Dr. Manu Rajput

Intercourse is meant to be a pleasurable and intimate experience. But it might become an unpleasant act if you are suffering from performance anxiety. When you are mentally occupied by questions such as "Do I look too fat?" or "Did I do that right?", sex stops being a gratifying experience.

Incessant anxiety over your ability or appearance can result in sex becoming nerve-wracking and stressful for you. It might even have you avoiding sex altogether. This psychological condition is termed as sexual performance anxiety.

Sex isn't only a physical reaction, there are emotions tied to it as well. If you are too stressed out and your mind is preoccupied, your body reflects your inner turmoil and you cannot get aroused.

Causes: The causes of sexual performance anxiety include:

1. Fear that you wouldn't be able to satisfy your partner and perform well sexually
2. Body image issues (Such as stressing about your weight)
3. Problems in your relationship
4. Men worry that their penis don't 'measure' up
5. Men might be concerned about taking too much time to orgasm, or about premature ejaculation
6. Women worry about not enjoying the experience or being unable to have an orgasm

Symptoms: Your mental state has a deep impact on your physical state. The effect of stress hormones norepinephrine and epinephrine can hinder your sexual performance. Symptoms of sexual performance anxiety include:

1. In men, blood vessels constrict due to the effect of stress hormones. This leads to reduced blood flow to the penis, thus making it difficult for the man to get an erection.
2. Often though it is less diagnosed in women, sexual performance anxiety leads to trouble in lubrication during sex. Lack of lubrication dims the desire to have sex.

Sexual performance anxiety is a vicious, inescapable cycle. Increased anxiety hampers you from having sex, making you think you won't be able to perform well, which causes even more anxiety.

Treatment: Consult a doctor you will be comfortable with discussing your problems. Sexual performance can be either treated by medication (if you have an underlying medical condition such as erectile dysfunction) or through therapy.

Talking to a therapist or counsellor about your problems can help you in several ways. You can learn to become more comfortable with yourself and your body. You can also understand your problems better, which can eliminate your anxiety.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Blood in semen occurs due to a variety of factors. It is also called 'hematospermia.' It mainly affects men after 30 years of age. After 50 years of age, blood in semen is caused due to prostate enlargement. Blood in semen is caused due to injuries, inflammation and blockage near the male reproductive system. Blood in semen can be linked to other diseases which might not be known by the affected person.

What can cause blood in semen?

1. Blood in semen can be caused due to infections, tumors and stones.
2. Abnormal body structure generally due to an autism spectrum disorder can also cause blood in semen.
3. Prostate biopsy (removal of tissues from the prostate region which produces semen) also leads to blood in sperm sometimes. Though this is temporary and heals within three to four weeks.
4. Vasectomy is a procedure done on men, which involves making small holes or slits in the scrotum so that the sperm doesn't flow during ejaculation. This is mainly done to prevent unwanted pregnancy. Sometimes, vasectomy causes blood in semen.
5. It is also caused by infections such as Herpes, Chlamydia and Trichomoniasis.
6. Sometimes, there are kidney stones found in the prostate called calculi, this is the most common reason for blood in semen.
7. Blood in semen can also be caused due to parasitic infection, tuberculosis or chronic liver diseases.

Symptoms of blood in semen:

1. Immense pain during ejaculation.
2. Pain during urination.
3. Acute lower back pain.
4. Low to mild fever.
5. Swelling in the scrotum and testes.
6. Tenderness in the scrotum, testes and groin area.

Diagnosing blood in semen:

1. While diagnosing blood in semen physical examinations are performed. The doctor checks for inflammation, swelling, tenderness and signs of injuries.
2. Sometimes sexually transmitted diseases also cause blood in semen. So, the doctor takes a blood test to see whether you have STD's or not.
3. Urine testing is also performed to see if any bacteria or abnormalities are found in the urine.
4. MRIs, ultrasounds and CT scans can also locate any obstructions in the pelvic area which might be a cause of blood in semen.

If you wish to discuss about any specific problem, you can consult a doctor.

Sex toys are a wonderful tool to spice up your love life and bring variety into the bedroom. The trend of using these toys is on their way up as more and more people are using them. However, there are certain things you should be mindful of while using them or if you are planning to start using them.

Some of the things you need to look out for are mentioned here.

1. Determine how porous a toy is: This is a very important factor while choosing a toy as this will determine how its usage in the long run affects your health. The porosity determines two things about the toy:
   • How absorbent the material is
   • What material it is made out of
     This is very important as extremely porous toys will encourage the accumulation of bacteria, which might fester in them and may increase the chance of infections in the long run. Material is also important as certain materials can be very harmful to your health when used in the long run.
2. The material or chemical composition of the toy: This is one of the most important things you need to look out for. Even before buying a toy, it is advisable to look for the chemical composition of the toy, if possible. It would be better to look at its packaging to determine the materials. Some toys are known to contain phthalates or chemical plasticizers which are classified as carcinogenic and are commonly found in cheap sex toys.
3. Using condoms with your toys: Most toys are supposed to be used with condoms as cleaning them and keeping them microbe free is much easier this way. Using condoms with your sex toys minimizes your chance of bacterial infection through the bacteria already deposited on the toy.
4. Choose higher quality products from known manufacturers: The sex toy industry is not regulated by medical bodies in most places across the world and thus, smaller manufacturers may cut corners on their products and use materials that will be harmful to your health. Thus, it is advisable to stick with better known manufacturers who are trusted by customers and are known to make only the best quality products, even if they are pricier.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Every man tries to please his partner in bed and make her feel really happy and satisfied. However, this always does not happen due to various reasons. Worrying about it is sometimes half the reason. Stop worrying about it and the results would definitely be better. 

Premature ejaculation is when either of the partners feels dissatisfied and wishes it could last longer. It is a very subjective situation and while some feel satisfied very quickly, others might take some time and wish it would last a little longer. 

A time-based definition is not therefore in place, and if a couple is facing an issue that the act does not last long, they could see a doctor to discuss if things are normal and if there is something that needs to be done about it. 

Causes: In most cases, there is not always a deep-seated physiological issue. A lot of it is psychological and easily managed. 

1. Psychological: Performance anxiety during intercourse, other stressors in life, habitual hurry towards climax or lack of understanding between the partners. 
2. Physiological: Hormonal issues, longstanding chronic illnesses, medication side effects, poor reflex mechanism, and infections in the reproductive tract, heredity, and surgical or accidental trauma leading to improper functioning of the organs. 

There is no effect of premature ejaculation in physiological or biological terms. Also there is no effect on fertility. It is however, a matter of dissatisfaction between partners which can add a lot of strain in the relationship. In very rare cases, the sperm count could be low and fertility treatments may be required. 

Some tips and techniques to improve premature ejaculation are as follows: 

1. With age, most men gradually gain control. While young adults seem to come far too quickly, those in the 30s and 40s are more in control. 
2. Meditation and Yoga help to manage stress better and therefore prolong erections 
3. Quitting smoking and alcohol can help in dealing with the problem of premature ejaculation in addition to a host of other problems 
4. A good amount of sleep (~8 hours) can help rest your brain and perform adequately 
5. Reduce consumption of caffeine which can improve brain functioning 
6. A mixture of boiled milk with honey and ginger added can help get rid of premature ejaculation 
7. Add asparagus root to a glass of boiled milk and drink daily and the results will surprise you 
8. Eating two to three cloves of garlic can help in keeping the erections longer 
9. Another great aphrodisiac is saffron, which helps in increasing the sexual drive 
10. To finely chopped carrots, add one spoon of honey and a half-boiled egg. This helps improve the quality and duration of erections 

These are few simple tips and techniques which can be used in managing premature ejaculation. As noted, in most cases, having a partner whom you can confide in is very important. If you wish to discuss about any specific problem, you can consult a doctor.

Stress can take a toll on your health in more ways than one and your sexual health is greatly and adversely impacted by stress. Stress can take a toll on the emotional relationship you share with your partner and also your own physical health, thus resulting in a hampered sex life.

Stress and Our Libido:

By now, we know that hormones affect our bodies in numerous ways from childhood to adolescence, pregnancy, menopause and beyond. Cortisol is one of the hormones produced by stress, and you might have heard of it if you’ve ever seen those late night diet pill commercials with the image of the pixelated woman gaining weight in her abdomen. Our bodies need this hormone, but in small doses for short bursts of time. If elevated levels of Cortisol are being produced for a prolonged period of time, they suppress our sex hormones. Lower quantity of sex hormones equals lower libido.

Impact of Stress on Sex:

1. Stress takes a toll on libido.
2. Low levels of libido imply lesser secretion of sex hormones, thus, affecting your sex life.
3. Stress can interfere with your fertility, ovulation and sperm count.
4. Stress can cause a shift in the hormones. In women, the change in hormones manifests in the form of an irregular ovulatory cycle.
5. Loss of intimacy.
6. Being under stress constantly can lead to anger, emotional outbursts, depression and loss of intimacy with your partner; thus affecting your sexual relations.
7. Stress also affects your body image negatively, thus leading to unpleasant and bad sex.

How to rejuvenate your sex life?

1. Communicate your feelings:  Many a times, communicating and sharing your feelings, desires and anxiety with your partner might be all that you need to rejuvenate your sex life.
2. Regular exercise and proper sleep: 20-30 minutes of body work out or a session of yoga everyday helps you to de-stress. A proper eight-hour sleep cycle will also go a long way in de-stressing you.
3. Supplements to boost your libido and energy: Taking multivitamins, minerals, zinc and other supplements helps to boost your energy levels and libido, thus allowing you to enjoy your sex life to the fullest.
4. Set the mood correctly: Set the right mood before your intimate sessions; with some soothing music, aromatic fragrance and dim lights. This can and will enhance your sex life by promoting relaxation, happiness and overall emotional well being. If you wish to discuss about any specific problem, you can consult a sexologist and ask a free question.

Erectile dysfunction is one of the most common issues faced by the male population. From hormonal problems to performance anxiety issues, the reason can be manifold. It is the inability of a male to achieve and maintain an erection leaving both him and the partner unsatisfied. It cannot be ignored as a minor issue, as it could severely affect morale and even break relationships. Ayurveda looks at erectile dysfunction (ED) as a manifestation of an underlying issue ranging from dislike for the partner to physical or mental exertion to reduced hormone levels to neurological diseases, hypothyroidism problem, depression, diabetes, and other cardiovascular problems.

There are a number of proven Ayurvedic remedies that can help in overcoming the issue of erectile dysfunction.

1. Boling drumstick flowers in milk and sipping a glass of this lukewarm mixture for 1 to 2 months can help in experiencing good erection that lasts longer and improves satisfaction.
2. A mix of chopped carrots, half-boiled egg and honey can be had every single day for a month to help get rid of erectile dysfunction.
3. Yet another remedy consists of making a paste of ginger to which honey is added and consumed daily 3 times a day.
4. Regular consumption of this herbal preparations helps in rejuvenating the reproductive organs. Some of the common herbs used include Ashwagandha, Shilajit, Rejuzoa, Vajimix, and Gokshura capsules
5. Good amount of sweets, nuts, milk and milk products, and lentils add to improved sexual life.
6. Try to avoid eating spicy and bitter foods
7. Include good amount of ghee on a regular basis
8. A good massage for the body with herbal oil provides relief from physical stress and also boosts sexual urge, which can prolong erection
9. Start doing yoga and meditation as one of the main reasons for ED is physical stress and anxiety
10. Performance anxiety can be managed with yoga, which can help in curing ED
11. Eat healthy, sleep for at least for 8 hours daily
12. Reduce or quit consumption of tobacco, alcohol and narcotic drugs
13. Regular physical exercise can also do wonders in curing ED

While these are some regular ways to manage and prolong erections, in most cases, there is also a psychological component to it. Reaching a good comfort level with your partner who can understand and help resolve the issue is very important. In almost 90% of the cases, an understanding partner can help solve the problem and completely cure the issue. So, in addition to trying these above medications, talk to your partner. As a next step, you and your partner can visit an Ayurvedic doctor, who can help find the last leg of cure for your problem. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

What is Low Sperm Count?
Low sperm count or ‘Oligospermia’ is a condition that indicates that the semen that you discharge after an intimate climax contains fewer sperm cells than normal (the limit being 15 million sperm cells in a milliliter of semen).

How would you know if you have a low sperm count?

1. You have difficulty in sustaining an erection during an intercourse.
2. Lump formation in your testicle region accompanied by pain.
3. Amount of body or facial hair reduces.
4. Inability to father a child even after indulging in unprotected sexual intercourse.

What causes a low sperm count?

1. Inflammation of the veins that may lead to draining of the testicles.
2. Infections can hinder production of sperms and affect your sperm health.
3. A condition called ‘Retrograde Ejaculation’ wherein the semen goes back into the bladder during an orgasm instead of an ejaculation through the tip of the penis.
4. Anti-sperm antibodies that mistakenly consider the sperm as a potential threat and try destroying them. This usually happens in case you have undergone a vasectomy (technique of male sterilization) surgery.
5. Cancerous or other benign tumors can also result in this condition by affecting one’s pituitary gland.
6. Testicles which haven’t descended to the sac from the abdomen.
7. Hormonal abnormalities.
8. Defects in the sperm duct.
9. Disorders in inherited chromosomes.
10. Celiac disease: A disorder caused because of gluten sensitivity.
11. Side-effects of certain medications such as antibiotic medicines or antifungal creams, chemotherapy, medications to treat ulcers and other anabolic steroids.
12. Environmental factors such as over-exposure to industrial chemicals, heavy metals such as lead, X-rays or radiations and long hours of bicycling.
13. Lifestyle and health related factors such as substance abuse, excessive consumption of alcohol, smoking tobacco, high levels of stress and being over-weight or obese.

Treatment

1. Surgery can be an option to fix the swelling of the veins and sperm retrieval methods to retrieve sperms from one’s testicles.
2. Nursing the infections using antibiotics; however, this may not end up restoring one’s fertility.
3. Hormonal therapies and treatments for treating low or excess levels of a few hormones or to treat the way your body uses certain hormones.
4. Assisted Reproductive Technology treatments that involve methods of normal ejaculation to obtain sperms or from sperm donors.

Erectile dysfunction is the inability to have or maintain an erection. It's not a disease, but it's provoked by some disease. A lot of men who have diabetes, testosterone level disorder, cardiovascular diseases, depression, severe anxiety and other problems tend to have the symptoms of ed. All these diseases can interfere with the process of erection. The most widespread cause of erectile dysfunction is the problem with vessels in the penis. When your vessels don't function well as a result of cardiovascular diseases, blood flow in the penis can't supply the penis with a normal portion of blood. So, as a result, your erection is week or you don't have any erection at all!