Category Archives: Sexual Health

MEN NO PAUSE

I suppose the label Men No Pause will be the choicest of labels most men after 50 would want to put on their doors when they meet friends of similar ages to brag about their colorful lives, their women conquest, the fast cars they have and the overseas trips they made. Of course there will be no mention of failing health or failing memory or failing strength, everything is fine if not better as though age freeze for them. Their better halves of course will have their own sessions. They are very much down to earth as they know age has caught up with them and they will not hesitate to be very open about their failing health, their ailing body and the number of trips they have to make to see their personal doctors and the number of trips they have to make to see their personal beautician for make over’s.

 

Women of all ages are aware of the term menopause unlike men who only know that men no pause. In fact there is this saying that life begins at 40 for men! That implies that before 40 they are children or teenager. That’s not surprising when you can see middle age men before 40 still hold on their membership in Youth Clubs and Youth Section of political parties!

 

Men as women do go through aging process or rather they pass through the golden year that is a real challenge to their health. In women their reproductive function ceased as they menopause. The female hormones wane dramatically following symptoms suggestive of emergence of menopause like flushes, mood swings, panic attacks, insomnia, palpitation, anxiety, loss of libido and depression. Other than that there is this tendency of contracting some chronic illness like hypertension, diabetes, coronary diseases etc. which is part of aging.

 

With regard to fertility, similar changes are taking place in the males as well. After 50, their fertility wanes but not ceased. That’s probably the reason why they keep trying to knock down young women even their artilleries are in bad shape. They produce less sperms with poor quality and started to have problems with their sexual prowess and especially if they contract diabetes, hypertension, hypercholesterolemia and coronary diseases. More than a third of them will have prostate problems, like enlarged prostate that might have a negative influence in their sexual function because of frequency in passing urine.

 

Having low testosterone does not just affect their libido. Testosterone is important for men. It is this elixir that gives them the male characteristics, the so called macho and virility. The very same hormone gives them the strength, the lean body mass, the muscle bulk, the bone strength, the heat and of course the libido. It is this hormone that maintains sperm production and sensitizes the sex center to respond to sexual desire. Just imagine what will happen if that very same hormone level dwindles down. This situation is called Andropause and sometime is also known as male menopause. You see a pathetic looking male with no sting. He sometimes look frail, no muscle, only bones and skin. He may appear grumpy and quarrelsome. He will have similar symptoms as seen in menopausal women like flushes, night sweats, insomnia, loss of memory, palpitations and specifically in men loss of nocturnal erections and looking fatigue. If this is something that is welcoming to him then it’s alright.

 

No men would want to be in that state, looking hopeless and helpless.
Like menopause, Andropause is now a recognized health issue in men. Men with ‘late onset hypogonadism’ or LOH as it is also being known as can be treated by Testosterone Replacement Therapy. Before testosteone is instituted, the aging male need to go for a medical assessment to evaluate his health status. His medical condition if any need to be treated. His prostate will be evaluated prior to providing him testosterone therapy. Since this therapy can be for life time, he needs to come for regular follow-up to monitor his prostate and general health. There is also alternative therapy in the form of herbal supplementation. Certain herbs like Tribulus terrestis and Eurycoma longifolia or Tongkat Ali have been found to stimulate the adrenals and testicles in producing natural testosterone. The water soluble extract have been found to be useful with less side effects. If he has problems with his prowess, medication that can improve blood flow to his genital organs can help, if the medication is suitable for him.

 

Men need not stay behind and suffer in silent. They need to emulate their better halves in opening up and take charge of their health. Putting the Men No Pause sign will not help. The signage should be Men Do Pause.

Why my level of climax is too fast?

Question:Warm regards to you. I like to know why and how and ways to overcome it. My question is my level of climax is too fast.Not even 2 minutes. Why is that so? Thank you.

 

Answer:
You are actually suffering from a condition known as rapid ejaculation and this happens because you do it in a hurry! When you are doing it in a hurry you will lose your focus and concentration and will ejaculate fast besides not getting what you and your partner aim for. Imagine you are doing a run and you make a dash from the very beginning, you will find yourself pretty exhausted halfway and will not be able to compleete the run. The same thing will happen to you when you make love to your partner in the same manner. You start your love making with heated passion. This will make you lose your concentration and focus. This willl result with you losing control and ejaculate. Try to take it easy by first warming up and take time to do the penetration. Firm up the pelvic floor muscles when you do the penetration and contol your pelvic thrust when you penetrate. Keep the penis in the vagina when you maintain the pelvic thrust so that the tip of the penis gets less pressure. You can put more pressure to the vaginal opening with the base of your penis and when you are ready you can do rapid pelvic thrust to increase pressure to the vaginal entrance, focussing on the clitoris and roof of vagina. As you are doing the pelvic thrusting you continue firming up your pelvic floor muscles so that in the event you ejaculate your erection is still firm enough to give more stimulation to the vagina to make your partner climax. This technique of lovemaking is known as Coital Alignment Technique. You need to practice this technique regularly to get use to it. If you still have problems you need to consult a doctor.

Reverse results

Question:
My husband and I have a wonderful sex life, but right after we have intercourse he almost immediately falls asleep. I, on the other hand, could go another round, go for a jog, clean the house. I’m so full of energy. It doesn’t matter what time of day or night it is. Why does sex always knock him out while it gives me this super energy boost?

 

Answer:
Many women out there would give their right arm for an answer to this one. Therefore, here goes. One or more of the following reasons usually account for why a man falls into a post-coital stupor:

  1. They are tired to begin with, and sex helps them relax and let go — figuratively and literally.
  2. The hormones men and women produce at orgasm namely Oxytocin and the natural opiate Beta-Endorphins can lead to the desire to lie back in the afterglow, and that sense of physical peace often leads to sleep.
  3. The ejaculatory release for men, and the inherent letting down of bodily tension, makes men physically tired.
  4. Most people (again, men and women) hold their breath during sex, breathe shallowly or do not focus on breathing. There is a possibility that he is not breathing deeply. That gives him oxygen deprivation, which causes sleepiness. In addition, it could (rare, though) persist into the next day.

 

Here is my explanation about his post coital stupor. He is probably fatigued before sex and all of those sensations — including orgasm — just propel him into the state for which his body is yearning: rest.

 

In rare cases, men who are exhausted by sex may have a medical condition. If you suspect something more serious, make sure your husband sees his doctor for a complete physical.

Oversensitive Partner

Question:
My husband gets offended if I wash off with water after sex. I do it because it’s much more comfortable for me to go to sleep if I’m all cleaned up and because it helps prevent yeast infections, which I’m prone to getting. He thinks it’s prudish and says that it ruins it for him. How can I get him to understand that I need to do this and that it’s normal?

Answer:
To wash after making love might make it more difficult for the woman to get pregnant because the semen is not settled and movement will only expel it and exposure to soap and water can destroy the active sperms. If your husband is aware of this, he is actually upset because you are actually practising family planning without his consent. If you have children and are not planning for one immediately then washing after sex is no longer an issue, at least no longer his issue but yours because of the various reasons you have mentioned like cleanliness and avoiding fungus infection. If he is not clear about this then you need to inform him. If he is still not clear, you need to take him to your family doctor for a briefing.

PMS Problems

Question:I have bad PMS, and so for about two weeks every month I’m on an emotional roller coaster. This has done real damage to our sex life. My husband has basically given up initiating sex since I so frequently turn him down, and he has a really hard time understanding what I go through. I do not know what to do.

 

Answer:
PMS is real! It affects the quality of life for millions of women, yet too many couples do not realize there are ways to battle this problem. Begin by identifying the specific symptoms you experience. Typical symptoms include fatigue, depression, irritability, angry outbursts, cravings for sweet and/or salty foods, headache, abdominal bloating, anxiety, confusion, difficulty with concentration and/or memory, swollen hands or feet, tender breasts and tearfulness. Next, keep a log of the dates you experience certain symptoms. On your monthly chart, mark your symptoms with a number from 0 to 10, indicating the severity of the symptom on a given day.

 

These charts will enable you to predict the onset of your internal warfare and plan ahead for its effects. Plan positive sexual times for you and your husband for the two weeks leading up to your symptoms. Then, depending on the severity of your PMS, plan for the type of sexual encounter that would meet your needs and help relieve your stress during that difficult time. For example, you might enjoy being caressed everywhere except your breasts and genitals. Alternatively, you may not want to be touched anywhere, but would enjoy caressing your husband. During those difficult two weeks, make time in your schedule for extra rest. Schedule a “walk-and-talk” time together to occur before your sexual time. Begin your actual physical time with a relaxing spa or a warm shower. Planning for your PMS will reduce the damage to your sex life and increase your husband’s understanding. It might also be possible to treat your PMS. Which may include healthy life style, vitamin supplementation and symptomatic treatment from your doctor.

 

Cheating Wife

Question:
I have been married to my wife for 10 years, and she has been cheating the whole time. She decided to stop cheating and wants to build our relationship, but to be quite honest, I am horrible with sex, romance and foreplay. I always have to ask her for sex and most of the time, she just does it with me because I nag her to death. I need advice on how to get what I want with sex, foreplay and love. My confidence level is so low and I am also about 20 kilos overweight. Plus, I get off in like one minute and although I’ve been reading about how to be a better lover, frankly, it is just not helping. Please help!

 

Answer:
It can be disturbing when one finds out that ones partner cheats. However, it is more disturbing when the real reason for the cheating falls on ones shoulder, in this case, failure to satisfy the partners sexual needs. Reading sex guide will be rather a futile attempt if one has no interest in sex. On the other hand, it is just not right to have sex with no feelings. Sex is not just a physical thing; it involves emotion and bonding between the partners. May be sex is not what the woman want, it is the caring and the loving. That is probably the reason why the partner decides to stop cheating and wants to build the relationship. Tender loving care is not just humping. It is more than that. The touching is more enjoyable than the penetration and after all, once ejaculation has taken place, the curtain falls. It is different when the skin touches the lips are locked and passion flows. Oral sex can be wonderful and pleasurable as well. Do something about the weight and stop nagging. Seek professional help when one has rapid ejaculation. There are numerous treatment options available. It is advisable for both couples to see the doctor so that both parties are aware and would be able to help each other. After all that is what marriage is all about caring for each other.

 

ESP – Enjoyable Safe Pleasure – Your Intimate Care Partner

Does it hurt for him to ask if I’ve finished my menses or try asking for sex?

p>Question:
Hello dr! I’ve been married for almost 7 months now, and I’ve noticed that my husband’s libido/interests in sex is kinda decreasing. I understood that he had been busy with his work lately. On the other note, I thought generally all men love to watch porn. My hubby do watch it before, but now he had stopped watching it. Reason-he said its too fake and boring. There are times I’ve invited him to watch together (I do watch porn for thoughts and tips, not addicted) he refused. If I had my period and didn’t have intercourse with him, he seems fine wit it… even up to 2 weeks or more! He’s never even bothered to ask if my period had ended or so.. I’ve confronted him saying how come he’s not being intimate or touchy with me, he just said that he thought I was still bleeding. He said he wouldn’t know until I told him that I’ve completely mense-free. Does it hurt for him to ask if I’ve finished my menses or try asking for sex..? Is it normal for some guys who don’t watch porn? I’ve noticed that it is me whose going all the way up to him from rubbing, caressing etc. Then it’ll start. I’m quite sexually emotional in this matter…How to make him addicted to have sex with me more often? How to make him have the urge of wanting to have sex with me? I’m quite an attractive woman with nice proportions of my body 5 according to him and most people), I’m not being a modest here but it sounds stupid if he finds me unattractive and no sex appeal. Please help me. Thanks dr..

 

Answer:
Looks like you have done your very best to seduce him and he seems to be cool about it. What was he like when he was chasing you before you tied the knot. For some guys the chasing and hunting part is interesting for them and the moment they get what they wanted, the chasing cools off and life becomes usual, that is back to routine and that is going to work and earning money. For some guys, once they are hitched they take life seriously and they take their partner for granted. They need to be reminded most of the time in a subtle way and they never like to be criticized. You may as well start everything for him, practically take care of him and pamper him the way mummy takes care of her boy and you provide what mummy cannot give him and that is sex. He will love you for that. You don’t have to wait for him to make the move, you make the move and he will take it from there. Continue with your seduction and take him as he is, after all he is the man you married.

 

Would I able to satisfy a woman with a short penis?

Question:
I have a miserable problem. It’s regarding the length of my penis. At a flaccid position, it is only 2 inches in length. Upon erection, it only extends to 4 inches. For your information, I’m also overweight. I stand at 171 cm and weigh 95 kg. I’m afraid to get married as I’m worried that my future wife will be disappointed when she looks at my penis. Would I able to satisfy a woman with a short penis? Would she complain about the length?

Answer:
The penis has always been the precious possession of the male and an organ to be proud of if one is well endowed. On the other hand, an enormous genital will strike terror to the female partner. Obsessing about penis size is nothing new. Erotic art throughout history is full of examples of exaggerated phalluses. When it came to depicting a heroic personage in erotic art, the size of the penis often symbolized the man’s vigour or sexual power. In the woman perspective, size is least thought about. The size of the man’s hearts is what that matters and the romance. What is the average penis size? The reported statistics vary, but some of the more credible measurements taken from a sample of men in the National University of Singapore and a Well Man Clinic in Kuala Lumpur revealed that the average erect penis is between 10-14 cms when measured from the base of the penis to the tip along the top side. The vast majority of erect penises (>85% of men) fell between 10-15 inches. A penis of less than 6cm in erected state will have difficulty with penetration. Obese man will appear to have a smallish phallus and this is because a good portion of the length is embedded in the fat! However, he will find he is not small after all. There are many so-called remedies to improve penile length and girth. It is always better to consult a doctor before one indulges into costly treatment. The so-called creams and capsules are useless and so also massaging the organ with various ‘magic’ oils. There is a penile extender device (Andropenis) that is already available in the market that can be used to add a few centimetres (between 2-5 cm) if applied correctly over a period of 9 hours for 4-6 months. Information on this device is available in www.drismailtambi.com

Should I give it a try to satisfy my partner’s strange fetish?

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Question:
My partner regularly asks whether he can lick my bottom. He says that if I give it a try, I would love it. Until now, I have vehemently rejected his requests, saying it is disgusting. Is it disgusting? Is it unhealthy? Is my partner gay? Should I give it a try to satisfy my partner’s strange fetish?

 

Answer:
Lovemaking is a mutual experience if both partners are enjoying it. It can be more exciting if both parties explore the wonders of lovemaking like changing positions and indulging in oral sex. Probably the cleanest organ of the body is the genital area as it is well covered and cleaned. The skin of the genitals is sensitive and touching with hands will not be as pleasant as compared to the lips and the tongue. There is no harm trying oral sex if one would like to experience something different in lovemaking. This would give a chance for the partner to get closer to you and to taste you literally.

Vulvodynia

Vulvodynia is the term used to describe women who experience the sensation of vulval burning and soreness in the absence of any obvious skin condition or infection. The sensation of burning and soreness of the vulva can be continuous (unprovoked vulvodynia) or on light touch eg. sexual intercourse or tampon use (provoked vulvodynia). Women who have unprovoked vulvodynia were formally know as having dysaesthetic vulvodynia where pain was felt without touch. Vestibulodynia is the term replacing vestibulitis where pain is felt on light touch. A recent change in the terminology of these conditions means that the description of women with vulvodynia can be more uniform amongst health professionals and patients. Many women have symptoms which overlap between both conditionsDysaesthetic vulvodynia and vestibulitis are now obsolete terms that you’ll hear less and less frequently as they are phased out.

 

What is it?
This condition is a cause of vulval burning and soreness usually as a consequence of irritation or hypersensitivity of the nerve fibres in the vulval skin. The abnormal nerve fibre signals from the skin are felt as a sensation of pain by the woman. This type of pain can occur even when the area is not touched. Another example of nerve-type (neuropathic pain) like vulvodynia is the pain some people experience with an attack of shingles. Once the rash of shingles has disappeared the area of skin where the rash was can be intensely painful and sore despite the skin appearing normal. The condition is called post-hepatic neuralgia.

 

What are the symptoms?
The pain described by women with unprovoked vulvodynia is often of a burning, aching nature. The intensity of pain can vary from mild discomfort to a severe constant pain which can even prevent you from sitting down comfortably. The pain is usually continuous and can interfere with sleep. As with long-term pain of any cause you can have good days and bad days. Itching is not usually a feature of the condition. The pain in unprovoked vulvodynia is not always restricted to the vulval area (area of skin on the outside of the vagina) and some women get pain elsewhere. This can be around the inside of the thighs, upper legs and even around the anus (back passage) and urethra (where you pass urine). Some women also have pain when they empty their bowels. Unprovoked vulvodynia can have an affect on sexual activity and is associated with pain during foreplay and penetration. In some women with unprovoked vulvodynia the burning sensation can be generalised over the whole genital area. Alternatively it can be localised to just the clitoris (clitorodynia) or just one side of the vulva (hemi-vulvodynia).

 

What is there to see on examination?
Usually there is nothing to see on examination as the problem lies with the nerve fibres themselves which are not visible to the skin. Just because your doctor cannot see anything does not mean that there is nothing present.

 

How is it treated?
Pain that originates from nerve fibres, is best treated with drugs that alter the way that the nerve fibres send their impulses to the spinal cord and give the sensation of pain. The most experience to date in treating vulvodynia has been with the tri-cyclic antidepressants. These can be prescribed by your doctor in doses lower than is used to treat depression. The drugs are used because is alters the way the nerve fibres transmit the sensation of pain, not because the doctor thinks it’s all in your mind! Some women do gain some benefit from different types of creams and lotions applied to the vulval area which do act as soothing agents, but it generally best to avoid all creams unless they have been prescribed by your doctor.

 

What is it NOT?
There are many conditions that it is not! It is not infective, it is not related to cancer, and you will not pass it on to your partner. As stated before, some women do experience pain on the insides of the thighs and around the anus, however, this will not spread further.

 

How does it differ from vestibulodynia (formerly vestibulitis)?

Vulvodynia (unprovoked pain) Vestibulodynia (provoked pain)
  • – Spontaneous pain
  • – Pain is burning and sore in nature
  • – Itching not usually a problem
  • – Can be generalised around the vulva or localised
  • – Pain with light touch eg tampon use or sexual intercourse
  • – Usually no symptoms at other times
  • – Can be generalised around the vulva or localised

What causes it?
For a minority of women with vulvodynia, back problems eg slipped discs, can cause spinal nerve compression and cause referred pain to the vulval area. In the majority of cases, however, the precise cause of the nerve damage or irritation remains unknown. It’s known as an idiopathic condition, ie with no known cause.

 

Treatments available from your doctor
Tricyclic antidepressant tablets mentioned above is a standard treatment. The treatment is in tablet form, starting at a low dose and then increasing every few days until the pain subsides. The response to treatment is not overnight and may take several weeks. It is often necessary to continue with treatment for three to six months. Examples of tablets include amitryptyline, nortryptyline and dothiepin.The major drawback for some women on treatment are the side-effects; however these usually settle within the first few weeks of treatment and are not usually exacerbated by increasing the dose. The most common effect is that of tiredness which affects many women. If this occurs try taking the tablets before you go to bed. If this makes you sleepy in the morning and you have difficulty in getting out of bed, try taking the dosage slightly earlier like at teatime. Constipation, having a dry mouth and occasional blurred vision are other complaints whilst on treatment. If you are constipated try taking Senna or Fybogel which are weak bowel stimulants. You should tell your doctor if you are pregnant or have suffered liver and heart problems prior to treatment. Remember that treatment is only for a limited time and not forever!

 

Treatments you can buy without prescription
Vaginal lubricants such as Sensilube, Astroglide or Pleasure Gel (ESP)  can help during intercourse. The are mucous-like and last longer than conventional lubricants. (See also aqueous cream, below.)

 

Complementary treatments are widely used by women with vulval pain and can be more successful than prescription based treatments. Most of the following treatments are available from health shops and can be used safely. If unsure ask your doctor. Aloe Vera gel, Calendula, Dr Bach Rescue cream, hypercal creams and Her Genicare Cream (ESP) are alternative, homeopathic treatments useful for treating sore and painful skin. Try each one separately, but be careful of irritation when applying the cream.

 

Aqueous cream is a very bland plain emollient (soothing cream) that is usually used for treating dried cracked skin. It is perfume-free and is therefore less likely to irritate than the steroid creams. Many women gain benefit from the use of this cream as it soothes and rehydrates the skin. Some women keep the cream in the fridge and this can help even further with inflamed skin. It can be used indefinitely and as frequently as you like. It is available without prescription and can be used as a soap substitute and even a sexual lubricant.

 

You can also use emulsifying ointment (available from pharmacies in 500mg tubs) for washing. If you find it too thick, thin it down with some boiling water. Emulsifying ointment or alternatively Epaderm cream both make good barrier creams for swimming and also good sexual lubricants.

 

For severe attacks of pain Aveeno (oatmeal) sitz baths are an alternative treatment available from most health shops without prescription. Place one sachet in the bath and bathe for 20 minutes. This can be repeated up to four times a day. Alternatively, Emulsiderm bath lotion may help, or Oilatum in the bath.

 

Acupuncture has been shown to benefit women with vulvodynia when the pain is continuous, however, it is important to have treatments which address the genital area.