Premature Ejaculation
What is premature ejaculation?
Premature ejaculation happens when a man has an orgasm sooner than he or his partner would like. Premature ejaculation can happen before or shortly after penetration.

There is no set time for how long a man should “last” during sex. But when a man has an orgasm before he wants to, he loses his erection and can’t continue with intercourse. Premature ejaculation can be frustrating and embarrassing. You may feel you don’t have enough time to enjoy sex. You may have difficulty satisfying your partner. For some men, embarrassment about premature ejaculation can cause problems with intimacy and damage their relationships. Different people define premature ejaculation in different ways. For some, it happens any time you climax before your partner is able to; for others, it is only a problem if it occurs more than fifty percent of the time. Either way, stopping premature ejaculation is a top priority for men who suffer from it.



Premature ejaculation is a common problem among men. About 30 percent to 40 percent of men have this problem at some time in their lives.



What causes premature ejaculation?
A number of emotional and physical factors can lead to premature ejaculation. It may happen when a man becomes too excited or stimulated, or if his penis is very sensitive. It may also happen if a man is nervous or uncomfortable with a new partner. Premature ejaculation is considered a psychological problem in some cases. Some doctors believe that early sexual experiences, especially those in which you may have hurried to reach climax in order to avoid being discovered, may establish a lifelong pattern. However, biological factors also may cause premature ejaculation. Some studies comparing men who experience premature ejaculation with those who don't have found differences between the two groups in certain hormone levels and in the sensitivity of their genitalia.

Other common causes include the following:

Anxiety about performance
Guilty feelings
Depression
Stress
Relationship problems
Men who have a low amount of a special chemical called serotonin in their brain may have problems with premature ejaculation.

Before stopping premature ejaculation effectively, you need to figure out why it's happening in the first place. Many times, psychological factors play a major role in the problem. Men suffering from depression often have trouble lasting long in bed. To stop premature ejaculation, you often need to get to the bottom of any existing psychological problems. Sometimes, physiological factors are to blame for an inability to last long in bed. Brain chemistry plays a big role, and figuring out any problems with brain chemicals can help stop premature ejaculation in a significant number of men.



Is premature ejaculation a sign of a serious health problem?
Not in most cases. Rarely, premature ejaculation results from a serious health problem, such as nervous system damage from surgery or trauma.



How is premature ejaculation treated?
Premature ejaculation often goes away without treatment. But if it happens frequently, and it makes you or your partner unhappy, you may want to talk to our doctor. There are several possible methods for delaying orgasm. or stop premature ejaculation, including Herbal pills, leaf-therapy and topical Herbal creams. The trick to stopping premature ejaculation, then, is finding out what works for you best. Talk to our Doctor



Behavioral methods
Behavioral methods are helpful for more than 95 percent of men who have premature ejaculation.

In this type of treatment, you practice controlling your ejaculation, either alone or with a partner.

In the start-and-stop method, you or your partner will stimulate your penis until you feel like you are about to have an orgasm. Then the stimulation stops for about 30 seconds. Once you regain control of your response, stimulation begins again. This process is repeated 3 or 4 times before you allow yourself to have an orgasm.

In addition to using a behavioral method, you may want to try thought distractions. For example, while you’re being sexually stimulated, think about the names of players on your favorite sports team.


Psychological assistance
Anxiety, depression and other emotional issues can lead to premature ejaculation. For these issues, seeking the help of a psychologist, psychiatrist or OUR DOCTOR may be helpful. Couples therapy may also help if relationship problems are the cause of premature ejaculation.


Medical treatments
Several medical treatments may help men who have premature ejaculation. Combination of herbal medicines which breaks up psychosomatic circles at various levels and reduces hyper-excitability of higher and lower centers these factors relieves and individual and enable better-timed performance. Strengthens all vital organ and brings pleasure and increase sexual vigour. Removes general debility. Also acts as an energizer and improves muscle tone. Effective in spermatorrhoea and increases density of semen., acting on high centre's of brain and locally
on the sex organs, directly & indirectly reduces anxiety and calms the individual, continued use for sometime corrects premature ejaculation.

For some men, simply wearing a condom can help delay ejaculation because it may make the penis slightly less sensitive.

www.roymedicalhall.com

SEX PERFORMANCE FAILURE IN MALE OR IMPOTENCE-TYPE & REMEDIES
SEX performance failure is a matter of great concern for A male person as he thinks himself as active partner and so wants always to be best strong sustained performer in Sex which is considered as sign or exhibition of his musculanity or his existence in as boss in Male dominant society,if this sexperformance is disturbed or fails he starts thinking that every thing has been lost .This Sex performance is always so much in mind of a common person that many starts assuming as some defect in it although they are normal because there is always a will to achieve perfection and superiority in it and such idea becomes more If they are exposed to sexual stimulation through talk,stories or video shows where Sex is depicted as most form of pleasure and enjoyment.
For this defective Sex performance, a word IMPOTENT has been coined on broad base where a man cannot perform sex with a partner .It simple meaning is a failure, weakness inability lack of interest in Sex performance. A man may start feeling that he is impotent but actually he is normal or may start that he has lost dignity, masculinity, wholeness and every thing of his life submitting himself to extreme psychosocial insult. But broadly Impotence in man means that even after proper stimulation(what to talk of normal self stimulation as self stimulation is common in adult male and male unlike female becomes stimulated or erection of penis occurs on mild exciting exposures as remembering,talking,watching listening of opposite partner or her activities dress,eye contact,voluntary or involuntary touch of normal body part,sexual organs or sexual act of another) stimulated by talking exhibition,touch or sexual excitation by opposite partner or sexual activities through book,videos,internet or mms etc man does not achieve proper erection or straightening,thickening ,hardening and tightening of Penis with or wthout secretion of small seminal fluid .But There are many degrees of erectile difficulties too. 1.Some men may be able to achieve an erection, but are not able to maintain it. 2.others become erect, but not extremely rigid. 3. Many others only have problems when they are with a new partner or with a long-time partner. And in last 4., there are those who cannot achieve an erection at all even after stimulation by an opposite sex partner to the extent of heating and touching G-spots. Although these problems has been categorises as stated above but still in most of them psychosocial disturbance remains the core factor.
Person may be suffering from a physical or emotional problem (or both) for which there are definite solutions. If problem is of an emotional nature, the following tips may help. If erectile problem arises from a medical condition, there are now many new medicines, surgeries and therapies that can help restore sexual health. What ever the nature of problem may be,but rule of its correction lies in the fact that almost every man has difficulties with erection at some time in his life and everybody feels some time in himself at least that he suffers from erectile dysfunction(ED). Therefore affected person is not abnormal only , nor he is alone affected by this non performance of Sex.There is no need to suffer in silence. Don't let once embarrassed in alone or silence and let this embrassment of self realisation of less or non-performance or less or no erection keep one from sexual health and happiness.Following type of disturbances of erectile dysfuctions are seen.
1.Low Performance Anxiety :It's not unusual for a man to have an occasional episode of impotence in form of less performance , after drinking alcohol or after a particularly stressful day. However, if he places too much emphasis on the incident and harbors fear that it may happen again, the anxiety itself may become a cause of erectile difficulties. Some men engage in thinking that distracts them or take away from their sexual performance. One should try to take over such low performance incidence and relieve the anxiety about having to get an erection.For such anxiety if no heed is paid to it or a good stimulation is kept such beliefs goes away and man resume strength again.
2.Stereo type Performance: One problem in people's sex lives is that many perform it through certain ruts and routines and they don't have much novelty. For example they always have sex at 11:30 at night with the lights off, with the same foreplay, and so on. Their sex lives are relatively invariant. Soon,their partner becomes about as exciting to them as a flounder. They can change their sex lives by incorporating some variety- go to another place or a different setting. Vary the routine. Buy wife some new night dresses or change sleeping room ,decorate with flowers,perfumes music or change stye of four play or coitus . one shoul spice up sex life.
3.Stress and Strain: Stress and Strain arising either from performance anxiety or from other life situations, can also be a culprit in erectile problems. Relaxation exercises are helpful. Deep breathe or progressive muscle relaxing, where the person consciously tenses and relaxes each part of the body in sequence. In and of itself, as a treatment for impotence, relaxation is not effective but it may be a good first step for someone trying to improve their own functioning.
4.Tension with partner: Marital or relationship difficulties are notorious contributors to sexual problems. Anger, resentment, and hurt feelings often spill into the couple's sex life, turning the bedroom into a battlefield. This situation is especially likely to develop if partners are non communicative ,communication of personal or familial matters and forgetting them during performance is the key for good sexual performance and isappearance of this Impotence.Familial tension,children problems or any other social disturbances or a bad environment will spoil a good Sex completely labelling it charge on male partner mostly as Impotence.
5.Walk,talk and Eat Sex: During Sex it is a rule that one should walk or prepares one self and partner in the way that Sex is only focus in mind.all narrations should be on this topic to increase libido and bring good orgasm and once achieved than one should enjoy in the way as Sex has been served as food. and only r expression of each other sex difficulties ,demanding sex or informing one’s failure or goodness clearly and methodology to get it corrected by showing action as to cover partner’s fault will bring forth good performance.
6.Be ware of intoxication:Now a days Alcohol intake is rampant in society and many think that after intoxication with Alcohol (both Partners) stimulat sex and performance but it is untrue as Alcohol causes uncoordination and synerigism leading to less performance.Similiary smoking,drugs or medicines neither can arouse or contemplate sex .so always avoid them before sex.Bear bars,dancing girls,nudity,aphrodisiac medicines and alluring music and robust lightening etc may bring orgasm but have got no relation with better performance as man gets easy and early excitement so until very experienced usually not able to sustain erection for long time and a second arousal and action is mandatory to satisfy the partner.Aphordisiac medicines and intake of Hasis or cocaine or Ganza or any opoid is habit forming and durg dendance can destroy life completely so never bring it in Sex which can be conducted normally between two willing partner in a lucid environment,time and place.
7.Positivity is the rule:So many fearful history/story or activity or imprint of past experience may surround a new comer or less performer or person suffering from some diseases or in older age as they cannot perform or make partner irritated,please donot think negative,please fullfil good hope aspiration and confidence with very positivity in mind ,a self determined confident can break any stone.many person think that they are not performer and many partner feel that they are not good looking or physique or age wise difference or married un married status to stimulate another partner or of not that status by education,position or economically to suit the partner but this doesnot have any place in Sex performance.As you meet with partner with zeal and positive energy and once sex is started ,sex itself is so inductive that such feelings goes away once orgasm is aroused by touching G spots or Clitors or by shacking and masturbating penis every thing is forgotten and a good performance comes so be remain positive,Every body some time feels that he is impotent as has either got slight erection with immediate discharge or late erection with no discharge or for female pain ,bleeding and loss of virginity or exposure of bad name and reputation all want to inhibit sex but good and strong determination overtake it immediately.
8.Win partner’s confidence: as stated in my article “Sex in recent perspective and modern definition”Partner is very important,now a days both partners are called active in SEX.a lazy partner can damage an active sex and a superactive cooperative partner cam make a sluggish boring sex into a dynamic charming sex.interaction,coordination,co-operation,harmony and synerigm is the backbone of good Sex.so always inuce partner bring eachother by stimulation Gspot of each other and start Sex with full orgasm and then perform all 04 stages of Sex taking and giving pleasure giving time to sex,simple rapid erction,penetration and ejaculation is a dry sex as we take food in hurry without any spice and taste to calm hunger but a good cuisine by a good cook with good presentation and slowly eating taking time provides us really interest pleasure and satisfication of food.
9.Read sex and know Sex: sex is so much important method of mental and physical relaxation in the life of an individual and its important in familial life is very strong as it brig better adhesion,cohesion,understanding,bondage liking and love that it canot be taken as a very light just to perform activities as we have modernised and cultured are food taking habit ,same way good,better and best Sex is very important so to know about Sex is mandatory ,how to bring good arousal or orgasm,increase intimacy and cooperation in performance and then sustaining the act.Now a days many formulas,medicines,mantras and tabeez and therapy are sold by socalled sex specialist to enlarge Penis size(most of the time Penis size is normal as first 2 inch of Vagina is only sensitive sexually for penetration so a normal 4-6 inch of Penis is enough for good Sex and no medicine can enlarge the penis except Sidlefinal(vigra) or tadalafil help some patients really suffering from Erectile Dysfunction(ED) in male patients only or testosterone only in castrated or otherwise Addison or any other hormnone disease) or to bring sex arousal,desire or bring Orgasmor increase sustainability ,to icrease power and duration of strokes and delayed ejaculations etc,But most of them are bogus ,only good practise under guidance of expert counselling bring forth good result,understand that sexual organs are as good parts of Body as other parts any abnormal behaviour with them as sex with children or mentally retarded persons may cause much harm bleeding,tear etc leading to death of child.similiarly to sex with animals or introducing different electrical devices and toy ,stimulation by binding with chains ,rods etc is unwanted and regarded as perversion and abnormal sex.
10.Good advise and expert counselling:Sex is so less discussed and expressed in personal life that a affected person remain under quota of days and years under depression and anxiety leading to irreversible stage of Impotence.if a good advise is sought such fear and apprehension goes immediately and rejuvenate the person.some time person is suffering from infections of genitilia as in Female and it remains cause of pain and bleeding during Sex which makes many female a freezed female or male is suffering from phimosis,hypospadius or epispadius or infection of glans or herpes or other infection of genitilia or tight and short frenulum or hydrocoele,spermatocoele,varicocoele or hernia or systemic disease of metabolic disorder as diabetes or protein loosing enteropathy or any systemic cardiovascular or renal or hepatic or hormonal abnormality that sex will remain low until root cause is treated and corrected,.In our country in middle aged person most of doctors donot ask about sex performance nor patient states it but diabete mellitus do affect sex performance too and actual attention should be paid to it ,same after menopause most female donot like to state any thing about sexual life but here Sex is not important to maintain good bondage and relations by relaxation but also helps us to burn good amount of calorie.
Therefore,IMPOTENCE is not necessarily a sex performance failure but lack of better understanding coordination and cooperation between partners because of their covered and hidden beliefs and lack of knowledge of Sex leading to somany psychological disturbance.
Dr.d.r.nakipuria

** author is a HIV & Sex Specialist
0943434143550
http://drnakipuria.jivisha.com

-HOW TO PERFORM ? A MODERN PERSPECTIVE & DEFINITION
---DR.D.R.NAKIPURIA
SEX although cannot be discussed or expressed openly in our society as it is a topic of intense personal matter and allowed to discuss by grown up or adults or matured in personal couple group or an advice by seniors to upcoming matured adults to practise it as per their experience.Beside this our society think its discussion may destroy social fabric as may stimulate youngster in early sexuality or indulgence of adults and old in abnormal sexuality beside legal partner.SEX has been broadly defined as meeting of two partners of opposite sex or meeting two external genital organs of opposite sex whether any pleasure or satisfication is achieved by this or not.As man has got Penis and it is penetrated in to vagina through introitus by man so he is called active partner and as female simply receives Penis so is called Passive partner but modern detail analysis of patients achieving full satisfication and pleasure by Sex and persons remaining unsatisfied and psychosocially disturbed after Sex has redefined this definition of SEX.
it is very important for a man being active partner realise very much,any defect in performance of Sex either of arousal or desire or LIBIDO or lack of excitement on stimulation by seeing or reading sexual activities or seeing or touching opposite sex partner or her activity or by stimulation through eyes,talk,exhibition or touch of partner or self induced involuntary erection( under influence of body hormones) i.e.,tightening,straightening,thickening and hardening of penis with slight secretion of seminal fluid over glans region with easy slipping of foreskin over it or called as ERECTION or it may be failure of pushing this erect penis in partner’s vagina through introitus or Ext.Genitilia Vulva or discharge of Seminal fluid into vagina immediately after penetration i.e.,EARLY EJACULATION resulting in loss of satisfication and pleasure as strokes gives more and more pleasure which reaches to peak slowly keeping pace with speed and force applied for stroke.by penis.The force is more applied by a thickened, tightened and straight erected penis ,that is why a good erection is mandatory for a good performance of sex.lack of such erection is called Erectile Dysfunction(ED).This enjoyment becomes more excited as partner’ vagina contracts involuntary or by active contraction of Pelvic muscles by partner is increased.Therefore ,apathy of partner,less excitement or lack of attention in sex by partner or deficiency of active cooperation and actions in Sex also result in getting good satisfication and pleasure.Female although by misnomer called as inactive partner but actually her cooperation from the stage of getting desire,attention,environment of Sex to getting aroused or ORGASM either by self excitement or by stimulation by partner by look,touch or reading books or watching video etc.,or after fourplay by partner which is very important in Female as they are less easily excited or reach peak to Orgasm and without her active cooperation Sex remains less pleasant and unfulfilled in satisfication.Role of Accessory or additional Genital organs like Body contour,Pubic Hairs,Moustache,hairs over chest/limbs(in Male),Face color of Body,color of Iris of eye ,shape,size of Eyes,Placement of Eyebrows,straight beak like nose,mouth opening,lips ,fore head,style of hairs over scalp,and contour,fullness,bogginess tightening,size ,shape resistance,compressibility of breast with coloring of areola and stargtening of nipples with shape of belly being scaphoid and centrally placed elliptical umbilicus ,proturbance of buttocks,broadening of Hips with slender slim straight fingers,toes limbs, soft palm and sole with absent of hairs over any part of body except straight small shiny pubic hairs with thickened puffy Labial folds is very important as they play indirect role to either initiate Sex or Libido or later to maintain Sex or good performance or more sustainable play.Early Ejaculation leads to flaccid ,small ,shrunken Penis which freezes immediately a Male partner as female is either at peak of orgasm or getting arousal for orgasm ,such sudden discharge makes her completely dissatisfied and uncomfortable as shrunken flaccid penis cause no dilatation of strchable compressed thickened roomy vagina or touching of cervix of Uterus or deep pockets of vagina around cervix or fournix .So either expressed by modern educated Female partner voluntarily or involuntarily expressed by face or body activities immediately or on subsequent occasion of Sex initiation by male partner who realises this as his biggest failure and suffer from self realised Gilty consciousness leading to Psychosocial disbalance leading to further damage in getting arousal or erection or performance of sex and vice versa.
Therefore,we have realised that sex is no more confined to one partner ,one partner may be less active but other partner can make him co active similiarly an uninterested or freezed partner can freeze or dissatisfy another partner.Previously if one partner is not performing particularly a male doesnot get erection or arousal to perform sex we called it IMPOTENCE and similiary a female doesnot get pregnancy after intercourse we called IMPOTENCE but it should be better termed as INFERTILITY but now a days sex has been better defined as stated above in following stages.
StgageI: Self or stimulated Aroursal and arousal of partner with full Orgasm.
Stage II:Erection of penis with penetration and reception of such erected penis by an active partner.
Stage III;-Mantenance of coital activites by cooperation of both partner ( both are as active no active or passive nomenclature).
StageIV;-Discharge or Ejaculation of Seminal fluid in vagina or condom or ouside gradually allowing partner to cool gradually and slowly.
Sex in different positions or in different openings beside vagina as Anal or oral or Arm pit sex is not called perversion but resource to achieve more pleasure and satisfication in which any of these four stage is fortified depending on which separate methodology we adopt like kissing or messaging of Breast increase stage I and III ,oral ,armpit and anal sex improves stage II,III and IV.Sex with children or old people or desibilated or mentally retarded people or against will of partner forcefully or under intoxification with alcohol ,drugs or sleeping pills is a crime and this needs no discussion as it is always painful .SEX IS A RESOURCE TO BRING JOY, HAPPINESS , SATISFICATION,LIKENESS,ADHERANCHE AND MORE HUMAN BONDAGE WITH LOVE IN LIFE IF IT PAINS EITHER PARTNER DURING OR AFTER PERFORMANCE IT SHOULD NOT BE CALLED SEX.Sex ,how much discarded for discussion openly in society is need of human being to mantain its progeny in universe but Sex is the only simple natural method of producing future generation but every act of Sex is not necessarily mean production as Human has reached highest growth in Animal Kingdom,he has to restrict the number of his progeny,that is why he has learned to enjoy Sex without production by developing so many methods of contraception like Condom,spermicidal jelly tablets,foams ,vaginal condom,pessary jellies,IUCDs ,oral contraceptive pills/injections/patches for female and male,sex during safe period,external ejaculation etc.,
Lack of availability of partner in war time battalions leads to sex with same sex partner and gradually a class of people called as GAY or LESBIANS has evolved in society in good number across the globe,they are perfect Humanbeings with good mental and social judgement but they got enjoyment with same sex or HOMOSEXUAL.They are no more defined as perverted or sexually abnormal persons ,many countries provide their activity as normal as Sex among HETROSEXUAL exist.even in India,their such act is now not under any screeing of unlawful activity.gradual wecome and accept of these Homosexual have added further definition of SEX where in Stage II erection of penis or penetration of Penis may or may not present and partner may utilise aroused finger /hand /toe or any soft compressible toy/instrument after excitement for penetration or simply with external genitilia or with accessory Genital organs as mentioned above completes further stages of SEX where Ejaculation may or may not come avoiding need of any contraception to avoid pregnancy but needed to arrest spread of sexual transmitted disease like HIV,Syphlis,Gonorrhoea,Herpes,Hepatitis B & C ,etc.But in this Homosexual activity which is regarded as abnormal activity by many as it turned very purpose of SEX and human existence of Love for man and woman keeping our social fabrics intact also involves very intimate cooperation of both partners,here both partners are highly active members as lethargy or apathy of one partner cannot initiate this at all and this strong love,affection,intimacy,bondage and physical contact has lead to more increase in their numbers in society .
In modern time if SEX is not performed keeping intact all 04 stages of SEX with strong bondage affinity and adherence of both partners leads to breaking in relations or crimes where SEX is performed by male as simple formality of penetration after slight or full erection knowing nothing about arousal of opposite partner and ejaculation ,satisfication,pleasure,enjoyment is left behind or never asked or taken care of where female is always acts as passive receiver and Male as dominant partner serve as active partner without any question or liking of opposite partner or self realisation of failure covered under social dominance of male over female or a female even unsatisfied either gets satisfication by illegal means or remain unsatisfied but never asks or challenge male partner under social obligation of male dominance and even pay price of Infertility (being discarded by family or divorced ) even having her no fault.Sex can be performed in many style and ways with use of fragrance,sweet smelling scents,powders,lotions,jeelies,perfumes wearing alluring clothes or creating inductive environment like rose petal bathing,swimming or candle light meetings under flower shade ,exorbiant seducing music and video shows,dance with slight intake of stimulants and usual duration of 10-20 minutes(which may be increased in some one who practise its regularly) for stage II-IV performance is regarded as normal Sex ,regarding frequency 1-5 times a day to once a week or month is regarded as normal sex but if its frequency reached more or filthy means of using electric vibrators,binding partner with rods,chains or belts or stimulation by smoking ,alcohol or drugs or burning partners body parts or genitilia or Accessory Genitilia by cigratte butts or by pin pricks or electric or thermal currents is perversion and abnormal sex which comes as obesity hypertension,heart disease comes after over eating.Sex under intoxication of excessive cigarette,alcohol or drug is always perfomed of low category as performance is mostly un coordinated and incomplete,so it is better to avoid it.Enviornment personal privacy and isolation is important for good Sex performance as Sex is always a private personal matter in our society,no body wants its open and frank exhibition and show.and we have been matured in this way through our culture and social rules that sex has been always a private matter of a couple through which person and society both grow,sharing and swaping of partners or multiple partners or prostitutions or Jigglos cannot be termed as normal lawful practice of society and has been regarded as offence in Sex.In no way Sex promotes separations,loneliness ,breaking and divorces and it is not limited to simple enjoyment and satisfication burning and destroying our social fabrics involving two willingful compatible and legal partners .simple meeting and performance of these IV stages where social fabrics is destroyed canot be termed as normal sex.hence sex with animals like horse,dogs,cattles canot be termed as normal Sex,these should be avoided as damage to our external genitilia or body parts may occur as animals are not trained to perform sex with human beings and many sexual transmitted disease can spread through it.As in our many acivities like eating ,reading,sleeping,playing etc we do some time nothing ,some time excess and these are termed abnormal activities ,same way in Sex if we either do apathy or doesnot involve our partner or do which should not be done or praticed or do excess then it is called abnormal sex or perversion which brings many diseases as obesity after excessive eating and Anxiety nervosa after no eating.Sex with children,mentally retarded persons or under pressure against will of even a partner is termed rape and regarded as unabailable offence in our system.

Hence sex requires two active willing legal partners for its true performance,if partners are either excited by oneself or by simple stimulation of each other and a private suitable place and time is selected,Sex can be performed excellently without need of any counselling, advice ,medicine or artificial allurement environmental things as mentioned above.In society so many quack doctors or self styled sex specialist doctors or therapy are advertised in print,electronic and internet media claiming better and best Sex.Nothing like this actually exist,if both partners are really happy and pleasant a good sex has been performed irrespective of its total duration and duration of any stage mentioned above or overlapping of stages,it is a continous live processnot a machnary computer which will always move through stages by giving every stage a good time ,these stages has ben enumerated to uderstnd Sex in better way .if intimacy,adherence and closeness achieved in partners with Conception(reproduction) then Sex has fulfilled its target(reproduction is not necessary as mentioned above) and there is no role of any thing ,instrument,medicine,doctor,counselling or therapy .A rumor is spread regarding penis size,so many instruments,medicines or message oil or sold to increase its size but for a better performance of sex only 2-4 inch penis is enough as only outer 2inch of vagina is sensitive to penetration so such size odf penis will give pleasure to both man and woman and till today no convincing scientific medicines has been discovered which can increase penis size,thickness or tightening.No medicine or therapy has come which increase arousal or libido in male or female (Testosterone helps only those male who have got less its amount in Blood not in normal male where if it used may cause prostatic cancer or toother virilising effect)but so amny are sold in market for increasing desireness or lure for sex .Sex is a totally personal psychological matter which can be easily controlled and maintained by psychological counselling removing childhood fear,apprehension or any doubt about Sex as sex is painful,sex is crime,sex is abnormality,sex always result in pregnancy,sex is discarded things and sex is a formality to be performed after marriage in first night only and after that on demand by husband (wife has go no right to ask sex or question sex),limited sex after child births,no sex after menopause,no sex during menstruation ,no sexual discussion among family or with children or in school ,our external genitilia are dirty parts of waste disposable only so should be never cleaned or cared for.A good development has taken place in some patients of actual Erectile Dysfunction (ED) where Sildefinal or tadalfil gives good result but it has got no effect on many patients of ED too and in normal persons it never increases size or erection of penis but sold like anything and even female takes it where it has got no role ,same way for delayed ejaculation so many medicines and creams and injections are marketed which is better controlled by psychological counselling and gradual practise and learning style of performing sex under guidance of an expert.After unprotected sex to avoid pregnancy I-pill or unwanted 72 are sold openly in market which are nothing but high doses of oestrogen and progesterone which completely disturb a woman’s menstrual cycle and in many woman as suffering from migraine,thrombosis,hypertension,jaundice etc., they are contraindicated so government should ban selling of these drugs with harmful side effects by advertising in TV and printed media as youngsters are now developing live in relations and sexual activities openly with removal of fear of getting pregnancy but risk of developing sexual transmitted diseases like HIV,Gonorrhoea,herpes ,septic abortions and infertility.
DR.D.R.NAKIPURIA

09434143550
***Author is an expert Sex and HIV practitioner

Sex is the need of our Physical,mental and spiritual and social health as important as hunger,thrist, sweating,breathing, heartbeating, movement,perception etc., are important for sustaining a life.Without Sex life cannot come to exist on this universe but its practise is mandatory to continue life in existence but still in our civil society sex not a topic of discussion in this part of the world. It is considered indecent to openly discuss issues related to sex. Society tries to avoid discussing certain facts about sex and sexuality, which gives rise to misconceptions about sex.To talk about Sex is considered as a starting point of promiscuity or perversion but it is not true rather sex education brings so much education in youngsters as they avoid getting perversion and bad effects of unprotected sex,or ill effects of sex in early teenager age and restrain themselves from indulging in abnormal seual behaviour,practice and paronography,more we cover something ,more is desire of human being to know about it.Therefore some common myths and their correct answer are mentioned below sothat we can know about them and get ourselves educated and donot suffer from mental agony leading to submission to ourselves to quack doctors,self made sexologist,hakims or false advertising medicines which are sold by advertisement in Newspaper,magazines, Tv and electronic media or by open announcement or commercial shops .

Sr. No Myths Facts
1. Men have stronger sexual urges than women. Sexual urge is equal in both the sexes.
2. For sexual satisfaction a couple should have orgasm simultaneously. It is not necessary for both partners to have simultaneous orgasm during sex.
3. A woman’s sex life ends with her menopause. Menopause marks the end of a woman’s reproductive life. Not her sex life.
4. Wet dreams are experienced only by men. Nocturnal orgasms or wet dreams can be experienced by women as well.
5. Wet dreams are sexual disorders. Nocturnal emissions (wet dreams) are not a sign of sexual disorder. They are a part of normal sexual process.
6. Frequent masturbation makes the penis shrink. The penis does not shrink when men indulge in masturbation.
7. Masturbation leads to nervous breakdown. Masturbation is a normal physiological activity. It is practiced by most of the individuals and does not lead to any abnormal behaviour or nervous breakdown.
8. If men masturbate the fixed quota of semen will be over. There is no fixed quota of semen. From puberty to death, semen will be produced only if the testicles are healthy.
9. One drop of semen is equivalent to 40 drops of blood. This is not true. Semen is produced by testes, seminal vesicles and prostate gland and not directly by blood.
10. Penis will grow big if you have special food and exercise. Whatever that is good for other body parts is also good for sex organs.
11. Sex education to youngsters may lead them to promiscuity. Educating the youngsters on sex and sexual behavior helps them to develop a healthy and positive attitude towards sexuality. Telling them about sex will not lead them to promiscuity. Even without sex education, people indulge in promiscuity.
12. Venereal disease occurs if you have done some misdeeds. No. venereal disease or infection is an infectious disease produced by infective organisms. These are sexually transmitted infections.
13. Venereal disease is cured if the man has sex with a virgin This is absolutely wrong. Infact the infected person will transmit the disease to the virgin.
14. Only homosexuals practice anal sex. No. Heterosexuals also practice anal sex.
15. Only perverts have oral sex. Oral sex is a normal act and can be practiced by both partners as long as they are interested and free from infections.
16. If a women cannot conceive she is not a female. Ability to conceive does not determine the feminity of a woman.
17. Women ejaculate during sexual intercourse. Women do not ejaculate during sexual intercourse.
18. Vasectomy makes a man impotent. Sterilization (vasectomy in male and tubectomy in female) does not diminish sexual desire. In fact, it removes the fear of pregnancy, which in turn may increase sexual desire.
19.Penis size is important for sexual satisfication for both men and women,long,thick,fatty penis is made by using some oil over it or taking medicines.
Vagina's first 2inch is only sensitive part so a 2inch size penis is enough to satisfy a female(A normal penis is 4-6 inches in size )For male size is not important for satisfication,erection and then time interval needed for ejaculation provide satisfication,both by good counselling and practising advise can be corrected,no medicine or oil for message increase size of Penis or increase time interval between erection andejaculation.Onlyin some patients of Erectile Disorder(ED)Viagra or Sildenafil or Tadalafil is important for erection only,in normal person it doesnot have any effect on early or sustained erection.In female it doesnot work,neither it inreases sustainability or delay in ejaculation,no medicines has ben formulated for these, psychocounselling and performance under guidance of expert bring miraculous chang.
20.Libido or desire for Sex is incresed by medicines.No such medicines has been invented,only by psychological counselling and performance under expert guidance with regular pratice brings forth good result with caring of enviornmental,familial ,religious and social factors being controlled and checked.
21.woman has got no sex during Menstrual period,women are bad during this time so donot touch or sex with them during this time.Menstruation is a physiological process where dYING OVUM IS EXPELLED BY UTERUS ,so sex is safe during this period as no chnce of getting pregnancy ,if practiced with protection it neither increase infection nor cause more bleeding in women ,women is as normal in mens as in other day.
22.Sex should not be practised after 50 or later age as it causes cancer or injuries to genitilia.Sex should be practised whenever Body demands it after menopause vagina may be dry soft lubricant jelly bring relief ,Sex burns some energy so it is also a n exercise secondly it binds or emotional relations more closely so needed to maintain famililial and social fabrics.
23.Copper-T or IUDS and Contraceptive Pills are bad as sexual performance is diminished .IUDS and contraceptive pills are safe contraceptive except for bleeding slight excessive during mens by iUDS in some woman and contraceptive pills doing rare damage in heart or jaundice patients they donot cause any harm in sexuality or sex performance in male or female.
24.To have sex with children is more pleasant ,no Children exteral genitilia(Vagina/Anus ) is not roomy or of good size(Small Penis) either to receive or offer sex so any practice with them by an adult result in tear of these parts leading to very sever bleeding and seroius pain resulting into death of child,so never dot it is a heinous crime.
25.Abnormal sex as sex by using candle,Vibrating toys or penis or plastic baloons or pumps or with animals is very soothing and enjoyable.No extra pleasure is received by these,normal sex in different postions and style are enough to provide satisfication even to regular and habitual users,for starter simple sex is enjoyable,never submit to these perversions.
26.Sex under intoxication of Alchohol or drugs / smoking is more satisfactory and rejoiable.Alcohol / intoxication badly affects our coordination and synerism so sexual performance is always of low grade and satisfication.
27.Pornography,videowatching increases sexual libido or desire,in normal life excitement is easily achieved by eye or body contact with partners or otherwise talk and enviornment,these thing may excite early but leads to early discharge resulting in unsatisfication as most time goes without foreplay and one partner is over and another may be under no excitement.
28.Torturing partner by excessive biting,deep penetration,binding partner with wire or chain or injuring by cigratte or by nedles or very abnormal positions give good satisfication and pleasure,no thease are simple perversions they donot have any place in normal sexual behaviour and satisfication,t hese are excesses leading to so many physicial and social hazards,never submit to them or practise them.
29.Young widows and prostitutes are more sexy and sex them provide more enjoy.Widows are part of our society and as good woman as other normal married or spinister woman,no body should be allowed to be remain widow in modern society or even they exist ,one should never think to sex with them against their desire,nothing special present in them.Prostitute whther in compulsion or with will is a crime ,never more sexual pleasure is received from them as mostly sex in in bad enviornment but habitual prostitute may provide some sex therapy if interested to do so as psychological counsellor in countries where prostitution is allowed legally.but it is still crime in our country .
30.Gays and lesbians get more pleasure and enjoyment ,in our society still it is not taken as good practise although these are not now considered as law breakers but one thing is sure Sex is accepted in our society to run progeny or continue human generation so on these points these have got no role ,pleasure is always in male to female or opposite sex if you get it otherwise it may be individual test but collectively no such pleasure present in such activities .
Dr.D.R.Nakipuria

09434143550
**writer is HIV/AIDS and Sex Specialist.

A sexual problem is anything that interferes with a woman’s satisfaction with sexual activity. When this happens, it is often referred by health professionals as female sexual dysfunction (FSD).
To understand why sexual problems occur, it is important to understand the sexual response cycle. This cycle is the same in both men and women, although at different rates and, obviously, with different physical changes.
Sexual response cycle: The cycle has 4 steps.
1. Desire (excitement phase) – Desire is a sexual “charge” that increases interest in and responsiveness to sexual activity. You feel “in the mood.” Your heartbeat and breathing quicken, and your skin becomes reddened (flushes).
2. Arousal (plateau phase) – Sexual stimulation–touch, vision, hearing, taste, smell, or imagination–brings about further physical changes. Fluids are secreted within the vagina, moistening the vagina, labia, and vulva. These fluids provide lubrication for intercourse. The vagina expands, and the clitoris enlarges. The nipples become hardened or erect.
3. Orgasm (climax) – At the peak of arousal, the muscles surrounding the vagina contract rhythmically, causing a pleasurable sensation. This is often referred to as the sexual climax.
4. Resolution – The vagina, clitoris, and surrounding areas return to their unaroused states. You feel content, relaxed, and possibly sleepy.
Every woman progresses through the cycle at her own rate, which is normal for her. A sexual problem may occur if any of these stages does not occur.
A. Sexual problems
The types of sexual problems in women correspond to the stages of the sexual response cycle. Inability to achieve any of the stages can interfere with sexual satisfaction and thus create a problem. Any of these can be very distressing for a woman, because everyone deserves a satisfying sex life. They can be distressing for her partner, too, and can lead to problems in the relationship.
Lack of sexual desire: – Lack of interest in sex, or desire for sex, is a common problem in both men and women, but especially in women. Lack of desire stops the sexual response cycle before it starts. Lack of desire is temporary in some people and an ongoing problem in others.
Difficulties becoming sexually aroused or achieving orgasm: – Inability to become sexually aroused is sometimes related to lack of desire. In other cases, the woman feels sexual desire but cannot become aroused. Orgasm may be delayed or does not occur at all (anorgasmia). This can be very distressing for a woman who feels desire and becomes aroused. It can create a vicious cycle in which the woman loses interest in sex because she does not have an orgasm.
Pain during intercourse: – Pain during intercourse (dyspareunia) is not uncommon. Like other sexual problems, it can cause a woman to lose interest in sex. A number of conditions may cause pain and / or discomfort during sexual intercourse. These conditions include:
1. Vaginal Infection: Certain vaginal infections such as vaginal yeast infections and trichomoniasis are often present without noticeable symptoms. However during sexual intercourse, the rubbing motion of the penis against the vagina and genitalia sometimes causes the symptoms of these vaginal infections to intensify causing stinging and burning. Genital herpes sores are another frequent cause of pain during sex.
2. Vaginal Irritation: Many products contain irritants which can cause vaginal irritation leading to discomfort or pain during vaginal sexual intercourse. These include: Any contraceptive foams, creams, or jellies, Allergic reactions to condoms, diaphragms, or latex gloves, Vaginal deodorant sprays, Scented tampons, Deodorant soaps, Laundry detergents in sensitive individuals, Excessive vaginal douching
3. Vaginal Dryness: Vaginal dryness often causes painful sexual intercourse. Normal vaginal lubrication is present for most women; however, during certain times the vagina may be dry and make vaginal penetration painful.
4. Vaginal Tightness: Occasionally this happens when you feel tense, or are not fully relaxed when penetration occurs. Difficulty in penetrating a tight vagina can happen even when vaginal lubrication is not a problem. Often, the first few times you engage in sexual intercourse, the vagina may be tight due to an unstretched hymen and cause pain at the time of penetration.

Sometimes a more severe condition called vaginismus is responsible for vaginal tightness; women with vaginismus experience strong, involuntary muscle spasms of the vaginal muscles during sexual intercourse or vaginal penetration by any object including fingers and tampons.
5. Pain of the Clitoris: The clitoris is the most sensitive part of the female genitalia. Gentle touching or rubbing of the clitoris is extremely pleasurable for some women, while for others it is unbearably painful. Clitoral pain may also occur due to poor hygiene; vaginal secretions may collect under the clitoral hood and if not carefully washed away may lead to pain.
6. Pelvic Pain: Occasionally a women will experience pelvic pain upon deep, thrusting penetration. Many conditions may cause this pain including:
• Tears in the ligaments that support the uterus (causes include problems during childbirth, inappropriately performed abortion, previous violent sexual intercourse or rape)
• Cervical, uterine, or tubal infections such as pelvic inflammatory disease (PID)
• Pelvic adhesions (often the result of previous pelvic surgery or PID)
• Endometriosis
• Ovarian cysts
• Uterine Fibroid Tumors
B. Psychological Factors
Impact of events during childhood and adolescence
Most studies that have assessed the impact of childhood experiences on female sexual dysfunction are methodologically flawed. They rely on retrospective recall, which is particularly problematic when emotional responses to the event as well as the actual occurrence of the event are being reported. However, there have been some probative links between childhood sexual abuse and having a later sexual dysfunction.
Relationship factors
A substantial body of research has explored the role of interpersonal factors in sexual dysfunction among women, particularly in relation to orgasmic response. These studies have largely focused on the impact of the quality of the relationship on the sexual functioning of the partners. Some studies have evaluated the role of specific relationship variables, whereas others have examined overall relationship satisfaction. Some studies have explored events; others have focused on attitudes as an empirical measure of relationship functioning. Subject populations have varied from distressed couples to sexually dysfunctional clients to those in satisfied relationships. Some major areas are relationship conflicts; extra-marital affairs; current physical, verbal or sexual abuse; sexual libido, desire or practices different from partner and poor sexual communication.
Individual factors
There has been little investigation of the impact of individual factors on sexual dysfunction in women. Such factors include stress, levels of fatigue, gender identity, health, extra marital relationship, financial, family or job problems, family illness or death, depression and other individual attributes and experiences that may alter sexual desire or response.
Physical factors
The female sexual dysfunction may occur due to physical factors have ranged from 30% to 40%. The disorders most likely to result in sexual dysfunction are those that lead to problems in circulatory or neurological function. These factors have been more extensively explored in men than in women. Physical etiologies such as neurological and cardiovascular illnesses have been directly implicated in both premature and retarded ejaculation as well as in erectile disorder, but the contribution of physiological factors to female sexual dysfunction is not so clear. However, recent literature does suggest that there may be an impairment in the arousal phase among diabetic women. Given that diabetic women show a significant variability in their response to this medical disorder, it is not surprising that the disease’s influence on arousal is also highly variable. In fact, the lack of a clear association between medical disorders and sexual functioning suggests that psychological factors play a significant part in the impact of these disorders on sexual functioning.
Other factors
• Changes related to menopause
• Communication problems with partner
• Damage to nerves due to surgery or trauma
• Fear of pain, infection, or being pregnant
• Feelings of guilt and shame about sex
• Lack of appropriate stimulation
• Lack of lubrication
• Medication
Medications
A. Medications that cause disorders of desire

Psychoactive medications
Antipsychotics
Barbiturates
Benzodiazepines
Selective serotonin reuptake inhibitors
Lithium
Tricyclic antidepressants

Cardiovascular and antihypertensive medications
Antilipid medications
Beta blockers
Clonidine (Catapres)
Digoxin
Spironolactone (Aldactone)

Hormonal preparations
Danazol (Danocrine)
GnRh agonists (e.g., Lupron, Synarel)
Oral contraceptives
Others
Histamine H2-receptor blockers and promotility agents
Indomethacin (Indocin)
Ketoconazole (Nizoral)
Phenytoin sodium (Dilantin)

B. Medications that cause disorders of arousal
Anticholinergics
Antihistamines
Antihypertensives
Psychoactive medications
Benzodiazepines
Selective serotonin reuptake inhibitors
Monoamine oxidase inhibitors
Tricyclic antidepressants
C. Medications that cause orgasmic dysfunction
Methyldopa (Aldomet)
Amphetamines and related anorexic drugs
Antipsychotics
Benzodiazepines
Selective serotonin reuptake inhibitors
Narcotics
Trazadone (Desyrel)
Tricyclic antidepressants

Diagnostic features
The DSM-IV (American Psychiatric Association) diagnostic criteria for female sexual arousal disorders are outlined here:
A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication-swelling response of sexual excitement.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due exclusively to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Treatment
A. Provide education
Provide information and education (e.g., about normal anatomy, sexual function, normal changes of aging, pregnancy, and menopause). Provide booklets, encourage reading; discuss sexual issues when a medical condition is diagnosed, a new medication is started, and during pre- and postoperative periods; give permission for sexual experimentation.
B. Enhance stimulation and eliminate routine
Encourage use of erotic materials (videos, books); suggest masturbation to maximize familiarity with pleasurable sensations; encourage communication during sexual activity; recommend use of vibrators, discuss varying positions, times of day or placesetc.
C. Provide distraction techniques
Encourage erotic or nonerotic fantasy; recommend pelvic muscle contraction and relaxation (similar to Kegel’s exercise) exercise with intercourse; recommend use of background music, videos or television.
D. Encourage noncoital behaviors
Recommend sensual massage, sensate-focus exercises (sensual massage with no involvement of sexual areas, where one partner provides the massage and the receiving partner provides feedback as to what feels good; aimed to promote comfort and communication between partners, oral or noncoital stimulation, with or without orgasm.
E. Minimize dyspareunia
Treat the causes of dyspareunia. Ask the patient to use jelly in case of vaginal dryness.

Homeopathic Medication
Dyspareunia : Arg. Nit, Sepia, Nat. mur, Lyss, Platina, Calc phos, Thuja, Acid nit.
Vaginismus : Cact, Plb, Bell, Canth, Puls, Silicia, Lyco, Nat mur, Ignatia, Ferrum.
Aversion to sex: Asar, Caust, Nat mur, Sepia
Anorgasmia : Berberis, Caust, Phos, Ferrum, Sepia
Diminished sexual desire : Caust, Nat mur, Ferrum, Sepia, Acid phos, Graph, Lyco
Dryness of vagina : Nat mur, sepia, Graph, Lycop, Ferrum

Dr. SUNEETH MATHEW BHMS, M.Sc(Psy), M.Phil(Clinical Psy), PG Dip in Criminology & Forensic Science.
Reader, Dept of Practice of Medicine, Hahnemann Homeopathic Medical College, Rasipuram, Salem.
Consultant, Dept of Psychosexual medicine, V-Care Multispecialty Homeopathy, Coimbatore, Baluserry, Mananthavadi and Ideal Speciality Institute, Perambra.
Cell: 09486382600 URL: www.holykings.info