Search Results: Doctor

You are browsing the search results for doctor

Bats and BALLS

Share

Today, we have a follow-up question from a fellow with a ball problem.

Last week this guy writes me to tell me he thinks he might have an abnormality in his nut sack. I wrote back to him: “I applaud you taking note of your balls in an inquisitive sort of way. Good for you! But you should also have at least a rudimentary understanding of your testicular anatomy. So that when you do your self-exam, you can have some sense about what it is you are examining.” To that purpose, I offered a medical diagram for him to look at. Despite my promptings to take his huevos to a doctor for a look see, he decided to write to me once again. D’oh!

Name: anoras
Gender:
Age: 47
Location: Northridge CA
Hey doc,
Thank you so much for your previous reply and for the diagram. Yes, I’ve seen it before but really didn’t look at it precisely — Ooops. So let’s see, the thing that goes into the testicles and that gangs up to the top of the testicle, that must be what I am referring to. Feeling my balls now I realize that it is at the top and not the bottom. Can I conclude that maybe I did feel it at that time on the top and thought it at the bottom, and/or that at that time maybe I my testicle turned around for some reason? Next, at the area where it is globulous, if pressure is placed on it, would it have a pain feeling rather than applying pressure anywhere else on the testicle? That is the question I’m asking, whether there are any areas on the testicle that you would naturally feel lumps and/or pain with any pressure. The next question would be if there are ways that the testicles can be turned around and when they do can they be readjusted. Thanks in advance for your understanding and great responses.

Sheesh, darling, take your nuts to a freakin’ doctor already, why don’t cha? Since I’m not there, while you root around in your groin, to see what you’re referring to, I’m not sure what you’re referring to. And even if I were there watching you poke and prod and I could feel what you feel, I wouldn’t hazard a guess about what’s going on with you. Ya know why? Because I am not a physician, that’s why!

You ask again about lumps. Here’s a rule of thumb for us all: If you got lumps of any sort see a doctor. You ask again about pressure and pain. Since I have no way of knowing what kind of pressure you are applying, all I can say is, if you’re applying lots of pressure, it’s probably gonna hurt. If your applying only light pressure and it hurts, I’d guess there’s a problem — see your doctor.

And no, I’ve never heard of inverted testicles — see your doctor!

Ok, audience, what have we learned in today’s lesson? If any of us has a concern about what we think might be an abnormality in our naughty parts…or any other part for that matter, don’t write me…especially more than once…go see the doctor. Get it? Got it? GOOD.

Good luck

Share

How to Have a Sex Life on Antidepressants

Share

When quitting isn’t an option, is it possible to overcome the sexual side effects that come with an SSRI?

By Shannon Holcroft

So, you’ve finally filled the antidepressant prescription that’s been acting as a bookmark for the most recent novel you’re feigning interest in. Somewhere between missing your own birthday party and watching everyone else have fun without you, you gave in. After a few medicated weeks, things are starting to look up. Except for your sex life, that is.

Just last week, you were tied to a kitchen chair enjoying an amazing (albeit rather mournful) few minutes of escape through sex. Today, getting naked seems less appealing than all the other pressing tasks you have new-found energy to complete.

“Is it the meds, or is it just me?” you wonder as you deep-clean the fridge with new vigour. After some soul-searching, it becomes clear that you’re still the same person—just with fewer festering foodstuffs and a lot less crying.

“It must be a side effect,” you decide. But months after filling your prescription, your genitals are still giving you the physiological equivalent of 8d2cc2c1a43108301b149f7f33e1664d.png

Why Antidepressants May Be a Downer for Your Sex Life

“[Sexual dysfunction] is a difficult, frustrating, and very common issue with this class of medications,” says Jean Kim, M.D., clinical assistant professor of psychiatry at George Washington University.

Twelve percent of American adults reported filling an antidepressant prescription in the most recent Medical Expenditure Panel Survey. Not just for clinical depression, but for all kinds of off-label conditions like chronic pain and insomnia.

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant class. And between 30 percent and 50 percent of individuals taking SSRIs experience sexual dysfunction. Desire, arousal and orgasm may be affected by changes in function of neurotransmitters like serotonin and dopamine; the very mechanisms through which SSRIs treat depression.

How to Work Around the Side Effects

When fighting to survive a potentially fatal mental illness, there are often more important concerns than getting it on. It’s frequently not an option to stop taking life-saving medication to avoid side effects. So what’s a sexual being to do?

Despite SSRIs being pretty pedestrian, there’s no concrete answer to addressing sexual side effects. “Unfortunately, not much is reliably effective to deal with this [sexual dysfunction],” Dr. Kim notes.

This may sound pretty gloomy, but there are plenty of things you can try to bring sexy times back around. “Don’t hesitate to bring up the issue with your prescribing clinician, as there might be some helpful interventions available,” says Dr. Kim.

Here are other ways to work around the sexual side effects of antidepressants:

1. Time It Right

“Some literature advises trying to have sexual activity when the serum level of a daily antidepressant might be lowest in the bloodstream,” says Dr. Kim. In other words, the ideal time to get it on is right before you take your next daily dose.

If your dosing schedule makes it tough to pencil in sexual activities, chat with your clinician about changing the time of day you take your meds. In many cases, there’s room for flexibility.

“This would not work much with some SSRIs that have a longer half-life like fluoxetine (Prozac),” Dr. Kim adds. Those taking antidepressants that exit the body quickly, like Paxil and Zoloft, could be in luck.

2. Switch It Up

Switching to a different medication, with the support of your prescribing clinician, may make all the difference. Certain antidepressants have a greater incidence of sexual side effects than others. Commonly prescribed SSRIs associated with a high frequency of sexual dysfunction include paroxetine (Paxil), sertraline (Zoloft) and fluoxetine (Prozac).

Besides exploring the SSRI class, venturing into atypical antidepressant territory is another option. Buproprion (Wellbutrin) is an atypical antidepressant observed to present the lowest sexual side-effect profile of all antidepressants.

It may take some trial and error, mixing and matching to identify what works best for you, but it will all be worth it when you can [insert favorite sex act here] to your heart’s content again.

3. Augment

Some treatment add-ons may act as antidotes to SSRI-induced sexual dysfunction. “Supplementing with other medications that have serotonin blocking effects (like cyproheptadine [Peritol] or buspirone [Buspar]) or enhance other neurotransmitters like dopamine (like Wellbutrin) might help,” says Dr. Kim. She is quick to note that these findings are yet be confirmed by “larger-scale randomized controlled clinical trials.”

“Another common strategy is to prescribe erectile dysfunction drugs like sildenafil (Viagra) and the like for as-needed use before activity,” says Dr. Kim. Viagra has been found to reduce sexual side effects, even if you’re not in possession of a penis. In Dr. Kim’s clinical experience, “[Viagra] seems to help in more than a few cases.” Discuss with your doctor before adding any more medications to the mix.

4. Exercise

Now’s the time to take up aquacycling, indoor surfing sans water or whatever fitness fad tickles your fancy. Keeping active could be the key to preventing sexual dysfunction caused by SSRIs.

“Sometimes sexual dysfunction is not just a primary SSRI drug side effect but part of underlying depression/anxiety as well,” Dr. Kim explains. “Anything that helps enhance overall blood circulation, mood and libido might be helpful, such as exercise.”

Complete Article HERE!

Share

Married LGBT older adults are healthier, happier than singles, study finds

Share

By

Same-sex marriage has been the law of the land for nearly two years — and in some states for even longer — but researchers can already detect positive health outcomes among couples who have tied the knot, a University of Washington study finds.

For years, studies have linked marriage with happiness among heterosexual couples. But a study from the UW School of Social Work is among the first to explore the potential benefits of marriage among LGBT couples. It is part of a national, groundbreaking longitudinal study with a representative sample of LGBT older adults, known as “Aging with Pride: National Health, Aging, Sexuality/Gender Study,” which focuses on how historical, environmental, psychological, behavioral, social and biological factors are associated with health, aging and quality of life.

UW researchers found that LGBT study participants who were married reported better physical and mental health, more social support and greater financial resources than those who were single. The findings were published in a February special supplement of The Gerontologist.

“In the nearly 50 years since Stonewall, same-sex marriage went from being a pipe dream to a legal quagmire to reality — and it may be one of the most profound changes to social policy in recent history,” said lead author Jayn Goldsen, research study supervisor in the UW School of Social Work.

Some 2.7 million adults ages 50 and older identify as lesbian, gay, bisexual or transgender — a number that is expected to nearly double by 2060.

Among LGBT people, marriage increased noticeably after a 2015 U.S. Supreme Court ruling legalized same-sex marriage nationwide. A 2016 Gallup Poll found that 49 percent of cohabiting gay couples were married, up from 38 percent before the ruling.

For the UW study, more than 1,800 LGBT people, ages 50 and older, were surveyed in 2014 in locations where gay marriage was already legal (32 states and Washington, D.C.). About one-fourth were married, another fourth were in a committed relationship, and half were single. Married respondents had spent an average of 23 years together, while those in a committed, unmarried relationship had spent an average of 16 years. Among the study participants, more women were married than men, and of the respondents who were married, most identified as non-Hispanic white.

Researchers found that, in general, participants in a relationship, whether married or in a long-term partnership, showed better health outcomes than those who were single. But those who were married fared even better, both socially and financially, than couples in unmarried, long-term partnerships. Single LGBT adults were more likely to have a disability; to report lower physical, psychological, social and environmental quality of life; and to have experienced the death of a partner, especially among men. The legalization of gay marriage at the federal level opens up access to many benefits, such as tax exemptions and Social Security survivor benefits that married, straight couples have long enjoyed. But that does not mean every LGBT couple was immediately ready to take that step.

According to Goldsen, marriage, for many older LGBT people, can be something of a conundrum — even a non-starter. LGBT seniors came of age at a time when laws and social exclusion kept many in the closet. Today’s unmarried couples may have made their own legal arrangements and feel that they don’t need the extra step of marriage — or they don’t want to participate in a traditionally heterosexual institution.

Goldsen also pointed to trends in heterosexual marriage: Fewer people are getting married, and those who do, do so later.

“More older people are living together and thinking outside the box. This was already happening within the LGBT community — couples were living together, but civil marriage wasn’t part of the story,” she said.

The different attitudes among older LGBT people toward marriage is something service providers, whether doctors, attorneys or tax professionals, should be aware of, Goldsen said. Telling a couple they should get married now simply because they can misses the individual nature of the choice.

“Service providers need to understand the historical context of this population,” she said. “Marriage isn’t for everyone. It is up to each person, and there are legal, financial and potentially societal ramifications.” For example, among the women in the study, those who were married were more likely to report experiencing bias in the larger community.

At the same time, Goldsen said, single LGBT older adults do not benefit from the marriage ruling, and other safeguards, such as anti-discrimination laws in employment, housing and public accommodations, are still lacking at the federal level.

Over time, Goldsen and colleagues will continue to examine the influence of same-sex marriage policy on partnership status and health.

The study was funded by the National Institutes of Health and the National Institute on Aging. Other researchers were Karen Fredriksen-Goldsen, Amanda Bryan, Hyun-Jun Kim and Sarah Jen in the UW School of Social Work; and Anna Muraco of Loyola Marymount University.

Complete Article HERE!

Share

Men who have sex with men account for over 80% of syphilis infection rates in the US

Share

MSM are 106 times more likely to get syphilis than men who exclusively have sex with women

Doctors advise waiting for the skin to heal after shaving before having sex

by

A new study of syphilis transmission rates reveals men who have sex with men account for 81.7% of cases in the United States.

This study found gay, bisexual or men who have sex with men are 106 times more likely to get the sexually transmitted disease.

Researchers analyzed data collected in 2015 and compiled the first of its kind state-by-state report on syphilis rates.

The study found gay and bisexual men living in the South had the highest rates of the disease, such as North Carolina, Mississippi and Louisiana.

North Carolina, for example, had 748 cases per 100,000 gay and bisexual men.

Alaska had the fewest cases, with only 73 cases per 100,000 gay and bisexual men.

HIV infects healthy immune cells in the human body by inserting its DNA into the cell’s genome

Fred Wyand, spokesman for the American Sexual Health Association urged people to look at the broader picture.

Wyand said: ‘Better access to healthcare, more welcoming attitudes, better support systems are all important, of course,’ WebMD reports.

‘We need to understand there are challenges faced by many gay and bisexual men greater than what most folks endure,’ Wyand concluded.

For a full list of State-specific cases of syphilis, check out the Morbidity and Mortality Weekly Report.

Why do men who have sex with men report higher numbers of syphilis?

A further breakdown highlights men who have sex with men accounts for 309 cases per 100,000.

This is in contrast to men who only have sex with women accounting for 2.9 cases per 100,000.

And women with 1.8 cases per 100,000.

Dr Robert Grant, chief medical officer of the San Francisco AIDS Foundation explains why this might be the case.

Grant told CBS News: ‘Now that we have effective therapies for HIV, people who were previously untested and tested infrequently are now getting tested.

‘Sexually transmitted infections tend to go together.

If they come in and ask for HIV testing, we test for syphilis, chlamydia and gonorrhea as well.

‘People have everything to gain and nothing to lose by getting an HIV and syphilis test.

‘This report will help reinvigorate people’s awareness and hopefully send the message that by getting a test and following through with treatment, we can decrease or even eliminate syphilis as a problem,’ Grant said.

Complete Article HERE!

Share

Undoing the STIgma: Normalizing the discourse surrounding STIs

Share

April is STD/STI Awareness Month.

By

Let’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

Share