What is dyspareunia?

What is dyspareunia?

The term “dyspareunia” means painful intercourse. A woman may feel pain at the start of penetration or with deep penetration. Or, pain may happen only with specific partners or in certain positions.

There are many reasons a woman may experience pain during intercourse. Here are the most common ones:

• poor lubrication
• medical conditions (such as ovarian cysts or pelvic inflammatory disease)
• allergies
• birth control devices that don’t fit correctly
• relationship/emotional problems
• vaginismus

Many of these issues can be treated easily under a doctor’s care.

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How common is it to “fake” an orgasm, and why do people do it?

How common is it to “fake” an orgasm, and why do people do it?

Both men and women pretend to have orgasms, and the practice of “faking” is fairly common. Research suggests that women are more likely to fake orgasm than men are.
For example, a 2009 study published in the Journal of Sex Research reported that among a group of college students, 25% of the men and 50% of the women had pretended to reach orgasm. Among participants who had had vaginal intercourse, 28% of men and 67% of women said they faked orgasm.
Women often fake orgasm by making corresponding sounds, like moaning or gasping. They may breathe more quickly or move in ways that make their partner think they are climaxing.
Since men typically ejaculate when they reach orgasm, faking it may be more challenging. However, if a man wears a condom, he might be able to dispose of it before his partner realizes he hasn’t climaxed.
Men and women cite many reasons for faking orgasm. Sometimes, they just want the encounter to end, especially if they know they are not going to climax.
Often, people have their partner’s feelings in mind when they fake orgasm. They want their partner to think they enjoyed the experience. Or, they may want to avoid making their partner feel inadequate or anxious about performance the next time they have sex.
Some heterosexual couples feel that there is a proper sequence for orgasm, with the woman climaxing first. So a woman may fake her orgasm to follow this sequence, even if she feels she will actually reach orgasm with a little more time.
Experts have also found that some women fake orgasm because it makes them more aroused, leading to greater sexual satisfaction.
Many couples think of orgasm as a goal to be achieved by the end of sex and that if orgasm doesn’t occur, they have failed in some way. But orgasm is a complex process that may not happen all the time. Focusing instead on the intimacy shared rather than a big climax can make sex more fulfilling for both partners. And if one partner does not reach orgasm regularly, it may be an opportunity for couples to discuss what pleases them or experiment with new sexual activities.

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How likely is sexual activity to trigger sudden cardiac arrest?

How likely is sexual activity to trigger sudden cardiac arrest?

While it is possible for someone to suffer sudden cardiac arrest during or just after sex, the odds of this happening are very low.

Sudden cardiac arrest occurs when a problem in the heart’s electrical system stops the heart from beating. Sometimes, this is caused by arrhythmias (abnormal heart rhythms). There are no warning signs for sudden cardiac arrest, and medical attention is needed immediately.

Sudden cardiac arrest is different from a heart attack, which occurs when blood flow to the heart is blocked.

In November 2017, scientists discussed the likelihood of sudden cardiac arrest during sex at a meeting of the American Heart Association.

They studied the medical records of 4,557 adults who had had sudden cardiac arrest between 2002 and 2015 in Oregon, United States. They determined that 34 of these cases – 32 men and 2 women – were related to sexual activity. In other words, less than 1% of all patients in the group had experienced sex-related sudden cardiac arrest. The events occurred either during sex or within an hour afterward.

These patients were likely to be male, middle-aged, and/or African-American. Many of them had a history of heart disease, and most took heart medication, the scientists said.

One finding that concerned the researchers was that only a third of the patients received cardiopulmonary resuscitation (CPR). When cardiac arrest occurs, CPR can save a person’s life. They called for more public education on CPR and encouraged people to learn it.

The risk of sex-related cardiac arrest is low, but heart patients are still advised to talk to their doctor if they have concerns about sexual activity.

Sex is safe for most heart patients, but anyone who has uncontrolled high blood pressure, chest pains, a weak heart, a history of heart attack, advanced heart failure, or an arrhythmia should get a doctor’s approval first.

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Does engaging in sex affect personal workouts or sporting performance?

Does engaging in sex affect personal workouts or sporting performance?

The notion that sexual activity before a sporting event affects performance has been a matter of some debate. Some athletes feel that sex before sports is detrimental. For example, boxer Muhammad Ali is believed to have abstained from sex for 6 weeks before a match. But some feel it helps. American football player Joe Namath reportedly had lots of sex before a game.

So which is better? Scientific studies show that sex before a workout usually doesn’t affect energy levels or strength, at least for men. Women’s results have not been widely studied.

Many male athletes who abstain feel that that the sexual frustration makes them more aggressive and gives them endurance. These feelings may or may not be related to testosterone. It is unclear whether abstaining or having sex raises or lowers testosterone levels, and every man is different.

On the other hand, some feel that having sex regularly, even before a sporting event or workout, helps athletes feel relaxed and focused. They can concentrate better because they are not distracted by sexual frustration.

Many experts say that while the actual act of sex will not hurt one’s performance, the circumstances surrounding the encounter might. If athletes are up late and partying, the lack of sleep and effects of alcohol could make them groggy the following day, leaving them with less energy and less ability to concentrate.

Experts have also suggested that athletic performance within a few hours of sex might not be optimal because it takes some time for the heart rate to stabilize. As a result, some athletes tire out more quickly.

Ultimately, the decision to abstain from sex before sports is up to the individual. However, maintaining other healthy habits - like getting enough sleep and following a diet rich in fruits, vegetables, and whole grains - will benefit short-term performance and long-term well-being.

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What causes priapism and how is it treated?

Priapism is a full, rigid erection that lasts for more than 4 hours. It is not necessarily caused by sexual stimulation and it is usually painful.

While priapism isn’t very common, it’s important for men to seek treatment immediately to avoid tissue damage. Left untreated, priapism will lead to erectile dysfunction (ED).

To understand priapism, it helps to review how erections occur.

In normal circumstances, erections are induced by signals from the nervous system – either as a result of sexual stimulation or thoughts or as a reflex during sleep. The signals cause arteries in the penis expand to allow more blood to flow in, causing the erection. Veins constrict to hold the blood in the penis and keep the erection rigid. After the man ejaculates (or if stimulation stops), the extra blood in the penis flows back into the body.

With priapism, there is a problem with this blood flow. Sometimes, too much blood flows into the penis as the erection forms. Or, the blood becomes trapped in the penis, unable to flow back out into the body as expected.

Priapism can have a number of causes, including the following:

• Blood disorders, such as sickle cell anemia and leukemia

• Substance abuse, including alcohol, marijuana, and cocaine

• Injury to the genitals, pelvis, or perineum (the area between the base of the penis and the anus)

• Spinal cord injury

• Carbon monoxide poisoning

• Venom from scorpions or black widow spiders

• Blood clots

Priapism can also be a side effect of certain prescription medications, including

  • Antidepressants

    • Erectile dysfunction (ED) drugs (oral and injected)

    • Mental illness medications

    • Blood thinners

    • Alpha blockers (sometimes used to treat high blood pressure or an enlarged prostate)

Treatment usually depends on the type of priapism.

Ischemic priapism, in which blood is trapped in the penis and can’t drain out, is an emergency and should be treated as quickly as possible to avoid damage to the penis.

Some common treatments are:

  • Aspiration. A small needle and syringe are used to drain the excess blood from the penis. Sometimes, a saline solution is flushed through the penis as well.

  • Medication. A drug may be injected into the penis. This drug narrows the blood vessels that let blood in. This makes it easier for the trapped blood to drain out.

  • Surgery. A shunt may be implanted so that blood flow can be redirected.

Men with sickle-cell anemia, a common cause of priapism, may be given treatment specifically for that condition.

Nonischemic priapism, when too much blood flows into the penis, may resolve on its own. Some doctors advise putting ice on the perineum. At times, surgery is done to prevent excess blood flow to the penis or to treat damage caused by an injury.

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What is pre-ejaculate or precum?

What is pre-ejaculate or precum؟

Pre-ejaculate, sometimes called precum, is a clear fluid that is released when a man becomes sexually aroused, but before he ejaculates. Sometimes, it can be seen at the tip of the penis, but many men don’t even notice it.

The fluid is produced by a pair of pea-sized glands called the Cowper’s glands, located near the urethra, a tube in the penis with a dual purpose: allowing urine and semen to exit the body.

Pre-ejaculate fluid neutralizes any acidity left by urine in the urethra, protecting sperm that flows through.

Men produce differing amounts of precum, from a few drops to about a teaspoon. Generally, the amount is nothing to worry about.

In rare cases, men produce much more fluid, and there have been reports of men whose clothes are soiled when they become aroused. Medications might help, and men in this situation are advised to see their doctor.

Many people wonder whether a woman can get pregnant from pre-ejaculate fluid. The answer is yes – although this is not common.

Typically, precum does not contain any sperm. However, if a man has ejaculated recently, sperm cells might still be found in the urethra and mix with the pre-ejaculate fluid. When this happens, it is still possible for a woman to become pregnant. For example, if a man removes his penis from his partner’s vagina before ejaculating (“pulling out”), sperm in the precum can still travel up the vagina and fertilize an egg.

For this reason, couples who do not wish to become pregnant should use condoms during all sexual activities.

It’s also important to know that sexually-transmitted infections, like HIV and chlamydia, can be transmitted through precum. For instance, if a person gives oral sex to a man, he or she could become infected through contact with pre-ejaculatory fluid. This is another important reason to practice safe sex.

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Peyronie’s Disease

What is Peyronie’s disease?

Peyronie’s disease is a disorder that causes areas of hardened scar tissue called plaques to form on the penis, just under the surface of the skin. These plaques make the penis less flexible. As a result, men with Peyronie’s disease have a noticeable curve in their penis. The penis may shorten as well.

Sexual intercourse can be difficult for men with Peyronie’s disease, especially if their curve is severe. Men may also experience pain and have problems with erections.

Experts aren’t sure what, exactly, causes Peyronie’s disease. It is believed to be a wound healing disorder. A man may injure his erect penis, such as through vigorous sex, and not even be aware that he has done so. However, the injury does not heal as it should. Instead, an excessive amount of scar tissue develops and does not break down as it typically would.

It’s also possible that some cases of Peyronie’s disease are inherited.

Peyronie’s disease occurs in two stages. The first is the “active” phase, which occurs during the first twelve to twenty-four months. During this phase, the disease progresses and the penis continues to bend.

Eventually, Peyronie’s disease stabilizes. This is called the “chronic” phase. At this time, pain usually subsides and the curve usually doesn’t worsen.

Not all men with Peyronie’s disease require treatment. For some, the condition goes away on its own. For others, the condition is not severe enough to require treatment.

However, many men decide to have treatment, which may involve surgery. Nonsurgical treatments are also available.

How do plaques cause the penis to bend?

Plaques form on the tunica albuginea, the flexible tissue that surrounds other tissue that fills with blood during an erection. Because the plaques are hardened scar tissue, they cause the tunica albuginea to lose its elastic quality. This makes the penis bend when erect.

Where are the plaques located?

Usually, the plaques are found on the upper side of the penis, but they can be found on the underside, too. Sometimes they look like small dents; other times, they form all around the penis, giving it an hourglass look.


How is Peyronie’s disease treated?

Surgery is the most common method. Tunica albuginea plication involves stitching tissue on the opposite side of the affected area to even out the bend. More severe cases are treated with a plaque incision and grafting procedure. Surgeons cut into the plaque and fill it with human or animal tissue.

How might Peyronie’s disease affect a man’s partner?

Peyronie’s disease is a condition that causes hardened plaques to form just under the skin of the penis. As a result, the penis loses flexibility and develops a distinct curve, sometimes to the point that sexual intercourse is difficult or impossible.

Men with Peyronie’s disease often feel pain and experience erectile dysfunction. But the condition can take an emotional and psychological toll as well. Men may feel depressed that their intimate relationships have changed, frustrated that they can’t perform like they used to, and anxious about satisfying their partner.

Peyronie’s disease can, in fact, have an impact on partners. In 2016, the Journal of Sexual Medicine published a study by Canadian researchers that shed some light on Peyronie’s effects on female partners.

Couples facing Peyronie’s disease are encouraged to keep the lines of communication open, especially in sexual matters. They might need to make some adjustments to their sexual routine, but it’s still possible to be intimate. Some couples in this situation benefit from sex therapy, which can help them express and work through their sexual concerns, needs, and relationship issues.

Are there personal health risk factors associated with Peyronie’s disease?

Peyronie’s disease is characterized by areas of bone-like collagen plaques that form inside the penis. Because these plaques are hard and inflexible, they cause the penis to bend. Peyronie’s disease can be painful and make sexual intercourse difficult.

The exact cause of Peyronie’s disease is unknown, but it is believed to be a wound healing disorder. In other words, the penis is injured and doesn’t heal properly. Peyronie’s disease may also be genetic or linked to certain connective tissue disorders like Dupuytren's contracture.

Personal health risk factors may also be involved. For example, high blood sugar and tobacco use may make it harder for wounds to heal normally. These factors could, indirectly, make a man more likely to develop Peyronie’s disease. Other potential risk factors include diabetes, heart disease, alcohol use, and high cholesterol.

In 2015, a team of Italian scientists investigated erectile dysfunction (ED), smoking, diabetes, and high blood pressure as possible risk factors for Peyronie’s disease. After collecting data from a group of 279 men (97 with Peyronie’s disease, 182 without), they found that cigarette smoking, high blood pressure, and ED were associated with Peyronie’s disease, but diabetes was not.

These results do not mean that any of these conditions cause Peyronie’s disease. The scientists explained that more study is necessary to see if removing a potential risk factor reduces rates of Peyronie’s disease.

How might Peyronie’s disease cause erectile dysfunction?

Scientists aren’t sure exactly some men with Peyronie’s disease also have ED, but the following factors might be involved:

  • The plaques may weaken the smooth muscle tissue in the penis, making it more difficult for an erection to occur.
  • The plaques may impair blood flow into the penis. As a result, there isn’t enough blood for a firm erection.
  • The plaques may cause blood to leave the penis too quickly, making the man lose the erection.


  • Men with Peyronie’s disease often feel depressed about their situation and anxious about sexual activity. These psychological issues can lead to erection problems.


If a man has ED along with Peyronie’s disease, he should talk to his doctor. The two conditions can be managed and a doctor can help determine what course of treatment is most appropriate.


Is there any relationship between penile curvature in men with Peyronie’s disease and ED?


One of the hallmarks of Peyronie’s disease is curvature of the penis. Plaques – areas of hardened scar tissue – cause the penis to lose some of its elasticity. This can make it bend when erect. For some men, the degree of curvature is so severe that they cannot have sex at all.

In July 2014, the International Journal of Impotence Research published a study that examined whether the degree and direction of a man’s curvature was associated with erectile dysfunction. They focused on vasculogenic ED, which involves poor blood flow to the penis.

The researchers found that the extent and direction of curvature did not appear to be related to ED.

“The role of [Peyronie’s disease] in the development of ED remains unclear at the present time,” they said.


What surgical treatments are available for Peyronie’s disease?

Surgical treatment for Peyronie’s disease is usually considered when a man is in the stable phase. At this point, the curvature has reached a plateau – not worsening, but not getting better.

Physicians will also consider the type of curvature and degree of erectile function when making decisions about surgery.

The most common surgical treatments for Peyronie’s disease include the following:

Nesbit Procedure (Tunica Albuginea Plication). The tunica albuginea is a thin layer of tissue that envelops the corpora cavernosa – two chambers of spongy tissue that fill with blood during an erection. Plaques caused by Peyronie’s disease form in the tunica albuginea.

During this procedure, the surgeon straightens the penis by folding small portions of the tunica albuginea on the opposite side of the curve. (Sometimes, these small portions are removed.) The surgeon then stitches the area, keeping the penis straight.

  • Plaque Incision and Grafting. Men with more severe cases of Peyronie’s disease may benefit from this technique. To straighten the penis, the surgeon cuts into the actual plaque and then fills the space with replacement tissue called a graft. The graft could come from another part of the patient’s body or from another human or animal.
  • Penile Prosthesis (Implant). Men who have both Peyronie’s disease and erectile dysfunction may decide to have a penile prosthesis, or implant. This procedure involves removing the corpora cavernosa and replacing them with cylinders, which straighten the penis.

Depending on the type of surgery and the man’s anatomy, there might be some penile shortening or loss of penile sensitivity after these procedures.

For men who have the Nesbit procedure or plaque incision and grafting, problems with erections could develop.

Concerned patients should ask their doctors about these issues. Resulting erectile dysfunction (ED) is usually treatable.

Men who are in the “active” stage of Peyronie’s disease, when the condition is still progressing, may choose nonsurgical treatments. Such treatments could include the following:

  • Intralesional Therapy.

In some cases, medication is injected directly into the plaques themselves. Verapamil and interferon are two such substances, which are hypothesized to stop the development of collagen, the protein from which the plaques are made. They are also suggested to help “remodel” the scar tissue, making the plaques smaller as the area heals. However, there are conflicting reports regarding the efficacy of these therapies in the treatment of Peyronie’s disease.

In December 2013, the U.S. Food and Drug Administration (FDA) approved the use of an injectable medicine called Xiaflex to treat Peyronie’s disease in the United States. Xiaflex is given in a treatment course of four cycles by a healthcare professional, many men reported better erections and improved sexual satisfaction.

  • Traction.

This technique involves wearing a special device designed to straighten the penis. This device pulls the penis straight. Wearing the traction device between six and nine hours a day (with thirty minute breaks every two hours) appears to have the best results, according to recent research. Traction therapy may also help restore some lost penile length. Apparently, more research is required to elucidate whether this therapy is a viable option for patients with Peyronie’s disease.

  • Vacuum Erection Devices (VEDs).

VEDs are sometimes used by men with erectile dysfunction (ED). But there are some studies demonstrating that it might also help men with Peyronie’s disease. To use a VED, a man places a clear plastic cylinder over his penis. The cylinder is connected to a pump, which, when activated, creates a vacuum. Once an erection has formed, a constriction ring is placed at the base to keep it strong for whatever duration is needed.

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What is orgasmic anhedoniapleasure dissociative orgasmic dysfunction?

What is orgasmic anhedoniapleasure dissociative orgasmic dysfunction?

The word “anhedonia” refers to the inability to experience pleasure from an activity that is normally considered pleasurable. People with orgasmic anhedonia (also called pleasure dissociative orgasmic dysfunction or PDOD) are unable to feel pleasure when they climax.

Orgasmic anhedonia/PDOD doesn’t affect sex drive. People with this rare condition still feel driven to have sex. Men still ejaculate. And women still know they’re reaching orgasm. The difference is that the pleasure is missing.

The situation can be quite frustrating for couples. People with orgasmic anhedonia/PDOD may be embarrassed or feel like they’re missing out. Partners may feel inadequate, like they are doing something wrong. Some partners are unaware of the situation.

Experts believe that orgasmic anhedonia/PDOD occurs because of a problem with neurochemicals in the brain, particularly dopamine. Patients may receive sexual stimulation, but there is a disconnect between the sensation and the part of the brain that recognizes that sensation as pleasurable.

It’s possible that the orgasmic anhedonia/PDOD is linked to psychological issues like depression or addiction. But it could also be connected to medications, high prolactin levels, low testosterone, or physical conditions like spinal cord injury.

If the cause of orgasmic anhedonia/PDOD can be identified, treating that issue may solve the problem. Sometimes, a combination of medical treatment and sex therapy is necessary.

People who do not feel pleasure during orgasm are encouraged to see their doctor.

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Does long term anabolic androgenic steroid use lead to heart problems?

Does long term anabolic androgenic steroid use lead to heart problems?

THE USE (abuse) of anabolicandrogenic steroids (AAS), such as synthetic testosterone and other androgens, has increased markedly in recent years.

The majority of AAS users do so to ‘improve’ physical appearance and body building rather than competitive sport.

Many users become dependent on these drugs. The side-effects of AAS abuse include acne, weight gain, mood changes (especially aggressive behaviour), decreased testes size and low sperm counts leading to infertility.

There is some evidence that longer term effects include prostate cancer and heart disease but good quality studies are lacking.

A recent American study1 from the journal Circulation assessed three different measures of cardiovascular disease (CVD) in weight-lifters aged 34 to 54 who had used AAS for at least two years compared to those who had not used AAS.

This cross-sectional study showed that users of AAS had significantly worse outcomes on the three CVD measures, although one measure was normal in those who had previously used AAS but were not using at the time of the study, suggesting some recovery after stopping the AAS.

However, the other two measures indicated long-term damage to heart function and atherosclerosis (build-up of plaques leading to clogging of the artery connected to the heart). Although this study had some limitations it adds to the evidence that there are serious health implications for men who do not have testosterone deficiency but are using steroids for other purposes.

The risks may be difficult to quantify as the drugs available from suppliers at the local gym or on the internet are not regulated.

They may contain unknown substances, have varying concentrations or may contain hormones mixed with other drugs or dietary supplements (mixing drugs can be dangerous as they may interact with each other).

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Sexual Health, Birth Control and Condoms

Sexual Health, Birth Control and Condoms

Sexual Health, Birth Control, and Condoms


What Causes Condoms to Come Off During Sex?

A condom may come off during sex because:

  • It's too large.Try a snug condom.
  • Loss of erection.Remove your penis, holding on to the rolled edge of the condom, as soon as you begin to lose your erection.

Where Can I Get Male Condoms?

Condoms can be purchased at most drug stores. Condoms also are sold in some vending machines in public restrooms.

How Effective Are Male Condoms for Birth Control?

Condoms are about 82% effective for birth control. With careful use, they are even more effective. Keep in mind that the best way to avoid getting pregnant is to not have sex (abstinence).

How Do Male Condoms Prevent STDs?

Latex condoms provide protection from sexually transmitted diseases by preventing the infected area from coming into contact with the partner. Polyurethane condoms provide some protection, although not as much as latex. Natural or lambskin condoms do not protect against STDs because they have larger holes or "pores" that allow the small particles that can cause some STDs to pass through. Many STDs -- including HSV, which causes herpes, and HPV or the human papillomavirus, which is the most common sexually transmitted infection -- can be transmitted from areas not covered by a condom.

Should Foam be Used With Male Condoms?

Contraceptive foam can offer added protection against pregnancy in case a condom breaks. Use of spermicides can irritate the genital tissues and may increase the risk of STDs, including HIV/AIDS.

How Effective Are Foam and Male Condoms?

When used together and properly, foam and condoms are about 97% effective in preventing pregnancy.

What Is a Female Condom?

The female condom is a lubricated polyurethane (plastic) tube that has a flexible ring at each end. One end of the tube is closed.

How Is the Female Condom Used?

Before sexual activity begins, the woman inserts the condom into her vagina so that the closed end of the tube covers the cervix, and the other end slightly covers the labia (lips on the outside of the vagina). The condom blocks sperm from entering the womb. Female condoms should be discarded after one use.


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