Articles on mammal male reproductive system

Hot Bath Tubs Can Kill Male Fertility

Dr. Bhavatej Enganti, Urologist
Are you a man madly in love with hot bath tubs or hot and relaxing Jacuzzi baths? It’s time to fall out of your love if you are planning a family. According to the researchers of the University of California, the constant exposure to the ‘wet heat’ can kill your fertility.Though this theory initiated as a speculation, a study conducted by a group of Urologists in the University of California helped it gain more factual ground. The study was conducted on a group of men who were used to hot bath tubs or hot water bath on a regular basis. They were exposed to water with higher temperature for at least 30 minutes in a week. When their semen samples were examined, it showed low sperm production and poor sperm motility rate compared to those who were less exposed to this type of heat.Men who have already been diagnosed with fertility disorders, over exposure to heated water can worsen the matter for them. However, the silver lining in this cloud is that the effect can be reversed. If you discontinue taking hot water baths for a considerable time; things tend to change for good. Men who kept away from hot bath tubs or hot water baths could see an increase in the production of healthy sperm having good motility rate in their semen. Their sperm count increased up to 49 percent.However, in some men this reversed infertility was not seen even after they reverted from the wet heat. This was basically due the effect of tobacco or the “gonadotoxic habit”. Most of them were found to be chain smokers.To conclude, constant exposure to wet heat can affect male fertility adversely. So, if you are eager to become a father, stop spending hours in hot bath tubs. It might be relaxing your mind and freshening up your tired body, but it is killing your fatherhood hopes silently.

Infertility Factors in Males and Females

Dr. Kaushal Kadam, Gynecologist/Obstetrician
In medical terms, infertility is referred to as a woman’s inability to conceive, even after a year of unprotected intercourse. Although infertility is considered to be a concern often associated with women, not many people know that male-related infertility accounts for one-third of the cases. Studies also indicate that the infertility cause remains unidentified in 25% of couples planning to have a baby.Here are some common and not-so-common factors of female and male infertility:Infertility in WomenCommon Factors·      Tubal Disease – damage or blockage of the Fallopian tubes.·      Ovulatory dysfunction or an ovulation – egg is not released from the ovary every month.·      Endometriosis – affects the function of the Fallopian tubes, uterus and ovaries.·      Uterine or cervical abnormalities – abnormalities in the shape or cavity of the uterus or problems with the opening/closing of the cervix.·      Gynecological problems - previous ectopic pregnancy or more than one miscarriage.Less Common Factors·      Premature menopause·      Use of medications that induce temporary infertility·      Polycystic Ovary Syndrome (PCOS)·      Absence of menstruationInfertility in MenCommon Factors·      Low sperm count or quality·      Problems with the delivery of sperm·      Erectile dysfunction·      Premature ejaculationLess Common Factors·      Inflammation of testes (Orchitis)·      Blocked testicle(s)·      Any drug treatment or exposure to chemotherapy, saunas or hot tubsSome common factors which can lead to infertility issues in both men and women are:·      Genetic abnormalities·      Lifestyle factors such as being overweight, stress, smoking, drugs or contact with/ingestion of harmful chemicals.·      Medical conditions like diabetes, epilepsy and thyroid (mostly in women).·      Age-related infertility - though it affects females more (after the age of 35), males suffer from it too.Medical tests could help to determine the actual cause of infertility, and artificial treatment options available to the couple thereafter.

Let's Talk About Men's Health!

Dr. Anish Kumar Gupta, Andrologist
In general, men have poorer health habits, poorer quality of health and shorter life expectancy than women. This may be because they are more likely to engage in unhealthy behaviour, and are at times less likely than women to adopt preventive health measures. But men’s health issues don’t affect only men - they have a significant impact on their family and friends, too.The conditions we will talk about can influence everything from sexual and marital relations to quality and length of life. Unfortunately, a lot of these issues - particularly the ones having to do with sex or masculinity - are very hard for men to talk about.TestosteroneTestosterone is the most important hormone for the normal growth and development of male sex and reproductive organs. it’s possible for the development of male characteristics such as body and facial hair, muscle growth and strength, and deep baritone of voice. Normal levels influence sexual function and production of sperm, and promote a healthy sex drive.Men’s testosterone levels naturally decrease as they age. But if the levels drop below the normal range - whether because of age, injury to the testicles, pituitary gland or hypothalamus, or a genetic disorder - some uncomfortable and often distressing symptoms may develop, including:1.     Diminished interest in sex.2.     Regression of secondary sexual characteristics, such as facial hair and deepening of the voice3.     Impotence or Erectile Dysfunction.4.     Depression5.     FatigueAs many as 50 million men are assumed to be suffering from testosterone deficiency, often associated with a condition called hypogonadism, but less than 1% receive treatment in India. Left unchecked for two long, this condition is linked with significant, long term health problems, such as loss of muscle mass and even osteoporosis.Fortunately, though, testosterone deficiency is usually very treatable.Treatment can take the form of testosterone replacement therapy, which helps provide and maintain normal levels of testosterone. Men should ask their doctors whether testosterone replacement therapy is appropriate for them.Hypogonadism is covered in another article written by me.ProstateThe prostate is a walnut sized gland that manufactures fluid for semen. It’s located just in front of the rectum, an area of the body that men are often embarrassed to talk about.Prostatitis is a significant health concern for men. While the cause of prostatitis are not well understood, it is believed that the condition might be caused by a bacterial infection or a inflammatory autoimmune response similar to that seen with allergies and asthma. Symptoms may include a discharge, discomfort, pain in the prostate or testicles, or frequent urination. A urologist should be consulted for proper treatment.The prostate naturally enlarges as men age. Early affects of this growth ( called BPH for benign prostatic hypertrophy) include painful urination or difficulty starting or stopping the stream of urine. Left untreated, BPH can lead to more serious problems, such as urinary tract infections, bladder and kidney damage, kidney stones or incontinence.Prostate CancerIt is the one of the most common cancer in men. Every year, over 200,000 men are diagnosed with this disease, and approximately 30,000 die. But if caught early, through either a digital rectal examination (DRE) or a prostate specific antigen (PSA) blood test, this disease is often treatable. In the early stages, prostate cancer causes no symptoms. However, as the disease develops, so do the red flags. Men should notify a doctor immediately if they notice any of the following1.     Hip or back pain.2.     Difficulty urinating.3.     Painful or burning urination.4.     Blood in the urine.A man may consider a baseline prostate specific antigen after knowing and understanding the natural history of the disease, complications of treatment and life expectancy. The baseline test can be done at an age of 40 years, though, recommendations vary. Asian population at large is known to have less incidence of prostate cancer as compared to our western counterparts. (Who is fit for Prostate Cancer Screening, would be covered in different article) TreatmentOptions for Cancer Prostate include surgical removal of Prostate, radiation, hormone therapy, immunotherapy and cryosurgery. Men with localised, low risk prostate cancer might choose active surveillance, closely monitoring the cancer to see if it progresses or becomes aggressive, to determine if treatment is needed. Options and possible side effects of treatment should be discussed with a urologist.Prostate cancer - Misconceptions Part 1 has been covered in another article.Testicular CancerCancer of the testicles is the most common cancer in the ages 15 to 35. Although it can’t be prevented, it has a high cure rate if detected early. Early detection is the key to success.Symptoms include:1.     Lumps / enlargement of testis.2.     A feeling of pulling or unusual weight in the scrotum.3.     Pain / discomfort in the testis or scrotum4.     Dull ache in the lower abdomen5.     Enlargement or tenderness of the breasts..The best way to spot testicular cancer is by doing a self examination. Unfortunately, too few boys and young men know that they should examine their testicles monthly, even fewer know how to do these exams, and too many feel uncomfortable touching themselves “down there”. So ask your loved one whether he knows how to do a testicular exam. If he doesn’t, encourage him to talk to his doctor about the proper way to do one. We will be also covering this topic in further articles.Testicular Self Examination has been covered in another article.ERECTILE DYSFUNCTION / IMPOTENCEIt is the inability of a man to get or to maintain an erection sufficient for his sexual needs or the needs of his partner. ED is incredibly common - most men have it briefly at some point in their lives. But for a many as 50 - 60 million men in India, ED is a chronic condition.Although ED becomes more common with age, men of any age can suffer with it. Sadly, they generally refuse to discuss  it with either their partner or their doctors. As a result, men feel embarrassed and women in their life often feel that the man in their life doesn’t find them attractive. So if you want to make love and your husband says he has a headache, pay attention; it might be something far more serious.Although 70% of the time, ED is caused by an underlying health problem, most often diabetes (as many as half of all men with diabetes suffer from ED). ED may also be caused by kidney disease, high blood pressure, high cholesterol, and drug or alcohol abuse or hypogonadism. The remaining 30% of the cases are cause by stress, anxiety, depression, or sometimes the medications used to treat these conditions.In most cases whether ED is caused by a physical or physiological problem, it’s treatable, which means it does not have to be natural or inevitable part of growing older. Treatments include drug therapy, penile implants, vacuum devices that manually create an erection, injections, or other alternatives. Your loved one should talk to his doctor to determine the cause and the most appropriate treatment.Erectile Dysfunction has been covered in detail in another article.

6 Tips for Improving Men's Health

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
So, some tips for men's health- as well as an attempt to eliminate some myths and misconceptions.Men’s health1. Stay healthyCheck regularly whether foreskin of penis (the skin covering the red portion of the penis, called “glans penis”) can be retracted backwards or not. This is for male who are not circumcised. And clean the materials (“white materials”- called smegma) collected beneath the skin regularly. If it cannot be retracted normally or during urination or intercourse, it is likely to be abnormal. And it may be a condition called “Phimosis”. If you feel you have phimosis or tight foreskin, do not force to retract it, because in doing so you will land up in more difficult and emergency situation, called “Paraphimosis”. So, only solution is to get it checked by doctor. Phimosis is common in males with diabetes and those having repeated infections. It can lead to further infections, problems during urination (that may even damage kidneys) and even cancer of penis in the long run.Do not ignore any abnormal swelling or ulcer or pain or tumour or any white or reddish patch in penis or scrotum. But some conditions are very normal like PPP (pearly penile papules) that look like small reddish or pinkish granules at the broader end of the glans penis. Similarly it is very common to have very dark pigmentation of penis and scrotum, even in very fairly skinned persons, especially in our country.Testicles should be checked regularly, at least once a week. Please remember, both testes are not of exactly same size and they do not lie exactly at the same level (one little above and one little low). And scrotum reacts with change of temperature. So, in cold days, scrotum contracts and you have scrotum lifted up so that testes lie at higher position. Conversely at warm days, they hang down more.But never ignore any injury, swelling or pain in scrotum or testes. Some peculiar sensation (“pain in lower abdomen”) is common during accidental pressing of testes and this indicates testes are normal. Absence of such sensation is usually abnormal. But if testicular pain persists you should not ignore it. The pain may be due to stone in kidney or infection in urine or testes or even tumour. And sharp stabbing pain indicates that there may be torsion which is a medical emergency (twisting of testis, if not treated early, can damage testes). The causes of testicular swelling are usually hydrocele (collection of water outside testes). Infection or tumour. Remember, testicular tumour or cancer is very common malignancy in young male but it responds well to treatment. Any swelling in scrotum above testes should also be noted. Sometimes it may be varicocele (swelling of veins above testes), hernia or some cysts.2. Urinary problemsDo not ignore if you have difficulty in urination like pain, requiring more pressure, increased frequency, difficult to start, not feeling any desire or very strong urge that is difficult to control. In younger age it is due to stone or infection or some narrowing of passage (urethral stricture). In older age, it is likely to be due to prostatic enlargement. Remember, prostate enlargement is common after 40 years but in very few cases, it may be cancer. Men with family history of prostatic cancer needs ‘cancer screening” like regular check up for detection of cancer in early stage.Blood in urine is another problem that indicates some injury or stone, tumour or infection. Even cancer in urinary tract can cause passage of blood in urine.3. Sexual ProblemsMost of the sexually active men are often obsessed about size of the penis. But it actually maters little for satisfaction unless it is abnormally low (“Micropenis”). Do not feel that the pictures shown in internet or film are real. So all the methods of ‘’enlargement techniques” are actually bogus. If it is micropenis, it needs proper evaluation to diagnose the cause of the cause and then the cause needs to be treated to achieve actual normal size.Masturbation is not harmful for sexual health except that it may interfere with concentration in other activities (like study and work) and sometimes can lead to premature ejaculation.Sometimes people complain about ‘’low sex stamina”. It is a vague term. It should be either of the three like low desire, erectile dysfunction (ED) or ejaculatory problems. Low desire for sex is a condition that needs proper evaluation to diagnose the cause. Remember, ”Viagra” is not the solution for each and every sexual problem. Low desire can be successfully treated if we can address the actual cause of such ‘’low desire”.ED is a common problem faced by many men, with increased incidence at older age. While some ED has psychological causes, majority of this can be due to some serious conditions like heart diseases, diabetes, nerve problems, hormonal problems, drugs and even some problems in penis itself etc. S, if you directly take “Viagra” without proper evaluation, you are actually damaging your health by delaying the diagnosis of heart disease or diabetes. Sometimes, it may be the earliest symptom of heart disease or diabetes. So, never ignore it.Painful erection, especially without sexual stimulation is called ‘Priapism” and thi is a quite serious problem. Not only it is caused by diseases like blood diseases, even cancers etc; it may damage the penis seriously.Any swelling of penis after intercourse should not be ignored, especially if it affects whole of the penis. This is called “Fracture of Penis” that is a medical emergency.Some people are facing problems with early ejaculation that leads to very low sex timing. This premature ejaculation (PE) is easily treatable by some drugs and few tips and exercises but it needs long term treatment. Please do not think that duration of ‘’normal” intercourse would be more than one hour. Anything around 5 minutes are sufficient for satisfaction.Similarly absence of ejaculation or presence of blood in semen or bleeding during intercourse are abnormal and needs medical attention, although these problems are relatively uncommon.4. InfectionInfection in sex organs may have long term consequences like urinary problems, infertility, sexual problems etc and so must not be ignored. All these have been discussed in point number one “”Stay Healthy”)5. Male InfertilityDue to changes in environment, food habits, addiction and pollution- male infertility is increasing. Semen test is integral part of male fertility testing. But remember, one abnormal semen analysis is not m=necessarily meaning that that person cannot father a baby. With advent of various treatment options, we need to know the cause of male infertility. The next plan is to treat the cause. Even if the cause cannot be treated, there is no loss of hope. Some male have normal sperm production in testes but sperms cannot come out in semen due to obstruction in the passage. In that case, collection of semen from testes can make that male father. On the other hand, if sperm is not produced inside the testes, we need to know the cause and then that cause should be corrected6. ContraceptionCondom is a very good method of contraceptive that also provides protection against infection. It prevents transmission of infection and STD (even HIV) from one partner to another. But correct use is very much important to know as often it breaks or slips due to incorrect use.Medical methods of male contraceptives (like pills) are not very much popular, unlike females, due to very few studies and serious side effects (like permanent sterility).Vasectomy is a very effective method of permanent family planning. It does not decrease sexual pleasure and needs very little operative time. It is very easy to do, even without need of hospitalization. But after vasectomy, the couple should use alternative contraceptive for at least 3 months, because immediately after vasectomy, the contraceptive benefits are not obtained.

Foreskin Problems in Boys

Dr. Sivasankar Jayakumar, Pediatric Surgeon
Foreskin is the piece of skin that covers the top of the penis. Foreskin problems such as tightness, ballooning, redness are very common. It can affect boys of all ages. Inadequate or incorrect information can cause confusion and anxiety to both patients and parents. This article will help parents to get some understanding on common foreskin problems in boys.Tight Foreskin or PhimosisIn boys, tight foreskin, also called as phimosis is very common. Because of the tightness, Sometimes the foreskin balloons at the time of passing urine. At birth, the foreskin is normally tight (Figure 1). However, as the boys get older, fluid is produced from the undersurface of the foreskin and makes it freely mobile. By the time the boys are around 10 years of age, the foreskin is completely free and mobile. Beyond the age of 10 years,if foreskins are not freely mobile, treatment is usually recommended.Figure 1: Normal tight foreskin    Figure 2: Flower appearanceAlthough tight foreskin is very common in young boys,it can also be seen after infection or inflammation of the foreskin. In a normal tight foreskin (physiological phimosis), pulling the foreskin back will show a flower like pink inner foreskin at the tip, as shown in Figure 2. However, if infection is present (pathological phimosis) the foreskin tip is flat and flower appearance is not seen.Inflamed ForeskinInflammation of the tip of the penis and foreskin (balanitis) are usually caused by chemical irritation, bacterial or fungal infection. The tip of foreskin becomes red, swollen and painful (Figure 3). After some time the inflamed foreskin becomes tight – as shown in Figure 4. Antibiotic and antifungal creams can be applied, along with regular warm sitz (antiseptic) bath and it usually works well.Figure 3: Balanitis         Figure 4: Inflamed & tight foreskin                                                 BXOInfected or inflamed foreskin should always be watched carefully, as they can result in a tight scar formation (BXO -Balanitis xerotica obliterans) (Figure 5). Steroid creams applied over the foreskin may improve the tightness, but not in all patients. In many patients, the tightness comes back immediately after stopping the cream applications. Most patients need circumcision (Removing the foreskin) which will cure the patient.Very rarely, the infection from the tip and head of the penis can spread into the whole penis. The whole penis appears swollen and red (Figure 6)and this condition is called balanoposthitis. Oral antibiotics (tablets and syrup) are usually not enough. Antibiotics given via the veins (intravenous) will reduce the redness and swelling quickly.Figure 5:BXO         Figure 6:Balanoposthitis                                ParaphimosisSometimes boys forget to pull the foreskin forward (back to normal) after cleaning or passing urine. The foreskin becomes red,swollen and appears like a balloon around the head of the penis (Figure 7). This is called paraphimosis and it is an emergency requiring surgery. If noticed early, the foreskin can be gently pulled forward to normal position under anaesthesia, otherwise the foreskin may need to be removed – circumcision.Figure 7: Paraphimosis.   Figure 8:Foreskin cystCysts in the foreskin are very common. The most common cysts are white in color and move along with the foreskin(Figure 8). They are not painful at all but can cause lot of anxiety. The normal fluid produced from the foreskin and glans (smegma) is trapped under the foreskin and forms a cyst. These cysts resolve on its’ own and do not need any surgery.

Defect of Low Sperm Count: The Way Forward

Dr. Sujoy Dasgupta, Gynecologist/Obstetrician
Semen analysis is an indispensable part of evaluation of an infertile couple. But the results of semen analysis often creates confusion. It is accepted that if semen analysis report is normal, male factor is usually said to be normal.Now what, if abnormality is found. Remember, semen abnormality is very common, even in those who are already having children. Because sperm production takes almost 3 months. So, your current semen analysis reveals your health 3 months ago. If you had fever or any heat exposure to scrotum (may be even tight underwear or hot tub bath) 3 months ago, your today's semen analysis will be abnormal. So, mere abnormality does not draw a conclusion, unless it is severely abnormal. Now, what we see in semen. There are various parameters. I'm not going into details. But to be simplified, sperm abnormality may be due to two basic reasons. 1) sperms are not produced by the testes in good quantity (amount) or quality (healthy- motility and looking normal). 2) sperms are produced normally by the testes but cannot come in semen due to defect in the sperm-carrying pathway (may cause low count, defective sperm and also low motility).One important thing is to remember, sperm production has nothing to do with manliness. You may feel absolutely normal with normal sex life but sperm production may be defective. So, first thing is not to feel depressed when the report comes abnormal. So, whenever we find abnormality, we have to detect the cause. Treatment without detecting thee cause is more likely to fail. So, first thing is- whether sperms are produced or not. Sperm production may be hampered due to diseases in testes- that may present since birth or may be due to some factors occurring later life. These include undescended testes, chromosomal defect, varicocele, diseases in the body (like tb, diabetes, kidney/ liver disease etc), heat exposure to scrotum, smoking, environmental poisons and even some drugs (including alcohol, marijuana, chemotherapy). These are called" testicular defects. In some cases, testes are normal but cannot produce sperms because of problems in other glands situated in brain (hypothalamus and pituitary). We call them" pre-testicular defects. Sperm carrying pathway may sometimes get obstructed due to diseases like infection, operations, some genetic defects. These are called" post-testicular or obstructive defects.In most cases of semen defect, treatment is not needed, as we can bypass the normal pathway and use the sperms produced in semen to make your partner pregnant with your own sperm. In severe cases, we can collect sperms from testes and impregnate your wife. In only very few unfortunate men or who cannot afford costly therapy, only option is donor sperm.In very few cases of testicular or pre_testicular defects, medicines can help (but in very few cases). In obstructive cases, surgery may be needed to correct the defect. But, often we don't need these treatments as the results are not good and take long time to get the results. So, why to wait and try doubtful treatments, when your prime aim is to father a baby? just one thing, don't get depressed and talk to doctor, he will find out the cause and give you the best result.

Does Penis Size Matter?

Dr. Khokar, Sexologist
While there is a common notion about the size of the penis and it being directly proportionate to the satisfaction factor, there are yet lot of other factors which actually contribute to attain mutual satisfaction.  It has become the mens ultimate desire to have the perfect size in order to satisfy a woman, but size very often is just an entity and not an asset.So does the penile size really matter?The size and it’s efficiency matters altogether different to various set of women.  Preferences vary from woman to woman.  Few would prefer the length and few the girth, but size, shape can never fully satisfy any woman.  It is a myth that size matters to woman.  There is a research which also talks about the length of the time you spend in the foreplay and the session actually impacting a woman’s satisfaction level to a much higher extent.  Men can put aside the worry about the size or shape because that is the only thing a woman is looking for.  Fact is women look for a whole lot of emotion quotients involved in the intercourse than the size and shape.What is the Average size of penis?The average size of an erect penis is about 5. to 6.2 inches.  Most of the men have fallen into the average slot, however, there is a very small percentage of adult men, about 0.6%, who suffer from a condition called micropenis which calls for medical attention.Size of penis and its effect on pregnancyThe required size of the penis to penetrate enough to impregnate is about 4 inches in the erect form.  There are lots of misconception with regards to this as to how the size effects reproduction.  Using certain positions such as missionary and slow withdrawal can help to a great extent.How penis size effects a man’s ego?Men have inhibitions about the size, it is an issue of their pride and ego.  Most of the times not having the right size becomes their greatest issue and this further alters their confidence level and affects their social life.  Feeling small, depression, inferiority complex, aggressiveness, withdrawal from society, shyness, solitude lifestyle, attention deficit syndrome many such psychological conditions can arise due to this small inhibition about size of penis.  In such acute conditions, it is better to immediately seek doctor’s or counselor’s advice.  It something bothers you to this level it is always better to talk to someone who know about this and will guide you in the right way.  Talking to your partner can also be of great help to you, by this you can know whether or not the size really matters to her.

Less Pleasure, More Pain- Is That How You See Intercourse?

Dr. Ramesh Maheshwari, Sexologist
DYSPAREUNIA (PAINFUL COITUS): Recurrent or persistent genital pain associated with sexual intercourse in either male or a female.In females, the pain may be superficial during penetration or deep during penile thrusting. The intensity of pain may range from mild discomfort to sharp pain. On examination, no genital abnormalities are seen. Repeated genital pain during coitus may result in the avoidance of sexual activity, disrupting existing sexual relationships.In Females, Dyspareunia can be of psychogenic or organic in origin-Pain in vaginal outlet and clitoris: If the hymen is intact, this is a source of irritation. Episiotomy scar can cause pain. Smegma accumulated under the foreskin of clitoris irritates the area and causes intense burning.Pain in the vagina: One of the common causes is failure to lubricate. This happens when the women has no affection, respect or understanding for her husband. Because of various fears like fear of pregnancy or of coitus, her natural responses will be inhibited. Many woman do not lubricate because of aging. Thin walls of vagina crack and bleed easily during the intercourse, causing discomfort that lasts for hours to days. Homosexual women will not lubricate in heterosexual activity. Infections of vaginal or urinary tract will give rise to burning, itching or pain in the vagina. When there is itching and burning but no infection, sensitivity to the rubber of condom is a possibility.Pain deep in pelvis: Laceration or tears in the ligaments which support the uterus, caused by gang rape or criminal abortion may result into pain deep in pelvis. It is associated with backache, throbbing in pelvis, tired feeling and painful menstruation . Endometriosis, infection in cervix, uterus, and tubes cause pain during thrusting . Infection can be due to gonorrhea or of E.coil.Hysterectomy, tumors and ovarian cysts can cause pain deep in the pelvis.Some men do not retract the prepuce during masturbation. Their glans of penis remains hypersensitive to touch. They find pain during coitus. In men with poor hygiene, the smegma accumulates on the glans, causing pain during coitus.Phimosis can cause pain during coitus. Allergy to condom rubber, jellies, foams and douching materials can give hypersensitivity reaction to the males. Infection of vaginal canal causes burning and itching. Fibrosis of penile tissue following a trauma causes pain during masturbation and intercourse.Reassurance, countering myths and misconceptions and supportive psychotherapy will be helpful in dyspareunia of psychogenic origin. Insufficient foreplay may lead to failure of lubrication in females. Thick hymen will need excision.Accumulation of smegma needs cleaning daily. Senile vaginitis requires hormonal replacement. Homosexual women are not amenable to any treatment.

Sexual Response Cycle in Males

Dr. Ramesh Maheshwari, Sexologist
Men and woman, with some sexually arousing stimulus, proceed through orgasm and end with a return of the body to a sexually unstimulated state. This is described in four stages: Excitement, Plateau, Orgasm, and Resolution. There is no sharply defined moments when one stage ends and the next begins. Each phase merges with the next phase.ExcitementMen: Erection of penis, marked increase in its size, and a rise in its angle. Erection may be triggered by penis itself or by sexually stimulating sight, smell or thought. It occurs in 3 to 8 seconds.A small penis may double in length, while in a large penis lengthening is less marked.Partial elevation and increase in the size of testes.Plateau Full erection of penis. Increase in size and full elevation of testes. Little secretion from Cowper’s glands appears at the Urethral meatus.OrgasmOrgasm occurs in two distinct stages. In the first stage the Vas deferens, the prostate and Seminal vesicles begin a series of contractions that forces semen into the bulb of the urethra. The man experiences a sensation of ‘Ejaculatory inevitability –the feeling of having reached brink of control. At this point ejaculation cannot be stopped. In the second stage of orgasm contraction of urethra and penis combined with contraction in the prostate to cause ejaculation (spurting of semen out of tip of penis). During ejaculation the neck of the urinary bladder is tightly shut to avoid any mixture of semen and urine. The rhythmic contractions of prostate, the perineal muscles and the penis occur initially at 0.8 seconds intervals.Male orgasm and ejaculation are not one and the same process. Although the two occur simultaneously, orgasm refers to muscular contraction and release of sexual tension, while ejaculation refers to the release of semen. Orgasm without ejaculation is common in boy before puberty.ResolutionMan is not able to have multiple orgasms. Immediately after the ejaculation man enters a ‘refractory period’ during which further orgasm or ejaculation is impossible. Usually the erection subsides quickly. There is grate variability in the duration of refractory period. It may last from few minutes to many hours. This period gets longer with each repeated ejaculation. As the man gets older, the refractory period gets longer. The period of return to the unaroused state is called the ‘resolution phase’. The anatomical and physiological changes that occurred during excitement and the plateau phase reverse. Blood is pumped out of penis and therefore loss of erection. The testes decrease in size and descend in scrotum.

Uterine Fibroids - Homoeopathy Can Save You From Surgery

Dr. Dhiraj Anuragi, Homeopath
What are uterine fibroids or myomasUterine fibroid or myoma is a non-cancerous i.e. benign growth in the uterus. They are also called fibromyoma, myofibroma and fibroleiomyoma.They vary in size, usually grow slowly, and may occur in the wall of the uterus or inside the cavity, in the cervix (the part below the uterus) or at times even on the outer side of uterus.They are usually made up ofmuscular or fibrous tissue of the uterus and blood vessels.Uterine fibroids or myomas are extremely common occur in 20 to 25% of women by age of 40 and 50% of women in general and are the most common cause of major surgery in women. They usually develop in women between 30 and 50 years of age.CausesNo one knows what exactly causes fibroids but their growth appears to depend on increases estrogen hormone levels.Because of this fibroids enlarge , during estrogen (hormonal) replacement therapy and pregnancy.Also oral contraceptives are know to cause them.SymptomsPatients may not have any symptoms and doctor discovering the uterine fibroids on physical examination or ultra-sonography.Excessive, heavy, irregular or prolonged bleeding.Uterine heaviness.Pain in lower abdomen in general.Painful sexual-intercourse.Bloating.Infertility.Abdominal lump.Urinary frequency.Bowel pressure with constant urging for stool.ComplicationsAnemia due to excessive heavy bleeding.Interference with growth of fetus during pregnancy.Could cause problem during delivery.Severe bleeding or infection.infertilityLab investigationsUltrasound of lower abdomen.Diet & nutritionReducing fat intake and increasing fiber intake will lessen your estrogen production and restore hormone balance, which may effectively combat fibroid growth.Incorporating more citrus fruits, red onions and leafy vegetables may also be effective against fibroid growth.A high-fiber diet will ease difficulty with moving your bowels.Homeopathy can help you avoid hysterectomyHomeopathy as a scientific system of therapeutics is based on identifying the individual as an entity and selecting the similimum according to his characteristics. In homoeopathy each individual is considered as a distinct entity with certain characteristics of his own and based on these characteristics we choose an identical medicinal picture. Sometimes, we come through remedies which seem to have similar profile but on closer observation we recognize the subtle difference which gives both a distinct identity. Thus we see that Individualization is one of the basic tenets of Homeopathy.Homeopathy believes that each individual of any race,nationality, breed or background has some characteristic features which differentiate him from all other of his own kind. Even two twins with same environmental and genetic background have some features which differentiates them. You must have seen that in a same family too every individual responds differently to same situation, a drench in rain may cause backache in one,fever in other and headache in the third. Why is it so? It is because each of us has a different Constitution, an all together different individuality. Every person reacts to any external agent according to his/her individuality.Fibroids are a leading cause of hysterectomy (the removal of the uterus). Removal of uterus leads to surgically induced menopause. The abrupt disruption in the production of hormones will cause symptoms that are more severe, more frequent and last longer compared with symptoms of natural menopause.Myomectomy is the surgical removal of the fibroid while preserving the uterus but recurrences are often observed.Homeopathic remedies tend to balance the hormones, cure the fibroids and reduce heavy menstrual bleeding.They are natural, effective, with no side effects and can be used even during pregnancy.There are more than 50 homeopathic medicines for fibroids. Some of the most commonly used preparations include:Aurum muriaticum natronatum - The sodium salt of the gold chloride decrease fibroid`s size by treating congestion and in duration of female genital organs. The woman may also suffer from depression, high blood pressure, palpitations.Calcarea carbonica - fibroids in menopause with heavy menstrual bleeding Chilly, stout and slow woman, easily tired by exertion.Calcarea fluorica - stony hard and multiple fibroids, fibrocystic breast disease. The woman is also prone to joint pain or bone spurs, hemorrhoids,varicose veins.Phosphorus - fibroids with heavy uterine bleeding. Anemia. Tall andslender woman. Open, friendly, anxious and fearful.Sepia - pelvic pain or discomfort, low back pain, frequent urinary tract infections and recurrent yeast infections, vaginal or uterine prolapse. Reserved, tired, depressed.The length of the treatment varies depending on the size and number of fibroids. In most cases fibroid-induced symptoms such as excessive menstrual bleeding, incontinence, and urinary frequency resolve within a month or two of receiving the correct homeopathic medicine. Homeopathy is a holistic treatment , therefore the homeopathic medicine not only cures your fibroid but also improves your overall health but first of all consult with a homoeopathic physician for selection of correct homoeopathic remedy.