Gonorrhoea is transmitted infection caused when people come in a physically intimate contact. It can affect both male and female. The most vulnerable organs that are susceptible to gonorrhoea infection include rectum, urethra, and throat. In females, gonorrhoea might affect the cervix as well. Since the infection spreads from having sex, there are wide chances that the baby gets affected too. Although there could be no visible symptoms of gonorrhoea, early detection and treatment increase the chances of a permanent cure.

How does gonorrhoea affect the sexual life?
Once a person gets affected, gonorrhoea may wreak havoc on the sex life of both a male and female. In males, there could be swelling and pain in one testicle leading to difficulty in having sex. Additionally, urination after sex becomes painful. There could be a pus-like discharge from the penis thereby completely obstructing the chances of sex.

In females, there could be abdominal pain during the intercourse. Intercourse itself could be extremely painful. Apart from this, the urination after sex could be very painful. Additionally, there are chances of vaginal discharge after sex. There are high chances of vaginal bleeding after sex followed by itching of the anus. If the bacteria are very active, lymph nodes of the throat getting swollen after oral sex.

The treatment plan for gonorrhoea in adults

Adults infected with the gonorrhoea bacteria are treated with antibiotics. Since gonorrhoea bacteria are increasingly becoming drug-resistant, doctors treat the patient with an antibiotic known as Ceftriaxone in the form of injection.
In addition to this, two antibiotics that are prescribed to be taken in the oral form include Doxycycline and Azithromycin. There are some studies which revealed that injectable Gentamicin along with oral Azithromycin is a successful combination that can treat gonorrhoea. Furthermore, this combination proves to be highly successful in treating patients who are allergic to cephalosporin-based antibiotics.
In addition to the treatment of the infected patient, the partner should also be thoroughly checked for symptoms of gonorrhoea treatment even if there exist no symptoms of the disease as such. There is a high likelihood of one partner getting infected in case the other one is infected.
If a baby gets infected with gonorrhea in the womb, he/she should get immediate eye medication to ensure that there no loss of vision when he/she is born. Babies should also get a dosage of antibiotics.
Some basic hygiene such as not having sex during the course of the treatment, use of protection during sex, avoiding oral sex, avoiding sex with multiple partners etc. should be followed.
Regular consultation with the doctor is necessary till the condition gets cured for good. 

Gonorrhea - How It Is Affecting Your Sexual Life?

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term. 

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
Tests for women: 
Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
Tests for men
Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing.

Complete Infertility Investigation - Why is It Important?

What are the latest advancements in male contraceptions?

The drawback of surgical approaches (such as vasectomy), especially patient compliance and the low success rates with condoms has spurred research on hormonal contraceptive dosage forms. There is a dearth of investigations in the development of pharmaceutical preparations. Evolving technology in the 21st century as well as improvement in living standards further underline the need for new male contraception approaches, especially those that entail new drug delivery methods.

Here are few areas where male contraception is being researched and used in some countries

Hormonal contraception for men is possible, and we are at the threshold of an important breakthrough. Combined testosterone plus progestin administration is more effective and safer than testosterone alone. Combination of testosterone plus an anti-androgenic progestin has several advantages over other formulations. In combined therapy, single injection formulation may have better compliance. 

Conventional male contraception 
Abstinence (doesn't work well)
Masturbation
Male condom
Vasectomy
There are other methods being developed but not sure they are there yet. But for guys? Their options are stuck in a time warp. If a man wants to take pregnancy prevention into his own hands, his choice basically comes down to condoms, a vasectomy, withdrawal, or abstinence. That s why it's so amazing that scientists are finally developing some real advancements when it comes to male contraception.

Researchers writing in the April issue of the Open Access Journal Contraception published a rundown of the top emerging options. A few hold real promise, particularly a daily or weekly pill that would deliver a dose of artificial hormones to a guy s bloodstream, which would then act on reproductive hormones to stop sperm from being produced. Like the female hormonal pill, the male hormonal pill would be reversible. But also like the female hormonal pill, there appear to be side effects, among them acne, weight gain, and even trickier to work around, changes in testosterone levels that trigger a plunge in libido.

Non-hormonal techniques are also being developed, particularly a vaccine that immunizes men with antibodies to halt sperm production. This so-called male birth-control shot is encouraging, because it targets sperm directly (rather than targeting other hormones in the body) and doesn t have the testosterone-lowering side effects of a hormonal pill. Each injection would last for long intervals (experts aren t yet sure how long), but the pregnancy-preventing effects would be reversible, if and when a guy decides he s ready to be a dad.

So when can you expect to see men rushing out to the pharmacy counter to pick up their new birth control Rx?  I think we may see a novel male contraceptive within 10-12 years, That may seem far off, but hey at least it s finally within sight.

Male Contraception - An Insight!

Knowing premature ejaculation - part 3: management and techniques (non-medical methods)

As shared in part 1and 2 of this series, because of premature ejaculation (pe), both the partners may end up experiencing highly unsatisfactory sex. In fact, it can increase anxiety, which may deteriorate the problem. 
Remember there is not a single magical drug or medicine in the chemist shop which can solve your problem overnight especially if you have chronic pe. Before seeking any medical treatment for pe, it is appropriate to consider the varied options for solving this issue. These include counseling with a sexual therapist, non- medical treatments like various exercises/ techniques and medical treatments including both modern and alternative medicine.

A. Counseling from an expert - sexual therapist or sexual medicine practitioner:
It is well understood that sex is in the mind. However, repeated pe/ failures can lead to lot of stress and disappointments. Anxiety due to pe itself is a big issue and can lead to recurrence of pe.
Reassurance from sexual therapist / counselor that pe is not a disease and can be easily treatable is relaxing for men who are facing this problem. So please share your detailed history and sexual habits with the expert. This may help the expert to guide you well.

B. Behavioral changes:

Some basic things may also help you to deal with the problem. 

1. Some men attempt to treat themselves for premature ejaculation by distracting themselves by thinking nonsexual thoughts (such as naming cricket players and records) to avoid getting excited too fast when approaching their partners. This helps them to focus their attention away from the sexual stimulation.

2. It is also suggested to men that they should relieve themselves of the sexual tension by ejaculating with self masturbation 1-2 hours before attempting sexual intercourse with their partner.

3. Using condoms is known to help in premature ejaculation in some men by decreasing sensation.

4. Women on top position usually helps to delay orgasm in men

 
C. Exercises &amp; techniques:

There are several exercise and techniques you can try sitting in your home.

1. The" stop and start" method:
This technique involves sexually stimulating the man by self until he feels like he is about to reach orgasm. Then he needs to stop the stimulation for about 20-30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. This can be continued for 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
2. The" squeeze" method:
 This technique involves sexually stimulating the man by self or by his partner until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans penis meets the shaft) for at least 15 seconds. Stop sexual stimulation for about 60 seconds, and then start it again. The person or couple may repeat this pattern for at least 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
3. Practice breathing exercises 

Deep breathing can greatly help in controlling the arousal and tension that cause early ejaculation. Men must avoid shallow breathing as it can trigger premature ejaculation. Instead, what you should do is spend 5 seconds taking in a long deep breath; then hold it for 3 seconds and then exhale for the next 5 seconds. If you can do this for 5 minutes in the bedroom without pause then you can control premature ejaculation.

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

Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)

Spread of HIV infection from a woman who has transmits HIV to her child during pregnancy, childbirth (labor and delivery), or breastfeeding (breast milk) is called as  Mother to child  transmission (MTCT) of HIV. It is also termed as the perinatal transmission of the HIV infection or  vertical  transmission. In the absence of medical intervention, perinatal transmission rates are very high, between 20-45% in different parts of the world. In various regions of the African subcontinent a large number of HIV infected children are present. It is a major cause of deaths in teens and adolescents in that region. 

Almost 90% of all HIV infected children live in the sub-Saharan Africa. In some districts of AP, Karnataka, Maharashtra and TN that were highly HIV-prone, we have several HIV infected children and adolescents. The virus replicates in the body and affects the immune system. Due to decreased immunity, various opportunistic infections enter the body and cause AIDS related symptoms. Prevention of HIV infection in infants and young children is now a high priority and has been the rallying point for enhanced prevention efforts. MTCT HIV infection can be prevented with adequate measures by way of Anti-retroviral treatment (ART). All expecting mothers who are HIV infected should have access to the preventive medical services throughout the gestation period, during labor and also during breastfeeding. 



Proper provision of resources with skilled staff and awareness programs can help in avoiding new infection cases. Breastfeeding is the primary source of transmission of infection from mother to child. Basically, once ART is started in an HIV infected pregnant woman that should continue forever. With proper ART course, chances of MTCT are near Zero. At the Unison Medicare & Research Centre; which is India s first fully comprehensive clinic for HIV Care and infectious Diseases, during last decade, not a single MTCT has occurred after treating more than 160 such HIV infected mothers. Even prior to that MTCT rate was lower than 1%. Our motto has been making the mothers virally suppressed commensurate with the global principle of  Undetectable = Untransmittable ! In fact now more and more HIV infected couples have been coming forward for an elective pregnancy. Even HIV un-infected children orphaned by AIDS or living with sick caregivers are at the great risk of emotional and physical abuse, which in turn increases the child s vulnerability to HIV infection. 

Reduction of risks to these vulnerable children is of great importance and various programs are being implemented for the welfare of orphans and vulnerable children. Various risk factors that are implicated in the transmission of HIV infection from mother to child are as follows: 

Increased viral load 
Genital tract viral load 
Reduced CD4 cell count 
Unprotected sexual intercourse with infected partner 
Smoking, Substance and drug abuse 
Deficiency of Vitamin A and other essential nutrients 
Presence of other Sexually transmitted diseases (STDs) 
Pre-term delivery 
Placental disruption 
Invasive monitoring of the fetus 
Breast feeding In most cases, HIV will not cross through the placenta from mother to baby. 
In an otherwise healthy mother, risk of child getting infected is low. Prenatal visits shouldn t be increased until a complication arises. The physician should observe symptoms of AIDS and pregnancy-related complications on a regular basis. HIV may be the direct cause or a marker of a complex interaction of related medical and social conditions that affect pregnancy. Most HIV positive women are usually asymptomatic and have no major obstetrical problems during their gestation period. They should receive similar obstetric antenatal care as the HIV-negative women, unless indicated by the need to provide specific treatment for HIV related conditions. There is no evidence of a need to increase the number of antenatal visits, provided there are no complications of the HIV infection, although additional counseling sessions may be required to reassure the mother and family. 

Care of the HIV positive woman during pregnancy should include ongoing counseling and support as an integral part of the management. Invasive diagnostic procedures, such as chorionic villus sampling, amniocentesis or cordo-centesis should be avoided wherever possible, due to a possible risk of infection of the fetus. In case you have a concern or query you can always consult an expert & get answers to your questions!

How Can We Achieve HIV-Free Generation?

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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