Articles on men s health

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.

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.

5 Men's Grooming Tips for Success

Ms. Raisa Luther, Psychotherapist
Grooming doesn't mean self-indulgence. It's self-care. If you care for your health, your well-being, your future, you'll take care of yourself.There are indications that men have started to take care of themselves. This is evident by the increasing amount they spend in salons and spas and the higher sales volumes of men's cosmetics.Sloppy looks indicate that you don't take care of yourself. If you don't care for yourself, you're not likely to care for others, or your job, or any other thing.Here are the top 5 grooming tips that will help you in your life - leading to more success in all areas of your life:1. Shave. Though the latest trend is to have an 'unshaven' look, it's not okay to have a bristle - it looks untidy. The impression it creates is that of a person who is careless, lazy and uncaring. Would you trust a doctor or a pilot with an unshaven chin?Same goes for your hairstyle. Neat and clean hair are attractive. Uncombed or bravely fashionable hair may be a put-off in normal circumstances - unless you're a rock star!2. Trim your nails. Regularly. Also, check your toes. Neat hands and feet give a signal that you care.3. Shoes are best. As a rule, shoes are a safe bet at the office. Sandals or slippers appear too casual. Unless, of course, you're in a traditional attire.4. Bathe. Every day, preferably twice a day. There's no worse put-off that body odor. Ensure you're clean and fresh, all the time.5. Coordinate. Some things match, others don't. For instance, a brown belt goes with brown shoes. Sports shoes don't go with a blazer. Caps are not worn indoors. Tuck-in shirts don't look good with a paunch. Remember, when you dress well, you're giving respect to others. You're telling others that they matter, that they're respected and you have taken pains to dress well for them. This way, if you give respect, you'll get respect. So go dress well for success!

Deflating Erection?! Know the Causes.

Dr. Anish Kumar Gupta, Andrologist
Loss of erection prematurely during sexual activity without ejaculation is what is the definition of a deflating erection. A lot of people face the same without understanding why the same is happening.Stress and Depression: Since brain is one of the most erogenous zones, a lot of causes are linked to a healthy brain. Both stress and depression can lead to difficulty in getting an erection, premature loss of erection, or even delayed orgasm in certain cases.Alcohol: More than a few drinks plays havoc with the axis of brain and phallus, leading to a heightened desire but early loss of erection at times.Medications and Drugs: Some medications for other medical conditions, can lead to a decrease in erectile function, most do not lead to deflation of an erection midway. This may be observed on the other hand with street drugs – like cocaine / ganja / hashish.Anger: Unexpressed anger or improperly expressed anger can contribute to performance problems in the bedroom. The same can be against your partner or anyone else, but the effect may be seen in the bedroom.Performance Anxiety: This is a circle you do not want to get into. Anxiety related to performance in bed or other life anxieties spilling into the bedroom can spiral into vicious cycle, which puts a big strain on the sex life and the relationship.Obesity: Affects the sexual performance, self-esteem, may play havoc with Sr. Testosterone. It can also be linked to high blood pressure. All can contribute to an early detumescence.Negative Self Image: A negative self image can make you worry about how one looks but also how well you will perform in bed.Low Libido: Low performance is not the same as lack of interest in sex. A lot of the factors listed above can also lead to low libido. This is another circle, which can get difficult to treat.It can be embarrassing to talk to someone about your sexual problems, but it’s the best way to get treated and getting back to intimacy with your partner.

Good Sleep for Good Health

Ms. Swati Kapoor, Dietitian/Nutritionist
Nothing makes you feel more refreshed than a good sleep in night. It is a natural cyclic state of resting for mind and body. There’s more to an ideal 7-8 hrs of sleep than just preparing our bodies for the next day. Adequate sleep is an essential part of good health and plays an important role in all body functions hence ensuring a better mental and physical fitness.The National Sleep Foundation (NSF) reported that good sleep is essential for a person’s health and well being.Lord Chesterfield very well said that “A light supper, a good night's sleep and a fine morning have often made a hero out of the same man, who, by indigestion, a restless night and a rainy morning would have proved a coward."Now, the question is “Can good sleep make good health?”Yes, sleep makes you feel better. Adequate sleep is a key part of a healthy lifestyle. Without it, one becomes more susceptible to health problems, such as heart disease, obesity, depression and many more. Some facts of sleep which lead to a healthy life are -Good Sleep Keeps Heart Healthy: Lack of sleep has been associated with worsening of blood pressure and cholesterol so some experts say that heart will be healthier if one gets between( 7 -9 hours) of sleep each night.Sleep Helps to Make Body Repairs: Sleep is a time for your body to repair damage caused by stress, ultraviolet rays and other harmful exposures. Your cells produce more protein while you are sleeping. These protein molecules form the building blocks for cells, allowing them to repair damage. This is the time when the cells undergo wear and tear and that’s what makes you feel refreshed in the morning.Good Sleep Reduces Stress: When your body is sleeping deficient, it goes into a state of stress. Therefore it is recommended to have good sleep in order to allow your body to cope with day’s stress and manage it in a better way with a relaxed mind. It is found that any amount of sleep deprivation reduces mental performance.Sleep & Weight Loss: Lack of sufficient sleep affects the appetite regulating hormones. It also aggravates cravings for high-fat and carbohydrate rich foods, making a route to weight gain. It also affects the body’s ability to regulate blood sugar levels, a key factor in weight management. So, if you want to be on a healthy weight, make sure you get a good sleep every night.Good Sleep Reduces Depression: Lack of proper sleep and depression is inter-linked. Depression may lead to insomnia and lack of sleep increases depression. Sleep impacts serotonin levels (feel-good hormone) which affect the mood of an individual.Sleep Prevents Cancer: People working for long hours have a higher risk for breast and colon cancer. There is evidence stating that good sleep can alter the balance of hormones in the body which may influence cancer progression.As very well said by Benjamin Franklin, “Early to bed and early to rise, makes a man healthy, wealthy & wise.”

Erectile Dysfunction (Ed) or Impotence

Dr. Adil Hingora, Homeopath
AllopathyAllopathy treatment gives a lot of emphasis to:Psychotherapy, counselling.Regular exercises, which increases blood flow to all parts of the body, increase level of male hormones, increase levels of certain neurohormones which are mood elevators.When psychotherapy fails to boost the person's self-image interventional modes are tried:Drugs (oral drugs, penile suppositories, ointments, injectibles hormone treatments and so on.)Vacuum devices - these work by drawing blood into the penis. It must be used just before intercourse.Surgery - as a last resort when all other methods fail to better erectile dysfunction (ED) or impotence. Prosthetic implants (artificial rods) are inserted into the penis and allowed to remain there. However, these are very expensive and also irreversible.All treatments aim at helping the individual achieve an erection and maintaining it long enough to perform intercourse. However, no treatment can provide a permanent cure for erectile dysfunction (ED) or impotence in allopathy.HomeopathyAn estimated 35 million men in United States of America experience erectile dysfunction (ED) or impotence at one time or another. That explains why there is such a huge market for products to strengthen or restore erections. There are many patients who tried herbal products that just did not work at all. And we have read alarming reports of men going blind or having heart attacks as a result of taking allopathic or conventional drugs prescribed.Fortunately, there is a permanent solution. Yes ED or impotence is treatable and at any age.Homeopathy offers remarkable results in erectile dysfuntion (ED) or impotence cases, which may have arisen from both physical and psychological causes. Both, the mental as well as physical components of the disorder can be addressed using homeopathic treatment.Homeopathy offers almost 203 remedies for men suffering from erectile dysfunction (ED) or impotence. Unlike allopathic medicines, homeopathic medicines are non toxic and non addictive. Doctors frequently treat patients suffering from anxiety, fear of failure to do sex, erectile dysfunction (ED) or impotence associated with stress and high blood pressure.Work stress, mid-life crisis and other issues affect men's health in various ways. Men facing the challenge of aging, retirement and finding new identities for themselves, find a particularly appropriate therapy in homeopathy, which addresses them on mental, emotional and physical levels.When combines with benefits of good nutrition, exercise and relaxation, homeopathy provides optimum support for such patients.Where the cause of erectile dysfunction (ED) or impotence is with other system diseases and due to drug effects, there also homeopathy provides better option.Homeopathy is strongly recommended.However, homeopathy is a 200 plus year old medical science that is fully regulated by the United States Food and Drug Administration (FDA). And all homeopathic medicines recognized by the well-respected Homeopathic Pharmacopoeia of United States (HPUS) have been tested and proven effective in carefully controlled clinical trials.Erectile dysfunction (ED) or impotence may be an indicator of other health imbalances which need to be addressed and should not be put off.There are 203 medicines which give great relief. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the doctor. The treatment is decided after thorough case taking of the patient. Thus remedies are designer made unlike allopathy in which all patients receive the same surgery or drugs although trade name may be different.With homeopathy, it is an issue that can be treated and overcome, allowing you and your partner to enjoy a full and satisfying loving relationship.Wishing you the joy of love and intimacy.Frustrated and embarrassed by Erectile Dysfunction (ED) or impotenceFew experiences are as disheartening to the intimacy of a loving couple as erectile dysfunction, the inability of the male partner to achieve and maintain an erection.This means even though a man has a strong desire to perform sexual act with a cooperative partner, he can not perform sexual act because of looseness (absense of erection) of his penis. Even if he performs the sexual act with his determined efforts he does not get the erection and gets afflicted with tiredness, perspiration and frustration to perform sex or intercourse.The term erectile dysfunction can mean the inability to achieve erection, an inconsistent ability to do so, or the ability to achieve only brief erections. ED (erectile dysfunction) may sometimes be even termed as Impotence.The likelihood of developing it increases with age. It is estimated that 1 in 10 men over the age of 21 suffer from impotence of ED (erectile dysfunction); most men suffer in silence. In America today, it is estimated that 25 to 30 million men suffer from erectile dysfunction, also known as impotence or ED.Why and how does erectile dysfunction (ED) or impotence happen?Erection of penis is a sequential event and any disruption in this sequence can cause erectile dysfunction (ED) or impotence. The sequence includes nerve impulse in brain, spinal column, area around penis and response in muscles, fibrous tissues, veins and arteries in and around corpora cavernosa. Damage to nerves, arteries, smooth muscles, fibrous tissues often as a result of disease is the most common cause.Most cases (70 to 80%) have some underlying pathology. In older men, ED usually has a physical cause. Incidence increases with age.Erectile dysfunction (ED) or impotence does not have to be a part of getting older. It is true that as you get older, you may need more stimulation (such as stroking or touching) to get an erection. You might also need more time between erections. But older men should still be able to get an erection and enjoy sex.Physical causes:Alcohol and tabacco useFatigueBrain or spinal cord injuriesHypogonadism leading to lower testosterone levelsLiver or kidney failureMultiple sclerosisParkinson's diseaseRadiation therapy to the testiclesStrokeSome types of prostate or bladder surgerySide effects of medicines like antihypertensives, antihistamines, antidepressants, tranquilizers, appetite suppressants, cimetidine. Drug side effects account for about 30% of cases.Pschological causes (feelings) that can lead to erectile dsyfunction (ED) or impotence:Feeling nervous about sex, perhaps because of a bad experience or because of a previous episode of impotence or erectile dysfunction (ED).Feeling stressed, including stress from work or family situations.Being troubled by problems in your relationship with your sex partner.Depression.Feeling so self conscious that you can not enjoy sex.Thinking that your sexual partner is reacting negatively to you.Whether the cause is physical or psychological, the damaging effects on both partners can often lead to the break up of the relationship.Lifestyle changes that may be helpful:Massaging the body with a herbal oil which gives a relief from physical exertion and also acts as an aphrodisiac. Mutual massage slows down lovemaking and opens up communication.Practicing yoga and meditation to overcome mental exertion and to cope with daily stress.Sleep at least for 8 hours a day.Avoiding the consumption of alcohol, tobacco, heroin and so on.Exercise regularly. Moderate (not excessive) exercise helps relax the body, boost energy levels, increase physical awareness, and stimulate sexuality.Practice different kinds of intimacy and touching; try not to focus only on the erection. Partners who proceed with patience and learn to enjoy each other in a variety of ways often return to full potency.Avoid hot, spicy and bitter foods.Add little fat in your diet.Give a gap of 4 days between two consecutive intercourses.Frequent sex prevents erectile dysfunction (ED) or impotence.Dr. Adil HingoraRaipur, Chhattisgarh INDIAOnline Consultation -

Erectile Dysfunction: Don’t Believe These Myths!

Dr. Yuvraj Arora Monga, General Physician
What is Erectile Dysfunction (ED)?A person having Erectile dysfunction (ED) is not able to achieve and/or maintain an erection of the penis sufficient for sexual activity. So, penis do not get hard at all or not enough for doing sex. ED is responsible for great deal of stress and anxiety as well as low self-confidence in men. Mostly its occasional, when you cannot get an erection and it is only temporary. But sometimes it occur repeatedly. There are lot of misconceptions about it in the mind of common man.Normally after emotional or physical stimulation there is an increased filling of blood in sponge like tissue of penis and decreased blood flow out of penis, so blood remain trapped in penis and it becomes hard and erect. Thus our ability to have erection is dependent of multiple factors like our emotions, hormones, nerves, blood vessels and cells of penis itself. A problem with anyof these elements can cause ED.It can occur at any age, but becomes more commonwith increasing age. In the older adult male, it is a major problem affecting more than 75% of men. Common Causes of ED:There are several factor's which causes bodily or mood changes & lead to ED. Physical causes means you have problems with penile structure itself or any bodily disease affecting it. Diseases include less blood flow to the penis or injury of  the nerves going to the penis (For example, multiple sclerosis, a stroke, Parkinson's disease, Spinal Injury etc.). Lifestyle disorders like high blood pressure(BP), Obesity (high body weight than normal for our height and Age), Diabetes (high blood sugar), etc. Also lack of male sexual hormone called testosterone, alcohol and drug abuse, clogged blood vessels (Atherosclerosis) and side effects of some medications causes ED. Sometimes psychological issues like anxiety, stress due to work or home environment, depression, relationship difficulties leads to ED.Myths associated with EDMyth 1: ED is part and parcel of your body’s aging processContrary to popular belief, ED is not a normal part of the aging process. If you’re having difficulty in getting an erection, the underlying cause can be medical in nature such as undiagnosed or diagnosed  cardiovascular disease, high blood pressure or diabetes.Myth 2: ED can’t be reversedThrough the right treatment and certain lifestyle changes, most of the cases of ED can be reversed to almost normal. It is said that sexual health and erectile performance can be enhanced when you improve the health of your heart. Exercising to bring about weight loss and quitting smoking are ways that experts advocate for improving the health of your heart.Myth 3: You are the only person to suffer from this problemThe common belief that ED affects only a few men is not true. Scientific studies  show that ED strikes about 5% of men aged 40 years and between 15-25% of men aged 65 years.Myth 4: It’s completely in your headThis isn’t true at all. The source of the problem could be certain parts of your body. In most cases, the cause is usually certain physiological problems such as heart disease, clogged arteries, high cholesterol, and Parkinson’s diseasesetcMyth 5: Only drugs and surgery can help you remove the problemED can be treated using a number of treatment options. Apart from pills and surgery, simple lifestyle changes can help to provide respite from the problem. Decreasing the consumption of alcohol, losing weight and even quitting smoking can improve your sexual health. Moreover, since the problem can also be due to an underlying medical condition such as high blood pressure; treating the underlying cause can help in easing your erection problems.You can continue reading more about this in Part 2 of this series here.

All You Need to Know About Premature Ejaculation: Part I

Dr. Yuvraj Arora Monga, General Physician
What is Premature Ejaculation (PE)?  Definitions and how commonly it occurs!Background:Many of the sexual issues are primarily not big problems. Because of the taboos and social beliefs they are not discussed openly, hence failed to get resolved. And they become big, because of continuous worry they give.In fact most of the times they are not even any symptom of any organic disease processor functional problem. Many of them are very basic issues because of ignorance, myths, and social taboos lead to development of anxieties, distress and further worsening of the problem in question.With basic issues what I mean is, that very commonly men are concerned about their performance in bed with their partner either wife or girlfriend. How best then can do, concern about their masturbation habits, size of penis, sperm quality and many more.  I am not writing this as a routine article for the sake of it, but truly it is the synopsis of a practice / experience spread over few years and interaction with hundred / thousands of people (shall not call them patients barring small percentage).Premature Ejaculation (PE) is one of them. Not a disease; Not at all! The person is sexually fit, having normal erections but just fails to hold the orgasm/ discharge for reasonable time. A very basic problem, but one gets worried. But we need to reassure it is not a disease and can be easily manageable.We will discuss this topic of Premature Ejaculation (PE) in 4 parts including what is it, how it happens, how to approach to resolve this problem with behavioural methods, exercises, techniques and medical remedies both modern as well as alternative medicine. Defining Premature Ejaculation (PE):Premature (early) ejaculation (PE) many a times is called with different names like "rapid ejaculation", "early ejaculation" or simply called as "early discharge". PE is the most common type of sexual dysfunction in men younger than 40 years and seen across all age groups. In elderly, more than 60 years of men, erectile dysfunction can be seen more commonly. In a study conducted by the Journal of Sexual Medicine, that revealed that this condition is almost equally prevalent in sexually active men of all age groups. If a man experiences uncontrollable ejaculation (discharge of semen from your penis) either before or shortly after sexual penetration (usually within 1-2 minutes of penetration), you may be suffering from premature ejaculation. Mayo clinic at USA defines PE when a man “always or nearly always ejaculates within one minute of penetration”.An occasional instance of premature ejaculation might not be cause for concern, but, if the problem occurs with more than 50% of attempted sexual relations, an abnormal pattern usually exists for which treatment may be required.Premature ejaculation typically takes place with negligible sexual stimulation and even before you wish to ejaculate. As a consequence of premature ejaculation, both you and your partner may end up experiencing highly unsatisfactory sex. In fact, it can dramatically increase anxiety, which may worsen the problem. Another way of describing premature ejaculation by most therapist or clinicians who treat PE is that as the occurrence of ejaculation sooner during sexual intercourse than he or his partner would like. This broad definition thus avoids specifying a precise “normal” duration for sexual activity and reaching a climax. The duration of sexual activity is highly variable and depends on many factors specific to each individual.Take a situation, a male may reach orgasm after 7 to 8 minutes of sexual intercourse, but if his partner is able to achieve climax most of the times in 5 minutes and both are satisfied with this timing, then this is not PE. Alternatively, a male might delay his ejaculation for up to 15- 20 minutes of sexual intercourse, but if his partner, even with foreplay, requires 25-30 minutes of total sexual activity before reaching climax, he may still consider his ejaculation premature because his partner has not been satisfied (at least, not through intercourse). But in routine practice we do not like to call this kind of situation as PE. So every individual is unique. Every couple is unique. Same individual may have different sexual behaviour with different partners at different times. Varied situations and varied places of performing the act have a role to play in determining the outcomes of individual sexual performance/s.Statistics of PE:You are not alone! Premature Ejaculation-PE is a common sexual complaint. Estimates vary, but as many as 30-40 % men across the world including India experience problem of PE at some time of life. Approximately 30%-70% of American males experience premature ejaculation. The National Health and Social Life Survey (NHSLS) indicate a prevalence of 30%, which is fairly spread across all adult age groups. Estimates of premature ejaculation rates in India and many European countries are similar to those of the United States.That is all for today’s information on this topic. In the next follow up parts, I shall discuss, types of PE, how it happens, how to approach the men / couple suffering from it to resolve this problem. The therapy includes wide spectrum of approach including counselling, behavioural methods, exercises, techniques and medical remedies both modern as well as alternative medicines.

How to Manage Your Erectile Dysfunction Effectively

Dr. Yuvraj Arora Monga, General Physician
There are enough options available which can keep every man sexually active regardless of the cause of erectile dysfunction (ED). However, it is important to get treated by a physician who is willing to give time to understand your problem and identify a suitable and most appropriate therapeutic option.Counselling Sessions:As with an electrical circuit, if there are any breaks in the system it will not function as a unit. Part of the process of psychosexual therapy would be to think about the actual emotional and/or psychological issues behind ED, and to attend to these with weekly counselling sessions. This realisation is an important first step for you to begin and resolve your erection problem. The patient normally implements the therapy advice at home, either alone or with a partner, between therapy sessions. This may help you maintain an erection for once, gradually building confidence.Relieving sexual anxiety:Telling your partner before you make love that you have this anxiety, and the feelings it causes. As a result, your partner will understand, and the two of you can work on it together.You can reduce some worries by being more giving with foreplay, even if your sexual performance isn't what you or your partner wanted, your partner will still be satisfied.Consider regular exercise which brings confidence in your body as your energy is also an important part of overcoming sexual anxiety.Non-Medical TherapiesWatermelon juice (Nature’s Viagra) & Ginseng (Herbal Viagra): L-Citrulline, an amino acid, present in watermelon can bring about significant improvement in blood flow to the penis, showing an improvement in erectile function. Another herb called Ginseng, specifically “red ginseng,” is known as the “herbal Viagra” that can improve sexual performance. Several research studies provide evidence for the effectiveness of these herbs in ED treatment.Kegel exercises: Pelvic exercises, involving the portion of the body between your waist and thighs, are commonly known as kegel exercises. Three months of kegel exercises twice daily can help to significantly improve your erection ability which strengthens the penile muscle. They also promote urinary control.Acupuncture therapy: The acupuncture needles are placed in the wall of the abdomen. By stimulating specific acupoints, the practitioner aims to restore the proper flow of energy in the body resolving ED.Eat  Right: Scientific study at Massachusetts on Male Aging has found that eating a diet rich in fruit, vegetables, fish, lesser red and processed meat, whole and refined grains decreased the likelihood of having ED. Intake of daily multivitamin and fortified foods is the best remedies for treating ED.Walking: Just 30 minutes of walking a day is linked with 41% drop in risk for ED. Moderate exercise can help restore sexual performance in obese middle-aged men with ED.Attention towards vascular health and making body slim: High blood pressure, high blood sugar, high cholesterol, and high triglycerides can all damage arteries in the penis along with heart and brain thereby leading to ED. Maintaining a trim waistline is a good defence for ED, as men with a 42-inch waist are 50% more likely to develop ED in comparison to 32-inch waist people.Avoid excessive alcohol: Chronic heavy drinking of alcohol can cause liver damage, nerve damage, and other conditions, interfering with the normal balance of male sex hormone (androgens) levels ultimately leading to ED.Intake of L-arginine: L-arginine, an amino acid, which is naturally present in the body and helps make nitric oxide, supports a successful erection. Nitric oxide is responsible for making the blood vessels relax, which helps sustain an erection for men.Medical therapy:ED can also be treated with oral medications, drugs insertions or injections into the penis. Oral medications that are normally prescribed to treat the dysfunction work for about 80% of men. They work by boosting the natural signals, which are generated during sexual activity so as to help you sustain an erection. Alprostadil is a type of medicine that causes blood vessels to expand, increasing  blood flow to the penis, thus facilitate an erection. Cialis, Levitra, Staxyn and Viagra work by a similar mechanism to cause erections. There are subtle differences in how long the drug works and how quickly it works.But kindly note drugs like Viagra are not recommended for normal person for recreational use. They should not be used as performance enhancing drugs for they also have their set of side effects and hence, should be taken under medical supervision.A vacuum erection device is a plastic tube that slips over the penis, making a seal with the skin of the body.  A pump at the other end of the tube creates a low-pressure vacuum around the erectile tissue, which results in an erection.Ayurvedic Medications:Klaibya in Ayurveda is defined as an inability to attain and keep sufficient rigid (firm) erection which is essential during sexual intercourse for the sexual needs or the needs of his female partner. Also, Vajikarana in Ayurveda means producing a horse's vigor. Some of the herbs used in Vajikarana include:Bulb of Allium sativum (Garlic) Root of Asparagus recemosus (Shatavari)Root of Boerhavia diffusa (Punarnava)Whole part of Cocculus cardifoli (Guduchi)Root of Panax ginseng (Ginseng)Seeds of Myristica fragraus (Nutmeg)Leaf & Root of Withania somnifera (Ashwagandha)Leaf & Seeds of Ginkgo bioloba (Ginkgo)Pitch of Asphaltum bitumen (Shilajit)Dried root of Lepidium Meyenii (Maca)Again please remember, all the above drugs/ remedies  should be taken under medical supervision after consultation from registered medical practitioner after proper diagnosis has been made.