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Nearly Half of U.S. Men Infected With HPV, Study Finds

Although a vaccine is available, too few are getting it when young

 

Many American men are infected with the cancer-causing human papillomavirus (HPV), but unlike women, men are more likely to stay infected throughout their lives, a new study finds.

About 45 percent of U.S. men are infected with the sexually transmitted disease, as are 45 percent of women. Among women, the prevalence of HPV infection drops to about 22 percent as they age, but it remains high among men, said lead researcher Dr. Jasmine Han. She is in the division ofgynecologic oncology at Womack Army Medical Center, in Fort Bragg, N.C.

“We don’t know why it stays high in men while it drops in women,” she said. “Among men it’s higher than expected.”

Han speculates that the virus may remain in men because it lives in the penile glands, while in women, the virus is near the surface of the vagina and is more easily shed.

Although a vaccine against HPV has been available since 2009, coverage remains low. Only about 11 percent of men and 33 percent of women have been vaccinated, Han said.

HPV is the most common sexually transmitted disease among men and women in the United States, according to background information in the study. About 79 million Americans are infected with some type of HPV, with approximately half of new infections occurring before age 24, the study authors said.

Most people infected with HPV don’t know they have it and don’t develop health problems from it, according to the U.S. Centers for Disease Control and Prevention.

But HPV is not a benign infection. More than 9,000 cases of HPV-related cancers occur in men each year. HPV is the cause of 63 percent of penile, 91 percent of anal, and 72 percent of oral and throat cancers, the researchers noted.

In addition, HPV among men is an indirect cause of cervical cancer in women. The virus is also responsible for 90 percent of genital warts. HPV can also lead to tumors in the respiratory tract, called respiratory papillomatosis.

Han believes that the HPV vaccine should be mandatory for both boys and girls.

The CDC recommends that all boys and girls aged 11 to 12 get two doses of the HPV vaccine.

“We want our children to be vaccinated with the HPV vaccine because it is a cancer vaccine,” Han said. “By getting vaccinated, you can prevent your sons and daughters from getting these HPV-associated cancers in later years,” she explained.

Fred Wyand is a spokesman for the American Sexual Health Association/National Cervical Cancer Coalition. “This study underscores that HPV is common in men, and that’s true throughout most of their lives,” he said.

“We’re doing a better job of getting young males vaccinated against HPV, but uptake is still way below the levels we’d like to see,” Wyand added.

To get parents to accept the vaccine for their children, Wyand suggested that doctors need to give a “clear, strong recommendation for vaccination and treat HPV immunization as a normal, routine part of adolescent vaccinations.”

To gauge the prevalence of HPV infection among men, Han and colleagues used data on nearly 1,900 men who took part in the 2013-2014 U.S. National Health and Nutrition Examination Survey. Samples from penile swabs were tested for HPV.

Overall, a little more than 45 percent of the men were infected with the cancer-causing virus. Among vaccine-eligible men, however, only about 11 percent had been vaccinated.

The lowest prevalence of the virus among men was about 29 percent for those aged 18 to 22, which increased to nearly 47 percent in men aged 23 to 27 and stayed high and constant as men aged, Han said.

It’s possible that the lower rate among younger men may have resulted from young men being vaccinated, the researchers said.

The report was published online Jan. 19 in the journal JAMA Oncology.

Complete Article HERE!

When You Are Old, Chinese, and Gay

Gay, lesbian, and bisexual retirees seek companionship and acceptance in old age, but some find it harder than others.

 

By Fan Yiying

Zhang Guowei, a 76-year-old bisexual veteran, is relishing his twilight years. “I couldn’t be happier with my life post-retirement,” says Zhang, who was a doctor in the army until 1994.

As a former military officer, Zhang’s monthly pension is 10,000 yuan ($1,440) — five times the average pension in Changde, the small city in central China’s Hunan province where he lives with his boyfriend. Zhang divorced his wife in 2003 and met the love of his life — Wu, who is 40 years younger — a year later on the internet. “I expect him to accompany me through the remainder of my life,” Zhang tells Sixth Tone after finishing his daily exercise routine.

Zhang says he is bisexual but prefers men. He gained support and understanding from his ex-wife and two daughters when he came out to them in 2003. When he passes on, his assets will be divided equally among his daughters and his boyfriend. “My kids have no problem sharing with Wu because they know he is the one taking care of me in my final years,” he says.

The May-December couple have been living together since 2005 in an apartment provided by the government for retired army cadres and their families. The 10-story building houses a dozen veterans in their 60s through 90s, some living alone and others with their spouses.

When Wu first moved in, Zhang told his neighbors that Wu was his gan erzi, or adopted son, whom he met online. (The Chinese concept of gan erzi allows for a sort of informal adoption of adults, with no legal or religious implications.) “I had this vague idea that they might be gay,” says 74-year-old Lu Shize, who lives downstairs. “But it’s none of my business to ask about his private life,” Lu adds.

Last year, following in other veterans’ footsteps, Zhang wrote a 218-page autobiography — including his experiences of recognizing his sexuality — and shared it with his fellow cadres. His neighbors were very understanding. “Everyone knows about us, and no one gossips or gives us a hard time,” Zhang says.

Lu, who had never before met any out gay or bisexual men, says he admires Zhang’s courage. “Being gay or not, it doesn’t change the way I see him,” Lu says. “We are in our 70s; what’s more important than being happy and healthy?”

China’s population is rapidly aging. The proportion of the population aged 60 or older was more than 16 percent at the end of 2015, according to the Ministry of Civil Affairs, and that number is only set to increase. The nation’s changing demography brings with it challenges for managing welfare and health care, especially as fewer seniors are able to count on their families for support.

Two older men hold a symbolic wedding ceremony in Beijing, Jan. 30, 2013.

Decades of family-planning restrictions mean that even seniors who have children often must become self-reliant, as children born during the one-child policy can’t afford to support two parents and four grandparents. As a result, for many elders, being childless is no longer a major concern or an unusual occurrence.

Wen Xiaojun, 56, is single and childless. Immediately after he retired in November from working as a civil servant, he rented an apartment in Sanya, on the southern island of Hainan, where he is spending six months avoiding the cold of his hometown in the eastern province of Zhejiang. “I still feel young and restless,” Wen tells Sixth Tone. “Being childless makes it easy for me to travel after retirement.”

Like other older people, LGBT seniors want to have rich, fulfilling, and independent lives. They hope that retirement will give them the opportunity to focus on what they truly love.

Wen enjoys his slow-paced life in Sanya. He goes to exhibitions, takes walks along the beach, plays volleyball with locals, and sometimes meets up with men he contacts through Blued — a popular gay social app, on which he hopes to find a long-term boyfriend.

But dating isn’t easy for older gay men. “Younger generations can build a relationship quickly by kissing or having sex soon after they meet offline,” Wen explains. “But we want something more spiritual and stable.”

Similarly, 62-year-old Ah Shan, as he’s called within the gay community, says that finding a partner is his biggest problem these days. His finances are secure, as he owns his apartment in Guangzhou — capital of southern China’s Guangdong province — and receives a monthly pension of about 5,000 yuan, but he has been single for four years and is ready for that to change. In the meantime, he is renting out one of his bedrooms to gay friends so he has some company at home.

Ah Shan poses for a picture in Guangzhou, Guangdong province, 2013.

Most gays, lesbians, and bisexuals of Ah Shan’s generation knew little about their sexual orientation until internet access became available at the turn of the millennium. Even when Ah Shan was working in the U.S. in the late 1980s, he refused to consider himself gay because the only information he’d heard about gay topics in China was AIDS-related or implied that homosexuality was shameful or immoral. “I think I was brainwashed,” Ah Shan laughs.

Over the last two years, Ah Shan has been working on a gay oral history project, recording the stories of older gay men in Guangzhou. He has talked to more than 60 gay men aged from 60 to 90, who have experienced some of China’s most critical historic moments, from the Cultural Revolution to the nation’s opening-up era. “If we don’t record them now, part of the important history of LGBT in China will be gone,” he says.

Many of the men are married and choose not to come out to their families. “They go to this particular park to chat with other gay men in the daytime to release their emotions, but when the sun goes down, they have to return home to bear their family responsibilities,” Ah Shan says with a sigh.

Ah Shan’s own parents passed away before he was brave enough to tell them the truth. His mother died in 2000, a year before homosexuality was declassified as a mental illness in China.

Compared with gay and bisexual men, older women find it even more difficult to disclose or discuss their sexual orientation. Since 2010, 45-year-old Yu Shi from Chengdu, the capital of Sichuan province, has been working on an oral history project for older same-sex-attracted women across China, but she says the process of locating participants and persuading them to share their stories is tough.

“Chinese women are in a weak position in the family, which doesn’t allow them to speak out for themselves,” Yu says, adding that of the 30 or so lesbians who have taken part in the project over the last six years, only one has come out to her family. Many won’t divorce their husbands even if they have female partners. “Chinese people are very concerned with saving face, and they think it’s a loss of face to get a divorce if you’re already a grandparent,” she says.

Yu and her 40-year-old girlfriend have lived together for over a decade, but despite their enduring, loving relationship, they can’t enjoy the security of a formal union, as same-sex marriage is not yet legal in China. Some issues can be resolved by making a will, but others — like legal or medical power of attorney — remain a problem.

According to Yu, some LGBT seniors who are single and childless have considered building their own retirement estate where they can live together and take care of one another. Although they aren’t opposed to regular nursing homes, Yu says “they prefer to live in a place where they can open their hearts and share their experiences with others in the same circumstances.”

A lesbian couple kiss each other during an event in Shanghai, Dec. 22, 2013.

As more and more seniors live separately from their children, retirement facilities in China have struggled to meet growing demand. The government encourages investment in privately owned nursing homes, but so far none have been established exclusively for members of sexual minority groups.

Little public attention is given to the needs of older LGBT people, but to Wang Anke, a 50-year-old bisexual woman from Beijing, these individuals don’t do enough to stand up for themselves, either. “We are almost invisible,” she says.

Wang married her husband in 1990 and plans to spend the rest of her life with him. Though Wang considers herself happy and fortunate, she says that most older lesbian and bisexual women she knows are pessimistic about their senior years. “They’re lonely and lack emotional care,” Wang says, adding that many would rather live alone than move into a nursing home where they fear they can’t be themselves. “Loneliness will go to the grave with them.”

But while some LGBT seniors advocate dedicated nursing homes, Ah Shan opposes the idea of separate services. “In the long run, LGBT people shouldn’t lock ourselves in a so-called safe place,” he says. “What we really need is for the overall environment to allow us to live comfortably in the community.”

Complete Article HERE!

New study finds girls feel unprepared for puberty

Girls from low-income families in the U.S. are unprepared for puberty and have largely negative experiences of this transition, according to researchers at Columbia University’s Mailman School of Public Health and the Johns Hopkins Bloomberg School of Public Health. Their latest paper on the puberty experiences of African-American, Caucasian, and Hispanic girls living mostly in urban areas of the Northeastern U.S. shows that the majority of low-income girls feel they lack the information and readiness to cope with the onset of menstruation. The research is one of the first comprehensive systematic reviews of the literature on puberty experiences of low-income girls in the U.S.

The findings are published online in the Journal of Adolescent Health.

“Puberty is the cornerstone of reproductive development,” said Marni Sommer, DrPH, MSN, RN, associate professor of Sociomedical Sciences at the Mailman School of Public Health. “Therefore, the transition through puberty is a critical period of development that provides an important opportunity to build a healthy foundation for sexual and reproductive health. Given the importance of this transition, the research is striking in its lack of quantity and quality to date.”

The investigators used Qualitative Research guidelines to review the data from peer-reviewed articles with a qualitative study design published between 2000 and 2014. They used a quality assessment form as a further check of the data.

The age of breast development and menarche has declined steadily in the U.S. during the last 25 years, with 48 percent of African-American girls experiencing signs of physical development by age 8. “This trend may mean that increasing numbers of African-American girls are not receiving adequately timed puberty education¬, leaving them uninformed and ill-prepared for this transition,” said Ann Herbert, doctoral candidate at the Bloomberg School of Public Health.

Although many of the girls reported being exposed to puberty topics from at least one source—mothers, sisters, or teachers—most felt that the information was inaccurate, insufficient, or provided too late. Girls also reported being disappointed in the information they received from mothers; meanwhile many mothers said they were unable to fully address their daughters’ needs. Mothers were uncertain about the right time to initiate conversations, uncomfortable with the topic, and uninformed about the physiology of menstruation. The timing of puberty also influenced girls’ puberty experiences.

The researchers noted that despite a strong focus on adolescent sexual health outcomes, such as sexually transmitted infections and teen pregnancy, clinicians and practitioners in the U.S. have yet to capitalize on the issues of puberty onset and menstruation as a window of opportunity to improve adolescent sexual and reproductive health. In addition, the current body of research leaves out many topics entirely. “For example, missing are the voices of adolescents with non-conforming gender role and sexual orientation,” Herbert said.

Earlier research showed that irrespective of race, higher-income girls had more knowledge about puberty, were more prepared for menarche, and had more positive attitudes about menstruation, strongly suggesting socioeconomic disparities related to preparation for puberty.

“Findings from the current review suggest that low-income girls today expressed a sentiment similar to girls studied in the 1980s and 1990s—a feeling that they were largely unprepared for puberty and menarche,” noted Herbert.

“Our review makes it clear that there is a need for new more robust interventions to support and provide information about for low-income , something we are considering for the coming years,” said Sommer.

Complete Article HERE!

For Veterans, Trauma Of War Can Persist In Struggles With Sexual Intimacy

U.S. Marines march in the annual Veterans Day Parade along Fifth Avenue in 2014 in New York City.

By

Much has been said about the physical and psychological injuries of war, like traumatic brain injury or post-traumatic stress disorder. But what we talk about less is how these conditions affect the sexual relationships of service members after they return from combat.

Since 2000, service members who were deployed received at least 138,000 diagnoses of PTSD. More than 350,000 have been diagnosed with traumatic brain injury since 2000. Evidence suggests the numbers are actually higher because many don’t seek treatment.

These conditions cause their own sexual side effects, such as emotional numbness, loss of libido and erectile dysfunction. And the long list of medications used to treat PTSD, TBI and other medical conditions can worsen those side effects.

‘He would sleep for days’

Chuck and Liz Rotenberry of Baltimore struggled with their own challenges when Chuck returned from Afghanistan in 2011. He’s a former Marine gunnery sergeant who trained military working dogs. He left active duty in 2012.

For Liz and Chuck, sex had never been a problem. They’ve been married for 14 years and they’re still very much in love. Liz says she fell for Chuck in high school. He was that guy who could always make her laugh, who always had a one-liner ready and never seemed sad.

But when Chuck returned from Afghanistan, their relationship would soon face its greatest challenge. Baby No. 4 was just two weeks away; for sure, it was a chaotic time. But Liz noticed pretty quickly, something was terribly wrong with her husband.

“I wouldn’t be able to find him in the house and he wouldn’t be outside, and I’d find him in a separate bedroom just crying,” Liz says. “He would sleep for days. He would have a hoodie on and be just tucked away in the bed, and he wouldn’t be able to get out of bed. He would have migraines that were so debilitating that it kept him in the bed.”

When Chuck was in Afghanistan, an IED — improvised explosive device — exploded 3 feet behind him. Shrapnel lodged into his neck and back.

It would take three years for someone at the Department of Veterans Affairs to explicitly lay out for Liz that Chuck had developed severe post-traumatic stress and suffered a traumatic brain injury — and that she would need to be his caregiver.

The Marine self-image

During that three-year period, there were times Chuck estimates he was taking 15 to 16 different medications twice a day.

Sex was usually the furthest thing from his mind.

“I didn’t think about it. I wanted to be with Liz, I wanted to be near her,” he says. “When the desire was there, it was unique. It was rare, as opposed to the way it was before. And a lot of times, with the mountains of medication I was on, you know, in my head [it was] all systems go, but that message didn’t go anywhere else.”

Liz noticed that Chuck stopped initiating physical affection.

“The thought of him reaching out to me to give me a hug wasn’t existent. It was like I had to give him the hug. I now had to step in and show him love,” she says.

Sometimes months would go by before they would have sex.

“It started off as being pretty embarrassing, pretty emasculating,” Chuck says. “It was like, ‘Really? This too doesn’t work?’ You blame it on, ‘Oh, it’s just the medication,’ or ‘You’re tired,’ or whatever initially, and you don’t realize it’s stress or my brain just doesn’t work like it used to.”

Liz and Chuck had never really talked about sex in any serious way before. So they kept avoiding the conversation — until this year. That’s when Chuck finally asked his primary care provider for help. The doctor prescribed four doses of Viagra a month. Liz and Chuck say the medication has improved things substantially — though they joke about how few doses the VA allots them every month.

But asking for just those four doses took Chuck three or four visits to the doctor before he could work up the nerve. He says it can be especially hard for a Marine to admit he’s having problems with sex because it contradicts a self-image so many Marines have.

“You know, as a Marine, you can do anything. You believe you can do anything, you’ve been trained to do nearly anything,” he says. “You’re physically fit. You’re mentally sound. Those are just the basics about being a Marine.”

If he has any advice for a Marine going through the same thing he and his wife are facing, he says you need to talk about it. Bring it up with your spouse. Bring it up with your doctors.

“Marines always jokingly hand out straws. You got to suck it up. You got to do what you need to do to get it done,” Chuck says. “It’s just a different mission. … Don’t let your pride ruin what you worked so hard for.”

 Complete Article HERE!

Redefining Sexuality after Stroke

You can have a healthy sex life after having a stroke.

By StrokeSmart Staff

You can have a healthy sex life after having a stroke. In fact, it’s a key part of getting back into a normal routine. The need to love and be loved is significant. Also, the physical and mental release that sex provides is important.

The quality of a couple’s sexual relationship following a stroke differs from couple to couple. Most couples find that their sexual relationship has changed, but not all find this to be a problem. The closeness that a couple shares before a stroke is the best indicator of how their relationship will evolve after the stroke.

However, having sex after a stroke can present problems and concerns for both you and your partner.

Stroke survivors often report a decrease in sexual desire. Women report a strong decrease in the ability to have an orgasm and men often have some degree of impotency. A stroke can change your body, how you feel and impact your sex life.

Having good communication with your partner, managing depression, controlling pain or incontinence and working with impotence can all help you resume a healthy sex life.

Communication is Key

Talking about sex is hard for many people. It gets even more complicated after having a stroke, when you may be unable to understand or say words or have uncontrollable laughing or crying spells. But it is critical to talk openly and honestly with your partner about your sexual needs, desires and concerns. Encourage your partner to do the same. If you are having a difficult time communicating with your partner about sex, an experienced counselor can help.

Depression, Pain and Medication — How They Effect Your Sex Drive

It is common for stroke survivors and their partners to suffer from depression. When you are depressed, you tend to have less interest in sexual intimacy. Depression can be treated with medications. You may also be taking medicine for anxiety, high blood pressure, spasticity, sleeping problems or allergies. Addressing these medical concerns can increase your sex drive. But know that some medication can also have side effects that interfere with your sex life. If your ability to enjoy sex has decreased since your stroke, talk with your doctor about medicines that have fewer sexual side effects.

Many stroke survivors also have problems with pain, contributing to a loss of sexual desire, impotence and the ability to have an orgasm. This is a normal reaction. Work with your doctor to develop a program to manage your pain and increase your sexual desire.

Controlling incontinence

If you are having trouble with controlling your bladder or bowel, being afraid that you will have an accident while making love is understandable. There are a few steps you can take to help make incontinence during sex less of a concern.

  • Go to the bathroom before having sex
  • Avoid positions that put pressure on the bladder
  • Don’t drink liquids before sexual activity
  • Talk to your partner about your concerns
  • Place plastic covering on the bed, or use an incontinence pad to help protect the bedding
  • Store cleaning supplies close in case of accidents

If you have a catheter, you can ask your doctor’s permission to remove it and put it back in afterwards. A woman with a catheter can tape it to one side. A man with a catheter can cover it with a lubricated condom. Using a lubricant or gel will make sex more comfortable.

Working With Impotence

Impotence refers to problems that interfere with sexual intercourse, such as a lack of sexual desire, being unable to keep an erection or trouble with ejaculation. Today, there are many options available to men with this problem. For most, the initial treatment is an oral medicine. If this doesn’t work, options include penile injections, penile implants or the use of vacuum devices. Men who are having problems with impotence should check with their doctors about corrective medicines. This is especially true if you have high blood pressure or are at risk for a heart attack. Once you have talked to your partner and you are both ready to begin a post-stroke sexual relationship, set yourself up to be comfortable. Start by reintroducing familiar activities such as kissing, touching and hugging. Create a calm, non-pressure environment and remember that sexual satisfaction, both giving and receiving, can be accomplished in many ways.

Ask the Doctor

Things to discuss with your doctor:

  1. Medications for depression and pain that have fewer sexual side effects.
  2. Changes you should expect when having sex and advice on how to deal with them. Be sure to discuss when it is safe to have sex again.
  3. Impotence and corrective medications.
  4. Incontinence — a urologist who specializes in urinary functions may be able to provide help in this area.

Tips for Enjoying Sex After a Stroke

  • Communicate your feelings honestly and openly.
  • if you have trouble talking, use touch to communicate. It is a very intimate way to express thoughts, needs and desires.
  • after stroke, your body and appearance may have changed. Take time for you and your partner to get used to these changes.
  • Maintain grooming and personal hygiene to feel attractive for yourself and for your partner.
  • explore your body for sexual sensations and areas of heightened sensitivity.
  • have intercourse when you are rested and relaxed and have enough time to enjoy each other.
  • try planning for sex in advance, so you can fully enjoy it.
  • Be creative, flexible and open to change.
  • the side of the body that lacks feeling or that causes you pain needs to be considered. Don’t be afraid to use gentle touch or massage in these areas.
  • if intercourse is too difficult, remember there are many ways to give and receive sexual satisfaction.

Complete Article HERE!