Peyronie's disease is a problem predominantly found in 3-9% of adult men, especially after 40 years of age. In the disease, a scar tissue is formed in the outer layer of the penis called tunica albuginea. Scar tissue is a just plaque inside the penis.

Peyronie's disease causes the penis to bend sideways or upwards and can make sex become difficult due to deformity and erection may be a painful process. It is usually associated with erectile dysfunctions, severe anxiety and reduced testosterone levels. It is worth noting that there are treatments for peyronie's disease, however, the pain often goes away on its own, generally, in 6-18 months of onset, but the deformity stays.

Here is everything you need to know about this disease:

Causes
It is not known exactly what causes peyronie's disease, however, there are some factors, which make it more likely than others. Here are those factors:

1. Trauma: this is the most common factor which causes peyronie's disease. It is believed that when someone suffers from tiny bleeding of the penis, which is very common in patients of diabetes, the plaque starts to build up. The injury or trauma, which causes the bleeding may go unnoticed as well.
2. Genes: genes are also a possible cause of peyronie's disease.

Symptoms
The symptoms of peyronie's disease vary, such as:
1. Pain on erection: there is usually pain in erection during the initial phase.
2. Bent penis: when the penis becomes hard before sex, it may bend downwards or sideways by more than 15 degree, so the vaginal entry becomes impossible or is painful for the partner.
3. Scars: tissue may form on other parts of the body, as well including the hand and feet. In fact, it has been said that men who have scarring in the hand, which affect the fingers are more likely to contract the disease as well.
One may see extensive scarring in hands in a disease called dupuytren's contracture. 

Treatment
1. Wait &amp; watch: it is worth noting the acute phase with pain is treated by wait and watch, controlling contributory factors like diabetes, low testosterone and psychogenic factors. Antioxidants are useful. Large number of cases are relieved of the pain in 1 to 1.5 years.
2. Intralesional injection: if the bend is significant enough to interfere in sexual functioning, it can be treated by injecting medicines in the plaque. The medicine, xiaflex is currently not available in india and other medicines given are not very effective.
3. Surgery: this is a last option when peyronie's disease has not gone on it's own and medicines are not helping either. The two most common procedures performed are removing the plaque and putting a tissue graft in its place and also removing the tissue opposite the plaque to counter the bending effect. The results are fairly good.

Going for a penile implant is the last option, which is a permanent solution and is commonly done in india. And, the success rate for penile implant is also very high.

Peyronie's Disease: About Bent Penis

Most medications are used because of their one particular therapeutic effect. However, invariably, they affect other organs or systems and produce some good and some adverse effects. The same happens with birth control pills (BCPs), which are the most commonly used method of contraception. It is also the most effective method. It contains the female hormones estrogen and progesterone in various combinations and these have an effect on various body functions, so it should come as a surprise that regular use of BCPs leads to a number of side effects.

Read on to know more

Intermenstrual bleeding: This is the most common side effect and occurs in about 90% of the women, but usually subsides within 3 months. They experience bleeding between their regular periods. While mere spotting can be ignored, bleeding for more than 4 to 5 days needs a visit to the doctor.
Missed period: It is very essential to take the pill at the same time daily. Sometimes, a period might be missed or may be very light and this should be reported.
Effect on libido: While some report a decrease in libido, there are others who experience an increased sex drive. This depends on the individual and not consistent.
Vaginal discharge: The amount and type of discharge can change when on the pill. Decreased lubrication may lead to a reduced sex drive, as it might be painful. If the discharge is foul-smelling or looks suspicious for an infection, then a doctor should be consulted.
Mood changes: Changes in mood and prominent mood swings are very common in women using contraceptives, with many feeling depressed often.
Effects on breasts: While it is not yet proven if they increase the risk of breast cancer, most women experience breast enlargement, tenderness, and sometimes pain. This is more common in between their periods.
Headaches and migraine: BCPs are also proven to have worsening effects on migraine and headaches.
Circulatory effects: Oral contraceptives increase the chances of heart attack and stroke, especially in women who are over 35 and are smokers. Most women experience a slight increase in blood pressure and are more prone to form blood clots. It is essential that contraceptives are used under medical guidance only.
Digestive effects: Oral contraceptives can cause loss of appetite, changes in body weight, diarrhea, and nausea. The weight gain is also attributed to increased fluid retention, especially in the hip and breast areas.
Skin: Some women may experience skin rashes and acne and sometimes hair loss due to the increased level of hormones in circulation.
It is very important that the pill is taken at the same time for best results. Any suspicious symptom should be immediately reported to the doctor.

10 Side Effects of Birth Control Pills

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

One of the most important decisions a couple takes is to start a family. It fills them with hope and joy of new future, but if the attempts have been unsuccessful for more than six months, it can take a toll on the relationship and the mental health of the couple. This is the time to seek fertility specialist who will be appropriate to analyze the situation and provide proper guidance. Read on to find out the exact indications to see a fertility specialist:

1. If a woman who is under the age of 35 is unable to get pregnant even after a year of having regular unprotected sex
2. A woman who has had more than three miscarriages
3. Someone who has suffered from blocked fallopian tubes and is in need of surgery
4. One who experiences irregular ovulation
5. A couple who has suffered from genital infections
6. A pregnant woman who has consumed an estrogen derivative
7. A man who has been diagnosed with low semen count, also known as poor motility
8. A couple who has not been diagnosed with any irregularity but is infertile

Which specialist should you visit?

If you or your partner or both have shown signs of infertility, then visiting the following specialists can be helpful:

Specialists for men

Urologists and Andrologists are specialists who treat men for infertility. Urologists conduct an analysis of semen quality, semen count, hormone levels, reproductive organs and abnormalities in bladder and kidneys. Andrologists are medical professionals who specialize in hormonal conditions and physiology of male infertility.

Specialists for women

Hormonal imbalance is one of the potent obstacles to pregnancy. If a general obstetrician/gynecologist has not been able to successfully treat a woman then she can visit a reproductive endocrinologist who specializes in hormonal disorders. Depending upon the nature of the problem, she can also visit a reproductive surgeon who deals with uterine abnormalities, endometriosis, and reproductive organ surgery.

When Should a Couple See a Fertility Specialist?

There is hardly any person who does not want to enjoy a healthy and satisfying sex life. As per Ayurveda, a healthy sex life is very much a reality provided one diligently follows the golden sex rules as mentioned in various Ayurvedic books and journals:

Ayurveda believes that a couple should refrain from having sex when the female partner is having her periods. Some health experts are of the belief that sex during periods may give rise to a condition termed as Endometriosis (the endometrial cells grow outside the uterus, often in the ovary or the fallopian tubes).
According to Ayurveda, an ideal sex position is one where the woman is lying with her face directed in an upward position.
Ayurveda also believes very overweight or obese people should avoid having sex.
Have sex only when your private parts are clean and healthy (as this helps to prevent infections and associated complications).
According to Ayurveda, loyalty and faithfulness are what gets a relationship going. Infidelity, adultery, or cheating on your wife is a crime that will only spell doom.
Ayurveda is against a couple having sex during pregnancy or immediately after delivery. One should have control over their urges. It further states that a 5-months time in the case of a C-section and 2-3 months interval in the case of a normal delivery will go a long way in ensuring a healthy sex life (will help the woman to recover well).
Ayurveda is vehemently opposes violent sex. Making love is suppose to soothe your soul rather than scar it. Violence during sex is not healthy at all.
Ayurveda believes in having sex using sexual organs. Thus, oral sex and other similar pleasures are a big No as per Ayurveda.
Ayurveda does not advocate the practice of having sex on days of prime significance such as festivals, various eclipses, on a full moon or new moon nights, to name a few.
Sex on empty stomach or after a heavy meal can trigger a plethora of health problems by causing a Vata and Pitta imbalance. The imbalance may give rise to digestive problems, headache, gastritis.
Ayurveda is strictly against the idea of having sex with aged women or with children.
Always have sex when both the partners are in a comfortable position. This is to ensure that you enjoy the intercourse sans any injury.
Never have sex if you are sick or physically and mentally not fit.
Having sex with animals (bestiality) is considered unhealthy as per Ayurveda.
Sex is not a wise idea when you have to lighten yourself (defecate or urinate).
According to Ayurveda, your sex life is governed by the four seasons during which your body strength changes.
The body strength is the lowest during the monsoon and summer, hence have less sex during that time (once in fifteen days).
With moderate body strength, sex once in three days is advisable during spring and summer.
During winter the body strength is at its peak, hence one can have sex daily.

Golden Sex Rules Of Ayurveda!

Hypogonadism in females occurs when your sex glands produce little or no sex hormones.The sex glands, also called gonads that are responsible for ovary formation in females, breast enlargement and in menstrual cycle.

What Are the Types of Female Hypogonadism?
There two types of hypogonadism are primary and central hypogonadism.

Primary Hypogonadism
Primary hypogonadism means that you don't have enough sex hormones in your body due to a problem in your gonads. Your gonads are still receiving the message to produce hormones from your brain, but they aren't able to produce them.

Central Hypogonadism or Secondary Hypogonadism
In central hypogonadism, the problem lies in your brain. The hypothalamus and pituitary gland in your brain, which control your gonads, aren't working properly.

Causes of Primary Hypogonadism
1. Autoimmune disorders, such as Addison's disease and hypoparathyroidism
2. Genetic disorders, such as Turner syndrome and Klinefelter syndrome
3. Severe infections
4. Liver and kidney diseases
5. Hemochromatosis, which happens when your body absorbs too much iron
6. Radiation exposure
7. Surgery of your sex organs

Causes of Central or Secondary Hypogonadism include
1. Genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development)
2 Infections, including HIV and AIDS
3. Pituitary disorders
4. Inflammatory diseases including sarcoidosis, tuberculosis, and histiocytosis
5. Obesity
6. Rapid weight loss
7. Nutritional deficiencies
8. Use of steroids or opiates (especially long-term usage)
9. Brain surgery
10. Radiation exposure
11. Injury to your pituitary gland or hypothalamus
12. A tumor in or near your pituitary gland

Symptoms that May Affect Females Include:
1. Lack of menstruation
2. Slow or absent breast growth
3. Hot flashes
4. Loss of body hair
5. Low or absent sex drive
6. Milky discharge from your breasts

Treatment for Hypogonadism in Women
Your treatment will involve increasing the amount of female sex hormones in your body. Your first line of treatment will probably be estrogen therapy if you've had a hysterectomy. Either a patch or pill can administer the supplemental estrogen hormone. Estrogen must be balanced with progesterone, because taking estrogen alone leads to a dangerous build up of the lining of the uterus (endometrial hyperplasia) that can lead to cancer of the uterus. Low-dose testosterone may be added for women with hypogonadism who have a low sex drive.

Types, Causes and Symptoms of Female Hypogonadism

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