Contraception, sex and relationship, Sex Health

Intrauterine contraceptive devices (IUCDs)

The intrauterine device have been used throughout the world. During the last couple of decades, however, there has been a significant improvement in its design and content. The idea is to obtain maximum efficacy without increasing the adverse effects. The device can be classified as open, when it has got no circumscribed aperture of larger than 5 mm so that a loop of intestine or omentum wouldn’t enter and become strangulated by accident, it perforates through the uterus and the peritoneal cavity. Lippes loop, Cu T, Cu 7, Multiload and Progestasert are examples of open devices. A closed devices like Grafenberg ring and Birnberg bow, if by accidental enter the abdominal cavity, they is a potential of causing strangulation of the gut; that’s why it is obsolete. The device may be nonmedicated as Lippes loop or medicated (bioactive) by incorporating a metal copper, in devices like Cu T-200, Cu T-380A, Multiload-250, Multiload-375. Hormone containing IUD either releasing progesterone (progestasert) or levonorgestrel (LNGIUS) has also been introduced.

Copper T 200 — The widely used medicated device is Copper T 200 B. It carries 215 sq mm surface area of fine copper wire wounded round the vertical stem of the device. Stem of the T-shaped device is made of a polyethylene frame. There is a polyethylene monofilament link at the end of the vertical stem for detection and removal. In spite of the copper being radiopaque, additional barium sulfate is incorporated in the device. The device contains 124 mg of copper. The copper is lost at the rate of about 50 μg per 24 hours during a period of one year. It is supplied inside a sterilized sealed packet. The device is to be removed after 4 years. Cu T 200 carries 200 sq mm surface area of wire containing 120 mg of copper and is removed after 3 years.

Cu T 380A — Cu T 380A carries total 380 mm2 surface area of copper wire wound around the stem (314 mm2) and each copper sleeve on the horizontal arms (33 mm2). The frame contains barium sulfate and is radiopaque. Replacement is every 10 years.

Multiload Cu 250 — The device emits 60–100 μg of copper per day during a period of one year. The device is to be replaced every 3 years.

Multiload–375 — The device is available in a sterilized sealed packet with an applicator. There is no introducer and no plunger. It has 375 mm2 surface area of copper wire wound around its vertical stem. Replacement is every 5 years.

Levonorgestrel intrauterine system (LNG-IUS) — This is a T-shaped device, with polydimethylsiloxane membrane around the stem which acts as a steroid reservoir. Total amount of levonorgestrel is 52 mg and is released at the rate 20 μg/day. This device is to be replaced every 7 years. Its efficacy is comparable to sterilization. It has many non-contraceptive benefits also.

Contraindication for IUCD

(1) Presence o\f pelvic infection current or within 3 months;

(2) Undiagnosed genital tract bleeding;

(3) Suspected pregnancy;

 (4) Distortion of the shape of the uterine cavity as in fibroid or congenital uterine-malformation;

(5) Severe dysmenorrhea;

(6) Past history of ectopic pregnancy;

(7) Within 6 weeks following cesarean section;

(8) STIs — Current or within 3 months;

(9) Trophoblastic disease;

(10) Significant immunosuppression. Additionally for CuT are:

(11) Wilson disease

(12) Copper allergy. For LNG-IUS:

(13) Hepatic tumor or hepatocellular disease (active); 

(14) Current breast cancer and

(15) Severe arterial disease.

sex and relationship, Sex Health

Adenomyosis

Adenomyosis is the condition of an ingrowth in the endometrium, both glandular & stromal components, directly into the myometrium.

Causes: The cause of such ingrowth is not known. It may be related to repeated childbirths, vigorous curettage or excess of estrogen effect. Pelvic endometriosis co-exists in about 40 percent.

Pathogenesis: Histologically, it is characterized by the extension of endometrial glands and stroma beneath the endometrial—myometrial interface (EMI). As the submucosa is absent, endometrial glands lie in direct contact with the underlying myometrium. It forms nests, deep within myometrium. Subsequently, threre is myometrial hyperplasia around the endometriotic foci. Myometrial zone anatomy was observed by MRI. A junctional zone (with low signal intensity on T2 weighted images) is defined at the innermost layer of myometrium. It is thought that the disturbance of normal junctional zone (JZ) predisposes to secondary infiltration of endometrial glands and stroma to inner myometrial zone. The disturbance of junctional zone (JZ) may be due to the endometrial factors, genetic predisposition or altered immune response. Trauma to the deeper endometrium (repeated curettage), causing breakdown of EMI is also taken as an important etiologic factor.

Pathology: The growth and tissue reaction in the endometrium depend on the response of the ectopic endometrial tissues to the ovarian steroids. If the basal layer is only present, the tissue reaction is much less, as it is unresponsive to hormones. But, if the functional zone is present which is responsive to hormones, the tissue reaction surrounding the endometrium is marked. There is hyperplasia of the myometrium producing diffuse enlargement of the uterus, sometimes symmetrically but at times, more on the posterior wall. The growth may be localized or may invade a polyp (adenomyomatous).

Naked eye appearance: There is diffuse symmetrical enlargement of the uterus; the posterior wall is often more thickened than the anterior one. The size usually does not increase more than a large orange (12–14 weeks pregnant uterus). On cut section, there is thickening of the uterine wall. The cut surface presents characteristic trabeculated appearances.

Unlike fibroid, there is no capsule surrounding the growth. There may be visible blood spots at places

 In about one-third, it remains asymptomatic being discovered on histological examination. The patients are usually parous with age usually above 40.

Treatment for Soft Erection

Symptoms:

Menorrhagia (70%)—The excessive bleeding is due to increased uterine cavity, associated endometrial hyperplasia and inadequate uterine contraction. During normal menstruation, there are antegrade propagation of subendometrial contractions from the fundus to the cervix. In adenomyosis with distorsion of junctional zone myometrial contractions are abnormal and inadequate (see below).

Dysmenorrhea (30%)—Progressively increased colicky pain during period is due to retrograde pattern of uterine contractions. It also depends on the number and depth of adenomyotic foci in the myometrium. When the depth of penetration is > 80% of the myometrium, the pain is severe. Other causes of pain are—local tissue edema and prostaglandins.

Dyspareunia or frequency of urination—are due to enlarged and tender uterus.

Infertility: Women with adenomyosis have a higher incidence of infertility and miscarriage.

Sex Health

Genital Tuberculosis

The incidence of genital tuberculosis varies widely with the social status of the patient and her environment. The incidence is about 1 per cent amongst the gynecological patients attending the outpatient department in the developing countries. Incidence is high (5–10%) amongst the patients with infertility. With the prevalence of HIV infection incidence of genital tuberculosis is rising. About 10 per cent of women with pelvic tuberculosis, have urinary tract tuberculosis.

The causative organism is Mycobacterium tuberculosis of human type. Very rarely the bovine type may affect the vulva. Genital tuberculosis is almost always secondary to primary infection elsewhere in the extragenital sites such as lungs (50%), lymph nodes, urinary tract, bones and joints. The fallopian tubes are invariably the primary sites of pelvic tuberculosis from where secondary spread occurs to other genital organs.

From any of the primary sites, the pelvic organs are involved by hematogenous spread in about 90 per cent cases. If the post-primary hematogenous spread coincides with the growth spurt of the pelvic vessels, the genital organs, the tubes in particular, are likely to be affected. Thus, the pelvic organs are infected during puberty. If the spread precedes the growth phase, the genital organs are spared. The infection remains dormant for a variable period of time (4–6 years) until clinical manifestations appear

The commonest site of affection is the fallopian tubes (100%). Both the tubes arection is in the submucosal layer (interstitial salpingitis) of the ampullary part of the tube. The infection may spread medially along the wall causing destruction of the muscles which are replaced by fibrous tissue. The walls get thickened, become calcified or even ossified. The thickening may at time become segmented. The infection may spread inwards; the mucosa gets swollen and destroyed. The fimbria are everted and the abdominal ostium usually remains patent. The elongated and distended distal tube with the patent abdominal ostium gives the appearance of “tobacco-pouch”. Occlusion of the ostium may however occur due to adhesions.The tubercles burst pouring the caseous material inside the lumen producing tubercular pyosalpinx, which may adhere to the ovaries and the surrounding structures. Often the infection spreads outwards producing perisalpingitis with exudation, causing dense adhesions with the surrounding structures— tubercular tubo-ovarian mass. Rarely, military tubercles may be found on the serosal surface of the tubes, uterus, peritoneum or intestines. These are often associated with tubercular peritonitis

Microscopic picture of the lesion is very characteristic irrespective of the organ involved. Typical granuloma consists of infiltration of multinucleated giant cells (Langhans), chronic inflammatory cells and epithelioid cells, surrounding a central area of caseation necrosis. Caseation may not be a constant feature.

The infection is restricted mostly (80%) to childbearing period (20–40 years). There may be past history of tubercular affection of the lungs or lymph glands. Genital tuberculosis occurs in 10–20 per cent of patients who have pulmonary tuberculosis in adolescence. A family history of contact may be available. Onset is mostly insidious. A flare up of the infection may occur acutely either spontaneously or following diagnostic endometrial curettage or hysterosalpingography.

erectile dysfunction, Male Enhancement, sex and relationship, Sex Health

Low Sex Drive in Women

As you advance in years, your libido may decline. Sex might become a source of frustration, even pain. Sexual dysfunction and low sex drive are common problems for women over forty. Libido loss may undermine your confidence. It may damage your relationship. It may also suggest that you may have other health issues that you should address. If you notice that you are not interested in having sex, request an appointment with your doctor to get your hormone levels checked. It only takes a blood test and some simple medical tests.

Many factors may cause a decline in your sexual desire.

Reasons of Low Sex Drive in Women

  • Problems in your Relationship

Probably you have problems with your partner and you cannot find a way to tell him. You still have sexual contact with him, however, your body will show him that something is wrong.

  • Your Age

Age can be amongst the causes. You may have age-related health issues. Even if you are healthy, you may lose your sex drive as you are nearing your menopause years and your body produces less female hormones like estrogen. Estrogen is a compound that affects your menstruation cycle and your reproductive abilities. Your testosterone level may decrease, too. Testosterone is a male sex hormone and an anabolic steroid. It affects your sex drive, your physical strength, and it prevents osteoporosis. Your ovaries and adrenal glands produce testosterone.

Your hormone levels have an impact on your health and well-being. You may consider a hormone replacement therapy. Ask your gynecologist or a health care provider before you decide to get an HRT.

  • Health Problems

Perhaps you have health problems that affect your libido. High blood pressure, anemia, diabetes, arthritis and cardiovascular diseases like coronary artery disease cause a decrease in your sex drive. They are serious problems. Get them treated.

  • Substance Abuse

Prescription medicine, street drugs and alcohol may kill off your libido. They make you tired, they mess with your sleeping patterns and cause insomnia; tiredness alone can be a reason of low sex drive. They also mess with your hormone levels.

  • Depression

Depressed people can find no pleasure in their favorite activities, sex included. Anxiety and workplace issues may make things worse. When you feel unhappy and insecure and you worry about your future, you cannot focus on a satisfying sex life.

  • Hormonal Problems

An underactive thyroid gland may make you tired and listless. It might be the reason of libido loss. Your thyroid is a butterfly shaped gland in your neck. It produces hormones. When it produces fewer hormones than it should, you may experience symptoms like weight gain, fatigue and low sex drive. Underactive thyroid can be a congenital problem, an autoimmune disorder or a result of high iodine consumption.

  • You Feel Weary

Sex requires energy and good physical health. Active, healthy, energetic persons have good sex life. Tired, weak persons do not have the energy to make love. Hectic lifestyle or imbalanced hormone levels may wear you off. According to doctors, it is rare that tired patients have physical health problems; stress and small problems in their everyday lives add up and sap their energy. Probably you work too much, you sleep too little or you have a disrupted sleeping pattern. If you are underweight or overweight, or you live with diabetes, you may feel tired all the time.

erectile dysfunction, premature ejaculation, sex and relationship, Sex Health

Sexual dysfunction – Facts and Symptoms

It is difficult to establish the prevalence of sexual problems in the population because of the difficulties involved in carrying out surveys of people’s sexual behaviour. The commonest kinds of problems presenting to a sexual dysfunction clinic are,

Women

Low sexual desire 50%

Orgasmic dysfunction 20%

Vaginismus 20%

Dyspareunia 5%

Men

Erectile dysfunction 60%

Premature ejaculation 15%

Delayed ejaculation 5%

Low sexual desire 5%

The assessment of sexual dysfunction

Patients with sexual problems initially often complain about other symptoms because they feel too embarrassed to reveal a sexual problem directly. For example, a patient may ask for help with anxiety, depression, poor sleep, or gynaecological symptoms. It is therefore important to ask routinely a few questions about sexual functioning when assessing patients with non-specific psychological or physical symptoms.

In a full assessment, the interviewer should begin by explaining why it will be necessary to ask about intimate details of the patient’s sexual life, and should then ask questions in a sympathetic, matter-of-fact way.

Whenever possible both sexual partners should be interviewed, at first separately and then together.

The assessment should cover the following issues.

  • Has the problem been present from the first intercourse, or did it start after a period of normal sexual functioning? Each partner should be asked, separately, whether the same problem has occurred with another partner, or during masturbation.
  • The strength of sexual drive should be assessed in terms of the frequency of sexual arousal, intercourse, and masturbation. Motivation for treatment of sexual dysfunction should be assessed, starting with questions about who took the initiative in seeking treatment and for what reason.
  • Assess each partner’s social relationships with the other sex, with particular reference to shyness and social inhibition.
  • Enquiries should be made about the partners’ feelings for one another: partners who lack a mutual caring relationship are unlikely to achieve a fully satisfactory sexual relationship. Many couples say that their relationship problems result from their sexual problems, when the causal connection is really the reverse. Tactful questions should be asked about commitment to the partner and, when appropriate, about infidelity and fears of sexually transmitted disease, including HIV.
  • Assess sexual development and sexual experience, paying particular attention to experiences such as child abuse, incest, or sexual assault that may have caused lasting anxiety or disgust about sex.
  • Enquiry should be made about homosexual as well as heterosexual feelings.
  • In the medical history, the most relevant things to look for are previous and present psychiatric and chronic physical disorders and their treatment, pregnancy, childbirth, and abortion(s), and use of alcohol or drugs, such as selective serotonin reuptake inhibitors (SSRIs).
  • In the mental state examination look especially for evidence of depressive disorder. Physical examination is important because physical illness often causes sexual problems Physical examination of women may require specialist gynaecological help. Further investigations may be necessary depending on the findings from the history and examination (e.g. if diabetes is suspected as a cause of sexual disorder).

erectile dysfunction, premature ejaculation, sex and relationship, Sex Health

Study Links Thyroid Problems with Erectile Dysfunction

The potential reasons for erectile dysfunction are numerous and differ broadly from coronary illness to other issue, yet specialists are finding that one common reason is regularly ignored.

A study published in the “Journal of Clinical Endocrinology & Metabolism” suggests a link between erectile dysfunction and thyroid problems – if you are suffering from impotence, the reason may be an undiagnosed thyroid problem. And, if you suffer from hypothyroidism (thyroid hormone production deficiency) or hyperthyroidism (thyroid operating surplus); you have higher risk of developing erectile dysfunction.

There is by all accounts solid association between different thyroid issue and erectile problem. Since thyroid ailment can influence upwards of one in ten men beyond 60 years old, this may imply that a considerable lot of those erectile dysfunction medication and its connected issues may have a sensibly basic sickness to treat.

The thyroid is a little organ situated close to the base of the neck. Keeping in mind it is minor; it discharges different hormones that have some degree of control over numerous organs of the body.

The good news is that with the treatment of gland problems, erectile dysfunction can be reversed. However, if symptoms persist after six months of treatment in thyroid problem, specific treatments for impotent should be realized.

Evaluating 27 men with hyperthyroidism, 44 with hypothyroidism, and 71 healthy men, the researchers found that 79% of men with thyroid dysfunction had some degree of erectile dysfunction – 85% of those with hypothyroidism and 71% of those with hyperthyroidism – compared to only 25% people without these conditions.

In addition, experts observe severe erectile dysfunction in 38% of those with insufficient functioning of the thyroid, and 29.6% of those with excessive operating gland.

With treatment to restore normal gland activity, only 30% of patients continued with erectile dysfunction, very close to the observed rate among those who had no thyroid problems.

In another recent study, analysts from the University of Modena, Italy, took a peek at right around 50 grown-up men who had hyperthyroidism or hypothyroidism. Every man was given a poll to reply about their sexual capacity and were then acquired some information about erectile dysfunction and related issues by a specialist.

Eventually, it was resolved that more than 63 percent of the men with hypothyroidism were determined to have low sexual desire, untimely discharge and postponed discharge. Among the men with hyperthyroidism, 50 percent were determined to have premature ejaculation, 17 percent with low sexual libido and 15 percent with erectile problem.

The majority of the men in the study were then treated for their thyroid disorder. Among the men with hypothyroidism, the frequency of untimely discharge or premature ejaculation dropped from 50 percent to 15 percent. Also, the low sexual craving and impotency vanished in the vast majority of the men.

The relationship between the thyroid and erectile disorder is not yet clear, but rather since thyroid sicknesses and erectile dysfunction are considerably more regular among men more than 60, these discoveries propose that maturing may not assume as large a part as already accepted.

dating, sex and relationship, Sex Health

Sexual behavior: What’s normal, what’s not

A large number of sexologists consider that the problem of the normal as compared to the abnormal sexual behavior is actually rhetoric in its essence. These experts assume that normal in sex is whatever suits a sex couple the best, what makes them satisfied and everything that fits into their specific system of sexual values. Oral sex is therefore a completely normal behavior for a couple, but only if both partners enjoy oral sex. As long as there is respect and responsibility in the sexual relationship, everything is perfectly fine.

However, it is not normal when one of the partners in the relationship does not do this for their own pleasure, but only because of the pressure created by the partner and the fear of rejection. This view applies equally to anal sex, bondage during sex activities, mutual masturbation, the use of obscene words, sex in unusual places, positions and circumstances and all the stunts that have a taste of something that is out of the ordinary. Mutual masturbation may be one of the best sexual stimulation. Don’t you think that female masturbation is very sexy?

Love and sexuality

Another group of sexologists advocates the importance of love as a measure of normality in the relationship between two adult partners. According to these authors, normal sexuality is a sexuality in which one person transmits messages of love, attachment, belonging and warmth to the other partner through sex.

Neurotic sexuality

Neurotic or abnormal sexuality, on the other hand, is sexuality in which sex is used as a discharger of accumulated dissatisfaction, aggression and the need to command, which aims at self-assertion or simply as a way in which individuals release their everyday tensions. Normal sexual person makes love periodically, only when they are eroticized by the presence of the person they love and at the same time they take the same amount of pleasure as they actually provide pleasure to their partner.

This viewpoint shows some logical weakness. First of all, there are practically no people who are absolutely free from tensions. Stress, aggressive impulses and feeling of guilt and every individual uses sex to empty these feelings from time to time. On the other hand, a small number of people who view themselves as completed persons and don’t need to prove themselves in the bed. In addition, there are individuals who have sex regardless of the presence or absence of the feeling of love. So, is it possible to determine what is normal and what is abnormal in sex? Not really. The real question is whether you should burden with this problem. It is certainly better to be abnormal in the bed with your loved one instead being normal alone. Being abnormal or creative for a better sexual health is better than a boring sex life.

Erotic fantasies

According to many studies, sex to a greater extent takes place in the minds of women and men than in bed. It turns out, that people between 18 and 22 years, spend more than 5 hours per day thinking about sex. As they grow older this amount of time is reduced, so people between 28 and 35 think about sex 2 hours a day. So, there is nothing wrong with erotic fantasies as long as the person knows how to separate reality from fantasies.

Male Enhancement, sex and relationship, Sex Health

Disorders of sexual preference

Disorders of sexual preference are sometimes known as paraphilias. A sexual preference can be said to be abnormal by three criteria.

1 Most people in a society regard the sexual preference as abnormal.

2 The sexual preference can be harmful to other people (e.g. sadistic sexual practices).

3 The person with the preference suffers from its consequences (e.g. from a conflict between sexual preferences and moral standards).

Doctors may be concerned with these conditions in three circumstances: they may be asked for help by the person with the abnormal sexual preference; they may be approached by the sexual partner; or they may be asked for an opinion when a person has been charged with an offence against the law. For example, exhibitionism or a sexual act with a child.

Disorders of sexual preference are divided into:

(i) abnormalities of the sexual ‘object’ and

(ii) disorders of the sexual act.

The aetiology of these conditions is not known, and the various theories will not be discussed. They may, however, be associated with the presence of other disorders, including depression, alcohol abuse, and dementia. Treatment is described after the descriptions of the disorders.

Disorders of preference of the sexual object

Fetishism

In this condition, an inanimate object is the preferred or only means of achieving sexual excitement. Almost all fetishists are men and most are heterosexual. Among the many objects that can evoke arousal in different people, common examples are rubber garments, women’s underclothes, and high-heeled shoes. The smell and texture of these objects is often as important as their appearance in evoking sexual arousal. Some fetishists buy the objects, but others steal them and so come to the notice of the police. Sometimes the behaviour is carried out with a willing partner or with a paid prostitute, but often it is a Solitary accompaniment of masturbation.

Fetishistic transvestism

In this condition, the person repeatedly wears clothes of the opposite sex as the preferred or only means of sexual arousal. It can be thought of as a special kind of fetishism. Nearly all transvestites are men. The clothing varies from a single garment to a complete set of clothing. Cross dressing nearly always begins after puberty. At first, the clothes are worn only in private; a few people, however, go on to wear the clothes in public. It usually hidden under male outer garments, but occasionally without precautions against discovery. A few transvestites wear a complete set of female garments; the condition then has to be distinguished from Trans sexualize. The essential difference is that transvestites are sexually aroused by wearing the clothing, while transsexuals are not.

Paedophilia

Paedophilia is repeated sexual activity or fantasy of such activity with prepubertal children as the preferred or only means of sexual excitement. Most paedophiles are men. Few paedophiles seek the help of doctors; those who do are mostly of middle age although the behaviour has often started earlier. From the ready sale of pornographic material depicting sex with children, it is likely that paedophilic fantasies are not rare, although paedophilia as an exclusive form of sexual behaviour is infrequent. The child is usually above the age of 9 years but prepubertal, and may be of the same or opposite sex to the paedophile. The sexual contact may involve fondling, masturbation, or full coitus with consequent injury to the child.

Disorders of preference of the sexual act

The second group of disorders of sexual preference involves variations in the behaviour carried out to obtain sexual arousal. Generally, the acts are directed towards other adults but sometimes towards children (e.g. by  some exhibitionists or sadists).

Exhibitionism

In this condition, sexual arousal is obtained repeatedly by exposure of the genitalia to an unprepared stranger. Nearly all exhibitionists are men. The act of exposure is usually preceded by a period of mounting tension which is released by the act. Usually, the exhibitionist seeks to shock or surprise a female. Most exhibitionists fall into two groups. The first consists of men with inhibited temperament who generally expose a flaccid penis and feel much guilt after the act. The second consists of men with aggressive personality traits who expose an erect penis while masturbating, and feel little guilt afterwards. In Britain, exhibitionists who are arrested are charged with the offence of indecent exposure.

When exhibitionism begins in middle or late life the possibility of organic brain disorder, depressive disorder; or alcoholism should be considered since these conditions occasionally ‘release’ this pattern of behaviour. In other people, the exhibitionism may start during a period of temporary stress.

Voyeurism

Voyeurism is observing others as the preferred and repeated way of obtaining sexual arousal. Most voyeurs are inhibited heterosexual men. Some voyeurs spy on couples who are having intercourse, others on women who are undressing or naked.

Sexual sadomasochism

Sadomasochism is a kind of sexual activity that involves inflicting pain of another person. If an individual is interested with such stimulation, the so called disorder is masochism. If they prefer to administer such stimulation, the disorder is called sadism.

Beating, whipping, and tying are common forms of such activity. Sometimes the acts are just symbolic, it may feel a little pain to spice thing up but not causing real injury.

Management of disorders of sexual preference

All cases of this kind should be referred to a specialist if possible, although the referring clinician should first cassess the problem as follows.

Assessment

The first step is to identify the problem and record its course. The second step is to exclude any mental disorder which may have released the sexual behaviour in a person; who previously experienced sexual fantasies but did not act on them. It is particularly important to seek these causes when the abnormal sexual behaviour appears for the first time in middle or late life. The third requirement is to assess normal sexual functioning, since one of the main aims of treatment is to strengthen this. Whenever possible the patient’s sexual partner should be interviewed. If normal sexual behaviour is inadequate, appropriate treatment is given.

Next, an assessment is made of the role of the abnormal behaviour in the patient’s life. As well as providing sexual arousal such behaviour may be used as a way of coping with loneliness, depression, or anxiety. If so, the patient should be helped to find adaptive ways of coping with these states.

Finally, motivation for treatment is assessed. Often the patient has been urged to attend by another person, usually the partner or the police. In such cases the patient may have no wish to change. Other patients seek help when they become temporarily depressed or guilty, either because the sexual behaviour has caused a problem, or because of some other reason. Such people may lose their motivation quickly when their mood returns to normal. It’s quite common now, it should be consider as special preference but not that abnormal.

erectile dysfunction, Male Enhancement, sex and relationship, Sex Health

Sex Tips for 40 and Above

At age 40 and above, most men, are engaged in toiling to fend for their family, take care of the bills, and trying their best to afford their families a decent lifestyle.

The workload at home and work hits us hard and without any pointers, we tend to neglect our duties, such as take care of the love machine (our bodies).

When our partners hit forty, their bodies start demanding for more sexual attention, we either deliver or fail miserably. So if you are reading this, chances are that your sex life needs a makeover ASAP and perhaps maintaining a hard erection is one of the problems you need to eradicate.

The good thing is, with this article, and you have a chance to nip the problem in the bud and save yourself. The following information works wonders ten times better that any soft erection treatment.

The Mysterious Brain

A man’s sexual drive prevails more in the brain. To be specific, the limbic system and the cerebral cortex areas are critical to performance in the bedroom and the sexual drive. These two parts play a crucial role in your sexual endeavor.

Did you know that you can literary achieve an orgasm when you either think of or dream about an incredible sexual experience? Let us see how this is possible.

The Cerebral Cortex: the gray matter region that forms the exterior layer of your brain. The part of the brain that handles the development of higher and deeper functions such as; thought, sensation and movement.

Now you see when you think about sex, this place gets triggered. The instant you get aroused, the signals coming from this region hasten your heart rate and triggers blood flow to your genitals. The cerebral cortex also indicates the process that forms an erection.

The Limbic System: It covers the hypothalamus, thalamus, amygdala and hippocampus regions. The system is linked to motivation, emotion and sexual drive. Extensive research has uncovered that exposure to sexual arousing images leads to an enhanced activity in man’s amygdalae area of the brain.

To sum up this point, when you have the two part of the brain working together, you will able to achieve, a long and lasting erection. If you are having trouble with your erection, it doesn’t necessarily have to do with your age, you need to reconfigure your thinking.

Combining elements such as active body training, healthy diet and de-stressing, you have the power to keep it up even in old age. Make sure that your head is where it is supposed to be when making love and you will have a great time!

Sex Life Story

The Stuck In A Rut Case

Many couples enjoy each other intimately during the first year or two in their relationship. The sex is passionate. However, as from the third year going on upwards, the intimacy level seems to cool down. The four/five times a week, turns into five times a month.

Some reasons such as stress due to work and children factor in, but there are times when people just fall out of love and intimacy turns into a chore and not a want. Again, poor lifestyles also make it hard for some to maintain a hard erection.

The question is, how do you solve the problem? Will soft erection treatment be of any help? To find out, below are some of the best solutions to evoke the spice that is lacking in your intimate relationship.

The Dinner Cliché

Yes, it might seem as a cliché, but it works. If you are having trouble with your Significant other or sexual partner and you are unable to get it up, get a restaurant. Yes, by inviting them to an excellent restaurant, you can enjoy a meal, enjoy a heartfelt conversation and help the two of you relax.

An atmosphere outside the four walls, you are used to can help you re-energize and get your juices flowing. Just make sure that your dinner is full of aphrodisiac desserts and healthy food. Woo, your lover as you once did and make reassurances.

The two of you without knowing it will ignite the spark that was there before and enjoy sensual pleasure once you get home.

Couple’s Retreat

So you have fallen out of love, and your penis is also not in the mood. If you still want to rekindle the relationship, get time off work and drive/somewhere far away where there are no distractions. A secluded, beach or cabin is an excellent idea.

There is nothing that makes people rekindle their love more than going somewhere they are going to do activities together. Alone time with your partner brings you closer and helps you strike off any element that was causing trouble.

Working together to make a meal or creating a fire for warmth and even general talk helps. A get away for a few days not only mends your relationship, it also revitalizes your sex life!

Adventurous Lot!

To get off the rut you are stuck in, you need to be first of all be honest with your sexual desires. Share them with your partner and let them in turn share theirs with you. Adventure is a great way to re-energize the sensational pleasure in your bodies.

If you like being walked all over in high heels, let her know. If she likes being spanked till her backside turns red, do it, you never know, maybe this is the missing link to a healthy erection!

Cure Erectile Dysfunction & Lasting Longer In Bed