The human immunodeficiency virus or hiv is a virus which causes hiv infection and leads to" acquired immunodeficiency syndrome" or aids. Hiv is transmitted by different means and ways.


Unprotected sex is a primary mode of transmission of the hiv virus from an infected person to a healthy person. Unprotected sex refers to having sexual intercourse without using a condom or any other mode of protection. It leads to hiv transmission along with other sexually transmitted infections.


How does hiv occur from unprotected sex?
While having sex without protection, the hiv present in the body fluids such as blood, sperm, vaginal fluid, pre-cum or anal mucus of an hiv infected patient can pass on to the body of his/her partner. The transmission occurs through the membranes of the penis in men, vagina in women, the rectum and also through mouth and throat. It is more likely for an hiv patient to pass on the virus during the first few months after getting infected. This is because the virus spreads over body fluids during this stage.


Which types of sex are more risky?
Hiv is transmitted the most by having vaginal or anal sex. Anal sex accounts for being the riskiest because the lining present in the anus is much more delicate than the vaginal lining. It is prone to more damage, easily. There are two types of anal sex: receptive anal sex and insertive anal sex. Receptive anal sex is more risky.


Hiv can also be acquired from oral sex. This can happen in case the person giving oral sex has ulcers in the mouth, sore and bleeding gums. In case the person receiving the oral sex is already infected, the other person gets hiv.


A person who has sex with multiple partners regularly is at a high risk of getting hiv because of unprotected sex.


Prevention
Getting hiv from unprotected sex can be avoided if you use these precautions:


- condoms
Condoms offer the precaution against hiv infection from anal or vaginal sex. They should be used by men before any kind of sexual contact to restrict the passing of semen or fluid, which may be infected by hiv.


- lubricants
Sex is made easier by using lubricants and reduces the risk of tearing in the vagina or anus due to friction. The risk of a condom breaking is reduced using lubricants.


- dental dams
This is another precautionary device, which is a small sheet of plastic. It has to be placed to cover the mouth of the vagina or anus and reduce the risk of hiv transmission.
Unprotected sex is the primary cause of hiv and people who do not take precautions before sex are likely to be infected by hiv.

HIV and Sex

All you need to know about Premature Ejaculation

Many of the sexual issues are primarily not big problems. However, because of the taboo and inhibition around them, they are not discussed openly, hence they also fail to get resolved and become bigger. In fact most of the times there are no visible symptoms of any functional problems. Many of them are very basic issues and because of ignorance, myths, and social taboos lead to development of anxieties, distress and further worsening of the problem.

Often men are concerned about their performance in bed with their partner. They worry about- how best then can do, masturbation habits, size of penis and sperm quality. 

Consequences of Premature ejaculation (PE): 
Both you and your partner may end up experiencing highly unsatisfactory sex. In fact, it can significantly increase anxiety, which may deteriorate the problem. 

PE is one such sexual issue. It's not a disease; Not at all..!! 
If a person is sexually fit and experiences normal erections but just fail to hold the orgasm/ discharge for reasonable time then he is suffering from premature ejaculation. It's  a very normal problem, which if managed properly it can be easily resolved.

We will discuss this PE in 4 parts covering: what it is in actual, how does it happen, how to approach to resolve this problem with behavioural methods, exercise, techniques and medical remedies present in both modern and alternative medicine. 
Let s understand the problem in this 1st part!

What is Premature Ejaculation? 

Premature (early) ejaculation also referred to as rapid ejaculation; also 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 men (>60 years) erectile dysfunction is more common. A study conducted by the Journal of Sexual Medicine 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), he may be suffering from PE. The Mayo clinic at the United States defines PE as a condition in which  a man  always or nearly always ejaculates within one minute of penetration."

Instances of PE:
An occasional instance of premature ejaculation might not be cause of concern, but, if the problem occurs more than 50% of attempted sexual relations signifies existence of abnormal pattern for which treatment is required.

Premature ejaculation takes place with negligible sexual stimulation and even before the desire 
to ejaculate. Another way of describing PE by most therapist or clinicians is 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 various 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 mostly in 5 minutes and both are satisfied with this timing, then this is not defined as 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 this kind of situation is NOT called as PE. So every individual and every couple is unique. Same individual may have different sexual behaviour with different partners and different circumstances. Varied situations and varied places of performing the act have a vital role to play in determining the outcomes of individual sexual performance/s.



Knowing Premature Ejaculation - PART 1: Understanding What is PE

In most diseases, early detection of the disease is the key to control the symptoms, cure, reduce progression and improve prognosis. This holds true for sexually transmitted diseases too. As soon as there is a mild degree of suspicious of having contracted a sexually transmitted disease, it is advisable to go for a test. Most of the STDs can develop into serious complications over a period of time, ranging from infertility to even death.

Complications: Why early diagnosis is important: When left undiagnosed and untreated, most STDs progress to cause severe damage from sterility to cancer to even death. Listed below are some complications associated with each of the common STDs.

Chlamydia: If left untreated, can lead to epididymitis and testicles shrinking and infertility in males. This is a condition where there is pus formation in the scrotum. In women, it can lead to pelvic inflammatory disease which is deep-seated and unable to cure completely. This brings with it symptoms ranging from abdominal pain to uterine infections to sterility.
Syphillis: Undiagnosed syphilis can lead to blindness and deafness. It can also be passed onto the newborn and lead to severe disabilities.
Gonorrhea: If diagnosed early, it can be cured completely with antibiotics. However, if left untreated, it can lead to infertility.
HIV/AIDS: Early diagnosis can help in curtailing the disease. If detected late, then the damage is quite extensive and treatment is both expensive and cannot help restore a lot of functions. 
Symptoms of Sexually transmitted diseases: If there is a doubt of having contracted an STD, then it is very important to get tested for the same. Some of the most common symptoms are listed below.

Women: The most common symptoms in women including painful urination, burning sensation, abnormal vaginal discharge (sometimes bleeding), warts, and abdominal pain.
Men: Testicular pain, urethral pain, painful urination, pain and inflammation in the prostate, sores, fever, and abdominal pain.
Prevention: Always practice safe sexual practices. When in doubt, refrain from sex until diagnosis and treatment is complete.

Testing for STDs: Some of the standard tests include:

1. Herpes- HSV I & II - 
2. Testing HIV-- Kits and ELISA available for testing 
3. Blood test for syphilis antibodies 
4. Chlamydia and Gonorrhoea - from urine as well as swabs for culture
It is understandable that getting tested for STDs is an embarrassing situation. However, there are options available where anonymity can be maintained when getting tested for STDs. This is a wise choice to make as the risk is not just for the person affected but for the partner and in some cases even for the fetus. Early testing can help prevent complications like infertility and cancer.

STD Testing - Why You Should Never Delay?

The prostate is a vital organ that located between the penis and the bladder. The prostate is involved in the release of the prostate fluid that keeps the sperm properly nourished. Prostate cancer, as the term indicates, is characterized by the abnormal and uncontrolled growth of cancerous cells in the prostate. Though the incidences of prostate cancer are low in India, necessary precautions and diagnostic steps should be carried out to prevent the condition from jeopardizing our lives.

Prostate screening includes two tests known as the Digital Rectal Exam (DRE) and Prostate-Specific Antigen test (PSA). PSA combined with DRE helps to identify prostate cancer at a very early stage. If any of the tests show an abnormality, a doctor might prescribe an ultrasound such as MRI Fusion or Prostate Biopsy to confirm the diagnosis.

Immediate treatment may not be necessary
For low-risk prostate cancer, doctors often recommend active surveillance that includes periodic blood tests, rectal exam, and biopsies.
Active surveillance helps a doctor to continuously track the growth of cancer cells and the possibility of their spread to other areas of the body.
Surveillance is fit for those who are already suffering from a serious condition or for those patients who are above the age of 60.
A surgical procedure to remove prostate cancer
Surgery is considered when the cancer has metastasized to surrounding tissue and the lymph nodes. There are two kinds of surgeries that a patient can go through- a Robot-Assisted surgery and a Retropubic surgery.
Radical Prostatectomy might have risks involved. It is, therefore, wise to discuss the pros and cons of the surgery with the doctor well in advance.
Understanding the treatment options

Radiation therapy: Radiation therapy involves the use of high-powered and high-frequency energy beams to kill cancer cells. Radiation therapy is often used to shrink the size of the cancer cells. There could be two types of radiation therapy-Brachytherapy and External beam radiation. Radiation therapy too can have its side effects. Doctors prescribe several medicines during therapy.
Hormone therapy: Hormone therapy helps to stop the production of a male hormone known as testosterone. This treatment option includes medication that completely stops the production of testosterone, the medications may also block the flow of testosterone on the cancer cells, and surgery to remove the testicles. Hormone therapy is used in advanced cancer stages.
Chemotherapy: Chemotherapy is a drug that goes into the body and kills rapidly growing and metastasizing cancer cells. It is administered through IV (intravenous), or orally as pill or both. This treatment option is employed when cancer spreads to a remote body location and does not respond to hormone therapy.
Biological therapy: Biological therapy involves the usage of the body s immune system to fight cancer. A type of biological therapy known as the sipuleucel-t is used to treat patients with advanced cancer stage and recurring cancer as well.

Prostate Cancer - How Biological Therapy Will Help?

Does watching porn together help you have a better sex life?

It is often said that the couples who do most day-to-day activities together are more committed towards each other. But does the same stand true when it comes to watching sexual content or pornography? Well, research certainly seems to indicate that, with a whopping 96% couples watch pornography together. Here are some pros and cons of viewing porn with your partner.

PROs-

1.  It may help you both in discovering your sexual preferences
It is important for both you and your partner to be on the same page when it comes to discovering your sexuality and figuring out each other’s sexual preferences. Just like adolescent sex education, pornography too educates you about the mechanics of sexual play. It is a useful tool that brings out the kinky side in you and makes you more open to discussions on things that pique your curiosity in the bedroom. As and when you see such visual imagery, it may appeal to you enough to try it out with your partner. Discuss such desires with your partner. This may help you in discovering what really turns you and your partner on.

2. It may help you in maintaining sexual fidelity in your relationship
Watching porn together with your partner can potentially increase the intensity of physical attraction between the two of you.This, as a result, leads to greater gratification for both of you, and if you are sexually satisfied by your partner, you are less likely to look for pleasure outside your relationship. Also, it is way healthier to indulge in it as a team rather than discovering your partner watching porn alone.

3. It may help both of you to pick up newer positions
Porn has the ability to expose you to new and exciting positions you never knew. About 58% of couples who viewed pornography claimed that the shared activity had a positive effect on their sex lives. New moves and unique positions are known to spice up sex lives. Men can surprise their women (or vice versa) with an exotic move or two. Porn may also help in decreasing shyness and in opening up your minds so that you can pick up and practice new moves.

CONs-

Although porn viewing may consist of potential benefits, it may also affect your relationship adversely. When watched in excess, porn may cause certain problems in your relationship, which are-

1. It might set up wrong expectations in reality
Porn movies give you a warped view of what beauty is. It may cause you to have unrealistically higher expectations from your partner, whereas the reality may not match your imaginative hopes and standards. As a result, it may also lead to frustration, aggression and infidelity.

2. It may lead to pornography addiction
 The visual and physical appeal of porn may impact a person’s mental or social well-being. Increased porn viewing may hint at a person’s social isolation, loss of interest in career and other activities etc. It may also make you highly dependent on it, as it allows immediate sexual gratification. As a result the usage may go out of control and relate directly to compulsive behaviour.

3. It may affect your sexual drive and libido
Making love to your partner in real-life may become a foreign concept, as porn can decrease your physical drive with the possibility of making you sexually lazy. Porn may also have certain side effects including probable loss of libido and even difficulty in lasting longer. It may also make regular intercourse seem boring as it may not have the same sensual and visual appeal as pornography.
After realising its various pros and cons if you want to use porn, it is advisable to not use it as replacement but as an accessory for better sexual well-being.

If you would like to consult with me privately, please click on 'Consult'.

Does Watching Porn Together Really Help You Have a Better Sex Life?

Vaginismus is a condition where vaginal contractions and squeezes may be caused due to pain during intercourse or due to the insertion of objects like tampons. This mildly uncomfortable condition is also characterised by spams and other symptoms like the feeling of coming up against a thick wall which can cause pain. This may be due to a variety of reasons starting from infections to anxiety. To a large extent, the treatment of this condition depends on the cause. Following are the various ways in which this condition can be treated.

    Sex Therapy: A sexologist or an expert who specialises in psychosexual medicine can help in treating this condition by conducting a series of counselling sessions where psychoanalysis will help in understanding and unravelling the cause of the condition. This may be followed by CBT or cognitive behavioural therapy. This kind of therapy usually helps in reprogramming the brain after the root cause for the condition is known. 
    Exercises: During sex therapy, the doctor may also teach you various kinds of exercises and vaginal trainers that can help you in strengthening the pelvic floor and relaxing the muscles as well. These vaginal trainers are especially helpful in equipping you suitably so that you can relax your vagina and let the insertion happen. Vaginal trainers consist of four smooth balls of plastic which can be inserted with the help of lubricants to help in stretching the vagina. 
    Relaxation: Getting yourself to relax is also a matter of exploration and touching, which can help you understand the kind of touch and the exact areas that make you tense. During sex therapy, you may be taught a technique known as progressive relaxation. This mode includes tensing and relaxing your muscles as you explore by inserting a finger. 
    Sensate Focus: This is a part of sex therapy and involves your partner. In this method, you will be asked to abstain from sex and touch each other without going to the genitals and other private parts. This will help in better arousal and sexual stimulation.
    Surgery: The last option for treating a very severe form of this condition is to put the patient through surgery which will seek to remove endometriosis, as these growths in the womb's lining can cause a lot of pain during intercourse. Also, vaginal enlargement surgery can be carried out with the help of episiotomy. 

This kind of procedure usually helps in fixing the scar tissue that may have been left from a previous procedure, which can restrict or block the vaginal path. Getting help at the right time for this condition is of great importance so as to have a normal sex life.

How to Treat Vaginismus

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