Dr. Nupur Pagore

What is Monogamous Relationship?

You (who have been tested for STD/STIs and don't have any) are having sex with only one partner (who also has been tested for STD/STIs and doesn't have any) who only has sex with you. And you both keep it that way! 

Stated another way, you are both STD/STI free and only have sex with each other. People of any sexual orientation can engage in monogamous relationships. The only thing implied by the term monogamy is that the relationship consists of two people who are romantically and/or sexually exclusive. Theoretically, outside of abstinence, this is really the safest type of "safer sex" that you can have. 

Celebrated on 1st December of each year, World AIDS Day, aims to spread awareness about HIV / AIDs. It is an STD wherein, HIV stands for human immunodeficiency infection and AIDS stands for acquired immune deficiency syndrome. The disease hinders the immune system in keeping up our body’s security against sickness. HIV causes individuals to end up wiped out with infections that regularly would not affect them and HIV leads to AIDS.

Understanding the Symptoms:

HIV has few or no signs or symptoms for up to ten years or more before side effects of AIDS tends to manifest. There is no cure for HIV/AIDS, yet treatment is accessible. A few people have HIV symptoms not long after being infected. These include:

1. There are a few phases of HIV illness. The primary HIV side effects may include swollen glands in the throat, armpit, or crotch.
2. Other early HIV symptoms incorporate slight fever, headaches, exhaustion, and muscle throbs.
3. These symptoms may keep on going for just a couple of weeks. At that point, there are typically no HIV indications for a long time. That is the reason it can be difficult to know whether or not a person is suffering from HIV.

The symptoms of AIDS show up in the most advanced phase of the HIV disease. These are as follows:

1. Along with a severely damaged immune system, a person with AIDS may likewise have thrush. A thrush is a thick, whitish covering on the tongue that is brought about by a yeast infection and now and then joined by a sore throat.
2. Serious or repetitive vaginal yeast infection.
3. Pelvic inflammatory illness.
4. Serious and frequent infections.
5. Unexplained fatigue that might be followed by headaches, dizziness.
6. Loss of more than ten pounds of weight that is not because of physical exercise or consuming fewer calories.

Risk Factors: There are a lot of ways in which you can get the infection. HIV is transmitted through blood, semen, vaginal fluids and breast milk. The most well-known ways in which HIV is spread, are:

1. Having sexual intercourse without a condom with somebody who has HIV/AIDS.
2. Using needles or syringes that have been used by someone who has HIV/AIDS.
3. Being punctured with a needle or surgical instrument that has been contaminated with HIV.
4. Getting HIV blood, semen or vaginal discharge into open injuries or wounds.
5. Babies born to women with HIV/AIDS can get HIV from their mothers during birth or from breastfeeding.

There are numerous ways in which you can protect yourself from HIV. These are as follows:

1. The most secure way is to limit the number of sexual partners you take on.
2. Try to have safer sex and always use protection.
3. Get your partners tested for HIV.
4. HIV tests are a typical piece of social insurance.

In case that you think you may have been infected by HIV, talk to a specialist or a doctor about testing. Discussing what risks you might have taken can help you choose whether testing is ideal for you. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Arthiritis, stroke or inner ear problems which cause dizziness can cause elders to fall.

If you get up in the morning with headache or pain on cheeks,its probable that you may be clenching or grinding your teeth at night.consult your dentist who can verify and provide you a solution for it.

How Gender Identity Disorder can be treated?

Hello friends, I am Dr. Anubhav Gupta. I am a consultant plastic surgeon working at Sir Ganga Ram Hospital, New Delhi. Today, I am going to talk about a condition which has increasingly become more frequent in our practice and that is Gender Identity Disorder.

Gender Identity Disorder is a condition where in a person has incongruency between his sex and gender. Let me explain it to you, a person whose phenotypic and genotypic condition is male, his sex is also male. For example, a person who is having external genitalia, penis, beard, etc that is his phenotype, that is his sex and that is also a genotypic test as gene XY, so that will be his sex. But, gender is what a person feels about himself. For example, a male who is having phenotype and genotype sex as male but he feels he is a female then that is the gender of that person. What a person feels about himself is called his gender. So, when there is an imbalance between the sex and the gender of a person, it is called Gender Identity Disorder.

Basically, it is not what is wrong about them, it is why they feel about this. There is something which is hardwired into their brain, that they don’t have a feeling of equilibrium with their sex. It is not a disease; it is the way they think. There are certain neurohormonal factors which at the time of development have been said to cause this condition but there are no researchers that conclude the cause of this condition.
Yes, the government of India has now recognized the third gender that is transgendered. People who are not in congruence with their sex have been recognized as legal by the government of India.
See, when these patients come us, basically there are now well-described guidelines. When the patient first, comes to me, I first tell them what the exact condition that they have is and I send the person to a psychiatrist for evaluation. We have to be sure whether they have Gender Identity Disorder before we go for the surgery. So, the psychiatrist starts his treatment, basically takes counseling sessions and he tries to ascertain whether this person is actually having gender identity disorder.

Now, the recommendations are that permanent gender surgery, that is the change of gender surgeries like penectomy and vagina creation and penile creation, these are gender surgeries and are permanent in nature, should not be done before 1-year certification by the psychiatrist has been given. But, other surgeries like face surgery, and breast surgery, can be done after 3 months of psychiatric evaluation. So, this is what we follow. Once a psychiatrist has seen and he certifies that this person has gender identity disorder, we start doing the facial surgeries, and once a period of 1 year has passed, in the meantime we also send him to an endocrinologist who counsels them about hormonal therapy and we further encourage them to cross dress and live in the society as the gender of which they feel they want to stay.

So, once these things fall into place then we move into surgery. And, before surgery, we also need a certification from another psychiatrist just to counter and confirm what the first psychiatrist has felt. So we have certification from two psychiatrists and after a period of one year, we can proceed to Permanent Gender Surgery. Before we do that gender surgery we also need to take an affidavit in the court of law in which the person who is undergoing the surgery and the surgeon, they understand the fact that it is a permanent surgery and the person who is undergoing surgery will not be able to procreate or reproduce in the future, and the patients, when they understand these factors are then counseled and then the surgery is done.

In male to female patients, the initial surgeries, we start with the face surgery, such as Genioplasty and Rhinoplasty. Then, these patients, if they require breasts, we go for a breast augmentation by implants. There are two types of implants; if the chest is having enough space, we can go for a silicone implant and sometimes the chest of males are very tight, then we have to use an expander implant. So these are the common surgeries. Then there is the genital surgery which is a permanent surgery where we do a penile disassembly surgery and we use the penile skin to create a new vagina and we do an orchiectomy at the same time and so we do a gender surgery.

In the female to male also, we start with the face, rhinoplasty, brow lift, genioplasty, McSteamy is done, and these are the initial surgeries. Mastectomy is done where the male chest is created. And, finally after one year of treatment, we go for a creation of a new phallus, we create a penis by the process of radial artery forearm flap, wherein we take the skin from the hand and we create a penis. After that, we can do testicular implants in the labia majora to create testicles. And later on, this surgery is successful of the penile reconstruction by radial artery forearm flap and the patient is having sensation till the tip of the penis. Then we do a final erectile implant which can even cause the erection.

If you have any further queries regarding this topic, you can contact me on Lybrate.
 

Alcohol can it affect your intimacy level with your partner, yes! But with this you might be wondering how can that be possible when you actually sustain yourself for long, maybe longer than you should be. It is probably the “whiskey penis”. Alcohol may give you a sense of elation at one point of time, but it is essentially a nervous depressant. The over consumption of alcohol mainly has a reduced effect on sensitivity for both men and women.

How alcohol affects sex life in men: The effect of alcohol on the sex life of men is immense. In most cases, chronic and acute cases of alcohol consumption have shown to reduce the production of testosterone in men. Since testosterone is the hormone that results in the increase in libido in men, the effects of alcohol really reduce the performance in men. It has shown to reduce pleasurability and it can also reduce the intensity of orgasms. Sometimes, it can cause difficulty in ejaculation or delayed ejaculation.

How alcohol affects sex life in women: Alcohol can have a very mixed effect on women in general. While it can increase sexual arousal and desire, it can also result in low sensitivity. Women have a higher percentage of fat as compared to water in their bodies, this means that alcohol has a more profound effect on their bodies as compared to that in men. Their bodies also take longer to process and eliminate the alcohol. While some women report a heightened sense of sexual arousal and an increase in the duration of the orgasm, a large number of women also complain of lesser lubrication.

Alcohol also has a psychological effect; that is the loss of inhibition that may help in developing carnal instincts when intoxicated. This psychological effect may have a more profound effect than the physiological effects as a result of which women might claim that alcohol does indeed help in better sex. If you wish to discuss about any specific problem, you can consult a sexologist.