009-01-07T04:29:00.001-08:00

Potency Assessment for Men

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

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

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

2009-01-07T04:22:00.000-08:00

The Little Blue Pill ... Plus Other Impotence Options

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

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

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

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

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

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

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

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

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

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

2009-01-07T04:21:00.001-08:00

Self-Test for Diagnosing Erectile Dysfunction

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

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

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

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

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

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

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

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

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

2009-01-07T04:03:00.001-08:00

Sexual-Desire Skin Patch Looks Promising

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

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

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

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

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

2009-01-07T03:59:00.001-08:00

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2009-01-07T03:58:00.001-08:00

Suffering From Sexual Dysfunction?

Options That Are Out There for Men and for Women

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

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

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

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

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

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

(cont'd)

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

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

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

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

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

2009-01-07T00:03:00.001-08:00

Are Supplements the Solution for a Sex Life Gone South?

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

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

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

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

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

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

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

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

Are Supplements the Solution? (cont'd)

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

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

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

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

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

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

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

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

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

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

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

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

2009-01-07T00:02:00.001-08:00

(STDs)

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

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

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

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

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

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

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

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

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

2009-01-06T23:58:00.000-08:00

safer sex

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

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

• unwanted pregnancy
• STDs
• emotional and psychological trauma

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To use a male condom correctly:

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

Other important safer sex practices:

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

Do not hesitate to call a healthcare professional:

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

2009-01-06T23:51:00.001-08:00

Erectile Dysfunction (Impotence)

What is Erectile Dysfunction?

What do we mean by Erectile Failure: is defined as persistent or recurrent, partial or/ complete, failure to obtain or sustain, an erection until completion of satisfactory sexual activity.
Alternative terms for erectile dysfunction are Impotence, erectile failure, erectile dysfunctions, sexual inadequacy, sexual weakness, less erection, decreased erection, failure in intercourse, sexual incompetence, unable to sex i.e. intercourse, erection problem, napunsakata, less hardness of penis, looseness of penis in mid of sex or before penetration, E. D., ED, etc.
The symbol for the man's "masculinity" is the erect penis. It represents manhood and is expected to be ready to perform at a moment's notice.
When man suffers with erectile failure it comes as a major shock, when suddenly the symbol of his masculinity does not respond on. It usually means much more to the man than the simple fact that he is not responding sexually at that moment. It causes him to question his status as an adequate male. Thus when he fails, becomes panicky.

Severity of Impotence: It can take on many forms as:
I t may be complete erectile disorder: i.e. some men achieve no erection at all. For others, an erection may occur in the regular manner, but as the love play continues the erection is lost (we call it mid failure). For still others, the erection may be maintained very adequately up to the point of entry. As soon as entry is either contemplated or attempted, the erection disappears. For some, erection may be maintained beyond the point of entry, and then wane after a period of activity inside the vagina. No matter when the erection goes away, its loss is always troublesome. Erectile dysfunctions though a benign disorder has a great impact on the affected individual. Patient feels frustrated, depressed, ashamed, has lowered self-esteem & may even disturb his family relationship. There has been an explosion in the interest in male sexual dysfunction with the development in techniques of modern scientific diagnosis & treatment of male sexual disorders with very good treatment outcomes. Now majority patients are cured by proper diagnosis & correction of the defect. Thus now more & more people are seeking medical advice regarding their problems.

How common erectile disorder is? In a survey in USA (1994) 39% of 40 Yr. old men, 67% of 70 Yr. old men complained of some degree of impotency. Complete erectile failures were present in 5% at age of 40 Yr., 15% at age 70 Yr.
In India 1 in every 10 men suffers from some degree of impotence.

How much erectile dysfunction affecting your quality of life?
If you are suffering with some of these problems it means you need treatment.
I feel frustrated because of my erection problem,
My erection problem makes me feel depressed,
I feel like less of man because of my erection problem,
I have lost confidence in my sexual ability.
I worry that I won't be able to get or keep an erection.
I feel that I have lost control over my erections
I worry about the future of my sex life,
I have lost pleasure in sex because of my erection problem
I try to avoid having sex,
I worry that I am not satisfying her because of my erection problem
The above questionnaire will decide that whether your problem is significant or not, if answer of any one question is yes then you must consult us either personally or through online & get cure of your sex problem.

CAUSES OF ERECTILE DYSFUNCTIONS

Impotence due to some well-defined causes (Internal defect i.e. organic or physical causes)
1) Hormones disorders are one of the common causes of impotence. There are two types of hormones in body, some hormones as male sex hormones stimulates erection & desire. Where as some other hormones inhibit the erection as prolactins & others. There are many male hormones in the body as serum testosterone, free testosterone DHEAS, Androstenidiones which, stimulate the sexual activity. So we have to test these hormones to finds out hormones disorders. Once the diagnosis is made they are easily treatable in few months time. Causes of hormone disorder may be Diabetics, Hypogonadisms (Testosterone deficiency), Hyperprolactinemias, Hypothyroidisms or Hyperthyroidisms, Cushing syndrome, Endocrines dysfunction Secondary to drugs/toxin & systemic diseases, Hypothalamic – pituitary deficiency: Idiopathic GnRH deficiency, Kallman syndrome, Prader-Willi syndrome, Laurence-Moon-Biedl syndrome, Hypothalamic deficiency, pituitary hypoplasia, Trauma, post surgical, postiradiation, Adenoma: craniopharyngioma, other), Vascular (pituitary infraction, carotid aneurysm), Infiltrative (Sarcoidosis, histiocytosis, hemochromatosis), Autoimmune hypophysitis, drug-induced hyperprolactinemias, Untreated endocrinopathies , Diabetics , Glucorticoid excess, Hypopituitarisms, Addison disease. Isolated gonadotropin deficiency, Pituitary or Hypothalamic defects, Associated with multiple pituitary hormones deficiencies: Idiopathic pan hypo-pituitarism (hypothalamic defects), Pituitary dysgenesis, Frohlich syndrome, fertile eunuch syndrome, Idiopathic hypopituitarism,Testicular failure, development defect, drugs, trauma, congenital defect, congenital adrenal hyperplasia, Chromosomal defect, testosterone hormone biosynthetic defect, Mumps orchitis leading to testicular atrophy, Primary testicular defect of testicular differentiation, inborn errors of testosterone synthesis, Klinefelters syndrome.

(2) Decreased blood supply to penis: Due to many disorders of penile artery & veins, decrease in blood circulation (flow) to penis occurs so that blood is unable to reach in the phallus so that penis does not becomes full hard. Or some times blood reaches in normal amount resulting in full hardness of organ but any time before or after vaginal penetration blood starts leaking back in to body leading to loss of erection. The causes of this may be as follows:

(i) Obstruction to arterial blood flow i.e. Decreased Penile blood supply to penis may be due to various diseases so that blood supply to penis may be decreased. So that either penis does not become fully hard or even if it becomes hard it soon become loose before intercourse or during intercourse. It can occur in young people or in older people also. This is one of the common causes of impotence. The causes of decreased blood supply may be Atherosclerotic, Diabetics, Hypertension, Heart Diseases & other vascular diseases as Arterial dysplasia, Post-Traumatic & Post-Surgical & damage to blood circulation due to various local disorders.

(ii) Veno - Occlusive dysfunction i.e. Venous Leak: There are certain conditions in which penis becomes full tight initially but very soon becomes loose because blood from penis leaks back. Normally during sexual excitation blood flows into penis & this blood is not allowed to go back in body by various venous valves. Due to certain disorder these valves may not work. So that blood coming in penis keeps leaking in body all the time so that either penis does not becomes fully hard or even if becomes fully hard it becomes loose any time during sex due to leakage of blood.

3) Penile Nerve Abnormality: When erectile dysfunction is caused by disorder of central nervous system or due to peripheral nerve is called neurogenic erectile disorder. This can be due to disorder of nervous system & Neuropathy d/t various causes, Ant. temporal lobe lesions: Stroke/epilepsy, Dis. of Spinal Cord: T-12 or below & Dis. of Peripheral Nerves :(Peripheral polyneuropathies, Autonomic neuropathies, Pelvic nerve trauma). All these disorders leads to decreased sensitivity of penis & sex centre to female touch & sexual excitation leading to less erection.

4) Sex Centre Disorder: In the brain there is a particular centre in the hippocampus of the brain, which regulates the penile erection during intercourse, the desire of sex time, taken in discharge & enjoyment of sexual act. So any disorder of sex centre due to various causes can lead to impotency, less desire & premature ejaculation.

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

(6) Penile corporal muscle abnormality due to various disease penile smooth muscles do not dilate so that blood is unable to reach in penis & it could not erect.

7) Local Causes Peyronies dis. (painful penile curvature d/t fibrosis), Penile trauma, carcinoma. Following Priapism (i.e. prolong longstanding erection) etc.

8) Other Systemic diseases (liver failure, renal failure, cardiac failure or other system failure etc.)

B) Drugs & Toxins various drugs impair sexual activity. So detailed drug history taking is must.
Antihypertensive (ß blocker, Thiazide diuretics,Clonidine & methylodopa) Antiandrogens (Spironolactone & Ketoconazole)
Antidepressants (Tricyclic antidepressants, Major Tranquillizers & Antipsychotics & Addictions of (Alcohol, Smoking, Heroine, methadone, Cannabis, opiates & marijuana)

(c) Psychogenic: Many psychiatric disorders as obsessive-compulsive disorder, Neurosis, schizophrenia, depression can cause impotence.

Primary Cause of Impotence: due to any of the above causes patient may fail during sex. Once a person fails due to any of the above causes as hormone disorder or decreased penile blood supply or any other cause after that patient starts thinking that he has some serious internal defect in sex organ. Secondary to this failure in sex, virtually all patient develop following three things, these three factors further worsen the erectile dysfunction caused by primary cause, and these are called.

These secondary factors are as follows:

1) Fear of failure In this the moment person thinks of going for sex, he start fearing that I may fail again thus he loses confidence in his sexual competence. This fear decreases his confidence further leading to further worsening of sex dysfunction. Many times due to this fear patient starts avoiding sex & his desire for intercourse decreases.

2) Sexual Performance anxiety means development of severe anxiety before real sex. Patient develops obsessive concern for full erection i.e. whether or not he can get a normal erection and if he does whether he can keep it long enough for intercourse to occur & his partner to be satisfied. Due to this anxiety He tries to erect his penis hard by concentrating more on it & contracting the pelvic & leg muscles rather than allow it to occur in natural response to erotic pleasure. But unluckily most people do not know that penis hardness occurs spontaneously & automatically in response to more & more enjoyment one gets in touching & loving the female body. Thus the more patient tries too make penis hard, the just opposite happens i.e. penis becomes looser. Thus this anxiety to perform better really further worsens the hardness of penis. This performance anxiety can be cured by sex therapy in few sittings.

3) Spectator attitude means whenever patient goes for sexual activity though he may be touching the body of female but his brain is always thinking and involuntarily (unconsciously) looking towards his penis i.e. whether his penis is getting hard or not. This is called spying of penis. Thus his mind is always preoccupied about penile hardness. Patient loses confidence in his performance, and instead of relaxing & enjoying he starts watching their sexual responses like 'spectators', rather than being involved in what is going on. So that in place of enjoying the female touch, he always keeps spying his penis leading to lack of enjoyment of sexual activity thus\leading to repeated failures.

These all above problems contributes to repeated failures.

So that in all cases of impotency after proper diagnosis & treatment of primary cause, these three secondary problems also need to be tackled by sex therapy then only patient can get permanent cure. So by sex therapy, the patient is taught how to avoid spectator role and become free of fear of failure & performance anxiety.

So above three secondary problems hinder into normal recovery of sexual function even if the original cause may have been cured.

It does not means that person is suffering from psychological erectile failure; instead it is a normal fear everybody develops due to failure in sex. Thus one should try to find out why he failed on very first time i.e. one should try to finds out any of the above nine causes of impotence.

Thus the anxiety of sex, fear of failure and spectatoring (the patient watching all the time to see if he is getting an erection or not) are also the important. After correcting primary cause the normal potency does not returns, because these three secondary factors interfere with normal sexual functioning. If these factors are also removed by sex therapy, sexual functioning soon becomes normal. The new, intensive team treatment of sexual dysfunction has revolutionized sex therapy. 'In most cases, for cure of impotence detailed sex counseling & sex therapy is necessary.

How common is impotence due to some well-defined internal causes?

Old belief is that most cases of impotence are Psychogenic is not correct. In one study Koremann & colleague found impotence due to some internal causes in > 90% of men & Psychogenic in 10%.

Thus Psychogenic cause should never be labeled unless Hormonal & other causes have been excluded by thorough ex amination, hormon.examination, hormon.0es & penile blood supply test.

DIAGNOSIS OF CAUSE OF IMPOTENCE

First step in proper treatment of Erectile Dysfunctions (impotence) is accurate diagnosis of cause. So we first try to find out cause. We take detailed history, thorough sex counseling, physical examination, examination of nerves and Penile arterial examination. After that depending on likelihood of particular, cause relevant tests are done All testing facilities are available at our centre. Thus you may consult us at our centre & at same time you may get all tests. done. The time taken in getting all the reports ready is 36 hours. So if you are from out of Delhi, you may come here for two days.

DETAILED HISTORY:
We take detail history about the onset of eredtile dysfunction i.e. whether it started Sudden or gradual, Primary or Secondary, Erections at other occasions, Response to previous therapy, Libido, Stress (physical or mental), H/O precipitation by some drugs, presence of Hypertension, Ischemic Heart Disease , claudication, trauma, DM, Sec. Sexual Characters, Hypothyroidisms, Hyperthyroidisms & Galactorrhoeas, Symptoms of sensory loss, epilepsy, Liver/Renal failure.

EXAMINATION OF GENITALS:
We examine whether Sexual Development is adequate or subnormal. For this testis size is measured by orchidometer (if patient is outstation then by ultrasound of testis) , Penis Length & girth is measured by phallometer. Galactorrhoea & features of other hormone disorder are checked up. Blood supply of penis is assessed by, palpating dorsal penile artery of penis. Nerves of penis examined by sensation testing, Deep Tendon reflexes & Bulbocavernosal reflexes. Then other systems are examined.

INVESTIGATIONS i.e. DIAGNOSTIC TESTS:

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

Step- I: Hormone Testing: There are two types of hormones in body some stimulates penile hardness whereas there are other hormones which inhibit penile stiffness.
Male & Female sex hormones & other associated Hormones are tested by latest-immunoassay techniques. These hormones includes total Testosterones, free testosterones, Prolactins, LH, FSH, T3, T4, TSH others as Cortical, E2, Free testosterones SHBG etc.. Among above tests relevant hormones are tested in that particular patient. Results are available in 36 hours. In the hormone testing either stimulatory sex hormones may be low leading to less erection or those hormones which are inhibitory may be high leading to inhibition of penile erection. These hormones are tested by taking blood sample from forearm. When we find out any of above hormone disorder simply correction of these hormone disorders corrects the erectile dysfunctions in two months time.
Blood glucose & other systemic test may be required depending on the need.

Step I1: Penile Blood Supply Testing:
This test is done to decide whether impotence is due to decreased blood supply to penis or disorders of nerves or due to some other causes. This test is also called PIPE (Pharmacological induced penile erection) test.
In this test we examine the dorsal penis artery & veins after giving the various Vasodilators either orally or as injectable, also we asses whether penis is getting full hard or not after vasodilator use, how long hardness is persisting in response to theses vasodilators. If penis is not becoming fully hard or not staying hard for at least fifteen minutes even after adequate dose of vasodilators than cause of impotence is inadequate blood supply to penis or due to leakage of blood out of penis due to venous leak. If penis is getting full hard and staying longer than fifteen minutes then cause is nerves of penis are not functioning or some other cause. There are two types of blood supply disorders are found on blood supply testing.

The first pattern is suggestive of penile arterial blockade in which blood does not flows in penis from blood circulation due to block in arterial supply of penis. This obstruction in vascular supply is diagnosed by above mentioned blood supply test in which after giving blood flow medicine we find that there is increase in blood flow in arteries of penis is less than normal with resultant absence of achievement of full hardness of penis for sufficient time. This test is very simple to perform if the concerned doctor is well trained & experienced. This is an O. P. D. procedure & takes approximately 30 minutes to perform the test. We do these tests daily at our centre as we have all the required instruments to do these tests. Once we diagnose that there is decreased blood supply to penis then we find out the cause of this inadequate blood flow.

Once the cause of decreased blood supply is diagnosed then treatment becomes very easy with virtually full chances of permanent cure.

Second pattern found on blood supply testing is Leakage of blood out of penis back into circulation after initial full erection (also known as Veno-occlusive dysfunction): In this defect, blood flows from circulation to penis normally but due to continuous leak of blood out of penis due to defect in penile valves whose job is to stop the leakage of blood out of penis, enough penis hardness is either not achieved or even if penis becomes fully hard it become loose there after due to leakage of blood out of it. When we do blood supply testing, in this disorder there is good blood flow in arteries of penis through out study, but there is continuous leakage of blood is seen through valves of penile veins.

Step-3: N.P.T. MONITORING: Penile Erection assessment at night (called as nocturnal penile tumescence) is done by Rigiscan device (it measures penile rigidity & diameter) to differentiate between impotence of psychogenic origin or due to some internal cause. If N.P.T. monitoring shows Normal results it means impotence is Psychogenic, if results are impaired means impotence is due to some internal cause.

Step 4: DUPLEX SCANNING: (Doppler & ultrasound scanning before & after vasodilator use) In this Testing with use of vasodilator drugs/Duplex vascular scanning is done to decide which type of problem patient is suffering, accordingly treatment is prescribed. It assesses arterial diameter & blood flow status. It helps in differentiating & pinpointing the cause of impotence i.e. whether it is arterial or venous cause & what is the specific cause of that problem so that it can be treated properly.

Step 5: Sex Counseling: After detail discussion with our male & female sex therapist, we try to finds out the root cause of sex problem then we treat accordingly. For counseling we take detail history of sexual development, his thoughts, his misconception about sex, his old experience in sex, his unconscious fears about sex. This counseling session unravels all the hidden psychological causes of sexual inadequacy.

Step 6: Other tests (If required)

1) Penile Nerve Testing: By conduction and sensory testing (NCV, EMG & VPT).
2) Psychoanalysis: To find different factor leading to psychogenic impotence.
3) Functional Studies: To see the penile response in provocation to various drugs.
4) 5) Arteriography: It is a Specialized X-Ray of penis before arterial opening i.e. opening of the blockade surgery. In this test a drug (dye) is infused which detects whether block is situated , whether it is localized or diffused. Once we localized the obstruction & its cause, then we decide whether it can be cured through medicine or surgery.

5) Cavernosometry & cavernosography (before venous leak surgery).

TREATMENT OF ERECTILE DYSFUNCTIONS

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

The various treatment option for patient with impotence are:

1) Hormone Therapy
2) Medicines to increase blood supply to penis (Oral & Local Gels)
3) Viagra & like drugs
4) Sex Therapy
5) Vacuum Erection Pumps
6) Injection therapy
7) Penile Blood Supply increasing Surgery
8) Penile Hardness Increasing Implants (Penile prosthesis)

(1) Hormone Therapy:

Hormone therapy is given to cure the problem whatever defect is found.

Hormones Therapy: Depending on the type of hormone disorder i.e. whether male sex hormones decreased or inhibitory hormones has increased, Hormone therapy is directed towards that. Hormone therapy usually cures the Hormone problem in 2 to 3 months time and they do not have any adverse effects as they given to only those patients in whom some hormone disorder is found.
The various hormone preparations & their route of administration are:
1. Oral testosterone preparations that is available in capsule form. It needs to be given one to three capsules daily. These have no side effects.

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

3. Sublingual Testosterone cyclodextrin is now available which is very fast acting & very effective is fast & has better effects on sex organs.

4. Local application of D.H.T. gel is new preparation for male hormone replacement. It is very effective without any side effects.

5. Injection Testosterone esters these includes Testosterone enanthate & testosterone cypionate given intramuscular injections every 10 to 14 days.
6. New human androgen receptor modulators they increase the effect of male hormone over androgens sensitive organs.

7) DHEAS tablets are available which are effective & has no side effects.
8)Treatment of hyperprolactinemia with cabergoline & Bromocriptine is done with quick cure of sexual dysfunctions.

(3)Medicines to increase blood supply to penis: (oral & local gel)

Medical treatment (i.e. prescription of various drugs to increase blood supply to penis, nerve rejuvenating etc are given to correct the basic cause found on investigations.
These drugs open the blockade of penile arteries so that blood flows into penis increases and penis becomes fully hard. The various drugs, which are effective to increase penile blood supply, are as follows. The particular drug needed in particular patient depends on the cause of erectile dysfunctions.
Oral Drugs: The various oral drugs are:

a. Yohimbine: By acting on alpha-receptors it dilates the penile blood supply. It is one of the common drug used for increasing penile blood supply. It is freely availalable as oral tablet.
b. Phentolamine: is also a good drug to increase blood flow in the penis. The effect of this drug increases manifold when it is used along with other commonly used vasodilators. It is used as oral, sublingual tablets. In advance cases it is given as injectable also.
c. Sublingual apomorphine is very effective in increasing penile blood supply.
d. Trazadon works on sex centre & increase penile blood supply.
e Oral Prostaglandin.

f Nalaxone
g Gene Therapy: In this modality of treatment blood supply to penis is increased by gene therapy. By the introduction new genes in body the generation of penile blood increasing substance nitric oxide generation increases in penile blood tissue leading to more blood supply & hardness of penis. This is a slow process takes longer time to have effect but once the effect starts coming the results are permanent. Thus it achieves the cure of impotence. This is effective & achieves permanent cure of impotence

3) Local Application of Gels / Drugs

a. MUSE is per urethral use of PGE1. In this medicated pellet is inserted into the Urethra. After insertion penis becomes hard with in 20 minutes. This hardness lasts for up to 60 minutes.
b. Topical preparations of papaverine
c. Topical preparations of prostaglandin E1
d. Vasoactive intestinal peptide
e. Local application of Minoxidil
f. Local application of Nitroglycerine
g. Local application of l-arginic acid

(3) Viagra & Like drugs

These drugs are good but temporary method of treatment because it does not treats the basic cause of sex problem. These drugs belong to following the groups:

Sildenafil,( Viagra, penegra, caverta) : one tablet works for 4 hours.

Tadalafil (Cialis, tadalis, megalis ) : one tablet works for 24 hours.

Vardenafil (Levitra): one tablet works for 6 hours.

It is a temporary therapy. After consumption of this tablet, patient gets hardness only temporarily. Once this tablet is consumed, the blood flow into penis increases & penis becomes fully hard in many patients. But this is an effective short-term treatment but it does not cures the basic problem. It also has certain side effects & many deaths have been reported after its use if not used with proper precaution. Thus it should not be consumed without the advise of experts. There need to have detailed physical examination before one is prescribed Viagra. So never take it without expert advise.
Dose used is 25 mg to maximum of 100mg. It should be taken 60 minutes before sexual intercourse.
5. Detailed Sex Education: In this patient is explained in detail about what is normal physiology of erection and what we can do in our daily life to increase erectile strength & staying it hard for longer time. Also we educate the patient how to satisfy the women so that she gets satisfactory orgasm and considers you a wonderful partner.

(4) Sex Therapy:

Once we found out the cause we treat internal causes like hormone disorder & decrease penile blood supply. But even after treating above basic primary causes of impotence, Many times patients still do not recovers fully because of his fear of failure, sexual performance anxiety and spectatoring attitude. These secondary factors do not allow him to function normally. For cure of these secondary problem patient needs details sex therapy. Basic purpose of this exercise is to make patient free of any fear of sexual performance. After this exercises all performance anxiety disappears. In sex therapy the patient is taught various exercises & how to use various body part in particular way so that erection become good, sustained & patient does not have any fear. Normally in six to eight sittings patient's all fear disappears. Sex therapy is a very effective in impotence, premature ejaculation. Thus we advise all of our patients not to hurry, and take few sessions of sex therapy sittings for permanent cure.

(5) Vacuum Pump Devices

Vacuum Pump Devices is a small instrument, application of it on penis, makes penis fully hard within three minutes. With this instrument patient does not have to consume any medicine. So it has no side effect.
(By this device a vacuum of > 100 mm of Hg is created around penis leading to Pooling of blood in penis resulting in full hardness).
Efficacy: Approximately 80% of patients get full erection & satisfied.

(6) Injection Therapy

The various drugs used as injections are
Injection of papaverine, ProstaglandinE1, & Phentolamine is used alone or in combination (bimix or trimix). This is a very effective mode of treatment of impotence. The dose of papaverine is 5mg. to 60mg. at one time. It work in 15 minutes & patient gets very hard erection, which lasts for at least thirty minutes. It is very good especially for those who fear that they may fail during sex. So that by taking this injection they can perform without fear & with hundred percent guarantee of success. It is a quiet popular form of treatment among boys & young adults. Especially for those, who have severe fear for failure for the first night or when expecting sexual encounter with a new partner.
Response - Success is achieved in approximately 90% patients.
Injection of ProstaglandinE1: dose used is 10 to 20 mg at one time .It is very effective with virtually no side effects.
Injection of Phentolamine normally it is used in combination with papaverine or Phentolamine.
Inj. Of Moxisylyte: available by the name of injection Erecnos.
Inj. of Vasoactive Intestinal Polypeptide: available by the name of injection Invicorp.

Treatment of underlying cause: When some underlying cause as diabetics, depression, high blood pressure (hypertension), or use of drug is diagnosed is treated accordingly.

Surgical Treatment

Surgical treatment is suggested only when all the above mode of therapy namely hormone therapy, blood supply increasing tablets, Viagra like drugs, & sex therapy has failed.

(7) Penile blood supply increasing surgery:

After investigations when it is diagnosed that blood supply is decreased. In majority of patient's blood supply can be normalized by many of the medicines as mentioned above, which have capacity to correct the vascular disorders. But in some cases surgery is required.
Before surgery for vascculogenic impotence, exact site of blockade is localized by Arteriography.
The various surgeries are as follows:
a) Arterial Recanalization surgery: After localizing the block, we open the blocked part of artery by vascular microsurgery, this is called recanalization vascular surgery. This is commonly done in younger patients.
b) Arterial bypass surgery: When we find that there is blockade in broad segment of dorsal penile artery then such a long segment can not be recanalized. In such cases we bypass the blocked portion of the artery by use of other inferior epigastric artery. In this normal artery is connected with penis artery distal to blocked artery so that blood flow normalizes.
c) Venous leak surgery: As we have mentioned above leakage of blood from penis to back into body in mid of erection is one of the cause of impotence. In this surgery the leaking veins is localized first by venography (cavernasometry & cavernosography). After localization of those veins through which blood is leaking are ligated i.e. tied. Thus venous leak stops & penis starts becoming full rock like hard & patient sexual problem normalizes. For this surgery we keep patient admitted for one day only.
At our centre our micro vascular surgeon is very expert in doing all above surgeries. In this surgery artery in which blockade is present is either opened or blocked area is bypassed by use of other artery so that blood Supply to penis is established. Result is very good when candidate for surgery is properly selected. This operation needs expertise. It is done under the guidance of operating microscopes.

(8) Penile Hardness Increasing Implants (Penile prosthesis):

There are some patients in whom blood supply increasing surgery is not possible. Thus penile implant is a good treatment in all those patients in whom cure is not possible inspite of all above treatments. In such cases we put intrapenile implants. After these surgery patient can resume his normal sexual functions.
There are two kinds of implants:
a) Malleable i.e. semi rigid implants:
b) Inflatable implants: Now days this implant is more in use as penile hardness is very good above all it may remain erect for longer time. This surgery takes approximately 30 minute by our surgeon.

There are certain penile implants which when applied into penis then its hardness become very hard.

Thus my advise to any body who is suffering with erectile disorder:

1) Please get yourself completely investigated, find out the cause, get complete treatment accordingly with good cure rate.

2) Never presume your problem as Psychogenic unless other causes have been excluded.

3) Remember males should be potent till late seventies unless they have some cause such as Hormone disorder or decreased penile blood supply. So at any age you may attain potency after complete diagnosis and treatment.

4) Remember Ayurvedic doctors do not have knowledge of various causes of erectile dysfunction and they just give empirical sex tonics with no improvement or only partial temporary improvement. Also unfortunately most Ayurvedic doctor exploit patients.

5) Now treatment of impotence is possible with satisfactory results with the availability of newer drugs.

Impotence in Diabetics

About 50% of diabetic patients with high blood sugar ultimately become impotent. It can occur at young age or old age. It occurs more frequently at older age & after many years of uncontrolled high blood sugar, but in some it can occur at younger age also. It is more common in patients with other associated complications as Nerve, Kidney or Heart involvement. In those in whom sugar is not well-controlled chances of developing impotence is more. It is also more in those who have hypertension & taking medicines for that & also in alcoholics & smokers.
The causes for impotence in diabetics are as follows: -
(i) Hormones Disorder (Deficiency of male sex hormones or increase in some inhibitory hormone as high prolactin & disorders of Thyroids can cause erectile dysfunctions.
(ii) Decreased penile blood supply due to deposition of cholesterol in penile blood circulation or in arteries supplying blood to penis.
(iii) Endothelial & smooth muscle disorders leads to decreased dilatation of penile vessels on sexual stimulation so that blood is unable to reach in penis thus full hardness is not achieved.
(iv) Affection of penile nerve i.e. penile neuropathy.
(v) Psychogenic factors as presence of depression or other psychiatric illness.
For detail investigation to diagnose the cause of erectile disorder read page diagnosis of cause of impotence
Treatment will be sex therapy, drugs, injection therapy, hormones & prosthesis etc. depending on the cause of impotence & etiology. For detail read treatment of impotence.
Impotence after heart attack (MI) is very common it occurs due to decreased penile blood supply decreases hormone, fear of another myocardial infarction (M.I.) & sex center disorder. This can be treated in three months time after proper investigation.
Erectile disorder in Chronic Renal failure: CRF & subsequent uremia are commonly associated with erectile dysfunctions (i.e. impotence) decreased desire. Approx. 60% of CRF patients suffers with impotence. It occurs due to decreased penile blood supply. Nerve involvement & hormone disorders.
Treatment includes drugs hormone therapy & injections for detail in section treatment of impotence.

2009-01-06T23:50:00.001-08:00

Premature Ejaculation (early discharge)

What is Premature Ejaculation?

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

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

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

Causes of Premature Ejaculation:

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

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

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

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

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

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

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

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

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

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

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

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

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

Diagnosis of Cause

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

Treatment:

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

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

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

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

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

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

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

2009-01-06T23:42:00.001-08:00

Small Penis / Penis Enlargement

What is small Penis?

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

Causes of small penis:

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

Male Hormones Disorder:

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

Diagnostic tests for diagnosing cause of small penis

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

These tests includes:

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

In biochemistry liver function or kidney function tests are done.

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

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

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

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

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

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

Combined Pituitary hormone tests are performed when suspecting pituitary disorder.

Molecular genetic studies done in some special cases.

Serum estrogen increased whenever testicular function is decreased.

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

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

TREATMENT OPTIONS FOR PENIS ENLARGEMENT

Penis enlargement by Hormone Therapy:

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

First We Test Whether Penis Enlargement Is Possible Or Not.

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

How this treatment works:

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

Treatment of Small Penis

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

This treatment can be either:

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

Surgical therapy: Penis enlargement surgeries

HORMONE TREATMENT

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

The various Treatment options are:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Response of Treatment:

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

Side Effects:

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

PENIS ENLARGEMENT SURGERY

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

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

Three types of surgeries are performed.

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

Response of Treatment

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

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

2009-01-06T23:41:00.001-08:00

Thin Penis / Girth Enhancement

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

Causes Of Thin Penis

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

It may occur due to

Male Hormones Disorder:

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

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

Diagnostic Test:

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

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

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

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

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

Combined Pituitary hormone tests are performed when suspecting pituitary disorder.

Molecular genetic studies done in some special cases.

Serum estrogen increased whenever testicular function is decreased.

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

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

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

Surgical therapy: Penis girth enhancement surgeries

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

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

Treatment: Treatment can be either

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

Hormone Treatment:

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

The various Treatment options are:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How this treatment works:

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

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

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

Penis Girth Enhancing Surgeries:

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

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

2009-01-06T23:38:00.001-08:00

Low Sex Desire (Decreased Libido)

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

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

(1) Hormones Disorder:

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

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

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

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

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

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

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

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

Diagnostic Tests:

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

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

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

Treatment:

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

(a) Hormone therapy:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Response of treatment:

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

Side Effects:

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

2009-01-06T23:37:00.001-08:00

Inability to consummate after marriage

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

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

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

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

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

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

2009-01-06T23:33:00.002-08:00

Homosexuality

Homosexuality

A) Homosexual Male :

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

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

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

2009-01-06T23:33:00.001-08:00

Delayed Ejaculation (Orgasm)

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

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

2009-01-06T23:30:00.001-08:00

Absent Ejaculation / Orgasm

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

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

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

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

2009-01-06T23:29:00.001-08:00

Dhat (whitish/semen like in urine)

Dhat

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

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

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

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

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

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

2009-01-06T23:26:00.001-08:00

Passing of Semen in Urine

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

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

2009-01-06T23:24:00.001-08:00

Watery Sticky Secretion From Penis

Small Penis / Penis Enlargement

CAUSES OF STICKY WATERY SECRETION PROBLEM

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

DIAGNOSIS OF CAUSE OF STICKY WATERY SECRETION PROBLEM

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

DETAILED HISTORY

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

EXAMINATION OF GENITALS

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

INVESTIGATIONS i.e. DIAGNOSTIC TESTS

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

TREATMENT

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

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

2009-01-06T23:21:00.001-08:00

Weakness After Sex or Masturbation

Weakness after sex or masturbation. (Post ejaculatory asthenia)

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

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

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

2009-01-06T23:20:00.001-08:00

Sexually Transmitted Diseases

AIDS / HIV

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

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

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

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

Chlamydia

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

Genital Warts

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

Gonorrhea (Gonococcal Urethritis)

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

Herpes (Genital herpes)

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

Syphilis

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

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

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

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

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

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

2009-01-06T23:17:00.001-08:00

Pain During Intercourse (Dyspareunia)

The causes of Pain during intercourse may be due to:

Dyspaerunia

Vaginismus

Dyspaerunia

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

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

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

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

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

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

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

6.) Sexual aversion disorder

7.) Connective tissue diseases leading to dryness

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

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

10.) Sicca syndrome

11.) Idiopathic

12.) Neoplasm's of vagina.

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

14.) Pemphigus vulgaris of vagina.

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

16.) Vulvar vestibulitis.

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

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

19.) Idiopathic vulvodynia.

20.) Atrophic vaginal mucosal atrophy.

21.) Sexual aversion disorder & female sexual arousal disorder

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

These secondary factors are as follows:

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

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

DIAGNOSIS OF CAUSE Of PAIN DURING SEX

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

DETAILED HISTORY:

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

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

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

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

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

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

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

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

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

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

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

2009-01-06T23:15:00.001-08:00

Vaginismus ( Pain with spasm at time of entry)

Vaginismus

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

The causes of vaginismus are

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

DIAGNOSIS OF CAUSE Of PAIN DURING SEX

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

DETAILED HISTORY

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

EXAMINATION OF GENITALS

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

INVESTIGATIONS i.e. DIAGNOSTIC TESTS

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

TREATMENT OF VAGINISMUS

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

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

2009-01-06T23:03:00.001-08:00

Low Sex Desire (Low Libido)

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

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

(1) Hormones Disorder:

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

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

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

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

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

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

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

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

Diagnostic Tests:

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

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

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

Treatment:

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

(a) Hormone therapy:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Response of treatment:

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

Side Effects:

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

2009-01-06T23:00:00.001-08:00

Absent Orgasm

Absent Orgasm

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

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

Causes of Lack of Orgasm Are

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

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

Disorders of Sex Centre

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

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

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

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

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

DIAGNOSIS OF CAUSE

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

DETAILED HISTORY

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

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

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

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