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Erectile dysfunction / Impotence.

Erectile dysfunction (ED), a more precise term for impotence, has been defined as the inability of the male sexual performance. A more specific defination diagnosis of E.D. is the persistent of repeated inability for atleast three months to attain & /or maintain an erection sufficient satisfactory sexual performance.

Question: What are the causes of sexual weakness / E.D. ?
Ans: E.D is generally categorized as :-

1. Organic : 
a) Endocrinologic
b) Neurologic
c) Vascular

2. Psychogenic :
a) Performance anxiety
b) Relationship conflict
c) Sexual inhibition]
d) Conflicts over sexual preference
e) Sexual abuse in childhood
f) Fear of pregnancy or sexually transmitted diseases.

3. Mixed/Others:
a) Age
b) Depression-Tension
c) Smoking
d) Diabetes
e) Renal, Hepatic diseases.
f) Heart diseases
g) Anger
h) Some medications
i) recreational drugs like alcohol, marijuana, cocaine, heroine also cause E.D

Question: How does erection occur ?
Ans: For erection to occur, several parts of the body must together. The brain sends messages to control the nerves, hormone levels, blood flow and muscles that cause and erection. If anything interferes with these messages or if any part of the system does not function correctly; an errection will not occur.

The brain controls all sexual functions, from perceiving arousal to initiating and controlling the psychological , hormonal, nerve and blood flow changes that lead to an errection.

Arteries deliver the extra blood to the penis that causes it to stiffen, veins then drain the blood out of the penis after intercourse.

Nerve impulses relay signals of arousal and sensation to and from the penis.

Hormone, including testosterone, control the male sex drive. Testosterone is secreted by the testicles.

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Question: Investigation required to know the exact cause of sexual weakness/E.D.?
Ans:
a) Physical Examination
b) Blood Test & Urine Test
c) Pipe Test
d) Penile blood flow studies
e) Sleep monitoring

Question: What are the modern & scientific treatments available for sexual weakness/E.D ?
Ans: E.D. is no more a non curable disease. the treatment of ED has changes a lot with increasing knowledge of causes of E.D. & day to day research of new methods & drugs. the following are the international and scientific treatment procedures to be used by qualified therapist in the treatment of male sexual weakness/E.D.
a) First line therapy
- Oral examination
- Hormone replacement therapy
- Vacuum constriction device
- Counseling ,Psychotherapy, Couple therapy.
b) Second line therapy
- Intracavernmosal self-injection
- Intraurtheralalalprostadil
c) Third line therapy
- Penile prostheses
- Corrective surgery (Penile revascularization etc)

Premature ejaculation

Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time. As long as it happens infrequently, it's not cause for concern.
However, you may meet the diagnostic criteria for premature ejaculation if you:

  • Always or nearly always ejaculate within one minute of penetration
  • Are unable to delay ejaculation during intercourse all or nearly all of the time
  • Afraid of foreplay as it may cause ejaculation
  • Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition. Medications, counseling and sexual techniques that delay ejaculation — or a combination of these — can help improve sex for you and your partner.

Night fall

Night fall or wet dreams is a very common occurrence among men, especiallyamong adolescents. This condition is characterized by involuntary ejaculation during sleep in the night or in the early hours of the morning. The problem of night fall can be very frustrating for young men because most of the times they don’t understand the reason for it and also because it is a very embarrassing thing to discuss with not only their parents but also with their peers. And more over so called “Desi Doctors” , “Quacks” , make youngsters believe it to be a disease which will harm their future, which in reality is not true.

The frequency of these nocturnal emissions varies from person to person, most men only experience this condition in their adolescent years but few may face it all their lives. So as you can see this condition is very common and nothing really to worry about.

Dhat

Dhant syndrome is a condition that is found in the Indian cultures in which male patients report that they suffer from premature ejaculation or impotence/E.D. due to leakage of sperm before intercourse .Male’s also believe that they are passing semen through their urine.Dhant comprises vague somatic symptoms of fatigue, weakness, anxiety, loss of appetite, guilt and sexual dysfunction attributed by the thought / misconception of loss of semen duringwatching erotic material or sexual talk or foreplay or during passing of stool and while passing urine.

Nil Sperm Count

Azoospermia (commonly referred to as “no sperm count”) is a male fertility issue many men face.Azoospermia , as the name suggests , refers to the condition in which there are no sperm in the semen. This diagnosis can come as a rude shock, because most men with a zero count have normal libido; normal sexual function; and their semen looks completely normal too. The diagnosis can only be made by examining the semen under a microscope in the laboratory.
Azoospermia needs to be differentiated from aspermia, or the absence of semen. This is a rare condition, in which the man cannot produce a semen sample, because he cannot ejaculate. This could be because of a psychologic problem called anejaculation; or a medical problem called retrograde ejaculation, in which the semen is discharged backwards into the urinary bladder, rather than forwards.

Pre & Post Marital Counselling

Pre-marital counseling is helpful for many couples who want an overview of challenges that face them once they marry. They want to establish the best possible relationship patterns to serve them for years to come. Other couples have specific issues they are stuck on, and they would like to examine and move ahead on these issues before they marry. Many couples enjoy the opportunity to uncover the many expectations, spoken and unspoken, they have about each other in preparation for marriage.
Post-Divorce counseling can help couples and/or their children that have conflict over family issues post-divorce. There may be tension involving financial issues, parenting schedules, new relationships or new or unanticipated circumstances such as new health or educational needs for a child. The family can minimize conflict and resolve these issues with family mediation.

Anorgasmia in women

Anorgasmia the medical term for regular difficulty reaching orgasm after ample sexual stimulation, causing you personal distress. Anorgasmia is a common occurrence, affecting a significant number of women.
Orgasms vary in intensity, and women vary in the frequency of their orgasms and the amount of stimulation necessary to trigger an orgasm. In fact, most women don't consistently have orgasms with vaginal penetration alone. Plus, orgasms often change with age, medical issues or medications you're taking.
If you're happy with the climax of your sexual activities, there's no need for concern.

Lack of desire

Sometimes patient is not completely impotent but it has less degree of symptoms such as early discharge, small size and low erection. If these symptoms are not cured & patient with the fear of time go to his partner for sex he develops lack of desire. Also he feels if he does perform sex with his partner he will fail and this fear of failure results in impotency.

Hymen Re-Construction

Hymenorrhaphy or hymen reconstruction surgery is the surgical restoration of the hymen. The term comes from the Greek words hymenmeaning "membrane", and raphḗ meaning "suture". It is also known as hymenoplasty, although strictly this term would also includehymenotomy. The basic aim is to cause bleeding during post-nuptial intercourse, which in some cultures is considered proof ofvirginity.

Hymen surgery

Simple repair
Repairing the hymen consists of piecing together the remnants by closing the tear, and is carried out as closely as possible to the date of the wedding. It is a very simple procedure that must be done at least 1 month to 6 weeks before the wedding so the internal sutures have disappeared completely. This procedure is well tolerated under local anaesthesia.

Vaginaplasty
This is a 'larger operation' where an incision is made in the vaginal membrane and both sides are pulled and stitched together. This must take place plenty of time before the wedding night so that it has time to heal. The procedure is performed under intravenous sedation and on an outpatient basis. The operation takes between one and two hours, and the patient can return to work the next day. Dissolvable stitches are used.

Varicocele

A varicocele is a varicose vein of the testicle and scrotum that may cause pain and lead to testicular atrophy (shrinkage of the testicles).

In healthy veins within the scrotum, one-way valves allow blood to flow from the testicles and scrotum back to the heart. In a varicocele, these valves do not function properly, causing blood to pool enlarging the vein. Experts believe that the raised temperature that results from the pooled blood in these blocked veins can decrease sperm count and motility of sperm and increase the number of deformed sperm. In fact, the incidence of varicoceles increases to 30 percent in couples who cannot have children.

Laparoscopic ligation or open surgical ligation, performed by a urologist, is the most common treatment for symptomatic varicoceles.

Phimosis

  • Phimosis is the inability to retract the foreskin behind the head (glans) of the penis.
  • Symptoms of phimosis may include:
    • difficulty or pain during urination,
    • painful erection or painful intercourse

How is phimosis diagnosed?
Your doctor can diagnose phimosis based on a thorough history and physical examination. Additional tests are usually not necessary.
How is phimosis treated?
Treatment is surgical.

Undescended testicle

Undescended testicle occurs when one or both testicles fail to move into the scrotum before birth.

Causes:
Most of the time, a boy’s testicles descend by the time he is 9 months old. Undescended testicles are fairly common in infants who are born early. The problem occurs less often in full-term infants.

Some babies have a condition called retractile testes and the health care provider may not be able find the testicles. In this case, the testicle is normal but is pulled back out of the scrotum by a muscle reflex. This is able to occur because the testicles are still small before puberty.

Testicles that do not naturally descend into the scrotum are considered abnormal. An undescended testicle is more likely to develop cancer.

Bringing the testicle into the scrotum can improve sperm production and increase the chances of good fertility.

Misconceptions about sex

Q. Does masturbation causes Weakness?
Ans.: No.

Q. Is nightfall a Disease?
Ans.: No.

Q. Can the size of penis decrease with age?
Ans.: No.

Q. Does dhant cause weakness?
Ans.: No.