Improving Your Sex Life

Revive Her Drive

Be ready to go through a complete transformation in the way that you think and feel about having sex with your wife or girlfriend! Revive Her Drive is like a Cheat Sheet to woo your woman the way she secretly wants you to, and simply cant express. The solution is based on female-friendly, easy-to-learn strategies that she will love! How nice will that moment be when shes lying in your arms, happy and spent, and she actually Thanks You for helping her to rediscover her sensual self? Shell be grateful that you, Her Man, now that you have the vision and skill to guide her into new, electrifying experiences even if she fights you or resists you now. Women Are sensual creatures. We women want pleasure, intimacy, connection, sensation as much as you do! Ill prove this to you. Once you know how to captivate her, you can turn her into a pleasure-seeking device within 24 hours. Getting that kind of responsiveness is the feedback you need to feel confident this program is working. Discover how Robert rekindled his relationship with Lauren using the tools within Revive Her Drive by watching this short presentation that lays out the whole strategy youll use to transform your intimate life into one of passion, surrender and fantasies-come-true. Continue reading...

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Treatment Of Female Orgasmic Disorder

Female orgasmic disorders involving delayed or absence of orgasm are frequently presenting clinical problems. Thorough evaluation of the onset, development and course of the disorder, psycho-sexual history, medical, psychiatric and psychological features of the patient are required to reveal the often multifactorial aetiology. Medication, other drug and alcohol use history also requires evaluation. Sexual behavior and the quality of the relationship are important considerations in evaluating these disorders. Other parameters of evaluation and treatment are similar to those in retarded orgasmic responses in the male.

Communicating about sex

Start with questions that are relevant to the patient and have the potential to be educational. For a patient with severe hip arthritis, the physician may say, Many people with hip arthritis find that pain and limitation of motion interfere with their sex life has this happened to you (and your spouse) This can be followed by a more general probe about sexual satisfaction based on the patient's response.

Is It Dangerous to Have Sex if Patients Have Angina or Have Had a Heart Attack

Active sex is like other forms of exercise that increase the heart rate and blood pressure. Sex for men without heart problems may cause breathlessness. In men with coronary heart disease, it may cause angina and rarely cause heart attacks. It is difficult to know if, or how often, sex has caused death due to a heart attack because it is difficult to find out and not the sort of question that is volunteered or asked at the time. Although theoretically, vigorous sex can trigger a heart attack (like severe exercise or stress), heart attacks occur for many reasons we do not understand. Most heart attacks do not occur during or shortly after sex.

When Can Patients Have Sex After Heart Surgery Or Angioplasty

Impotence is quite common after a heart procedure. Most patients do not ask about sexual matters with their doctor or the nurses in hospital, probably because when they come into the hospital and when recovering from heart surgery, sex is not the most pressing thing on their minds. There are no rules about sex after either coronary artery surgery or angioplasty. Most of it is common sense. No trials have been done about how, where, and when sex can or should be safely resumed after these procedures. The breastbone (sternum) is usually cut (actually with an electric saw ) to allow the surgeon to get at the heart to do the operation. It takes several weeks for the breastbone to knit. Therefore, it is important that it is not displaced or put out of alignment. If it is, it won't heal and it can be very painful and unpleasant. Although it may take around 12 weeks for it to heal completely, it is probably safe to have sex before the 12-week period is over as long as no pressure is put on...

When Is It Safe to Have Sex after a Heart Attack

It is probably safe to have sex after a heart attack as soon as the person is able to walk half a mile or up a flight of stairs without angina or breathlessness. The time it takes for people to feel in the mood for sex and self-confident varies a lot, from a few weeks to months. Patients and or their partners who are scared to have sex because they think it would be dangerous should speak to their internist or cardiologist.

Object relationships through the Freudian lens

In Freud's topographical model, anxiety was understood as a triangulation of blocked libido (i.e. undischarged sexual feelings). Anxiety was itself regarded as a discharge phenomenon, which precluded the mental representation of deflected somatic sexual impulses. The id was then thought to be responsible for producing anxiety. Freud later understood this formulation to have been an error. In his second theory, anxiety resulted primarily from conflict between the various demands exerted upon the ego by the id and superego. This new conceptualisation of anxiety had important repercussions. It led Freud to shift from an energetic model to a meaning model, whereby childhood wishes were associated with childhood dangers related to loss (e.g. loss of an object, loss of the object's love, loss of or injury to the genital castration and fear of punishment guilt ). Within this model, a threatening wish-seeking expression in consciousness signals danger to the ego, which, in turn, gives rise to...

Female Sexual Function After RPIPAA

Many studies examined sexual function after RP-IPAA and particularly sexual satisfaction, desire, ability to experience orgasm and coital frequency 40, 43, 45, 46 . Results were satisfactory, as most of these aspects are influenced very little by surgery. However, a percentage of patients, ranging from 3 to 18 , were afraid of having stool leaks during intercourse. In contrast, especially in those with postoperatively unchanged or increased coital frequency from 82 to 100 , the appearance of dys-pareunia was a rather frequent complication. Incidence varied considerably, from 0 to 38 41, 42 , stabilising in most works at 25 . Moreover, Farouk found that the incidence of this complication after surgery seems to increase over time 47 .

Epidemiology Of Aidsrelated Lymphoma

Recently, the use of highly active anti-retroviral therapy (HAART) has been associated with a change in the natural history of HIV infection, leading to a 49 decline in AIDS mortality in 1997-8, and a significant decrease in the incidence of Kaposi's sarcoma (KS) and various opportunistic infections. It remains unclear whether the use of HAART will lead to a decreased incidence of AIDS-related lymphoma. In the Multicenter AIDS Cohort Study (MACS), rates of lymphoma increased by 21 per year between 1989-94 and 1996-7, at the same time that rates of KS fell by 66 (4). In the San Francisco cohort study of men who have sex with men (MSM), no significant decrease in the incidence of lymphoma has been demonstrated, when 1993-5 was compared to 1996 (5). In the CDC-sponsored Spectrum of Disease Study, based upon case records from 89 hospitals and clinics in nine U.S. cities, the incidence of primary brain lymphoma decreased from 8.5 cases 1000 person-years in 1994 to 0.9 cases 1000...

The Metaphysics of Mental States

These subjective characters of brain states are probabilisti-cally nomically related to various other properties of brain states, have causal roles, and may have functions. But it is not part of common sense that they are no more than such causal roles or functions, and in fact is a pretty firm postulate of reflective common sense that they are more than that. There has been considerable debate on this point in recent philosophy. Block convincingly fights the battle for common sense with more diligence, engagement, imagination, and intelligence than I possess. Those who are seriously tempted by the idea that the properties of our brain states of which we are aware when we have an orgasm or taste a chocolate chip cookie are not only properties that have a causal role and serve some function, but simply are the properties of having that role or playing that function, should stop at this point and read Mental Paint and Mental Latex (Block 1995b) or its descendant Mental Paint (Block...

Hivhcv Knowledge Among People With Severe Mental Illness and Their Providers

AIDS is the ultimate result of HIV infection, and knowledge about AIDS-related issues among United States and Canadian psychiatric patients appears to be relatively good compared with that of nonpsychiatric groups. Correct responses to AIDS knowledge questionnaires in a variety of psychiatric patient groups ranged from 63 to 80 (Chuang and Atkinson 1996 McKinnon et al. 1996 Otto-Salaj et al. 1998), a comparable accuracy rate to that found in the general United States population (Hardy 1990). Still, many psychiatric patients held critical misinterpretations. For example, in one study 42 were unaware they could be infected by injection drug use (Katz et al. 1994), and in another, 48 believed that careful cleansing after sex would provide protection from the virus (Otto-Salaj et al. 1998). Comparable studies about HCV knowledge among patients have not been completed. Although knowledge is necessary, it is not sufficient to reduce unsafe behaviors.

Anal Cancer And Its Precursors

Anal cancer has traditionally been considered a rare disease, occurring in women at about one tenth the incidence of cervical cancer. However, unlike the declining incidence of cervical cancer, the incidence of anal cancer in women has been increasing at a rate of about 2 per year in the United States and also has been rising in European countries such as Denmark (107). Anal cancer is more common in women than in men, but its incidence is highest among men who have practiced receptive anal intercourse, among whom the incidence of anal cancer was estimated to be as high at 35 100,000 (2). Therefore, the incidence of anal cancer among these men is similar to that of cervical cancer among women prior to the introduction of routine cervical cytology screening. Moreover, because the data used to generate this estimate predated the onset of the HIV epidemic, they presumably reflect the incidence of anal cancer among HIV-negative men with a history of receptive anal intercourse (hereafter...

Treatment Of Sexual Dysfunctionan Integrated Approach

Masters & Johnson (1966, 1970) proposed an approach to the treatment of sexual difficulties that took these problems out of the realm of long-term psychotherapy. Their investigation of sexual functioning, and focused therapy for sexual difficulties, was an important shift in treatment which created the specialty of 'sex therapy'. Their approach was essentially behavioral in its focus and based around the in vivo desensitization, anxiety control and positive rehearsal of appropriate intimacy skills, all incorporated into the 'sensate focus' technique. The second stage of treatment comes out of the developing rapport and the process of establishing the aetiology. It involves giving the patient and their partner permission to discuss openly in a non-judgemental way sexuality, sexual beliefs, sexual feelings and the general emotional context within which the sexual involvement occurs. The fourth component of treatment involves therapeutic interventions specifically targeting sexual...

Problems answers in Appendix 1

The probability of being infected with HIV from each single exposure to one of the following events is approximately unprotected sexual intercourse with an HIV carrier, 0.005 sharing an infected needle for intravenous drug use, 0.007 needlestick injuries in healthcare workers, 0.003. The cumulative probability of being infected P(i) after n occurrences is given by the formula (a) five occurrences of unprotected sexual intercourse with an HIV carrier (c) one needlestick injury in a healthcare worker who subsequently has unprotected sexual intercourse with an HIV carrier three times.

Metaphorical Therapies

Other metaphors including warmth, sweating, and so on, may also be used to enhance the sexual response. Cartoon or dramatic representations of the most erotic involvement have also been used (Araoz, 1982) to rehearse, give permission for and enhance involvement in sexual activity. Symbolic transformation of the parts of the anatomy which may be perceived negatively has also been used to remove anxiety-based inhibitory responses (Araoz, 1982) (e.g. the labia are perceived as the petals of a lovely flower or the penis may be represented as a beautiful ivory or marble column, and so on).

Treatment Of Disorders Of Sexual Interest Or Desire

Disorders of sexual interest have become one of the more commonly presenting disorders and their treatment is by no means straightforward. Schover & LoPiccolo (1982) found that up to 50 of patients presenting in the 'sex therapy clinic' complained of 'inhibited sexual desire' and yet, as Hammond (1990) notes, this is one of the most complex and least successfully treated of the sexual disorders. Careful evaluation is required to exclude medical and psychiatric causes. If of a psychological aetiology, such disorders may arise from inadequacies in sexual stimulation an inability to become absorbed in sexual intimacy distracting negative self talk, thoughts or images anxiety, guilt, or anger or a lack of sexual pleasure resulting in little interest due to there being insufficient pay-off for sexual activity. Traumatic sexual experiences and inadequate parental models are also frequently implicated in the aetiology of disorders of sexual desire (Hammond, 1990). The nature of the...

Treatment Of Premature Ejaculation

Acquired oversensitivity to sexual stimulation has been implicated in those who observe their sexual responsiveness too closely. On that basis, partial genital anaesthesia to reduce erotic stimulation has been used (Doane, 1971) with a later return of sensation during intercourse. Time distortion techniques have been applied to extend the perceived length of time of sexual activity, reducing anxiety and resulting in a reduction of overarousal.

The Enigma of Sublimation

Freud's best known illustration of sublimation can be found in his essay on Leonardo de Vinci, where Freud described how Leonardo's voyeuristic, childish sexual curiosity was transformed into scientific curiosity. Freud wrote, The child's sexual impulses are powerful enough to sexual-ize thinking itself and to color intellectual operations with pleasure and anxiety that belong to sexual processes proper. Here an investigation becomes a sexual activity, and the feeling that comes from settling things in one's mind and explaining them replaces sexual satisfaction (1910). Freud could have been talking about himself.

Female reproductive immunology

The first exposure of the female to paternal antigens (that may be expressed by the foetus) occurs after sexual intercourse. Although sperm bear foreign antigens, they are not recognised by the female's immune system and so are not destroyed. This may be due to non-specific suppressor factors in the semen. Indeed, high molecular weight substances found in seminal plasma have been shown to inhibit antigen-, mitogen- and alloantigen-stimulated lymphopro-liferation. This inhibition may influence subsequent responses after implantation of the foetus.

Characteristics of Rapists

Young men already espouse these rape supportive values by the time they are in junior high and high school. A recent incident in Lakewood, California, is indicative of the way in which boys are socialized to think about girls. The community was stunned when seven young women filed charges against members of the Spur Posse, a group of 25 to 30 popular middle-class teenage boys. The Spur Posse had a competition to scoreon as many girls as possible by whatever means. The boys kept count of the young girls with whom they had sex, many of them scoring 60 or more conquests (Gelman, 1993). One 16-year-old girl reported that during a sexual encounter a Posse member took her clothes and refused to return them unless she had sex with other Posse members. Eight of the boys were arrested on charges ranging from rape to unlawful intercourse with underage girls. Only two of the Spur Posse members were charged, one with having sex with a 10-year-old girl (Smolowe, 1993). The rest of the Spur Posse...

Adverse Events From Cannabis Administration

Some investigators may accept a woman's self-report of reproductive status (e.g., hysterectomy, tubal ligation), abstinence from sexual activity, or use of contraception. However, it is prudent to confirm reproductive status with medical records and to have women with reproductive potential undergo pregnancy testing prior to study participation. Periodic pregnancy testing may be needed if the study extends over a period of time.

Managing Sexual Difficulties

Communication is critical to achieving a positive, enjoyable sexual relationship, and feelings must be dealt with openly and honestly. It is important to convey information about what feels pleasurable and what does not and to experiment with different sexual positions and creative, alternative ways to give and receive pleasure. Our society emphasizes normal or proper ways to obtain sexual gratification, which tends to make sex goal-oriented toward intercourse and orgasm. However, many people find great physical and psychological satisfaction from activities that traditionally have been termed fore-play. One excellent way to decrease or completely eliminate pressures and expectations is to become less goal-oriented by renaming such activities sexplay. Sexual expression may be directed to parts of the body other than the genitals, increasing cuddling, caressing, massage, or other forms of touch, and it may involve experimenting with oral sex, masturbation, a vibrator, or other devices....

Reproductive System Of Female Mammals

Reproductive system, is to produce offspring. The role of the female is very complex She must produce gametes (sex cells) called ova (singular, ovum) or eggs, provide the site for the combination of ova with sperm from the male (fertilization), and nourish and protect a developing fetus during pregnancy. She also must provide for the delivery of offspring from her body to the outside. These functions are carried out by a group of organs or structures and a number of chemicals called hormones. The major organs of the system include ovaries, which produce ova and hormones uterine (Fallopian) tubes that transport the ovum and provide the site of fertilization the uterus, which houses the developing offspring the vagina, which receives the male penis and sperm during sexual intercourse and also functions as a birth canal and the external genitals. Hormones important to the function of the female reproductive system include estrogen and progesterone from the ovaries, and...

Epidemiology of HIV Infection

There are three principal modes of transmission of HIV, as worked out com-mendably quickly within a couple of years of the recognition of the first cases of AIDS in Los Angeles- sexual intercourse, exchange of blood, and perinatal transmission. Sexual intercourse now accounts for some 80 of all infections The risk of transmission is higher to the passive (receptive) partner, generally the female, and higher following anal intercourse (estimated at 1 per episode) than vaginal intercourse (estimated about 0.1 per episode). Another concurrent sexually transmitted disease enhances the risk by an order of magnitude, especially if genital ulcers are present, as in syphilis or chancroid. Obviously the risk is also greatly enhanced the greater the number of different sexual partners. Although trace amounts of virus can be detected from time to time in a range of bodily secretions including saliva, there is no evidence that infection can be transmitted from person to person by kissing or any...

Heterogeneities and dynamical complexities

Several modeling approaches have been applied to capture heterogeneity in patterns of social contact, focusing primarily on the spread of contagious infections in human populations. One strategy is to group individuals into classes (e.g. social status, kinship, or sexual activity) and describe contacts among classes in terms of a mixing matrix, where the entries in each of the cells describe the frequency distribution of contacts per unit time (Blower and McLean 1991). The most important insight gained from these models is that the pattern of contacts between different activity classes has a major impact on parasite spread (Jacquez et al. 1988). Specifically, a high degree of mixing within an activity class results in a more rapid initial spread but a lower population-wide prevalence, as compared to a higher degree of mixing among activity classes. Despite their importance in human epidemiology, mixing matrices have not been applied widely to animal social and mating systems because...

Functional Neuroanatomy Of Penile Function

Ischiocavernosus Erection

The process of ejaculation involves two steps emission and ejaculation proper. Emission consists of the deposition of secretions from the peri-urethral glands, seminal vesicles, and prostate as well as sperm from the vas deferens into the posterior urethra. This results from the rhythmic contraction of smooth muscle in the walls of these organs. The accumulation of this fluid precedes ejaculation proper by 1 to 2 s and provides the sensation of ejaculatory inevitability. Emission is under sympathetic control from the presacral and hypogastric nerves that originate in the T10-L2 spinal cord levels (33). Ejaculation proper (projectile ejaculation) involves sympathetic controlled closure of the bladder neck, the opening of the external urethral sphincter, and contraction of the bulbo-ure-thral muscles for propulsion of the ejaculate. These are striated muscles innervated by somatic fibers carried in the pudendal nerve. Orgasm can occur despite damage to the sympathetic ganglia however,...

The Erotic and Sexualised Transference

More has been written about resistances arising from aggressive impulses than those arising out of loving or sexual feelings towards the therapist. It is not the aim of this general chapter to enter into a detailed discussion of specific types of transference, but a few words on the erotic transference are perhaps indicated since it usually elicits considerable anxiety in the therapist. Think about whether the patient is sexualising the relationship. In contrast to the patient I described above, the one who sexualises the therapeutic relationship is using sexual feelings and fantasies to attack the therapy and the therapist. Another of my patients who was very disturbed would often come to the session reporting the previous night's sexual exploits with young prostitutes. He gave me detailed descriptions of what he did to the young girl and I regularly found myself both repelled and intimidated by these revelations. I felt as if he was relating to me as Think about whether the type of...

The role of unconscious phantasy

Phantasy was considered by Klein to be an innate capacity. She postulated that the pre-verbal infant was born with innate knowledge about sexual intercourse (in a rudimentary form), the penis and the vagina. She believed that these innate phantasies formed the basis of the baby's rich unconscious phantasy life and interacted with external reality. These ideas often alienate those approaching Kleinian thinking for the first time. However, it is well worthwhile persevering since there are many other aspects of her theorising that are very helpful. More specifically, whilst we might well query the notion of innate phantasies, Klein nevertheless offers us a very sophisticated view of phantasy in general, namely, an object-relational view. This perspective suggests that in a phantasy, we are relating in our mind to another person or feel that we are treated by another person in a highly specified way. For example, as we give a talk at work to our colleagues, we think to ourselves ''This is...

Female sex organs produce eggs receive sperm and nurture the embryo

Colon Uterus

The external opening of a female human infant's vagina is partly covered by a thin membrane, the hymen. Eventually the hymen becomes ruptured by vigorous physical activity or first sexual intercourse it can sometimes make first intercourse difficult or painful for the female.

Alice C Thornton David Adkins and Janet Arno Introduction

Sexually transmitted diseases (STDs) are a complex set of syndromes involving more than 25 pathogens acquired through sexual activity. A majority of the 12 million Americans infected with STDs each year are not treated in a public STD clinic (1). This emphasizes the need for all clinicians to be aware of and provide management for STDs according to the Center for Disease Controls' (CDC) STD Treatment Guidelines (2). In an era of emerging antimicrobial resistance and incurable viral STDs, prevention of infection is crucial.

Hormone Production Sexual Development and Activity Hormone Production

Follicle Stimulating Levels Men

Sexual Activity Although there is no reason to expect a disturbance in sexual activity because men who were formerly cryptorchid have normal development and testosterone levels and a normal interest and abilities for sexual functioning, an early report suggested that sexual drive seemed to be diminished (130). Also, men who were formerly cryptorchid have been reported to be less sexually active as adults when judged by frequency of intercourse, although the mean age of onset of masturbation and coitus were not different than normal. It is of interest that a direct relationship was found between frequency of intercourse and both testicular volume and testosterone levels (142). Also, unpublished data from the Children's Hospital of Pittsburgh cohort of formerly cryptorchid men indicate that frequency of intercourse is lower than in control men. These data are not well substantiated.

Natural History Of Cervical Hpv Infection And Csil

Cervix Cancer Lsil

Epidemiologic studies of cervical HPV infection suggest that the age-related prevalence of HPV infection, as determined by polymerase chain reaction (PCR), is highest among women in their late teens and early 20s (8). These data suggest that that most women acquire HPV infection relatively early after initiation of sexual activity. The age-related prevalence of cervical HPV infection declines thereafter, probably through development of immunity to HPV. HPV infection in these women has either been cleared or the level of infection may have been reduced to levels that are undetectable using current technology, perhaps with small foci of latent infection. In addition, low prevalence among older women may represent a cohort effect given changes in sexual behaviors that have occurred in the last few decades. Consistent with a role for HPV in the pathogenesis of anogenital SIL and invasive cancer, the epidemiology of these two diseases tracks closely with risk factors associated with sexual...

The Human Sexual Response

Vaginal Vasocongestion

The sexual response, similar in both sexes, is often divided into four phases excitation, plateau, orgasm, and resolution. The excitation phase, also known as arousal, is characterized by myo-tonia (increased muscle tone) and vasocongestion (the engorgement of a sexual organ with blood). This results in erection of the nipples in both sexes, although the effect is more intense and evident in females than in males. The clitoris swells (analogous to erection of the penis), and the labia minora swell to more than twice their previous size. Vasocongestion of the vagina leads to secretion of fluid, producing vaginal lubrication. Vasocongestion also causes considerable enlargement of the uterus, and in women who have not breast-fed a baby the breasts may enlarge as well. (pigmented areas surrounding the nipples). Pronounced engorgement of the outer third of the vagina produces what Masters and Johnson, two scientists who performed pioneering studies of the human sexual response, called the...

Stage 3 Identifying the Defences

Lisa was in her early thirties, a successful professional woman who came into therapy because of an inability to establish an intimate relationship. She related a painful early history of being ''passed around'' professional carers as her parents travelled extensively. As she was growing up she had experienced her parents as very demanding of her. She had achieved academically and was the perfect hostess, yet she found intimate relationships, especially with men, very difficult. She had only managed to sustain one sexual relationship whilst at university but since then she had remained single. Lisa approached therapy dutifully and with precision. She was exactly on time and even a few minutes' lateness would give rise to self-reproach. She was keen to ''do it right'' and in so doing she constrained the therapeutic space. I soon became aware of ''no-go'' areas, especially in relation to her sexuality. She told me that she was wary of psychoanalysis because it was ''obsessed with sex''...

Diseases Characterized By Vaginal Discharge

Despite being the most common cause of vaginal discharge, the pathogenesis and mode of acquisition of BV are poorly understood. There is ample evidence that it is at least in part an STD. Risk factors for BV include multiple sexual partners, a new sexual partner, douching, and intrauterine device (IUD) as contraceptive method (52). Carriage rates are higher among sexually active women than in sexually inexperienced women (52). There appears to be no counterpart infection in men and there is no evidence that treatment of sexual partners is beneficial (52).

The Gymnosperms Naked Seeds

Strobilus Betina Pinus

There are four clades of living gymnosperms today. The cycads (phylum Cy-cadophyta) are palmlike plants of the Tropics and Subtropics, growing as tall as 20 meters (Figure 30.4a). Of the present-day gymnosperms, the cycads are probably closest to the earliest seed plants. Ginkgos (phylum Ginkgophyta), which were common during the Meso-zoic era, are represented today by a single genus and species, Ginkgo biloba, the maidenhair tree (Figure 30.4b). There are both male (microsporangiate) and female (megasporangiate) maidenhair trees. The difference is determined by X and Y sex chromosomes, as in humans few other plants have sex chromosomes. The phylum Gnetophyta consists of three very different genera that share certain characteristics with

Parthenogenesis is the development of unfertilized eggs

Whiptail Lizard Sex

Parthenogenetic reproduction in some species requires sexual activity, even though this activity does not fertilize eggs. The eggs of parthenogenetically reproducing ticks and mites, for example, develop only after the animals have mated, even though the eggs remain unfertilized. One case that has been investigated extensively by David Crews and his students at the University of Texas is parthenogenetic reproduction in a species of whiptail lizard. There are no males in this species, but females act as males, engaging in all aspects of courtship display and mating, even though no sperm are produced or transferred (Figure 43.2). Whether a specific female acts as a female or as a male depends on her hormonal state at the time, but sexual activity is required to stimulate release of eggs from the ovary.

Menstrual and obstetric history

A 30-year-0ld female schoolteacher was admitted for investigation of 7 kg weight loss, tiredness and malaise of 3 months' duration. Systemic enquiry was otherwise normal. She had two children by her partner in a stable relationship of 5 years' duration. There was no history of drug use and physical examination was initially normal. The diagnosis was unclear until after complaining of a sore throat, she was found to have oral candidiasis. Suspecting an immunodeficiency disorder, a sexual history was then taken and reveaied that 2 years previously, while her partner was abroad, she had unprotected sexual intercourse with a bisexual friend. An HIV test was performed and was positive her partner and her second child were also later found to be HIV-positive. How many sexual partners have you had in the lasl 12 months ejaculation, or orgasm Females Have you had any problems with sexual drive, pain during intercourse or orgasm

Spinal Mechanisms And Pathways

Additionally, bilateral anterolateral cordotomies in humans result in the complete loss of erectile function and block orgasm-associated sensations. Because touch and two-point discrimination are not altered by this procedure, it appears likely that the erotic quality of genital stimulation depends on the ascending fibers running with the spinothalamic pathways for pain and temperature. In monkeys, electrical stimulation along the course of the spinothalamic pathways at the level of the brain stem elicits erection and ejaculation (219). The relevant fibers could be traced to the caudal thalamic intralaminar nuclei, which may be the receiving area for erotic genital sensation. Stimulation of these nuclei in humans has been reported to cause erotic feelings and orgasm. Under normal conditions, it seems likely that psychogenic and reflexic stimuli act in a synergistic manner to produce erections. Psychogenic erections in paraplegic men are usually short-lived, only partial, and lack the...

Female Sexual Arousal Disorder

The diagnostic criteria of female sexual arousal disorder revolve around inability to attain or maintain adequate sexual arousal, including vaginal vasocongestion, lubrication and vaginal expansion to allow satisfactory sexual activity. This disorder may manifest itself as a dyspareunia but is not classified as such if arousal difficulties are the primary aetiology. The use of fantasy with or without masturbation is an important strategy in the treatment of female sexual dysfunctions which centre around insufficient arousal. By its nature hypnosis allows absorption in fantasy and since in the hypnotic state a hypnotized subject may respond to fantasy as if it were reality, hypnotic techniques provide good opportunities for rehearsal of effective sexual functioning. Hammond (1990) provides some ideas about the appropriate suggestions to use to enhance sexual arousal and encourage vaginal lubrication. These strategies may be similarly applied in hypo-active desire disorders, dyspareunia...

Role Of Intrinsic GnRh Deficiency In Mediating Lowamplitude Lh Secretion

Pituitary Leydig Cell Axis

Experiments in the male mouse and rat support an important, but not exclusive, role of GnRH-deficient hypogonadotropism in the hypoandrogenemia of aging (41-44). Evidence to this end includes (1) decreased castration-, naloxone-, and restraint stress-induced LH release in the older rodent (24,42,45-47) (2) diminished in vivo LH pulse amplitude in senescent animals (43,48) (3) reduced in vitro hypothalamic GnRH secretion (49,50) (4) altered GnRH neuronal synaptology (51) (5) preservation of the stimulatory efficacy of GnRH (43,52) and (6) restoration of sexual activity in the impotent animal by fetal hypothalamic neuronal transplantation (53). Although such observations afford important clues for clinical investigation, the regulation of GnRH outflow in the laboratory animal is complex, multifactorial, and incompletely defined.

Trachoma Lymphogranuloma venereum

C. trachomatis is responsible for 30-60 of cases of nongonococcal urethritis (NGU) in men. Possible complications include prosta-titis and epididymitis. The pathogens are communicated by venereal trans-mission.The source of infection is the female sexual partner, who often shows no clinical symptoms.

Symbioses Commensalisms and Parasitisms

Coevolved relationships are not restricted to beneficial or nonbeneficial relationships between plants and animals. They also include an immense number of relationships between animals and other animals, and even between plants and other plants. Among these various types of coevolved situations can be found subcategories such as symbioses, commensalisms, and parasitisms. The first two involve relationships beneficial to varying degrees that feature interactions of increasing physical intimacy between or among two or more species. Parasitism involves an intimate relationship produced through coevolution in which one participant, the host, experiences serious harm or even death through exploitation by the parasite. Predation is probably the most obvious form of coevolution among higher animals such as vertebrates. Modern carnivores such as the canines and felines and their prey are a dramatic example of coevolution at work. Animal hunters over time responded to the improved defenses of...

Sexually Transmitted Proctitis Proctocolitis And Enteritis

Infection of the GI tract may occur from anal intercourse (proctitis) or sexual activity that includes fecal-oral contact (enteritis). Proctocolitis may occur with either route. Proctitis is characterized by anorectal pain, tenesmus, and rectal discharge and may be caused by GC, C. trachomatis including LGV strains or serovars, HSV, or T. pallidum (2). Patients with acute proctitis who practice receptive anal intercourse should be examined with anoscopy to make a specific diagnosis. Although proctitis due to GC responds well to regimens recommended for uncomplicated GC infection, if pus is present on examination of the rectum, 125 mg of ceftriaxone intramuscularly plus 100 mg of doxycycline twice daily for 7 d is recommended. Rectal chlamydial infection due to the non-LGV serovars is unusual and probably responds to the regimens recommended for urethritis. LGV may cause a hemorrhagic proctitis associated with regional lymphadenitis. LGV is treated with 100 mg of doxycycline orally...

Hypogonadism Can Result From Defects at Several Levels

To establish the cause(s) of reproductive dysfunction, physical examination and medical history, semen analysis, hormone determinations, hormone stimulation tests, and genetic analysis are performed. Physical examination should establish whether eunuchoidal features (i.e., infantile appearance of external genitalia and poor or absent development of secondary sex characteristics) are present. In men with adult-onset reproductive dysfunction, physical examination can uncover problems such as cryptorchidism (nondescendent testes), testicular injury, varicocele (an abnormality of the spermatic vasculature), testicular tumors, prostatic inflammation, or gynecomastia. Medical and family history help determine delayed puberty, anosmia (an inability to smell, often associated with GnRH dysfunction), previous fertility, changes in sexual performance, ejacula-tory disturbances, or impotence (an inability to achieve or maintain erection).

Definition And Theoretical Background

Consider efforts to truly isolate the effects of specific dietary practices, occupational exposures, or sexual behavior. The challenges are apparent in that these exposures are not incurred in any sense randomly. The choice of diet, job, or sexual partner is integrally tied to many other dimensions of a person's life, at least some of which are also likely to affect the risk of disease. We obviously cannot ethically or feasibly randomize such experiences, however, and thus must accept the scientifically second-best approach of trying to understand and control for the influences of other associated factors. We must reflect carefully on other known determinants of the health outcomes of interest that are likely to be associated with the exposure of primary interest and make statistical adjustment for those markers, simulating to the extent possible a situation in which the exposures themselves had been randomly allocated. Accepting that the ideal is not attainable in no way detracts...

Anatomical and behavioral adaptations bring eggs and sperm together

But numbers alone do not guarantee that gametes will meet. The reproductive activities of the males and females of a population must be synchronized, since released gametes have a limited life span. Seasonal breeders may use day length, changes in temperature, or changes in weather to time their production and release of gametes. Social stimulation is also important. Sexual activity by one member of a population can stimulate others to engage in it.

Other Cardiovascular Reflexes and Responses

Many physiological states such as eating and sexual activity are also associated with changes in blood pressure. For example, attending business meetings raises mean blood pressure by 20 mmHg, walking increases it 10 mmHg, and sleeping lowers it 10 mmHg. Mood also has a significant effect on blood pressure, which tends to be lower when people report that they are happy than when they are angry or anxious.

Changes In Cervical Cancer Incidence In The United States

Cancer of the cervix is the third most common cancer of the female genital tract, following uterine cancer and ovarian cancer, respectively. From 1950 to 1991, data from the Surveillance, Epidemiology, and End Results (SEER) Program show that the incidence of cervical cancer declined nearly 77 among Caucasian women. However, a slight increase in cervical cancer was detected between 1986 and 1991 among women of all races, rising from 8.0 100,000 between 1981 and 1985 to 8.7 100,000 between 1986 and 1991. It is not clear if this represents a cohort effect reflecting a possible earlier initiation of sexual activity and more sexual partners among American women, or changes in cytology screening in at-risk populations. In 1995, there were 15,800 incident cases of cervical cancer in the United States and 4800 deaths from cervical cancer. For women diagnosed with cervical cancer between 1983 and 1989, the 5-yr survival rate was nearly 67 , and this rate has remained relatively stable since....

Paul B Pritchard III MD

The neonatal state is associated with high levels of serum PRL. Other physiologic elevations of PRL occur during pregnancy, preparatory to lactation, and during lactation itself. Breast manipulation during nursing or sexual activity produces a transient increase in serum PRL (Table 5.1).

Male Erectile Disorder

Crasilneck (1979, 1982) reported an extensive follow-up study of the application of hypnosis to individual patients with erectile dysfunction. Direct suggestions of firm, hard erections can be of assistance, or metaphorical associations of erectile firmness may be suggested in indirect approaches. Suggestions of arm or finger catalepsy may be transferred to erectile functioning (Crasilneck & Hall, 1975 Araoz, 1982 Hammond, 1990). Post-hypnotic suggestions of erectile firmness have proved successful (Crasilneck & Hall, 1975). Hypnotically assisted age regression to a time of successful sexual functioning may be used (Kroger & Fezler, 1976) Hypnotically based desensitization and rehearsal of sexual success may aid in reestablishing confidence and the expectation of successful functioning. Hypnosis may also be used to explore and accentuate past or present sexual fantasies which may then be incorporated into contemporary sexual activity, either in reality with the current...

Specific Activities as Potential Triggers of Acute Myocardial Infarction

Trigger Worksheets For Mental Health

Sexual intercourse (94) Sexual Activity Anecdotal reports have related sexual intercourse to the onset of myocardial infarction (92,93), but there are little systematic data addressing this question. The Myocardial Infarction Onset Study interviewed 858 patients who were sexually active in the year prior to their myocardial infarction 9 reported sexual activity within 24 h and 3 reported sexual activity within 2 h of the index acute myocardial infarction (94). From case-crossover analysis, the relative risk of myocardial infarction following intercourse was 2.5 (95 confidence interval 1.7-3.7). In contrast to the data for physical exertion, where the period of increased risk persisted for 1 h, the post-coital risk remained elevated for 2 h. There was no difference between patients with and without a history of angina pectoris however, it was observed that regular exercise at > 6 METs > 3 X wk decreased the relative risk to a nonsignificant 1.2 (95 confidence interval 0.4-3.7)...

Sexual Aversion Disorder

Sexual aversions are most commonly found to be equivalent to phobic responses, with both anxiety and avoidance being major components of the difficulties. Hypnosis can be used to facilitate systematic desensitization in fantasy and in reality in much the same way as it would be used with other phobic disorders. Facilitation of anxiety control through the use of cued relaxation while thinking of, fantasizing about, or actually involved in sexual activity, is a very useful component of the use of hypnosis. The use of imaginal exposure to the sexual situation using hypnosis also facilitates the desensitization process. Both uses of hypnosis in effect also assist in curtailing avoidance behaviors. Hammond (1990) provides many suggestions to overcome sexual aversion. While the approach to what is essentially a sexual phobia can include a formalized desensitization paradigm, permissive approaches are likely to be more successful in representing sexual activity as an emotional and sensuous...

Sexual Dysfunction Related to the Disease

Sexual desire may be reduced by generalised debility or by the presence of perianal or cutaneous fistulas which alter the acceptance of his her own body image and thus make the patient uncomfortable and embarrassed with his or her partner. More often, the constant presence of symptoms like abdominal pain and diarrhoea are the cause of reduced relational and sexual activity 9 .

Gas exchange and metabolic rate during activity

Flight is not the only reason for elevated metabolic rates. Other forms of locomotion, including both pedestrian locomotion and swimming are responsible for increases in metabolic rate, as are calling (Lighton 1987 Reinhold 1999), sexual activity (Giesel et al. 1989 Woods and Stevenson 1996), thermoregulation (both for flight and in the absence of flight), colony homeostasis (Heinrich 1993), and feeding. For example, Megasoma elephas (Coleoptera, Scarabaeidae) responds to reduced ambient temperatures by endothermic heat production, in the absence of any form of activity (Fig. 3.15) (Morgan and Bartholomew 1982), while in another group of scarabaeids, the winter active rain beetles, males maintain elevated thoracic temperatures and metabolic rates while searching for females (Morgan 1987). In the leaf-cutting ant, Atta sexdens, leaf-cutting activity results in high metabolic rates with factorial aerobic scopes of

F600 Paranoid personality disorder

Personality disorder characterized by excessive sensitivity to setbacks, unforgiveness of insults suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner and a combative and tenacious sense of personal rights. There may be excessive self-importance, and there is often excessive self-reference.

Ulcerative Colitis Pouch Surgery

Cleaner and 87 said that their sex image was better than it had been with a stoma. Similarly, 87 said that they were more at ease socially and 87 that they were more able to pursue normal sporting interests. In our own series, the functional outcome and quality of life was as follows 73 said that they had unquestionably improved, 89 stated that having a pouch operation was definitely worth the effort, none regretted the pouch but 16 were uncertain whether this was the best operation for them. Despite this, 73 would definitely recommend the operation to a friend. When this cohort of patients was interviewed by an independent assessor, 38 stated that they were concerned about going out, 32 said that they were often worried about taking holidays, 26 had minor concerns about normal sexual activity and 7 had severe sexual morbidity. nificant improvement in quality of life. Sexual satisfaction improved, there was much greater freedom to move about and travel without urgency, there was...

The Biology of Emotions

The chemistry of the brain also plays an important part in animal and human emotions. The neu-rotransmitter dopamine is released in copious amounts during periods of pleasure and excitement. Researchers have found that rats experience an increase of dopamine when engaging in activities that appear to suggest play. Research has also shown that if dopamine production is blocked in rats through the administration of a dopamine-blocking agent, the rat's play activity disappears. The effects of the hormone oxytocin have been studied in small mammals and appear to be related to sexual activity and bonding behaviors. In humans, oxytocin is released in mothers who are nursing their infants and is considered to aid in the mother-child bond. Researchers have investigated the role of oxytocin in bonding among voles. If a female vole is injected with oxytocin, the animal will quickly select a mate. When a female vole is given a drug to block oxytocin, however, mate selection never takes place.

The Clinical Effect of Leydig Cell Dysfunction

Howell et al. (22) investigated a cohort of men treated with MVPP, ChlVPP EVA hybrid, or high-dose chemotherapy for several malignancies. They identified a cohort of 35 men with biochemical evidence of mild Leydig cell insufficiency, as defined by a raised LH level and a testosterone level in the lower half of the normal range or, frankly, subnormal. They demonstrated significantly reduced bone mineral density at the hip in these men compared with a similarly treated cohort with normal hormone levels and found some evidence of altered body composition, reduced sexual activity, and mood alterations (42,43). The men were then enrolled into a 12-mo randomized, single-blind placebo-controlled testosterone replacement trial (44). However, during the 12-mo study period, there were no significant improvements in bone density, body

Vital Genitourinary Infections

Several other very important human pathogens are shed in semen and in female genital secretions and are transmitted by sexual intercourse but cause no disease in the genital tract itself. Foremost among these, ol course, are the human immunodeficiency viruses HIV-1 and H1V-2, but the list also includes the human T-cell lymphotropic viruses HTLV-1 and HTLV-2, hepatitis B and C viruses, and the herpesviruses, cytomegalovirus, and (probably) Fpstein-Barr virus. Many more viruses are regularly conveyed between male homosexuals, depending largely on their particular sexual activities and number of partners. These include enteric viruses such as hepatitis A as well as those just listed.

Hypnotic Interventions in the Treatment of Sexual Dysfunctions

Clinical difficulties in sexual functioning can arise at any phase of the normal sexual response and can come about from a wide variety of causes. The phases represented in normal sexual response are respectively sexual interest sexual arousal sexual penetration sexual orgasm, post-sexual resolution and post-sexual feelings. At each phase of the emotional and physical response, male sexual functioning may be hindered. Factors involved in the likely aetiology of the respective disorders are dealt with later.

Characteristics of Offenders

In a comprehensive examination of correlates of a proclivity to sexually harass, Bartling and Eisenman (1993) looked at many of the same beliefs that we have previously examined when discussing perpetrators of rape. They found that there is a significant relationship between the self-professed likelihood to rape and the likelihood to sexually harass. Men who said they were likely to sexually harass a woman also scored higher in adversarial sexual beliefs, rape myth acceptance, and acceptance of interpersonal violence than men who reported no likelihood of harassing (Bartling & Eisenman, 1993). Research by Reilly, Lott, Caldwell and DeLuca (1 992) confirms these findings and extends them by finding that these variables were also significantly related to actual confessed experience as a sexual victimizer as measured by the Koss Sexual Experiences Survey. A vivid example of the demonstration of this constellation of traits is the recent Navy Tailhook incident. During this incident, 83...

Human sexual responses consist of four phases

The responses of both women and men to sexual stimulation consist of four phases excitement, plateau, orgasm, and resolution. As sexual excitement begins in a woman, her heart rate and blood pressure rise, muscular tension increases, her breasts swell, and her nipples become erect. Her external genitals, including the sensitive clitoris, swell as they become filled with blood, and the walls of the vagina secrete lubricating fluid that facilitates copulation. As a woman's sexual excitement increases, she enters the plateau phase. Her blood pressure and heart rate rise further, her breathing becomes rapid, and the clitoris begins to re-tract the greater the excitement, the greater the retraction. The sensitivity once focused in the clitoris spreads over the external genitals, and the clitoris itself becomes even more sensitive. Orgasm may last as long as a few minutes, and, unlike men, some women can experience several orgasms in rapid succession. During the resolution phase, blood...

What is Beauty

It is easy to understand why childlike features in an adult can move someone, in the same way as freckles, full red cheeks, long eyelashes, blond curls, well-defined and full lips. Among men, as we can see in a few of the great sex symbols, the side parting (Clark Gable, Gary Cooper), an untidy mane of hair (Leonardo de Caprio) and daily shaving can only be explained as the desire for a childlike appearance. It is not necessary, however, to have all these attributes one is usually sufficient.

Future Directions

Anger (R.R 2.3) Sexual activity (R.R 2.1) Anger (R.R 2.3) Sexual activity (R.R 2.1) Besides awakening, other triggers of acute myocardial infarction identified in carefully controlled epidemiologic studies include, heavy physical exertion, sexual intercourse, and outbursts of anger. Exposure to substances such as marijuana, cocaine, and heavy air pollution have also been shown to be triggers. The relative risk of physical exertion or sexual activity triggering infarction can be reduced by vigorous exercise several times weekly.

Copulation

Copulation, also called coitus or sexual intercourse, is the process by which sperm are placed directly into the female reproductive system by the male reproductive system, thus assuring that sperm and ova are in close contact for fertilization. It is also a critical adaptation for land-based reproduction, since on land, unlike in the water, sperm released into the environment cannot swim to ova that have also been released. The behaviors leading up to copulation are also important in assuring that gametes of the same species meet for fertilization.

Sexuality and IBD

Must be carefully examined in regard to physical problems, difficulties relating to their sex life and the possibility of pregnancy 11 . Women with UC usually do not present a higher incidence of gynaecological diseases, except those who have undergone ileal pouch anal anastomosis (IPAA) and presenting a higher incidence of dyspareunia. In women with CD, approximately 25 develop organic and functional gynaecological complications such as menstrual irregularity, amenorrhoea, inflammatory pelvic masses, abscesses and fistulae that, in the case of failure of medical therapy, require surgery, which is psychologically invalidating and greatly affect their quality of life and sexuality, especially if associated with laparotomies and creation of stomas.

Epidemiology

In the United States, AIDS was the leading cause of death in young men in 1996. Encouragingly, new AIDS cases reported to the Centers for Disease Control (CDC) declined 12 from 1996 to 1997 (3). Deaths from AIDS also fell by 47 from 1996 to 1997. According to the CDC, AIDS is no longer the number one cause of death in American men aged 25-44 (2,3). This decline in disease progression is believed to primarily result from the use of new, potent antiretroviral medications. An estimated 665,357 people were living with AIDS in the United States as of the end of June 30, 1998 (3). Similar to worldwide trends, the number of AIDS cases among women in the United States has steadily increased to 22 since 1985. Caucasians account for the largest percentage of infected Americans at 45 . Men having sex with men (MSM) account for the greatest percentage of cases (45 ), followed by injection drug users (22 ). Transmission by heterosexual contact, while not accounting for the majority of cases in the...

Outcome Measures

Patient reported complete return to satisfactory sexual functioning with erections sufficient for penetration (confirmed by partner). Partial response. Patient and partner reported some improvement in quality of erections (frequency or rigidity) but insufficient to restore satisfactory sexual performance. Failure. Patient and partner reported no change in erectile functioning from pretreatment levels.

Seroepidemiology

In a cohort of men in San Francisco, it was shown that HHV-8 infection is associated with the number of homosexual partners and correlates with a previous history of a sexually transmitted disease (STD, such as gonorrhoea) and HIV infection (122), suggesting that HHV-8 is sexually transmitted. In homosexual men attending the STD clinic at St. Thomas Hospital in London, in univariate analysis HHV-8 prevalence was correlated with a history of sex with an American, suggesting that HHV-8 was perhaps first introduced into the homosexual communities in the epicenters of HIV in the United States before spreading to Europe (123). At the moment we can conclude that HHV-8 is transmitted among homosexual men during sex, although this does not necessarily imply sexual transmission. Although one group reported the frequent detection of HHV-8 in the semen of healthy Italian donors (141), in North America and the United Kingdom the current consensus is that HHV-8 is present only intermittently in...

Sexism and Racism

Women of color, in contrast, are groomed from birth to be primarily the lovers, mothers, and partners (however unequal) of men of color, who are also oppressed by white men. They are also perceived by white men as workers and as objects of sexual power and aggression. This objectification allows white men to express power and aggression in sexual terms that are not complicated by the emotional entanglements that are present in their relationships with white women. Women have been conceptualized in terms of dual dichotomies white goddess black she-devil, chaste virgin nigger whore the blond blue-eyed doll the exotic 'mulatto' object of sexual craving'' (Rich, 1979). This distance from and access to the source of white male privilege creates differences in the relational power of women of color and white women. The avenues of advancement that are open to white women who conform to prescribed standards of middle-class femininity are not even a theoretical possibility for women of color....

Hiv Disease

The disease is spread through contact of infected body fluids, usually blood, semen or breast milk, by the mucous membranes or directly into the recipient's blood or an open wound. The vast majority of cases of HIV-1 infection in the world are the result of heterosexual intercourse. In the United States, the disease was originally largely confined to homosexual men and then spread into intravenous drug users through the sharing of needles. HIV infection is now rapidly increasing among women, both through intravenous drug use and via sexual intercourse with infected men. Pediatric HIV infection usually occurs during labor and delivery from an infected mother but may also occur earlier in gestation or later, as a result of breast feeding.

Conflating Feelings

The eroticization of feelings of humiliation is a familiar example of the conflation of very different affect systems, which, as I have noted, is a uniquely human attribute. The conflation of feelings of humiliation and erotic excitement can be illustrated by the narrative structure of certain fantasies. These accounts also illustrate the importance of unconscious intentionality as a director of the corporeal imagination. The conflation of erotic feelings and humiliation is evident in fantasies of being beaten.5 I have no way of estimating the prevalence of fantasies of being beaten, but the writer Daphne Merkin, in a New Yorker article (1996), described her life-long preoccupation with fantasies of being beaten on the buttocks. Fantasies of being beaten, controlled, and humiliated may, for some, be necessary to achieve orgasm. A humiliating fantasy of this sort may take the following form one is taken captive by a man (or woman) and is humiliated by being forced to urinate or...

Hindbrain

The major components of the limbic system are the thalamus, the hypothalamus, the hippocampus, the amygdala, and the septum. The thalamus primarily serves to process and relay sensory information to specific parts of the forebrain. The hypothalamus functions in basic survival behaviors such as eating, drinking, sexual activity, aggression, and fear and also helps regulate the body's internal environment. It also regulates the activity of the pituitary gland, which in turn controls hormonal secretions from other glands. The hippocampus and the amygdala are involved in the formation of new memories, the retention of memory, and emotions. The septum also is involved with emotions in that it serves as an area determining experiences of pleasure.

Time After Exposure

Transmission ol HDV occurs by exactly the same routes as does HBV, namely, parenteral, perinatal, sexual, and contact. In developing countries of high HDV prevalence it is likely that most of the spread occurs horizontally among children by contact with open skin lesions, etc., and among adolescents and young adults by sexual intercourse. Perinatal transmission is less common than with HBV. In developed countries of low prevalence, such as North America, temperate South America, Australia, and western and north-

The sexual history

Sexual dysfunction and sexually transmitted diseases are common they are not confined to young adults, or to promiscuous individuals. Although such topics are often avoided by patients because of embarrassment, it is particularly important to ask patients about sexual function and activity and if they have any of the disorders known to predispose to sexual dysfunction. These include diabetes mellitus, alcohol abuse, chronic renal failure, marital difficulty or psychological disorder. Similarly, when sexually transmitted diseases are suspected, e.g. IIIV. hepatitis or pelvic inflammatory disease, a careful sexual history should be undertaken. In females, dyspareunia (pain related to sexual intercourse) or failure to achieve an orgasm are common and are frequently caused by. or lead to. psychological difficulties. In males, loss of libido, premature ejaculation and inability to maintain an erection may also be primarily psychological. Questions should be asked objectively with tact and...

Termite Society

The termites, or Isoptera, differ from the social Hymenoptera in a number of ways. They derive from a much more primitive group of insects and have been described as little more than social cockroaches. Instead of the strong female bias characteristic of the ants, bees, and wasps, termites have regular sex determination thus, workers have a fifty-fifty sex ratio. Additionally, termite development lacks complete metamorphosis. Rather, the young termites resemble adults in form from their earliest stages. As a consequence of these differences, immature forms can function as workers from an early age, and at least among the lower termites they regularly do so.

Diagnosis

A careful history should be taken to address any recent exposure to an enteric pathogen (a diarrheal illness after travel) or a sexually transmitted pathogen (a new sexual partner). The typical interval between the triggering infection and RS is 1 to 4 weeks, but exceptions earlier or later have been described. A prior history of low back pain or recurrent tendinitis is not uncommon. A history of recent antibiotic therapy is relevant to interpretation of any culture results. Prior episodes of uveitis may not be mentioned by the patient unless specifically sought.

Chronic hepatitis B

Humans are the sole reservoir of HBV. Transmission is parenteral, either with blood or body fluids containing HBV (sexual intercourse) that come into contact with mucosa, lesions, or microlesions in the skin. In transmission by blood, the tiniest amounts contaminating syringe needles, ear-piercing needles, tattooing instruments, etc. suffice to produce an infection. Hepatitis B infections from blood transfusions have been greatly reduced by thorough screening of blood donors for HBs antigens, despite which patients receiving multiple transfusions or dialysis remain a high-risk group.

Sperm Selection

During sexual intercourse, several tens of millions of spermatozoa are deposited in the vagina. From these, only one will fertilize the oocyte in the end. The selection takes place at multiple sequential steps, when the ejaculated spermatozoa have to negotiate environments that owing to their physical, chemical, or biological properties act as barriers. The low intravaginal pH is incompatible with sperm survival for extended time periods so that only those spermatozoa that can rapidly enter the less hostile cervical canal remain in play. Cervical mucus slows down sperm progression and this phenomenon is accentuated by the complicated architecture of the cervical canal. Because sexual intercourse and ovulation are not biologically linked in humans, this situation increases the chance of conception by retaining potentially fertilizing spermatozoa in the cervical crypts, thus allowing their progressive release and enabling fertilization during a prolonged time after sperm deposition in...

Post Sexual Distress

A small number of patients present with post-sexual guilt, fears or depression. These phenomena are seldom considered specifically a sexual disorder, but rather a disorder of functioning that has a sexual focus. Self-condemnation over sexual feelings or activities often represents an overly obsessive, anxiety-prone personality with a specific sexual focus. An overly restrictive family background with negative attitudes to sexuality or strict moral or religious restrictions on sexuality are often involved. The nature of this disorder needs to be considered in terms of the socio-cultural and religious background of the patient involved. Early up-bringing and familial attitudes to sexuality are the most likely causes of this disorder

Sexuality

Sexuality is a complex part of life, one that is difficult to define or measure because its expression is special and private for each individual. It has its roots in being human and adds a richness and pleasure to life that goes far beyond the sexual act. Although our society has recently become more open about sex and sexuality, many myths and negative attitudes still exist concerning the sexuality of those who have a chronic illness such as MS. Many people think that a diagnosis of MS means that their sexual life has ended, that it somehow is wrong or inappropriate to continue having sexual needs or to seek information about maintaining a satisfying sexual life. spasticity, bowel and bladder problems, pain, and fatigue. The psychological feelings associated with coping with an illness such as MS, including anxiety and depression, also may interfere with sexual expression and desire. Additionally, the partner of an individual who is coping with illness may experience a similar range...

Endocrine disrupters

Endocrine-disrupting chemicals may be pesticides or metabolites of pesticides, as well as industrial and household chemicals. Oestrogen-active compounds are also found naturally in plants, and are called phytoestrogens. A well-known case of phytoestrogen action is the occurrence of isoflavonoids in Australian clover, Trifolium subterraneum (Leguminosae), which was identified as the cause of impaired sexual performance in sheep. Phytoestrogens from soybean (Glycine max, Leguminosae) are considered as an alternative to oestrogen therapy for menopausal symptoms. Why plants would produce compounds that affect the endocrine system of vertebrates is not clear. Maybe it is just a side effect, while the main function of these compounds lies elsewhere. For example, isoflavonoids are also implicated in signalling between plants and microorganisms in the rhizosphere. Still, it is often assumed that plants have evolved phytoestrogens as a defence strategy against herbivory. If this is the case,...

Assessing Lethality

It is important to recognize the potential lethality of partner maltreatment for both legal and clinical reasons. Browne (1987) compared battered women who killed their partners with others who did not. She identified some patterns present prior to partner homicide the men abused alcohol and or drugs the men made threats to kill their partners the physical attacks increased in frequency and the women sustained severe injuries and the women were likely to have been raped or forced into other sexual acts by the male partner. Similarly, Gelles, Lackner, and Wolfner (1994) used the literature to identify 10 risk factors that are associated with severe violence. Risk factors associated with the male are age between 18 and 30 years unemployment use of illicit drugs having a high school education or less, and or a blue collar job and being raised in a home with domestic violence. Relationship characteristics related to severe violence include the male and female have different religious...

Recreation

Strenuous and protracted exercise is not confined to sport and may occur during recreational activities, such as prolonged and vigorous dancing. These social events may also involve the consumption of alcohol, another potential cause of promoting and protracting hypoglycaemia. Some 'recreational' drugs such as amphetamines have been associated with promoting frenetic behaviour and increased metabolic rate, which may then induce hypoglycaemia in people treated with insulin (Jenks and Watkinson, 1998). Young people with type 1 diabetes who attend clubs or parties often avoid the potential risk and embarrassment of hypoglycaemia by not taking their insulin before the social event. Although this may seem to be a pragmatic approach, the problem with this strategy is that exercise may worsen the pre-existing hyperglycaemia, and could promote development of ketoacidosis. A modest reduction of insulin dose, combined with appropriate high carbohydrate snacks and the judicious consumption of...

Syphilis

Nationwide statistics for syphilis are most important for early syphilis (primary and secondary) because these represent the recently acquired (incident) cases, and the cases that are most infectious. Primary and secondary syphilis are relatively uncommon in older adults, with only 4 of the cases in the U.S. occurring in persons aged 55 yr and older during 1997 (8). Nationwide efforts for syphilis elimination have led to dramatic declines in syphilis rates in all age groups, but between 1996 and 1997, the rates in persons aged 55 and older decreased only slightly. Regardless of age group, early syphilis is highly infectious, with an estimated 30-60 chance of acquiring infection after a single sexual contact (9). In older women, the risk may be higher due to vaginal thinning in the postmenopausal state leading to more abrasions during sexual intercourse. Syphilis should be considered in the differential of any new genital ulceration, especially if the ulceration is painless, or for...

William G Eckert

Forensic anthropologists are experts in the identification of bones and skeletal remains. Their studies provide information about sex, race, age, and time of death. They may also lend support to investigations concerning living cases such as a mix-up of children in a hospital nursery or skeletal identification of persons involved in immigration problems. The forensic anthropologist

Autonomic Seizures

Genital sensation with sexual content and sexual auras arise more commonly from limbic or temporal lobe regions (66). Ictal orgasm or priapism have also been reported (67). Other types of sexual automatisms have been described (68,69). These are motor automatisms (pelvic thrusting) from the frontal lobe and genital sensations (from parietal or limbic structures).

Serum Prolactin

The measurement of serum prolactin is a useful blood test in diagnosing seizure disorders. Prolactin is a polypeptide hormone produced by the anterior pituitary, involved in milk production and endocrine function. Unlike most pituitary hormones, prolactin is under negative hypothalamic control via prolactin inhibiting factor. When seizure activity influences the hypothalamic-pitu-itary axis, prolactin inhibiting factor is presumed to be inhibited itself, and prolactin is released into the circulation. Trimble (105) first showed that serum prolactin rises with generalized epileptic seizures, but not with psy-chogenic seizure-like episodes. Complex partial seizures can also raise serum prolactin. Sensitivity is approximately 90 for tonic-clonic seizures and 70 for complex partial seizures (106). Complex partial seizures originating in the frontal lobes rarely elevate serum pro-lactin (89,90), again emphasizing the difficulty in diagnosis of frontal lobe epilepsy. Several conditions can...

Menstrual Cycle

Physiology Oocyte Development

In human females and other primates that have menstrual cycles, coitus (sexual intercourse) may be permitted at any time of the cycle. Nonprimate female mammals, by contrast, are sexually receptive (in heat or estrus) only at a particular time in their cycles, shortly before or after ovulation. These animals are therefore said to have estrous cycles. Bleeding occurs in some animals (such as dogs and cats) that have estrous cycles shortly before they permit coitus. This bleeding is a result of high estrogen secretion and is not associated with shedding of the endometrium. The bleeding that accompanies menstruation, by contrast, is caused by a fall in estrogen and progesterone secretion.

Time Of Birth

The date of birth is most accurately indicated as 266 days, or 38 weeks, after fertilization. The oocyte is usually fertilized within 12 hours of ovulation. However, sperm deposited in the reproductive tract up to 6 days prior to ovulation can survive to fertilize oocytes. Thus, most pregnancies occur when sexual intercourse occurs within a 6-day period that ends on the day of ovulation. A

Complications

Overall, satisfaction with sex life seems to be higher in patients who have had TUMT than in patients who have had TURP, with 55 of patients undergoing microwave thermotherapy reported as very satisfied vs 21 of those who underwent TURP. However, only 27 of this population were satisfied with their urinary flow after TUMT compared with 74 of patients after TURP.

Rape Myths

The She lied about it myth denies that a rape ever happened. This belief revolves around the common belief that women use the charge of rape to get even with errant boyfriends, to cover up a sexual relationship about which they now have second thoughts, or that resulted in an unwanted pregnancy. Researchers have found that rape has about the same unfounded rate as any other felony crime. And often, when police do find the rape charge unfounded, it is based on their own belief in rape myths (Rozee-Koker & Polk, 1986). She lied about it myths may also involve the belief that women have so-called rape fantasies. Both men and women have fantasies of being taken,having an attractive person find them irresistible, sweep them off their feet, and take over control of sex (with no performance anxieties, pregnancy, or disease risks). In these fantasies, the woman (or man) chooses the partner, the acts, and can end it at will. Few people have rape fantasies that include forced sex with a...

Sexual Function

It is well known that androgen replacement restores sexual function in hypogonadal men. These include sexual desire (libido), sexual fantasies, sexual enjoyment and frequency of sexual thoughts, sexual activities, and erectile function. In younger hypogo-nadal men, sexual performance, including erectile dysfunction, is improved by androgen replacement therapy (13-17). In older men, erectile dysfunction is usually multifactorial other causes, such as vascular, neurogenic, psychogenic, medication-induced, and cavernosal problems may predominate. Improvement in erectile function by testosterone treatment of androgen-deficient older men may be minimal or not as significant as in younger subjects (18-20). Although objective data are limited, it is possible that in androgen-deficient older men whose erectile dysfunction has been improved by phosphodiesterase V inhibitors (e.g., Sildenafil, Vardenafil, and Tadalfil) sexual performance may benefit by cotreatment with testosterone through...

The Sexual Response

The normal male sexual response has three phases desire, lubrication-swelling (excitement, plateau phases), and orgasm. The first response to sexual stimulation is erection, which is accompanied by increases in muscle tension, heart rate, blood pressure, and respiration. This then plateaus with advanced lubrication and swelling and is followed by a series of contractions by which the sympathetic nervous system allows for ejaculation (emission). Finally, the body returns to its resting state during the resolution stage. and orgasm. The factors involved in the desire phase are not well understood but clearly may be affected by MS. Increased sexual excitement is accompanied by muscle tension, increased blood flow to the clitoris, and the beginning of vaginal lubrication, which then plateaus with increased lubrication and swelling. Orgasm consists of rhythmic contractions of the muscles around the vagina and uterus.

Erectile Dysfunction

Open prostatectomy can have an adverse impact on sexual performance. The review conducted by McConnell and associates revealed postoperative erectile dysfunction in 32 , 16 , and 18 in patients undergoing perineal, retropubic, and suprapubic prostatectomy, respectively (21). In theory, leaving an intact and nonviolated prostatic capsule should mitigate against the development of either incontinence or erectile dysfunction. It has been assumed that preexisting erectile dysfunction may be more pervasive than previously suggested. However, the study conducted by Ertekin et al. documented postoperative erectile dysfunction in more than half of patients who claimed preoperative potency and subsequently underwent suprapubic prostatectomy (25). In that study, however, there was no clear connection between surgical technique and development of erectile dysfunction. As anticipated, the incidence of retrograde ejaculation is very high, occurring in about 77 of all cases, a rate similar to that...

Androgen Deficiency

Men with chronic renal failure exhibit features consistent with classical androgen deficiency reproductive manifestations, including gynecomastia, impotence, testicular atrophy, impaired spermatogenesis, and infertility, as well as somatic disorders of bone, muscle, and other androgen responsive tissues (1,2). However, only a single well-controlled study has examined androgen replacement therapy in men with uremia (34). Nineteen men who were receiving regular hemodialysis were randomized to receive either oral testosterone undecanoate (240 mg d) or placebo for 12 wk. Libido and sexual activity were increased, but hemoglobin was unchanged. There were no adverse clinical effects or hepatotoxicity. Effects on bone, muscle, cognition, and well-being were not reported. Further studies examining physiological androgen replacement therapy in men with chronic renal failure, notably using nonparenteral therapies in view of the increased bleeding risks in men with chronic renal failure, would...

Time Distortion

Time distortion may be used to deal with both delayed and premature ejaculation as well as anorgasmia or delayed female orgasm. Time may be expanded so that the time to reach orgasm appears long and satisfying or time may be truncated to bring the orgasmic response earlier in the arousal cycle. Such a distortion of perceived time is then generally carried over into an alteration of actual time in the sexual situation, most likely as a result of anxiety reduction, attitude and cognitive change and sexual rehearsal of effective functioning.

Depression

Communication, everyday life, and sexual satisfaction seem to be the areas of marriage that are disrupted most. The degree of disability is a major determinant of the extent to which the marital relationship is affected. Spouses may feel frustrated about a reduction in shared pleasurable activities, helpless in response to seeing their wife or husband in pain, and fearful regarding their future. 3. Sexuality. Persons with rheumatic diseases may be vulnerable to sexual problems because of the physical changes caused by the illness and their attendant emotional distress. However, studies comparing rheumatic disease patients with healthy persons in comparison groups have found no differences in sexual satisfaction, although arthritis patients do report declines in sexual satisfaction with time. Sexual dissatisfaction is greater for those with severe joint involvement or greater functional disability. In one study, some spouses reported not having sex for fear they would hurt their...

The Menstrual Cycle

Under normal conditions, ovulation occurs at timed intervals. Sexual intercourse may occur at any time during the cycle, but fertilization occurs only during the postovulatory period. Once pregnancy occurs, ovulation ceases, and after parturition, lactation also inhibits ovulation. The first menstrual cycle occurs in adolescence, usually around age 12. The initial period of bleeding is called the menarche. The first few cycles are usually irregular and anovulatory, as the result of delayed maturation of the positive feedback by estradiol on a hypothalamus that fails to secrete significant GnRH. During puberty, LH secretion occurs more during periods of sleep than during periods of being awake, resulting in a diurnal cycle.

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