Tuesday, July 3, 2012

Understanding Male Sexual Problems -- the Basics









                Problems with sexual functioning are common, affecting more than half of all couples at some time. Although sexual dysfunction rarely threatens physical health, it can take a heavy psychological toll, bringing on depression, anxiety, and debilitating feelings of inadequacy. Many sexual problems are actually symptoms of other more serious heath disorders.
Determining which factors are affecting your ability to enjoy your sexuality -- whether psychological or physical -- can be very difficult and will require great patience from you, your partner, and your health care provider. Problems may be difficult to resolve without expert help, especially because misinformation and embarrassment are leading causes of sexual dysfunction.
If your sexual problem only occurs under a particular set of circumstances, or only with certain sexual partners, then your condition is considered to be "situational" rather than "generalized" (occurring regardless of the circumstances or partner).
The major categories of sexual dysfunction in men include:
  • Erectile dysfunction (sometimes called impotence): the inability to have or maintain an erection sufficient for sexual functioning.
  • Premature ejaculation : an inability to delay orgasm and ejaculation, such that it occurs very early in the course of sexual contact, leaving the other partner dissatisfied.
  • Male orgasmic disorder: an inability to reach orgasm (climax) with a partner; or the inability to achieve orgasm without lengthy sexual contact; or the inability to have an orgasm during intercourse. In some cases, orgasm can be achieved only through masturbation or oral sex.
  • Inhibited or hypoactive sexual desire: a disinterest in sexual contact or complete lack of sexual desire.
  • Retrograde ejaculation: the semen,rather than emerging from the end of the penis, moves backward into the bladder during orgasm.
  • Priapism: a prolonged erection unaccompanied by sexual desire; this rare condition is potentially dangerous and requires immediate medical attention.
Many of these sexual conditions will occur at some point during the course of a man's life. In fact, some researchers only consider a diagnosis of sexual dysfunction if the problem occurs in 25% of all attempted sexual encounters.

What Causes Male Sexual Problems?

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Because the sexual response is so complex, involving multiple factors, there are many causes of sexual dysfunction. Sometimes simple lack of information is to blame. Emotional issues may be a barrier to a healthy sex life. An erection involves the nervous and vascular systems (the network of arteries and veins) and appropriate levels of hormones, so problems with any of these systems can interfere with sexual functioning. Common problems include the following:
  • Hypogonadism, in which the testicles do not produce enough testosterone
  • Thyroid disorders (both hyperthyroidism and hypothyroidism)
  • Adrenal lesions (Cushing's syndrome)
  • Noncancerous pituitary growths that increase levels of a hormone called prolactin
  • Diseases that affect the nervous system, including strokes, spinal cord injuries, multiple sclerosis, long-standing diabetes, and Parkinson's disease
  • Damage following pelvic surgery (such as prostate, colon, or bladder surgery)
  • Conditions that affect the penis directly, such as Peyronie's disease (penile curvature) or injury to the penis itself or to the arteries, veins, or nerves that supply the penis
  • Any serious and debilitating diseases that result in intense fatigue, including emphysema, chronic bronchitis, heart disease, cirrhosis, cancer, and kidney failure
  • Premature ejaculation (PE) is usually not due to physical causes, although the problem is sometimes linked to a neurological disorder, prostate infections, or urethritis. Possible psychological causes include:
    • Anxiety
    • Guilt feelings about sex
    • Ambivalence toward women
    • Learned behavior pattern of rapid ejaculation seen with frequent masturbation or infrequent sexual activity
    Erection problems can be caused by:
    • Blockages in the blood flow to the penis
    • Atherosclerosis, or hardening of the arteries leading to the penis
    • Damage to arteries or nerves after radiation treatment
    • Leaky veins
    • Low levels of the male hormone testosterone or other hormonal disturbances
    • Conditions or behaviors that increase the risk of vascular disease, such as smoking, high blood pressure, diabetes, and high cholesterol or the medications to treat these and other disorders
    Painful intercourse usually has physical causes such as these:
    • An infection of the prostate, urethra, or testes, which can be initiated by sexually transmitted diseases, such as chlamydia and genital herpes
    • An allergic reaction to spermicide or condoms
    • Peyronie's disease, fibrous plaques on the upper side of the penis that often produce a painful bend during erection
    • Arthritis of the lower back
     
    Lack of sexual desire  may be due to any of these factors:
    • Physical illness
    • Hormonal abnormality (usually low testosterone levels)
    • Medications that affect libido
    • Psychological causes, including depression or interpersonal problems, which a therapist may help identify
    Retrograde ejaculation may occur in men from these causes:
    • Prostate or urethral surgery
    • Medication that keeps the bladder neck open
    • Diabetes (which can injure the nerves that normally close the bladder during ejaculation)
    Can Medication Cause Sexual Problems?
    Many medications have been implicated in sexual dysfunction, causing inhibited sexual desire and/or erectile dysfunction, such as:
    • Drugs to treat high blood pressure
    • Diuretics (including thiazides and spironolactone)
    • Histamine blockers
    • Antidepressant medications
    • Common over-the-counter preparations (particularly antihistamines and decongestants)
    • Anti-psychotic medications
    • Sedatives
    • Medications used to treat anxiety
    • Use of drugs, including alcohol, methadone and heroin, anabolic steroids, and tobacco
    Psychological Factors in Sexual Problems
    Psychological factors play an important role. You may find it difficult to enjoy a sexual relationship if:
    • You are under a lot of stress
    • Your relationship is troubled
    • You have a history of traumatic sexual encounters (rape or incest)
    • You were raised in a family with strict sexual taboos
    • You're afraid of getting your partner pregnant or of contracting a sexually-transmitted disease
    • You have negative feelings (including guilt, anger, fear, low self-esteem, and anxiety)
    • You are depressed
    • You are severely fatigued
    Environmental Factors in Sexual Problems
    You may find it difficult to enjoy sex if there is no safe, private place to relax and allow yourself to become sexual, or if fatigue due to an overly busy work and personal life robs you of the energy to participate sexually. Parents may find it difficult to find the time to be sexually intimate, given the demands/presence of their children. Fear of contracting HIV (human immunodeficiency virus, which can lead to AIDS), the difficulties of striving for "safer sex," and the psychological effects of discrimination, are just a few of the factors that can cause anxieties in gay men.

    Source WebMD


Thursday, June 23, 2011

Common Pregnancy Pains and Their Causes



Your body is constantly changing now that you are pregnant, which may cause discomfort. Some pregnancy discomforts may occur in the early weeks, while others occur only as you get closer to delivery. Other pregnancy discomforts may appear early and then go away, only to come back later. This is normal and usually does not mean something is wrong.
Every woman's pregnancy is unique, and some of the discomforts described in this article may not affect you. Discuss any concerns about pregnancy discomforts you are having with your health care provider.

Pregnancy Breast Changes

Most pregnant women will feel some changes in their breasts. Your breasts will increase in size as your milk glands enlarge and the fat tissue increases, causing breast firmness and tenderness in the first and last few months of pregnancy. Bluish veins may also appear as your blood supply increases. Your nipples will also darken and a thick fluid called colostrum may leak from your breasts. All of these breast changes are normal.
Recommendations:
  • Wear a bra that provides firm support.
  • Choose cotton bras or those made from other natural fibers.
  • Increase your bra size as your breasts become larger. Your bra should fit well without irritating your nipples. Try maternity or nursing bras, which provide more support and can be used after pregnancy if you choose to breastfeed.
  • To ease discomfort and maintain support, try wearing a bra during the night and day.
  • Tuck a cotton handkerchief or gauze pad into each bra cup to absorb leaking fluid. Nursing pads, which you can buy in a pharmacy, are also available. Make sure to change these pads as needed to prevent irritation to the underlying skin.
  • Clean your breasts with warm water only; do not use soap or other products since they can cause dryness.

Pregnancy Fatigue

Your growing baby requires extra energy, which may make you feel tired. Sometimes, feeling tired may be a sign of anemia (low iron in the blood), which is common during pregnancy.
Recommendations:
  • Get plenty of rest; go to bed early at night and try taking naps during the day.
  • Maintain a regular schedule when possible but pace your activities; balance activity with rest when needed.
  • Exercise daily to increase your energy level.
  • If you think anemia may be a concern, ask your health care provider to test your blood.

Pregnancy Nausea or Vomiting

An upset stomach is one of the most common discomforts during pregnancy. Nausea is a result of hormonal changes and most often occurs early in pregnancy until your body adjusts to the increased production of hormones.
Nausea can begin in early pregnancy, but is usually gone by the fourth month. It can occur at any time of the day but may be worse in the morning when your stomach is empty (this is often called "morning sickness") or if you are not eating enough.
Recommendations:
  • If nausea is a problem in the morning, eat dry foods like cereal, toast or crackers before getting out of bed. Or, try eating a high-protein snack such as lean meat or cheese before going to bed (protein takes longer to digest).
  • Eat small meals or snacks every 2-3 hours rather than three large meals. Eat slowly and chew your food completely.
  • Sip on fluids throughout the day. Avoid large amounts of fluids at one time. Try cool, clear fruit juices, such as apple or grape juice.
  • Avoid spicy, fried, or greasy foods.
  • If you are bothered by strong smells, eat foods cold or at room temperature and avoid odors that bother you.
  • Talk to your doctor about taking vitamin B6 or other treatments.
  • Contact your health care provider if your vomiting is constant or so severe that you can't keep fluids or foods down. This can cause dehydration and should be treated right away.

Pregnancy Frequent Urination

During the first trimester, your growing uterus and growing baby press against your bladder, causing a frequent need to urinate. This will happen again in the third trimester when the baby's head drops into the pelvis before birth.
Recommendations:
  • Avoid tight-fitting underwear, pants, or pantyhose.
  • Contact your health care provider if your urine burns or stings. This can be a sign of a urinary tract infection and should be treated right away.

Pregnancy Headaches

Headaches can be caused by tension, congestion, constipation, or in some cases,preeclampsia. They can occur anytime during pregnancy.
Recommendations:
  • Apply an ice pack to your forehead or the back of your neck.
  • Rest, sit, or lie quietly in a low-lit room. Close your eyes and try to release the tension in your back, neck, and shoulders.
  • Try Tylenol (acetaminophen) occasionally. Ask your health care provider before taking any other medications for your headaches.
  • Contact your health care provider if you have nausea with your headaches, if your headache is severe and does not go away, or if you have blurry vision, double vision, or blind spots

Pregnancy Bleeding and Swollen Gums

The increase in your circulation and supply of certain hormones may cause tenderness, swelling and bleeding of gums.
Recommendations:
  • Take proper care of your teeth and gums. Brush and floss regularly.
  • Get a dental checkup early in your pregnancy to make sure your teeth and mouth are healthy. See your dentist if you have a problem.

Pregnancy Constipation

Your hormones as well as vitamins and iron supplements may cause constipation (difficulty passing stool or incomplete or infrequent passage of hard stools). Pressure on your rectum from your uterus may also cause constipation.
Recommendations:
  • Add more fiber (such as whole grain foods, fresh fruits, and vegetables) to your diet.
  • Drink plenty of fluids daily (at least 6-8 glasses of water and 1-2 glasses of fruit or prune juice).
  • Drink warm liquids, especially in the morning.
  • Exercise daily.
  • Set a regular time for bowel movements; avoid straining when having a bowel movement.
  • Discuss the use of a laxative with your health care providers; they may recommend natural fiber laxatives or stool softeners.
 

Pregnancy Dizziness (Feeling Faint)

Dizziness can occur anytime middle to late pregnancy. The pregnancy hormone progesterone dilates blood vessels so blood tends to pool in the legs. In addition, more blood is going to your growing uterus. This can cause a decrease in blood pressure, especially when changing positions, resulting in dizziness.
Faintness and dizziness can also be affected by poor eating habits. When your blood sugar levels are too low, you may feel faint.
Recommendations:
  • Move around often when standing for long periods of time.
  • Try lying on your left side to rest.
  • Try to move slowly when standing from a sitting position; avoid sudden movements.
  • Eat regular meals to prevent low blood sugar.

Difficulty Sleeping During Pregnancy

Finding a comfortable resting position can become difficult later in pregnancy.
Recommendations:
  • Don't take sleep medication.
  • Try drinking warm milk at bedtime.
  • Try taking a warm shower or bath before bedtime.
  • Use extra pillows for support while sleeping. Lying on your side, place a pillow under your head, abdomen, behind your back and between your knees to prevent muscle strain and help you get the rest you need. You will probably feel better lying on your left side; this improves circulation of blood throughout your body.

Pregnancy Heartburn or Indigestion

Heartburn (indigestion) is a burning feeling that starts in the stomach and seems to rise to the throat. It occurs during pregnancy because your digestive system works more slowly due to changing hormone levels. Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward.
Recommendations:
  • Eat several small meals each day instead of three large meals.
  • Eat slowly.
  • Drink warm liquids such as herbal tea.
  • Avoid fried, spicy, or rich foods, or any foods that seem to give you indigestion.
  • Don't lie down directly after eating.
  • Keep the head of your bed higher than the foot of your bed. Or, place pillows under your shoulders to prevent stomach acids from rising into your chest.
  • Don't mix fatty foods with sweets in one meal and try to separate liquids and solids at meals.
  • Try heartburn relievers such as Tums, Maalox, Titralac, Mylanta, Riopan, or Gaviscon.

Pregnancy Hemorrhoids

Hemorrhoids are swollen veins that appear as painful lumps on the anus. They may form as a result of increased circulation and pressure on the rectum and vagina from your growing baby.
Recommendations:
  • Try to avoid constipation; constipation can cause hemorrhoids and will make them more painful.
  • Try to avoid sitting or standing for long periods of time; change your position frequently.
  • Make an effort not to strain during a bowel movement.
  • Apply ice packs or cold compresses to the area or take a warm bath a few times a day to provide relief.
  • Avoid tight-fitting underwear, pants, or pantyhose.
  • Discuss the use of a hemorrhoid treatment with your health care provider.


Pregnancy Varicose Veinspregnancy

An increased volume of blood and the pressure of your growing uterus can slow your circulation, sometimes causing the veins in your legs to become larger or swollen.
Recommendations:
Although varicose veins are usually hereditary, here are some preventive tips:
  • Avoid standing or sitting in one place for long periods. It's important to get up and move around often.
  • Avoid remaining in any position that might restrict the circulation in your legs (such as crossing your legs while sitting).
  • Elevate your legs and feet while sitting.
  • Exercise regularly.
  • Wear support hose but avoid any leg wear that is too tight.

Pregnancy Leg Cramps

Pressure from your growing uterus can cause leg cramps or sharp pains down your legs.
Recommendations:
  • Be sure to eat and drink foods and beverages rich in calcium (such as milk, broccoli or cheese).
  • Wear comfortable, low-heeled shoes.
  • Try wearing support hose but avoid any leg wear that is too tight.
  • Elevate your legs when possible; avoid crossing your legs.
  • Exercise daily.
  • Stretch your legs before going to bed.
  • Avoid lying on your back, since the weight of your body and the pressure of your enlarged uterus can slow the circulation in your legs, causing cramps.
  • Gently stretch any muscle that becomes cramped by straightening your leg, flexing your foot, and pulling your toes toward you.
  • Try massaging the cramp, or apply heat or a hot water bottle to the sore area.

Pregnancy Nasal Congestion

You may have a "stuffy nose" or feel like you have a cold. Pregnancy hormones sometimes dry out the lining in your nose, making it inflamed and swollen.
Recommendations:
  • Apply a warm, wet washcloth to your cheeks, eyes, and nose to reduce congestion.
  • Don't use nose sprays; they can aggravate your symptoms.
  • Drink plenty of fluids (at least 6-8 glasses of fluids a day) to thin mucus.
  • Elevate your head with an extra pillow while sleeping to prevent mucus from blocking your throat.
  • Use a humidifier or vaporizer to add moisture to the air.

Shortness of Breath During Pregnancy

Shortness of breath can occur due to increased upward pressure of the uterus
Recommendations:
  • When walking, slow down and rest a few moments.
  • Raise your arms over your head (this lifts your rib cage and allows you to breathe in more air).
  • Avoid lying flat on your back, and try sleeping with your head elevated.

Pregnancy Stretch Marks

Stretch marks are a type of scar tissue that forms when the skin's normal elasticity is not enough for the stretching required during pregnancy. They usually appear on the abdomen and can also appear on the breasts, buttocks or thighs. While they won't disappear completely, stretch marks will fade after delivery. Stretch marks affect the surface under the skin and are usually not preventable.
Recommendations:
  • Be sure that your diet contains enough sources of the nutrients needed for healthy skin (especially vitamins C and E).
  • Apply lotion to your skin to keep it soft and reduce dryness.
  • Exercise daily.

Swelling in the Feet and Legs During Pregnancy

Pressure from the growing uterus on the blood vessels carrying blood from the lower body causes fluid retention that results in swelling (edema) in the legs and feet.
Recommendations:
  • Try not to stay on your feet for long periods of time. Avoid standing in one place.
  • Drink plenty of fluids (at least 6-8 glasses of fluids a day).
  • Avoid foods high in salt (sodium).
  • Elevate your legs and feet while sitting. Avoid crossing your legs.
  • Wear loose, comfortable clothing; tight clothing can slow circulation and increase fluid retention.
  • Don't wear tight shoes; choose supportive shoes with low, wide heels.
  • Keep your diet rich in protein; too little protein can cause fluid retention.
  • Notify your health care provider if your hands or face swell. This may be a warning sign of preeclampsia.
  • Rest on your side during the day to help increase blood flow to your kidneys.

Vaginal Discharge During Pregnancy

Increased blood supply and hormones cause your vagina to increase normal secretions. Normal vaginal discharge is white or clear, non irritating, odorless and may look yellow when dry on your underwear or panty liners.
Recommendations:
  • Choose cotton underwear or brands made from other natural fibers.
  • Avoid tight-fitting jeans or pants.
  • Do not douche. It is possible that you can introduce air into your circulatory system or break your bag of waters in later pregnancy.
  • Clean the vaginal area often with soap and water.
  • Wipe yourself from front to back.
  • Contact your health care provider if you have burning, itching, irritation or swelling, bad odor, bloody discharge, or bright yellow or green discharge (these symptoms could be a sign of infection).

Pregnancy Backaches

Backaches are usually caused by the strain put on the back muscles, changing hormone levels, and changes in your posture.
Recommendations:
  • Wear low-heeled (but not flat) shoes.
  • Avoid lifting heavy objects.
  • Squat down with your knees bent when picking things up instead of bending down at the waist.
  • Don't stand on your feet for long periods. If you need to stand for long periods, place one foot on a stool or box for support.
  • Sit in a chair with good back support, or place a small pillow behind your lower back. Also place your feet on a footrest or stool.
  • Check that your bed is firm. If needed, put a board between the mattress and box spring.
  • Sleep on your left or right side with a pillow between your legs for support.
  • Apply a hot water bottle, heating pad on low setting, take a warm bath or shower, or try massage.
  • Perform exercises, as advised by your health care provider, to make your back muscles stronger and help relieve the soreness.
  • Maintain good posture. Standing up straight will ease the strain on your back.
  • Contact your health care provider if you have a low backache that goes around your stomach and does not go away within one hour after you change position or rest. This might be a sign of premature labor.

Abdominal Pain or Discomfort

Sharp, shooting pains on either side of your stomach may result from the stretching tissue supporting your growing uterus. These pains may also travel down your thigh and into your leg.
Recommendations:
  • Change your position or activity until you are comfortable; avoid sharp turns or movements.
  • If you have a sudden pain in your abdomen, bend forward to the point of pain to relieve tension and relax the tissue.
  • Apply a hot water bottle, heating pad, or take a warm bath or shower.
  • Try massage.
  • Make sure you are getting enough fluids.
  • Take Tylenol (acetaminophen), occasionally.
  • Contact your health care provider if the pain is severe or constant or if you are less than 36 weeks pregnant and you have signs of labor.

Braxton-Hicks Contractions

The muscles in your uterus will contract (tighten) as early as the second trimester of pregnancy on. Irregular, infrequent contractions are called Braxton-Hickscontractions (also known as "false labor pains"). These are normal during pregnancy.
Recommendations:
  • Try to relax
  • Change positions. Sometimes this can alleviate the contractions.