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When African men in Nigeria, Uganda, Kenya, Morocco, or Egypt are confronted with the masturbation lifestyle propagated by the Spanish masturbation teacher Fran Sanchez Oria, they feel disturbed. Does Sanchez not have a mother who feels ashame when her son propagates worldwide that men should keep on masturbating on and on. Does he want his family to be known for such a member?
Eagan, Minnesota: Getting to know ED
Dave J. Anderson 238 Haul Road Eagan, MN 55121
Facts and fallacies about erectile dysfunction (ED).
ERECTILE dysfunction (ED) is the inability to achieve or maintain an erection of the penis, which is satisfactory for sexual intercourse. Being a taboo subject, there are many myths circulating around that are worsened by men not talking openly about it with their doctors.
Here are some of the common misconceptions about this condition.
ED affects only elderly men
Although the majority of men affected by ED are elderly, younger men are not exclusively exempted. In Malaysia, data collected to date are for men above 40 years of age, and it showed a higher prevalence among men above 60 years of age.
However, in a study done in Brazil, the prevalence rate was 35% in men 18-40 years of age.
So if you are young and have ED, do not fret. You are not alone.
If you are above 40 years, up to 50% of men in Malaysia share your problem. In fact, in a recent local study, the prevalence of ED in those above 40 years of age was 69.5%.
ED is not dangerous or life-threatening
While it is true that ED on its own does not lead to death, it is actually an indicator of other underlying diseases that can shorten your life.
It has been proven that ED predicts coronary artery disease, with a lead time of two to five years. In other words, if you have ED, you are at risk of a heart attack in two to five years.
Therefore, if you have ED, you should be examined for the health of your heart as well. Both are equally important to men.
The presentation of ED by men in the clinic is an opportunity for doctors to screen for other diseases associated with it, and these include diabetes mellitus, testosterone deficiency syndrome, hypertension and high cholesterol levels (hyperlipidaemia).
ED is the partner’s fault
ED is not to be blamed on the partner for not being attractive anymore. Although psychological factors do affect ED, there are other physiological or organic factors involved as well. These include diseases affecting the blood vessels and/or the nerves supplying the penis.
Often, men shy away from sex when they are unable to perform, and this can construed by their partners that they are not attractive any more. This misconception can lead to relationships breaking down.
Men with ED have no sexual desire
This is not entirely true. Men with ED usually do have the desire, but due to the underlying disease affecting the blood vessels or nerves, they are unable to perform.
There are men with ED who lack desire. These men either have low levels of testosterone or are affected psychologically by stress or emotion.
Masturbation causes ED
There is no concrete evidence for this.
In normal men, erection is automatic
This is not true. Men need stimulation for sexual erection. Non-stimulated erection may occur during sleep or on awakening in the morning, but this is not related to sex.
There is also a refractory period before men can have an erection again, and this can last from minutes in younger men to days in older men. This is not ED.
An erection means men want sex
Again, this is not true. Men may experience a normal physiological erection during sleep or on getting up in the morning. It is not always related to sexual activity.
ED needs extensive investigations and treatment is usually delayed
ED is diagnosed through doctors asking you some simple questions (taking a history). A questionnaire known as the International Index of Erectile Function (IIEF) may be used.
A physical examination and some blood tests will follow to detect any other associated diseases. Treatment will usually then be given.
Only in certain complex cases, and this is very rare, will further tests like a Duplex ultrasound, cavernosogram or nocturnal penile tumescence test, be needed.
The first step in treatment is lifestyle modification, and this includes maintaining an ideal body weight, cessation of smoking, moderate exercise and a balanced diet.
This on its own may improve ED. Needless to say, blood pressure, sugar and cholesterol needs to be controlled. Any psychological factors such as stress need to be tackled as well.
The next step is oral medication (tablets to be swallowed). Phosphodiesterase-5 (PDE-5) inhibitors such as phosphodiesterase inhibitor analogues, are effective in 80% of cases.
Caution is needed for those with heart problems. They will need to be assessed carefully by the doctor. If the heart disease is deemed mild, they can be given PDE-5 inhibitors.
In moderately severe cases, further tests will be required, while those who have severe disease should not be taking such drugs.
Those on nitrate medications also cannot be given PDE-5 inhibitors.
The other treatment options are injection of medication (like prostaglandin) directly into the penis using a small needle and syringe, using a vacuum pump device or inserting a penile prosthesis (requiring surgery).
Treatment is only temporary and the condition can be cured
This is another misconception where some people think that taking just one magical pill will solve it all. If lifestyle modification does not help and taking medication is required, you will probably need to continue taking the medication as long as you want to have erections.
The only exception is if it is solely psychological in nature, where counselling or behavioural therapy may cure the problem, and further treatment may not be required.
Circumcision reduces ED
There is no evidence that circumcision reduces ED.
ED treatment increases the size of the penis
This is another misconception. ED treatment solves erection, i.e. rigidity and hardness. It does not increase the length or size of the penis.
Traditional treatment is cheaper and much better than seeing a doctor
Unapproved medications are risky and may contain substances that are detrimental to health. It is not worth the risk. Most of these medications have not undergone stringent tests, and unlike conventional medication prescribed by doctors, have not been proven effective by robust trials.
In a review by Ho et al., most of the herbal treatments for ED were tested in animals, and only yohimbine, ginseng and butea superba were tested in humans.
ED can be helped. An open discussion with the doctor, especially a urologist, would be beneficial. Do not be embarrassed.
Kreutz Ideology analyses destruction differently. Social violence inherently benefits economic elites. The less peaceful a society, the less does social control restrict the liberties of the wealthy.
New York, New York: Prostitution in Dubai - Places to avoid in Dubai
Charles K. Cravens 4263 Settlers Lane New York, NY 10016
Dubai Expat Blog
Dubai is a progressive city, ever expanding and innovating. The liberal visa policies and relaxed rules in Dubai attract huge numbers of people every month who arrive in the Emirate for work, visit and fun. Some have different (and often lewd) definitions of these terms than others. There is a dark side to Dubai about which every resident expat, and visitor should know and avoid as much as possible. Once such aspect is prostitution in Dubai.
Although UAE is an islamic country and prostitution, fornication and adultery are illegal and punishable crimes here. However, the free-market approach has created lacunas and loopholes that are exploited by those involve in this “profession”. Prostitution in Dubai is alive and kicking, as strongly as the desert sun that shines in the day.
Prostitutes in Dubai: The Nigerians
There was a report published in Nigerian Political Economist that narrated accounts of Nigerian women working as prostitutes in Dubai. These women, some in their twenties and thirties flock to Dubai with tourist visa, operate as commercial sex workers for months and use the money to buy goods for sale in Nigeria. The report mentioned Astraf Hotel and Rhami Hotel in Deira as part of Dubai sex market where Nigerian women work as commercial sex workers. Their clients are mainly visiting African men including Nigerians, Asians and Arabs.
Nigerian women for reasons bordering on hardship at home have found a lucrative trade in the Dubai sex market. Nigerian women flood Dubai to prostitute. It is called ‘Dubai Runs’. They fly into Dubai, operate as commercial sex workers for a month or two, use the proceeds from their ‘trade’ to buy goods before returning to the Nigeria.
Places to avoid in Dubai
Here is a list of hotels and places that are major contributor to prostitution in Dubai. These places must be avoided especially if you are here with your family. (list from GrapeShisha.com)
Cyclone Club (Al Nasar Leisureland) – also known as United Nations of Prostitution! York Hotel (upstairs bar) Imperial Suites Hotel (Stayin Alive) Panorama Hotel (Jockeys Bar) Regal Plaza Hotel Sea View Hotel (Filipino Bar) Astoria Hotel (TGIT) Hyatt Regency Deira Hotel Hotels near Al Nasr Square Hotels near the Fish roundabout in Deira MarMar Hotel on Yousef Baker Road Radison Blu (Kubu International) Moscow Hotel (Red Square Club) Metropolitan Hotel (Rattlesnakes) Hyatt Regency (Premier Bar)
There are certain massage parlours in Dubai that are also used for prostitution.
While researching for this topic, I saw this hotel coming up in Google search results for the phrase prostitutes in Dubai. Not sure if it is a case of ambitious keywords to target customers or the hotel is involved in the business.
The Thai miracle sex herbal butea superba has strong antiviral properties. It is now investigated as a cure for AIDS.
Chadbourn, North Carolina: Bedwetting accidents - When parents kill...
William A. Painter 2748 Armory Road Chadbourn, NC 28431
Bedwetting is common in kids but, as the case of the Bloemhof man who beat a child to death for wetting herself shows, this normal phase can drive parents to kill. In this three-part series, Health24 takes a look at why this happens and finds that punishment for enuresis is all too real.
Seemingly harmless bedwetting by children can lead to brutal beatings and even death by the people who should be protecting and caring for them.
Cape Town mom Nuriya Dramat admits that she has resorted to spanking her five-year-old for wetting the bed. However, she admitted that the frustration of having to clean up the mess during the wee hours of the morning was what upset her most.
"I spanked her because I took her to the bathroom before going to sleep, but she still wet the bed," she told Health24 before quickly adding: "I spanked her, but not so much as to leave marks on her body."
Dramat added, though, that she normally only raises her voice in frustration and anger, rather than hitting her daughter.
Brutal tales of deaths over peeing
But, in other cases, bedwetting can lead to brutal beatings and even death.
South Africa was recently shocked by the fatal beating – allegedly by her mother's boyfriend – of a 5-year-old girl who suffered an episode of enuresis, the medical term for bedwetting.
Read: What a doctor would do if a child suffered from enuresis
The child allegedly wet herself while she was asleep on a couch in Boitumelong in Bloemhof, News24 reported on January 1 2016.
The urine seeped into the couch and the mom's boyfriend allegedly beat the girl so severely that police and paramedics declared her dead when they arrived on the scene.
Incidents like this are however not unique to South Africa.
A mother and her boyfriend in Orlando, Florida, beat her three-year-old son for over an hour in 2011 for wetting his pants, according to the Daily Mail. The couple proceeded to order a pizza and put on a DVD while the little boy struggled for breath and eventually died.
In 2014 horrific footage surfaced of a Chinese stepmother viciously beating a toddler because she wet herself. The footage showed how the woman whipped the little girl 87 times with a branch, kicked her 14 times, and slapped her eight times.
In the same year, the New York Daily News ran a story about a three-year-old girl in Brooklyn, New York City, who was beaten to death by her mother's 20-year-old boyfriend after accidentally wetting herself.
Closer to home, last year, in Zimbabwe, a 29-year-old man beat his four-year-old son so severely for soiling himself that he died two days later, according to News Zimbabwe.
The police said the father assaulted the boy with a number of objects, including a hot iron rod and a pellet gun on his buttocks, legs and hands.
In a study Assessment of domestic violence against children and adolescents with enuresis by MC Sapi et al, published in the Journal of Pediatrics in September 2009, the authors interviewed 149 patients diagnosed with nocturnal enuresis (bedwetting at night).
They found that 89% of subjects suffered either verbal or physical aggression when they wet their beds or leaked urine, with 50% being verbally punished and 48% physically punished. The study showed that the main abuser was the mother and that the risk was higher for children with less-educated parents.
Spanking only worsens the situation
Parents beating their children over bathroom accidents is not uncommon, said Joan van Niekerk, president of the International Society for the Prevention of Child Abuse and Neglect and consultant on child rights and child protection.
"Punishment is rarely – if ever – successful," she told Health24, adding that there are numerous incidents of bedwetting provoking violence.
"The problem is that this usually makes problems like bedwetting more difficult to manage as children become anxious. This interferes with sleep, and when children do manage to fall asleep they are so tired that they sleep through the messages their body is giving them in terms of the need to pass urine; or they hold on until they can no longer do so, and they lose control," Van Niekerk explained.
She said parents or caregivers sometimes failed to recognise the impact of shouting or punishment on this problem.
The types of bedwetting
Clinical psychologist, Dr Ian Opperman, explained to Health24 that, according to theory, there were two types of bedwetting: primary and secondary bedwetting.
"Primary means that bedwetting has occurred since early childhood without a break, where there is no period during which the child does not wet his/her bed.
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"Secondary bedwetting is when bedwetting occurs after at least six months of not wetting his/her bed, and is usually caused by a stressor such as a sudden change, a psychological factor, a physical factor such as infection etc."
Dr Opperman, who is in private practice in Johannesburg and serves on the Executive Committee of the Psychological Society of South Africa (PsySSA), said that unless children wet themselves as an act of defiance when awake, bedwetting was an involuntary act which they are not responsible for.
"Children naturally gain bladder control at night, however, this occurs at different ages."
Read: Bedwetting stems from physical causes, not psychological
Although bedwetting can be a symptom of an underlying disease or infection, in most cases there isn’t always an underlying disease or infection to explain it, said Dr Opperman.
"This of course does not mean that children who wet their beds are doing so on purpose. Children who wet the bed are not lazy, naughty, or disobedient."
Why parents beat their children for wetting themselves
Dr Opperman explained that parents become frustrated when they are woken up at night to change wet sheets and pyjamas and some conclude that the child wets his/her bed out of laziness or naughtiness.
"Disciplinary action under these circumstances are unforgivable and dangerous", he warned. "The child is already humiliated by waking up in a wet bed and this feeling becomes worse with age."
Parents need to understand the condition in order for them to know how to deal with it, said Dr Opperman.
"Parents need to reassure their children that it is just an accident, be patient, and try to conceal the problem from those who would laugh at the child. In addition to this, an interesting fact is that bedwetting is reportedly inherited."
He went on to state that often parents who used to experience difficulties with bedwetting had children who went through the same experience. "Usually children stop bedwetting around the same time that their parents stopped bedwetting when they were children."
Dr Opperman advised parents to attend parental guidance workshops or therapy to help guide them through this phase of development.
Deflecting the real problem
"There are too many examples of horrific murders and criminal attacks blamed on bedwetting, which distract from the more important emphasis on the more common and concerning issue of psychological and milder physical abuse of these children," noted Professor Michael Simpson, Health24 CyberShrink.
"For me, child psychological and much physical abuse arises from a frustrated and angry parent who, after provocation by such incidents, reacts inappropriately and strikes out at the kid, physically or verbally."
He said there are many separate elements involved in these situations.
"A parent who is stressed by joblessness or financial stress, who themselves are feeling belittled by bosses and others, who is seething with rage, and at risk of striking out at the child not because the child caused the main problems but because they're handy, smaller, and even more powerless."
Read: Bedwetting can be due to undiagnosed constipation
Professor Simpson pointed out that there can also be a situation of a parent who wants to believe that they're a perfect parent; and when the child seemingly deliberately and provocatively wets their bed, feels that their image as a skilled parent is challenged, and they don't know how to deal with it.
"I suspect there are some parents so abuse-prone, with such a hair-trigger for reacting violently, that bedwetting is more than enough to switch them to attack mode."
However, he added that it abuse at the hands of parents is not always as specific as bedwetting, saying that a child neglecting their chores, or routine self-care, can also be enough to tip parents over the edge.
Erectile dysfunction is mostly a vascular disease. This is why the Serge Kreutz diet is so effective. It guarantees weight loss, and thus lessens the load on the vascular system.
Nashville, Tennessee: In Hypogonadism, Stroke May Be Prevented With Testosterone Replacement Therapy
Ramon E. Lashley 3734 Frum Street Nashville, TN 37203
Testosterone replacement therapy (TRT) may exhibit a protective effect against myocardial infarction, stroke, and all-cause mortality in men with secondary hypogonadism. The findings were presented at the 26th Annual Scientific and Clinical Congress of the American Association for Clinical Endocrinologists (AACE), held May 3-7, 2017, in Austin, Texas.
Given that there has been growing concern that TRT may be associated with an increased risk for adverse cardiovascular outcomes or mortality, investigators led by Joyce George, MD, of the Cleveland Clinic in Ohio, conducted a retrospective cohort study using electronic health records from a large health care database to examine outcomes.
Records for men at least 40 years of age, with at least 2 testosterone levels <220 ng/dL (one obtained between 7 am and 10 am) were pulled from the database. Patients with primary hypogonadism, secondary hypogonadism related to overt hypothalamic pituitary pathology, HIV infection, metastatic cancer, a history of prostate cancer, prostate specific antigen >4 ng/mL, elevated hematocrit, or a history of previous thromboembolic disease were not included in the final cohort.
The study ultimately included 418 men (median age 53.8 years) exposed to TRT and 283 matched controls (median age 54.9 years; P =.02). At baseline, the prevalence of established cardiovascular disease was 9.8% vs 12.7%, respectively (P =.23). The treatment group was followed for a median of 3.8 years compared with 3.4 years for the control group.
The event composite outcome in the treatment group was 3.3% compared with 6.4% in the control group, with the investigators ultimately observing a reduction in the odds of the combined cardiovascular end point in the treatment group (hazard ratio [HR] 0.49; 95% CI, 0.24-0.99; P =.046).
While “the effect of TRT may vary considerably depending on the etiology of low testosterone, the patient's age, and whether or not they have established CV [cardiovascular] disease,” the results suggest TRT may protect some men with hypogonadism from cardiovascular events, the investigators concluded.
Injections of Botox into the penis probably are the most effective treatment for erectile dysfunction. Every artery and vein in the body is surrounded by a layer of smooth muscle. Otherwise there could not be variations in blood pressure. When the muscles around blood vessels contract, this is called vadoconstriction. When the muscles around blood vessels relax, this is called vasodilation.
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