A sustained and painful erection (Priapism)

Priapism refers to an erection, usually painful, that lasts for more than four hours and is not necessarily the result of sexual arousal. This condition develops when blood in the penis becomes trapped and unable to drain. The condition is most common between the ages of 5 to 10 years and 20 to 50 years.

Priapism needs to be treated immediately to avoid the likely outcome of permanent erectile dysfunction. Priapism does not usually resolve itself so medical attention is definitely required.

Causes of Priapism

Although up to one third of cases have no specific cause, other conditions causing priapism include:

Sickle cell anemia. Up to 42% of men with sickle cell will develop priapism.

Alcohol and cocaine abuse

Spinal cord trauma or conditions

Trauma to the genital area

Medications such as Desyrel used to treat depression, Thorazine used to treat certain mental illnesses

Medications to prevent blood clotting and drugs used to treat blood pressure can all cause priapism

Anesthesia

In rare cases some types of penile cancer can cause priapism
Penile injections designed to treat impotence can also cause priapism

Penis changes that cause priapism

In a normal erection the veins narrow and that’s what makes the penis get bigger and hard. In priapism the veins do not relax after an orgasm so the penis remains erect and usually becomes very painful.

Diagnosis of Priapism

The doctor will ask about your medical history and examine you. He may do some tests, possibly an ultrasound or angiogram and blood tests.

Treatment of Priapism

Treatment is aimed at making the erection go, then treating the underlying cause, if one can be discovered. Treatment is usually in the form of injecting a decongestant medication, often following the draining of a small amount of blood from the penis to relieve pressure. A local anesthetic to numb the penis is usually given prior to this procedure.

Surgery will be required to restore normal blood flow if the cause is a ruptured artery. A surgical shunt for low flow priapism may be required. This is inserted into the penis to divert the blood flow and restore normal blood flow and function.

People with sickle-cell disease usually receive intravenous fluids and a transfusion of blood. If that fails to have the desired effect surgery may be required.

Some men experience semi-erect and painless erections. This is usually a result of trauma where too much blood flowing into the penis, rather than narrowed veins, is the cause. This can be treated via surgery or with a catheter threaded through blood vessels in the groin.

Importance of medical intervention for Priapism

Always seek treatment as quickly as possible to avoid any future problems of permanent erectile dysfunction.

Source: About.com

Stoned Sperm

A study by scientists Andrology in the Department of Gynecology and Obstetrics at the University at Buffalo School of Medicine in New York 2005 found that regular smokers of cannabis have less seminal fluid and lower sperm counts. The sperm were much more likely to swim too fast too early and were, therefore, too exhausted to reach their goal fertilization of the female’s egg. Cannabis smokers also produced less sperm and less seminal fluid.

The findings from the study compared the sperm of 22 cannabis smokers and 59 fertile men. It is the first research that compares the sperm’s so called ‘swimming behavior’. The cannabis smokers were all ‘frequent users’, meaning they smoked cannabis an average of 14 times in one week over 5 years.

Dr Berkman reported that it was unclear exactly why cannabis has such an effect on sperm. One of the possibilities is that the active ingredient THC (tetrahydrocannabinol) stimulates the sperm cells and disturbs their swimming. It may block mechanism that are designed to weed out (get it?!) malfunctioning sperm.

Obviously many cannabis smokers father children. The researchers believe that if a man has borderline sperm counts cannabis smoking may ‘push them over the edge into infertility’. At the present time the researchers are unable to say how long it takes for the sperm to get back to normal if the drug is stopped.

At present this is only one study with quite a small sample. Fertility does depend on a lot of other factors, exercise, diet, health of the individual, cigarette smoking etc. Further research is needed.

Source: About.com

Birth control and family planning

Definition

Which form of birth control you choose depends on a number of different factors, including your health,how often you have sex,and whether or not you want children.

Alternative Names

Contraception; Family planning and contraception

Information

Here are some factors to consider when selecting a birth control method:

• Effectiveness -- How well does the method prevent pregnancy? Look at the number of pregnancies in 100 women using that method over a period of one year. If an unplanned pregnancy would be viewed as potentially devastating to the individual or couple, a highly effective method should be chosen. In contrast, if a couple is simply trying to postpone pregnancy, but feels that a pregnancy could be welcomed if it occurred earlier than planned, a less effective method may be a reasonable choice.
• Cost -- is the method affordable?
• Health risk -- What are the potential health risks? For example, birth control pills are usually not recommended for women over age 35 who also smoke.
• Partner involvement -- The willingness of a partner to accept and support a given method may affect your choice of birth control. However, you also may want to re-consider a sexual relationship with a partner unwilling to take an active and supportive role.
• Permanence -- Do you want a temporary (and generally less effective) method, or a long-term or even permanent (and more effective) method?
• Preventing HIV and sexually transmitted diseases (STDs) -- Many methods offer no protection against STDs. In general, condoms are the best choice for preventing STDs, especially when combined with spermicides.
• Availability -- Can the method be used without a prescription, provider visit, or, in the case of minors, parental consent?

  CONDOMS

• A condom is a thin latex or polyurethane sheath. The male condom is placed around the erect penis. The female condom is placed inside the vagina before intercourse. Semen collects inside the condom, which must be carefully removed after intercourse.
• A condom must be worn at all times during intercourse to prevent pregnancy.
• Condoms are available in most drug and grocery stores. Some family planning clinics offer free condoms.
• Latex condoms help prevent HIV and other STDs. Polyurethane condoms may give some protection against STDs, but they are not as effective as latex ones.
• About 14 pregnancies occur over 1 year out of 100 couples using male condoms, and about 21 pregnancies occur over 1 year out of 100 couples using female condoms. They are more effective when spermicide is also used.
• Risks include irritation and allergic reactions, particularly to latex.
• Condoms are used only once.

SPERMICIDES

• Spermicides are chemical jellies, foams, creams, or suppositories that kill sperm.
• They can be purchased in most drug and grocery stores.
• This method used by itself is not very effective. About 26 pregnancies occur over 1 year out of 100 women using this method alone.
• Spermicides are generally combined with other methods (such as condoms or diaphragm) as extra protection.
• Warning: The spermicide nonoxynol-9 can help prevent pregnancy, but also may increase the risk of HIV transmission.
• Risks include irritation and allergic reactions.

DIAPHRAGM AND CERVICAL CAP

• A diaphragm is a flexible rubber cup that is filled with spermicidal cream or jelly.
• It is placed into the vagina over the cervix, before intercourse, to prevent sperm from reaching the uterus.
• It should be left in place for 6 to 8 hours after intercourse.
• Diaphragms must be prescribed by a woman's health care provider, who determines the correct type and size of diaphragm for the woman.
• About 5-20 pregnancies occur over 1 year in 100 women using this method, depending on proper use.
• A similar, smaller device is called a cervical cap.
• Risks include irritation and allergic reactions to the diaphragm or spermicide, and urinary tract infection. In rare cases, toxic shock syndrome may develop in women who leave the diaphragm in too long. A cervical cap may cause an abnormal Pap test.

VAGINAL SPONGE

• Vaginal contraceptive sponges are soft synthetic sponges saturated with a spermicide. Prior to intercourse, the sponge is moistened, inserted into the vagina, and placed over the cervix. After intercourse, the sponge is left in place for 6 to 8 hours.
• It is quite similar to the diaphragm as a barrier mechanism, but you do not need to be fitted by your doctor. The sponge can be purchased over the counter.
• In April 2005, the FDA granted re-approval for the Today sponge to return to the U.S. market.
• About 18 to 28 pregnancies occur over one year for every 100 women using this method.
• The sponge may be more effective in women who have not previously delivered a baby.
• Risks include irritation, allergic reaction, trouble removing the sponge. In rare cases, toxic shock syndrome may occur.

COMBINATION BIRTH CONTROL PILLS

• Also called oral contraceptives or just the "pill", this method combines the hormones estrogen and progestin to prevent ovulation.
• A health care provider must prescribe birth control pills.
• The method is highly effective if the woman remembers to take her pill consistently each day.
• Women who experience unpleasant side effects on one type of pill are usually able to adjust to a different type.
• About 2 to 3 pregnancies occur over 1 year out of 100 women who never miss a pill.
• Birth control pills may decrease a woman's risk for ovarian cancer.
• Birth controll pills may cause a number of side effects, including dizziness, irregular menstrual cycles, nausea, mood changes, and weight gain. In rare cases, they can lead to high blood pressure, blood clots, heart attack, and stroke.

THE MINI-PILL

• The "mini-pill" is a type of birth control pill that contains only progestin, no estrogen.
• It is an alternative for women who are sensitive to estrogen or cannot take estrogen for other reasons.
• The effectiveness of progestin-only oral contraceptives is slightly less than that of the combination type. About 3 pregnancies occur over a 1 year period in 100 women using this method.
• Risks include irregular bleeding, weight gain, and breast tenderness.

THREE-MONTH PILL (SEASONALE)

• In 2003, the FDA-approved an estrogen and progestin pill called Seasonale. It is taken for three straight months, followed by one week of inactive pills.
• A women gets her period about four times a year, during the 13th week of her cycle.
• Seasonale is available by prescription.
• Fewer than 2 out of 100 women per year get pregnant using this method.
• The risks are similar to other birth control pills. Some women may have more spotting between periods.
• The pills must be taken daily, preferably at the same time of day.

PROGESTIN IMPLANTS

• Implants are small rods implanted surgically beneath the skin, usually on the upper arm. The rods release a continuous dose of progestin to prevent ovulation.
• Implants work for 5 years. The initial cost is generally higher than some other methods, but the overall cost may be less over the 5-year period.
• The Norplant implant has been removed from the U.S. market. A similar implanted rod system, Implanon, is available. It works for 3 years.
• Less than 1 pregnancy occurs over 1 year out of 100 women using this type of contraception.

HORMONE INJECTIONS

• Progestin injections, such as Depo-Provera, are given into the muscles of the upper arm or buttocks. This injection prevents ovulation.
• A single shot works for up to 90 days.
• Less than 1 pregnancy occurs over 1 year in 100 women using this method.
• Sometimes the effect of this medication lasts longer than 90 days. If you are planning to become pregnant in the near future, you might consider a different method.

SKIN PATCH

• The skin patch (Ortho Evra) is placed on your shoulder, buttocks, or other convenient location. It continually releases progestin and estrogen. Like other hormone methods, a prescription is required.
• The patch provides weekly protection. A new patch is applied each week for three weeks, followed by one week without a patch.
• About 1 pregnancy occurs over 1 year out of 100 women using this method.
• Estrogen levels are higher with the patch than with birth control pills. In theory, higher estrogen levels may increase your risk of blood clots.

VAGINAL RING

• The vaginal ring (NuvaRing) is a flexible ring about 2 inches wide that is placed into the vagina. It releases the hormones progestin and estrogen.
• A prescription is required.
• The woman inserts it herself. It stays in the vagina for 3 weeks. At the end of the third week, the woman takes the ring out for 1 week. The ring should not be removed until the end of the 3 weeks.
• About 1 pregnancy occurs over 1 year out of 100 women using this method.
• Side effects (nausea, breast tenderness) are less severe than those caused by birth control pills or patches.
• Risks include vaginal discharge and vaginitis, as well as those similar to the combined birth control pill.

IUD

• The IUD is a small plastic or copper device placed inside the woman's uterus by her health care provider. Some IUDs release small amounts of progestin. IUDs may be left in place for 5 - 10 years, depending on the device used
• IUDs can be placed at almost any time.
• IUDs are safe and work well. Fewer than 1 out of 100 women per year will get pregnant using an IUD.
• Risks and complications include cramps, bleeding (sometimes severe), and perforation of the uterus.

NATURAL FAMILY PLANNING

• This method involves observing certain body changes in the woman (for example, changes in cervical mucus and basal body temperature) and recording them on a calendar to determine when ovulation occurs. The couple abstains from unprotected sex for several days before and after the day ovulation is believed to occur.
• This method requires education and training in recognizing the body's changes, as well as a great deal of continuous and committed effort.
• About 15 to 20 pregnancies occur over 1 year out of 100 women using this method (for those who are properly trained).

TUBAL LIGATION

• During tubal ligation, a woman's fallopian tubes are cut, sealed, or blocked by a special clip, preventing eggs and sperm from entering the tubes. It is usually performed immediately after childbirth, or by laparoscopic surgery.
• Tubal ligations are best for women and couples who believe they never wish to have children in the future. While viewed as a permanent method, the operation can sometimes be reversed if a woman later chooses to become pregnant.

VASECTOMY

• A vasectomy is a simple, permanent procedure for men. The vas deferens (the tubes that carry sperm) are cut and sealed.
• A vasectomy is performed safely in a doctors office using a local anesthetic to numb the area.
• Vasectomies are best for men and couples who believe they never wish to have children in the future. While often viewed as a permanent method, they can sometimes be reversed.

EMERGENCY ("MORNING AFTER") BIRTH CONTROL

• The "morning after" pill consists of two doses of hormone pills taken as soon as possible within 72 hours after unprotected intercourse.
• The pill is available without a prescription for purchase by anyone 18 years and older.
• The pill may prevent pregnancy by temporarily blocking eggs from being produced, by stopping fertilization, or keeping a fertilized egg from becoming implanted in the uterus.
• The morning after pill may be appropriate in cases of rape; having a condom break or slip off during sex; missing two or more birth control pills during a monthly cycle; and having unplanned sex.
• Risks include nausea, vomiting, abdominal pain, fatigue, and headache.

UNRELIABLE METHODS

• Coitus interruptus is the withdrawal of the penis from the vagina prior to ejaculation. Some semen frequently escapes prior to full withdrawal, enough to cause a pregnancy.
• Douching shortly after sex is ineffective because sperm can make their way past the cervix within 90 seconds after ejaculation.
• Breastfeeding. Despite the myths, women who are breastfeeding can become pregnant.

CALL YOUR HEALTH CARE PROVIDER IF:

• You would like to further information about birth control options
• You want to start using a specific method of birth control that requires a prescription or needs to be inserted by a health care provider
• You have had unprotected intercourse or method failure (for example, a broken condom) within the past 72 hours, and you do not want to become pregnant

Source: About.com

Male Orgasm

The male orgasm is a complex experience. The major function of the male orgasm usually includes the ejaculation of sperm. The function of the female orgasm is less clear although there are many common features in the male and female orgasmic experience.

In the 1950s Robert Kinsey, a scientist who first explored human sexuality in any detail, described the orgasm as, 'an explosive discharge of neuromuscular tension'! There is still a lot about the male orgasm that is not entirely understood.

Ejaculation and the Male Orgasm
The male orgasm is not just about ejaculation. It is possible to have an orgasm without ejaculation.

Pre-adolescent boys may experience an orgasm without ejaculation.

Some men do not have an ejaculation until several seconds after orgasm.

Some men, who are incapable of ejaculation, are still capable of orgasm.

Some men, may experience several ejaculations and go on to have further orgasms, but without ejaculation.

Physical Experience of the Male orgasm

The male orgasm seems to have psychological as well as a physical effects. Some men say that they have a more focal experience, feeling the orgasm in the scrotum and the genital area. Other men report their orgasm as a feeling that spreads over to some parts of the body and others that their orgasm is felt all over. How much of this is physical and how much psychological is difficult to judge.

What Happens During the Male Orgasm?

During the male sex act a man's pelvic thrusts become less voluntary and other muscles of the body begin to contract rhythmically. As the orgasm begins, heart rate, blood pressure and respiration all increase.

Some Differences Between Male and Female Orgasms

Although many experiences have common ground there are differences between the male and female orgasm.
The female orgasm has the effect of sucking sperm towards the egg,(the ovum) in the fallopian tube.
Women can often experience an orgasm for a longer period of time than a man.
Women are, in general, more capable of rapidly returning to orgasm immediately after an orgasmic experience.

Control over Ejaculation during Orgasm

Ejaculation is often felt to be disappointing if it happens too quickly. A disappointment that may also be felt by your sexual partner.

Kinsey reported nocturnal emissions in 85% of men, an obvious sign of sexual excitement and in most cases, orgasm. During adolescence and the early 20s this can happen once or twice a month.

Male Multiple Orgasms

Men report multiple orgasm more than women in the Kinsey report. 14% of women reported being multiple orgasmic and between 15-20% of men.

Source: About.com

Laptops and male infertility

Are you sitting with your computer on your lap? A small research project from Yefim Sheynkin at the State University of New York has found that the heat from your laptop can elevate the temperature of your scrotum by up to 2.8 degrees. That may be nice but the problem is that there is a well demonstrated link between high testicular temperature and infertility.

The team at the university plan to test whether laptops have a significant effect on the performance and quality of sperm when they look at a larger sample of men. If you are having problems concieving a baby with your partner it is maybe worth considering. Men whose sperm quality is hampering fatherhood are often told to try cooling the temperature of their scrotum by wearing looser pants and by avoiding hot baths.

The study team headed by Yefim Sheynkin have suggested heavy laptop use over a number of years "may cause irreversible or partially reversible changes in male reproductive function". We wait to see. In the meantime it may be worth placing your laptop on a table or moving it as far away from your testicles as is workable to increase your chances of parenthood.

Source: About.com

Premature Ejaculation

Defined as ejaculating before either partner achieves satisfaction, premature ejaculation is one of the most common complaints affecting most men from time to time. It often occurs early in relationships when sexual excitement, some anxiety and over stimulation are common features. It is also more common in younger men who are finding out about sexual activity and sexual relationships and men of all ages after a long period without sex. Premature ejaculation is rarely caused by any underlying disease, structural or physical problems.

Performance Anxiety

Performance anxiety may be the major cause and talking to your sexual partner about your feelings may well help. Remember it is a common experience for men and women. Relax more and the problem often goes away.

Techniques to Prevent Premature Ejaculation

Self Distraction to prevent premature ejaculation

If your arousal levels are getting too high and a climax is beginning, take a deep breath and think about something else, something very boring if possible. When you are less aroused but maintaining an erection you can then continue.

Stop and Start Method for premature ejaculation

If you find yourself nearing climax withdraw your penis from your partner and allow yourself to relax enough to prevent ejaculation. By starting and stopping sexual stimulation you can learn to prolong the sex act.

Squeeze Methods can help prevent premature ejaculation

This method involves either the man or his partner squeezing (fairly firmly) the end or the tip of the penis for 10 to 20 seconds when ejaculation is imminent, withholding stimulation for about 30 seconds, then continuing stimulation. This can be repeated until ejaculation is desired. The stop and start method can be used with the squeeze method as well.

Desensitizing Creams for premature ejaculation

Creams can be used to desensitize the end of the penis. They act like a local or tropical anesthetic. Thicker condoms (or two condoms) can also desensitize by decreasing sensitivity and therefore stimulation, thus prolonging the sexual act.

More Foreplay prevents premature ejaculation

Stimulate your partner to a state of high arousal before you have your genitals touched, that way ejaculation and orgasm can be achieved about the same time.

Masturbation to prevent premature ejaculation

Practice different methods by yourself. Getting to know your feelings and sensations gives you the chance to gain confidence.

Remember getting good at sex and overcoming premature ejaculation can take a bit of time. Practice makes perfect. If you find that things are not improving then help is available from sex therapists who are experts in this field.

Source: About.com

Healthy Sperm

If you are planning a family it is worth spending a few moments to read this article. It could help you maximize your fertility

How men make babies!

50 million sperm are discharged during just one ejaculation in a normal healthy male. It can take that many to begin the journey to the vagina, the cervix and on to the fallopian tubes. From all those millions of sperm only one or two will make it to a mature egg that is ready to be fertilized.

The state of sperm health research

Until recently the health of sperm was identified by microscopic observation of their speed and shape. Advances in genetics looking at the composition of sperm are leading to more accurate identification of healthy sperm.

Current research indicates that male sperm counts are declining in many parts of the world, including America and Europe. In one Danish study a 1 per cent decline per year in the sperm count has been recorded over the last 50 years. Such findings have their critics particularly in the face of more recent studies that suggest no such decline. On balance however the current wisdom suggests there is some decline in sperm counts and there seems to be consensus on at least most of the causes; the most important of which are listed below:

What can I do to make my sperm fit, healthy and potent?

It is important to remember that there is still a lot to be learnt about male fertility. We do know that a lot of the things that make sperm healthy are the things that are healthy for men anyway. So even if it takes a while for your partner to get pregnant you are not wasting your time!

Tight trousers and underwear, synthetic material and heat.

It has been suggested that all these affect fertility so get out those baggy cotton boxers! Keep the family jewels cool. It is known that the scrotum area needs to be 4 degrees lower than body temperature.

Climate.

Some experts suggest that climate and seasons, countries, regions and different years may all have an influence on sperm counts and fertility. One piece of research showed the sperm count in New York was much higher than Los Angeles, that Finland's was higher than Britain.

Hot tubs.

Frequent hot tubs have been shown to lower sperm counts. Have a shower instead.

Alcohol.

Alcohol can damage sperm. Limit your alcohol intake when you are trying to improve your fertility.

Drugs.

There are a number of drugs that affect fertility, amongst them are steroids, cytotoxic drugs used in cancer treatments and opiates. Contact your family doctor if you are on any long term medication that you are worried may affect your fertility. Doctors should always inform you of any side effects but it is always easy to check if you have forgotten.

Environmental toxins.

There is quite a lot of conflicting evidence about the substances that may cause damage to sperm. It is known that radiation causes damage and birth defects. Other substances thought to have a detrimental effect on sperm are some perfumes containing phthalates, some types of pesticides, organic mercury, polychlorinated biphenyls, estrogens in water supply. Many of these substances are still the subject of on-going research.

Smoking.

Smokers have been shown to be up to half as fertile as non smokers.

Time of day

Sperm counts are higher in the morning so a.m. intercourse is best for baby making!

Excessive ejaculation and prolonged abstinence.

Both are known to affect the number and quality of sperm. Intercourse every 2 to 3 days helps maintain volume.

Diet.

A healthy balanced diet is important. Healthy body healthy sperm!

Supplements

Folic acid in combination with zinc sulfate has been shown to have often dramatic effects on sperm counts. Some men when taking these supplements increased their sperm count by as much as 74 per cent.

Seek advice

If you are concerned about your potency and think your sperm are not fit and healthy contact your family doctor. Some simple tests on your semen and a look at your general fitness will provide some answers.

Source: About.com