Weight Loss » Men’s Health-Erectile Dysfunction

ISD AND THE MIND: SEXUAL TRAUMA AND ISD – CASES OF INCEST

admin — Tue, 12 Jul 2011 15:09:32 +0000

Up to one million cases of incest are reported each year. It is estimated that one out of every four adult women and one out of every eight men were sexually abused in some way during childhood, often by an adult whom they knew and trusted. As you might expect, and as you well know if it happened to you, when an adult has sex with or otherwise sexually abuses a child, the child does not welcome the activity, rarely understands what is happening, and almost always feels powerless to prevent or stop it. Incest, because it also destroys the child’s trust and sense of safety, as well as the normal boundaries of parent-child relationships, inflicts deep psychological wounds that can last a lifetime.

Victims of incest and child molestation often go through life feeling helpless, dirty, damaged, or different from other people. They may blame themselves for what happened, think they have some inherently “evil” or “bad” part that draws unwanted attention to them, believe sex is dangerous or the only thing they are “good for,” feel powerless to control anything about their lives, or attempt to control every aspect of daily living. More often than not, they find it exceedingly difficult to trust or share any details about themselves with other people, making relationships problematic and true intimacy out of the question. They have numbed any feelings, including sexual ones, that may be associated with the abuse. We have yet to meet a childhood sexual-abuse victim whose sexuality had not been negatively affected in some way.

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MALE PROBLEMS – INTRODUCTION

admin — Tue, 07 Apr 2009 07:29:21 +0000

While childbirth is an experience of women, its effect on their partners should not be forgotten. From the moment the woman shows the first physical signs of pregnancy it is clear that the baby belongs to her and that she is its mother. The man who has no such evidence that he is the father has to cope with the emotional changes that fatherhood entails. In extreme cases this may lead to denial or rejection of parenthood and to a break-up of the relationship. Acknowledgement of his part in the pregnancy may be provided by attendance at antenatal classes and at the birth. However, diminished sexual response by the woman because of early symptoms of pregnancy such as tiredness, sickness and discomfort may increase his already present feelings of envy, resentment or rivalry of the growing baby, and be further reinforced by the mother’s preoccupation with the baby once it is born.

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THE STEREOTYPES – ‘MEN NEED TO BE IN CONTROL’ (INTRAUTERINE CONTRACEPTIVE DEVICES (IUCDS) – CONCLUSION)

admin — Tue, 07 Apr 2009 07:22:49 +0000

Most men have heard of expulsion and perforation. A woman came asking for a second IUCD 10 years and a second marriage after being perforated by her first device. The doctor was amazed after this failure, although in some ways it was a sensible request. She was now hypertensive, so the Pill was not suitable, and as she was no longer nulliparous, the risk of another perforation was slight. But the doctor wanted to hear the reasons why she was prepared to try something again when it had caused problems the first time.

The first coil had been resented. The marriage had already gone wrong and she seemed to blame her first husband more than the doctor for the perforation. ‘In a way I was glad it had to be removed [even by laparoscopy]. From then on we used condoms, but not very often.’ He was a policeman with no sense of fun. ‘At least it kept his truncheon covered.’ Now she wanted all barriers removed so as to welcome her new man, and he was worth some risk.

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THE WANTED BABY – DO I WANT A BABY? (NOT HAVING A BABY)

admin — Tue, 07 Apr 2009 07:16:32 +0000

She returned a few weeks later a much happier person. She said that the opportunity to share with the doctor her disappointment at the probability of not having a baby had enabled her to see things in a fresh light. It enabled her to talk about the grief that she felt for the baby she would not have, and she could see that it might be like a bereavement, full of different emotions, some anger some sadness, and even some relief that she would not have all the responsibilities that children bring. She loved her husband very much and wanted to spend her life with him. She had been able to talk about her disappointments with him and found that he had not deliberately been ignoring her needs, but that it had been too difficult for him to talk to her. They had made love several times without any pain.

Mrs. N. had learned that the problem did not lie in the fact that other people were ignoring the existence of her feelings, but that her ability to withhold and hide her feelings had been the cause of all her emotional and physical pain. She could now move on to the process of going through the various feelings of grief knowing that to make love involved a strong emotional as well as a physical element. Now she had brought her ambivalent feelings about a baby into the open with her husband it had become an easier sharing process, and there was less pain. She was still undecided about whether she wanted a baby but the dilemma was no longer expressed as a physical problem.

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THE VERY YOUNG – CONCLUSION

admin — Tue, 07 Apr 2009 07:10:01 +0000

When a young person is brought to the doctor by someone older, whether parent, teacher, social worker or friend, it can be very helpful if the anxieties of that person can also be examined. When working in a clinic with a social worker it is often possible for her to conduct this interview. In a normal surgery or clinic the doctor will usually have to see both the girl and the accompanying person. It is important that the girl agrees to this and has trust that her confidences will not be broken. She may well be relieved when the worries are eased and some of the pressure is taken off her. Such a dual role can be particularly difficult for the general practitioner with responsibilities to the whole family, and he or she is often grateful to be able to obtain help for the girl from another doctor.

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CONTRACEPTIVES – USING NOTHING

admin — Tue, 07 Apr 2009 07:01:19 +0000

One gulf between perceptions is well illustrated by contrasting the attitudes of doctors and patients towards the simplest of all methods of birth control – nothing. Unfortunately, the consequences of this method frequently require some medical interference at a later date, postcoital contraception or termination, for example. Doctors tend to see patients who use nothing as being ignorant, feckless or even stupid, and are tempted to treat a subsequent request for help in this light. Many patients will agree, in the cold light of the next day or a missed period, hence the amazing number of reported burst sheaths, but, if the real reasons for using no protection at all are not explored, the situation can easily occur again.

Many users of the ‘nothing method’ are under 16 years of age. It seems to be the policy of our society to emphasize that using contraception is an adult affair. Social concern with the rising tide of teenage pregnancies may be on the increase, but for the young themselves, newspaper headlines blazon adult priorities and moralities. Should parents be told of medical consultations concerning the under-16s, whatever the wishes of the young individual concerned?

The message is clear, sex is private – unless you use birth control.

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DRUGS THAT MAKE THE PROSTATE SHRINK(5 –ALFA REDUCTASE INHIBITORS (FINASTERIDE, PROSCAR)) : STUDY

admin — Mon, 30 Mar 2009 08:38:58 +0000

In one study of 1,600 men with BPH, finasteride shrank prostate size over a two-year period by an average of 25 percent, improved urinary flow signifi-candy in 31 percent of the patients, and brought some relief of symptoms in 71 percent of these men. Finasteride achieved this benefit with very few side effects—the main one being the development of impotence, which occurred in only 3.4 percent of men and was reversible when the men stopped taking the drug.

Results from this and other studies show that while this drug is helpful, it’s riot for everybody. The gains in urine flow, for example, are much higher in men who undergo the TUR procedure, and for men with minimal symptoms, these gains would hardly be noticeable. However, the drug might prove helpful in men with moderate to severe symptoms of BPH—for example, those with a weak urinary stream, hesitancy in starting urination, or who are making so many nighttime trips to the bathroom that they’re losing sleep.

The bottom line: Currently, a man taking finasteride has about a 30 percent chance of seeing a significant improvement in his symptoms—and this will come only after six months to a year of taking the drug. Finasteride is not a fast-acting treatment for BPH. Its major advantage is that it causes the prostate to shrink—and in control studies, it appears that once the prostate does shrink, it tends to stay shrunk. Perhaps most exciting is that it may prevent the disease of BPH from progressing.

However, there’s another point worth noting: About 10 percent of men who undergo prostatectomy for the treatment of BPH are found to have some cancer in the bits of prostate tissue that are removed. This is one of the advantages of having surgery for BPH; you can rule out the presence of prostate cancer. But in men taking medicine to treat BPH, the presence or absence of prostate cancer is less easily determined.

One concern with finasteride is that it lowers concentrations of prostate-specific antigen (PSA) in the blood by 50 percent. Why is this a problem? In recent years, the PSA blood test has become an important means of checking for prostate cancer, and finasteride could obscure the results of this test in the men who are taking the drug. Therefore, before embarking on a long-term course of finasteride, it’s vital to have a digital rectal exam and PSA blood test and, if your PSA is high (see discussion of PSA in Chapter 3), a prostate biopsy to rule out the presence of cancer.

Once a man is on finasteride, his PSA levels should drop about 50 percent during the first year and then remain constant. If his PSA levels fall to less than 50 percent, or if they start to rise while he’s on the drug, something’s not right, and there are two possibilities. One is that he’s not taking the drug regularly or properly. The other is far more serious—he could have prostate cancer. In any event, a change in PSA levels definitely needs to be investigated.

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WHEN BPH NEEDS TO BE TREATED: AN UNSTABLE BLADDER

admin — Mon, 30 Mar 2009 08:28:39 +0000

An Unstable Bladder, with urge incontinence. From half to as many as 80 percent of men with BPH eventually develop bladder instability, producing the irritative symptoms caused by an embattled, strained bladder. In most cases, these go away with surgical relief of the obstruction—again, the results depend on how much of a burden the bladder has borne, and for how long. These symptoms include increasingly frequent or urgent urination, particularly during the night, and most significantly, urge incontinence—a real warning sign that the bladder is in trouble. If this is not treated (by easing the obstruction), it may reach a point where the damage is irreversible and this incontinence is permanent. Or, if a man delays treatment for too long and then has surgical treatment, this urge incontinence can actually get worse—because the obstruction has been relieved, now there’s even less tissue to hold back these uninhibited contractions when they occur.

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WHEN CANCER SPREADS BEYOND THE PROSTATE…

admin — Mon, 30 Mar 2009 08:22:38 +0000

When cancer spreads beyond the prostate, it cannot be cured— but it can be controlled. The main way to do this is by hormone therapy—shutting down the hormones that feed the prostate and nourish the cancer. There are several kinds of hormone therapy; each one targets a different link in the hormonal chain of events that affects the prostate.

Prostate growth is tightly controlled by a major hormone, testosterone, which is made by the testcles. Testosterone circulates in the blood and enters the prostate, where it’s soon transformed into another powerful hormone called DHT, the active hormone within the prostate.

The amount of testosterone that circulates in the blood is carefully monitored by the brain, and this is where the whole hormone chain really begins. The hypothalamus makes a substance called LHRH, a chemical signal that’s dispatched to the nearby pituitary gland. It tells the pituitary gland to make, among other things, a hormone called LH. LH, in turn, tells the testicles to make testosterone. Think of the domino effect—LHRH, LH, testosterone, DHT.

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TELLING CANCER CELLS WHEN TO DIE

admin — Mon, 30 Mar 2009 08:14:05 +0000

Scientists know that all cells, cancerous and normal, have a genetic pathway called programmed cell death. The problem is, cells often ignore this pathway. In the normal prostate, androgens keep androgen-dependent cells alive; these cells become relatively immortal (it’s like pumping air to a deep-sea diver). But when this life-giving supply of hormones is shut off—by physical or chemical castration—the picture changes. The change in hormones triggers a series of events in which certain genes are expressed, and new proteins are made. Some scientists believe these new proteins prompt a buildup of free calcium in the cells. And the prolonged increase in calcium activates what one Johns Hopkins scientist describes as a “suicide enzyme.” This “suicide” enzyme, something called a calcium-magnesium-dependent end nuclease, functions as a sort of wrecking ball. It breaks down the DNA in the nucleus, and wipes out the cell’s genetic memory bank. The cell no longer replicates, but dies. Over time, it begins to fragment; tiny chunks are later recycled as building materials by other cells. “This is an active process,” the scientist explains, “in which the cell that is destined to die is actively involved in its own death.”

This process happens all the time, particularly during fetal development, “or we wouldn’t be able to develop as people who have arms and legs and appendages,” the scientist continues. “When you’re developing, you have limb buds.

In order to develop digits—our fingers, for example—the cells that are in between the fingers literally have to die. And that’s a particularly tricky, coordinated process. You can imagine—you’ve got to make some cells die and other cells have to live, right next to them.”

Androgen-independent cells, while all this is going on, experience no such increase in calcium. Although they possess a similar suicide pathway, it is not activated.

This is an area of intensive work for prostate cancer researchers—figuring out how to kill these cells, or better yet, how to get them to kill themselves.

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