Category Archives: Health Concerns

Sexual side effects of prostate treatments include ejaculatory dysfunction

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Even if patients are 100 percent satisfied with the treatment and can urinate perfectly, they may be unhappy that they can’t ejaculate.

Medications that treat lower urinary tract symptoms and enlarged prostates may cause sexual dysfunction, but some urologists don’t discuss this with patients, according to a survey of doctors.

Although more than half of the physicians said they discuss ejaculatory dysfunction when prescribing the most common treatments, most don’t routinely offer alternatives, the study authors report in World Journal of Urology.

“We need to think about the entire picture as doctors. Even if patients are 100 percent satisfied with the treatment and can urinate perfectly, they may be unhappy that they can’t ejaculate anymore,” said lead study author Dr. Simone Giona of King’s College Hospital in London.

Lower urinary tract symptoms and prostatic hyperplasia – an enlarged prostate – cause difficulty with urination, urgency and leaking. Patients sometimes wait until symptoms worsen before seeking treatment, often because they know treatments could affect sexual function, Giona said.

“That’s very important for some men, even if they’re 75 or 80 years old,” Giona said in a telephone interview. “We need to talk to patients about their expectations and offer the treatments that will help them, including new alternatives.”

Giona and colleagues surveyed 245 urologists attending the 2015 World Congress of Endourology in London. They asked what prostate treatment options the urologists offered their patients, how often they discussed the different types of treatments available, how often they discussed ejaculatory dysfunction with patients and how often they discussed alternative treatments based on the risk of sexual dysfunction.

About 70 percent of survey participants said they discuss erectile dysfunction before prescribing alpha blockers, although there’s no evidence currently that these medications impair sexual function. Most urologists said they discuss treatment-related erectile dysfunction, but those with the busiest practices and higher caseloads were most likely to discuss sexual side effects.

On the other hand, most respondents said they don’t routinely discuss alternative therapies based on the risk of sexual dysfunction, and those with the highest caseloads were least likely to offer alternatives.

“We’d expect that a urologist with more experience would have a wider picture of the best treatment, but maybe they don’t discuss options other than what they prefer or know best,” Giona said. “We need to make sure patients have options and we’re not missing the rest.”

A limitation of the study is that the responses were not analyzed according to the participants’ region or country of origin, which might highlight differences in what’s available. Some countries don’t yet offer some of the treatment options, but few survey respondents marked “not applicable” while answering the questions, the study authors note.

“Patients should mention all their worries and discuss their sex life concerns,” Giona said. “Urologists should get a full picture of what will make their patients happy.”

Current guidelines recommend lifestyle modification, medication or surgery for enlarged prostates. All options can impact sexual function, but some affect libido, erection, ejaculation and semen volume more than other options. In this study, the most common treatments were medications such as alpha blockers and 5alpha-reductase inhibitors, followed by surgical options such as Transurethral Resection of the Prostate (TURP) and laser procedures such as Holmium Laser Enucleation of the Prostate (HoLEP) and GreenLight Photoselective Vaporisation of the Prostate (PVP).

“Patients didn’t previously have choices about their treatments and accepted the side effects,” said Dr. Tobias Kohler of the Mayo Clinic in Rochester, Minnesota, who wasn’t involved in the study.

“But now, we’re seeing minimally invasive treatments that offer excellent improvement and low risk of sexual side effects,” Kohler said in a telephone interview.

“Now the conversation needs to be whether patients should take a pill or treat the problem definitively and prevent the progression of bladder dysfunction,” Kohler said.

“Patients should educate themselves on the risks and benefits of prostate treatments,” he said. “Upfront procedures could offer little risk and a lot of reward.”

Complete Article HERE!

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For Menopause Sex Discomfort, Gel Worked as Well as Estrogen

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Study find gels worked as well as prescription hormone tablets at reducing symptoms of menopause-related sexual discomfort.

By Lindsey Tanner

In a study of women with menopause-related sexual discomfort, gels worked as well as prescription hormone tablets at reducing symptoms.

The researchers say the results suggest low-cost, over-the-counter moisturizers might be the best option.

Most women in the study reported some relief from their most bothersome symptoms — painful intercourse, vaginal dryness or itching — regardless of treatment. Still, not quite half the women experienced what researchers considered a meaningful decline in symptom severity.

The problems are linked with declining levels of the hormone estrogen, which happens to all women when they reach menopause.

What baffles researchers is why only about half of women experience bothersome symptoms. Without that answer, pinpointing the cause and finding the perfect solution is difficult, said Dr. Caroline Mitchell, the study’s lead author and a researcher at Massachusetts General Hospital.
Continue reading the main story

“Until we know why, our treatments are really just pretty broad attempts,” Mitchell said. “We’re not targeting the true biological root cause.”

Researchers enrolled 300 women at a Kaiser Permanente research institute in Seattle and at the University of Minnesota. Women were randomly assigned to one of three treatments: prescription vaginal estrogen tablets and a gel with inactive ingredients; placebo tablets and Replens over-the counter moisturizer; or placebo tablets and the inert gel. Treatment lasted 12 weeks.

The results were published Monday in JAMA Internal Medicine. The National Institutes of Health paid for the study and the researchers have no financial ties to the products studied.

A journal editorial says there have been few similar studies and most were too small to reach conclusive results.

The latest results show that prescription treatment that can cost $200 is no better than over-the-counter moisturizers costing less than $20. The researchers noted that some women may prefer tablets to creams, which can be messy, but the extra money won’t buy extra relief.

Women with troublesome symptoms “should choose the cheapest moisturizer or lubricant available over the counter — at least until new evidence arises to suggest that there is any benefit to doing otherwise,” the editorial said.

Complete Article HERE!

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Consensual sex is key to happiness and good health, science says

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It’s not just that sex is fun – it’s also good for your physical and mental health.

Some of my research is focused on how men and women differ in the links between sexuality, mental and physical health, and relationship quality. In this article, I write from my findings and that of others on how sex is important to our love, mental health, relations and survival. At the end, I suggest a solution for individuals who are avoiding sex for a common reason – chronic disease.

Good sex makes us happy

Good sex is an inseparable part of our well-being and happiness. Those of us who engage in more sex report better quality of life. Sexual intercourse is linked to high satisfaction across life domains. In one of my studies on 551 married patients with heart disease, individuals who had a higher frequency of sexual intercourse reported higher marital quality, marital consensus, marital coherence, marital affection expression and overall marital satisfaction. These results are replicated in multiple studies.

In a study by another team, partners who both experienced orgasm during sex were considerably happier. These findings are shown inside and outside of the United States.

Sex keeps us alive

Although early initiation of sex such as during adolescence is a risk factor for mortality, having a sound sexual life in adulthood is linked to low mortality. In a seven-year follow-up study of men 17 years old or older, erectile dysfunction and having no sexual activity at baseline predicted increased mortality over time. Similar findings were shown in younger men. This is probably because more physically healthy individuals are sexually active.

No sex and forced sex makes us depressed

There is a two-way road between bad sex and depression. Depression is also a reason for bad sex, particularly for women. And, men who are depressed are more likely to sexually abuse their partners.

And it’s important to note, in the wake of continuing news of sexual assault and abuse, that forced sex in intimate relations make people depressed, paranoid, jealous, and ruins relationships. Couples who experience unwanted sex have a higher risk for experiencing other types of abuse, as bad habits tend to cluster.

Sex different for men and women?

Men and women differ in the degree to which their sexual act is attached to their physical, emotional, and relational well-being. Various reasons play a role among both genders, but for women, sexual function is heavily influenced by mental health and relationship quality.

By contrast, for men sexual health reflects physical health. This is also intuitive as the most common sexual disorders are due to problems with desire and erection for women and men, respectively.

Reasons for avoiding sex

As I explained in another article in The Conversation, sexual avoidance for those who have a partner or are in a relationship happens for a long list of reasons, including pain, medications, depression and chronic disease. Common diseases such as heart disease interfere with sex by causing fear and anxiety of sexual intercourse.

Aging should not be considered as a sexless age. Studies have shown that older adults acquire skills and strategies that can buffer age-related declines in their sexual life, particularly when they are in a positive relationship. This is called seniors’ sexual wisdom.

Back on track

Because people avoid sex for a variety of reasons, there is no single answer for those who want to become sexually active again. For many men, physical health problems are barriers. If they suffer from erectile dysfunction, they can seek medical help for that.

If fear of sex in the presence of chronic disease is a problem, there can be medical help for that as well. For many women, common barriers are relational dissatisfaction and mental health. For both men and women, the first step is to talk about their sexual life with their physician, counselor or therapist.

At least half of all medical visits do not cover any discussion about sexual life of patients. Embarrassment and lack of time are among the most common barrier. So make sure you make time to talk to your doctor or health care provider.

Neither the doctor nor the patient should wait for the other person to start a dialogue about their sexual concerns. The “don’t tell, don’t ask” does not take us anywhere. The solution is “do tell, do ask.”

Complete Article HERE!

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Vaginismus: a major psychological reason women experience pain during sex

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If you have never heard of vaginismus, it’s time to get it on your radar.

Don’t suffer in silence

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Aly Dilks, sexual health expert and clinical director at The Women’s Health Clinic, says: ‘It is the term used to describe recurrent or persistent involuntary tightening of muscles around the vagina whenever penetration is attempted,’

According to Vaginismus Awareness, the condition affects at least two in every 1,000 women at some point in their lifetime.

Approximately 10% of adult women have experienced painful intercourse in the past six months.

‘It’s not fully understood why the condition happens [but] factors can include thinking the vagina is too small, negative sexual thoughts – thinking sex will be painful and cause damage – and previous sexual abuse,’ says Ms Dilks.

She also lists damage to the vagina – common during childbirth or an episiotomy, a painful first sexual experience, relationship problems, and fear of pregnancy as other potential triggers.

Pain is not limited to sex.

Some women find inserting tampons or fingers painful; others find any type of penetration intolerable.

Unlike other causes of vaginal pain, such as an infection, vaginismus is a psychological problem that cannot be cured with a straightforward prescription.

There’s effective treatment

Help is available beyond search engine suggestions

This is not to say it can’t be treated: Vaginismus Awareness reports a 95% chance of treating this psychological condition effectively, and many women receive referrals to a sex therapist as a first port of call.

Colin Richards is a relationship and sex mentor and the founder of Intimacy Matters.

He says: ‘As a practitioner who works with both the psychological and physiological, about 20% of female clients that come to me for treatment around sexual performance come with some level of vaginismus.

‘The psycho-sensual treatment I offer involves talking through the psychological influences, followed by sensual massage that is given in controlled, professional space.

‘It allows the new emotional tools to emerge in an authentic, non-judgemental way.’

Both Ms Dilks and Mr Richards also suggest vaginal trainers: four, smooth, plastic penis-shaped objects in different sizes.

They can be used in the privacy of your own home, at your own pace. Ms Dilks says: ‘Once you feel comfortable inserting the smallest one, you can move on to the second size, and so on.’

‘It doesn’t matter how long it takes – whether it’s days, weeks, or months.’

Vaginismus is just one of many types of sexual frustrations and fears women face but, says Mr Richards, it is probably the most challenging for the sufferer.

That challenge is perpetuated by a lack of awareness and the taboo that still surrounds female sexuality, even when women talk to one another.

Yet it can have major implications on a woman’s sex life, self-esteem, body image and her relationships.

Hope for sufferers

Women can be reluctant to talk about their sex life, even with other women

If you have pain during sex, during your period, or if there’s anything that concerns you about your sexual health, don’t suffer in silence; women have been doing that for too long, and vaginismus is something for which there is a proven treatment.

Mr Richards says: ‘In my experience, if one can get to the root psychological cause of the anxiety or fear, then the vaginismus can be removed completely.

‘I have seen improvement over a period of three to six appointments.

‘As the mind learns that sexual penetration is not painful or wrong, and is, in fact, pleasurable, the body soon responds and lets go of the need to tense up.

‘[The woman] remains calm, and feels familiar with the situation, and so confident that everything should be fine.’

Complete Article HERE!

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7 Reasons Why Your Crotch Itches

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It may not be the most couth move men make, but there are occasions when guys grab at their balls for a quick scratch or adjustment. There are also times, however, when the urge to scratch is intense because you are experiencing a serious itching sensation, perhaps one that keeps recurring. Should you be concerned? Would you like to know why your crotch itches and what you can do about it?

Here are seven reasons why your crotch itches and, thankfully, ways you can stop itchy balls in their tracks. Some fixes are quick while others take a bit more time, but follow the suggestions and you should have your hand out of your pants in no time.

Chafing

Running and other athletic activities that can cause your thighs to rub together are typical causes of chafing. The rubbing can result in inflammation and minute cracks in the outer skin layer, resulting in a burning or itchy rash. You can protect your skin and eliminate the itching and burning by using a moisturizing cream that contains colloidal oatmeal along with one that provides zinc oxide. Natural remedies include aloe vera gel or olive oil rubbed into the affected area.

Contact dermatitis

This super itchy condition is caused when your skin makes contact with an allergen, which could be the material in your underwear, a new laundry detergent, fabric softener, or soap, or towels. Contact dermatitis usually looks like a bumpy red rash that may be accompanied by an oozing fluid. The effective treatment is to eliminate the cause, which may take a little detective work. If you recently started using a new soap, laundry detergent, or fabric softener, return to your old one. If you have new underwear, you may need to wash it several times (in your tried-and-true) detergent before wearing them. If you have contact dermatitis, you should notice results within 10 to 14 days or sooner.

Fungal infections

If a fungal infection is the cause of your itchiness, you likely will also have a rash or other noticeable skin condition. A yeast infection, for example, is usually accompanied by moist, shiny skin on the penis as well as white deposits in the skin folds and an itchy red rash. Other fungal infections may appear slightly differently. All fungal infections can be treated with antifungal cream (e.g., clotrimazole). A natural alternative is coconut oil, while other remedies (e.g., tea tree oil, oregano oil), when mixed with an appropriate amount of carrier oil, can be helpful as well. Discuss the best mixture of oils with a knowledgeable practitioner.

Genital warts

The human papillomavirus (HPV) is characterized by the presence of genital warts, which are usually soft, skin-colored growths that may even look like tiny florets of cauliflower. Fortunately, these itchy warts don’t cause any other symptoms, but they also are merely a visible representation of a systemic virus. You can successfully treat genital warts with topical medications available over the counter (e.g., imiquimod, podofilox, sinecatechins) or by prescription (e.g., podophyllin, trichloroacetic acid) or have the warts frozen or burned off by your doctor. However, the virus will remain in your system, and the warts may return at a later time.

Herpes

Sometimes itching is the first symptom of an infection with the herpes virus, a sexually transmitted disease. The itching quickly turns into burning, after which blisters can develop. If the blisters break, they can result in painful ulcers. The best treatment strategy is to see your physician, who can prescribe an antiviral medication such as acyclovir or valacyclovir hydrochloride. You also should inform any sexual partners of your infection so they can treated as well.

Intertrigo

Intertrigo is an inflammatory condition that forms in the folds of the skin. It is usually chronic, and along with itching you can experience burning, pain, and stinging. Intertrigo is caused and aggravated by exposure to friction, heat, moisture, and lack of air circulation. In some cases, intertrigo is complicated by a fungal, bacterial, or viral infection. Men who are obese and/or who have diabetes are frequently affected.

Treatment includes keeping the affected area as clean and dry as possible. Avoid wearing tight clothing that restricts air circulation. Use a barrier cream to help prevent irritation. Your doctor may suggest short-term use of a topical steroid to manage inflammation. If you have an infection, an antifungal or antibiotic ointment may be necessary.

Pubic lice

If you notice tiny yellowish or white specks near the roots of your pubic hair and the itching is intense, there’s a good chance you have eggs belonging to pubic lice (aka, crabs). Once the eggs hatch, the parasites are gray-white or tan and can cause quite a bit of itching and irritation as they crawl. You should see your healthcare provider as soon as possible for an accurate diagnosis.

Treatment of pubic lice typically includes use of a lotion or shampoo that contains either permethrin or pyrethrins with piperonyl butoxide, which kills lice. Natural remedies include holding a soft cloth soaked with equal amounts of apple cider vinegar and water on the affected area for about 30 minutes. Repeat daily as needed. Both peppermint and tea tree oils, mixed with an appropriate amount of carrier oil, can help eliminate pubic lice as well.

Complete Article HERE!

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