Archive for the 'Men’s Health-Erectile Dysfunction' Category
Sexually transmitted diseases (STDs) are a group of communicable diseases which are usually transmitted by sexual contact. They are a major public health problem in all countries.
Since the second edition of the Handbook in 1982, the field of STD has undergone major change with the appearance of Acquired Immune Deficiency Syndrome (AIDS) in 1981 and the subsequent recognition of human immunodeficiency virus (HIV) infection.
The appearance of this disease brought into focus the sexual transmission of disease among homosexual men and the effect on disease patterns of changes in sexual behaviour. It has also highlighted the importance of counselling and confidentiality in the management of these diseases.
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When Bryan died at age seventy-one, more than three hundred people came to his funeral, for he was beloved by relatives, coworkers, and old schoolmates. He was one of those quiet people who live modest, productive lives and thereby subtly enrich the lives of all around them; and she quietly and without fanfare loved him well and made the decisions without lording it over anybody. They were the kind of people you never read about in the newspaper or see on TV news— because they were not superachievers or grandstanders. They just did what had to be done, and quietly did it well.
Sue often thought about Bryan after his death (although fondly rather than sadly), recalling with love even his crudest jokes. In this happy-go-lucky way, he had fulfilled her—and she, accepting him and cherishing him complete with all his flaws plus her own, had fulfilled him.
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“It’s just a slap, that’s all. Just a slap between husband and wife. You’ll feel a short burning sensation, and your cheek will be red for a while, but there’ll be no permanent damage.”
“What are you talking about?”
“Please let me. Please.”
“No.”
“Just once. Just one little slap?” “I’m trying to watch television!”
“You’re crazy.”
“I know. May I slap you?”
“You’ll let me watch television afterward?”
“Yes.”
“All right. If you insist. Go ahead—slap me.” The wife walks up, pulls her arm back, and slaps the husband with as much of her might as she thinks proper. “There,” he says. “Feel better?” “Much, much better.”
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“How about if I do it tomorrow morning?”
“Really? I’ll believe it when I see it.”
“But first you have to do something for me in exchange.”
“In exchange? What do you mean?”
“I’m proposing we do a barter. A service for a service.”
“What service could I possibly provide you, I wonder.”
“Well—funny you should ask. I was kind of thinking about a little sexual service.”
“You know I’m not sexually attracted to you.”
“I know. I’m not asking you to be attracted. I’m just asking you to lie back and let me do vile and unruly things to your body.”
“What kinds of vile and unruly things?”
“Nothing too weird. Just standard stuff. How about it? A clean attic for an hour of indifferent sex.”
“And I just have to lie back? I don’t have to be interested at all?”
“Right. I’ll do everything.”
“Do I have to kiss you?”
“Not unless you want to.”
“Do I have to hug you?”
“Not unless you want to.”
“Do I have to fake an orgasm?”
“Not unless you want to.”
“That sounds like a deal I can’t refuse.”
“I thought so.”
“When do we start?”
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Players: Husband, wife, and therapist (optional). Activists: Both. Setting: Home.
Aim: Channel anger into a harmless physical battle that serves to elicit deeper feelings and bring about insight.
Game Plan: If the couple is in therapy, they may begin by having a foam-bat fight in the therapist’s office. If not, a friend may play the role of therapist, using this book as a guide. Supervision is often required (just as athletic games require referees) in order to keep the rules as well as set the framework of the contest.
The rules of this game are that the contestants should stand facing one another in the middle of a large room in which all furniture is out of the way. A formal “ring” may be set up if desired, roped off like a boxing ring, with some kind of padded floor (a king-size mattress or thick rug will do). At a designated start time they should begin striking one another with foam bats, aiming above the waist and avoiding the face. Foam bats can be bought from toy stores, or made with 1″ x 10″ x 18″ foam strips rolled up like newspapers.
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“I’ll tell you, but first you have to agree to the game. And once you make a commitment to the game, you can’t back out, no matter how hard the questions are.”
“Oh, so that’s how it is.”
“That’s how it is.”
Once the respondent spouse agrees to the game, the activist spouse finds out what the three wishes are, promises to do them, and then asks three pertinent questions. These questions should be designed to get the truth out into the open so that it is not acted out sexually or in any other way. Examples: “Do you still love me?” “Are you bored with me sexually?” “Are you having an affair?” “Why don’t you look at me when we’re having sex?” These questions will be just as hard to ask as they are to answer, and are the very issues that are being avoided. Hence it will be quite difficult for both partners to play this game. It will entail much soul-searching, confronting, working through feelings, and give-and-take.
By the time the three questions are asked and answered, the first spouse may no longer be in the mood to have three wishes granted—at least not at that moment. So what might have been instant gratification of the wishes turns out to be delayed gratification. Inadvertently, the “active” impulsive has learned a lesson in tolerating frustration, taking responsibility, and long-range planning.
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Infected newborns may have no symptoms, or the symptoms may be severe enough to cause brain damage and death. At birth, a child who is infected may not have a positive blood test, for the disease may take several weeks to show up on blood tests; for this reason, children born to high-risk mothers must have follow-up tests performed a few weeks after birth. Symptoms in infected newborns include brain damage, bone deformities, dental malformations, hearing loss, and rash. Women who are pregnant and are infected with syphilis have a higher risk of miscarriage: only 20 percent of women with syphilis will carry a fetus to term and deliver a normal, healthy baby. In the United States and in many other parts of the world, testing for syphilis is a routine part of prenatal health care.
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The first year of infection is the worst for most people, because they have more frequent outbreaks. Until the virus becomes less active, taking the medication on a suppressive basis can be very helpful. Of course certain people won’t need to do this, because they won’t have frequent outbreaks or their outbreaks will be manageable. A person who decides to take medication suppressively for a time may want to try stopping it at some point to see if the virus is still as active. If, after stopping the medication, that person continues to have very frequent outbreaks, then he or she will probably want to resume suppressive treatment. Otherwise, using the medication only to treat outbreaks might be the best approach. Taking these antiviral medications suppressively does not appear to cause the herpes virus to become resistant to them. Such resistance occurs only very rarely, in immunocompromised persons. Studies have shown that suppressive use of acyclovir for ten years has not been associated with either resistance or adverse side effects. There are no known effects on sperm production in men or on fertility in men or women.
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In topical treatments, either podophyllin (10-25% solution) or trichloracetic acid (TCA; 80-90% solution) is painted on external warts on the genitals and near the anus, either alone or in combination with liquid nitrogen. The treatments are applied only to the warts and not to the surrounding, normal skin, since they can be irritating to normal tissue. These treatments destroy the skin cells where the virus is located, and podophyllin also prevents wart cells from dividing.
Podophyllin, which has been used as a treatment for warts for half a century, is applied only to visible external warts. It is not used on warts on the mucosal skin (as in the inner labia, vagina, or urethra), because it can be absorbed into the system and cause side effects. Application of podophyllin is usually not painful, although it must be washed off four to six hours after application in order to avoid irritation of the skin. A follow-up visit for repeat treatment is recommended in one or two weeks if the wart does not clear up. This method of treatment has a clearance rate of 32-79 percent and a recurrence rate of 27-65 percent. It should not be used during pregnancy.
Milder-strength podophyllin is available by prescription as either a solution or a gel. Called podofilox (0.5% podophyllin), it is used primarily to treat external genital warts and is most effective for small warts. Podofilox is applied to the warts twice a day for three days (without washing it off), followed by a four-day period of no treatment. This cycle can be repeated for up to a total of four weeks. If the warts are not gone by then, stronger treatment must be obtained from a health care provider. (For larger warts, stronger treatment may be necessary from the start.) Podofilox is not recommended for warts that are difficult to reach.
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Some people have the mistaken belief that if their partner doesn’t ejaculate, they can’t become infected with an STD. This is not true. Pre-ejaculate can also transmit infections. If a person starts having penetrative sex without a condom, and then uses a condom for the rest of the intercourse, that person has had unsafe sex.
People come up with many different reasons to justify not using condoms. Some of the most common are the following:
—They’re uncomfortable. —They’re unattractive.
—They decrease my pleasure in sex because they decrease sensation.
— I’m afraid they won’t work.
— I’m embarrassed to buy them.
— I’m embarrassed to put them on in front of my partner.
— I’m afraid they’ll spoil the mood.
— I’m on the pill, so my partner doesn’t have to use condoms for protection against sexually transmitted infections.
My answer to all these arguments is that there are two important reasons for using condoms:
—They can protect you from an unwanted pregnancy.
—They can protect you from acquiring a sexually transmitted infection, which could make you infertile (e.g., pelvic inflammatory disease) or cause your death (e.g., HIV).
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