Improving Your Sex Life

Revive Her Drive

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

Revive Her Drive Summary


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Author: Tim and Susan Bratton
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Evidence of Sexual Intercourse

The slides should be placed either in clean plastic slide holders or in new cardboard holders. The latter should not be reused to prevent carryover of vaginal or seminal material to a subsequent slide placed in the cardboard container. Vaginal, rectal and oral slides should be stained in an attempt to identify any spermatozoa. If sperm are present, DNA analysis of the swabs is performed. When no sperm are observed, part of each of the swabs from the vagina, rectum, and mouth can be used for presumptive tests for acid phosphatase. If, however, sexual intercourse is still strongly suspected, or if the acid phosphatase test was weakly positive or questionable, an assay for semen-specific protein P30 should be performed. Occasionally, P30 is positive in the face of a negative acid phosphatase. If the acid phosphatase or P30 tests are positive, even if no spermatozoa are seen, DNA analysis should be performed.2 The survival time of spermatozoa in the vagina of living individuals as...

Box 21 View of a woman included in a clinical trial without her knowledge

She notes that of the many women included in this and similar trials and suffering similar long-term medical problems, many cannot have sexual intercourse, some are housebound through pain and incontinence and some have tried to commit suicide. As a result, marriages have broken up and children have been fostered. All are understandably angry about what has happened to them 21 .

Discharge And Home Healthcare Guidelines

Encourage the patient to discuss any sexual concerns he or his partner may have after surgery with the appropriate counselors. Reassure the patient that a session can be set up by the nurse or physician whenever one is indicated. Usually, the physician recommends that the patient have no sexual intercourse or masturbation for several weeks after invasive procedures.

Francine Cournos and Karen McKinnon

We correctly have moved away from the concept of risk groups, because anyone who engages in risky sexual and drug use behaviors may acquire or transmit HIV. Nonetheless, it remains true that most countries currently have epidemics that are concentrated in vulnerable populations such as injection drug users (IDUs), men who have sex with men (MSM), and sex workers Men who have sex with men elevated rates of alcohol substance use disorders and depression

Risk Of Maternal Infection During Pregnancy

Genital herpes occurs with a frequency of about 1 at any time during gestation (15,16). Recurrent genital herpes infections are the most common form of genital HSV during gestation (13). However, as discussed below, it is the woman with primary HSV disease who is at highest risk of transmitting the virus to her baby. About 10 of HSV-2-seronegative pregnant women have an HSV-2-seropositive sexual partner and thus are at risk of contracting a primary HSV-2 infection (17). Among such discordant couples, women who are seronegative for both HSV-1 and HSV-2 have an estimated chance of seroconversion for either virus of 3.7 those women who are already seropositive for HSV-1 have an estimated chance of HSV-2 seroconversion of 1.7 (18). Approximately two-thirds of women who acquire genital herpes during pregnancy have no symptoms to suggest a genital HSV infection (18). Of women who deliver an HSV-infected infant, 60-80 have no evidence of genital HSV infection at the time of delivery and have...

Modeling Hiv Rates As A Function Of Incarceration Rates

Such transmission would be affected, they assert, by tattooing, drug use, and high-risk sexual activity. In the Georgia Prison study, all of these behaviors were reported by cases as well as controls, with the self-reported rates of having received a tattoo in prison'' emerging as a particularly significant risk factor for seroconversion in prison. Hence, a significant element of the model receives significant support from these findings. The Johnson-Raphael model, however, is only partially dependent on the assumption that the disparity between black and white HIV infection rates is a function of in-prison HIV risk behavior. The authors' major focus was to test the degree to which ''sexual relationship markets'' that is, the manner in which members of sexually active groups form and break up sexual relationships are influenced by rates of incarceration. Of particular importance are the effects of incarceration on the total lifetime number of sex partners and the likelihood of...

Gender Ethnicracial And Life Span Considerations

Although the occurrence of chlamydial infection is related more to sexual practices than to age, many women with chlamydial infection are young, under 24 years of age, and single. Indigent women with no prenatal care are a high-risk group. The rate of infection is also highest in African American women, and it is highest in the southern states. With more teens engaging in sexual activity, more adolescents of both genders are contracting infections. Depending on the population, 5 to 35 of pregnant women are infected with C. trachomatis.

Pharmacologic Highlights

Explain strategies to reverse CAD through a program that includes a very low fat diet, aerobic exercise, and stress-reduction techniques. Information about resumption of sexual activity acceptable for the medical condition is helpful. Patient information literature is abundant and available from cardiac rehabilitation programs, as well as the American Heart Association. Although many patients will be admitted on the day of surgery, preoperative teaching about the intensive care unit environment, the procedure, postoperative coughing and breathing exercises, and postoperative expectations of care is essential. The surgery is a family crisis that may lead to a long recovery, patient dysfunction, and even death. The family needs emotional support and constant information about the patient's progress.

Chronic paroxysmal hemicrania

There is no suggestion of one of the disorders such as trigeminal neuralgia, idiopathic stabbing headache, cough headache, benign exertional headache, headache associated with sexual activity, or hypnic headache. 1. There is no suggestion of one of the disorders such as trigeminal neuralgia, idiopathic stabbing headache, cough headache, benign exertional headache, headache associated with sexual activity, or hypnic headache.

Diagnostic Criteria for Sunct Syndrome

3History and physical and neurological examinations do not suggest any of the disorders, such as trigeminal neuralgia, idiopathic stabbing headache, cough headache, benign exertional headache, headache associated with sexual activity, or hypnic headache, or history and or physical and or neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but attacks do not occur for the first time in close temporal relation to the disorder.

Epidemiology And Routes Of Transmission

At the moment, the exact risk factors and routes for HHV-8 transmission are not clear. Epidemiological evidence suggests that the virus is largely transmitted sexually in North America and certain northern European countries. There is a higher rate of infection in homosexual AIDS patients as compared to heterosexual AIDS patients. In the United States, the San Francisco Men's Health study showed that HHV-8 infection in this group of homosexual men was high and was linearly associated with the number of male sexual partners (24). Similarly, a study of a cohort of Danish homosexual men also showed that HHV-8 infection was associated with receptive anal intercourse (25). The likely sources of infection in this population are infected semen and feces. The virus has not yet been found in fecal matter, but viral DNA can be detected in the semen by the polymerase chain reaction (PCR) technique. It has been reported that HHV-8 can be detected in the PBMCs in between 12 and 25 of homosexual...

Primary Nursing Diagnosis

Sexual activity is prohibited during the treatment process. If epididymitis is recurrent, an epididymectomy under local anesthesia or a vasectomy may be indicated, and this will result in sterility. If orchitis develops, it is treated with diethylstilbestrol (DES), which may relieve pain, fever, and swelling. Severe cases of orchitis may require surgery to drain the hydrocele and improve testicular circulation.

Sexually Transmitted Diseases

If you have any reason to believe that you have been exposed to an STD, consult your physician without delay. Many STDs are highly contagious, and if you have sexual contact with someone who has an STD, you have a high risk of becoming infected. While having multiple sexual partners increases your risk of contracting an STD, even a person in a monogamous relationship can be at risk, since one partner might be harboring an infection acquired years earlier. Note that the term is safer sex rather than safe sex because abstinence is the only guarantee against STDs. To help prevent the transmission of an STD, follow these precautions every time you have sex Use a latex condom (see page 197) each and every time you have sex, including anal and oral sex. Never reuse a condom. Don't have sex with a stranger. Avoid having sex with multiple partners. Monogamy with an uninfected partner who is monogamous virtually nullifies the chances that you will contract an infection. Don't have sex if you...

Taking Responsibility for Birth Control

Couples have attempted to control conception throughout the centuries using a variety of techniques, such as eating special herbs, performing religious rituals, or timing sexual intercourse with different phases of the moon. But safe and effective methods of contraception have been available only since 1930. you still should have a clear understanding of the female reproductive system and the menstrual cycle. Such knowledge not only increases the chances of success with the method you choose but also can enhance your sexual satisfaction. The method you choose will not be effective unless it is used correctly and consistently. Both partners need to share responsibility for birth control.

Athome methods of overcoming dysfunction

If, after completing the above steps, an orgasm has not been reached, the patient may find that the use of a vibrator on or around the clitoris is effective. c. Once masturbation has resulted in orgasm, the patient should masturbate with her partner present and demonstrate pleasurable stimulation techniques.

Concluding Remarks and Perspectives

The characterization of the genes that control sexual development in Drosophila contributed significantly to the understanding of the molecular strategies behind sex determination, sex behavior, and the development of the germline (see Chapters 1.2 and 1.4). This knowledge paved the way for the study of the sex-determination mechanisms in other insects, so that the understanding of evolution of the sex-determining mechanisms is now possible. This will undoubtedly also contribute to an increased understanding of the evolution of other genetic pathways. In addition, results from studies on the mechanisms that control sexual development, are likely to contribute to the development of novel

Negotiating Childrens Autonomy

As teenagers act with increasing autonomy, their power increases and their parents' decreases. From the point of view of some teenagers, their parents' control becomes quite limited. As one teenage boy said, Punishments are not very effective. You can still do what you want. Like if you have to come in at 11 instead of 12, you can still have sex before 11. You can still go out at recess in school and smoke a joint.

Philip Bialer Rosalind G Hoffman and Jeffrey Ditzell

Injecting drug use (IDU) is a major vector of HIV transmission in many parts of the world. (Needle et al., 2001) While sexual transmission of HIV predominates in endemic areas such as sub-Saharan Africa, IDU and commercial sex are the major transmission modes in South and Southeast Asia, where approximately 7.4 million people are living with HIV (UNAIDS, 2005). IDU is also the main risk behavior in Latin America (HIV prevalence 1.8 million) and Eastern Europe and Central Asia (HIV prevalence 1.6 million UNAIDS, 2005). Approximately 27 of the cumulative adult cases of HIV AIDS in the United States are due to IDU (CDC, 2005). Heterosexual exposure to HIV in the United States most often involves sexual contact with injection drug users (IDUs). When taking this into account along with the category of men who have sex with men and are exposed to IDU, the proportion of HIV AIDS associated with IDU approaches 50 . In addition, there is a high prevalence of non-injecting drug use among gay...

Chlamydia Trachomatis

Routine screening of asymptomatic, sexually active adolescent females undergoing pelvic examination is recommended. Annual screening should be done for women age 20-24 years who are either inconsistent users of barrier contraceptives or who acquired a new sex partner or had more than one sexual partner in the past 3 months. II. Gonorrhea. Gonorrhea has an incidence of 800,000 cases annually. Routine screening for gonorrhea is recommended among women at high risk of infection, including prostitutes, women with a history of repeated episodes of gonorrhea, women under age 25 years with two or more sex partners in the past year, and women with mucopurulent cervicitis.

Clinical evaluation

A new sexual partner increases the risk of acquiring sexually transmitted diseases, such as trichomonas, chlamydia, or Neisseria gonorrheae. Trichomoniasis often occurs during or immediately after the menstrual period candida vulvovaginitis often occurs during the premenstrual period.

Sex and social evolution in primates

A less costly alternative counterstrategy would be to prevent infanticide by manipulating the male's assessment of paternity or his actual chances of it through sexual behaviour.2 This chapter explores the possibility that the variation in primate sexual behaviour and physiology is an adaptation to reduce the risk of male infanticide (see also Hrdy, 1981 Hrdy and Whitten, 1987). The hypothesis examined in this chapter is that female sexuality in species vulnerable to male infanticide has been molded by the dual need for paternity concentration and confusion concentration in order to elicit infant protection from the likely father, confusion in order to prevent infanticide from non-likely fathers (see also Nunn, in press). The right balance of confusion and concentration is achieved by (i) prolonged mating periods, often accompanied by actively pursued polyandrous mating, (ii) mating during non-fertile periods, such as pregnancy, (iii) making ovulation unpredictable, thus blurring the...

Physiological Effects

The plateau stage of drug effects lasts 3-4 hours. The principal desired effect, according to most users, is a profound feeling of relatedness to the rest of the world. Most users experience this feeling as a powerful connection to those around them, as well as to the universe (Leister, Grob, Bravo, & Walsh, 1992). Although the desire for sex can increase, the ability to achieve arousal and orgasm is greatly diminished in both men and women (Buffum & Moser, 1986). MDMA has thus been termed a sensual, not a sexual, drug. The prescription drug sildenafil (Viagra) may be taken in order to counteract this effect, and may be sold along with MDMA (Weir, 2000) the successor medications involving sexual enhancement can be expected to be used in this manner. The array of physical effects and behaviors produced by MDMA is remarkably similar across mammalian species (Green et al., 1995) and includes mild psychomotor restlessness, bruxism, trismus, anorexia, diaphoresis, hot flashes, tremor, and...

Disorders of the Bladder and Urethra

Until recently, nearly all men experienced erectile dysfunction after bladder removal surgery, but surgical improvements have reduced the likelihood of this side effect. However, men who have had their prostate gland and seminal vesicles removed no longer produce semen, so they do not ejaculate when they have an orgasm, and they are infertile.

Mechanism of Action

MDMA is a dirty drug, affecting many neurotransmitter systems. It is primarily serotonergic, and its principal mechanism of action is as an indirect seroto-nergic agonist (Ames & Wirshing, 1993 Rattray, 1991 Sprague et al., 1998). The drug's effects, and side effects (an arbitrary distinction), including anorexia, psychomotor agitation, difficulty in achieving orgasm, and profound feelings of empathy, can be explained as a result of the flooding of the serotonin system (Beck & Rosenbaum, 1994). After ingestion, MDMA is taken up by the serotonin cells through active channels, effecting the release of serotonin stores. MDMA also blocks reuptake of serotonin, and this contributes to its length of action. Although it inhibits the synthesis of new serotonin, this does not contribute to the intoxication phase, but it may contribute to sustained feelings of depression reported by some users and to a diminished magnitude of subjective effects when the next dose is taken within a few days of...

Biopsychosocial Aspects Of Hiv And Aids

Psychiatrists make ideal AIDS educators. General psychiatrists who work in the areas of inpatient and outpatient psychiatry settings, private offices, addiction psychiatry, geriatric psychiatry, child and adolescent psychiatry, correctional facilities, and long-term care facilities are all in a prime position to provide education, help prevent transmission of HIV, suggest or provide condoms and information about safe sex, and suggest or offer HIV testing to lead toward early diagnosis and treatment. Most psychiatrists take detailed sexual and drug histories and work with patients to help them change behaviors. The significance of taking a detailed sexual history was especially evident in a population-based study of men in New York City. This study revealed discordance between sexual behavior and self-reported sexual identity nearly 10 of straight-identified men reported at least one sexual encounter with another man in the previous year (Pathela et al., 2006). Most psychiatrists form...

Nottingham Health Profile

The Nottingham Health Profile contains two parts Part I contains 38 items that cover 6 domains of experience pain, physical mobility, sleep, emotional reactions, energy, and social isolation. Part II includes perceived problems in 7 areas of life paid employment, jobs around the house, personal relationships, social life, sex life, hobbies, and holidays.

Severe Mental Illness And Hiv Risk

Chronically mental ill patients have an increased risk of acquiring HIV through practicing risky sexual behaviors, abusing substances, and taking part in social networks that have a higher prevalence of HIV. Individuals with mental illness have variable knowledge of HIV risks and safer sex practices, with a diagnosis of schizophrenia being a specific predictor of having poor knowledge of such risks and practices. More importantly, increased knowledge of HIV risk behaviors does not translate to less risk behaviors on the part of individuals with mental illness. In fact, some studies have found that mentally ill individuals who practice risky behaviors had greater knowledge of HIV risks than those who did not (Chuang and Atkinson, 1996, McKinnon etal., 1996). Risk behaviors more common among psychiatric patients include multiple partners, partners with known HIV-positive status, substance use during sex, trading sex for money, drugs, or housing, and lack ofcondom use (Treisman and...

Epidemiology And Transmission

Among adults, epidemiological studies support sexual activity as a route of spread for GBS (8). Mother-to-infant transmission of GBS can occur either prior to birth by the ascending route through ruptured membranes or at the time of delivery by contact with the organism in the birth canal. Less commonly, infants may acquire GBS through

Dating Sex And College

In time, I became increasingly aware of dating and sex. However, unlike many of my peers, I did not date. I had crushes on some girls, but given my outsider and stigmatized status, it did not seem likely that I could get a date. The combination of rumors that I was gay my participation in music, art, and theater and my academic achievements put me in a tough spot. Socially, I did spend some time with a small group of my classmates, much of it during lunch. It was reassuring to have some bonds with a group of other nerds, sissies, and outsiders of both genders. Few members of this group dated or were sexually active as far as I knew, and we were all disparaged to varying degrees by the populars.

The Females Who Forgot to Be

But before turning to such evidence, it is first critical to put sex in perspective. To correct the stereotype of ''coyness,'' I emphasize female sexual activity but, as always in such debates, reality exists in a plane distinct from that predefined by the debate. In this case, reality is hours and hours, sometimes months and months, of existence where sexual behavior is not even an issue, hours where animals are walking, feeding, resting, grooming. Among baboons (as in some human societies) months pass when a pregnant or lactating mother engages in no sexual behavior at all. The same is generally true for langurs, except that females under particular conditions possess a capacity to solicit and copulate with males even if pregnant or lactating, and they sometimes do so. At such times, the patterning of sexual receptivity among langurs could not be easily distinguished from that of a modern woman. The same could be said for the relatively noncyclical, semicontinuous,...

Sexually Transmitted Diseases Introduction

Sexually transmitted diseases (STD) are a diverse group of viral, bacterial, protozoal, and ectoparasitic infections that have a common route of transmission through sexual intercourse. Infectious organisms associated with STDs include Chlamydia trachomatis Neisseria gonorrhoeae bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis syphilis herpes simplex papillomavirus (genital warts) genital herpes and HIV. Infection by each of the above organisms has its own pattern of clinical patterns medications treatments prognosis transmission dynamics host response to infection and patterns of sexual contact.

Timing And Routes Of Infection

Epidemiological evidence strongly suggests that the infant acquires chlamydial infection from the mother during vaginal delivery. Ascending infection through intact membranes during pregnancy can occur, but is very rare. Depending on the population examined, cervical infection with C. trachomatis has been reported in 2-30 of pregnant women attending prenatal clinics (4-8). In most studies, chlamydial infection was far more prevalent than gonococcal infection. The prevalence of chlamydial infection is associated more weakly with socioeconomic status, urban or rural residence, and race or ethnicity than are gonorrhea and syphilis. The prevalence of C. trachomatis infection is consistently higher than 5 among sexually active adolescent and young adult women attending outpatient clinics, regardless of the region of the country, location of the clinic (urban or rural), and the race or ethnicity of the population. Among sexually active adolescents, prevalences commonly exceed 10 and may...

Clinical Application Questions

A 45-year-old man seeks your advice regarding lesions on the penile shaft that have recurred four times over the preceding 6 months. He is recently divorced and has participated in unprotected sexual activity with two partners. He is concerned about possible genital herpes. Exam reveals a single lesion on the left mid-penile shaft with what appear to be dry crusted vesicles on an erythematous base. Regional lymph nodes are normal. 3. The rapid immunofluorescence (RIF) test for herpes is positive and confirms the presence of HSV-2, but a serologic test for syphilis is negative, as are the HIV titers. What counseling will you give the patient regarding future sexual activity

Hormonal Control Of Brain Gender

One might expect the hypothalamus to be a target of gonadal hormones during development. Lesion and stimulation studies show that some hypothalamic regions are involved directly in the production of sex-specific behaviors. For example, medial preoptic neurons fire rapidly just prior to male copulation, and copulatory behavior is disrupted when this area is lesioned. Medial preoptic neurons are also known to take up more testosterone than any other brain region in adult animals. One of the first studies to show that male and female brains actually differ in a measurable way was an ultrastructural study in the preoptic area (Raisman and Field, 1973). A few years later, it was found that one part of the preoptic area, aptly named the sexual dimorphic nucleus of the preoptic area (SDN-POA), is so much larger in male rats than females that one can actually see the difference in tissue sections without using a microscope (Figure 10.18A). A similar difference is found in the primate...

Tract Infection DRG CategoT 320

During their lifetime, and acute UTIs account for approximately 7 million healthcare visits per year for young women. About 20 of women who develop a UTI experience recurrences. Women are more prone to UTIs than men because of natural anatomic variations. The female urethra is only about 1 to 2 inches in length, whereas the male urethra is 7 to 8 inches long. The female urethra is also closer to the anus than is the male urethra, increasing women's risk for fecal contamination. The motion during sexual intercourse also increases the female's risk for infection.

Hair Replacement Surgery

The doctor will tell you to avoid washing your hair for 2 days after surgery. When you wash your hair, wash it gently. Because strenuous activity increases blood flow to the scalp, you will need to avoid vigorous exercise and sexual activity until your doctor tells you otherwise. Avoid all contact sports and other activities that may cause damage to the treated area. Any sutures will be removed within 7 to 10 days. Several separate surgical procedures may be needed to complete the hair replacement, depending on the size of the bald area. A year may pass before the grafted hair is totally grown.

Autonomic Nervous System Effects

Sure, the activation of digestive and gut activity, increased secretory activity from exocrine glands, the opening of sphincters, contraction of bladder smooth muscle, constriction of the pupil of the eye, and contraction of the ciliary muscle. During sexual intercourse, the sympathetic and parasympathetic divisions do not oppose but complement each other, since erection is a parasympathetic activity, while ejaculation is sympathetically controlled.

The Living Rape Victim

Vagina Rape Victim

If examination of victims is by physicians, they should preferably be senior staff obstetrician gynecologists and not residents. Senior staff members are more experienced and their testimony will carry greater weight in court. In addition, a resident might have moved out of the area by the time the case comes to court. In court, the physician or forensic nurse is never expected to state whether the crime of rape has occurred. Rape is not a diagnosis, it is a matter of jurisprudence. All that the examiner can do is document any evidence of trauma, determine, if possible, whether there has been recent sexual intercourse, and collect trace evidence. Did the assailant's penis penetrate the vulva Did the assailant experience orgasm Did the assailant wear a condom Similar questions regarding anal and oral intercourse should also be asked. The victim is asked whether she douched, bathed, showered, defecated, or urinated prior to the examination. All the aforementioned factors can influence...

With Autistic Spectrum Disorders

Puts wishes and feelings into action or into somatic states ( My tummy hurts ). Unable to use ideas to elaborate wishes and feelings (e.g., hits when mad, hugs or demands physical intimacy when needy, rather than experiencing idea of anger or expressing wish for closeness).

Clinical Trial Issues

The efficacy of androgen replacement therapy is best assessed by monitoring the patient's serum testosterone responses,1'2 because variability in response to testosterone therapy in hypogonadal males in libido, potency, sexual activity, feeling of well-being, motivation, energy level, aggressiveness, stamina, and hematocrit is considerable. Increases in body hair, muscle mass and strength, and bone mass may require months to years of therapy. In sexually immature, eunuchoidal males, androgen replacement therapy may also cause secondary sexual characteristics and long bone growth.

Cocaine and Other Stimulants

Methamphetamine use has reached almost epidemic proportions among gay men in urban centers and is often associated with risk behaviors including sharing of needles for those who inject and unprotected sexual activity. Some have suggested that met-hamphetamines are associated with more intense sexual excitement. When amphetamines are taken along with sildenafil (Viagra), referred to as sextasy, this combination allows for longer and rougher intercourse, which may promote tears in anal mucosa (Halkitis et al., 2001) and therefore promote HIV transmission. Compared to nonusers, gay men who use methamphetamine have been shown to have more sexual partners and to be more likely to participate in anal receptive intercourse, less likely to use condoms, and more likely to be HIV infected (Molitor et al., 1998 Shoptaw et al., 2002). looking at risk behaviors in this population found that, compared to nonusers, the men who used metham-phetamine had more sex partners, had more vaginal and anal...

Sexual Desire and Aging

Male Steriod Facies

Several factors play a role in determining whether an older person is sexually active, including the biological processes associated with normal aging, the desire to engage in some form of sexual activity, and availability of a suitable partner and privacy for sexual expression. Among men, some sexual problems may increase with age, but not necessarily because of aging. The incidence of erectile dysfunction increases for men over 40 and escalates with each decade. The intensity of sexual sensation among men over 40 may be reduced, as may be the speed of erection and the force of ejaculation. Compared with younger men, middle-aged men (45 to 50 years old) are more likely to experience orgasm in one stage, involving a shorter orgasmic period and a rapid shrinking of the erection after ejaculation. The amount of time before another erection can be achieved usually increases, as does the amount of time an erection can be maintained. Many healthy older men maintain their production of...

Incidence And Sources Of Cytomegalovirus Infection

The overall incidence of CMV infection in adults estimated from large studies of blood donors, hospital workers, and pregnant women is around 1-2 per year (17,19,20). Higher rates of primary CMV infection have been documented in women of lower socioeconomic status. In developing countries, most people acquire CMV during early childhood. Studies have clearly shown the importance of both sexual activity and close contact with CMV-infected children as sources of maternal CMV infection (11). Evidence for sexual transmission of CMV is provided by studies that showed higher rates of CMV seropositivity in young women with other indicators of sexual activity, such as sexually transmitted diseases, greater number of sex partners, or young age at sexual debut (21,22). The results of a case-control study showed that Intrapartum transmission of CMV occurs in around 50 of infants born to mothers shedding CMV from the cervix or vagina at the time of delivery (33). Genital tract shedding of CMV is...

Diagnostic Tests For Evaluation Of Chlamydia Infection In The Mother And Infant

Currently available commercial NAATs have FDA approval for cervical swabs from women, urethral swabs from men, and urine from men and women. However, the sensitivity for detection of C. trachomatis in urine from women is less than for the cervix (78-96 ). The use of noninvasive specimens such as urine is especially useful in high-prevalence populations such as sexually active adolescents (9). A second-generation TMA was just recently approved for vaginal specimens from women.

Alcohol Induced Sexual Dysfunction

Sexual dysfunction refers to impairment in sexual desire, arousal, or orgasm, or presence of pain associated with intercourse as a result of alcohol use. Alcohol-induced sexual dysfunction differs from a primary sexual disorder in that improvement would be expected with abstinence from alcohol.

An Alternative Explanation

Donald Symons, in his book The Evolution of Human Sexuality (1979), argues that female orgasm is not an adaptation. He develops a story parallel to the one about male nipples female orgasm exists because orgasm is strongly selected in males, and because of their common embryological form, women are born with the potential for having orgasms, too.26 Part of the story, then, is that orgasm is strongly selected in males this is fairly plausible, since it is difficult for male mammals to reproduce without ejaculation, which requires a reflex response in certain muscles. These muscles are, in fact, the same (homologous) muscles that are involved in female orgasm. It is also significant that the intervals between contractions in orgasm is 4 5 of a second in both men and women. This is considered evidence that orgasm is a reflex with the same developmental origin in both sexes. Finally, this theory is also supported by the evidence of orgasm in non-human primates. The observed orgasms occur...

Interpersonal Schemas Associated with Childhood Abuse

The interpersonal schema for attachment that emerges in an abusive caretak-ing setting deviates from the format proposed above. For example, in a physically assaultive home, proximity, a condition for care, may also elicit physical assault. Thus care and physical assault become paired. In sexually abusive homes, proximity may elicit sexual activity. Such contingency experiences might lead to templates of interpersonal relatedness that, whatever their particulars, suggest that to be interpersonally engaged means to be abused, and that abuse is a way to be connected. Because these schemas are assumed to be the templates for future behaviors, and because they are automatically activated, it is easy to see how negative patterns set down in childhood can guide the adult toward repeating activities that are maladaptive in adulthood. For example, a young woman from an abusive family who has developed the understanding that interpersonal relatedness is contingent on sexual behavior is more...

Mollicutes As Agents Of Human Disease

Following puberty, colonization of the male and female lower urogenital tract by M. hominis and Ureaplasma spp usually occurs as a result of sexual activity. Up to 80 of women may harbor ureaplasmas and more than 50 may harbor M. hominis. These organisms are also commonly found in the lower urogenital tract of pregnant women, and they usually persist throughout pregnancy, providing a reservoir for transmission to the developing fetus and neonate (5). In most healthy adults, mycoplasmas and ureaplasmas exist primarily as commensals, associated with the mucosal surfaces, and rarely cause serious invasive disease. However, in persons who are immunocompro-mised, especially if hypogammaglobulinemia invasion of extragenital sites can occur. If one considers pregnant women and preterm infants to have an altered immune status, it is not surprising that these organisms can cause invasive and destructive disease when given the right circumstances.

Disorders of the Reproductive System

The vas deferens is a long duct that carries sperm from the epididymis past the prostate gland and into the seminal vesicle. The prostate gland and seminal vesicle produce fluids that support the sperm and make up 98 percent of the semen that is ejaculated through the urethra during orgasm. The urethra is also part of the urinary tract and transports urine from the bladder.


Since AIDS was first recognized in the early 1980s, there have been over 25 million deaths and 65 million individuals infected with the virus (CDC, 2006). The most recent estimates (2005) suggest that 64 of the 38.6 (33.4-46.0) million HIV-positive people worldwide live in sub-Saharan Africa (UNAIDS, 2006). The first decade of the pandemic was characterized by a restricted distribution of HIV infection in (a) industrialized countries where risk behaviors included unprotected sexual contact among men who have sex with men (MSM) and sharing of contaminated needles and drug paraphernalia by injecting drug users, and (b) in central, east and West Africa and the Caribbean where the virus spread in the general population through heterosexual transmission. The second decade witnessed the rapid spread of HIV to almost every part of the world along with increasing viral subtype diversity. There was an explosive increase of HIV in southern Africa, with prevalence rates of less than 1 in 1990 to...

Specific History

Syphilis serology should be done in all sexually active patients. The lesions of PR and the lesions of secondary syphilis are not clinically distinguishable. This is an important differential in all sexually active persons. Both eruptions can be similar and both can undergo spontaneous resolution. Patients with syphilis usually have associated constitutional symptoms of fatigue, fever, and myalgias. In addition, there are often palmar lesions, mucous membrane lesions, and a generalized adenopathy. A syphilis serology with the same precautions noted above is definitive.

Negative Life Events

Investigators employing interview-based, contextual methods have observed consistent effects of negative life events on declines in immune system parameters in HIV-positive men who have sex with men (MSM Leserman,2003). Specifically, cumulative negative life events were associated with reductions in natural killer (NK) and cytotoxic suppressor (CD8+) cell counts over a 2-year period in a cohort of HIV-positive MSM recruited in the pre-HAART era (Leserman et al., 1997). The clinical significance of these findings is supported by data indicating that these immune cell subsets may play a key role in suppressing HIV replication (Ironson et al., 2001 Cruess et al., 2003).

Roman Specker

Syphilis (e.g., that it is not transmitted by sexual intercourse). After the death of Bontius, his notes had been published in 1658 by Gulielmo Piso in six books of his work ''de Indiae utriusque re naturali et medica'' (Fig. 5). It is worth noting that Alibert in 1832 copied part of the text from Bontius word by word.


Tant, independent contribution to the level of HIV AIDS in poor communities of color. The fact that HIV-positive inmates had sex with men and women prison staff people who, in principle, are members of sexual networks outside the prison also raises the issue of how much this indirect connection to sexual networks in the general community contributes to rates of HIV beyond the prison walls.

Sexual Dysfunction

Desire (the wish to engage in sexual activity) is triggered by thought or verbal and visual cues. 3. Orgasm (the climax of sexual excitement) occurs at ejaculation (the emission of semen from the penis) muscle tension increases throughout the body. 4. Resolution (a sense of well-being and complete muscle relaxation) follows orgasm. Psychological problems, neurological problems, abnormalities in blood flow, damage to the genital organs, hormonal imbalance, and the use of drugs or medications all can interfere with any of the four stages of normal sexual function. Erectile dysfunction occurs when one or more of these factors persistently interfere with the ability to achieve and maintain an erection sufficient to complete sexual intercourse. control sensation in the penis and, therefore, are not responsible for orgasms, they influence the firmness of the penis during erection. Stress, tension, depression, worry, guilt, and anger can also inhibit sexual performance. These psychological...

Sexual History

Persons with HIV and AIDS have sexual needs as well as needs for companionship, tenderness, love, and romance. Many individuals are extremely uncomfortable discussing sexual feelings and may suffer in silence with problems of arousal, pain, or excitement. Some persons find it difficult to ask a partner to use a condom. Men and women with HIV and AIDS have a high prevalence of alcohol and other drug use and some may continue substance use and associated HIV risk Sexual Experience 15. Do you have (a) sexual partner(s) 16. Are you sexually active 17. What is the frequency of your sexual activity 18. Have you noticed a change in the frequency of your sexual activity (herpes, gonorrhea, syphilis) or HIV infection How many sexual partners do you have 25. How many sexual partners have you had 26. How has your number of sexual partners changed over time 29. What lubricants do you use during sexual intercourse

Penile Disorders

Phimosis is shrinking or tightening of the foreskin. This is normal in a newborn or an infant, but the foreskin usually loosens up by puberty. In older men, the condition may result from prolonged irritation, and it may interfere with urination or sexual activity. Phimosis may be associated with penile cancer. The usual treatment is circumcision (surgical removal of the foreskin). In some men, the penis becomes curved during an erection. This condition is called Peyronie's disease. The cause is unknown, but fibrous or scar tissue forms inside the penis and causes it to bend at an angle during an erection. This painful condition makes sexual penetration difficult or impossible. The disease often resolves itself over several months. Vitamin E is the first-line treatment for this condition. Injections of corticosteroids into the affected area are sometimes helpful. Ultrasound therapy also has worked for some men. Surgery may cure the disease, but it can cause further scarring and make...

Birth Control

Most polls on sexual behavior show that more than half of all American teenagers are sexually active by age 17. However, polls also show that only one third of all parents talk to their children about birth control, and two thirds of all sexually active teenagers never or rarely use contraceptives. This lack of communication may partly explain why there are about one million unwanted teenage pregnancies each year in the United States.

Human Cases

In most of the literature on the evolution of human sexuality, much attention is paid to the distinct attributes of human beings. The continual sexual ''receptivity'' of the human female is contrasted with the (supposed) strict hormonal restrictions on sexual activity in non-human animals. Human beings are supposed to be uniquely adapted to be sexually free from hormonal dictates, the possessors of a separate and self-constructed sexuality. When it comes to evolutionary explanations of women's sexuality, though, the tight connection between reproduction and sexuality remains firmly in place. This ''making sense'' is precisely what I'm interested in. According to these researchers, female sexuality doesn't make sense unless it is in the service of reproduction. There is no scientific defense offered for this assumption. A similar assumption is also present in the evolutionary explanations offered for female orgasm. I have examined thirteen stories for the evolution of human female...

Lack of arousal

Difficulty becoming sexually aroused may occur if there is insufficient foreplay or if either partner is emotionally d istracted. Arousal phase dysfu nc-tion may be manifest by insufficient vasocongestion. 2. Treatment consists of Sensate Focus exercises. In these exercises, the woman and her partner take turns caressing each other's body, except for the genital area. When caressing becomes pleasurable for both partners, they move on to manual genital stimulation, and then to further sexual activity.


In these explanations women are presumed to have orgasms nearly always with intercourse, as men do. Women are presumed to return to the resting state following orgasm, as men do. One could object that Morris is a relatively easy target, so I will offer the following tidbit in defense of my analysis. Gordon Gallup and Susan Suarez published, in 1983, a technical discussion on optimal reproductive strategies for biped-alism, and took up Morris' anti-gravity line of argument. They argue that orgasm would be adaptive because it would keep the woman lying down, and hence keep the semen from escaping. In the context of these paragraphs on female orgasm, they state, ''it is widely acknowledged that intercourse frequently acts as a mild sedative. The average individual requires about five minutes of repose before returning to a normal state after orgasm.''25 The scientific reference they offer for this particular generalization is Kinsey 1948, which is, in fact, exclusively on male sexual...

Frontal Lobe Lesions

Progressive Supranuclear Palsy

Lesions of the cingulate gyrus and premotor cortex produce syndromes ranging from abulia (loss of drive) to akinetic mutism (p. 120) and generally characterized by apathy, loss of interest, inertia, loss of initiative, decreased sexual activity, loss of emotion, and loss of planning ability. Urinary and fecal incontinence occur because of the loss of (cortical) perception of the urge to urinate and defecate. Altered voiding frequency or sudden voiding is the result. These patients are usually impaired in their capacity for divided attention (the processing of new information and adaptation to altered requirements, i.e., flexibility) and for directed attention (selective attention to a particular thing or task). Their attention span is short, they are easily distracted, they have difficulty in the execution of motor sequences, and they tend to perseverate (to persist in a particular activity or thought). Increased distractibility and prolonged reaction times impair performance in the...


Health care providers should maintain a low threshold for the diagnosis of PID, and sexually active young women with lower abdominal, adnexal, and cervical motion tenderness should receive empiric treatment. The specificity of these clinical criteria can be enhanced by the presence of fever, abnormal cervical vaginal discharge, elevated ESR and or serum C-reactive protein, and the demonstration of cervical gonorrhea or chlamydia infection.

Club Drugs

Lematic in terms of HIV transmission, as the parties often go on for several days, with drug use and sexual activity being the primary objectives. Although some of these parties originally began as fund-raisers for HIV service organizations, most of these organizations have since distanced themselves from such functions and they have taken on independent lives oftheir own through magazines and Web sites. Drugs commonly used at circuit parties include MDMA, ketamine, gamma-hydroxybutyric acid (GHB), methamphet-amine, cocaine, marijuana, and alcohol (Bialer, 2002) The club drugs that are of the most concern in relation to HIV AIDS are MDMA, GHB, and metham-phetamine. Although MDMA was first synthesized in 1912, its use among youth and gay men has increased greatly only in recent years. One study from Seattle indicated that 41 of gay men aged 20 to 29 years surveyed used Ecstasy at some time in their lives (Community Epi-demiologic Work Group, 2000). MDMA seems to achieve its effects by...

Hepatitis B Virus

Mothers who exhibit symptoms of acute hepatitis, including fever, jaundice, abdominal pain, and who by history engaged in high-risk behaviors for acquisition of HBV (e.g., promiscuous sexual practices, sex with a known HBV carrier, or intravenous drug use) should be screened for viral markers of infection. Most states require that all mothers be tested for laboratory evidence of hepatitis B infection.

Quality of Life

Quality of life after colectomy for colonic inertia has not been well documented in the majority of studies and should be an important component of future studies. Wexner et al45 found an improvement of quality of life in their 16 patients who underwent subtotal colectomy initial activity limitations attributed to the patients' bowel habits improved after the operation and the numbers of patients with social, vocational, physical, or sexual activity limitations were all reduced after surgery. Nyam et al18 assessed quality of life, although they did not use a validated instrument parameters assessed were sex life, social activity, sports, housework, recreation, family relationships, and travel, which were scored 1 to 5. Overall quality of life was good or improved (scores of 3 or more) in 89 of patients at 6 months, and this improvement was seen in all aspects of lifestyle surveyed and it persisted at 3 and 5 years.


Normal sexual function changes in men elderly men take longer to get an erection and have an increased refractory period (after ejaculation it takes longer before the patient can have another erection). Delayed ejaculation is common, and the patient may ejaculate only 1. of every 3 times that he has sex. impotence and lack of sexual desire are not normal and should be investigated. Look for psychological (depression) as well as physical causes. Medications, especially antihypertensives, are notorious culprits. 5. Normal sexual function changes in women for decreased lubrication, advise water-soluble lubricants. Atrophy of clitoris, labia, and vaginal tissues may cause dyspareunia treat with estrogen cream. Delayed orgasm is common, but lack of sexual desire is not normal and should be investigated (psychological or physical causes).

Preventive Services

Preventive services may involve early prenatal care to prevent babies with low birth weight and infant deaths reduction of tobacco use, dietary fat intake, and high blood pressure in an effort to prevent heart disease and stroke mammography, clinical breast examination, Pap tests, fecal occult blood tests, and digital rectal examinations to detect and treat cancers before they spread increasing use of condoms among sexually active men with multiple partners to prevent STDs and increasing immunization to help eliminate infectious diseases such as tuberculosis, diphtheria, polio, rubella, and measles.

Lower abdominal pain

All sexually active women presenting with lower abdominal pain should be carefully evaluated for the presence of salpingitis and or endometritis-pelvic inflammatory disease (PID). In addition, routine bimanual and abdominal examinations should be carried out on all women with a presumptive STI, since some women with PID or endometritis will not complain of lower abdominal pain. Women with endometritis may present with complaints of vaginal discharge and or bleeding and or uterine tenderness on pelvic examination. Symptoms suggestive of PID include abdominal pain, dyspareunia, vaginal discharge, menometrorrhagia, dysuria, pain associated with menses, fever, and sometimes nausea and vomiting.


Female sexual dysfunction (FSD) is a complex and controversial disorder that includes components of desire and arousal and orgasmic and sex pain disorders (dyspareunia and vaginismus).14'15 FSD consists of four recognized disorders hypoactive sexual desire disorder (HSDD) associated with decreased arousal and sexual aversion female sexual desire disorder (FSAD) associated with decreased arousal orgasmic disorder, a difficulty or inability to achieve orgasm and sexual pain disorder. HSDD can be treated with a transdermal testosterone patch, although a Food and Drug Administration (FDA) advisory panel declined to recommend approval for the Intrinsa transdermal testosterone in 2005 due to concerns with long-term safety and clinical trial endpoint issues.16 While there is a major psychological component in decreased sexual desire, as discussed above, the success of the PDE5 inhibitors in promoting erections in males has led to a hypothesis that FSAD is caused by a decreased blood flow to...

Sexual Concerns

Individuals who have experienced sexual assault or CSA frequently report problems with sexual functioning and sexual satisfaction (e.g., see Browne & Finkelhor, 1986 Leonard & Follette, 2002 Resick, 1993, for reviews). Many individuals experience a relationship between childhood sexual abuse and later sexual problems, which has been supported by numerous empirical studies and case reports. CSA survivors are reported to have significantly more sexual problems (Becker, Skinner, Abel, Axelrod, & Cichon, 1984 Sarwer & Durlak, 1996 Wenninger & Heiman, 1998), more negative sexual symptoms (Gold, 1986), to be less satisfied with their sexual functioning (Jackson, Calhoun, Amick, Maddever, & Habif, 1990), and to be less satisfied with their present sexual relationship (Gold, 1986) than nonabused women in the control group. Researchers have investigated the various types of sexual problems experienced by CSA and sexual assault survivors. According to the DSM-IV, there are four types of sexual...


Trichomoniasis is an equal-opportunity STD, as likely to infect men as women, but much less likely to cause symptoms in men. However, even if you have no symptoms, if you are infected, you can infect your sexual partner. Trichomoniasis in men will usually respond to treatment with antibiotics within a week. It is important to wait until the disease is cured before having sexual intercourse because this infection spreads easily. If you don't have a condom, your partner may want to use a female condom, which is a soft, thin polyurethane sheath that fits inside the vagina and has a visible outer ring. A female condom doesn't protect against STDs as well as a male condom, but is better than no condom. It can be inserted up to 8 hours before sex and does not have to be removed immediately afterward.


With all infections but Candida sp., treat the patient's sexual partners and give counseling (e.g., condoms). Note Any sexually active woman of reproductive age with abnormal uterine bleeding should have a pregnancy test first. Secondary amenorrhea in a previously menstruating, sexually active woman of reproductive age, the diagnosis is pregnancy until proved otherwise, (with a negative human chorionic gonadotropin assay). Amenorrhea is not uncommon in hard-training athletes (due to exercise induced depression of gonadotropin releasing hormone). Watch for amenorrhea as a presenting Any sexually active woman of reproductive cic t who hits iimenonka .should have a pregnancy test as the first step in evaluation.

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