HIV Test – Easy & Confidential - By: b.thompsom
What type of test is there for HIV?
The actual test name for determining if HIV is present is called the Elisa confirmed by Western Blot test. Most people infected with HIV will show a positive test result within 3 months of exposure to HIV, using the screening test (repeated Elisa). If the screening test proves positive, that result is immediately confirmed with the Western Blot confirmation, which uses the same blood sample (you will not be required to give another blood sample). If you test for HIV before the antibodies have had enough time to appear (this process is called Seroconversion), you may receive a “false negative” result. If you believe you may have returned a false negative result, we recommend testing again within 6 months.
What kind of sample is required?
This HIV Test requires a blood sample which will be drawn by a medical professional at local testing facility of your choosing.
How to Prepare for Your Test?
No advance preparation is required before your test - just be prepared to have your blood drawn during the visit.
When can I expect results?
HIV blood test results are usually available within 1-5 days, but when ordered with other tests will only be available after all tests have been resulted. After you purchase your test from us, you can choose to receive a phone call or email with your results.
Is there an at-home test kit for HIV?
We do not currently offer an at-home testing option for HIV as the test requires blood to be drawn by a medical professional, ensuring maximum accuracy for test results.
What if I have a positive result?
If you get tested and are returned a positive result, we are here to help. Through our partnership with the American Social Health Association (ASHA), we have certified expert STD counselors to help you interpret results and discuss any concerns you may have. Additionally, we have medical doctors available 24-7 (by appointment) that can answer any questions you may have and refer you to a local specialist who can help you.
Purchasing your Test:
Local Center Testing: Choose a local testing center convenient to you, and show up within business hours (no appointment is required).
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Acquired Delayed Ejaculation - By: David I Crawford
Psychological Factors
The only way to determine the cause(s) of delayed ejaculation is the clinical interview. There are no specific characteristics of psychologically induced acquired delayed ejaculation. Obviously, the ejaculation disturbance has not existed previously. In addition, the onset may be sudden, the delay may be situational and also intermittent. Some factors may be related to the development of acquired delayed ejaculation, such as a psychological trauma (for example, the discovery of the partner’s infidelity), or lack of sexual and psychological stimulation (inadequate technique or lack of attention on sexual cues).
Organic Factors
The onset of ejaculation delay may be sudden or gradual and deteriorates progressively to global unremitting ejaculatory inhibition. A rather normal delay of ejaculation occurs during aging. Androgen deficiency or hypogonadism may be accompanied by loss of sexual desire and delay of ejaculation. Any neurological disease, injury, or surgical procedure that traumatizes the lumbar sympathetic ganglia and the connecting nerves (multiple sclerosis, diabetic neuropathy, abdominoperineal resection, lumbar sympathectomy) may lead to a delay or failure of ejaculation. A wide range of drugs (SSRIs, tricyclic antidepressants, antipsychotics, alpha-sympathicolytics) can impair the ejaculatory process through central and peripheral mechanisms. Alcohol can delay or abolish ejaculation by a direct effect after acute abuse and indirectly by neurological or hormonal disturbances during chronic abuse.
Treatment of Acquired Delayed Ejaculation
In order to exclude pharmacological causes of delayed ejaculation, one has to carefully review the patients concomitant drugs that are likely to inhibit ejaculation. In those cases, an alternative drug should be tried, or in case of antidepressants, reduction of dose or antidote may be required. Neuropathic inhibition Male Ejaculation and Orgasmic Disorders 237 of ejaculation is usually irreversible and the patient should be counseled to optimize his and his partner’s enjoyment from the residual sexual functioning. Androgen deficiency requires appropriate testosterone replacement therapy. In the case of inadequate stimulation, pelvic floor exercises may be helpful. Most patients require general advice on reducing precipitating factors, reduction in alcohol use, finding more time for sexual activity when not fatigued.
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Retarded Ejaculation - By: David I Crawford
Many people believe that retarded ejaculation is not a real problem for a couple, as they argue that retarded ejaculation enables a man to go on enough time to enable his female partner to be satisfied with one or even multiple orgasms. The reality of this syndrome is different. Many men suffer from delayed ejaculation and their female partners are very frustrated by it. Quite a number of women think they are not attractive to their partner and that he will be able to ejaculate when making love with another woman. Obviously, if coitus goes on too long, it may become painful for her. The failure to conceive is often a reason to seek help.
Definition
In DSM-IV (American Psychiatric Association, 1994), retarded ejaculation is termed Male Orgasmic Disorder and defined as “a persistent or recurrent delay in, or absence of, orgasm in a male following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person’s age, judges to be adequate in focus, intensity, and duration.” In more simple terms, retarded ejaculation means that a man finds it difficult or impossible to ejaculate, despite the presence of adequate sexual stimulation, erection, and conscious desire to achieve orgasm. Some of these men may struggle to ejaculate with such desperation that they may physically exhaust themselves, and sometimes even their partner, in the attempt. Delayed ejaculation may occur in coitus, masturbation (either by the patient or by the partner), as well as during anal or oral intercourse.
Throughout the years, a variety of terms have been used to refer to this ejaculatory disorder. Synonyms for delayed ejaculation are retarded ejaculation, inhibited ejaculation, difficult ejaculation, late ejaculation, and ejaculatio retarda or retardata. Other terms for failure of ejaculation are inability to ejaculate, no ejaculation, anejaculation, ejaculatory incompetence, impotentia ejaculandi or ejaculationis, ejaculatio deficiens or nulla, and lack (loss, failure, inability) of ejaculation.
It has to be noted that in DSM-IV there is no formal distinction between retarded ejaculation and failure of ejaculation. Both entities are erroneously termed male orgasmic disorder.
One distinguishes a lifelong (primary) and acquired (secondary) form. If the disorder has always been present, the disorder is termed as lifelong. In the acquired form, the disorder appears somewhere in life after previous normal ejaculatory functioning.
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Premature Ejaculation Course of Rapidity - By: David I Crawford
It is generally believed that aging delays ejaculation. This assumption, might be true for men with a normal or average ejaculation time but has never been investigated in men with premature ejaculation. In a stopwatch study of 110 consecutively enrolled men (aged 18–65 years) with lifelong premature ejaculation, 76% reported that throughout their lives, their speed of ejaculation had remained as rapid as at the first sexual contacts in puberty and adolescence, 23% reported that it had become even gradually faster with aging, and only 1% reported that it had become slower. From these data, it is questioned whether the fixed rapidity and even paradoxical shortening of the ejaculation latency time while getting older should be recognized as a part of the pathogenetic process of premature ejaculation. According to Waldinger, early ejaculation is thought of as a part of a normal biological variation of the IELT in men, but its paradoxical or fixed course through life is considered as being pathological. Chronic premature ejaculation appears to be the clinical syndrome of primary (lifelong) premature ejaculation. As yet, there is no real cure for lifelong premature ejaculation, though drugs may alleviate the symptoms, but only as long as they are being taken.
Premature Ejaculation and Genetics
In 1943, Schapiro noted that men with premature ejaculation seemed to have family members with similar complaints. Remarkably, this interesting observation has never been cited. To investigate the potential familial occurrence of premature ejaculation, I routinely asked 237 consecutively enrolled men with premature ejaculation about the family occurrence of similar complaints. Because of embarrassment only 14 men consented to ask male relatives about ejaculation latency. These 14 men reported a total of 11 first degree male relatives with information available for direct personal interview. In fact, 10 relatives fulfilled our strictly defined criterion of an ejaculation time of 1 min or less. In this small selected group of men, the calculated risk of having a first relative 230 Waldinger with premature ejaculation was 91%. Therefore, the odds of family occurrence are much higher than the suggested population prevalence rate of 4–39%. Moreover, the high odds ratio indicates a familiar occurrence of the syndrome, far higher than by chance alone. On the basis of this preliminary observation, the influence of genetics gains substantial credibility.
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I Want To Get A Syphilis Test - By: b.thompsom
What type of test is there for Syphilis?
The technical name for the Syphilis test is the “Syphilis Rapid Plasma Reagin (RPR)” test with titer and confirmation by Fluorescent Treponemal Antibody (FTA). This is a blood test that detects that antibodies produced by an infected person’s body, that help fight off the infection of Syphilis. A positive screening could indicate a current or previous infection, as the antibodies stay in the body for years which is why we do the confirmation test to make sure.
What kind of sample is required?
The Syphilis Test requires a blood sample which will be drawn by a medical professional at local testing facility of your choosing.
How to Prepare for Your Test?
No advance preparation is required before your test - just be prepared to have your blood drawn during the visit.
When can I expect results?
Syphilis test results are usually available in 1-5 business days. After you purchase your test from us, you can choose to receive a phone call or email with your results.
What is included in the cost of the test?
Your purchase not only includes the actual testing, but also includes a free post-results phone consultation with our physician. You never have to pay to call our on-call counselors or our in-house physician. Due to the complexity of medication and treatment for syphilis, our physician cannot prescribe medication over the phone; however we can refer you to a local specialist who can help you.
Are there treatment options for Syphilis infection?
Yes, there is treatment available for Syphilis infection. If you return a positive result, our physician will be able to discuss treatment options with you and refer you to a local specialist for continued treatment.
Is there an at-home test kit for Syphilis?
We do not currently offer an at-home testing option for Syphilis as the test requires blood to be drawn by a medical professional, ensuring maximum accuracy for test results.
How often should I get tested for Syphilis?
There is a possibility that the blood test for Syphilis may not find antibodies for up to three months after exposure to the bacteria. If you think you may have been exposed to syphilis, getting another test within 6 months is recommended for your own peace of mind.
Purchasing your Test:
Local Center Testing: Choose a local testing center convenient to you, and show up within business hours (no appointment is required).
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Trichomoniasis test with GetSTDtested is easy and safe - By: b.thompsom
What type of test is there for Trichomoniasis?
The Trichomoniasis test offered by getSTDtested.com is a urine-based test technically named the "Trichomoniasis Vaginalis RNA Qualitative TMA" test. Due to the nature of the test, we can only offer this test through our at-home collection kit that you can use from the comfort of your own home.
What kind of sample is required?
Our Trichomoniasis test requires a simple urine sample, mailed back to our lab through our at-home collection kit.
How to prepare for your test?
The only required preparation is to not urinate for at least one hour before giving your sample.
When can I expect results?
Trichomoniasis test results are usually available in 7-10 business days after we receive your sample at our lab. Please plan for 2-3 business days of shipping in addition to the testing time. After you purchase your test from us, you can choose to receive a phone call or email with your results.
What if I have a positive result?
If you get tested and are returned a positive result, we are here to help. Through our partnership with the American Social Health Association (ASHA), we have certified expert STD counselors to help you interpret results and discuss any concerns you may have. Additionally, we have medical doctors available by appointment that can answer any questions you may have and, in most cases, are even licensed to prescribe treatment. It is important to note that a doctor's consultation is included in the price of your test, but there will be an additional charge if you would like our physician to prescribe treatment.
Purchasing your Test:
At this time, we can only offer at-home collection for the Trichomoniasis test package:
At-Home Test Kit: Test from the privacy of your own home with our at-home STD test kit. Once you receive our collection kit in the mail, you will send a urine sample back to our lab for analysis. Click here to purchase an at-home Trichomoniasis test kit. Click here to purchase an at-home Trichomoniasis test kit
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Signs of Pregnancy: Some Initial Information - By: controllingaddiction
The signs that a baby is going to come ion your life, give you lots of joys and happiness. The mother should get immense care and nourishment in a time of pregnancy whether it is a first baby or second. A pregnancy can bring many changes in the body and the changes continue until the baby takes the birth. The mother should understand the pregnancy as early as possible and this can help her to care for the future. The Early signs of pregnancy are the stage when the woman gets the feeling of being ‘pregnant’. The signs can be at variance from one person to other; however, some of the symptoms are completely similar. A late period is the first sign of pregnancy. It also said as missed period. If the woman has an irregular period since the early time, she may not understand it. Many of the other conditions can also lead to a missed period condition like intake of drugs, birth control pills any mental stress. Thus, the symptoms should also include others. The woman is in the early stage of pregnancy can have a light or heavy spotting or vaginal bleeding. It generally happens after twelve days of the egg formation. The blood that is released may look like pink or brownish red. This can stay for at least two days. This is medically known as implantation bleeding. She can also suffer with fainting. Her interest of having foods can also be less.
The woman who is pregnant will also have a change in the breasts. The breasts will be swollen and sensitive. Within a period of two weeks of the egg formation, the breasts get the affects. They become sensitive because of the hormonal changes. The other symptoms like nausea are also a very typical sign. This condition is also very much popular as ‘morning sickness’. Here, the pregnant woman may have a frequent feeling of vomiting especially in the early morning or at night. The signs of pregnancy also increase the level of estrogen in the body and thus, the stomach gets empty very slowly. It also causes an allergic sense to odors or smells. Here, the smell can even be the smell of cooking or cigarette smoking and perfume. In a pregnant woman, the uterus expands and applies pressure to the urinary bladder. The blood and the other fluids inside the body also start increasing and give nurture to the fetus. In this way, it forces the kidney to release more fluids. As a result, the woman feels more number of urination. The pregnant woman may also face constipation. Because of the increased level of progesterone, the food goes through the intestines very slowly and this creates constipation in the woman. The woman will have headaches. A pregnant woman will also have a frequent mood swings and change in her food habits. She can also a habit of sleepiness and a low back pain. The woman who is suffering with any kind of allergy, heart disease, sexually transmitted diseases or even cancer or tumor should go for an immediate check up to have a safe delivery. The medical experts do the pregnancy check up through a physical view of the overall health like the pulses, heartbeats, the blood pressure level and the sugar level. They also verify if the woman have a History of any disease or other sickness. A blood test and a urine test also recognize the health condition of a pregnant woman.
The woman who is pregnant should always maintain some care for health. She should have an intake of iron and Vitamin rich foods. Her food should also include enough amount of Zinc and other minerals. The pregnant woman should also have a frequent intake of water and other liquids. She should maintain a habit of mild exercises , yoga and meditation.
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Ejaculation Threshold Hypothesis - By: David I Crawford
In order to understand the suggested biological variation of the IELT in relation to the serotonergic system, delaying effects of SSRIs and suggested genetics, Waldinger and co-workers have proposed the existence of a threshold of the IELT.
In the case of a low setpoint of the threshold, men can only sustain a small amount of sexual arousal prior to ejaculation. Whatever these men do or fantasize during intercourse, any control of ejaculation remains marginal and these men ejaculate easily even when they are not fully aroused. The low threshold is assumed to be associated with a low 5-HT neurotransmission and probably a hypofunction of the 5-HT2C receptor and/or a hyperfunction of the 5-HT1A receptor, as mentioned earlier.
In the case of a higher setpoint, men will experience more control over their ejaculation time. They can sustain more sexual arousal before ejaculating. In these men, 5-HT neurotransmission varies around a normal or averaged level and the 5-HT2C receptor functions normally. The mean and range values of the setpoints that are considered to be normal or averaged are not known. These men have the neurobiological ability to voluntarily decide to get an ejaculation quickly or after a longer duration of intercourse.
In case of a high or very high setpoint, men may experience difficulty in ejaculating or cannot get an ejaculation even when fully sexually aroused. At a high setpoint, 5-HT neurotransmission is supposed to be increased, the 5-HT2C receptor sensitivity is enhanced, and/or the 5-HT1A receptor sensitivity is decreased.
According to this threshold hypothesis, it appears to be the level of 5-HT2C and 5-HT1A receptor activation that determines the setpoint and associated ejaculation latency time of an individual man. In case of men with premature ejaculation or any man using serotonergic antidepressants, the SSRIs and clomipramine activate the 5-HT2C receptor and therefore switch the setpoint to a higher level leading to a delay in ejaculation. The effects of SSRIs on the setpoint appear to be individually determined; some men respond with extreme delay whereas others only experience a small delay at the same dose of the drug. Moreover, cessation of treatment results in a uniform reset of the setpoint within 3–5 days to the lower individually determined reference level, which is assumed genetically determined.
It is speculated that the threshold is mediated by serotonin neurotransmission and 5-HT receptors in the brainstem or spinal cord and may consist of serotonergic fibers that inhibit neurons that convey somatosensory information from the genitals. It is suggested that SSRIs enhance the inhibitory effects of these serotonergic neurons. However, also the cerebral cortex may mediate inhibitory impulses, but currently this has not been demonstrated. Apart from a suggested SSRI-induced increased inhibition of sensory input, the SSRIs might also delay ejaculation by interfering with spinal cord motoneurons of peripheral neurons that inhibit the internal genitals. Further studies are needed to unravel this important and intriguing question.
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More About Chlamydia Tests - By: b.thompsom
What type of test is there for Chlamydia?
The actual test name for determining if Chlamydia is present is called the Chlamydia Nucleic Acid Amplification (NAAT) Test. This is a urine test that is based on amplification of the DNA that is present in Chlamydia trachomatis. The urine test is simple and normally preferable to the traditional method that requires swabbing. This urine test for Chlamydia trachomatis is currently the gold standard for testing and is widely used across the country in both doctor's offices and hospitals.
What kind of sample is required?
Our Chlamydia test requires a simple urine sample, given at either a local testing center or mailed back to our lab (if you choose to test from the privacy of your own home).
How to prepare for your test?
The only required preparation is to not urinate for at least one hour before giving your sample.
When can I expect results?
Chlamydia test results are usually available in 1-5 business days. After you purchase your test from us, you can choose to receive a phone call or email with your results.
What if I have a positive result?
If you get tested and are returned a positive result, we are here to help. Through our partnership with the American Social Health Association (ASHA), we have certified expert STD counselors to help you interpret results and discuss any concerns you may have. Additionally, we have medical doctors available 24-7 (by appointment) that can answer any questions you may have and, in most cases, are even licensed to prescribe treatment. It is important to note that a doctor’s consultation is included in the price of your test, but there will be an additional charge is you would like our physician to prescribe treatment.
Purchasing your Test:
We offer 2 different types of Chlamydia test packages:
Local Center Testing: Choose a local testing center convenient to you, and show up within business hours (no appointment is required).
At-Home Test Kit: Test from the privacy of your own home with our at-home STD test kit. Once you receive our test kit in the mail, you will send a urine sample back to our lab for analysis.
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Male Ejaculation and Orgasmic Disorders - Psychotherapy - By: David I Crawford
The psychoanalytic idea of unconscious conflicts being the cause of premature ejaculation has never been investigated in a manner that allowed generalization, as only case reports on psychoanalytic therapy have been published.
But this is also true for behavioural therapy. Masters and Johnson deliberately refuted a definition of premature ejaculation in terms of a man’s ejaculation time duration. Instead, they insisted on defining premature ejaculation in terms of the female partner response, for example, as a male’s inability to inhibit ejaculation long enough for the partner to reach orgasm in 50% of intercourses. It is obvious that their definition is inadequate because it implies that any male partner of females who have difficulty in reaching orgasm on 50% of intercourses suffers from premature ejaculation.
Masters and Johnson argued that premature ejaculation was conditioned by experiencing first sexual contacts in a rapid way (e.g., in the back seat of a car or with an impatient prostitute). However, Masters and Johnson, and sexologists who followed their ideas, have never provided any evidence-based data for this assumption. Regarding their proposed behavioral squeeze technique treatment, Masters and Johnson claimed a 97% success for delaying ejaculation. However, this very high percentage of success has never been replicated by others.
Usually, a lack of reproducible data leads to critical comments. This is one of the basic principles of evidence-based medicine. The effects of a treatment intervention should be reproducible by others. However, critical comments were not appreciated in the traditional sexological thinking of the late 20th century. This nonscientifically supported and uncritical belief in behavioral treatment still exists today, in spite of clear evidence-based medical research in favor of the neurobiological view. But the criticism is justified. The methodological insufficiencies of the report of Masters and Johnson are very serious. Their report on the efficacy of the squeeze method contains numerous biases.
First, there was a bias in selection and allocation of the subjects, the patients were not randomized to the new squeeze technique, or the older stop– start technique, or a nonsense behavioral technique. Second, the treatment design was open and not double-blinded. Further, the diagnosis of premature ejaculation was not quantified and therefore inaccurate, particularly since Masters and Johnson used an obscure definition of premature ejaculation. Baseline data were not reported, and inclusion and exclusion criteria were lacking. The assessment of success was subjectively reported without quantification or scoring scales. In addition, Masters and Johnson did not provide any information on their data processing. In spite of all these methodological flaws, their behavioral technique has received worldwide uncritical acceptance and been promoted as the best method of treatment. Even the very poor results of two studies on behavioral therapy (also poorly designed) could not prevent sexologists from continuing to claim the squeeze technique as the best method of treatment. Not only the squeeze technique, but also all sorts of psychotherapy, including thought stopping, Gestalt therapy, transactional analysis, group therapy, and bibliotherapy, have been proposed as being effective. Also the efficacy of these psychotherapies has only been suggested in case reports and were never investigated in well-designed controlled studies.
In my opinion, the uncritical acceptance of the squeeze technique as first choice treatment is a clear example of the influence of opinion- or authoritybased medicine, as in those years Masters and Johnson were famous for their new approaches in the treatment of sexual disorders. It did not seem to be an issue then that Masters and Johnson—these so highly esteemed sexologists— did not produce any evidence-based data for their claimed discovery.
Evidence-Based Research: Drug Treatment
In contrast with the easily accepted behavioral treatment by sexologists, drug treatment had to prove itself far more explicitly to avoid rejection by professionals in the field. Only a few physicians have tried to develop drug strategies to treat premature ejaculation. Currently, in spite of some residual ambiguous attitudes of many sexologists, drug treatment with serotonergic antidepressants are accepted as effective therapy. Despite of all circumstantial evidence, it should be emphasized that a scientific approach to investigating empirical evidence remains obligatory. To investigate how far differences in methodology may be of influence on clinical outcome of drug treatment studies, Waldinger and co-workers conducted an systematic review and meta-analysis of all drug treatment studies that were published between 1943 and 2003.
In this study, several methodological evidence-based criteria were compared such as study design (single-blind and open-design vs. double-blind), tools for diagnostic testing (stopwatch vs. subjective reporting or questionnaire) and means of assessment (prospective vs. retrospective). The results revealed that from 79 publications on drug treatment, 35 studies involved serotonergic antidepressants. It was clearly demonstrated that both single-blind and opendesign studies as well as studies using a questionnaire or subjective report on the ejaculation time led to a higher variability, that means exaggerated responses, in ejaculatory delay. Only eight studies (18.5%) fulfilled all criteria of evidence-based medicine, for example, double-blind studies prospectively using real time stopwatch assessments at each intercourse both at baseline and during the drug trial. Regarding daily treatment, a similar efficacy for paroxetine, clomipramine, sertraline, and fluoxetine has been demonstrated, whereas the efficacy of paroxetine was found to be clearly stronger than all aforementioned drugs.
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Sexually Transmitted Diseases- Frequently Asked Questions - By: b.thompsom
Can I really get tested today?
Yes! After you choose your online STD tests, you will pick a local STD testing center convenient to you - you will NOT need to make an appointment to get tested. Just print out your Lab Order Requisition form supplied after you check out (it will be sent via email), and bring it to your chosen local STD testing center during their normal business hours. If you order tests after the local STD center has closed, you can get STD tested at any time the following business day.
How soon will I get my results?
You can expect your test results within 5 business days of your lab visit. Although, in some cases, you can receive your STD test results within as little as 24–48 hours. Please note that the test you order, as well as the local STD testing center you choose can be factors in the amount of time it takes to receive your results and the general expectation is to receive your results in 5 business days. Our at-home tests take longer as we ship your at-home test kit to you, and you in turn ship your sample back to our lab for testing.
Where is GetSTDtested.com located?
GetSTDtested.com and its parent company, DTC MD, are located in Chicago, Illinois. We offer more local STD Testing Centers than anyone else with over 2,000 local testing facilities across 47 states (we currently do not offer services in NY, NJ, and RI).
Is there an STD Testing Center close to me?
Through our partnerships, we offer more local STD testing centers than anyone else. With over 2,000 facilities across 47 states (we currently do not offer services in NY, NJ, and RI), you should have no problem finding a testing center local to you. Once you have chosen your desired test(s), your next step will be to pick the testing center most convenient to you. Enter your Zip Code and, using Google Maps, we will show every testing center in your locale. Pick the most convenient location and proceed to the checkout. If you experience any issues, never hesitate to call our Customer Care toll-free at 866-749-6269.
Which STD tests does GetSTDtested.com offer?
Get tested at a local STD testing center for: HIV, Herpes 1, Herpes 2, Chlamydia, Gonorrhea, Hepatitis B, Hepatitis C and Syphilis. Additionally, we offer at-home STD testing for Gonorrhea, Chlamydia and Trichomonaisis.
Do you offer any at-home STD tests?
Yes, we currently offer at-home STD tests for both Gonorrhea and Chlamydia.
How much does it cost?
The costs of our tests are different based on the number of tests purchased, and whether the ordered tests are for testing at a local STD testing center, or part of our at-home package.
What STDs should I be tested for?
Our test recommendation tool has been developed in cooperation with the nations leading experts on STDs and infectious diseases - Lynn Barkley, ASHA; Bobbie Van Der Pol, Indiana University School of Medicine; Neil Skolnik, Abington Family Medicine
Worried you may have one or more specific STDs? Feel free to speak with one of our on-call STD counselors at 866-749-6269 – they can help you quantify your risk and choose which STD test(s) to order. If you would like to learn more about specific STDs and their symptoms, please visit getstdtested.com
How accurate is the STD test? Is there any chance my results could be wrong?
We use the same STD tests that you would receive at a hospital – so be assured you are testing with the most accurate tests available.
What if I get a positive result?
If you get STD tested and receive a positive result, we are here to help. Through our partnership with the American Social Health Association (ASHA), we have certified expert STD counselors available to help you interpret results and discuss any concerns you may have. Additionally, we have medical doctors available that can answer any questions you may have and, in most cases, are even licensed to prescribe treatment. It is important to note that a doctor’s consultation is included in the price of your test, but there will be an additional charge if you would like our physician to prescribe treatment. So give us a call today at 866-749-6269 to discuss any concerns you may have.
Are my results 100% confidential?
Yes, your sexual health is a private matter and we treat it as such with 100% confidentiality. We will never share any of your information, including your STD test results, other than when a positive result is required by law to be provided to the State Health Department for statistical purposes.
Can I use my health insurance to pay for my test?
We cannot accept health insurance as an immediate form of payment. However, your STD Test order will be approved by a physician – meaning it can be submitted to most insurance agencies for reimbursement. To find out your exact level of reimbursement, please contact your health insurance provider. To order tests off of our website, purchases will need to be made via Credit Card or prepaid Credit Card. You can also use your Health Savings Account (HSA) Credit Card if you have one.
Is there any type of payment plan?
Yes, we do give you the option of paying at check out, or paying before you receive your test results. We cannot accept any partial payments or payment plans online at this time, but if you would like to discuss partial payments please call us at 866-749-6269.
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Neurobiology Of Ejaculation - By: David I Crawford
Serotonin, 5-Hydroxytryptamine Neurotransmission and 5-HT Receptors
For a better understanding of the neurobiology of premature and delayed ejaculation and its treatments, it is a prerequisite to have some basic knowledge of what is happening in serotonergic neurons in the central nervous system.
Serotonergic neurons originate in the raphe nuclei and adjacent reticular formation in the brainstem. There is a clear dichotomy in the serotonergic (5-hydroxytryptamine, 5-HT) system neuronal cell groups. A rostral part with cell-bodies in the midbrain and rostral pons projecting to the forebrain and a caudal part with cell-bodies predominantly in the medulla oblongata with projections to the spinal cord. In the forebrain and spinal cord, the serotonergic neurons contact other serotonergic neurons. The location of connection is the synaps, in which the neurotransmitter serotonin provides information from one neuron to another. After its fabrication in the cell-body, serotonin runs through the serotonergic neuron to the presynaptic membrane, through which it is released into the synaps. In the synaps, serotonin proceeds to receptors at the opposite neuron (postsynaptic receptors) and after it has contacted these receptors serotonin runs back to the presynaptic membrane. Through the activity of serotonin transporters (5-HTT) in the presynaptic membrane, serotonin is brought back into the presynaptic neuron. The process of serotonin release and its action on postsynaptic receptors is called serotonergic neurotransmission.
There is normally a sort of equilibrium in the serotonergic neurotransmission system due to remarkable mechanisms. If too much serotonin is released from the presynaptic neuron into the synaps, the so-called 5-HT1B autoreceptors, located in the presynaptic membrane, become activated. Their activation results in a diminished release of serotonin in the synaps. Consequently, the equilibrium is restored. This feedback mechanism of the cell, where the released 5-HT inhibits its own release, is a frequently occurring principle in neurotransmitter regulation and can allow the system with the possibility to prevent overstimulation of postsynaptic receptors.
However, serotonergic neurotransmission becomes seriously disturbed by the action of serotonergic antidepressants. Selective serotonin reuptake inhibitors (SSRIs) block the 5-HT transporters, both in the presynaptic membrane and around the cell-body. As a consequence, serotonin concentration increases outside the cell-body and in the synapses. Owing to the increased serotonin levels, 5-HT1A autoreceptors at the surface of the cell-body and 5-HT1B autoreceptors in the presynaptic membrane become activated. The activation of both the somatodendritic 5-HT1A autoreceptors and the presynaptic 5-HT1B autoreceptors results in an inhibition of 5-HT release into the synaptic cleft. Consequently, serotonin concentration in the synaps diminishes but remains slightly increased due to blockage of the 5-HT transporters leading to some stimulation of all postsynaptic 5-HT receptors. After some days, the 5-HT1A and 5-HT1B autoreceptors become desensitized resulting in a diminished inhibitory action of these receptors to 5-HT release. Consequently, serotonin again becomes released into the synaps. However, due to the SSRI-induced continuous blockade of the 5-HT transporters, serotonin cannot get back into the presynaptic neuron, and as a consequence serotonin levels in the synaps become higher. This increased serotoneric neurotransmission exerts a stronger effect on all postsynaptic receptors. It is the action of those postsynaptic receptors that determines the clinical effects of the SSRIs.
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Causes and Symptoms of Erectile Dysfunction - By: Quade Davidson
It is a failure to even start let alone complete; in some circumstances it may start and end early unfairly causing disappointment to both parties. The descriptive terms of its symptoms are many. All in all this failure requires full comprehension of sources of the trouble to be able to get a corrective measure.
This consistent inability has power to kick but produces no results; unlike impotence which implies no power and no results at all. Erectile dysfunction may occur sometimes out of a mental instability; and may be used as a symptom of some form of detectable ailment.
It could give rise to erectile disorder or the common sexual dysfunctions in the final analysis. There is no doubt, adults and many youth attach sex to a lot of events in their lives as they grow or as they perform different daily tasks. In the event that symptoms emerge that indicate the presence of may be erectile dysfunction or a related feature, quality of life is put at stake. Such occurrences kill the subjects quietly because none is ready to share out this misconception.
Erectile dysfunction may be described further by way of understanding the chemistry of the male organ and how it behaves or misbehaves during and before the act of coitus. As an external organ protruding and hanging on the surface, its level headedness is measured by how firm it behaves before and during the sexual activity. The main supplier of signals remains elsewhere and how it is received tells us something about this organ. The organ has two apartments namely corpora cavernosa and corpus spongiosum.
Both are containers with compact veins that dilate and compress the organ very well producing a firm erection. Muscles at this time are supposed to relax so as to allow this smooth flow. A lot of work is done; it is not just a mechanical device that has locks and valves, a mechanism drives and coordinates the entire process to the end.
Unfortunately, with erectile dysfunction, this cyclic description is absent, instead you will find the organ missing some steps and doing the opposite. It may allow a little of the blood in and fail to hold for as long as it is wanted or it may not allow at all. The veins could be narrow as a result of arteriosclerosis or little amount of nitric oxide is sent to switch on the mechanism of love play. The point here is there are many ailments that temper with this organ physically. The simmering difference in chemicals that play this role turns out to be harmful in the final analysis.
This disorder may be handled by providing the body with what is crucial like pumping in more testosterone and working on any ailment that is bend on disrupting this organ from rendering its biological service.
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The Effects Of Drugs On Women’S Orgasmic Ability - By: David I Crawford
A number of psychotherapeutic drugs have been noted to affect the ability of women to attain orgasm. The selective serotonin reuptake inhibitors (SSRIs) frequently affect orgasmic functioning, leading to delayed orgasm or anorgasmia. There is variability, however, in that some antidepressants have been associated with anorgasmia less frequently than others. For example, the antidepressant, nefazodone, has been reported to produce fewer sexual side effects in women than many of the earlier-generation SSRIs. Nephazodone increases serotonin activity in general while simultaneously inhibiting serotonin activity at the serotonin2 (5-HT2) receptor. Stimulation of 5-HT2 receptors has been reported to inhibit the release of both norepinephrine and dopamine from several brain areas. Because dopamine and norepinephrine have been reported to facilitate sexual behavior, the decrease in serotonergic activity at 5-HT2 receptors (and consequent possible increase in dopamine and norepinephrine) could explain the decreased incidence of anorgasmia noted with nefazodone. Cyproheptadine is also a 5-HT2 receptor antagonist and has been used with some success as an antidote to SSRI-induced orgasmic dysfunction.
Among the typical SSRIs, paroxetine has been reported to delay orgasm more frequently than fluvoxetine, fluoxetine, and sertraline and more than nefazadone, fluoxetine and venlafaxine. One explanation for this greater impairment may be that paroxetine is a more potent inhibitor of the serotonin transporter than are fluoxetine and fluvoxetine, and does not inhibit the dopamine transporter, as does sertraline and, to a lesser degree, fluoxetine and fluvoxetine. As noted earlier, dopamine antagonists impair several aspects of sexual function. Women treated with fluoxetine, paroxetine, and sertraline for anxiety disorders reported delays in reaching orgasm and decreased quality of orgasm at 1 and 2 month follow-ups. However, the impairments in the fluoxetine group decreased by the end of the third month. In contrast to these findings of impaired orgasm with fluoxetine, one multicenter open-label study of fluoxetine reported an improvement in women’s orgasmic ability associated with the amelioration of depression.
Several factors may explain the discrepancy between such studies. First, there may be individual differences in the numbers and anatomical distributions of receptor subtypes, and in the influence of the SSRI on subsequent dopamine and norepinephrine release. In addition, for some women, improvements in mood and interpersonal functioning, which result from the antidepressant properties of these drugs, may offset neurochemical changes that may adversely impact orgasmic ability.
Antipsychotic medications have also been reported to inhibit orgasm in women. This is likely attributable to the blockade of dopamine receptors in areas critical for sexual function (e.g., medial preoptic area, paraventricular nuclei), or indirectly from increased prolactin levels, extrapyramidal side effects, or sedation. A retrospective clinical study of women taking antiepilepsy drugs (primarily benzodiazepines) reported they found orgasm less satisfying than did the healthy, unmedicated controls. These effects were not attributable to alterations in free testosterone levels with antiepilepsy medication use.
Nitric oxide stimulates guanylate cyclase release, which triggers the conversion of guanosine triphosphate to cGMP. cGMP activity relaxes the smooth muscles of the penile tissue allowing vasocongestion and erection. Sildenafil (Viagraw) potentiates the activity of cGMP by inhibiting phosphodiesterase type 5, the endogenous substance responsible for cGMP deactivation. This increases and prolongs cGMP activity, which increases and prolongs vasocongestion, and enables erection. There have been mixed reports of the effects of sildenafil on women’s orgasmic function. Caruso et al. found improved sexual arousal and orgasm with sildenafil. However, only a minority of women responded positively in several other studies. A number of case studies have reported a reversal of antidepressant-induced anorgasmia with sildenafil but, to date, no placebo-controlled studies have been conducted.
Drugs that inhibit beta-adrenergic receptors do not seem to adversely impact women’s orgasmic ability. In a retrospective questionnaire study of 1080 women, there were no reports of significant increases in difficulty achieving orgasm while taking hydralazine, beta-adrenergic antagonists, or methyldopa. In a prospective randomized double-blind study of 345 women over a period of 24 months, antihypertensive medications did not substantially impact orgasm ability. Similarly, atropine, a cholinergic acting agent, did not affect subjective sexual arousal or orgasm in women.
In an uncontrolled, open-label study, estrogen was reported to facilitate orgasmic function in 25% of 188 premenopausal women. However, a retrospective study of 66 women who had undergone hysterectomy and oophorectomy found no difference in orgasmic ability between the 33 who received conjugated estrogens and the 33 who did not. In a single blind study comparing estrogen plus progestin hormone replacement therapy (HRT) to tibolone, a drug which can be metabolized into estrogenic, androgenic, and progestogenic compounds, there was no effect of HRT or tibolone in 50 postmenopausal women. An open-label study of 48 women found a significant improvement after 3 months of tibolone treatment, but not HRT.
In a 3 month, prospective, open-label study of 44 women who had undergone hysterectomy and oophorectomy, monthly injections of estrogen and testosterone increased the rates of orgasm during the first 3 weeks following treatment, compared with the woman’s own baseline and compared to estrogen alone or no treatment. Similar results were noted in a well-controlled study of 75 women who had undergone hysterectomy and oophorectomy. Conjugated estrogens were administered either alone or with testosterone (150 or 300 mg/day) in transdermal patches. The higher dose of testosterone improved orgasm pleasure. However, as was the case in the Sherwin and Gelfand study, the testosterone levels noted in this study were substantially greater than that regarded as being within the normal range for intact women. In an open-label, uncontrolled study, dehydroepiandrosterone (DHEA) (50 mg/day orally) was used to treat 113 women with low levels of testosterone and DHEA and complaints of orgasmic difficulty. After 3 months of treatment, the women reported a greater frequency of orgasm compared with pretreatment levels.
In summary, drugs that increase serotonergic activity (e.g., antidepressants), or decrease dopaminergic activity (e.g., antipsychotics) adversely impact female orgasm. The degree to which the former of these influences orgasm appears to be dependent upon which serotonin receptor subtype they activate/inhibit. Beta-adrenergic drugs and estrogenic compounds do not seem to have a substantial impact on women’s orgasm ability. High doses of testosterone seem to facilitate orgasmic ability but future controlled studies are needed to assess the impact of more moderate doses of testosterone on women’s orgasmic ability.
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Facing Problems Due to Micro Penis size? - By: Nains Onlines
Penis sizes are at about 5.08 inches to 5.9 inches. Everyone keen to know what the exact and standard size of penis of a man in the world which is more suitable for sex with mutual partner. But there are a lot of differences in penis sizes in the world. Some of penis is too many short and some of them are very big then the lower size case penis. Now you don't to get worried if your penis size is much smaller and you have to face shame for its smaller sizes. Any size that is smaller than that range could be ashamed of by any man. Talk about embarrassing locker room situations. It is not surprising how men who are gifted with bigger ‘assets’ almost always readily show to other men their huge penises as a form of self-flattery. Vigrx Plus is the easiest way to get urn power back and find ourselves again as a complete and perfect man in urn sexual event.
Those with smaller sizes could only wish to have their penises grow several inches more in length and in girth. There is truly an obsession about penis sizes. Myth and stereotypes mostly point to bigger organs. In general, national penis average size is about 6 inches. But because many men want to grow bigger penises, many penis enlargement methods are now being employed. Penile enlargement now seems natural among men, just as many women are obsessed about breast enlargement.
Men should understand more about penis sizes. Logically, men are born with equal sizes. The growth in penis starts during the puberty stage of boys. Some boys take early adolescence at about the age of 11 while some come later at about the age of 15. Thus, when the adolescence period sets in, no boys could take the same size at the same time. However, many teens are not able to grow their sizes bigger. When this happens, there could be insecurities about sizes that could be carried over on until adulthood. Do small penises really exist? Of course, they do. You probably have heard about micro penises. Having a micro penis is a condition when the penis fails to undergo normal and optimal growth. In general, in such cases, erect penises could only measure up to 2 inches. It is estimated that about 0.6% of men are identified with the condition. Such men could also suffer at the same time with lower self esteem and self confidence especially when dealing with women and using the male locker rooms and urinals.
The possible cause of micro penis could be traced as far back to conception at the mother’s womb. Scientific studies suggest that men with micro penises could have suffered as fetuses in testosterone deficiency especially during their moms’ second and third trimester of pregnancy. Lack of enough testosterone during the stage could result to stunting in the growth of the penis, which could unfortunately be carried out until adulthood. Small penises need not be a problem anymore. Latest advances in medical technology could pose different remedies and solutions to the condition. If you definitely want to increase urn penis size, then it’s time to employ VigRx plus pills. You can buy and find more information about Vigrx plus and its ingredients online from http://www.penisenlargementways.com/.
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Why Do Women Have Orgasms? - By: David I Crawford
It is generally accepted that female orgasms are not essential for reproduction, and any benefit that they may have for female biology is, as yet, unclear. Early theorists believed that orgasm via intercourse activated ovulation and closed off the womb to air, thus facilitating conception. When it was later shown that the human female was a spontaneous ovulator at mid-cycle, and that this was unconnected to coitus, the discourse re-focused on the role of uterine suction created by orgasmic contractions in moving ejaculated spermatozoa through the cervix into the uterus and then fallopian tubes. However, there is now good evidence that the fastest transport of spermatozoa into the human uterus is actually in the sexually unstimulated condition.
An essential feature of sexual arousal of the female genitalia is to create the expansion of the vagina (vaginal tenting) and elevation of the uterocervix from the posterior vaginal wall. This reduces the possibility of the rapid entry of ejaculated spermatozoa into the uterus and gives time for the initiation of the decoagulation of semen and the capacitation of the spermatozoa to begin, decreasing the chance of incompetent sperm being transported too rapidly into the fallopian tubes. By dissipating arousal and initiating the resolution of the tenting, orgasm may allow the earlier entry of the spermatozoa into the cervical canal and their subsequent rapid transport to the fallopian tubes.
It has been suggested that women may use orgasm, initiated either from coitus or masturbation, as a way to manipulate the ejaculate in the vagina. This highly contentious concept is based on the amount of “flowback” (semen/fluid) lost from the vagina. The claim is that the amount of flowback containing spermatozoa varies with the precise timing of the woman’s orgasm in relation to the time of deposition of the ejaculate into the vagina. Low sperm retention is thought to be associated with female orgasms that occur less than 1 min before vaginal deposition while maximum retention is thought to occur with orgasms occurring shortly after deposition. If orgasm occurs earlier than 1 min before the ejaculate, deposition sperm retention is the same as when there is no orgasm. According to Baker and Bellis the effect of orgasm on sperm retention lasts only for the period of 1 min before semen deposition and up to 45 min later.
An additional function of women’s orgasm, which may play a role in the reproductive process, is that if the woman attains orgasm during coitus, the associated contractions of the vagina can facilitate male ejaculation. This would allow the woman to capture the sperm of her chosen inseminator. In addition, as noted earlier, orgasm increases the secretion of prolactin. If prolactin in plasma is able to enter into the vaginal, cervical or uterine fluids, it may influence the entry of calcium into the sperm and this action could play a role in the activation of spermatozoa in the female tract.
There have been a number of other explanations offered for why women have orgasms. Some of those explanations are as follows. To the extent that orgasm is an intensely pleasurable sensation, it serves as a reward for the acceptance of the danger of coitus with its possibility of pregnancy and of possible death in childbirth. Orgasm serves as a means for resolving pelvic vasocongestion and vaginal tenting, and for inducing lassitude to keep the female horizontal and thereby reducing seminal “flowback.” Through both psychological (loss of body boundaries and separateness) and physiological (oxytocin release) means, orgasm may enhance pair bonding. Lastly, by its activation of muscular contractions and the concomitant increased blood flow, orgasms maintain the functionality of the genital tract.
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What Causes Orgasm? - By: David I Crawford
Orgasms can be induced via erotic stimulation of a variety of genital and nongenital sites. The clitoris and vagina (especially the anterior wall including Halban’s fascia and urethra) are the most usual sites of stimulation, but stimulation of the periurethral glands, breast/nipple or mons, mental-imagery or fantasy, or hypnosis have also been reported to induce orgasm. Orgasms have been noted to occur during sleep, hence consciousness is not an absolute requirement. Cases of “spontaneous orgasm” have occasionally been described in the psychiatric literature where no obvious sexual stimulus can be ascertained. The precise mechanism that triggers orgasm has been a topic of debate for many years but, as of yet, no definitive mechanisms have been identified.
Only very recently have investigators examined the brain areas activated during orgasm in women. Compared to preorgasm levels of sexual arousal, the brain areas activated during orgasm in women included the paraventricular nucleus of the hypothalamus, the periaqueductal gray of the midbrain, the hippocampus, and the cerebellum. Other areas shown to be activated during sexual arousal include the amygdala, the anterior basal ganglia, and several regions of the cortex including the anterior cingulated, frontal, parietal, temporal, and insular cortices. Some of these areas may be more involved in the perception of sexual stimuli than with the actual triggering of orgasm. Further studies that compare brain imaging during sexual arousal without orgasm with brain imaging at orgasm are needed to determine whether there are any areas of the brain specifically involved in generating orgasm.
Gender Differences In Orgasm
Although some therapists have suggested that different types of orgasm exist for men, it is generally believed that typologies of orgasm intriguingly exist only for 196 Meston and Levin women. Most of the research in this area is derived from self-reports of women who distinguish orgasmic sensations induced by clitoral stimulation (warm, ticklish, electrical, sharp) from those induced by vaginal stimulation (throbbing, deep, soothing, comfortable). Masters and Johnson claimed that all orgasms in women were physiologically identical regardless of the source of stimulation. However, they did not have the instrumentation to obtain detailed muscular recordings for possible differences between clitoral- and vaginalinduced orgasms. There is now some limited physiological laboratory evidence to suggest that different patterns of uterine (smooth muscle) and striated pelvic muscular activity may occur with vaginal anterior wall stimulation as opposed to clitoral stimulation.
Several other physiological differences between male and female orgasms have been proposed. First, unlike men, women can have repeated (multiple) orgasms separated by very short intervals, and women can have extended orgasms that last for long periods of time. Secondly, men have a divided rhythmic pattern of muscular contractions that has not been noted in women. Thirdly, in men, once orgasm is initiated its further expression is automatic even if sexual stimulation is stopped. In contrast, if stimulation is stopped in the middle of either clitoral-induced or vaginal-induced orgasm, orgasm is halted in women.
In terms of gender differences in the psychological experience of orgasm, written descriptions of orgasms by men and women with any obvious gender clues removed could not be differentiated by sex, when read by other males and females. This suggests that men and women share common mental experiences during orgasm.
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What Is Orgasm? - By: David I Crawford
Orgasm is a transient peak sensation of intense pleasure that is accompanied by a number of physiological body changes. In men, orgasm is normally accompanied by ejaculation, which makes the event easily identifiable. In women, however, the achievement of orgasm appears to be less facile than for males and recognizing that it has occurred is often difficult for some women. Objective indicators that orgasm has occurred have been sought for many years. Kinsey et al. proposed “the abrupt cessation of the ofttimes strenuous movements and extreme tensions of the previous sexual activity and the peace of the resulting state” as the most obvious evidence that orgasm had occurred in women. Masters and Johnson described the onset of orgasm as a “sensation of suspension or stoppage.” In order to serve as a clear marker of orgasm, however, the indicator must involve a bodily change that is unique to orgasm. This necessarily rules out simple measures like peaks of blood pressure, heart and respiratory rates, or even a woman’s own vocalizations because such events can occur during high levels of sexual arousal that fail to culminate in orgasm.
Remarkably, most of the so-called objective indicators of female orgasm rely on the original, nearly 40-year-old observations and descriptions of Masters and Johnson. They include physiological changes that indicate impending orgasm (prospective), occur during actual orgasm (current), and/or indicate that an orgasm has occurred (retrospective). With regard to prospective changes, during sexual arousal the labia become engorged with blood, increase in size, and undergo vivid color changes. The color changes (light pink to deep red) are presumably due to the changing hemodynamics of the tissue in relation to increased blood flow, tissue congestion, and tissue metabolism (oxygen consumption), indicating the balance between oxygenated (red/pink) and deoxygenated or reduced hemoglobin (blue). Following orgasm, the color of the labia rapidly changes (within 10–15 s) from deep red to light pink. There has been little detailed study of the minora labia apart from the suggested mechanism by which they become lubricated and their increased temperature during sexual arousal has been used as an objective indicator of arousal prior to and after orgasm.
Contractions of the vagina, uterus, and anal sphincter have been proposed as current indicators of orgasm. The resting vagina is a collapsed tube lined with a stratified squamous epithelium, approximating an elongated S-shape in longitudinal section and an H-shape in cross-section. It is anchored amid a bed of powerful, voluntary, striated muscles (pelvic diaphragm, consisting of the pubococcygeus and iliococcygeus muscle). According to Masters and Johnson <>, p. 118], contractions recorded in the vagina begin about 2–4 s after the subjective experience of the start of orgasm. They occur in many pre- and postmenopausal women and are due to the activation of the circumvaginal striated muscles which involuntarily contract in about 0.8 s repetitions. This squeezes the outer third of the vagina the “orgasmic platform” by Masters and Johnson] with a force that gradually becomes weaker as the interval between contractions increases. Vaginal rhythmic contractions vary greatly between women in their number and strength, and are dependent on the duration of the orgasm and the strength of the pelvic musculature. Masters and Johnson reported that the stronger the orgasm the greater the number of contractions and, thus indirectly, the longer the duration of orgasm (as each contraction was about 0.8 s apart). However, using physiological (pressure) recordings of the contractions, other researchers have failed to find a link between vaginal contractions and the perceived intensity or duration of the orgasm. Moreover, while Masters and Johnson proposed that vaginal contractions are a definitive sign of orgasm having occurred, other authors have noted that not all women who claim to experience orgasms show vaginal contractions. Uterine contractions have also been proposed as the terminative signal for sexual arousal in multiorgasmic women but too few investigations have assessed orgasmic uterine contractions to make a definitive statement. While voluntary contractions of the anal sphincter can occur during sexual arousal and are sometimes used by women to facilitate or enhance arousal, involuntary contractions occur only during orgasm. Such contractions are more frequently observed during masturbation than during coitus. As with uterine contractions, few studies on anal sphincter contractions during orgasm have been published.
A number of questionnaire studies have reported that orgasm through stimulation of the so-called G-spot (named after Ernst Grafenberg, who reportedly first described the phenomenon) causes a substantial number of women to expel fluid from their urethra. However, there has been no scientific evidence to support the assertion that women ejaculate a fluid distinguishable from urine at the time of orgasm. Moreover, there has not been consistent evidence for any anatomical structure or “spot” on the anterior vaginal wall apart from the known paraurethral glands and spongiosal tissue around the urethra, which could cause sexually pleasurable sensations when stimulated.
Physiological changes noted to occur after orgasm (retrospective) include areolae (the pigmented skin area around the nipple of the breasts) decongestion, enhanced vaginal pulse amplitude (measured by photoplethysmography), and raised prolactin levels. During sexual arousal, the primary areolae swell up, likely due to both vasocongestion and smooth muscle contraction. The volume expansion can become so marked that the swollen areolae hide a large part of the base of the erect nipples making it look as though they have lost their erection. At orgasm, the loss of volume is so rapid that the areolae become corrugated before becoming flatter. This provides a visual indicator that orgasm has occurred. In the absence of orgasm, the areolae detumescence is much slower and the corrugation does not develop. There has been minimal study of areolae changes during arousal and orgasm.
Changes in the blood supply to vaginal tissue before, during, and after orgasm were recorded by photoplethysmography in seven young women by Geer and Quartararo. Sexual arousal by masturbation caused an increase in the vaginal pulse amplitude signal compared to the basal values in all women. Immediately after the end of orgasm, however, vaginal pulse amplitude was actually significantly greater than before orgasm in five of the seven women (71%) and was not significantly less in the other two. The postorgasmic period of maximum amplitude lasts for about 10–30 s and then slowly returns to its resting level. Other recordings in the literature have shown similar changes.
Studies by Exton and colleagues have reported that prolactin secretion (a peptide hormone secreted by the lactotrophic cells of the anterior pituitary gland) is not activated by sexual arousal per se but is specifically activated and doubled in plasma concentration with orgasm. This elevation occurs directly after orgasm and is maintained for about 60 min.
In summary, specific physiological indicators that orgasm has occurred include rapid color changes of the labia; contractions of the vagina, uterus, and anal sphincter; areolae decongestion; enhanced vaginal pulse amplitude; and raised prolactin levels.
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Can Sex toys cause infection? - By: Richard Conrad
Many people who are not used to making use of sex toys during sex intercourse often are in a dilemma regarding whether or not sex toys can cause infection when used. Well the answer to the question - can sex toys cause infection is – yes they can. But the answer should not be seen as a negativity of use of sex toys because even the use of condoms can at times lead to infection if proper precautions are not kept.
Bacterial infection in the vagina has happened previously and can take place again. In some cases people have witnessed fungal infection too. Some of the other symptoms are soreness, itchiness, discharge from the female vaginal and bad odor are some of the symptoms that people have experienced.
Here below are some basic sex toys usage instructions that would go a long way in helping you avoid even the most negligible chances of getting vaginal infection from the use of sex toys.
Since sex toys are foreign objects that will enter the female body one should be very careful, if proper care is not taken then you are at high risk of contracting infection. The one basic step that you should take is that of cleaning and sterilizing these objects every time you use them and after you have used them.
Another important thing that you should remember when shopping for sex toys is that the material of the product should not be a hard one. You can choose products made using silicon as they tend to be softer and safe than most others.
There are various kinds of sex toys products available in the market these days. Some of the more popular products are butt plugs but before purchasing one of these you should be sure that you know how to make use of these. Probably you can read the instruction manual to understand such sex toys better.
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Female Sexual Arousal Disorder - Recommendations For Clinical Practice - By: David I Crawford
We would like to end with five questions that may help establish the heart of the problem in women with complaints about reduced or absent arousal and desire.
The first question is whether the client wants to be sexual at all. This question may refer to people that were excluded from Masters and Johnson’s studies. These may be people so deeply involved in relational conflict, that they, as Masters and Johnson put it, need legal advice instead of sex and relationship therapy. The prognosis for a rewarding sexual relationship, even if all the relational discord was to be resolved, seems to be poor. Learning to stop arguing or learning to do that more effectively does not necessarily improve the sexual relationship. For that, as we have argued, situations with positive sexual meanings are a first prerequisite.
The second question refers to the sensitivity of the sexual system. As we have seen, in healthy women problems related to genital unresponsiveness are unlikely. For clinicians who need to rule out that organic etiology is underlying sexual arousal difficulties, or who question genital responsiveness for other reasons, a psychophysiological assessment will provide indispensable additional information.
Next, are there, on the basis of sexual history, positive expectations regarding sex? Are there any sexual rewards? And are these expectations activated in the given sexual situation, and which new sexual stimuli are likely to be sexually rewarding? When there are no or only a few positive experiences, one can try to help women find these experiences. A confrontation with sexual stimuli will probably only be rewarding by the sexually rewarding experience. Our disposition to respond positively to tactile stimulation must become associated with sexual stimuli.
If all these conditions are satisfied and the sexual system is activated, there will be a cascade of events that occur partly automatic and partly on the basis of conscious decisions. Whether we will be sexually active will depend, ultimately, on decisions about the partner, the circumstances, and on ideas about how we want to shape our sexual lives.
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Female Sexual Arousal Disorder - Pharmacotherapy - By: David I Crawford
In the relatively short time span, compared to psychologic treatments, that pharmacological treatments have become available for men, since 1998, the effect of pharmacological treatments in women with sexual arousal problems has been investigated in several controlled and uncontrolled studies. To date, none of the treatments listed here have been approved.
Phosphodiesterase Inhibitors
Sildenafil is the first pharmacological treatment that has been investigated on a reasonable scale in controlled studies with female subjects. In the very first laboratory study, 12 healthy premenopausal women without sexual dysfunction were randomized to receive a single oral 50 mg dose of sildenafil or matching placebo in the first session and alternate medication in a second session. Although sildenafil was found effective in enhancing vaginal engorgement (VPA) during erotic stimulus conditions, these changes were not associated with an effect on subjective sexual arousal. The first large controlled at home study in 557 estrogenized and 204 estrogen-deficient pre- and postmenopausal women with sexual problems that included, but were not limited to, sexual arousal disorders, found no improvement with 10–100 mg of sildenafil on subjective sexual arousal and subjective perception of genital arousal, as assessed by several different measures. Women identified as having DSM-IV arousal disorder without concomitant hypoactive sexual desire disorder did show benefit of sildenafil beyond placebo. Also, an Italian study found improvement on subjective sexual arousal, pleasure, orgasm, and even on frequency of orgasm, in premenopausal women with sexual arousal complaints, although these results were obtained with unvalidated questionnaires. A second study from the same group in sexually functional women showed benefit of sildenafil over placebo on arousal, orgasm, and enjoyment, now with a validated questionnaire. A small, recent placebo-controlled laboratory study of women diagnosed with genital arousal disorder suggested only a small minority of them might benefit from sildenafil. The controlled laboratory study of Sipski et al. in women with SCI found an enhancing effect of sildenafil on genital (VPA) and subjective sexual arousal. The beneficial effects of sildenafil over placebo were most evident in the strongest stimulus condition of both visual and manual stimulation. Several, yet unpublished, controlled studies in women with FSAD found no improvement of sildenafil.
These conflicting findings have probably led to Pfizer’s recent decision to end their program of testing efficacy of sildenafil in women. It would be theoretically and clinically meaningful to investigate which factors may have been responsible for these inconsistent findings. Possible candidates are: inadequate sexual stimulation (sildenafil will not be effective without sexual stimulation); inadequate outcome measures; wrong patient group (e.g., women with sexual problems unrelated to genital responsiveness); estrogen depletion. In most studies, women with a medical condition were excluded from the trials. This may have been an unfortunate choice. We have argued that women with various medical conditions may have an impaired genital response and may therefore have more to gain from a genital arousal enhancing agent such as sildenafil than medically healthy women.
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All About Chlamydia Tests! - By: b.thompsom
What type of test is there for Chlamydia?
The actual test name for determining if Chlamydia is present is called the Chlamydia Nucleic Acid Amplification (NAAT) Test. This is a urine test that is based on amplification of the DNA that is present in Chlamydia trachomatis. The urine test is simple and normally preferable to the traditional method that requires swabbing. This urine test for Chlamydia trachomatis is currently the gold standard for testing and is widely used across the country in both doctor's offices and hospitals.
What kind of sample is required?
Our Chlamydia test requires a simple urine sample, given at either a local testing center or mailed back to our lab (if you choose to test from the privacy of your own home).
How to prepare for your test?
The only required preparation is to not urinate for at least one hour before giving your sample.
When can I expect results?
Chlamydia test results are usually available in 2-3 business days. After you purchase your test from us, you can choose to receive a phone call or email with your results.
What if I have a positive result?
If you get tested and are returned a positive result, we are here to help. Through our partnership with the American Social Health Association (ASHA), we have certified expert STD counselors on-call 24 hours a day to help you interpret results and discuss any concerns you may have. Additionally, we have medical doctors available 24-7 (by appointment) that can answer any questions you may have and, in most cases, are even licensed to prescribe treatment. It is important to note that a doctor’s consultation is included in the price of your test, but there will be an additional charge is you would like our physician to prescribe treatment.
Purchasing your Test:
We offer 2 different types of Chlamydia test packages:
Local Center Testing: Choose a local testing center convenient to you, and show up within business hours (no appointment is required).
At-Home Test Kit: Test from the privacy of your own home with our at-home STD test kit. Once you receive our test kit in the mail, you will send a urine sample back to our lab for analysis.
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The Increase in Sexually Transmitted Infections - By: Becky Gilette
Despite all of the advertising online, in newspapers and magazines, on the radio and TV, STD cases continue to increase in the young within the UK, year upon year.
It's now documented that nearly 500,000 cases of sexually transmitted infections were reported in the United Kingdom in 2009, with teenagers and young adults mainly responsible. This is an increase of 12,000 sexually transmitted infections on the year before.
As a result of information I’ll be providing further on in this post, it’s thought by professionals, that vulnerability lies with young women, as many lack the ability and confidence to negotiate safer sex when their partner tries without protection.
Almost two thirds of new sexually transmitted infections in females occurred in those under the age of 25. This included 73% of new gonorrhoea cases, 66% of new genital wart cases, and almost 90% of new Chlamydia cases in females.
This is only for new cases, but as a result of poor sexual health practises of many teenagers, the re-infection rate is also rising. Roughly 10% of women under the age of 20 were re-infected with a sexually transmitted infection inside a year of receiving care for a previous sexually transmitted infection. This statistic is worse for men, as roughly 12% of men under twenty years old were in the same situation.
This is just astonishing because of the amount of sexual education provided in schools, as well as the availability of information in connection with practising safe sex, to those in this age bracket. Those in this age range obviously know the risks involved, undoubtedly, much like me, they would have been shown the graphic pictures in a sex education class, or they’ve probably stumbled across something whilst online. Either way, the message doesn’t seem to be getting through regarding what can happen during intercourse, and the potential pitfalls of unprotected sex.
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Activation Together With Regulation As In Sexual Response - By: David I Crawford
Processing of Sexual Information
In a series of studies we conducted included in the 1990s, we consistently found that women’s genital response and even sexual feelings are not 136 Laan, Everaerd, and in addition Both strongly correlated, thinking that affect influences sexual feelings. Other studies had similar findings. In men, correlations between genital response also sexual feelings are usually significantly positive, suggesting that for men’s sexual feelings awareness of their genital response are the most essential source.
A surprising finding from our studies was the ease with which healthy women become genitally aroused in response in erotic film stimuli. Once watching an erotic film depicting explicit sexual activity, nearly all women respond using increased vaginal vasocongestion. This particular increase occurs within seconds after the onset when using the stimulus, which suggests a relatively automatized response mechanism for which conscious cognitive processes won t be necessary. Perhaps when these explicit sexual stimuli are negatively evaluated, or induce little or no feelings of sexual arousal, genital responses are elicited. Genital arousal intensity was found to covary consistently with stimulus explicitness, defined given that the extent with which sexual organs and therefore sexual behaviors are exposed. That automatized response occurs not only in young women without sexual problems, although also in women with a testosterone deficiency, in postmenopausal women, and then in women with sexual arousal disorder. Such responses are also found during unconsensual sexual activity.
Such a highly automatized mechanism is adaptive from a strictly evolutionary perspective. Whether genital responding with sexual stimuli did not come to pass, our species can not survive. Targeted women, a small increase in vasocongestion gives vaginal lubrication, which obviously facilitates sexual interaction. One might be tempted with assume that, for adaptive reasons, a explicit visual sexual stimuli utilised in our studies represent a class of unlearned stimuli, in which we are innately prepared to respond. These stimuli seem to override the effects as in various attempts at voluntary control.
Emotional stimuli may evoke emotional responses without the involvement of conscious cognitive processes. For instance, subliminal presentation as in slides using phobic objects results in fear responses in phobic subjects. While stimuli are consciously recognized and additionally processed, these are evaluated, for instance because being good or bad, attractive or dangereous. According to O'hman, the evolutionary relevance of stimuli may very well be most vital prerequisite targeted such a quick, preattentive analysis. Perhaps sexual stimuli fall within this category and can they be unconsciously evaluated plus processed. A number of experiments in which sexual stimuli were presented subliminally with male subjects showed that this is indeed possible. Preattentive processing as in sexual stimuli occurs in women also, but looks with be dependent upon this type of prime. Explicit sexual primes do not lead in priming-effects, still romantic sexual primes do. This seems with contradict Ohman’s notion that evolutionary relevant primes are able to be unconsciously processed. Likely, preattentive processing are not entirely governed by evolution, on the other hand partly the result of overlearning or conditioning.
A prerequisite of automatic processing seems to be that sexual meaning resulting of visual sexual stimuli is easily accessible in memory. About the basis as in a series of priming experiments Janssen et al. presented an information processing model of sexual response. Two information processing pathways are distinguished. The first pathway are about appraisal of sexual stimuli and even response generation. This particular pathway are thought to depend largely on automatic or unconscious processes. The next pathway concerns attention and regulation. In this particular model, sexual arousal are assumed to begin with the activation of sexual meanings that are stored in explicit memory. Sexual stimuli might elicit different memory traces depending upon the subject’s prior experience. This particular in turn activates physiological responses. It directs attention towards stimulus and additionally ensures that attention remains focused for the sexual meaning with all the stimulus. This particular harmonic cooperation between the automatic pathway and attentional processes eventually outcome in genital responses and then sexual feelings. Disagreement between sexual response components should happen, according to this model, when the sexual stimulus elicits sexual meanings yet somehow also nonsexual, as well as more specifically, antagonistic emotional meanings. The sexual meanings activate genital response, although the balancing of sexual and nonsexual meanings determine to what extent sexual feelings are experienced.
The reason that disagreement between genital or subjective sexual arousal happens more often in women might suggest which for women sexual stimuli possess, greater often than for men, sexual yet somehow also nonsexual or even negative meanings. There is some evidence that sexual stimuli generate negative sexual meanings in women more often than in men. Sexual stimuli evoke mostly positive sexual emotions in men, on the other hand a host as in other nonsexual meanings, both positive and contravening, in women.
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Activation And Additionally Regulation Of Sexual Response - By: David I Crawford
Processing as in Sexual Information
In a series of studies we conducted of the 1990s, we consistently found that women’s genital response and therefore sexual feelings are not 136 Laan, Everaerd, as well as Both strongly correlated, knowing the affect influences sexual feelings. Other studies had similar findings. In men, correlations between genital response and then sexual feelings are usually significantly great, suggesting that for men’s sexual feelings awareness of their genital response is it most paramount source.
A surprising finding of our studies was the ease with which healthy women become genitally aroused in response with erotic film stimuli. To watching an erotic film depicting explicit sexual activity, best women respond using increased vaginal vasocongestion. That increase occurs within seconds after the onset of those stimulus, which suggests a relatively automatized response mechanism for which conscious cognitive processes won t be necessary. Perhaps when these explicit sexual stimuli are negatively evaluated, or induce little or no feelings of sexual arousal, genital responses are elicited. Genital arousal intensity was found to covary consistently with stimulus explicitness, defined due to the fact extent to which sexual organs and therefore sexual behaviors are exposed. This automatized response occurs not only in young women without sexual problems, on the other hand also in women with a testosterone deficiency, in postmenopausal women, and additionally in women using sexual arousal disorder. Such responses are also found during unconsensual sexual activity.
Such a highly automatized mechanism is adaptive of a strictly evolutionary perspective. Whether genital responding to sexual stimuli did not befall, our species should not survive. Targeted women, a growth in vasocongestion produces vaginal lubrication, which obviously facilitates sexual interaction. One might be tempted with assume that, targeted adaptive reasons, this explicit visual sexual stimuli utilised in our studies represent a class of unlearned stimuli, to which we are innately prepared to respond. These stimuli look to override this effects as in various attempts at voluntary control.
Emotional stimuli can evoke emotional responses without the involvement of conscious cognitive processes. For instance, subliminal presentation as in slides using phobic objects results in fear responses in phobic subjects. While stimuli are consciously recognized also processed, these are evaluated, targeted instance because being good or bad, attractive or dangereous. According to O'hman, the evolutionary relevance as in stimuli is the only most relevant prerequisite for such a quick, preattentive analysis. Perhaps sexual stimuli fall within this category and can they be unconsciously evaluated and then processed. A number of experiments in which sexual stimuli were presented subliminally with male subjects showed which this are indeed possible. Preattentive processing of sexual stimuli happens in women as well, however looks to be dependent upon the type as in prime. Explicit sexual primes do not lead to priming-effects, yet romantic sexual primes do. This seems in contradict Ohman’s notion that evolutionary relevant primes are usually unconsciously processed. Likely, preattentive processing are not entirely governed by evolution, although partly the result of overlearning or conditioning.
A prerequisite of automatic processing seems to be that sexual meaning resulting of visual sexual stimuli is easily accessible in memory. To the basis of a series of priming experiments Janssen et al. presented an information processing model of sexual response. Two information processing pathways are distinguished. Customers pathway are about appraisal of sexual stimuli and then response generation. This particular pathway is thought to depend largely on automatic or unconscious processes. The second pathway concerns attention and regulation. In this model, sexual arousal is assumed to begin with the activation of sexual meanings which are stored in explicit memory. Sexual stimuli may elicit other diverse memory traces depending upon the subject’s before experience. This in turn activates physiological responses. It directs attention on the stimulus not to mention ensures that attention remains focused around the sexual meaning of an stimulus. That harmonic cooperation between the automatic pathway and thus attentional processes eventually results in genital responses and so sexual feelings. Disagreement between sexual response components should crop up, according to this model, when the sexual stimulus elicits sexual meanings on the contrary also nonsexual, plus more specifically, antagonistic emotional meanings. The sexual meanings activate genital response, nonetheless the balancing as in sexual then nonsexual meanings determine to what extent sexual feelings are experienced.
The reason that disagreement between genital combined with subjective sexual arousal happens more often in women might suggest which for women sexual stimuli have, extra often than for men, sexual then again also nonsexual or even negative meanings. There is some evidence that sexual stimuli generate negative sexual meanings in women more often than in men. Sexual stimuli evoke mostly positive sexual emotions in men, then again a host as in other nonsexual meanings, both positive and negative, in women.
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Female Sexual Arousal Disorder - Diagnostic Procedures - By: David I Crawford
An ideal protocol for the assessment of FSAD should be constructed following theoretical then factual knowledge that belong to the physiological, psychophysiological, and as well psychological mechanisms involved. This protocol then describes the most parsimonious route from presentation as in complaints with capable therapy. Unfortunately, we are at present far from a consensus on the best probable causes of FSAD. Despite this particular disagreement, at least two diagnostic procedures should be considered. Firstly, assessment of sexual dysfunction in a biopsychosocial context should start with a verification because of the chief complaints in a clinical interview. A aim inside of clinical interview is to try to gather information concerning current sexual functioning, onset of the classic sexual complaint, the context in which a difficulties happen, and furthermore psychological issues that may provide because etiological or keeping factors for the sexal problems, like depression, anxiety, personality factors, negative self- as well as body image, and furthermore feelings of shame or guilt that might result from religious taboos. Sexual problems are similar complications of anxiety disorders not to mention impaired sexual desire, arousal combined with satisfaction. Laboratory studies suggest potential enhancement of genital arousal by a tiny types anxiety, however this precise cognitive, affective, or physiological processes by which anxiety and additionally women’s sexual function are related possess as yet in be identified. This ongoing work as in Bancroft plus Janssen exploring a dual control model of sexual excitation and as well inhibition in men and in women, may clarify each role of anxiety in women’s predisposition in sexual inhibition as well as in sexual excitement. Essential important on the other hand difficult tasks will be assess whether inadequate sexual stimulation is underlying this sexual problems, which requires detailed probing as in (number bunch lot in) sexual activities, conditions under which sexual activity takes place, before sexual functioning, or sexual and even emotional feelings for the partner. Several studies possess shown that detrimental sexual and furthermore emotional feelings for the partner are in the best quality predictors targeted sexual problems. The clinician should always ask if for example the woman has ever experienced sexual abuse, because this might seriously affect sexual functioning. A number of women do not feel sufficiently safe during the initial interview with reveal such experiences; nevertheless, it is necessary to inquire about sexual abuse to help make clear which traumatic sexual experiences should be discussed. The initial clinical interview should help the clinician in formulating the problem and so in deciding what treatment is indicated. An important issue ?s a agreement between therapist then patient about the formulation when using the problem also the nature of those therapy. To reach a decision with take treatment, this patient needs to be properly informed about the diagnosis and so the remedy involve.
Ideally, in the case of suspected FSAD, the initial interviews is followed by a psychophysiological assessment. In assessment through the physical aspects as in sexual arousal, the main question to be answered are whether, using adequate stimulation by means of audiovisual, cognitive (fantasy), and/or vibrotactile stimuli, a lubrication–swelling response is possible. Although psychophysiological testing with date are not a routine assessment, we feel that such a make sure it works are crucial in establishing this etiology of FSAD targeted two reasons. A learn that was discussed extensively from a previous paragraph demonstrated how difficult it is in rule out which sexual arousal problems commonly are not caused by a lack of adequate sexual stimulation. Secondly, it showed which impaired genital response cannot be assessed on your basis of an anamnestic interview. Women with sexual arousal disorder could possibly be less aware of their own genital changes, with which they lack adequate proprioceptive suggestion that can further increase their arousal. If a genital response is possible, perhaps for other investigations indicate this existence of a variable that might compromise physical responses, an organic contribution to your arousal problem of the classic individual women is clinically irrelevant. Because was shown before, sexual arousal problems in medically healthy women are best likely additional often related to inadequate sexual stimulation due to contextual additionally relational variables than to somatic causes. Targeted estrogen deplete women, care ought to taken not with simply facilitate painless intercourse at a nonaroused state with a lubricant but yet in consider the possibility which estrogen lack has unmasked long-term lack of sexual arousal that is certainly as in contextual etiology. As in note, nonresponse covered in the psychophysiological assessment isn t going to automatically imply organicity. This woman can have been too nervous or distracted for the stimuli to be effective, or a stimuli offered cannot need matched her sexual preferences. This particular obstical of suboptimal sensitivity is not unique in that make sure it works, a number of other well setup diagnostic tests of that nature have a similar disadvantage.
Two other procedures could be used to corroborate findings that come from the clinical interview and the psychophysiological assessment. Talk about is it play with as in selfreport measures supplementary to your clinical interview. The Female Sexual Function Index (FSFI) is usually a brief, multidimensional scale targeted assessing sexual function in women, as well as are currently the most often utilised solution. Recently, diagnostic cutoff scores were developed by means of sophisticated statistical procedures. Self-report measures commonly are not very helpful targeted clinical purposes because they lack sensitivity together with specificity with regard with causes that belong to the individual patient’s dysfunction.
Secondly, a meticulous focused pelvic exam in medically healthy women is likely in order once lack of arousal are accompanied by complaints as in pain or vaginistic response during sexual activity, or any time a psychophysiological assessment has yielded nonresponse. In our latter case, rare diseases like connective tissue disorder, most likely are identified. Throughout the former cases the purpose the exam could possibly be extended educational than medical, for instance with observe a consequences as in pelvic floor muscle activity. An examination which found no abnormalities may also be as in therapeutic value. Sometimes a general physical examination, not to mention central nervous group or hormone levels is required, though in most of the cases only genital examination are necessary. In women using neurological disease affecting pelvic nerves or with a history as in pelvic trauma, a detailed neurological genital exam is probably needed, clarifying light touch, pressure, pain, temperature sensation, anal and additionally vaginal tone, voluntary tightening of anus, and furthermore vaginal and thus bulbocavernosal reflexes. This clinician should be aware with all the emotional impact as in a physical examination and the importance as in timing. If your woman is very anxious about being examined it is appropriate in wait until she feels over secure. In the case of women who are usually not familiar with self-examination of their genitalia, it is preferable in advice self-examination at domicile before a doctor carries out an examination. It is recommended that the procedure is interpreted in detail, what shall combined with what will not take place, along with woman’s understanding then consent obtained. It is important to realize which one medical exam is not capable to examine function, because the genitalia are examined in a nonaroused state. Because such, a medical exam may never replace a psychophysiological assessment.
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Is Absent or Impaired Genital Responsiveness a Valid Diagnostic Criterion? - By: David I Crawford
In a recent study we investigated whether pre- and postmenopausal women with sexual arousal disorder are less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems. Twenty-nine women with sexual arousal disorder, without any somatic or mental comorbidity, diagnosed using strict DSM-IV criteria, and 30 age-matched women without sexual problems were shown sexual stimuli depicting cunnilingus and intercourse. Genital arousal was assessed as vaginal pulse amplitude (VPA) using vaginal photoplethysmography. We found no significant differences in mean and maximum genital response between the women with and without sexual arousal disorder, nor in latency of genital response. The women with sexual arousal disorder were no less genitally responsive to visual sexual stimuli than age- and menopausal status-matched women without such problems, even though they had been carefully diagnosed, using strict and unambiguous criteria of impaired genital responsiveness. These findings are in line with previous studies. The sexual problems these women report were clearly not related to their potential to become genitally aroused. In medically healthy women absent or impaired genital responsiveness is not a valid diagnostic criterion.
It is clear that the sexual stimuli used in this laboratory study (even though these stimuli were merely visual) were effective in evoking genital response. In an ecologically more valid environment (e.g., at home), sexual stimuli may not always be present or effective. Sexual stimulation must have been effective at one point in the participants’ lives, because primary anorgasmia was an exclusion criterion. Even though a serious attempt was made to rule out lack of adequate sexual stimulation as a factor explaining the sexual arousal problems, data on sexual responsiveness collected in the anamnestic interview suggested that the women diagnosed with sexual arousal disorder are unable, in their present situation, to provide themselves with adequate sexual stimulation. The exclusion, halfway through the study, of a participant who no longer met the criteria for sexual arousal disorder after having met a new sexual partner, also illustrates that inadequate sexual stimulation may be one of the most important reasons for sexual arousal problems.
In this study, genital responses did not differ between the groups with and without sexual arousal disorder, but sexual feelings and affect did. The women with FSAD reported weaker feelings of sexual arousal, weaker genital sensations, weaker sensuous feelings and positive affect, and stronger negative affect in response to sexual stimulation than the women without sexual problems. Two explanations may account for this. Firstly, women with sexual arousal disorder may differ from women without sexual problems in their appreciation of sexual stimuli. These stimuli, even though they were effective in generating genital response, evoked feelings of anxiety, disgust, and worry. These negative feelings may have downplayed reports of sexual feelings, and were probably evoked by the sexual stimuli and not by the participants becoming aware of their genital response, because reports of genital response were unrelated to actual genital response. Negative appreciation of sexual stimuli may extend to, and perhaps even be amplified in, real-life sexual situations, because in such situations, any negative affect (i.e., towards the partner or the sexual interaction) may be more salient. Negative affect may, therefore, be partly responsible for the sexual arousal problems in the women diagnosed with sexual arousal disorder.
Secondly, women with sexual arousal disorder may be less aware of their own genital changes, with which they lack adequate proprioceptive feedback that may further increase their arousal. The general absence of meaningful correlations between VPA and sexual feelings in this and other studies (see next section) supports this notion. Perhaps women with sexual arousal disorder have less intense feedback from the genitals to the brain; there are no data, at present, to substantiate this idea. It is impossible to decide which of these explanations is more likely, because in real-life situations it can never be established with certainty that sexual stimulation is adequate, and awareness of genital response is dependent upon the intensity of the sexual stimulation. In addition, these explanations are not mutually exclusive. We can conclude, however, that the sexual problems of the women with sexual arousal disorder are not related to their potential to become genitally aroused. We propose that in healthy women with sexual arousal disorder, lack of adequate sexual stimulation, with or without concurrent negative affect, underlies the sexual arousal problems.
Organic etiology may underlie sexual disorders in women with a medical condition. There are only a handful of studies that have employed VPA measurements in women with a medical condition. The only psychophysiological study to date that found a significant effect of sildenafil on VPA in women with sexual arousal disorder was done in women with SCI, suggesting that in this group there was an impaired genital response that can be improved with sildenafil. Another study compared genital response during visual sexual stimulation of women with diabetes mellitus and healthy women, showing that VPA was significantly lower in the first group. A very recent study measured VPA in medically healthy women, in women who had undergone a simple hysterectomy, and in women with a history of radical hysterectomy for cervical cancer. Only in the last group was VPA during visual sexual stimuli impaired, whereas the women with simple hysterectomies reported to experience more sexual problems than the other two groups. Not presence of sexual arousal problems but presence of a medical condition that influences sexual response may therefore be the most important determinant of impaired genital responsiveness.
Medical conditions that have been associated with sexual arousal disorder, other than SCI and diabetes, are pelvic and breast cancer, multiple sclerosis, brain injury, and cardiac disease. Mental disorders such as depression may also interfere with sexual function. It is important to consider the direct biological influence of disease on sexual pathways and function, but equally important is the impact of the experience of illness. Disease may change body presentation and body esteem; ideal sexual scenarios may be disturbed by constraints that accompany illness. In many patients, sexual arousal and desire may decrease in connection with grief about the loss of normal health and uncertainty about illness outcome. Damage to the autonomic pelvic nerves, which are not always easily identified in surgery to the rectum, uterus, or vagina, is associated with sexual dysfunction in women. Medications such as antihypertensives, selective serotonine reuptake inhibitors, and benzodiazepines, as well as chemotherapy, most likely due to chemotherapy-induced ovarian failure, impair sexual response. In addition, the incidence of women complaining of lack of sexual arousal increases in the years around the natural menopausal transition. According to Park et al., postmenopausal women with sexual complaints, who are not on estrogen replacement therapy, are particularly vulnerable to what they call a vasculogenic sexual dysfunction. However, psychophysiological and preliminary functional magnetic resonance imaging studies of increases in genital congestion in response to erotic stimulation, fail to identify differences between pre- and postmenopausal women. This would suggest that although urogenital aging results in changes in anatomy and physiology of the genitals, postmenopausal women preserve their genital responsiveness when sufficiently sexually stimulated. The vaginal dryness and dyspareunia experienced by some postmenopausal women may result from longstanding lack of sexual arousal/protection from pain previously afforded by estrogen related relatively high blood flow in the unaroused state.
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Female Sexual Arousal Disorder - Diagnosing FSAD - By: David I Crawford
FSAD refers to inhibition of the “vasocongestion–lubrication response” to sexual stimulation. In the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), FSAD (302.72) is defined as the pervasive or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication–swelling response of sexual excitement, coupled with marked distress or interpersonal difficulty. The DSM classification of sexual disorders has been derived from phases of the sexual response cycle, on the basis of the work of Masters and Johnson and Kaplan. This model depicts a sexual desire phase and a subsequent sexual arousal phase, characterized by genital vasocongestion, followed by a plateau phase of higher arousal, resulting in orgasm and subsequent resolution. It is assumed in this model that women’s sexual response is similar to men’s, such that women’s sexual dysfunction in DSM-IV mirrors categories of men’s sexual dysfunction. In contrast to the third edition of the DSM manual, subjective sexual experience is no longer part of the definition, possibly in a further attempt to match norms and criteria for men’s and women’s sexual dysfunctions.
There are a number of serious problems with the current DSM-IV classification criteria. Firstly, although the DSM-IV explicitly requires the clinician to assess the adequacy of sexual stimulation only when considering the diagnosis of FOD, adequacy of sexual stimulation is a critical variable in evaluating each of the female sexual dysfunctions, and FSAD in particular. Exactly what is adequate sexual stimulation? Some sort of physical (genital) stimulation is a necessary, but not necessarily sufficient, prerequisite for arousal. For many women, adequate sexual arousal involves physical as well as “psychological” and “situational” stimulation, such as intimacy with a partner, the exchange of confidences, the sharing of hopes and dreams and fears, and not only directly prior to the sexual event. What if certain types of sexual stimulation have been adequate in the past, but not anymore? Is it evidence of FSAD, or could it be explained in terms of habituation or an adaptation to changing life circumstances? And what is meant by “completion of the sexual activity?” Is it masturbation to orgasm, sexual contact with a partner, sexual contact including coitus? These are very different activities that are known to differ in their sexually arousing qualities.
Secondly, the description of the first problem demonstrates that clinical judgements are required about sexual stimulation and the severity of the problem, the validity of which is questionable. The clinician has to evaluate what is normal, based on age, life circumstances, and sexual experience. Research on the basis of which clear criteria can be formulated, is lacking. There is a great variety in the ease with which women can become sexually aroused and which types of stimulation are required.
Thirdly, due to the lack of clear diagnostic criteria, it is often unclear in which cases an FSAD diagnosis or one of the other three main DSM-IV diagnoses is appropriate. The four primary DSM-IV diagnoses pertaining to lack of desire, arousal, orgasm problems or sexual pain, are not independent. Only very infrequently do women present with sexual arousal problems when seeking help for their sexual difficulties, but that does not mean that insufficient sexual arousal is an unimportant factor in the etiology of these difficulties. In actual clinical practice, classification is often done on the basis of the way in which complaints are presented. If the woman is complaining of lack of sexual desire, the diagnosis of hypoactive sexual desire disorder is easily given. If she reports trouble reaching orgasm or cannot climax at all, FOD is the most likely diagnosis. If she reports pain during intercourse, or if penetration is difficult or impossible, the clinician may conclude that dyspareunia or vaginismus is the most accurate diagnostic label. In general, women have difficulty perceiving genital changes associated with sexual arousal. However, women who report little or no desire for sexual activity, lack of orgasm, or sexual pain, may in fact be insufficiently sexually aroused during sexual activity. It is particularly difficult to differentiate between FSAD and FOD. FOD is defined as the persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. In cases where the clinician does not have access to a psychophysiological test in which a woman is presented with (visual and/or tactile) sexual stimuli, while genital responses are being measured, it cannot be established that her deficient orgasmic response occurs despite a normal sexual excitement phase, unless she reports feelings of sexual arousal. Ironically, this subjective criterion has been removed in the DSM-IV.
Studies investigating the efficacy of psychological treatments for sexual dysfunction have demonstrated that directed masturbation training combined with sensate focus techniques is very effective for women with primary anorgasmia to become orgasmic. In fact, this is the only psychological treatment of sexual dysfunctions that deserves the label “well established,” and is probably efficacious in secondary orgasmic disorder. The success of this treatment suggests that lack of adequate sexual stimulation is an important etiological factor underlying primary, and probably also secundary, anorgasmia. Consequently, if the clinician would strictly adhere to the DSM-IV criteria, the diagnosis of neither FSAD nor FOD would be appropriate, because the problem can be reversed by adequate sexual stimulation. In any case, primary orgasmic problems may not justify a separate diagnostic category. Perhaps the diagnosis of FOD should be restricted to those women who are strongly sexually aroused but have difficulty surrendering to orgasm. There are no clinical or epidemiological studies that differentiate between women with primary or secondary anorgasmia and other orgasm problems, so we do not know how prevalent this is. Segraves argued that FSAD hardly exists as a distinct entity, whereas we, in contrast, argue that in a classification system based on the etiology of sexual complaints, FSAD should be considered to be the most important female sexual dysfunction, with complaints of lack of desire and orgasm, and pain, frequently being consequences of FSAD.
Finally, there is a good deal of evidence that, especially for women, physiological response does not coincide with subjective experience. Women’s subjective experience of sexual arousal appears to be based more on their appraisal of the situation than on their bodily responses. Thus, in the DSM-IV definition of FSAD, probably the most important aspect of women’s experience of sexual arousal is neglected, given that absent or impaired genital responsiveness to sexual stimuli is the sole diagnostic criterion for an FSAD diagnosis.
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Internet Information on STDs & Self Diagnosis - By: b.thompsom
You’ve ever tried to Google the symptoms of your latest health concern, then you’re certainly not alone.
Based on the logistical difficulties involved with taking time off of work to schedule appointments with medical professionals, many people want an easier method. And given the wide array of medically-informative websites available courtesy of the Internet, these days, there are plenty of people who will choose in favor of website aids for self-diagnosis and purchasing certain healthcare services. According to the Pew Internet Research project, the overwhelming majority of Americans search online for important healthcare information, and Americans are increasingly apt to purchase healthcare services online.
Of course, this strategy comes with a number of significant drawbacks; specifically, the fact that the ability to read words on a website does not always correlate with the ability to perform an accurate medical diagnosis. In fact, in these types of situations, the average person attempting to diagnose his condition can easily end up doing one of two things; either he succeeds in working himself up into a frenzy by diagnosing himself with the worst possible scenario, or he fails to comprehend the seriousness of his condition by chalking his symptoms up to the most innocuous medical option of the bunch.
While the Internet can be a great tool for obtaining health-related information, the absence of professional input during most online information searches less than optimal. After all, in most cases, a website cannot take the place of a medical exam or a laboratory test, and since many different conditions of varying severity can often present themselves with similar symptoms, it can be extraordinarily difficult to come up with a definitive medical diagnosis based on reading material alone.
Fortunately, when it comes to STD testing, there is one website out there that allows Internet users to research the symptoms associated with certain conditions and then put that knowledge to good practical use. An online STD testing company called getSTDtested.com stocks its pages with detailed information regarding the signs and symptoms (or lack thereof) that are typically associated with eight distinct, well-known STDs. Browsers can peruse the site, perform a self online STD diagnosis based on STD symptoms, compare their symptoms with those listed in conjunction with the various STDs covered, and start to take action. Contrary to other medical websites that offer similar information but stop at that, getSTDtested.com offers its readers the chance to act on their suspicions by ordering reliable STD tests online and subsequently getting results within the privacy of their homes. Since getSTDtested.com partners with some of the most reliable testing facilities throughout the country, its test results are just as accurate as those that any doctor would provide. However, since there are plenty of people out there who much prefer pointing and clicking to taking time off to visit a doctor, the company provides an essential service that other medical websites do not.
As the founder and CEO of getSTDtested.com, Tracey Powell is a firm believer in STD awareness and prevention. He is also quite realistic, as he realizes that plenty of people are likely to resist the notion of seeing a doctor for the purpose of STD testing, be it reluctance, lack of time, or concerns regarding their privacy. By offering a platform for people to not only do their research on STDs, but to take their newly-acquired knowledge to the next level by getting tested for STDs, Tracey has truly propelled the concept of online healthcare consumerism to the next level. After all, as credible as certain medical websites might be, most do not - and cannot - offer the same absolute diagnostic results as getSTDtested.com. And while many would agree that researching one's potential condition online is a great way to equip oneself with knowledge-based power, there is a very obvious flaw to this system; a lack of physical diagnostic tools to confirm even the most intelligent reader's personal conclusions. Therefore, it is clear that getSTDtested.com offers customers a unique opportunity; the ability to combine personally-obtained online research with actual, reliable medical science.
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Female Sexual Arousal Disorder - The Anterior Vaginal Wall - By: David I Crawford
When Masters and Johnson released their account of the physiology of the sexual response, they opposed Freud's theory of the transition of erogeneous zones in women. According to these famous sexologists, nerve endings in the vagina are highly sparse. Thus, during coital stimulant the clitoris is stimulated indirectly, perhaps through the movement or friction of the labia. Hite's data supported this point of view. Almost all women who reached orgasm through stimulus from coitus alone had experienced orgasm through masturbation. Many women needed complementary manual stimulant to sexual climax during coitus, and an even larger number was unable to orgasm during coitus at all.
Apparently, coitus alone is not a very effectual stimulus for orgasm in women. In 1950, Grafenberg offered an alternative to Masters and Johnson's explanation for the relative ineffectualness of coitus to stimulate orgasm. He identified an area of erectile tissue on the anterior wall of the vagina along the course of the urethra, about a third of the way in from the introitus and below the base of the bladder. Strong digital stimulant of this zone would activate a quick and high level of sexual arousal which, if maintained, induced orgasm. This paper was ignored until 1982, at which time this area was renamed as the G-spot. According to Levin, nevertheless, there is no credible scientific prove for the presence of either a unique G-spot with its own plexus of nerve fibers or for the fluid that is frequently expelled when orgasm is achieved from stimulation of this area being anything other than urine. Because it is hard to see how strong stimulation of this G-spot would not also stimulate other erogeneous structures such as the urethra and clitoral tissue, Levin argues that the whole area should be viewed as the anterior wall erogeneous complex. Grafenberg pointed out that coitus in the so-called missionary position (ventral ventral) prevents stimulus of the anterior vaginal wall and would thus not be optimally sexually arousing for women. Instead, contact with the anterior wall is very close, when the intercourse is performed more bestiarum or a la vache that is, a posteriori . Thence, Grafenberg's suggestion was not that coitus itself is an inefficient sexual stimulus for women, but only coitus in the missionary position.
Sensitivity of the entire vaginal wall has been explored in several studies. Weijmar Schultz et al. used an electrical stimulus for exploration under nonerotic circumstances. This study sustains sensitiveness of the anterior vaginal wall, even though sensitivity of this area was much lower than that of the clitoris.
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Female Sexual Arousal Disorder - Anatomy and Physiology - By: David I Crawford
Clitoris and Surrounding Erectile Tissue
There is a considerable density of tactile receptors in the clitoris. The anterior vaginal wall is also rich in tactile receptors. Freud entertained a developmental idea about volatility to explain how a little girl turns into a woman. He indicated that from the onset of puberty, libido increases in boys; at the same time, in girls, a fresh wave of repression occurs that affects clitoridal sexuality. This finite period of anasthesia, Freud thought, was needed to enable successful transferrence of a girl's erotogenic susceptibleness to stimulant from the clitoris to the vaginal orifice. Even though his proposition that there are also tactile receptors in the anterior vaginal wall is correct, there is no prove that the anterior wall becomes excitable at the expense of clitoral sensitivity. Contrary to Freud's belief, there is large evidence that women who learned to know their own sexuality through masturbation are able to transfer this knowledge (or skill) to coital stimulation with a partner. For a long time, ideas similar to those of Freud have been used to suppress masturbation in girls and women. Even today there are many women with a partner, who feel guilty when masturbating.
The clitoris contains two stripes of erectile tissue (corpora cavernosum) that diverge into the crura inside the labia majora. On the basis of recent anatomical studies, O Connell et al. offered to rename these structures as bulbs of the clitoris. They found that there is erectile tissue connected to the clitoris and extending backwards, surrounding the perineal part of the urethra. Yet, most anatomical facts have been known for a long time. The clitoris parasympathethic innervation comes from lumbosacral segments L2 S2, while its sympathetic supply is from the hypogastric superior plexus. The pudendal and hypogastric nerves serve its sensory innervation. It responds with increased blood flow and tumescence on being stimulated through sexual arousal. Nitric oxide synthase (NOS), among many other neuropeptides, has been identified in the complex network of nerves in the clitoral tissue.
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Female Sexual Arousal Disorder - By: David I Crawford
The Maiden Must Be Kissed Into A Woman
Most pharmacological treatments that are currently being produced for women with sexual arousal disorder are pointed at remedying a vasculogenic deficit. In a study we did in the late 1990s we compared pre- and postmenopausal women with and without sexual arousal disorder, diagnosed according to strict DSM-IV criteria. Women with any somatic or mental comorbidity were excluded. This study investigated whether pre- and postmenopausal women with sexual arousal disorder were less genitally responsive to visual sexual stimuli than pre- and postmenopausal women without sexual problems. From the findings of this study we concluded that in such women, sexual arousal disorder is unconnected to organic etiology. In other words, we are convinced, from this and other studies to be reviewed, that in women without any somatic or mental comorbidity, impaired genital responsiveness is not a valid diagnostic criterion. The sexual problems of women with sexual arousal disorder are not related to their potential to become genitally aroused. We suggest that in healthy women with sexual arousal disorder, lack of adequate sexual stimulation, with or without concurrent negative effect, underlies sexual arousal problems. This view is at odds with the dominant view on male sexual arousal problems.
In the history of sexological science, the study of women's sexuality has been omitted, or has been obscured by comparisons with sexuality of men. In textbooks, descriptions of women and men's sexuality were often aimed at increasing awareness of similarities in physiological and psychological mechanisms. Even today, clear formulations of women's sexual problems and dysfunctions seem hindered by dominance of the male model.
For a long time, the general idea in western culture has been that although women may have a disposition for sexual feelings, in decent and healthy women these feelings will only be aroused by a loving husband. In women, specially in those who live a natural and healthy life, sexual excitement also tends to occur spontaneously, but by no means so often as in men. In a very large number of women the sexual impulse stays latent until aroused by a lover's caresses. The youth spontaneously becomes a man; but the maiden as it has been said must be kissed into a woman . Stekel believed that it was a man's task to arouse sexual feelings in a woman, a responsibility that should not be taken lightly. As a matter of fact it is the duty of every man whose wife is unfortunately anaesthetic to investigate for himself his marital partner's erogenous zones, adroitly, carefully until he determines the areas or positions which are adequate of rousing his wife's libido and of bringing on her orgasm during intercourse . He disapprovingly remarked: There are men so brutally blunt and so selfish that they take no trouble to study their wives so as to become acquainted with their erogenous zones and learn to meet their particular desires . About half a century earlier, a book entitled The Functions and Disorder of the Reproductive Organs by W. Acton, a surgeon, passed through many editions and was popularly regarded as a standard authority on the subjects with which it dealt. The book was almost solely concerned with men; the author evidently regarded the function of reproduction as exclusively appertaining to men. He claimed that women, if well brought up, are, and should be, absolutely ignorant of all matters concerning it. I should say, this author remarked, that the majority of women (happily for society) are not very much troubled with sexual feeling of any kind. The assumption that women do possess sexual feelings he considered a vile aspersion.
It was not until the late 18th century, yet, that the above view had become the superior one. For thousands of years prior to this, scholars had accepted that concept could not take place without the woman becoming sexually aroused and having an orgasm. Therefore, sexual pleasure for women was not only accepted, but also essential. Nevertheless, although sexual feelings in women were acknowledged, they were not always regarded to be unproblematic. Shorter summarized the prevalent view of women's sexuality in the Middle Ages as follows: Women are furnaces of carnality, who time and again will lead men to perdition, if given a chance. Because the flame of female sexuality could snuff out a man's spirit, women had sexually to be broken and controlled .
Ellis had distinctive thoughts about differences between women and men relating the physiological mechanisms involved in sexuality. In men, the process of tumescence and detumescence was regarded to be simple. In women we have in the clitoris a corresponding apparatus on a small scale, but behind this has developed a much more extensive mechanism, which also demands satisfaction, and requires for that satisfaction the presence of different conditions that are almost antagonistic. . . . It is the difference, roughly speaking, between a lock and a key. . . .We have to imagine a lock that not only requires a key to fit it, but should only be entered at the right moment, and, under the best conditions, may only become adjusted to the key by considerable use . It seems that phrases such as an extensive mechanism behind the clitoris served to conceal ignorance about physiological facts. Even today, scholars acknowledge that it is glaringly obvious that we know so little about sexual arousal that we cannot answer some of the most elementary questions about the human genital function .
Laqueur demonstrated that conceptions about human sexuality were not the result of scientific progress. Alternatively, he argued, they were part of social and political changes, explicable only within the context of battles over gender and power . Feminists have long criticized the notion that the behavior and abilities of women are uniquely determined by their biology. This criticism led to an almost total rejection of the role of biology in the construction of gender. It also contributed to an image of female sexuality devoid of the body. Masters and Johnson were the first to cautiously study and describe the genital and extragenital changes that occurred in sexually aroused women. Tiefer critiqued the suggestion of the human sexual reaction cycle as a universal model for sexual response, not in the least because the concept of sexual desire was not involved in the model, therewith eliminating an element which is notoriously variable within populations . She argued that the human sexual response cycle, with its genital focus, neglects women's sexual priorities and experiences. Indeed, Masters and Johnson did not assess the subjective sexual experience of the 694 men and women who were studied. Their emphasis on peripheral physiology, particularly the genital vasocongestive processes connected with sexual response, may reflect the influence of primarily male-dominated theorizing and research in sexology, with its inevitable emphasis on penile vaginal sexual contact. Tiefer questioned why problems such as too little tenderness or partner has no sense of romance were excluded. These problems have been frequently reported by women. The sexual reaction cycle model assumes men and women have and like the same kind of sexuality. Nevertheless, different studies show that women care more about tenderness and intimacy, and men care more about sexual gratification in sexual relationships. There seems to be support for the cliche Men give love to get sex, and women give sex to get love. Men and women are raised with different sets of sexual values. Tiefer concludes that focusing on the physical aspects of sexuality and ignoring other aspects of the sexual response cycle favors men's value training over women's.
Sexual Aversion Disorder - Diagnostic Criteria - By: David I Crawford
DSM-IV-TR includes sexual aversion disorder in its Sexual and Gender Identity Disorders classification (Table 1.1).
Table 1.1 DSM-IV-TR Criteria for Sexual Aversion Disorder
A. Persistent or recurrent extreme aversion to, and avoidance of, all (or almost all) genital sexual contact with a sexual partner
B. The disturbance causes marked distress or interpersonal difficulty
C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction)
In response to these criteria, The Sexual Function Health Council of the American Foundation for Urologic Disease convened the Consensus Development Panel on Female Sexual Dysfunction. Their declared opinion was that DSM-IV is limited to mental disorders and thus too limited to offer a useful, broad diagnostic classification for female sexual dysfunction.
Two of the panel's suggested amendments to the DSM-IV criteria are applicable to sexual aversion. While the DSM-IV criteria emphasize interpersonal distress, the panel preferred to emphasize personal distress as vital to the diagnosis. Second, the panel specifically distinguished between psychogenic and organically based disorders. This revised classification system includes sexual aversion under the category of sexual desire disorders along with hypoactive sexual desire disorders (Table 1.2).
Table 1.2 1999 Consensus Classification of Female Sexual Dysfunction
I. Sexual desire disorders
A. Hypoactive sexual desire disorder
B. Sexual aversion disorder
II. Sexual arousal disorder
III. Orgasmic disorder
IV. Sexual pain disorders
A. Dyspareunia
B. Vaginismus
C. Other sexual pain disorders
The consensus panel acquired a very detailed document to identify and justify their new classification system. Sexual aversion disorder, yet, was given little attention and by virtue of being placed in the category of sexual desire disorders, is potential to be overlooked.
DSM-IV-TR distinguishes between lifelong (primary) and incurred (secondary) sexual aversion. This is a differentiation that, in light of Mowrer's two-factor theory, is tough to defend. From the view of learning theory, aversion must, by definition, be acquired. Lifelong sexual aversion must still have been acquired at some point along the way. Crenshaw specifies lifelong aversion as a negative or unenthusiastic response to sexual interactions from earliest memories to present. However, no matter how absent the memory of life before the aversion, the aversion was certainly learned, either directly or vicariously. Crenshaw observes that patients presenting with primary aversion often were raised in strict religious and moral environments, which supports our contention that the aversion was learned, albeit vicariously. She also indicates that there may have been some history of psychosexual trauma, which again would have been learned and not lifelong.
We indicate that these early authors may have intended that primary refers to aversion developed so early in life that the individual did not have the opportunity to have normal partnered sexual behavior before acquiring the aversion. Cases in the literature identified as examples of primary aversion [e.g., case history of Bridgitte and Ms. C and case histories 1 and 2 - typically involve early, presexual negative conditioning of sex in childhood, mediated by environmental learning but specifically not by sexual abuse. Secondary aversion, in contrast, would be diagnosed in cases of specific recollection of childhood abuse or later negative sexual experience that is the proximate cause of current sexual aversion.
It is further possible that this secondary descriptor has been maintained in the taxonomies because sexual aversion has been confounded with hypoactive sexual desire. Hypoactive sexual desire may legitimately be either a biologic or a learned condition. The biologic contribution could well have been present since birth or early in life and thereby constitute a primary or lifelong condition. Moreover, a patient with hypoactive sexual desire may become avoidant of sexual activity. Sexual disinterest in the context of the demands of a relationship could evolve into irritation or anger and appear clinically very much like aversion. This demonstration, nevertheless, would be absent in the fear and anxiety response to sexual behavior, which is crucial for the aversion diagnosis.
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Fast facts about the most common STDs - By: b.thompsom
Below are some fast facts about the most common STDs in the United States. These statistics are based on findings released by the US Center for Disease Control (CDC) in 2009 for the year 2008.
Chlamydia:
• Chlamydia is the most prevalent sexually transmitted infection in the US.
• In 2008, over 1.2 million reported cases of Chlamydia (1,210,523) were reported to the CDC
o Note: CDC research indicates that most individuals infected with Chlamydia never experience symptoms. Because of this, many infections go unreported. Based on this knowledge, the CDC estimates that there are roughly 2.8 million actual cases of infection in the US every year.
• In the US, the rate of Chlamydia infection is about 401.3 cases per 100,000 people
• Women, especially younger women and those that are minorities, seem to be most at risk for Chlamydia infection. In 2008, young women aged 15 to 19 years comprised the highest numbers of reported cases (342,875) and highest rates of Chlamydia (3,275.8 per 100,000 females) infection
• For those young women aged 20 – 20, there were 323,696 reported cases of infection in 2008
• Chlamydia infection among men is reported to be on the rise. Between 2004 and 2008, there was a 45% increase in infection among men
Gonorrhea:
• Gonorrhea is the second most common Sexually Transmitted Infection (also referred to as an STD) in the United States.
• In 2008, there were 336,742 reported cases of Gonorrhea infection
o Note: CDC research indicates that many individuals infected with Gonorrhea never experience symptoms; therefore, their infection goes unreported. Because of this, the CDC estimates that there are roughly twice as many Gonorrheal infections annually, over what is actually reported.
• The rate of infection in the US is 111.6 cases per 100,000 people.
• Since 2000, rates of infection between men and women have remained somewhat similar. In 2008, rates of infection among men and women were as follows:
o Women: 119.4 cases per 100,000 people
o Men: 103.0 cases per 100,000 people
• Young women and teenage girls seem to have the highest rate of Gonorrhea infection. In 2008, the infection rates of teenage girls and young women were as follows:
o Girls age 15 to 19 years: 636.8 cases per 100,000 girls
Women age 20 to 24 years: 608.6 cases per 100,000 females
Syphilis:
• Although previously on the brink of complete elimination less than 10 years ago, Syphilis has once again become a health threat as rates of infection have steadily been on the rise since 2001
• In 2008 there were the highest number of reported cases since 1995. In fact, there were 13,500 cases of primary and secondary Syphilis that year alone
o The rate of infection in 2008 rose 18% from 2007. Previously at a rate of 3.8 cases of infection per every 100,000 people, Syphilis infection rose in 2008 to an estimated 4.5 cases per every 100,000 individuals
• Syphilis infection continues to be reported highest within the gay male community (men having sex with other men). In 2008, CDC data reported 63% of reported Syphilis infections were among gay and bisexual men, as opposed to only 4% of infections back in 2000
• The rate of infection among women in the US increased 36% from 2007 to 2008. In 2007, there was an estimated 1.1 cases per every 100,000 females, while in 2008 there was an estimated 1.5 infections per every 100,000
In 2008, there were 431 cases of congenital Syphilis (transmission from mother to infant during childbirth) reported to the CDC. These cases constitute a rate of infection of 10.1 Syphilis transmissions per 100,000 live births.
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Age-Related Hypogonadal Syndrome - Treatment - By: David I Crawford
General Considerations
The DSM-IV-TR diagnosis of any sexual dysfunction has four requirements: first, diagnostic subtyping must occur (see Classification section in this chapter); second, another Axis I diagnosis be excluded (except another sexual dysfunction); third, an existing medical circumstance could not explain the dysfunction; and fourth, substance abuse also not be present. In the absence of a thorough assessment (history, physical and laboratory exams when appropriate), the clinician is actually looking at a presenting symptom rather than a diagnosis. The two should not be confused. The distinction is crucial.
Treatment follows diagnostic subtyping. (A) If HSDD is acquired and generalized, the clinician must make essential efforts towards finding the explanation(s) for the change. HSDD is sometimes (the oftenness appears to be unknown) companied by another sexual dysfunction, especially erectile dysfunction, and when both occur together, it may be revealing and utilizable to find out which came first and to act accordingly. One might see how a lack of sexual desire can cause erectile problems. Yet, the opposite is not so clear. The extent to which the presence of erectile dysfunction can result in a generalized lack of sexual desire appears to be entirely unknown. (B) If HSDD is lifelong but situational, a biogenic explanation is unlikely and individual psychotherapy undertaken by a mental health professional seems preferable. (C) If HSDD is incurred but situational, a biogenic explanation is, again, unlikely (with the possibly exception of hyperprolactinemia). In this circumstance, psychotherapy seems indicated but depending on the apparent etiology, could be provided individually or together with a partner. (D) If the history reveals that HSDD has been lifelong and generalized, change is unlikely and the clinician should direct therapeutic energy towards helping the person (or, more likely, the couple) to adapt. Kinsey's admonition seems relevant: . . . there is a certain disbelief in the profession of the existence of people who are basically low in capacity to respond. This amounts to asserting that all people are more or less equal in their sexual endowments, and ignores the existence of individual variance. No one who knows how remarkably various individuals may be in morphology, in physiological reactions, and in other psychologic capacities, could conceptualise of erotic contents (of all things) that were basically uniform throughout a population.
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Age-Related Hypogonadal Syndrome - Diagnosis - By: David I Crawford
Low sexual desire is commonly regarded as a symptom of andropause/ADAM/ PADAM. To explain the desire shift, a great deal of emphasis has been given to laboratory values, especially alterations in T. Yet, the typical history has incurred much less attention. Only one analyse of aging men seems to have analysed different manifestations of sexual desire. Schiavi et al. reported on 77 volunteer couples who replied to an announcement concerning a examination of constituents contributing to health, well-being, and marital satisfaction in older men. Three groups of men were compared: 45 54, 55 64, and 65 74. The accompanying were determinations related to the issue of sexual desire: (i) sexual interest, responsiveness, and activity was noted even among the oldest men; (ii) increasing age was associated with erectile dysfunction, but not with HSDD or PE (premature ejaculation); (iii) the following frequencies consistently reduced with age: desire for sex, sexual thoughts, maximum time uncomfortable without sex, coitus, and masturbation; and (iv) . . . the degree of satisfaction with the men's own sexual functioning or enjoyment of marital sexuality did not change with age .
As far as the laboratory is concerned, measuring BAT is the preferable parameter for determining hypogonadism, although it is not always available. Abnormality is evaluated by comparing the T level with young adult men. If the testosterone level is below or at the lower limit, it is prudent to reassert the results with a second determination with assessment of LH and . . . FSH.
Etiology
In addition to hormones, many other switches take place in male physiology which lead to the aging process. One nonsexual example that is referred for the use of offering perspective, is the multiple factors which are connected with diminished bone mass and which include: low estradiol (E2), vitamin D deficiency, low GH, low T, poor nutrition, smoking, certain medications, excess alcohol, inactivity, lack of exercise, poor calcium intake, genetic predisposition, and certain illnesses.
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Male Sexual Desire Disorder - Age-Related Hypogonadal Syndrome - By: David I Crawford
Terminology and Definitions
Hypogonadism relates to the results of minimized function of the gonads; happens at any age and for a variety of causes; and is classified into two forms on the basis of the source of the problem, that is, either of testicular origin, or as a effect of disorder in the hypothalamic-pituitary axis. Sex-related phenomena linked with hypogonadism are described in the Hormones section of this chapter.
The term andropause indicates a specific type of hypogonadism that is correlated to aging in men and is said to consist of the following: minimized sexual desire and erectile function, diminish in intellectual activity, fatigue, depression, decrease in lean body mass, skin alterations, decrease in body hair, decrease in bone mineral density resulting in osteoporosis, and increase in visceral fat and obesity. The word andropause is an attempt to draw a parallel in men to the experience of menopause in women. Whereas menopause occurs abruptly, andropause is said to come about quite slowly. As well, menopause is linked with the irreversible end of reproductive life, whereas in men spermatogenesis and fertility continue into old age. In the opinion of some observers, trying to equate the two is rather questionable.
The existence of andropause is a subject of controversy partly because of large difficulty distinguishing this syndrome from age-related confounding variables such as nonendocrine sicknesses (both acute and chronic diseases), poor nutrition (inadequate or excessive food intake), smoking, alcohol use, and medications. Some observers have less doubt about the existence of a disorder but prefer to use a different name: ADAM (androgen decline in the aging male), or PADAM (partial ADAM which refers to androgen decline that is still within the normal range).
To emphasise the fact that many hormones decline with age, the word adrenopause has also been utilised to describe the diminution of the adrenal androgens DHEA and DHEAS, and somatopause to describe the same in the somatotrophic hormone, growth hormone (GH).
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Presence of Another Sexual or Gender Disorder in a Patient or Partner - By: David I Crawford
Sexual Dysfunctions
Three studies establish that it is common for HSDD to be connected (or comorbid or correlated) with another sexual dysfunction. Nevertheless, correlation is not the same as causation. The same factor(s) may lead in both disorders. However, the observation is at least noteworthy, and beyond that, may be etiologically meaningful.
1. Segraves and Segraves reported on 906 subjects (including 374 men) who had been recruited for a pharmaceutical company study of sexual disorders. Only the men will be discussed in this article. They were described as age 51 (SD = 10.1), and 30% (n = 113) had a primary diagnosis of HSDD. Almost half (47%) had a secondary diagnosis of erectile impairment and a few (n = 3) had retarded ejaculation (patients with premature ejaculation were excluded from the study).
2. Schiavi reviewed 2500 charts of individuals and couples referred between 1974 and 1991. This survey included 1775 men, of which 13.3% (n = 236) were 60 years old or older (range 60 84). Most of the men (66%) were diagnosed with erectile disorder but 28% had HSDD either alone [3% (n = 8) - or affiliated with another sexrelated diagnosis [ED 14% (n = 34); PE 11% (n = 27) - . In some, erectile dysfunction was the cause while in others it was the result. In most it was not possible to define the primary dysfunction .
3. Together with colleagues, Schiavi also analyzed the psychobiology of a group of sexually healthy men aged 45 74 living in stable sexual relationships. Seventy-seven couples were studied. One of the issues considered was a comparison of men with and without a sexual dysfunction. Seventeen men met their criteria for erectile dysfunction and five for HSDD (22% and 6.5%, respectively, of the total group). They found a significant difference in the age of the HSDD men who did and did not have accompanying erectile dysfunction (70.8 and 58.6 years, respectively). They added that the number of men with HSDD was too small to do any statistical comparisons with men who were not experiencing this disorder. Sexual difficulties in a partner, for example, intercourse-related pain experienced by a woman, may result in profound change in the level of sexual desire in the other person.
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Sex Depends on Buoyant Good Health - By: David I Crawford
One of the tragedies of illness is that it usually prevents a normal sex life. Because sex is a means of expressing love and is perhaps the deepest form of human communication, a marriage without it is sterile and often an outright endurance contest. Although major sexual problems, such as impotency and frigidity, and a horde of minor ones are emotional in origin, intercourse is often not enjoyed simply because a partner is tired, has a headache, has not slept well the night before, or feels tense or depressed and wants nothing more than to be left alone.
Any person who is irritable, critical, nagging, or lacks the energy to take a bath is scarcely setting the stage for an evening of ecstasy. During my years of consulting work, dozens of men and hundreds of women have talked to me about their sex problems; and some of the commonest complaints I have heard are that feet smell bad and that the mate has halitosis. Such seemingly insignificant things can prevent a woman from having a fulfilling orgasm and a man a sustained erection.
Much of the joy of sex depends on buoyant good health, which most people can achieve--if they really want it--to a far greater degree than they think possible.
Research is Meager
Partly because of reticence, little research has been done concerning the effect of nutrition on sexual performance. It is known, however, that protein, essential fatty acids, vitamin E, and several of the B vitamins are essential before the sex hormones can be produced. A lack of protein causes a loss of sex interest and a decrease in sperm count. Unless vitamin E is adequate. the testicles of all varieties of laboratory and farm animals degenerate and there is a decrease in both the sex hormones and the pituitary hormone gonadotropin, which stimulate the sex glands. Vitamin E also protects the sex hormones from destruction by oxygen. People in famine areas and in concentration camps have invariably reported loss of sex interest; and during World War II men in prison camps found discussions of recipes more fascinating than of sex. Malnourished individuals of reproductive age may have an almost total absence of sex hormones and of the pituitary hormone that stimulates the sex glands, though recovery occurs when the diet is made adequate. Men deficient in vitamin B6 have become impotent; and during stress, the sex urge and sperm production diminish. The motility and fertility of sperm are in proportion to the amount of vitamin E in a man's semen. Autopsy studies of poorly nourished people of sexually active age have shown shriveled ovaries and testicles, a decrease in the cells that produce sperm or ova, vast areas of dead tissue and much scarring; and the ovaries and testicles alike have been loaded with brown pigment characteristic of a vitamin-E deficiency. The changes were similar to those seen in advanced senility and in animals deficient in anyone of several nutrients, particularly vitamin E.
Too Few Calories
During World War II, scientists at the University of Minnesota undertook semi-starvation experiments to learn how to rehabilitate persons released from prison camps. When conscientious objectors were kept on diets supplying only 1,600 calories daily, they noticed a marked decrease in sexual desire, became melancholy, morbid, anxious, depressed, subject to hysteria, and were said to be "indistinguishable from many severely neurotic patients." They suffered fatigue, weakness, decreased ability to work, and cold hands and feet, found it impossible to concentrate, and became social introverts When their diet was restricted in both calories and B vitamins, all symptoms became markedly intensified. The investigators concluded that "a superior dietary throughout life may spell the difference between alert, successful living and marginal effectiveness."
Thousands of persons, especially women, eat less than 1,600 calories daily, presumably to be sufficiently attractive to be more loved. Yet fatigue, depression, hysteria, and lack of sex interest scarcely make them rollicking bed partners. Men who eat little because alcohol fills their calorie needs usually suffer from general malnutrition associated with a loss of sex interest and inability to maintain erections, both of which are corrected when an adequate diet is adhered to.
If the B Vitamins are Under Supplied
In dozens of experiments men and women volunteers have remained on diets lacking one or another of the B vitamins, and the symptoms produced would invariably make a fulfilling sex life impossible. Individuals under supplied with vitamin B1 quickly became fatigued, depressed, forgetful, irritable, quarrelsome, apathetic, confused, restless, anxious, and unco-operative; they neglected their work and appearance, became intolerant of details and noise, and suffered from insomnia, nervousness, paranoid tendencies, and hypochondriasis, all of which were relieved soon after the vitamin was given. When volunteers in a mental hospital stayed on a diet deficient in this vitamin, their emotional problems, even though psychological in origin, became greatly intensified.
A lack of the B vitamin niacin amide results in such confusion, disorientation, clouding of consciousness, and hallucinations that it can cause total mental breakdown. One doctor tells of a niacin-deficient woman who thought her neighbors were planning to kill her and who could see and feel vicious animals attacking her; yet 48 hours after the vitamin was given, she was completely rational. Mild deficiencies, associated with irritability, suspicions, imaginary unfairness, and mental depression, usually described as "the blues," are common and can prevent family life from being happy.
Induced pantothenic-acid deficiencies have caused persons to become irritable, depressed, quarrelsome, hot-tempered, easily upset over trivialities, and to want to be left alone; they were obviously uninterested in sex. Similarly, volunteers lacking vitamin B6 not only become highly nervous, tense, irritable, depressed, and mentally confused, but develop halitosis and hemorrhoids and pass quantities of malodorous gas, all of which would decrease both sex appeal and sex interest. Fatigue, confusion, irritability, and mental depression have also occurred when deficiencies of folic acid or biotin have been produced. The lack of B vitamins is so commonplace as to affect almost every American family not interested in nutrition. It can wreck a once good marriage and leave parents not only unable to be loving, kind, and patient toward each other but also quick with harsh words, which cause permanent emotional scarring of their children. In contrast, energetic good health allows richness, joy, harmony, and sexual fulfillment.
Other Deficiencies
An under supply of several other nutrients can also affect sexual expression. Persons mildly deficient in magnesium become highly nervous, irritable, quarelsome, and may change from friendly, outgoing, cooperative individuals to surly, belligerent, apathetic ones. Yet magnesium deficiencies are widespread indeed. Even the horrible mental torture of delirium tremens, which sometimes occurs in non-drinkers following acute infections, injuries, or surgery, has been corrected merely by giving water, salt, and a small amount of magnesium.
A protein deficiency or an imbalance of amino acids can cause mental depression, apathy, peevishness, and a desire to be left undisturbed; and a lack of calcium results in nervous tension and irritability. Such faulty nutrition is largely responsible for the present widespread use of tranquilizers, though a person who is drugged is scarcely a wholehearted sex partner.
Regardless of the cause, the exhausted or depressed individual finds it extremely difficult to eat highly nutritious foods, and his poor food habits result in ever greater emotional upsets and still less satisfactory sex life. A vicious circle is set up which not infrequently leads to a "nervous breakdown."
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Sexual Disorder - Biological, Psychological, and Social - By: David I Crawford
Not only are there multiple origins for HSDD in men, but the theoretical perspective of the observer regarding sexual issues as a whole make understanding sexual problems like HSDD even more difficult.
One might look first at differing points of view about sexuality in general. Some view sexual difficulties from primarily a biomedical position and regard sex as natural. Kolodny et al. wrote: to determine sex as natural means just as an individual cannot be learned to sweat or how to digest food, a man cannot be taught to have an erection, nor can a woman be taught to lubricate vaginally. Because the reflex pathways of sexual functioning are inborn does not mean that they are immune from disruption due to impaired health, cultural conditioning, or interpersonal stress. Some have reworded naturally to mean automatically, without purpose or without effort .
Others look at sexuality and see the absence of involvement as being crucial to understanding the psychological origins of many sexual difficulties. One can in particular value (and learn from) the implications of the absence of intimacy for sexual relationships generally, and sexual desire in particular, when looking at the plight of those with a serious mental illness who, by the very nature of the disorder, also have significant intimacy difficulties. The roots of intimacy difficulties are in the patient's past . . . this . . . needs to be thoroughly researched because it may well have included excitement in his or her family-of-origin, as well as a shortage of love and nurturing connections which are so often a rehearsal for love relationships later in life. Also, the patient's past may not have involved the experimental love and sexual relationships of adolescence in which so much learning takes place about oneself and others.
However others look at sexual matters from a social constructionist point of veiw. Tiefer wrote that the primary influences on women's sexuality are the norms of the culture, those internalized by women themselves and those imposed by institutions and enacted by significant others in women's lives.
It may well be that these viewpoints do not apply equally to men and women, and that sexuality in men is, for example, more natural. Still, even as the word natural is applied to men, it does not explain the contribution to sexual problems of either intimacy issues or cultural variations in sexual behavior.
During development and growth, there is interaction with the environment that builds up experience and potentiation of sexual stimuli. The social and cultural environment determines sexual expression and the meaning of sexual experience .
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Male Hypoactive Sexual Desire Disorder - Epidemiology - By: David I Crawford
The best information on the epidemiology of sexual disinterest in men comes from surveys of the average population and convenience samples. In the literature on this subject, little attempt is made to distinguish between the various diagnostic subtypes.
An excellent reference of population-based information on sexual disinterest in men comes from the National Health and Social Life Survey (NHSLS; 15). 78 Maurice Laumann and his colleagues interviewed a probability sample of 3432 adults (including 1410 men) in the US between the ages of 18 and 59. Because the study is so often cited, it is worth examining the results in some detail.
In a 90 min interview on many sex-related subjects, one of the questions asked was during the last 12 months has there ever been a period of several months or more when you lacked interest in having sex? (No obvious attempt was made to subtype the responses.) Overall, 16% of the men said they were indeed not interested in sex (vs. 33% of the women). When the responses were gathered into 5-year groupings, the highest numbers of those who answered yes were from men who were in two groups: those who were 40 44 and 50 59 years old. These numbers do not quite fit with the common perception of waning sexual desire with increasing age. The figures seem to indicate a bigger degree of complexity. Contrary to expectations, the fewest men who answered yes were in the group of men who were 44 49 years. Looking at the opposite end of the sexually active age spectrum, and again not quite fitting with standard beliefs, 14% of the youngest group of men (18 24 years old) also answered positively.
Some social elements examined in the Laumann et al. study correlated with lack of sexual desire in men. Those who answered affirmatively included 20% of the never married men (vs. 12% of the married); 22% of the men whose education was less than high school (vs. most of the other levels of education where the range was 13 16%); and 20% of black men (vs. 15% of whites). The impact of religion was unclear with no one religious group outstanding. The relationship to poverty was large in that 25% of poor men responded positively (vs. 13 15% of men at other income levels).
In the same survey, health and happiness were also individually connected with sexual disinterest. The greater the impairment of health and the magnitude of unhappiness, the greater the extent of sexual disinterest.
Further analysis of the sexual dysfunction data from the NHSLS survey used multivariate techniques to estimate the relative risk (RR) for each demographic characteristic as well as for key risk factors. In comparing the oldest group of men to the youngest, the former were three times as potential to have low sexual desire. Likewise, never married men were almost three times as likely to experience lack of sexual desire compared to those who were presently married.
The statistical method of latent class analysis (LCA) was also utilized for analysing risk factors and quality-of-life concomitants in relation to classes of sexual dysfunction instead than individual symptoms. Risk factors that were found to be forecasters of low sexual desire in men included daily alcohol consumption, poor to fair health, and emotional problems or stress. The same was true of thinking about sex less than once weekly (more than three times as likely vs. those who thought about sex more than once weekly), ever had any same-sex activity (more than twice as likely vs. those that never did), and sexually touched before puberty (about twice as likely vs. those that were not touched).
When looking at quality-of-life concomitants, men with low sexual desire experienced a low level of physical satisfaction and a low level of general happiness, with their primary partner.
Another survey utilising a stratified probability sample was conducted in Britain and concerned the prevalence of sexual function problems in people who had at least one heterosexual partner in the past year. The study took place from 1999 to 2000 and involved 11,461 men and women aged 16 44. The response rate was 65.4%. Problems were described according to two duration periods: those which lasted at least 1 month in the past year, and those which lasted at least six months in the past year. Thirty-five percent of men reported at least one sexual problem in the past year, and lack of desire in sex was the most common such concern (17%) in the shorter time period. The prevalence dropped to 2% when considering the at least 6-months time frame.
In yet another study involving 100 normal volunteer couples who were well-educated and who viewed their marriages as ones that were working, Frank et al. found that a similar (to the US and UK studies) percentage of men (16%) were sexually disinterested. Similarly, when a sample of gay men were asked about sexual concerns, including lack of interest in or desire for sex, 16% said it was a current problem and 49% indicated that it was a problem at some time in their lives.
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Normal Sexual Desire for Men - By: David I Crawford
If one accepts the notion that sexuality generally and sexual desire in particular may be different in men and women, another question quickly follows: when looking at sexual desire, what is normal for men? A corollary to this question is: since there is a general understanding that sexual activity shifts with age, what represents normal sexual desire for men as they get older?
An exceptional source of information on men and sexuality (including sexual desire) is the Massachusetts Male Aging Study (MMAS), a survey that compound a random sample of men in the general population aged 40 70, and one in which questions were asked about sexual issues from the viewpoint of both behavior and personal thinking. A total of 1709 men taken part in the study. A self-administered questionnaire included 23 items on such sex-related subjects as: satisfaction; frequence of activity; frequence of desire; frequency of thoughts, fantasies, or erotic dreams; frequence of erections and erectile difficulties; orgasm difficulties; genital pain; frequence of ejaculation; and mental attitudes to sexual changes with age. Studies were divided into two categories: behavioural and subjective phenomena. Only the latter will receive comment here, as sexual desire is a subjective phenomenon (which, indeed, might have behavioral consequences but far from always).
Outcomes of the survey suggested a consistent and profound fall with age in feeling desire, in sexual thoughts and dreams, and in the desired level of sexual activity. The fall in sexual interest neither preceded nor followed a similar decline in sexual behavior or events. They appeared to occur together. Since the data were cross-sectional, it was not possible to answer the question about which came first . . . there was no evidence here of a disjunction between the level of sexual activity desired and the level of activity actually reported; it is not the case that as men age they desire at a level that is various from that which they report. Nevertheless, the authors also found that satisfaction did not follow the same path in that . . . men in their sixties reported levels of satisfaction with their sex life and partners at about the same level as younger men in their forties.
The authors of the MMAS considered many factors that might be associated with the decline in sexual interest and found that aging and its social correlates . . . were strongly predictive of reduced involvement with sexual activity . . . (and that) . . . good health was associated with more involvement . . . The authors concluded that the MMAS study, by considering men in their middle years, goes part way towards filling the gap of up-to-date normative data available to inform clinicians as to the regular levels of activity and interest of normally aging men.
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About Chlamydia - By: b.thompsom
What Everyone Should Know About Chlamydia
In the grand scheme of STDs, Chlamydia is generally regarded as one of the “not so bad†diseases out there. Most people don’t tend to regard Chlamydia as a life-changing disease such as HIV; however, if untreated, Chlamydia can come with its own share of long-term repercussions. Tracey Powell is the founder of getSTDtested.com, an online STD testing company that protects customer privacy, and he stresses the importance of educating people about the facts and risks of Chlamydia so that they can protect themselves from the infection & its potential health effects. The following are some of the things that everyone should know about Chlamydia:
It’s more common than you might think
Chlamydia is actually the most frequently-reported bacterial STD in the United States. Though the disease tends to affect women more so than men, men are just as likely to contract the disease and spread it on to their partners. In fact, since men are less likely to ever show any symptoms from the infection, they often walk around unaware that they have the disease, and women then become more frequently re-infected due to their sexual partners not being treated.
It can get complicated
Chlamydia is one of those diseases that, if left untreated, can have serious long-term side effects, particularly for women. While complications among men are rare, untreated Chlamydia can cause irreversible damage in women, including chronic pelvic pain, infertility, and potentially-fatal ectopic pregnancies (pregnancies that occur outside the uterus). Women who are infected with Chlamydia are also more likely to contract HIV if exposed. In order to ensure early detection and prevent an untreated infection from causing irreversible damage, regular screening is important and recommended for all sexually active adults.
It often doesn’t come with symptoms
One of the scariest things about Chlamydia is the fact that it often comes with no recognizable symptoms. For this reason, it’s important to get tested for Chlamydia even if there’s no physical indication that the disease might be present
It can be easily treated and cured
When caught early, Chlamydia can be nipped in the bud before the infected party experiences any sort of side effects, temporary or otherwise. Treatment can be administered in as little as a single dose of antibiotics, though sometimes a full week of medication is needed to eliminate the infection. In fact, one of the most ironic things about Chlamydia is the fact that it can be cured in a snap as long as a doctor knows to treat it; all the more reason for people to get tested for it on a regular basis.
It can be prevented
The best way to avoid Chlamydia, as well as any STD for that matter, is to abstain from sexual contact, or to be in a monogamous relationship with a partner who has been tested and confirmed to be uninfected. Chlamydia can be transmitted during various types of sexual activity and intercourse. Condoms can help reduce the risk of spreading Chlamydia from one person to another, though they offer no absolute guarantee.
Now that you know the facts about Chlamydia, you should feel free to discuss Chlamydia testing with your doctor if you feel that you are at risk. If you’re not comfortable doing so, then you could always visit getSTDtested.com and order your own Chlamydia test. Remember, Chlamydia is something that doesn’t have to be a long-term problem as long as you don’t let it become one. Get tested so you can cross Chlamydia off your list of things to worry about.
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Female Hypoactive Sexual Desire Disorder - Hormonal Treatment - By: David I Crawford
Testosterone
Long-term data for safety and benefit of testosterone therapy in women are lacking, but such data are necessary before long-term practice of testosterone can be recommended. Likewise, safety data for the practice of testosterone in nonestrogen exchanged postmenopausal women are lacking and no recommendation for its practice can be made currently. Nor can the supplementation of T to premenopausal women be recommended until such time there exist safety and efficacy data. Unluckily, any enduring benefit after short-term treatment, although theoretically potential, is unproven. In addition, supplementing T on a temporary basis only, could have unfavorable results on the couple if an improvement associated with T therapy is no longer apparent when it is withdrawn.
If despite the above, T supplementation is contemplated, careful assessment must establish absence of ongoing psychological (interpersonal, intrapersonal, contextual, and societal) or physical factors negatively affecting sexual desire and arousability. On the basis of available data, no specific testosterone regimen or dose can yet be advocated. The chosen formulation of testosterone must have pharmacokinetic data indicating that it produces blood levels within the normal premenopausal range. Accomplishing physiological free testosterone levels by transdermal delivery appears to be the best approach.
Contraindications to testosterone therapy include androgenic alopecia, seborrhea, or acne, hirsutism as well as a history of polycystic ovary syndrome, and estrogen depletion. Oral methyl testosterone therapy is contraindicated in women with hyperlipidemia or liver dysfunction. Regular follow up is both clinical inspection of skin and hair for seborrhea, acne, hirsutism, and alopecia and biochemical through monitoring of free/bioavailable testosterone and SHBG, keeping these values within the normal range for premenopausal women. Of note, methyl-T is not included in the regular assays for T. Possibly, the target level for older women should be even lower but this stays obscure. Lipid profile and glucose tolerance are also monitored. The current recommendation is to prescribe only for 12 months owing to lack of extended safety data.
Tibolone
Tibolone is a synthetic steroid with tissue selective estrogenic, progestogenic, and androgenic actions. In practice in Europe for more than 10 years, tibolone provides some relief from vasomotor symptoms, estrogen agonist activity on the vagina and bone, but not on the endometrium. Tibilone was thought not to have estrogen agonist activity on breast tissue; but a recent, albeit nonrandomized but very significant study of postmenopausal hormonal therapy showed a similar increase in breast cancer in women receiving tibolone and those receiving various combinations of estrogen and progestins. The average (presumed beneficial) estrogenic results on lipids are not seen, but it is of note that tibolone does not promote (unwanted) coagulation. Prospective randomized trials comparing tibolone to placebo or to various formulations of estrogen and progestin therapy have been done. Although in most but not all, there was profound improvement in sexual interest in the women receiving tibolone; no study focused on sexually dysfunctional women. Recruitment centered on vasomotor symptoms or bone density. Studies in postmenopausal women with loss of arousability and therefore of sexual desire are needed.
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Kamasutra and sex games - By: Jerfy Smesat
Sex is one expression of human nature and the neediness for sexual satisfaction is almost as important as the need for food or housing. Not for nothing because one of the strongest senses is the instinct of procreation, which is quality of all living beings. Still, people have already gone quite far from irrational animals, including - and in relation to their hint life. Modern man attracts not just sex itself, and a pleasant and varied sex. In addition, various sex does not mean permanent change of sexual partners. His personal life can vary in other ways. For example, when we recall the tasteful art of making love, we should mention the KamaSutra. KamaSutra is a famed ancient Indian treatise on the art of bodily love. Striptease and erotic games are a great way not only to get satisfaction in sex itself, but also to give the positive impressions for sexual partner. It is very important because a good partner always thinks not only about his own pleasure - on the contrary, this time going by the edge, and the person most importantly - to give pleasure to their partner. And the KamaSutra is just tell how to do it. Of course, this exposition on sex looks at many technical matters and sometimes erotic poses, as insinuated in KamaSutra, look like some kind of acrobatic trains. Nevertheless, we should not forget that the Indians are famous for their philosophical way of thinking, and their position to sex is no exception. Technics of sex - this is very pleasant, but without the mental feeling to your partner this fun, neither he nor you do not get. True erotic is not just a set of some movements, it is a bite more: a seductive look, a baffling half-smile, graceful movements, the voice that touches the thin strings of the soul interlocutor ... And, sure, people will not look sexy, if he himself does not feel attractive. Thus, if you want to have an extraordinary and wonderful sex - study the various manuals and guidelines, yet, do not forget about the careful and gentle attitude towards your partner, as well as self-love (surely, within reasonable limits). Love and be loved!
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Sexual Dysfunction, Management of Low Interest - By: David I Crawford
Psychological Treatments
Psychological therapy is the keystone of the management of low sexual desire. Given the imposed blending of mind and body, making deliberate alterations in thoughts, attitudes behavior, results not only to changed feelings and emotions but changed sexual physiology. Under the term sex therapy typically the woman's negative thoughts and attitudes to sex, her distractions during sexual stimulation, the need for more altered, more prolonged, or simply different sexual stimuli, the need for the couple to guide each other; and the common needs of safety, privacy, and optimal timing of sexual interaction will be addressed. Sensate focus techniques whereby there is a graded transition from touching and caressing that is not specifically sexual to that which is sensual to that which is frankly sexual, may sometimes be included. The approach is one of systematic desensitisation common to other behavioral therapies. Cognitive Female Hypoactive Sexual Desire Disorder behavioral therapy (CBT) focuses on the reconstituting of myths or distorted thinking about sex. Couple therapy may be required focusing on interpersonal issues including trust, respect, as well as ways to relate to each other, which foster sexual attraction. Psychodynamic therapy is often recommended to handle issues in the woman's past developmental period. Particular attention to family of origin and relationships to parental figures is often needed. A further component is that of systemic therapy, sexual differentiation, that is, the ability to balance want for contact with the partner vs. desire for uniqueness as an individual. Schnarch indicates that this is extremely significant for healthy sexual desire.
In directing the types of treatments, construction of the woman's sex response cycle will clarify the breaks or the sites of weakness. When emotional intimacy with the partner is minimal such that motivation and arousability are negatively affected, the couple is suggested to receive relationship counseling before or possibly alternatively of any sex therapy. When problems are due to lack of effectual stimuli, contexts, negative thoughts, and attitudes about sex, or nonsexual distractions are present, a combination of CBT and sex therapy is usually given. Similarly, explanation, CBT, and sex therapy can be given when the main issue seems to be expectation of an inevitably negative outcome.
Recent outcome studies include one in 2001 of 74 couples randomized to 12 weeks of CBT or an untreated control group. Of the women receiving CBT who met the criteria of hypoactive sexual desire pretreatment, 26% retained to do so at the end of treatment and 36% met the criteria 1 year later. The CBT group experienced profound advances in sexual satisfaction, perception of sexual arousal, dyadic adjustment, improved selfrepertoire, sexual pleasure, and perceived self-esteem, as well as general increase in motivation, mood, and lessening of anxiety. In a noncontrolled study of the same year, CBT was assessed in 54 women having a broad spectrum of sexual dysfunction. Fifty-four percent of the women still had the same sexual complaints after treatment, although the broad levels of sexual dysfunction were reduced and there were more positive attitudes towards sex and increased sexual enjoyment and less perception of being a sexual failure. A study of 39 women with low desire in 1993 randomized one group of women to receive standard interventions of sex therapy vs. a group also receiving specific orgasm consistency training. Although both groups improved, benefit was greater in those in the combined group, particularly regarding arousal. A larger study in 1997 of CBT in 365 couples with a range of sexual dysfunction, showed 70% of women improved at 1-year after treatment.
Studies have described factors associated with better prognosis. Those constituents include the overall quality of a couple s nonsexual relationship, the couple's motivation to enter treatment, the degree of physical attraction between the partners, an absence of major psychiatric disorder, attention to systemic issues in the relationship, the male partner's motivation to obtain a successful result to therapy, and the amount of sensate focus experiences the couple accomplish in their last week of therapy.
Nevertheless, benefit from psychological treatment is to some degree unclear because the outcome measures used reflect male sexual desire but show a broad normative range across sexually healthy women. In addition, subjective arousal and excitement is rarely addressed despite the data supporting its major importance relative to genital congestion, and its close blending with desire.
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A Closer Look at the Biological Basis of Women s Sexual Desire and Arousability Part 2 - By: David I Crawford
Cross-sectional and cohort studies of sexual response and T values are inconclusive. Either there is no correlativity between T levels and sexual variables correlativity with estradiol levels but not T, or a correlation of free-T with levels of sexual desire. There have been different short-term randomized controlled studies of T administration to women complaining of diminished sexual interest and satisfaction. An improved outcome has been found by most but not all of these trials, but the T levels produced were not clearly within the physiological range. The study with levels closest to the physiological was of oophorized women, and showed benefit only in older women receiving 300 mg/day of transdermal T, with correlated blood levels at or slightly above the normal range for premenopausal women. Of note, the correct range for postmenopausal women is unclear. A very recent study of T administration to premenopausal women did show benefit over placebo, but the free androgen index was above the upper limit for normal premenopausal women. Of major importance is the fact that these examines have been only of short duration, and, therefore, safety data are very limited. Moreover, only estrogen replete women have been studied.
Despite documented progressive loss of DHEA and DHEAS in women from late 30s onwards, the results of DHEA supplementation to improve sexual health have been conflicting.
The term androgen deficiency syndrome has been practiced recently. Still, the usual criteria utilised in endocrinology for administration of a deficiency state have not been met. These include:
1. Symptoms regularly associated with low levels of the hormone;
2. Relationship of symptoms to the established biological actions of the hormone;
3. Reversal of symptoms on administration of the hormone in doses which are physiological and not pharmacological.
None of these criteria is fully met in the case of androgen deficiency syndrome . In addition, a specific level of testosterone in women, which can be considered diagnostic of androgen deficiency, has not been established.
Some of this confusion may be in part owing to problems in measuring T, including a lack of assay specificity. Free-T is preferably measured by balance dialysis, but this is rarely available in clinical practice. Free-T correlates more closely with the biological effects of the hormone than does the total because most of the circulating T is bound to SHBG which prevents diffusion into tissues. Unfortunately, the analogue attempts for free-T are inaccurate. Free-T can be calculated if the total T, albumin, and SHBG are known. Nevertheless, at the low levels of T acquired in women, few assays of total T are reliable. Whichever attempt is used, thorough validation is necessary. Another major complicating factor is that much T activity within the cell is derived 52 Basson intracellularly from ovarian adrenal precursors. This intracellular T cannot be measured. Judging T activity from measuring testosterone metabolites is not yet standardized.
There is clearly a clinical dilemma. Clinicians repeatedly see previously responsive women markedly distressed from their lost arousability none of their formerly useful stimuli are effectual. Typically, this is of gradual onset in the late 40s or early 50s. Loss of innate sexual thoughts and fantasies is not the issue. The context of their sexual lives has not altered they speak of a sexual deadness . Accurate measures of T activity and long-term randomized controlled trials of physiological T therapy are very much needed. Clearly, this loss of arousability appertains to just a subgroup of mid-life women perhaps partially explaining the inconsistencies amongst reports of T levels of women in mid-life and older in the general population.
The free-T can be reduced by about 50% by many oral contraceptive pills and by administration of glucocorticoids. There has been little research in these areas that is accommodating to clinicians.
The risks of T administration include those that are familiar, for example, greater sebum production, acne, loss of scalp hair, stimulation of facial and other body hair, as well as other potential risks including metabolic dysfunction in some women. This is based on the fact that although in the condition of polycystic ovarian syndrome, it appears that hyperinsulinemia is usually the cause of the hyperandrogenism, there are some reports of situations in which hyperandrogenism causes insulin resistance. There is also a risk that other concerns will come to light if women are given testosterone when estrogen deficient, in view of the recent withdrawal of large numbers of women from estrogen therapy owing to the results of the women's health initiative study.
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Sexual Dysfunction - Multidisciplinary Team Approach - By: David I Crawford
The conception is a simple one with a long history; sometimes, two heads are better than one. Treatment may need a multidisciplinary team in cases of profound dysfunction, and may be contrary to success even under this ideal condition. There are many models for working together. Team approaches and composition will vary corresponding to clinician specialty training, interest, and geographic resources. Although some expert physicians work alone, other PCPs, urologists, and gynecologists have set up in house multidisciplinary teams where nurses, physician associates, and master s level MHPs render the sex counseling. This approach has obvious rewards and disfavours. In cases of more severe PSOs, the patient(s) will be referred out for psychopharmacology, cognitivebehavioral therapy, and marital therapy in various permutations, provided by doctoral level MHPs. Yet, typically a clinician refers within their own academic institution, or within their own professional referral network a kind of virtual multidisciplinary team. Endocrine, gynecologic, or urologic referrals for the patient or partner may be necessary, and would usually be readily available. Still, MHPs trained in sex therapy will experience the greatest number of new chances for interdisciplinary participation to enhance and optimise patient response to sexual pharmaceuticals. Discovering psychological factors does not necessarily mean that nonpsychiatric physicians must treat them. If not inclined to counsel, or, if uncomfortable, these physicians should consider referring or working together with a sex therapist. All clinicians should be encouraged to practice to their own comfort level. Indeed, some PCP will not have the expertise to adequately diagnose PSOs, independent of their ability or willingness to treat these factors. Knowingness of their own limitations will appropriately prompt these physicians to refer their patients for adjunctive consultation. Physicians who prescribe PDE-5s and future sexual pharmaceuticals may need adjunctive assistance, referring to sex therapists, because of their own psychological sophistication or due noncompliance on their patient's part. Whether the referral is physician or patient originated, sex therapists are ready to effectively assist in educating the patient about maximizing their response to the sexual situation. They are able to help re-motivate people who have failed initial medical treatments, as well as aiding patients to adjust to second and third line treatments. They help make patients receptive to trying again. Sex therapists are also equipped to facilitate resolve the intrapsychic and interpersonal blocks (resistance) to restoring sexual health. Some clinicians are uncomfortable discussing sex, and many significant issues persist unexplored because of clinician anxiousness and time constraints. Sex therapists can handle event and process based developmental factors, which predisposed the patient to demonstrate the sexual dysfunction. They are trained to handle the most difficult cases involving process-based trauma that are replicated in the current relationship. Sex therapists working adjunctively with the PCP, urologist, or gynecologist could render all the previously talked about sex counseling, as well as handling PSOs with greater therapeutic depth. Sex therapists can enhance hope, facilitate optimism and maximise placebo response. There can be an enhanced individualization of treatment format, by fine-tuning therapeutic suggestions, as well as improving response to medication by optimizing timing and titration of dose. Sex therapists have a sophisticated appreciation of predisposing (constitutional and prior life experience), contributing factors triggering dysfunction, and factors holding sexual dysfunction. Eventually, sex therapists are skilled in utilising cognitive-behavioral techniques for relapse prevention. All of these issues affect potential and capacity for successful restoration of sexual health.
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Adult sexual roleplay - By: Lushwear
Intimate fantasy role playing is a great way to spice up your sex activity. With society being more and more at ease about sexuality, with sex advice and articles written all over the newspapers and magazines many adults are now feeling more comfortable to explore their secret sexual desires.
So what is sexy fantasy role-play? Fantasy role-play is essentially a person acting out an alternative role. For instance a lady may work as Shop assistance in her factual life; however she may act as the part of an erotic college girl for her man.
Many adults have some kind of intimate fantasy that involves a form of uniform.
Wearing a seductive fantasy costume is a good and effortless way of role - playing. There is a full choice of women's adult fancy dress costumes to choose from, however these erotic costumes are usually very intimate and revealing for instance they may show off a women's nipples, backside and other intimate body parts so they should only be worn in private for your partner.
Dressing up as a hot secretary, sexy nurse or naughty sailor girl all are great fantasy outfits to arouse your partner. Ask what your boyfriends favorite fantasies are, for example if your partner is aroused by nurses then you should purchase a nurse fantasy outfit. Dressing up as a nurse can take your sex life to another level. Wearing PVC and rubber wear can also be another sexual fantasy. If your spouse enjoys some PVC wear why not blend the two fantasies and wear a PVC naughty nurse costume.
Other kinds of sexy fantasy role playing include watching naughty DVDs and acting out the scenario in the DVD. For instance you may be watching an adult DVD with a business office and mischievous secretary setting. The secretary may have to 'impress' her boss with some intimate favors to acquire the 'job'. You could dress up in a sexy secretary outfit and play out the setting from the movie. Some other role-playing may include acting out a scene from a movie. For instance 007is a popular theme. You could be one of the bond girls. Fantasy role playing is safe, and can be good to a couple who want to zest up their love life.
The only down side of sexual role play is if you or your significant other feels awkward with the fantasy or scenario. For instance your boyfriend may desire you to dress up in rubber and you may feel embarrassed with this. Before trying any type of fantasy role play the limits have to be set by both partner, not just one of the parties. Discuss what kind of fantasies and styles of clothing you are comfortable to wear. If you are unsure with something you should have a 'stop' word such as 'Toast'. When either partner says this word, you should finish the fantasy role play. A nice and fun sex life is all about being happy and having courtesy for each other's sexual limits.
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Sexual Dysfunction - Partner Issues - By: David I Crawford
Sexual Dysfunction - Partner Issues
Recovering potency does not automatically render into the couple resuming sexual intercourse. Psychological problems may provide the best handling futile. PDE-5 discontinuance or failure rates of 20-40% are not due to adverse outcomes. Opposition to sexual love is frequently emotional and the most common mid-level psychological causes of sexual dysfunction are relationship elements. Mate dynamics can aid determine correct pharmaceutical pick on the basis of analysis of the couple's premorbid sexual script and relationship. Still many partner related psychosexual results may also adversely impact outcome.
Cooperation vs. Attendance
Mild fast reasons of sexual dysfunction are often subject to brief counseling in the physician's office. Yet the most average mid-level relationship causes may present considerable difficulty for the nonpsychiatric physician handling sexual dysfunction within the context of a typically brief office visit. How might this challenge be met? The complexness of this enigma can be decreased or settled. The physician s challenge is not inevitably requiring an office visit with the partner, as many CME programs have advocated. Rather, the emphasis should be on appraising the level of partner cooperation and support. Since Masters and Johnson, sex therapists have realized that sexual dysfunction is a couples problem, not just the identified patient's problem. Nevertheless, almost equally long ago, this author and others identified that the key partner treatment issue was supportive cooperation, independent of actual attendance during the office visit. Broadly speaking, encourage partner attending with committed couples, allowing appraisal and counseling for both. Yet, the issue is never forced. Handling format is a psychotherapeutic issue and rapport is never undermined. Although conjoint consultation is a good policy, it is not constantly the right choice! A man or woman in a new dating is probably better-off seeing the physician alone, than stressing a new relationship by insisting on a cooperative visit.
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Sexual Disfuncombination therapyion - Combination Therapy Guidelines: Who, How, and When? - By: David I Crawford
There are two alternative models for combination therapy: both will likely be acquired within the model of sexual medicine, by various clinicians. First, working alone, PCPs, urologists, psychiatrists, and finally gynecologists will incorporate sex counseling with their sexual pharmaceutical armamentarium to treat sexual dysfunction. Sex Perelman counseling in this situation, is applying sex therapy strategies and methods to overcome psychosocial resistance to sexual funcombination therapyion and satisfacombination therapyion (20). In a second model, the above clinicians will cooperate with nonphysician MHPs (sex therapists), resolving sexual dysfunction(s) through a coordinated multidisciplinary team approach to treatment. The clinical combinations will change according to the showing symptoms, as well as the changing expertise of these health care providers. The utilisation of these two different models will require three steps.
(i) The clinician first consulted by the patient will view their involvement, training, and competence.
(ii) The bio-psychosocial hardness and complexness of the sexual dysfunction as a manifestation of both psychosocial and organic facombination therapyors will be evaluated.
(iii) The clinician in consideration of the two previous criteria, together with patient preference, will determine who starts treatment, as well as, how and when to refer. The guidelines for managing the relative hardness of the dysfuncombination therapyion will fundamentally be extended, but continue to match the type of treatment algorithm.
Categorizing Psychosocial Obstacles to Treatment
Whether or not a physician works alone, as in the first model, or as part of a multidisciplinary team, as in the second, will be partly established by the psychosocial complexity of the case. This combination therapy model accommodates Althof and Lieblum's Proposed Integrated Model for Treating Erecombination therapyile Dysfuncombination therapyion. Nevertheless, it must be emphasized that this author is advocating a combination therapy model for all sexual dysfunction. The treating clinician would diagnose the patient(s) as suffering from mild, moderate, or severe PSOs to thriving restoration of sexual funcombination therapyion and satisfacombination therapyion. This characombination therapyerization would be established on an appraisal of all the accessible information obtained during the evaluation. This would include an appraisal of the facombination therapyors. This appraisal would basically take on the psychosocial (cognitive, behavioral, cultural, and contextual) facombination therapyors predisposing, precipitating, and maintaining the sexual dysfunction. This would be a dynamic diagnosis, continuously reevaluated as treatment progressed. The consulted clinician would continue treatment or make referrals on the basis of progression obtained. These PSOs are classified as follows:
1. Mild PSOs: No significant or mild obstacles to successful medical treatment.
2. Moderate PSOs: Some significant obstacles to successful medical treatment.
3. Severe PSOs: Substantial to overwhelming obstacles to successful medical treatment.
Sexual Dysfuncombination Therapyion Treatment Guidelines
Although no objecombination therapyive data sets the criteria for diagnosing these three PSO categories, they will become a useful heuristic device to aid clinicians know when to refer. For instance, Severe PSOs may need psychotherapeutic or psychopharmacologic treatment prior to the initiation of treatment utilizing sexual pharmaceuticals in order to reestablish sexual funcombination therapyioning and satisfacombination therapyion. Most nonmedical MHPs will cooperate with physicians to augment their own treatments, as sexual pharmaceuticals are likely to offer an ever-increasing role in MHP's treatment schemes and armamentarium for sexual dysfunction. Additionally, this treatment matrix will render a useable tool for sex therapist physicians (usually psychiatrists), when determining whether to treat themselves, or seek cooperative assistance.
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Try an Adult Toy - By: 4your pleasure
Those who have never heard about these possibilities and provisions of adult enjoyment might sound susceptive about their normality and term them as awkward or embarrassing arrangement. But, those who have tried an adult toy before use it without any feeling any guilty or any such degrading notion. They find it natural and a perfect alternate of risky arrangements for bodily pleasure, that everyone needs at one time or other. The best recommendations and advise about the use and acceptance of adult toys can be obtained in adult parties where you meet your likes and come to know about the way they keep themselves satisfied and body content without risking health or repute in out of home ventures.
In case you have also come of the age and feeling a urgent need to satisfy adulthood, you can start learning about the adult toy parities in your realm. There are generally thronged by the women of all age in their fancy lingerie. These adult parties provide them liberty to let their urges culminate in real pleasure and try all their notions and motions in an unrestricted area for adults activities. These adult parties are popular among the age, mostly because they provide you a community of similar aspirants and share your views and valuables with soothing partners. These adult parties are the perfect place to experience lingerie and adult toys at their best use and amuse.
If you have not tried an adult toy or lingerie before, and not coming to an opportunity of attending an adult party there, you can resort to PC with your woes. It will certainly provide you ways to get your things done in strictly in your privacy but without resistant. You can order adult toys, adult lingerie and many more similar products online. There are many online portals selling such body instruments for men and women both. It is true that you can get better information about these tools and their application in adult party and might encounter an opportunity to advocate the real thing there, but in case you have failed to make your way to one, internet is not a bad option either.
These online adult toy stores and sex instrument provide complete information about the product and also instruction for their use. You can find suitable option to suite your tastes and interests and place your order online. They ship your order to your address in a way that anyone would hardly be noticing what you have got. Not unless you tell them what, at least.
In case you are still feeling shy on shopping these products, even online, let me tell you that you are not going to be the first and only person shopping your satisfaction online. There are many women who order these products and there are many who try every new thing they come across. It’s a way to play and enjoy the ecstasy.
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How Ladies Use the Bunny Vibrator and the Extreme Arousal Gel to Receive Excellent Orgasm - By: Allan Michael Taylor
One of the greatest ways of giving a lady a great mind blowing orgasm is to arouse both the g-spot and the clitoris at the same time. Blokes who know how to get this done have women openly pouring their hearts out to them simply because they are rare to find. Guys ejaculate easily and more often than their female counterpart.
The primary reason the rabbit vibrator pumped up in fame amongst present day women is due to the fact that it arouses both the clitoris and the g-spot at the same time in a matter or a blink – sending them to a blissful land of erotic pleasure!
Soon you will be discovering what the rabbit or bunny vibe entails and how it can be used to its utmost potential to give ladies great repeated climaxes.
As you know, rabbit vibes are great sex toys that can give women great orgasm in a pleasant way. However, making use of a rabbit vibe alone may still limit the untapped pleasure this vibe is able to give. In these days, women use a new kind of gel called, The Intense Stimulating or Arousal Gel. Basically, a stimulating gel does exactly as its name state, 'it stimulates women far more during sexual acts." Several women today are beginning to fathom how good these gels are at arousing them to get more pleasure quickly during sexual acts.
Before an arousing gel is used on a lady, it is good to get the woman relaxed and a little bit sexually aroused through foreplay such as kissing, cuddling etc. Of course, if you plan using it by yourself you will be able to tell by the feelings you get in your body if you're set to go. Now, once the lady is relaxed and slightly sexually in the mood you can then use the stimulating gel on the clitoris, and also gently start using the rabbit vibrator to get the great delightful feeling. You are guaranteed to climax in no time! It's as easy as that.
There is however an important point to consider as regards getting the best arousal gel. Make sure you get a gel or cream that has the "L-arginine." One widely known stimulating gel that has the "L-arginine" is the G Female Stimulating Gel. L-arginine is used to make the nitric oxide (this is a compound found in the body) that relaxes blood vessels. previous studies have found that L-arginine may help with conditions that improve when blood vessels are relaxed. It is also known as an amino acid that has numerous functions in the human body. For the purpose of this post, L-arginine is an ingredient that induces the amount of stimulation gotten from the arousal gel.
Conclusively, women can experience lovely orgasm during erotic plays by combining the use of the rabbit vibrator and the arousing or stimulating gel – ladies will definitely not regret using these two great products.
Thank you.
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Sexual Disorders - Evolving Models - By: David I Crawford
Most of the clinicians involved in the treatment or research of sexual disorders are probably not very contented with the current nomenclature, which is largely unidimensional and not including all nuances and prospects of sexual problems. The nomenclature does not deal with mental, relational, and situational constituents of human sexuality. Some of these problems, especially the ones associated to female sexuality.
A 26-year-old male who complains being distressed because ejaculating within 30 60 sec after penetration during sexual practice with his wife, but experiences no quick ejaculation while masturbating technically matches the diagnostic measures for premature ejaculation. Still, the diagnosis of premature ejaculation doesn't fully account the range and psychology of his sexual dysfunction. The same could be implied in the case of 67-year-old married male who begun to compulsively masturbate about 2 years ago. He thinks about other men being around at times while masturbating, or at times he masturbates just without any thoughts, in different places, for example, while driving. Is his diagnosis sexual disorder not otherwise specified? Or obsessive-compulsive disorder? Do these diagnoses-labels facilitate the clinician in any way?
The recent diagnostic system, rewording Winston Churchill, is probably the worst diagnostic system exclude for all those that have been tried. It certainly could be better. Recently, Fagan proposed a systematic way in which clinician coordinate the mass of information about sex. We discuss it in more details for two reasons it clearly establishes that human sexuality, as other 6 Segraves and Balon areas, needs a more complex and sophisticated diagnostic system, and it exemplifies one of probably many possible approaches.
Fagan suggests using the system of four perspectives, or four different ways to view a clinical case, which was originally developed by McHugh and Slavney (48) for all psychiatric disorders. He believes that these four perspectives are a more complex way of viewing clinical information and then communicating that information to clinicians, colleagues, and the individual with the clinical problem or disorder.
These four perspectives are:
1. The disease perspective
2. The dimension perspective
3. The behavior perspective
4. The life story perspective
The disease perspective is categorical, the patient either has or does not have the disease. As Fagan remarks, this is the base of the medical model, but not the whole story. This perspective turns to physiology, anatomy, and medicine to study about patients sexual problem.
The dimension perspective centers on measurement (dimensional gradation and quantification). Cases of the objects of measurements are intelligence quotient, behavioral patterns, mood, or personality traits.
The behavior perspective focussing on the behaviour of an person who is goal directed, or teleological. Fagan explains that the behavior position is to cognitive-behavioral clinician what the disease perspective is to physician.
Finally, the life story perspective is what most people link with psychotherapy. It relies on the story told by the patient to give some meaning and focusing to their life.
Fagan underlines that no single perspective is, in itself, more valuable than any other, and each perspective can contribute to the conceptualization. His proposal aids, in part, to handle several problems. First, human sexuality is much more complicated than just attaining reliable erection and, as noted, the medical diagnosis does not take on psychological, relational, and other factors. Second, not all sexually disordered behavior has a psychiatric diagnosis. Third, sexual diagnosis is an alternate and developing construct. Fourth, sexual diagnosis doesn't involve causality.
Fagan indicates that one should choose the primary perspective that best fits the patient and then mix the other perspectives into the conceptualization and treatment to make use of the additional contributions they may provide. He as well emphasizes that perspectives are conjunctive and not disjunctive.
Fagan feels that utilizing the four perspectives is more accommodating in delineating sexual dysfunctions and conceptualising their treatment. Some will probably see this proposal too composite or not composite sufficient, overly inclusive or not inclusive enough, not practical enough or too practical. Nonetheless, we feel that it is an interesting and thoughtful proposal, which may further induce and facilitate the debate about the diagnostic issues in the area of sexual disorders.
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Epidemiology of Sexual Disfunction - By: David I Crawford
Numerous population reviews in this and other countries show a high preponderance of sexual issues in the general population. These reviews show that 40% of women have evidence of psychosexual disfunction. The related number for men is 30%. We have more evidence relating the prevalence of sexual issues in men than women although the data base in both groups is rapidly growing. Correlates of erectile disfunction in men include diabetes, vascular disease, age, and cigarette smoking. Serum dehydroepiandrosterone and high-density lipoprotein cholesterol were found to be negatively connected with erectile problems. Depression was correlated with erectile function in cross sectional studies, whereas passive personality traits tended to predict who would develop impotence in a prospective study. Studies in other countries have, in general, found reasonably similar rates of erectile disfunction in the same age population and also that erectile disfunction tends to correlate with the presence of diabetes, higher age, cardiovascular disease, and depression.
It's essential to mark that depression is not the only mental disorder linked with sexual dysfunction(s). Sexual disfunction occurs in course of schizophrenia or anxiety disorders.
Many recent studies went beyond gathering pure epidemiological data and studied the affect of sexual disfunction on men suffering from various sexual dysfunctions. For instance, Moore et al. discovered that younger men suffering from erectile disfunction reported relatively less relationship satisfaction, greater depressive symptomatology, more negative reactions from mates, and less job satisfaction than older men. They concluded that older men experience less difficulty than younger men adjusting to life with erectile disfunction. Symonds et al. questioned men with self-diagnosed premature ejaculation. In their comparatively small sample, they found that men with early ejaculation had a sense that premature ejaculation was causing (not exclusively) 4 Segraves and Balon lower self-esteem and had impact on forming a relationship. Determinations of these two studies emphasize the complexness of sexual dysfunctions/disorders and their link to an overall functioning and wellbeing.
A population study of US females aged 18 65 found that 33% of US females described low libido, difficulty with orgasm, or trouble with lubrication for at least 1 month in the previous year. Other studies have described similar findings. Hawton analyzed sexual activity in a community sample in Oxford, United Kingdom and found that 17% reported never feeling an orgasm and only 29% reported experiencing climax at least 50% of the time. Marital satisfaction was the superior forecaster of sexual activity and satisfaction. Dunn also reported several population studies in the United Kingdom. Approximately 40% of the women reported a sexual issue, the most common being difficulty achieving sexual climax. A recent population study in Sweden of sexual behaviour in women aged 18 74 discovered that the most common problems were low desire followed by climax and arousal difficulties. They also reported substantial co-morbidity between sexual disorders. Some questioned the methodology of epidemiological studies of sexual dysfunction as too simple and medicalized.
Laumann et al. have recently completed a survey of 27,500 men and women aged 40 80 in 29 countries. In Northern European countries, deficiency of sexual interest was reported in 25.3% of women. problems with climax and pain were reported in 16.9% and 17.7%, respectively. In men, low libido was reported in 12%, erectile dysfunction in 12%, and quick ejaculation in 20.6%. Corresponding values were reported for other world regions, with small differences in prevalence among different regions.
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