How to Keep Your Sex Life Healthy in Marriage

Revive Her Drive

Be ready to go through a complete transformation in the way that you think and feel about having sex with your wife or girlfriend! Revive Her Drive is like a Cheat Sheet to woo your woman the way she secretly wants you to, and simply cant express. The solution is based on female-friendly, easy-to-learn strategies that she will love! How nice will that moment be when shes lying in your arms, happy and spent, and she actually Thanks You for helping her to rediscover her sensual self? Shell be grateful that you, Her Man, now that you have the vision and skill to guide her into new, electrifying experiences even if she fights you or resists you now. Women Are sensual creatures. We women want pleasure, intimacy, connection, sensation as much as you do! Ill prove this to you. Once you know how to captivate her, you can turn her into a pleasure-seeking device within 24 hours. Getting that kind of responsiveness is the feedback you need to feel confident this program is working. Discover how Robert rekindled his relationship with Lauren using the tools within Revive Her Drive by watching this short presentation that lays out the whole strategy youll use to transform your intimate life into one of passion, surrender and fantasies-come-true. Read more...

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Psychogenic Factors that Impair Sexual Ability

Through its pervasive influences on a diversity of mind-brain functions, stress can increase or diminish a variety of motivational urges, including sexuality. While mild stress can sometimes increase sexual urges, sustained stress diminishes erotic urges. Indeed, one of the primary stress hormones in the brain, CRH, dramatically reduces all prosocial and sexual activities, as well as all other appetites, when released within the brain (Chapter 21). 1998), consistently promote sexual urges, but many reduce them in ways that are often emotionally troublesome to people. The most widespread problems are associated with the anorgasmia and reductions in sexual motivation that result from the use of antide-pressants, most recently the selective serotonin reuptake inhibitors (SSRIs) (Rosen et al., 1999). However, other agents are not without problems (Gitlin, 1994), and there are some drugs that can facilitate sexual abilities (Crenshaw and Goldberg, 1996). Mammalian sexual energy is...

Managing adult sexual relationships

Growing up, I had few friends and little social interaction. CAH can affect your social life both through its impact on self-esteem, body image and confidence but also through the necessity, for some, for frequent hospital visits and in-patient stays simply to stay well and alive. Like any teenager, I had begun to have sexual feelings but was too scared and frightened to explore them. So, while my friends and peers seemed to be getting on with their lives and having boyfriends, I avoided the issue, shut off and suppressed feelings, got on with my schooling and then work. I felt isolated and lonely and lacked confidence around people - a very common experience for those with CAH (May, Boyle and Grant 1996). I wondered how anyone could love or want me, thought that I could not reciprocate and felt a failure -though more failed by society and doctors as surgery made me look worse than 'nature's mistakes'. Libido is another unknown. For many women it can range from 'low' to 'high'. With...

Oral Sex is Not Considered Safe

Like all sexual activity, oral sex carries some risk of infection with a sexually transmitted disease (STD), including Human Immunodeficiency Virus (HIV), particularly when one partner or the other is known to be infected, when either partner's STD HIV status is unknown, and or when either partner is not monogamous or injects drugs. Numerous studies have demonstrated that oral sex can result in the transmission of HIV and other STDs. Abstaining from oral, anal, and vaginal sex all together or having sex with a mutually monogamous uninfected partner are the only ways that people can be completely protected from the transmission of HIV and other STDs. Oral sex with someone who is infected with HIV is not risk-free. Some people have indicated that they are less concerned about HIV because of new treatments and they are being less careful to avoid getting infected. But, in spite of the new treatments available to help the body manage an HIV infection, HIV remains a serious, lifelong...

Copulatory behavior and measures of female sexual motivation or desire

As in males, female sexual behavior can be divided into sequential appetitive and consummatory components (Fig. 1.1). In the female rat, these aspects of sexual behavior are also referred to as proceptive and receptive components, two different aspects of sexual behavior displayed by estrous females in the presence of sexually-active males. To solicit attention and approach of the male, the female displays a variety of active proceptive behavioral patterns, including solicitations, hops and darts, and ear-wiggles. As mentioned above, receptivity has been used to describe the behavioral postures assumed by females to allow mounting by a male, with the lordosis reflex being the best known and most studied response. Unfortunately, there is no counterpart for lordosis in women. In contrast, psychologic arousal or desire in women is likely to be very close to proceptivity. For this reason, the study of proceptive behaviors is also relevant to any preclinical investigation of potential of...

Alterations in Orgasm

Most of the post-radical prostatectomy sexual dysfunction literature has focused specifically on erectile dysfunction, and changes in orgasm have been reported in post-prostatectomy patients 14-16 . Orgasm, which is often considered to be a goal and reinforcer of sexual behavior, remains the least understood phase of the sexual response cycle. Alterations in orgasm, and in particular its absence, are associated with significant reductions in emotional and physical satisfaction, which in turn may lead to sexual avoidance behavior and secondary relationship discord 17-18 . Barnas et al., in a questionnaire-based analysis, demonstrated that orgasmic dysfunction is a relatively prevalent problem in the post-RP population 19 . The alterations identified in this study include complete absence of orgasm, alterations in intensity, and orgasmic pain. Decreased intensity of orgasm or the complete lack of orgasm was reported by 74 of the patients surveyed. Fourteen percent of the patient...

Sexual Intercourse Human

Human sexual intercourse, or coitus, is one of the most common sexual outlets among adults. Although it is usually considered in the context of marriage, premarital and extramarital intercourse are also widely practiced. Adolescents appear to be engaging in sexual intercourse more frequently than in the past. Although cultures differ widely in their acceptance of premarital intercourse, U.S. customs have been traditionally more restrictive than most. Sexual intercourse generally refers to penile penetration of the vagina, the most common sexual expression between opposite-sexed partners practiced in the United States. In a large national survey study of over 3,000 participants, Laumann, Gagnon, Michael, and Michaels (1994) found that 95 of men and 97 of women reported that they had experienced vaginal intercourse. Other sexual techniques with opposite-sex partners include anal intercourse and oral sex (both cunnilingus, i.e., male mouth on female genitalia, and fellatio, i.e., female...

Why should my sexual partner be told that I have a sexually transmitted disease

If you have a sexually transmitted disease, any or all of the people you had sex with (vaginal, oral, or anal sex) may also be infected with the disease. But they may not even know they are infected. By notifying them, you can help ensure they receive the medical treatment they need. Telling your partner shows you respect and care about them. Your honesty may build trust and may encourage your partner to share sexual health information with you. Telling your partner may also prevent future misunderstandings or legal action. Many people who are infected with an STD do not notice any symptoms, until they become very ill. For example, while most (though not all) men who are infected with Chlamydia or gonorrhea get symptoms within 30 days of becoming infected, most women do not. Instead, many women may not notice their infection at all, until it causes very serious problems, like pelvic inflammatory disease (PID) or infertility. It is very important that everyone who may have been exposed...

Female Sex Therapy

Sex therapy starts with the correct diagnosis of the sexual dysfunction presented by the patient. This is not an easy task considering the vague diagnoses provided by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV American Psychiatric Association, 2000), the high comorbidity of sexual dysfunctions, and the lack of age-related norms for the female sexual response. The common agreement is to look at medical etiology of the sexual complaints and then to follow with the investigation of personal and relational aspects. After this initial phase, the most liberal therapists discuss potential goals and patient's expectations, which are not limited to sexual intercourse but could include skills such as communication and assertiveness, or feelings of enjoyment and comfort during sexual behaviors. The techniques used in sex therapy vary according to treatment goals, dysfunction, and patient characteristics. Because sex therapy is a symptom-oriented...

Orgasmic Dysfunction

Orgasmic dysfunction is present when the female has great difficulty in experiencing orgasm or is unable to do so with effective sexual stimulation. Adequate desire and physiological and emotional arousal may be present, but anxiety interrupts the arousal buildup prior to the orgasmic relief. Controversy reigned for many years about the types of female orgasm and the desirability of each. Vaginal and cli-toral orgasms were alleged before the work of Masters and Johnson in 1966. With laboratory data, they concluded that all orgasms are essentially similar and consist of sensory input from the clitoris and muscle contractions by the vagina. Conclusive data do not exist concerning the incidence of women who have orgasms during coitus without concurrent clitoral stimulation, although estimates range from 30 to 50 .

Sex Therapy Female

Sex therapy starts with the correct diagnosis of the sexual dysfunction presented by the patient. Making a correct diagnosis is not an easy task due to the vague diagnoses provided by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR American Psychiatric Association ApA , 2000), the high comorbidity of sexual dysfunctions, and the lack of age-related norms for the female sexual response. The common agreement is to look at medical etiology of the sexual complaints and then to follow with the investigation of personal and relational aspects. After this initial phase, the most liberal therapists discuss potential goals and patient expectations, which are not limited to sexual intercourse but could include skills such as communication and assertiveness or feelings of enjoyment and comfort during sexual behaviors. The techniques used in sex therapy vary according to treatment goals, dysfunction, and patient characteristics. Because sex therapy employs a symptom-oriented...


In males and females, orgasm is characterized by a peak in sexual pleasure that is accompanied by rhythmic contractions of the genital and reproductive organs, cardiovascular and respiratory changes, and a release of sexual tension. In males, orgasm generally occurs in two stages emission, which refers to rhythmic muscular contractions that force semen into the ejaculatory ducts, and expulsion, which is the release of semen through the urethra (ejaculation). Unlike males, some females (approximately 15 ) are able to experience multiple orgasms, and some women experience orgasm and perhaps ejaculation when the Grafenberg spot, an area along the anterior wall of the vagina, is stimulated. Contrary to Freud's assertion of two distinct types of orgasm in females, clitoral (the infantile orgasm) and vaginal (the mature orgasm), Masters and Johnson (1966) found no physiological differences in orgasm produced by vaginal versus clitoral stimulation. Other researchers note that intensity of...

Child Partnering and Health

There has been a tendency, reflected in large part in both our legal and clinical perspectives on incest, to view incest as a discrete event of sexual intercourse among family members, to decontextualize the act, to view the act itself as the problem, and to attribute blame as a means of situating incest-related guilt in a specified individual (Reidy and Hochstadt, 1993 Taubman, 1984). Mothers may often be blamed for their failure to detect and or report the incest, while daughters may be accused of causing the incest through their alleged seductive behavior (McIntyre, 1981). Incestuous events may be attributed to the existence of hostility between a mother and her daughter, as well as role reversal between the two. Among mental health professionals, the degree to which the father is blamed has been found to be inversely related to the age of the child, with increasing blame assigned to the father with the child's younger age (Kalichman, Craig, and Crowe, 1986). Male, as contrasted...

Implications for Research and Practice

Although there is some data to the contrary, available research clearly documents the ill-effects of child-adult sexual activity on the child, regardless of whether that activity occurs with a member of the child's family, a non-family member known to the child, or a stranger. However, our ability to utilize these data for prevention and intervention programs is hindered by the lack of consistency across studies in the definitions used and in the failure to distinguish the child-adult relationship and the context in which it occurs. For instance, are the psychological effects of familial sexual different in frequency or severity than those of nonfamilial sexual activity between an adult and child Does sexual activity that consists of kissing only, or exposure of genitals without touching result in the same adverse health consequences as does penetration The intervention approach to be taken in instances of adult-child incestuous activity may be vastly different than those that would...

Origins of Fetish Practice

The fetish may be a part of the sexual partner's body or may be the sexual partner herself. For example, just as a high-heeled leather boot may represent a female with a penis the so-called phallic woman so a A number of researchers have hypothesized that, based on classical conditioning theory, individuals' sexual response system becomes conditioned to respond to particular stimuli that are characteristics of the potential sexual partner, such as feet, shoes, etc. and consequently becomes preoccupied sexually with that stimulus rather than the partner associated with it. Empirical research has demonstrated, for instance, that men may be conditioned under experimental conditions to develop an erection in response to specific stimuli, such as boots (Rachman, 1966 Rachman and Hodgson, 1968). Reinforcement to maintain the behavior over an extended period of time may result from masturbation and orgasm (McGuire, Carlisle, and Young, 1965). Other researchers, however, have criticized the...

Multibonding Across Cultures Case Examples

As indicated, attitudes towards the bonding of multiple parties concurrently varies across cultures and societies and may range from encouragement of and support for formalized multi-party unions to the imposition of legal sanctions. Within this broad spectrum, societies may accept, tolerate, or decry less formal arrangements, such as sexual relationships outside of a primary, legally sanctioned relationship. This section examines the occurrence of multiple unions in three diverse settings and communities Mormons in the United States and Bedouin-Arabs in Israel. the Church's relocation from the Midwest to the Great Basin. In 1852, Brigham Young announced that plural marriage would be the official doctrine of the Church (Batchelor, Watson, and Wilde, 2000). Both Mormons and non-Mormons of this time referred to the system of a man's marriage to more than one woman as polygamy, celestial marriage, plural marriage, plurality, and the principle, (Hardy and Erickson, 2001), while Mormons...

Pedophilia and Child Molestation

These uses of the term pedophilia are in contrast to its use as a clinical diagnosis. The Diagnostic and Statistical Manual, Fourth Edition, Text Revision requires that three elements be present to warrant a diagnosis of pedophilia (1) recurrent and intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children for a period of at least six months (2) marked distress or interpersonal difficulties as a result of these urges or fantasies, or actually having acted on them and (3) the individual is at least 16 years of age and at least five years older than the children who are the subject of the urges, fantasies, or behavior (American Psychiatric Association, 2000). However, individuals who are in late adolescence and are involved in a sexual relationship with someone who is 12 or 13 years of age will not be considered to be suffering from pedophilia. Underlying this definition and these criteria is an implicit...

Origins of Multibonding

Religious belief also appears to play a role in the formation of formalized polygynous unions. As an example, 92 of the population of Mali identifies as Muslim (Madhavan, 2002). Islam permits men to have as many as four wives (El Azayem and Hedayat-Diba, 1994 Madhavan, 2002) and views polygamy as protecting the family from possible deviation to illegal sexual intercourse and from contracting sexually transmitted diseases (El Azayem and Hedayat-Diba, 1994). Consequently, it is not surprising that 45 of Mali's married women have been found to be in polygynous unions (Madhavan, 2002). In Ghana, polygamous marriages have been found to be more frequent among Muslim women who ascribe to traditional religious beliefs (Klomegah, 1997). However, a study of polygamy among Muslims in India found that a minority were in polygamous marriages (Haqqi, 1974). teachings of Mutual Criticism, Male Continence, and Complex Marriage, meaning that marriage and private property were abolished and the...

Commercial Partnering and Health

Gynecological problems are the most frequent health problem among trafficked women (Zimmerman, Yun, Schvab et al., 2003). Women who have been forced into sexual activity through trafficking have reported unintended pregnancies and the termination of those pregnancies in the country of destination. A number of the abortions resulted in complications (Zimmerman, Yun, Schvab et al., 2003). One man, who had begun making adult films at the age of 17, stated, I don't know, I feel scared to have a sexual relationship with a girl. I don't know what it's going to be like or if I am going to be too rough. greater number of non-paying sexual partners (Tideman, Thompson, Rose et al., 2003). Morse and colleagues (1999) reported from their study of 211 male sex workers, that the workers sold more than 164,000 sex acts during a one-year period. Thirty-seven HIV-positive workers As with female sex workers, the context in which the sex work occurs may be critical to understanding the level of risk and...

Monogamy and Health

Mechanisms to reduce the risk of transmission of diseases such as HIV AIDS, syphilis, gonorrhea, and Chlamydia. One must logically ask, What are the consequences of a failure to utilize safer sex precautions, such as monogamy or condoms It has been estimated that a woman engaging in 50 unprotected acts of vaginal intercourse with 50 different sexual partners has a 55 chance of pregnancy, a 5 chance of contracting Chlamydia, and a .001 chance of contracting HIV in a U.S. low-risk population (Cohen and Bruce, 1997). The HIV risk increases to .002 in the college population. The 1991 General Social Survey of 1212 individuals conducted by the National Opinion Research Center found that 11 of the female respondents and 21 of the participating males indicated having had sexual relations with someone other than their spouse during their marriage (Greeley, 1994). Among men, sex outside of marriage was associated with a belief that adultery is not wrong, dissatisfaction with family life, a...

Fetish and Health

In the gay S&M scene, encounters are often facilitated through leather bars, leather clubs, and leather baths. The costume that is expected at these locations may serve as a mechanism for controlling entry. Standardized colors and signals, such as the placement of a handkerchief or scarf of a particular color, provide potential sexual partners with preliminary information regarding an individual's preferred activities (Lee, 1983 Wiseman, 1996). The actual screening of a potential partner, however, is left to the individual. Oftentimes, because there are often a limited number of establishments catering to S&M-interested individuals, the proposed partner may be a familiar face in the bar or may have earned a reputation to other bar clientele or to the bartender. Although there Risks that have been identified in conjunction with gay S&M sex include being detained longer than desired, more uncomfortable positions or conditions than desired, being subjected to more discipline than...

Defining Monogamy

An exclusive sexual relationship between a woman and a man, whilst non-monogamy refers to a woman being involved in parallel, plural sexual relationships. Relationships can also be characterized by emotional or economic factors (Robinson, 1997). ital relationships only, sexual relationships only, male-female sexual relationships only, and a social-sexual dichotomy in relationships. The relevance and applicability of the concept to non-male-female relationships has also been challenged pair-bonded couples, regardless of the sex or sexual orientation of the partners, have similar notions regarding the exclusivity to be maintained within the framework of that relationship and that these notions are shared by both members of the couple. Such may not be the case. As an example, 1 of 1212 married adults participating in the General Social Survey indicated that sex with someone other than one's spouse while married is never wrong (Greeley, 1994). If, in fact, this opinion is reflective of...

Sex Work

The term prostitution has been defined as the act or instance of offering or devoting one's talent to an unworthy use or cause (American Heritage Dictionary) or the performance of a sexual act for material gain (Andesron and Estes, 1998 152). It has often been used to denote sex work engaged in for monetary remuneration. This usage fails to acknowledge those instances of exchange involving the receipt of gifts by a woman from a married man not her husband, in appreciation of her continuing companionship and sexual favors the partnering of a man and a woman following a first date during which he pays for dinner and drinks or the receipt by a woman or a man of gifts within the context of a loveless, cold marriage. However, if the woman requests money, specifically in exchange for sex, if she solicits and accepts payment in some form for sex, then she is a prostitute. The request for payment, not the sexual act and not receiving something of value for sexual services, is the action being...

Defining Fetish

Fetishism occurred when the fetich itself (rather than the person associated with it) becomes the exclusive object of sexual desire so that, rather than sexual intercourse, strange manipulations of the fetich became the sexual aim (Krafft-Ebing, 1886 spelling as in original text). Empirical research, however, suggests that intimacy and fetishism are able to coexist, either within a specific relationship, or through the maintenance of a primary relationship while engaging in fetish behavior with outside partners (Weinberg, Williams, and Calhan, 1994). Level 1 Individuals experience a slight preference for certain kinds of sex partners, sexual stimuli or sexual activity. The term fetish should not be applied at this level. Level 2 This represents the lowest level of fetishism, where a strong preference exists for certain kinds of sex partners, sexual stimuli or sexual activity.


Definitions of pornography clearly vary over time, culture, and place. The Concise Oxford Dictionary of Current English defines pornography as the explicit description or exhibition of sexual activity in literature, films, etc. intended to stimulate erotic rather than aesthetic or emotional feelings (Allen, 1990). In the United States, the legal classification of a writing, video, song, or other endeavor as pornography rests on a determination of whether an average person, applying contemporary community standards, would find that the work, taken as a whole, appeals to prurient interests whether the work depicts in a patently offensive manner sexual conduct defined by closely drafted relevant state law or whether the work, taken as a whole, lacks serious literary, artistic, political, or scientific value (Miller v. California, 1972). In contrast, annotations to the Criminal Code of Canada indicate that the courts have delineated three categories of pornography explicit sex with...

Professional practice

The only universally accepted sexual activity is that which is seen to take place for reproductive purposes within marriage this is explicit in most religions and many societies and implicit in others. Sexual deviance is often measured in terms of how far away an activity is from this norm. If children 2. How is the way that I am dealing with this young person going to affect his or her future sexual health, sexual feelings and sexual relationships As already indicated, even quite young children may be shy about nakedness and concerned about physical privacy. Children and young people of all ages may fail to disclose symptoms if they fear that disclosure could prompt an unwanted physical examination. Symptoms may be relocated to more 'public' parts of the body and some 'disgusting' symptoms such as discharges not reported at all. Any discussion of menstruation may be experienced as intensely embarrassing, especially with an adult of the opposite sex. Children may feel the need to keep...

Meaning of parenthood

A study examining prevention of teenage pregnancy in the US (Stevens-Simon, Beach and Klerman 2001) provides a useful meta-analysis of previous research examining why some teenagers are reluctant to actively prevent pregnancy. For example, some thought a pregnancy might improve (or at least not worsen) their relations with family, peers or sexual partners might help them cope with depression and loneliness might dispel their concerns about infertility or might signal their passage into adulthood (Luker 1996 Rainey, Stevens-Simon and Kaplan 1993 Stevens-Simon 1998 Stevens-Simon et al. 1996 Winter 1988). While still concentrating on pregnant or previously pregnant girls, qualitative research has begun to acknowledge that some adolescents view pregnancy and childbearing positively and may desire children (Gordon 1996 Quinlivan and Evans 2000). While a good deal of research has excluded never-pregnant females, still more has excluded male adolescents. Only three studies could be...

Pathogenesis of Infections

HPV infection can be acquired in a variety of ways such as abrasions of the skin, sexual intercourse and passage through an infected birth canal, and results in a variety of clinical conditions (Table 1) (Shah and Howley, 1996). Most of these lesions have benign prognoses, but they may be associated with high levels of morbidity. For example, exophytic anogenital warts, one of the most common sexually transmitted diseases, usually cause itching, burning and pain, and have a significant negative effect on the psychosexual wellbeing of the individual. Other lesions, however, may undergo malignant transformation. In the case of flat anogenital warts, lesions in the uterine cervix may progress towards invasive carcinoma and 50 of the diagnosed population will ultimately die of the disease, accounting for about 15 of cancer-related deaths worldwide. The progression of benign papillomas to invasive cancers has certain characteristics which are shared in different species (Shah, 1990 Shah...

LUST Sexual Love and Nurturant CARE Systems of the Brain

Basal forebrain, septal, and anterior hypothalamic preoptic areas of the brain, coursing medially down to the PAG (Pfaff, 1999). The gender specific LUST systems have distinct components as well as many overlapping ones. For instance, female sexuality has been linked more clearly to the dynamics of oxytocinergic brain systems, while male sexuality is more dependent on vasopressinergic components that uniquely energize male sexual eagerness. The orgasmic components for all genders have strong opioid and oxytocinergic aspects.

What is the magnitude of the problem

Chlamydia is the most frequently reported infectious disease in the United States. An estimated 2.8 million Americans are infected with chlamydia each year. Women are frequently re-infected if their sex partners are not treated. Between 1 and 16 of young, sexually active Americans is infected - and most infected people are not aware of their infection. Men with signs or symptoms might have a discharge from their penis or a burning sensation when urinating. Men might also have burning and itching around the opening of the penis. Chlamydia can also be found in the throats of women and men having oral sex with an infected partner.

How can I protect myself from STDs

Not having sex is the most effective way to prevent getting an infection. Monogamy is also safe two people who only have sex with each other are safe if neither partner is infected. For people who choose to have sex outside a monogamous relationship, a latex condom put on before beginning sex and worn until the penis is withdrawn can reduce risk. Washing the genitals, urinating, or douching after sex does not prevent STDs. For more detailed information on strategies to reduce your risk of acquiring STD HIV see SHARP Fact Choosing Safer Options Reduces Risk at

Sexuality And The Passions Of The Brain Introductory Remarks

Sexual motivational systems lie at the root of some of the most intense human feelings, ranging from the eroticism and cravings of sexual arousal to the delights and disappointments of orgasm, not to mention social bondings and attachments, not to mention the ongoing dynamics of social relationships and dependencies. Sexual motivation and sexual performance are often dissociated (Everitt, 1990), as are social urges and commitments, especially in the presence of negative mood and emotional states. To better grasp how these relationships may permeate psychiatric concerns, the aim of this brief section is to provide an overview of the neural underpinnings of mammalian sexuality. Let us briefly consider these topics in reverse order (1) What are the factors that impair sexual ability (2) What is it about the organization of our brains that creates, at least at a statistical level, the neurophysiology of maleness and femaleness (3) What leads us to have...

Female Sexual Arousal Disorder

Female sexual arousal disorder (FSAD) is operationalized as the difficulty in reaching and maintaining vaginal lubrication or genital swelling until the completion of the sexual activity (ApA, 2000). Recently, theorists have argued that diagnosis of FSAD should consider not only the physiological dimension of sexual arousal (i.e., lubrication) but the psychological experience as well. Women of all ages may experience difficulty lubricating, although it tends to be more of a problem in later life, typically after menopause. Female sexual arousal disorder is generally assessed and treated in conjunction with female orgasmic disorder or HSDD. To date, there are no validated treatments that focus exclusively on treating female arousal problems, although a number of pharmacological agents for enhancing vaginal engorgement and lubrication are currently under investigation. Techniques are often employed to help the patient become aware of her anxiety or her sexual turn-off thoughts,...

How can trichomoniasis be prevented

Refraining from having sexual intercourse is the best way to prevent transmission of trichomoniasis and other STDs, including HIV. People can choose to not have sex. People can also decide to wait, or delay sex, until a later time in their life. They may choose to have personal relationships that do not involve sex. Choose Outer-course vs. intercourse Monogamy is sex between two people, who only have sex with each other, as part of a long-term relationship. If neither partner is infected, there is no risk of disease transmission. Getting to know your partner and his her sexual history before you decide to have sex can also reduce your chance of exposure to disease. A series of short-term relationships is not as safe because of the increased risk that one of those partners will be infected. Use Condoms and other barriers Although not as safe as abstinence or monogamy, the correct and consistent use of latex condoms during sexual intercourse - vaginal, anal, or oral - can reduce a...

Gender Specific Behavior

The presence of receptors for the different gonadal hormones in the brain differs between the sexes. For example, it was noted previously that in females LH is released in relationship to the cyclical activation of the reproductive organs, whereas in males LH release is continuous at a steady level. Release of LH is regulated by neurosecretory cells of the anterior pituitary that secrete LH-releasing hormone (LHRH). The LHRH neurosecretory cells do not have sex-steroid receptors. These cells, however, receive neural input from neurons in the preoptic area of the hypothalamus. These preoptic neurons do have receptors for estrogen. Thus in normal females, as the ovarian follicles grow, the secreted estrogen stimulates neurons in the preoptic hypothalamus, which in turn stimulate LHRH neurosecretory cells to produce LH. In the brains of genetic females that have been exposed to high levels of androgens either prenatally or immediately postnatally, the preoptic cells do not express...

Figure 5 Agespecific incidence rates of Hodgkin disease among males Based on data from Ferlay et a Globocan 2000 Cancer

Religion, ethnic origin and race are frequently interrelated. The realization that environmental factors, including lifestyles, are more important than hereditary factors in explaining cancer variation among population groups (Lichtenstein et al, 2000) has suggested that those groupings should be viewed in the socio-cultural, rather than genetic, context. Several hypotheses concerning cancer causation have been generated by the unusual lifestyles and cancer occurrence patterns among Mormons and Seventh Day Adventists in the United States. Also, the low incidence of cervical cancer among nuns has led to the hypothesis that sexual activity is an important determinant of this cancer. occurrence in the female reproductive organs. Marital status associations, most likely reflecting underlying causal links of nulliparity with breast cancer, sexual activity with cervical cancer and low parity with ovarian cancer, are stronger in socio-cultural settings in which marital status is strongly...

So what can be learnt from this

Potentially be anyone in the multi-disciplinary team) at a time of their choosing. For some, this may be quite early in the process and, for others, it may not be until they actively start to contemplate becoming sexually active or becoming parents. When teenagers are diagnosed with cancer, they are likely to miss significant amounts of schooling and may also find themselves dislocated from their previous peer and friendship groups. This may in turn reduce their access to information about sexual matters at an educative, social and emotional level. It is not clear whether parents and or professionals can fill any of that gap but unless the need is acknowledged and attempts made by adults to build that bridge, then teenagers with cancer may be particularly disadvantaged.

Are there other causes of hepatitis

Type A is found in human feces and is transmitted from person to person through ingestion, either of contaminated food or water or by direct ingestion of even small fecal particles during sexual activity. For this reason, people who handle food should wear gloves and wash their hands after using the restroom

Male Sexual Dysfunction Male Erectile Disorder

Sion ads, this disorder has become the definitive example of sexual disorders that affect men. Male Erectile Disorder (ED) is defined by an inability to attain or maintain an erection until completion of sexual activity, and is associated with marked distress or interpersonal difficulty (American Psychiatric Association ApA , 2000). Epidemiological studies have not typically included assessment of sexual disorders, but sex researchers who have studied the prevalence of ED in community samples have found rates ranging from 3 to 9 of men of all ages (Spector & Carey, 1990). 1994). Previous estimates of ED complaints in clinical samples have indicated that from 36 to 48 of men who present for treatment in sex clinics have a primary diagnosis of male erectile disorder (Ackerman & Carey, 1995). Current estimates of clinical prevalence are missing, and may be important in describing the change in treatment for erectile dysfunction from sex therapy to pharmacology. Physiologically-based risk...

Human Immunodeficiency Virus HIV

The human immunodeficiency virus was discovered in 1983 (Barre-Sinoussi et al., 1983) and firmly associated with AIDS in 1984 (Gallo et al., 1984). It is a human retrovirus, belonging to the lentivirus sub-family and is distinguished by its single-stranded RNA genome, which replicates via a DNA intermediate through the action of the enzyme 'reverse transcriptase' and integrates into the host chromosomal DNA. Although the first cases of HIV disease were reported as recently as 1981, the epidemic continues to escalate and the World Health Organisation (WHO) estimates that over 38 million young adults have been infected, the majority in sub-Saharan Africa. The three primary routes of transmission --- sexual intercourse, blood contact and from mother to infant --- were proposed on the basis of the epidemiology of AIDS, even before the identification of HIV. Of those, heterosexual transmission accounts for over 80 of new infections worldwide, while the importance of contact with infected...

Reproductive Behavior

Thalamus involved in the regulation of sexual behavior. Oxytocin injections into the hypothalamus of estrogen-primed female rats facilitate female sexual behavior, while oxytocin antagonists block this behavior. Oxytocin may also play a role in sexual performance in males. For example, oxytocin levels in the cerebrospinal fluid are elevated after ejaculation in male rats and oxytocin injections decrease the latency to ejaculation. Oxytocin also stimulates the occurrence of spontaneous, noncontact penile erections in male rats. The role of oxytocin in human sexuality is unclear however, plasma oxytocin levels increase during sexual arousal and peak at orgasm in both men and women.

Clinical features

Sexual intercourse is usually attempted and often achieved. There may also be prolonged masturbation and sexual activity with children, which may lead to the allegation of sexual abuse or assault. There is no recollection of the event but afterwards there may be a feeling of guilt, shame or embarrassment.

How can I avoid infection with HIV

Two people who know they are not infected and who have no other sex partners besides each other cannot contract HIV. When a person has sex with a person whose STD status is unknown, a latex condom put on before beginning sex and worn until the penis is withdrawn can greatly reduce the risk of infection. Only lab tests can confirm someone has HIV. It is not obvious by looking to determine whether a partner has HIV or any other STD. Washing the genitals, urinating, or douching after sex does not prevent STDs.

Hiv Substance Abuse And The Impact On Infants

An assessment of HIV risk in mothers of 6750 children with perinatally acquired AIDS in the United States revealed 41 with history of injection drug use, 34 had had sexual contact with a partner with or at risk for HIV AIDS, 2 were recipients of contaminated blood or blood products, and in 13 no risk was specified (38). Not only are infants born to drug-dependent HIV-seropositive women at significant risk of becoming HIV-seropositive themselves, they are also at higher risk for a variety of other adverse outcomes (39). There is a rising incidence of mothers infected with HIV secondary to drug use. The association between cocaine use and high-risk sexual activity, including sex for drugs and multiple sexual partners, has led to a rising incidence of HIV infection in cocaine-using mothers. Sex with multiple partners increases the chances of reinfection with multiple HIV serotypes and greater virulence of infection. These features may be responsible for the higher rates of persistent...

Variable Stimulation Of The Immune System Of Primates Under Different Conditions

The long-term survival of the pathogen in a vertebrate host depends on proper balance (or evasion) of the pathogen with the host's immune system. A possibly critical factor of difference among modern humans, the Stone Age man, and the modern non-human primate needs to be recognized here. Some of the possible differences would make the response greater or weaker, and could consequently support or conflict with the hypothesis proposed here. This balance could depend on the variety and extent of immune stimulation in general and is in addition to the responses of these host species to their particular retroviruses. The stimulation of the immune system, variety of stimulations, and the age dependency of individuals exposed to other antigens before they are challenged by viral antigen do vary greatly (see for example, Miedema and Klein, 1996). There must be marked differences in the antigenic stimulation of the members of primate societies in the wild, the humans in developing countries,...

Differentiating issues for behaviourally affected teens

Although not the focus of this chapter, it is unclear whether there has ever been a study comparing behaviourally infected children and perinatally infected children with regard to issues around self-esteem, disclosure, sexual relationships or childbearing. Youth who are behaviourally infected have known life before being HIV-positive. Some oftheir views and actions may be strongly influenced by their experience of growing up HIV-negative. There may be differences in the perceptions of those who are perinatally infected versus those who are behaviourally infected. For instance, in order to have been behaviourally infected in the first world, the individual concerned had to be (knowingly or unknowingly) exposed to drug use or a sexual relationship or abuse.

RAI Causes Birth Defects

Dose of RAI, which would go directly to the fetal thyroid gland and cause severe damage to the fetus. This is why all women in childbearing years have pregnancy tests prior to treatment just to make sure. In other words, you'll need to have a pregnancy test even if you're using birth control, you've had a tubal ligation, or you haven't had sex in months. Even nuns have to have pregnancy tests The pregnancy test detects the hormone HCG, or human chorionic gonadotropin, the hormone the developing embryo makes. I (Ken) usually advise you wait six months after this treatment before trying to conceive. (Of course, pregnancy carries other risks that have nothing to do with radioactive iodine.) For more information on pregnancy and thyroid disease, see Chapter 13.

HIVpositive children and the experience of pregnancy

In another situation the teen's HIV was behaviourally acquired but her mother was also HIV-positive. The role for unconscious motivation behind not protecting oneself during sexual activity when one is aware of HIV and lives in a home with someone who is HIV-positive must be thought about. This mother had a younger HIV-infected child. This teen had a healthy, HIV-negative child and was able to give her mother the gift of a 'healthy child' to live in her household.

How Do I Use a female condom

The female condom can be inserted up to eight hours before sex begins. The woman inserts the female condom with her fingers, much like a tampon with no applicator. Remove and insert a new female condom if the female condom rips or tears during insertion or use the outer ring is pushed inside the penis enters outside the pouch the female condom bunches inside the vagina or you have sex again. 4

Oral Sex and the Risk of Sexually Transmitted Diseases

HIV - Measuring the exact risk of HIV transmission as a result of oral sex is very difficult. In addition, if sexually active individuals practice oral sex in addition to other forms of sex, when transmission occurs, it is difficult to determine whether or not it occurred as a result of oral sex or another sexual activity. Finally, several co-factors can increase the risk of HIV transmission through oral sex, including oral ulcers, bleeding gums, genital sores, and the presence of other STDs.

Less Health Risking Behaviors

Still another factor in the mechanism linking religion and health may be that religious behavior leads to less participation in those behaviors known to be in direct opposition to good health. Jarvis and Northcott (1987) reviewed the practices of members of nine major religions and found significant differences from nonpracticing controls in two main areas Most religions (1) prescribe behavior that prevents illness or death or that assists in treatment of sickness and (2) proscribe behavior that is harmful to life or that would hinder treatment. Woods and Ironson (1999), in their examination of the role of religiosity-spirituality in medically ill patients, reported that those patients identifying themselves as religious were more apt to cite their religious beliefs as the reason they did not smoke, did not drink, and chose healthy diets than did those patients not identifying themselves as religious. Several studies report positive correlations between reported religiosity and...

Hypoactive Sexual Desire Disorder

Women with Hypoactive Sexual Desire Disorder (HSDD) complain of a low interest in general sexual activities. There are currently no empirically validated treatments for HSDD. Sex therapy techniques generally consist of 15 to 45 sessions of cognitive therapy aimed at restructuring thoughts or beliefs that may adversely impact sexual desire (e.g., women should not initiate sexual activities, sex is dirty ) and to address negative underlying relationship issues. Behavioral approaches are utilized to teach patients to express intimacy and affection in both nonsexual (e.g., holding hands, hugging) and sexual ways, to incorporate new techniques into their sexual repertoire that may enhance their sexual pleasure, and to increase sexual communication. Testosterone is effective in restoring sexual desire in women with abnormally low testosterone levels (e.g., secondary to removal of the adrenal glands, bilateral removal of the ovaries, menopause).

Sexual Aversion Disorder

Defined as the avoidance of sexual genital contact with a partner, Sexual Aversion Disorder (SAD) has a high comor-bidity with history of sexual abuse, vaginismus, and dys-pareunia. Treatment for this condition often combines couples therapy and cognitive therapy and focuses on solving conflict areas within the couple, such as emotional differences and issues of control. Anxiety reduction techniques such as systematic desensitization are used when the aversion is accompanied by strong feelings of anxiety. Systematic desensitization consists of identifying a hierarchy of sexual activities that provoke anxiety and then pairing relaxation techniques with imagining the sexual activity. The goal is for the patient to feel relaxed while imagining each sexual activity and eventually while actually engaging in each sexual activity. Some therapists feel that, during treatment of sexual abuse survivors, trauma-related issues need to be resolved before SAD is addressed.

Benefits of androgen therapy

T therapy may have more significant effects on libido than on erectile function 170 . In one study, normalization of serum T levels in hypogonadal men with ED resulted in only short-term improvement (one month) in erectile function and sexual satisfaction, while improvement of sexual desire was statistically significant for the six months of the study, making the use of T therapy alone questionable in this population 74 . However, T monotherapy did improve sexual performance, desire, and motivation in men with hypogonadism, in clinical trials with transdermal T-gel formulation. Maximal improvement occurred on day 30 and continued for the six-month duration of the study 30 . T therapy improved orgasmic function 73 . In another randomized, placebo-controlled study, short-term transdermal T administration improved the erectile response to sildenafil by increasing arterial inflow to the penis during sexual stimulation 52 . T was also shown to improve arterial flow and subsequent response...

Years old ten weeks into my fourth pregnancy

Early menopause is now becoming a recognized long-term complication of chemotherapy given in adolescence (Marsden and Hacker 2003). Young adult cancer survivors are often advised to wait two years following the completion of treatment before trying to conceive, when health prospects become brighter. There is also evidence to suggest that teen-cancer-survivors exhibit delayed sexual maturity and first sexual experiences occur later than their peers (Kokkonen et al. 1997). These factors combine to limit duration of potential childbearing years. Communication concerning a shortening of reproductive years could serve to decrease psychological distress in the future by giving a survivor the correct facts to make an informed choice.

Genital Tract Infections

In a university study of women with urethral syndrome who had sterile bladder urine, the etiology was found to be related to the presence or absence of pyuria. Infection with C. trachomatis was demonstrated in 62 of women with pyuria and 6 of women without (Stamm et al., 1980). In this report, pyuria was defined as fewer than eight leukocytes per ml of uncentrifuged midstream urine. N. gonorrhoeae was not found to be associated with the urethral syndrome in this population of university students. However, in indigent female populations attending emergency rooms, gonococcal infection was found to be significantly correlated with dysuria, accounting for 61 of the cases studied. C. trachomatis is probably the leading cause of urethral syndrome in female contacts of men with non-gonococcal urethritis (Paavonen et al., 1986), whereas both N. gonorrhoeae and C. trachomatis may be important among women who are at high risk of gonorrhea. HSV infections, though not commonly found among women...

Complications of penile prosthetic surgery and their management

Erectile Radiology

A correct procedure in a properly selected patient does not necessarily result in a satisfactory outcome for the patient. A common reason for patient dissatisfaction is the lack of adequate engorgement of the glans during sexual activity. Typically, the patient reports that the corpora cavernosa are perfectly rigid after activating the implant but the glans remains soft, interfering with the patient's sexual satisfaction. Mulhall et al. 40 recently reported a beneficial effect of oral sildenafil on glans engorgement in patients with penile implants complaining of lack of glans engorgement. By using the IIEF, the authors also showed that sildenafil caused a statistically significant improvement in implant assisted intercourse. Similar results with the use of 500 g of intra-urethral alprostadil were reported by Chew and Stuckey 41 in a patient who had been treated with a Dynaflex prosthesis. penile implant than in those treated with sildenafil or intracavernosal injection therapy....

Openness sex education and sexual health services

Parents and teachers are often nervous about addressing the sensitive and potentially embarrassing subject of sex education. While some adults may fear that once young people know that sexual intercourse exists they will immediately rush off to try it, the evidence is to the contrary (Kirby 2002). Those countries that appear to offer the most effective sex education have the lowest teenage pregnancy rates and a higher average age for the start of sexual activity (Alan Guttmacher Institute 2001). Good sex education results in young people being more considered about sexual matters and more selective in their choice and number of sexual partners. DiCenso and colleagues (2002) confirmed that if the content of this education is wholly or predominantly biological, the outcomes are poorer. Curricula that are more broadly based and include 'sex and relationships education' or 'personal and social education' are more effective. The promotion of the idea of sexual abstinence until marriage may...

Abdominal Muscle Contractions During Labor

During the first 4 to 5 weeks after parturition, the uterus involutes. Its weight becomes less than half its immediate postpartum weight within 1 week, and in 4 weeks, if the mother lactates, the uterus may become as small as it was before pregnancy. This effect of lactation results from the suppression of pituitary gonadotropin and ovarian hormone secretion during the first few months of lactation, as discussed later. During early involution of the uterus, the placental site on the endometrial surface autolyzes, causing a vaginal discharge known as lochia, which is first bloody and then serous in nature, continuing for a total of about 10 days. After this time, the endometrial surface becomes re-epithelialized and ready for normal, nongravid sex life again.

Role for 5HT in Depression

Serotonergic neurons play a key role in the modulation, organization and coordination of appropriate responses to a wide variety of stimuli. As noted, 5-HT acts primarily as an inhibitory neurotransmitter, has a significant role in several behaviors that are consistently disturbed in many persons with depression (e.g., mood, sleep, sexual activity, appetite, circadian and seasonal rhythms, neuroendocrine functions, body temperature, motor activity, and cognitive function).14-17 Studies suggesting that 5-HT function is abnormal in depression have revealed 1) decreased brain concentration of 5-HT and decreased CSF concentrations of 5-HIAA 2) alterations of both presynaptic and postsynaptic CNS serotonergic receptors 3) alterations in putative peripheral markers of CNS serotonergic function such as platelet 5-HT uptake, platelet 3H imipramine or 3H paroxetine binding, platelet 5-HT2 receptor density, and whole blood 5-HT content and 4) receptor abnormalities in post-mortem brain tissue...

The primate connection

In time, this difficulty tends to be partly rectified as new reconnaissances are undertaken and new observations are made. For a long time, for instance, the common gibbon was viewed as the very model of a monogamous mammal in terms of mate fidelity. Minimal dimorphism, the fact that pairs spend most of the day in close proximity in a relationship that apparently lasts over many reproductive cycles, if not for a lifetime, and the fact that the male is actively involved in caring for the young (and in guarding their mother from approaching neighboring males) - all helped to boost up this stereotype. More recently, however, the stereotype was partly shattered by new observations on the actual conduct of these Asian apes in the wild. Following three study groups of white-handed gibbons (Hylobates lar) in the rain forest of Thailand over two separate periods (totaling about 20 months) researchers were able to detect extra-pair sexual activity with some...

Rectification of terms

In humans, sexual dysfunctions form around the categories of sexual arousal, desire, orgasm, and pain. Arousal may be separated into physiologic genital arousal (sometimes referred to as potency ) and subjective or psychologic arousal that denotes a conscious awareness of the genital sensations. However, this psychologic arousal may be an important component of sexual desire (sometimes referred to as libido or motivation ). Sexual arousal and desire sum into behavioral responses of copulation Excitement (motor responses in anticipation of sexual activity or in response to hormonal stimulation) Instrumental responding (desire to obtain a sex partner) Solicitation, hops and darts (desire to initiate sexual activity) Conditioned copulatory behavior (e.g. copulatory responses in places paired with sexual or other rewards, or in the presence or absence of conditioned incentive cues) Copulatory behavior after several ejaculatory series Estrus termination

How can I protect myself from contracting chlamydia

Refraining from having sexual intercourse with an infected partner is the best way to prevent transmission of HIV and other STDs. People can choose to not have sex. People can also decide to wait, or delay sex, until a later time in their life. They may choose to have personal relationships that do not involve sex. Choose Outer-course vs. Intercourse Monogamy is sex between two people, who only have sex with each other, as part of a long-term relationship. If neither partner is infected, there is no risk of disease transmission. Getting to know your partner and his her sexual history before you decide to have sex can also reduce your chance of exposure to disease. A series of short-term relationships is not as safe because of the increased risk that one of those partners will be infected. Use Condoms and other barriers Although not as safe as abstinence or monogamy, the correct and consistent use of latex condoms during sexual intercourse - vaginal, anal, or oral - can reduce a...

Routine laboratory tests

Functioning, including intensity of libido, frequency of nocturnal erections, and frequency of sexual activity 25,26 . Furthermore, additional research in which an acute hypogonadal state was induced (in experimental animals and eugonadal males), not only confirmed the importance of physiologic levels of testosterone in maintaining normal sexual behavior, but also highlighted the dose-response relationships between testosterone levels and the various androgen-dependent processes, including sexual function.

Sexual Response Sexual Desire

Sexual desire refers to the broad interest in sexual objects or experiences and is generally inferred by self-reported frequency of sexual thoughts, fantasies, dreams, wishes, and interest in initiating and or engaging in sexual experiences. Definition of this construct is complicated by factors such as attitudes, opportunity partner availability, mood, and health. Relationship factors, individual preferences for sexual variety and emotional intimacy are closely linked to sexual desire. Androgens appear to also play a role. In males, about 95 of androgens (e.g., testosterone) are produced by the testes the remainder is produced by the outer adrenal glands. In females, androgens are produced by the ovaries and adrenal glands in quantities much lower than in males (about 20-40 times less Rako, 1996). In both males and females, decreased testosterone levels due to, for example, orchidectomy (removal of testes) or oophorectomy (removal of ovaries) have been linked to impaired sexual...

The Impact of Sexually Transmitted Diseases and Unplanned Pregnancy

Sexually transmitted diseases (STDs) refer to the more than 25 infectious organisms transmitted primarily through sexual activity (USDHHS 2000). According to the American Social Health Association, the United States has the highest STD rates of any country in the industrialized world - an estimated 15.3 million new infections each year (ASHA, 1999). Of the top ten infections in the U.S., five are STDs. The secrecy and shame surrounding STDs interfere with communication between parents and children, sexual partners, teachers and students, and even patients and health care providers. According to the CDC (2000) in their 1999 STD report, Considering these three components, prevention strategies for all STDs would include the first two components since the prevention of HIV transmission is closely related to the prevention of other STDs. For those individuals who choose to engage in sexual activity outside of a mutually monogamous relationship with an uninfected partner, increasing condom...

Assessment of Testicular Function

Following pubertal staging and hormone analysis, semen analysis is necessary to confirm spermatogen-esis. The sample should be fresh and properly collected. This usually involves abstaining from sexual intercourse for 3-5 days and collecting the specimen by masturbation. Sperm count and quality can provide useful information about the likelihood of natural fertilization and, hence, whether assisted reproduction may be required. The sperm count should be at least 20 x 106 per ml. Since recovery from damage to germinal epithelium may occur 5-10 years (or even later) after therapy, these counts should be repeated from time to time, as such evaluation is indicated.

Reproductive and Hormonal Functions of the Male and Function of the Pineal Gland

The reproductive functions of the male can be divided into three major subdivisions (1) spermatogenesis, which means simply the formation of sperm (2) performance of the male sexual act and (3) regulation of male reproductive functions by the various hormones. Associated with these reproductive functions are the effects of the male sex hormones on the accessory sexual organs, cellular metabolism, growth, and other functions of the body.

Abnormalities of female genital tract and intersex disorders

The vaginal dimple can vary in length from just a slight depression between the labia to up to 5-6 cm. Vaginal dilators, made of plastic or glass, are used to stretch the vaginal skin and the patient is encouraged to apply pressure for 15 minutes twice daily with successive sizes of dilator. An adequately sized vagina is usually formed by six months but this may take longer and long-term use of dilators may be required, depending upon the frequency of sexual intercourse. A number of surgical approaches have been employed to create a neo-vagina, although are rarely required. Diagnosis is often not made until puberty or sometimes not until commencement of sexual activity It can usually be made without the need for a laparoscopy. Sometimes, however, an ultrasound scan will reveal the presence of a uterine remnant (anlagan), which is usually small and hardly ever of sufficient size to function normally If there is active endometrial tissue within the uterine anlagan, the patient may...

Logistic regression in action

Than a woman is predicted to be 2.24X 1.17 2.62 times more likely to have hypertension. Thus the model assumes that age and sex act independently on hypertension, and so the risks multiply. This can be checked by including an interaction term between age and sex in the model as described in Chapter 2. If this is found to be significant, it implies there is effect modification between age and sex, and so if the interaction was positive it would imply that an older man is at much greater risk of hypertension than would be predicted by his age and sex separately.

Treatment of men with sexual dysfunction and hyperprolactinemia

The literature contains some observations of marked improvement of sexual dysfunctions associated with HPRL following non-specific treatments such as psycho- or sex-therapy 250 or, as concerns ED, sildenafil 241,253 . However, PRL-lowering dopamine-agonists (bromocriptine, lisuride, quina-golide, and cabergolide, the latter one being effective following a single administration per week) 254 most often not only normalize all aspects of sexual function, but also shrink the possible pituitary ade noma, or at least prevent its growth 18,230 . In addition, unlike PDE5-I, PRL-lowering agents allow return of sexual desire, and in the case of ED spontaneous erections, and avoid the necessity to plan sexual intercourse. Therefore dopamine-agonists should be the first choice treatment. This therapy may not be definitive. If PRL returns within the normal range, while there is no macro-adenoma, it may be stopped every year, or every other year, for several weeks before determining the PRL level....

Formulation Of Aetiological Hypotheses

According to the rule of difference, when both a particular set of factors and the incidence of a particular cancer differ between two populations, one or more of these factors will likely contribute to the occurrence of the disease. When the difference in incidence is large, in relative terms, and only one or two factors form the differentiating set, then the hypothesis is more likely to be correct, and vice versa. Thus, the relatively high incidence of Kaposi sarcoma among homosexual men in the United States in the early 1980s indicated that sexual preference was involved in the occurrence of the disease, since few other, if any, characteristics distinguish homosexual from heterosexual men. Also, the lower incidence of cervical cancer among nuns points to sexual activity as an important causal factor, since nuns differ from other women with respect to only a few characteristics and practices. By contrast, the usually higher incidence of lung cancer in large cities cannot be...

The Components of Sexual Desire

Is clinically useful to think of desire as consisting of drive (biologic), motive (individual and relationship psychology), and wish (cultural) components 11 . The drive component of desire is what we could expect to be explained (some day) by the neuro-chemical mechanisms in the brain. The motivational component of desire might be a result of the interaction of the couple, for instance I want to have sex with her, otherwise she will leave . And the cultural component of desire can be best represented by what is considered a highly desirable partner in a culture, with whom the man needs to have desire in order to conform to the cultural demand of a true man . Both in clinical practice and in the general surveys that explore the level of sexual desire the three components are always interwoven.

Sexual motivation and desire

Desire has always been difficult to define objectively. In the DSM-IV-TR, the diagnosis of hypoactive sexual desire disorder is given when desire for and fantasy about sexual activity are chronically or recurrently deficient or absent. By converse logic, then sexual desire is the presence of desire for, and fantasy about, sexual activity. This definition appears coherent but is circular. How does desire manifest itself Like people, animals manifest sexual excitement behaviorally. They increase their motor output in anticipation of copulation and work for the opportunity to copulate or to obtain primary or secondary (conditioned) sexual rewards associated with copulation. Animals will also choose between two or more sexual incentives based on the strength of the incentive cues and the animal's own internal drive state. What characterizes these behaviors is that they occur before copulation Courtship, operant responses, conditioned locomotion in anticipation of sex, time spent near a...

Alphaadrenoceptor blockers

Ties, as well as to NO synthase (NOS) stimulatory effects 30,31 . In the dog model intracavernously injected phentolamine resulted in a 50-100 increase in arterial blood flow without showing any impact on the veno-occlusive mechanism 32 . In contrast, in the same animal experiment papaverine resulted in a 300-700 increase in blood circulation and simultaneous blockade of venous drainage. The intra-cavernous injection of phentolamine 5 mg only resulted in penile tumescence but not rigidity 33 , whereas a combination of phentolamine and pa-paverine showed additive efficacy resulting in long-standing rigid erections sufficient for sexual intercourse 34 .

Sexual Health and Responsibility Program SHARP

SHARP's Sexual Health Primer includes the impact of STDs and unplanned pregnancy, Risk Assessment and Risk Reduction Counseling -Guidance and Training for Health Care Providers, SHARP Facts Fact Sheets on STDs unplanned pregnancy HIV testing options for risk reduction male and female condoms talking to teens about sexual responsibility and family planning. This course is available on the SHARP website. SHARP issues a certificate of training to each person who completes the 40-question exam. Continuing education credit is awarded. Sexual Partner Counseling and Referral. This self-study course covers the CDC's 11-step process for bringing to treatment the sexual partners of patients infected with sexually transmitted infections. SHARP issues a certificate of training to each person who completes the 33-question quiz. Continuing education credit is awarded.

Hypoactive Sexual Desire Disorder HSDD

HSDD is a disorder characterized by absent or low desire for sexual activity that is associated with interpersonal difficulty or distress (ApA, 2000). A distinction is made between receptive and proceptive sexual behaviors, with a lack of proceptive behavior most indicative of true low sexual desire (Pridal & LoPiccolo, 2000). HSDD affects both men and women, and it is the most common primary diagnosis in cases of sexual dysfunction. Segraves and Segraves (1991) conducted a large pharmaceutical study for sexual disorders and found that 19 of clients with a primary diagnosis of HSDD were male. Prevalence estimates for community samples indicate a rate of 15 for males (Rosen & Leiblum, 1995). apeutic intervention. Perhaps because of this, quality treatment outcome measures for low drive are relatively scarce (see O'Donohue et al., 1999). However, some studies have demonstrated good treatment results using a complex, cognitive-behavioral treatment program (LoPiccolo & Friedman, 1988)...

Acceptance Longterm Use and Dropout Rates of VCD

Although VCD therapy is able to produce erections sufficient for sexual intercourse in more than 75 of users 29 , the main reasons for discontinuation of VCD therapy were ineffectiveness, side effects, the time-consuming nature of the procedure, lack of acceptance by patient and partner, and the relatively high costs of the devices 28 . Once VCD turned out to be effective, significant increase in frequency of intercourse, sexual arousal, coital orgasm and sexual satisfaction was reported by patients' partners 30 .

Etiological Background of Sexual Dysfunction from a Psychologic Interpersonal Perspective

Precipitating factors are those that initiate or trigger sexual problems. For any one individual it is impossible to predict which factors, under what circumstances, will impair sexual desire or performance. Nonetheless, an individual's vulnerability to a particular set of circumstances can precipitate sexual dysfunction. For instance, traumatic events such as the discovery of a spouse's infidelity may cause one man to lose his sexual desire while another man's desire may increase. While initially a precipitating event may be problematic and distressing, it need not necessarily lead to a diagnosable dysfunction in the long term. Over time however, repetition of such events, especially those that damage self-confidence and self-esteem result in sexual dysfunction, even in reasonably resilient individuals. Examples of such precipitating events include con-flictual separation or divorce, a sudden brush with death through an accident or disease process, or unsatisfying sexual experiences....

The squeeze technique

Concurrent with practicing the stop-start process, the couple is encouraged to spend time in mutual pleasuring involving non-genital massage and caressing, following the programme known as sensate focus . This is essential to reduce the genital-focused interaction of the ejaculatory control process. It is also essential for the man to be encouraged to satisfy the sexual needs of his partner during the training programme.

History and Epidemiology of Male Sexual Dysfunction

It seems paradoxical that among the physiologic functions of the human body, sexual function has generated the greatest popular awareness and curiosity, but the least scientific inquiry. Despite the considerable human behavior, both virtuous and evil, that has been motivated by human sexuality, restrictive social attitudes and taboos have severely inhibited scientific investigation of human sexual function. Working within a restrictive social environment, a few irrepressible investigators and observers of human behavior have changed the course of modern social science and philosophy through their interests in sexual medicine and sexual psychology. Sigmund Freud brought new concepts of the importance of sexuality to the forefront of Western creative thinking at the end of the 19 th century and beginning of the 20th century 1 . As early as 1896, the aphrodisiac effects of yohimbine were reported by Leopold Spiegel, who extracted this substance from the bark of the West African yohimbe...

Epidemiology of Erectile Dysfunction

Even though erectile dysfunction increases significantly with increasing age, there is evidence of continued sexual activity in men over 70, and even beyond age 80. For men in the age range 70 to 79, a study conducted in Germany 25 reported that 71 of men were sexually active, and a study in Japan 41 reported that 55 to 70 of men were sexually active 41 . The Japanese study also reported that 44 of men over age 80 were sexually active. Another study showed that, for men aged 50 to 80 in the United States and six European countries, the number of sexual activities per month was consistently between 5.4 and 6.5 (Fig. 4.1) 42 . These epidemiologic studies strongly suggest that a large percentage of men remain sexually active into their 70s and beyond. Fig. 4.1 Sexual activities per month in age groups 50 to 80 years. From Rosen R. etal. 42 . Fig. 4.1 Sexual activities per month in age groups 50 to 80 years. From Rosen R. etal. 42 .

How is psychogenic ED diagnosed

Variability of erectile function is the hallmark of psychogenic ED. Take the example of the man who reports excellent morning erections, moderately good erections with fantasy or masturbation, and poor erections with foreplay and attempts at intercourse. This man, by history, has clear psychogenic ED. No physical scenario can explain the variability of erectile function. Note that in this example the patient's function worsens as he becomes involved with a partner, suggesting the role of performance anxiety or interpersonal anxiety. Psychologic and relational variables can enhance or inhibit the physiologic aspects of sexual response. There is, however, great variability in men's vulnerability to sexual dysfunction and likewise ability to compensate for these factors. Psychologic factors can help men resist declining erectile function. For example, a man with good self-esteem, broad sexual experience, and a loving and arousing partner can partially compensate against organic factors...

Treatment of Hypoactive Sexual Desire

Treatment of HSD is directed to the putative cause of the condition. There are no effective symptomatic treatments for HSD, as there are for erectile dysfunction (i.e. phosphodiesterase-5 (PDE-5) inhibitors). Bupropion, an antidepressant medication that has an effect in the re-uptake of dopamine and norepinephrine 41 , has been studied, and it has shown a modest effect on women with HSD when compared to placebo (using the slow-release form starting 150 mg day for one week and then 300 mg day) 42,43 . An early report by Crenshaw and co-workers 44 included men and women who were not depressed, but who had some form of psychosexual dysfunction (inhibited sexual desire, inhibited sexual excitement or inhibited orgasm), and indicated some positive effect on patient's rated libido and global improvement, which was statistically significant compared to placebo unfortunately, it is not clear from the report how many men responded. The response rates, though statistically significant when...

Models of male sexual dysfunctions

Male rats that do not perform sexually are typically taken out of behavioral studies, so there is very little known about their actual erectile responsiveness. This proportion is generally low, especially if the males are pre-exposed to the test chambers prior to their initial sexual experiences. Some of these males do not display any interest in the female, and do not initiate any kind of sexual activity. However, other males display sexual interest and mount repeatedly, but do not achieve vaginal intromission. The lack of intromission may stem from an inability to achieve erection. Indeed, erectile responses in isolation and intromissions during copulation are both very sensitive to disruption by several classes of drug, including psychomotor stimulants, dopamine and noradren-ergic antagonists, and opioid agonists. Acute or chronic treatment with selective serotonin reuptake inhibitors (SSRIs) does not appear to alter erectile responses or the number of intromissions prior to...

Epidemiology and Risk Factors HIV1 is transmitted

By either sexual contact, parenteral exposure to blood, blood products or body fluids, or from mother to infant. In the United States, western Europe, Australia, and in some Latin American countries, the majority of AIDS cases were initially among men infected through sex with other men. In the United States, the proportion that this group now represents has declined from approximately 72 percent in 1936 to 53 percent. y It is estimated that 75 percent of HIV-1 infection worldwide is the result of heterosexual transmission. Heterosexual transmission predominates in sub-Saharan Africa, the Caribbean, Southeast Asia (Thailand), and India. At present in the United States, the number of women with heterosexually acquired infection continues to rise.

Female Sexual Function

Gonadally-intact female rats of reproductive age go into sexual heat every four to five days immediately after ovulation. This process is initiated by the sequential actions of estrogen and progesterone (and possibly also androgens) in the brain and periphery, so that sexual behaviour shows an estrous cycle . Although women (and certain other primate females) can engage in sexual activity throughout their menstrual cycle, there is a peak rise in female-initiated sexual activity around the time of ovulation, suggesting that estrogen-induced neuro-chemical systems have been conserved throughout mammalian evolution. It is important to emphasize that compared to human males, in whom ability to achieve and maintain erections sufficient for sexual activity is also good for self-esteem related to competent sexual performance, in women there is no clear relationship between physiologic performance and sexual desire. The subjective feeling of sexual arousal results more from cognitive...

Nonresponders to PDE5 inhibitors

Quite frequently this veno-occlusive dysfunction (syn venous leak or cavernous insufficiency) is associated with severe impairment of the penile arterial blood supply in the penile color Doppler findings. But many so-called non-respon-ders may be rescued by appropriate counseling, by treatment of concomitant diseases or change in medication use. The definition of a real non-responder is justified if no success is seen under the following conditions use of at least four tablets with the highest dose of the respective PDE-5 inhibitor, at four different occasions, under optimal conditions (appropriate sexual stimulation, appropriate interval between tablet intake and sexual activity, with sildenafil and vardenafil fasting conditions for two hours, and with tadalafil keeping an interval of at least two hours between intake and sexual activity) (personal experience).

Psychotherapy of erectile dysfunction

Men with lifelong and acquired erectile dysfunctions typically achieve significant gains initially and over the long term, following participation in sex therapy. Men with acquired disorders tend to fare better than those with lifelong problems. Masters and Johnson 3 reported initial failure rates of 41 and 26 for lifelong (primary) and acquired (secondary) erectile dysfunction, respectively. Their 2-5 year follow-up of this cohort indicated sustained gains. Sex therapy treatment of ED consists of a variety of interventions such as systematic desensitization, sensate focus, interpersonal therapy, behavioral assignments, psychodynamic interventions, sex education, communications and sexual skills training and masturbation exercises. It has not been possible to statistically analyze the precise contribution of any of these single interventions to overall success.

The role of anxiety in sexual dysfunction

Anxiety played a significant role in early psychody-namic formulations of sexual dysfunction and later became the foundation for the etiologic concepts of sex therapy established by Masters and Johnson 3 and Kaplan 4 . Kaplan believed that sexually related anxiety became the final common pathway through which multiple negative influences led to sexual dysfunction.

During Ejaculation Thesperm Passesto What

Stimulation of the Female Sexual Act. As is true in the male sexual act, successful performance of the female sexual act depends on both psychic stimulation and local sexual stimulation. Thinking sexual thoughts can lead to female sexual desire, and this aids greatly in the performance of the female sexual act. Such desire is based largely on a woman's background training as well as on her physiological drive, although sexual desire does increase in proportion to the level of sex hormones secreted. Desire also changes during the monthly sexual cycle, reaching a peak near the time of ovulation, probably because of the high levels of estrogen secretion during the preovulatory period. Parasympathetic signals also pass to the bilateral Bartholin's glands located beneath the labia minora and cause them to secrete mucus immediately inside the introitus. This mucus is responsible for much of the lubrication during sexual intercourse, although much is also provided by mucus secreted by the...

Background Information On Tuberculosis And

TB is not transmitted through food and water or by sexual intercourse, blood transfusion, or mosquitoes. Worldwide the most common route of HIV transmission is through sexual intercourse. Other sexually transmitted infections (especially those that cause genital ulcers) increase the risk of HIV transmission. The main routes of HIV transmission vary between regions. The main routes of transmission of HIV in sub-Saharan Africa are through sexual intercourse, blood and from mother to infant. In most low-income countries roughly equal numbers of men and women are HIV-infected. Bloodborne HIV transmission occurs through contaminated blood transfusion, injections with contaminated needles and syringes, and the use of non-sterile skin-piercing instruments. The commonest route of HIV transmission in the fast-growing HIV epidemics in the Russian Federation and Ukraine is through injecting drug use.

Intracavernous injection test combined with Dopplerduplex ultrasound

Drug-induced erection reveals possible cavernous deformations in Peyronie's disease such as cavernous notches, or deviations that could themselves impair sexual intercourse 28,29 . These anatomic changes of the corpus cavernosum or tunica albuginea, could be relevant in certain cases. Many clinicians find the expense of the Doppler duplex ultrasound cost prohibitive, and thus move to less costly devices. The Knoll MIDUS Ultrasound System serves to evaluate the penile blood flow after injection of a vasoactive agent such as PGE1 30 . While the type of ultrasound used may be left to the discretion of the clinician, it is clear that the ultrasound combined with the injection of a vasoactive agent provides a clear evaluation of the cavernosal arterial supply to the penis.

Responsibility of hypogonadism

Data accumulated in such men show that T is required for pubertal acquisition of gender characteristics as well as adult sexual behavior and functional capacity, including libido, ejaculation, and spontaneous erections. Administration of T during placebo-controlled studies demonstrated that sexual desire and arousal are T-dependent 13,29,30 and represent the main impact of T on sexual function of men. The frequency of sexual activity 13,30,31 and spontaneous erections (especially sleep related, i.e. morning and nocturnal) 13,29,32 are also clearly T-dependent. The psychic erections (i.e. in response to erotic stimuli) were initially thought to be androgen-independent 33 , but are in fact partly T-dependent 34 . Ejaculations 31 and orgasm 35 are also partly androgen-dependent. individual 10,36 , but markedly variable between individuals 10,31,36 , and may be specific to each parameter of sexual function 37 . For example, in a study by Kelleher, the average T level from which...


In male rats, castration or the administration of androgen synthesis inhibitors, like cyproterone acetate, disrupt and ultimately eliminate copulatory behaviors and penile reflexes progressively over time. They also shrink androgen sensitive peripheral tissues (e.g. penis and prostate). Although the degree of disruption depends on the amount of androgen synthesis inhibition that is induced (e.g. moderate following low doses of cyproterone acetate to total disruption following castration), the amount of time it takes to reach an asymptotic level of behavioral or reflexive performance depends on the level of sexual experience male rats have prior to treatment. In each case, subsequent exogenous administration of androgens or estrogens can restore sexual interest and copulatory behavior, with nonaromatizable androgens (such as dihydrotes-tosterone) restoring peripheral tissues, and aro-matizable androgens (e.g. testosterone) restoring behavioural measures. As with hypogonadal men,...

How do you get HPV or genital warts

Genital HPV and genital warts are usually spread by direct, skin-to-skin contact during vaginal, anal or (rarely) oral sex with someone who has this infection. Genital warts are growths or bumps that appear on the vulva, in or around the vagina or anus, on the cervix, or on the penis, scrotum, or groin. They may be raised or flat, single or multiple, small or large. Warts may appear within several weeks after sex with a person who has HPV or they may take months or years to appear or they may never appear. This makes it hard to know exactly when you got the virus or from whom you got it. (Warts on other parts of the body, such as the hands, are caused by different types of HPV. People do not get genital warts by touching warts on their hands or feet.)

General considerations for the three PDE5 Inhibitors

Regarding the general assessment question (GAQ) Has the treatment you have been taking improved your erections This efficacy tool does not really tell whether the patient is able to attain an erection sufficient for sexual intercourse or not. This relatively weak efficacy measure is widely used, especially by pharmaceutical companies, because usually it yields the highest success rates. The IIEF was originally developed to evaluate the clinical efficacy of sildenafil (Viagra ) and became the most accepted and used efficacy tool for drugs assigned to treat ED world wide. It comprises 15 questions in five domains, addressing erectile and orgasmic function, sexual desire, sexual satisfaction and overall satisfaction. Each question has six response options scoring between zero (worst) and five (best result). For evaluation of the erectile efficacy of a drug the IIEF erectile function (EF) domain, comprising questions 1-5 and 15, represents the strongest efficacy tool, with a score 25...

Postoperative management

Place during the first follow-up visit appointment seven to ten days after surgery. Sexual activity is not allowed until six weeks after the procedure, when the second outpatient visit should take place. Ideally, validated instruments, including the IIEF, should be used at three, six and or 12 months after surgery to produce objective outcome data once the patient has resumed sexual activity on a regular basis. Particular care should be taken in assessing penile length and sensitivity, which represent two possible patient complaints 14 .

Monoamine Reuptake Inhibitors

Duloxetine is dosed once daily with a usual initial daily dose of 60 mg. It shows a benign side effect profile, similar to SSRIs, with most patients tolerating the drug extremely well. When side effects occur, the most common include insomnia and asthenia (Goldstein et al., 2002 Detke et al., 2002). There were no significant cardiovascular or genitourinary side effects, no weight gain, and sexual side effects as measured by the Arizona Sexual Experiences Scale did not differ from placebo (Goldstein et al., 2002).

Instrumental Conditioning

Instrumental conditioning represents a form of behavioral change that depends on the temporal relationship (contingency) between a response and an environmental outcome. The response might correspond to pressing a bar, lifting a leg, turning a wheel, or navigating a maze. In the laboratory, the outcome is typically a biologically relevant event, such as food, water, or a frightening shock. Outside the laboratory, behavior can be modified by a variety of events including social praise, access to a sexual partner, or a stimulus that has acquired value (e.g., money). Outcomes capable of modifying an organism's behavior are sometimes called reinforcers and the process through which they influence behavior is known as reinforcement. Examples of an instrumental contingency include praising a child for waiting quietly or providing a food pellet to a rat whenever it presses a bar. According to Thorndike's law of effect, these contingencies should bring about a lasting change in behavior,...

How can we reduce our risk of getting one of these diseases What are the options Abstain from sex or delay sex

Refraining from having sexual intercourse with an infected partner is the best way to prevent transmission of HIV and other STDs. People can choose to not have sex. People can also decide to wait, or delay sex, until a later time in their life. They may choose to have personal relationships that do not involve sex. Choose Outer-course vs. Intercourse But, if you choose to have sex, there are things you can do to reduce the risk of acquiring a sexually Monogamy is sex between two people, who only have sex with each other, as part of a long-term relationship. If neither partner is infected, there is no risk of disease transmission. Getting to know your partner and his her sexual history before you decide to have sex can also reduce your chance of exposure to disease. A series of short-term relationships is not as safe because of the increased risk that one of those partners will be infected. Use Condoms and other barriers Although not as safe as abstinence or monogamy, the correct and...