Common Sexually Transmitted Diseases (HPV and genital warts )

Human papillomavirus (HPV), among the most common causes of STDs in the world, refers to not one, but 60 viruses. Some cause different types of warts. Many are found on feet, hands or other parts of the body, and some live in the genital area and are spread through genital contact. Although some forms of HPV virus cause cervical and other genital cancers, according to Planned Parenthood, the HPVs that cause genital warts do not seem to be directly associated with these cancers. However, women should have regular Pap smears so that pre-cancerous conditions can be treated.
Genital warts are very contagious. About two thirds of people who have sexual contact with a partner with genital warts develop them within three months. In women, genital warts can occur on the outside and inside of the vagina, on the cervix, or around the anus. In men, genital warts are less common, but occur on the tip of the penis, on the shaft of the penis, on the scrotum or around the anus. Rarely, genital warts can develop in the mouth or throat of a person who has had oral sexual contact with an infected person.
Genital warts often occur in clusters and can be very tiny or can spread into large masses. Left untreated, genital warts often disappear. In other cases, they eventually may develop into a fleshy, raised growth with a cauliflower-like appearance. There is no way to predict whether the warts will grow or disappear. If you suspect you have genital warts, you should see a health care provider.
Prevention: People should stop all sexual contact as soon as they know or think they have genital warts and seek treatment immediately to avoid spreading them. However, symptoms are not always visible. It is uncertain whether condoms protect you from this particular STD.
How you get HPV and genital warts: Sexual contact with an infected person
Symptoms: Sometimes none ;Firm, rough warts, sometimes flat, sometimes clustered;Irritation, burning and itching;Foul smell;Painful intercourse;Increased vaginal discharge
Diagnosis: Genital examination; microscopic analysis of tissue samples; Pap tests
Treatment:Removal through freezing, burning or laser treatment; Topical creams; Injection of antiviral drugs

HIV/AIDS (overview)

Human immunodeficiency virus (HIV) causes acquired immune deficiency syndrome (AIDS), which is deadly if left untreated. An HIV infection damages the immune system, your body's defense against disease and infection. A person can die from "opportunistic" infections from bacteria, viruses and other types of microscopic organisms that are usually harmless to healthy people. Because the immune system is damaged, the body of someone with this condition cannot defend itself well. AIDS is the final stage of HIV infection, when opportunistic infections occur because of a greatly weakened immune system.
Several types of white cells work to protect you. One type - called the lymphocytes - includes B cells and T cells. The B cells produce antibodies (CD4 cells) that destroy organisms invading the body. T cells help regulate the production of these antibodies. Two types of T cells are helper cells and suppressor cells. Helper cells help create antibodies and so-called cell-mediated immunity that also assist in the defense against certain infections. Suppressor cells stop or suppress immune reactions. As these helper cells are destroyed, the immune system fails and AIDS develops.
In the United States, more than half a million people have died from AIDS, and about 35,000 people are infected annually. Nearly 300,000 are living with AIDS.
Prognosis
Since 1996, the introduction of powerful antiretroviral therapies has dramatically decreased the number of people who develop AIDS. Before better therapies and medical treatments existed to take care of complications, it was thought people could live an average of 10 years after HIV infection.
Early detection of HIV infection can extend your life if you are treated with antiretroviral therapy, but to date, this infection cannot be cured. These medications must be taken for life.

Common Sexually Transmitted Diseases (Herpes )

Herpes can take two forms: fever blisters on the mouth or face (oral herpes, or HSV-type 1), or those appearing in the genital area (genital herpes, or HSV-type 2). Both forms are spread from skin-to-skin contact, either to the mouth or genital area. Often, people who have herpes don't have symptoms, but others have outbreaks of blisters or ulcers. Herpes infection is life-long, but outbreaks can be suppressed with medication.
Herpes is contagious just before an outbreak of blisters, when the skin may itch or tingle. The disease is most contagious when the sores are open and least contagious when the skin is normal. Outbreaks last about two weeks, but afterwards, the virus remains in the body. It can become active and cause an outbreak again at any time. Some people never experience more than one outbreak while others have frequent outbreaks.
Although no cure exists for herpes, over the course of a few years, outbreaks tend to become less frequent, usually ending almost entirely within five or six years.
Transmission of herpes from mother to baby during delivery can have grave consequences. However, infection is less likely to occur during a herpes recurrence than an initial episode.
Prevention: Frequently, people experience warning signs before an outbreak, when herpes is most contagious. These include a tingling, burning or itching sensation. That's a signal to avoid sexual contact of any kind until the outbreak is over and all signs of sores and scabs have disappeared. Between outbreaks, condoms can help reduce the spread of herpes between asymptomatic people.
How you get herpes: Skin-to-skin contact with an infected person who may or may not exhibit symptoms, including kissing or any form of sexual contact.
Symptoms: Blisters or open sores ;Pain;Itching,Flu-like symptoms during first episodes.
Diagnosis: Fluid is taken from sores and tested in the laboratory
Treatment:Cannot be cured; symptoms may be suppressed or relieved with medication

Common Sexually Transmitted Diseases(Chlamydia)

It's called the silent STD. Chlamydia is the most common bacterial sexually transmitted disease in the United States, with about 4 million new cases reported each year. There are usually no early symptoms of Chlamydia, which, in part, explains the high incidence of the disease. Chlamydia can cause infertility in both men and women. The disease can be cured with antibiotics.
Chlamydia occurs four times more often than gonorrhea. A pregnant woman may pass the infection to her baby during delivery, causing infection of the eyes or possibly pneumonia.
Prevention: Many doctors recommend everyone who has had more than one sex partner, especially women 25 and younger, be tested for Chlamydia infection regularly, even if they have no symptoms. Using condoms or diaphragms during sexual intercourse may help reduce the transmission of Chlamydia.
How you get Chlamydia:Unprotected vaginal, oral or anal sex with an infected partner.
Symptoms: Frequently none ,Genital discharge;Bleeding between periods;Low-grade fever;Painful urination or intercourse;Inflamed or itchy rectum;Conjunctivitis
Diagnosis:Laboratory testing of genital secretions or urine sample.
Treatment:Antibiotics

Benign Prostatic Hyperplasia

The prostate normally enlarges in men as they age. However, not all men develop symptoms of BPH.
A derivative of the male hormone testosterone called dihydrotestosterone (DHT), which is concentrated in the prostate, may be associated with growth of the prostate. As men age, their bodies don't produce as much testosterone. However, DHT is still produced. Because the DHT is concentrated in the prostate, this may encourage cell growth.
Another theory talks about the proportions of estrogen and testosterone in a man's body. As men age, there is a higher proportion of estrogen compared to testosterone. Animal studies have suggested that higher amounts of estrogen within the prostate gland may trigger substances that promote prostate cell growth.
It is not known what makes the prostate more or less susceptible to hormonal effects. Age, nationality or a family history of BPH may account for this susceptibility to some extent.

Benign Prostatic Hyperplasia

Prostate gland
The prostate is a walnut-sized gland that makes up part of the male reproductive system. The prostate gland makes some of the milky fluid (semen) that carries sperm. It is located in front of the rectum and just below the bladder, where urine is stored. The prostate gland surrounds the urethra, the canal through which urine passes out of the body. During a man's orgasm (sexual climax), muscles squeeze the prostate's fluid into the urethra. Sperm, which are made in the testicles, also go into the urethra during orgasm. The milky fluid carries the sperm through the penis during orgasm.
Prostate gland enlargement
It is common for the prostate gland to enlarge as men age. The enlargement of the prostate gland is called benign prostatic hyperplasia, or BPH. Most enlargements are NOT due to cancer.
Though the prostate continues to grow during most of a man's life, the enlargement doesn't usually cause problems before age 40. However, more than half of men in their 60s and as many as 90 percent in their 70s and 80s have some symptoms of BPH, according to the National Institutes of Health.
As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the prostate to press against the urethra. This causes the wall of the bladder to thicken and become irritated. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
Eventually, the bladder weakens and loses the ability to empty itself completely, so urine remains in the bladder. The narrowing of the urethra makes the urine stream weak and leads to straining in an attempt to empty the bladder. The most common cause of difficulty with urination in men is enlargement of the prostate gland.
Symptoms May Include:
Difficulty starting to urinate
Weak urination stream
Interruption of urination stream
Dribbling at end of urination
Sensation of incomplete bladder emptying
Urge to urinate frequently, especially at night
Deep discomfort in lower abdomen
Incontinence

Can a Vitamin Cut Prostate Cancer Risk

Simply being male and getting older puts you at risk for prostate cancer. But could you cut that risk if you took common vitamins and minerals?
Preliminary evidence suggests that you can. Vitamin E and the mineral selenium have been shown in some small studies to cut the risk of prostate cancer between 30 percent and 60 percent. Now, researchers are giving the vitamin and mineral a second look in the largest-ever prostate cancer prevention trial.
More than a few good men
The National Cancer Institute (NCI) and a network of researchers known as the Southwest Oncology Group (SWOG) are looking for "quite a few good men" to participate in the Selenium and Vitamin E Cancer Prevention Trial, or SELECT, according to Charles A. Coltman Jr., M.D., chairman of SWOG and director of the San Antonio Cancer Institute in Texas.
The study will include a total of 32,400 healthy men of all races and ethnic backgrounds who are age 55 and older (50 and older for African-American men).
"Previous research with vitamin E and selenium - in studies that focused on other kinds of cancer - suggested that these nutrients might prevent prostate cancer. SELECT is focused on prostate cancer, and when the study is finished, we will know for sure whether these supplements can prevent the disease," Coltman says.
During the next 12 years, doctors in medical centers across the United States, Puerto Rico and Canada will follow participating patients to see whether those taking vitamin E and/or selenium develop cancer less frequently than those taking placebos.
The American Cancer Society (ACS) says men who participate in the study not only have a chance to prevent prostate cancer for themselves but also may help their sons and grandsons live free from the disease.
Prostate cancer is the most common cancer among men, except for skin cancer. In 2006, about 234,460 new cases of prostate cancer will be diagnosed in the United States. Though slow-growing and easily treated in the early stage, prostate cancer, unfortunately, usually isn't diagnosed until the disease has advanced. The ACS estimates more about 27,350 will die from the disease in 2006.
Three-fourths of men who are diagnosed are 65 and older. Your risk for developing prostate cancer is higher if your father or brother has had the disease. It is much more common in African-American men than in Caucasian men and less common in Asians and Native Americans.
Early evidence encouraging
The SELECT study is an outgrowth of two studies. In 1996 selenium was studied for the prevention of non-melanoma skin cancer in 1,000 men and women. It wasn't found effective for skin cancer prevention, but investigators did report a 60 percent decrease in the incidence of prostate cancer. Then, in a lung cancer study published in 1998, more than 29,000 male smokers took beta-carotene and vitamin E to determine if these supplements have any lung cancer prevention benefit. Again, the study revealed an unexpected result. Neither of the nutrients showed any effect against lung cancer, but those who took vitamin E had 32 percent less prostate cancer than the general population.
Vitamin E and selenium are antioxidants, which are nutrients believed to help control cell damage that can lead to cancer. Both vitamin E and selenium are normally found in water and food in small amounts. Selenium is especially found in meat, seafood and Brazil nuts. Good sources of vitamin E are vegetables, vegetable oil, nuts and egg yolks.
Because the earlier studies are promising, the Prostate Cancer Research Institute (PCRI) recommends both vitamin E and selenium as part of a diet to reduce the risk of prostate cancer. Seidmon recommends that men start taking vitamin E and selenium supplements by age 40. PCRI is a nonprofit educational and research center in Los Angeles founded by two medical oncologists.
How much to take
If you want to take these nutrients as part of your own health regimen, the daily amounts recommended in the study, 200 micrograms of selenium and 400 International Units of vitamin E are more than what's typically found in a multivitamin.
Some evidence suggests that a diet high in animal fat may increase your risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk. A few studies have suggested that having a vasectomy might increase a man's risk for prostate cancer. However, the NCI says this finding has not been supported.
When should you get screened?
All men with a family history of prostate cancer or breast cancer on their mother's side are advised to have a yearly PSA blood test and digital rectal testing starting between ages 35 to 40, according to the PCRI.
In a digital rectal exam, the doctor uses his finger to feel if the prostate is enlarged, a sign that a cancerous tumor may be present. Also, the PSA test can detect levels of prostate specific antigen, or PSA, which is a hormone in the blood. Normally, the PSA level is between zero and four.
If the annual test shows that the PSA level is increasing, then further evaluation is recommended. Even if it's within the normal range, when the number is increasing, there should be additional testing with an ultrasound and biopsy, the PCRI urges.
If there's no family history of prostate or breast cancer, the PCRI recommends annual testing for all men starting at age 40. The American Urologic Association has a more specific recommendation; it suggests annual testing at age 40 for all black males and age 50 for all white males.
"We know that between 10 percent and 20 percent of all men have occult-stage cancer," says E. James Seidmon, M.D., professor of urology and diagnostic imaging at Temple University Medical School in Philadelphia. In occult-stage cancer, the cancerous cells are present, but there are no symptoms.
"The cancer is there and it's growing, but because it's so slow-growing, we have to wait until we see the rise in PSA to find it. The majority of diagnoses are being made this way," states Seidmon.

Know Your Prostate Cancer Risks

Most men are offered prostate screening starting at age 50. However, some would benefit from screening at an earlier age. African-Americans, for instance, are nearly twice as likely to develop prostate cancer. A family history of prostate cancer is also a major risk factor. About 10 percent of cases are associated with family history, where the heredity pattern for prostate cancer is between father and son or two brothers. Research implicates specific gene mutations in these families that lead to prostate cancer susceptibility.
Earlier screening
If your brother or father had prostate cancer, your own risk doubles and continues to rise with the number of relatives having the disease. If they developed prostate cancer at a young age, the risk is still higher. For men without any relatives with prostate cancer, screening tests (DRE and PSA) should begin at age 50. For those with a first-degree relative (father or brother) with prostate cancer, doctors offer screening at 45.
The importance of family history
If your father or brother has prostate cancer, you are more likely to develop the disease six or seven years earlier than men without any history of prostate cancer in the family.
The more relatives, the higher the risk. Three or more relatives increase the risk by 35 to 45 percent.
If your father was diagnosed younger than age 60, your risk is about 20 percent greater than the general population.
The prostate gland and screening
The prostate gland sits below the bladder, in front of the rectum and surrounds the urethra (urine tube) that leads into the penis. The prostate turns the semen into a favorable environment for sperm. The screening tests take advantage of the prostate's relatively easy access and one of its products, prostate specific antigen (PSA).
Digital rectal exam (DRE)
The back portion of the prostate is close to the rectum. So a doctor can feel the surface of the prostate by inserting a gloved finger and feeling for lumps or any irregularities on the surface.
Prostate specific antigen (PSA) test
The PSA is a blood test for a protein unique to the prostate gland. Most PSA exists in semen, but a small portion of it is circulating in the blood. If greater than a count of 4, the risk for prostate cancer increases. The "normal" for each man depends on several factors, including age and size of the prostate. An elevated PSA level may also indicate that there is an infection of the prostate (prostatitis). Doctors don't make any decisions based on a single PSA reading, but observe changes in PSA over time. The results help the doctor decide whether a biopsy is necessary to see if there is cancer within the gland.
What you can do
Know your prostate family history: Who has or had prostate cancer? At what age were they diagnosed?
Don't panic if you find out there is a family history of prostate cancer. Remember: prostate cancer grows very slowly compared to other kinds of cancer. Thus, if diagnosed early enough prostate cancer can be cured.
Get screened. The American Cancer Society recommends that men with a family history of prostate cancer be screened at age 45 (usually screening starts at 50).

Prostatitis

Prostatitis is an inflammation of the prostate gland, a common condition in adult males. Often caused by infection, prostatitis may develop rapidly (acute) or slowly (chronic).
Description
Prostatitis may be the symptom-producing disease of the genitourinary tract for which men most often seek medical help. About 40% of visits to a specialist in genitourinary problems (urologist) are for prostatitis. Forms of prostate inflammation include acute and chronic bacterial prostatitis and inflammation not caused by bacterial infection. A painful condition called prostatodynia, which may be caused by abnormal nerves or muscles in the region, is also thought to be a form of prostatitis. The chronic bacterial form is sometimes experienced by men whose sex partners have a bacterial infection of the vagina, making this a sexually transmitted disease. Other cases occur when small stones form within the prostate and become infected. Sometimes infection is caused by poor hygiene, surgical procedures, or even swimming in polluted water.
The sexually transmitted disease gonorrhea may sometimes cause prostatitis, and tuberculosis may spread to the prostate. Parasites and fungi may infect the prostate gland. Some men whose prostatitis is not caused by any microorganism have microscopic collections of cells called granulomas in their prostate tissue. Whether viruses also may cause prostatitis is debatable.
Causes and symptoms
However the inflammation may begin, it causes blockages in the tiny glands within the prostate so that secretions build up, and the prostate swells. In acute cases, this swelling can occur very suddenly and cause considerable pain. When prostatitis develops gradually, trouble with the flow of urine may be the first symptom. Small stones may form, because the body attempts to neutralize bacteria by coating them with calcium. These stones may become infected themselves and make the condition worse.
Symptoms and signs that are typically experienced by men with prostatitis include:
Difficulties in urinating. Most urinary problems are caused when the swollen prostate blocks the tube that carries urine from the bladder to the outside of the body (urethra). Patients feel the need to urinate more often than usual, often urgently. Urination is sometimes painful. It is hard to start the flow of urine and difficult to totally empty the bladder. Patients wake up at night to urinate. The stream may be weak or split. Dribbling after attempts to urinate may leave embarrassing wet spots on clothing. In severe prostatitis blood or sand-like particles (small calcium collections) may be passed in the urine.
Pain. Besides pain when urinating, caused by prostate swelling, stimulation of nerves in the prostate gland may cause pain in the penis, one or both testicles, the lower stomach, the low back, and the area between the scrotum and the anus (perineum). Some patients experience pain during or after ejaculation, whenever they sit down or walk, or during bowel movements.
Sex and fertility. The pain of prostatitis can make it impossible to enjoy sex. Men with prostatitis may be troubled by early release of sperm (premature ejaculation). Occasionally there is blood in the semen. Some of the drugs prescribed to ease the flow of the urine can dampen the desire to have sex. Because the normal prostate secretions make up part of the semen, prostatitis may lower fertility by severely lowering the number of sperm and making them less mobile.
Psychological problems. A man with prostatitis who feels that nothing can be done and he "just has to live with it" may experience serious depression. Low sexual desire certainly contributes to depression.
A person with acute prostatitis may suddenly develop fever and chills, along with rapidly developing urinary symptoms and pain in the perineum or low back. This state is a medical emergency that demands immediate medical help.
Most often the symptoms and physical findings are enough to form a diagnosis of prostatitis. When the examiner inserts a finger in the rectum, the swollen prostate can be felt; it may be extremely tender when probed. Squeezing the gland slightly will produce a few drops of fluid that may be cultured to learn whether bacteria are present. The fluid typically contains a large number of white blood cells, especially the cells used to fight off infection (macrophages). Note: too much pressure on the prostate can force bacteria into the blood and cause a serious general infection. Many patients with chronic bacterial prostatitis also have recurring urinary tract infections (diagnosed by examining and culturing urine samples). These infections can be an important clue to the diagnosis. If doubt remains, the urologist may insert a special instrument called a cystoscope through the penis to directly view the prostate from inside and see whether it looks inflamed.
Acute prostatitis is first treated with antibiotics. Even though it may be difficult for drugs to actually get into the inflamed prostate, most patients do quickly get better. If intravenous antibiotics are needed or the bladder is retaining urine, a hospital stay may be necessary. Broad-spectrum antibiotics that work against most bacteria are used first. At the same time tests are done with samples of prostatic fluid to determine which bacterium is causing the infection, so that drugs can be prescribed to fight the specific germ. In chronic cases, the best results are obtained with a combination of the antibiotics trimethoprim and sulfamethoxazole. Oral antibiotics should be given for one to three months; longer, if necessary. If a fungus or some other organism is causing infection, special drugs are available. If chronic prostatitis continues despite all medical efforts and is seriously affecting the patient's life, the prostate may be removed surgically.
Nonbacterial prostatitis requires other measures to relieve urinary symptoms. These measures include drugs that fight inflammation (steroids or nonsteroids) and a type of drug called an alpha-blocker that reduces muscle tension. Reduced muscle tension eases urine flow, allowing the bladder to empty. A narrowed urethra may be widened by placing a collapsed balloon at the site of obstruction and expanding it. This procedure is called balloon dilation. The effects of such dilation are usually temporary. Some physicians believe that stress is an important factor in prostatitis, and therefore prescribe diazepam (Valium) or another tranquilizer. The type of prostatitis known as prostatodynia is usually treated with a combination of muscle relaxing drugs, heat, special exercises, and sometimes a tranquilizer.
There are a number of "tips" for relieving symptoms of prostatitis. They are especially helpful early on, before antibiotics have a chance to cure infection, or for patients with chronic or non-bacterial prostatitis:
Hot sitz baths. Exposing the perineum to very hot water for 20 minutes or longer often relieves pain.
Ice. When heat does not help, ice packs, or simply placing a small ice cube in the rectum, may relieve pain for hours.
Water. A patient who has to urinate very often may want to cut back on his fluid intake but this will cause dehydration and increase the risk of bladder infection. Instead, it is best to drink plenty of water.
Diet. Most doctors recommend cutting out--or cutting down on--caffeine (as in coffee or tea), alcohol, and spicy or acid foods. Constipation should be avoided because large, hard bowel movements may press on the swollen prostate and cause great pain. Bran cereals and whole-grain breads are helpful.
Exercise. It is especially important for patients with chronic prostatitis to keep up their activity level. Simply walking often will help (unless walking happens to make the pain worse).
Frequent ejaculation. Ejaculating two or three times a week often is recommended, especially when taking antibiotics.
A treatment popularized in the Philippines is called "prostate drainage." At regular intervals, a finger is inserted into the rectum, to exert pressure on the prostate at the same time that an antibiotic treatment is given. Acupuncture and Chinese herbal medicine also can be effective in treating prostatitis. Nutritional supplements that support the prostate, including zinc, omega-3 fatty acids, several amino acids, and anti-inflammatory nutrients and herbs, can help reduce pain and promote healing. Western herbal medicine recommends saw palmetto (Serenoa repens) to support the prostate gland. Hot and cold contrast sitz baths can help reduce inflammation.
Most patients with acute bacterial prostatitis are cured if they receive proper antibiotic treatment. Every effort should be made to get a cure at the acute stage because chronic prostatitis can be much more difficult to eliminate. If the acute illness is not controlled, complications such as a localized infection (prostatic abscess), kidney infection, or infection of the blood (septicemia) may develop. When chronic prostatitis cannot be cured, it still is possible to keep urinary symptoms under control and keep the patient active by using low doses of antibiotics and other measures. If a man with any form of prostatitis develops serious psychological problems, he should be referred to a psychiatric specialist.
Potential sources of infection should be avoided. Good perineal hygiene should be maintained and sex should be avoided when one's partner has an active bacterial vaginal infection. If the kidneys, bladder, or other genitourinary organs are infected, prompt treatment may prevent the development of prostatitis. By far the best way of preventing chronic prostatitis is to treat an initial acute episode promptly and effectively.

Premature Ejaculation (general view)

Premature ejaculation occurs when male sexual climax (orgasm) occurs before a man wishes it or too quickly during intercourse to satisfy his partner. Premature ejaculation is the most commonly reported sexual complaint of men and couples. The highest number of complaints is among teenage, young adult, and sexually inexperienced males. Increased risk is associated with sexual inexperience and lack of knowledge of normal male sexual responses. There are several reasons why a man may ejaculate prematurely. For some men, the cause is due to an innate reflex or psychological predisposition of the nervous system. Sometimes it can be caused by certain drugs, such as non-prescription cold medications. Psychological factors, such as stress, fear, or guilt can also play a role. Examples of psychological factors include guilt that the sexual activity is wrong or sinful, fear of getting caught, or stress from problems at work or home.
In general, symptoms are when a male reaches climax in less than two minutes or when it occurs before the male or couple want it to occur. There are no tests used to diagnose premature ejaculation. It is usually determined by the male involved based on his belief that he reached orgasm too quickly. General guidelines for premature ejaculation is if it occurs in two minutes or less, or prior to about 15 thrusts during sexual intercourse. In 1966, William H. Masters and Virginia E. Johnson published Human Sexual Response, in which they broke the first ground in approaching this topic from a new perspective. Their method was devised by Dr. James Seman and has been modified subsequently by Dr. Helen Singer Kaplan and others.
A competent and orthodox sex therapist will spend much more time focusing on the personal than the sexual relationship between the two people who come for treatment. Without emotional intimacy, sexual relations are superficial and sexual problems such as premature ejaculation are not always overcome. With that foremost in mind, a careful plan is outlined that requires dedication, patience, and commitment by both partners. It necessarily begins by prohibiting intercourse for an extended period of time-at least a week, often a month. This is very important to the man because "performance anxiety" is the greatest enemy of performance. If he knows he cannot have intercourse he is able to relax and focus on the exercises. The first stage is called "sensate focus" and involves his concentration on the process of sexual arousal and climax. He should learn to recognize each step in the process, most particularly the moment just before the "point of no return." Ideally, this stage of treatment requires the man's partner to be devoted to his sensations. In order to regain equality, he should in turn spend separate time stimulating and pleasing his mate, without intercourse.
At this point the techniques diverge. The original "squeeze technique" requires that the partner become expert at squeezing the head of the penis at intervals to prevent orgasm. The modified procedure, described by Dr. Ruth Westheimer, calls upon the man to instruct the partner when to stop stimulating him to give him a chance to draw back. A series of stages follows, each offering greater stimulation as the couple gains greater control over his arousal. This whole process has been called "outercourse." After a period of weeks, they will have together retrained his response and gained satisfactory control over it. In addition, they will each have learned much about the other's unique sexuality and ways to increase each other's pleasure.
With either technique, the emphasis is on the mutual goal of satisfactory sexual relations for both partners.
However, the 1990s ushered in a new era in the treatment of premature ejaculation when physicians discovered that certain antidepression drugs had a side effect of delaying ejaculation. Clinical studies have shown that a class of antidepressants called selective seratonin reuptake inhibitors (SSRIs) can be very effective in prolonging the time to ejaculation. The individual drugs and the average amount of time they delay ejaculation are fluoxetine (Prozac), one to two minutes with doses of 20-40 milligrams per day (mg/day) and eight minutes with 60 mg/day; paroxetine (Paxil), three to 10 minutes with doses of 20-40 mg/day; and sertraline (Zoloft), two to five minutes with doses of 50-200 mg/day.
There are several alternative products, usually found in health food and nutrition stores, designed to be sprayed or rubbed on the penis to delay ejaculation. Although the products promise results, there are no valid clinical studies to support the claims. A device called a testicular restraint, sold through erotic mail-order magazines, sometimes helps men delay ejaculation. The Velcro-like device restrains the testicles from their natural tendency to move during sex. Testicular movement can cause premature ejaculation.
The "squeeze technique" has elicited a 95% success rate, whereby the patient is able to control ejaculation. Treatment with SSRIs is effective in 85-90% of cases. However, the effectiveness begins to decrease after five weeks of daily administration. Although more studies are needed, this suggests the SSRIs are more effective when used on an as-needed basis.
The best prevention is obtaining adequate information on normal sexual responses of males before having sex. It is also helpful to have sex in a comfortable, relaxed, private setting, free of guilt, stress, and fear.

Erectile Dysfunction and Hypertension

Recent analyses suggest that about 67-68% of men with hypertension have some degree of erectile dysfunction (ED). With about 25 million men in the US with hypertension, substantial numbers of hypertension-related ED exist that tend to be of a more severe nature than the general population. Men with ED are also more likely to have hypertension. Thiazide diuretic and beta-blocker therapy may contribute to ED. Phosphodiesterase-5 (PDE5) inhibitors are effective therapy in men with ED owing to hypertension who are taking antihypertensive medicines including those on multiple antihypertensive medicines. The addition of PDE5 inhibitors to usual common antihypertensive medicines (diuretics, beta blockers, calcium blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers) results in either no or small additive reductions in blood pressure (BP) and no increase in serious clinical adverse events. There are however precautions regarding the use of PDE5 inhibitors in patients taking alpha blockers for either hypertension or benign prostatic hypertrophy, as some patients may develop orthostatic hypotension. Organic nitrates remain an absolute contraindication for PDE5 inhibitors because synergistic and symptomatic reductions in BP may occur in some patients with this drug combination.

Erectile Dysfunction.4

Oral pharmacotherapy is very effective and safe method for Erectile Dysfunction, especially the advent of phosphodiesterase type 5 inhibitors: sildenafil, tadanafil and vardenafil. Sildenafil was the first PDE5 inhibitor and >20 million men have been treated in the 6yr since its launch. It is effective after 30-60 mi from administration. Tadanafil is effective from 30min after administeration, but its peak efficacy is expected in about 2 h. efficacy is maintained for up to 36h. Its efficacy is not influenced by food. Vardenafil is effective after 30min from administeration. Its effect is reduced by a heavy fatty meal.

Life Science.Stem Cell

The study of stem cell stem from the research of mouse embryonal carcinoma cell. Stem cell is a kind of cell that can self-renewal and can be differentiated into other kinds of cells. Nowadays, the main content of the study of stem cell is the separation, identification, self-renewal and the plasticity of stem cell. Clinic application is the ultimate aim of scientist, but it seems that more research is still required before final goal can be completed.

Erectile dysfunction.2

Erectile Dysfunction is ver common in aging man. Statistical data from MMAS (Massachusetts Male Aging Study)shows the overall probability of complete impotence tripled from 5% in subjects 40 years old to 15% in subjects 70 years old. There are also other studies which support this view. The reason why the prevalence of ED in aging man is so high is associated with many factors. Treatment for ED in aging man is recommended by EAU with two-steps therapy, which will be discussed in detail in the later.

Prostate Cancer

Prostate Cancer is the most frequently diagnosed cancer in men, especially in west countries. Thanks to the discovery of Prostate Specific Antigen, which serves as a mark of prostate cancer, the disease could be found in an early-stage. prostatectomy or radiation, the most common treatments for localized disease, have a high rate of cure. Treatment for advanced disease includes hormonal treatment (also known as androgen deprivation therapy) and chemotherapy. A number of new, promising agents are currently in development. Especially findings of susceptive genes could bring more revolutions

Premature Ejaculation.1

Definitely, Premature Ejaculation is another disease that embarrassed men. In fact, the concensus of the difinition of Premature Ejaculation have not reached by far. The etiology of Premature Ejaculation is complexed, including psychogenic and organic. It seems that psychogenic factors account for the most of Premature Ejaculation. The recent advances, including the etiology,epidemiology and treatment, about Premature Ejaculation will be elaborated in the later.

Erectile dysfunction.1

the difinition of erectile dysfunction is that: The inability to achieve and maintain an erectile sufficient to permit satisfactory sexual intercourse. many studies show that erectile dysfunction is associated with many diseases bisides itself organic and psychogenic causes, including hypertension, diabetes and depression. oberviously , the application of PDE5 inhibitor successfully improves the life of ED patients ,but its etiology still remains to be futher studied.

Men.Sex.1

Weekly, I make cavernosography for patients who were diagnosed with Erectile Dysfunction. Most of them were found problems with penile arteriovenous fistula. Sometimes, The results confused me since nothing could be found to be responsible for the arteriovenous fistula. Recent study of epidemiology shows organic reason is mainly the etilogy of Erectile Dysfunction(ED is classified with psychogenic, organic and mixed)

On The Road Of Medicine

Medicine is a kind of science that is profound and elaborate. Although it is an extremely old science, There are still a lot which are waitting for us to explore. miserably and mirthfully, I became a medical student in order to satisfy my parents desire. On the road of medicine, I find a truth: the more you learn, the less you know.