A couple of decades ago, medical professionals believed that a lot of females could not climax at all. There are a number of reasons for this. It is easy for the male to know when he has achieved an orgasm, which usually happens with ejaculation, which is quite evident. For the females, on the other hand, it is not so evident. It is a perceived feeling and while the media showcase it in a particular way, reality is far moved from it.
There are various reasons why it is very difficult to pin this down. Orgasms are not just an elusive feeling for the woman, it is an elusive topic for the medical professionals too. Read on to know some of the common causes (more beliefs or notions) about this and some simple but effective ways of managing this.
- Private topic: Girls are very shy compared to boys and both their exposure to sex education and discussion about this is limited compared to boys. We might tend to think of it as common in India alone, but this is true across a vast number of countries. We are not alone! This shyness continues into their later years too, and unless transformed by the partner, it may continue to be a topic that is shunned.
- Purpose: Sex is more deemed as a form of procreation rather than for sex. Therefore, while sex is necessary for conception, orgasm is not. This is one more reason (strange but true) that orgasm is very elusive for a woman.
- Psychological factors: It could be guilt from past relationships or fear of past abuse. It could be fear of losing control or fear of coming across as vulnerable. For any of these reasons, women can have difficulties climaxing during the act.
In men, the causes are more defined and physical in nature and include erectile dysfunction, premature ejaculation, retrograde ejaculation, and delayed ejaculation.
Whatever the cause of the problem, the first step in coping up with the issue is to acknowledge the issue. Being a private topic, this is not something that is going to draw the person towards medical help. However, this needs to be discussed frankly with the partner or with the doctor. Getting the partner involved removes a lot of psychological barriers (guilt, fear, anxiety, etc.) This would result in natural ironing out of issues, improving the performance of both the people involved.
If that does not happen, seeking professional help, be it medical help to correct physical issues or counselling, is the next suggestion. A frank discussion will do wonders, and what was once elusive can be well within your reach.

The Elusive Orgasm - Causes and Coping!

Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

5 mind reasons you might not be getting an orgasm

Sex is not only a physical need, sex is a great way to emotionally bond and get closer to your partner as well. Any dissatisfaction in the bedroom can affect other aspects of your life, and can lead to fights, squabbles and general unhappiness. The inability to orgasm can become a major bone of contention. There can be various reasons behind the inability to climax. Some of the common ones are detailed below:

1. Lack of stimulation

Studies show that only 25% of women reach climax during sexual intercourse. The remaining 75% of women require more stimulation, like fingers or even toys and tongues to reach orgasm. Amongst this is a subset of 10-15% of women who never reach orgasm. Thus, a large number of women require extra stimulation to achieve climax during sex. You must talk to your partner about putting in some extra effort and providing the extra stimulation you need to achieve climax.

2. Over-thinking

Many men and women over-think their actions in bed. From their expressions to how they are reacting and how they are making their partner feel - everything is under constant scrutiny and revision. This leads to a lot of stress, which can hinder your ability to reach orgasm. You need to relax in the bedroom, because whatever you do will feel good in some way or another. Your anxieties can also distract you from what is going on, which means you don't get the chance to fully experience the pleasures of sex. If it helps, speak to your partner about your anxieties and tell them what you are stressing about during sex.

3. Differences between men and women 

Men are visual creatures. This means that what they see turns them on. A woman's orgasm, on the other hand, happens in her head. Thus, men and women have different roots to their stimulation. Lack of an orgasm might mean either of these needs isn't being fulfilled. A great way to work around this and make sex more fun is to include a lot of foreplay in your love-making session. You can do this by trying out role-playing or using sex toys. Make sure to take it slow for a great build-up to your orgasm.

4. Performance issues

Porn has an impact on your sex life. It can increase your expectations to a considerable extent, which may not be fulfilled, thus hampering your experience in the bedroom. A lot of people become so focused on reproducing that experience that they forget that its real life. The focus on performance overwhelms their actual experience of sex, which results in an inability to reach orgasm. Try to accept the fact that you don't really have to perform for your partner. Your partner appreciates you for what you are, despite everything.

5. Mental blocks

A problem in the relationship, certain health conditions like depression, past trauma and negative social conditioning can all have negative impacts on your ability to orgasm. Talk to your partner about past trauma if you have any, and what your triggers are. Consider speaking to a sex therapist as mental health issues should never be neglected. Depression hits the libido hard, and the problem is only compounded by antidepressants. Negative social conditioning can only be helped by therapy, so try to reach out to a mental health professional.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Why You Must Try Kegel Exercises for a Happier Sex Life

5 Mind Reasons You Might Not Be Getting an Orgasm

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

4 reasons why your vagina can be hurtful

In India, along with a lack of sex education, there is also a lack of knowledge about hygiene of the privates amongst women even in urban areas. When a woman experiences pain in her vagina, while it could be because of various reasons and not necessarily alarming, one does get alarmed. 

Let us understand the reasons.

1. Yeast infection: Dry and itchy vagina can feel painful after a while. Yeast infections are very common and usually most women experience them. They can be treated by medicines, yet it is best to get in touch with your doctor and get a prescription. Your doctor will prescribe an anti-fungal cream after a pelvic exam.

2. Vaginal dryness: This usually happens to post-menopausal women but can also happen to younger women because of certain birth control pills which are low in estrogen and dry up the moisture in one's vagina.

3. Pelvic inflammatory disease: If you are having regular pains during penetration and during your periods, it could be endometriosis. During examination, the pain is usually linked to the lower abdomen where the ovaries are.

4. Vulvodynia: These are mysterious pains which come &amp; go and can be treated with medicines.

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

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Top 4 Reasons Why Your Vagina Hurts

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