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good sex

The four words that ensure good sex

Normalizing giving and receiving feedback is essential, according to experts

Communication is not just what we do when we have to present a work in public, give a speech or simply call a friend. Forgetting this information may be damaging your life, in every way, also your sex life. Although speaking is a spontaneous and natural act, this fact quickly gets us used to not paying attention to what we say but, above all, to what we do not say.

Having a healthy sex life often depends on a phrase as simple as it is ignored: have you ever asked the other person what they like? This is the key to sexual pedagogy that many specialists are trying to do today, because in the age of communication it disappears from the most daily actions. Dr. P K Gupta, the best sexologist in Delhi who disseminates his knowledge through blogs, emphasizes the importance of asking, knowing, and engaging in a dialogue that helps bring people closer (even closer) in their sexual relationships.

“In my opinion, one of the hottest things is when a couple asks: ‘Like this?’“, Dr Gupta says in one of his posts. For this sexologist in Delhi, communication is a necessary tool for pleasure, since asking gives rise to experiment: “Having control of sex and letting your partner know when he is doing something right leads to more pleasure and a deeper connection.” Also, ensure that talking during sex improves communication in other areas of your life.

Essential for affection

It is impossible for the other person to know everything about you, not even if it is your partner, because sometimes even you don’t really know what you like and what you don’t, precisely because you ignore the occasional chat. “Some of us hope that our partners intuitively know our sexual desires, but that is rarely possible,” says Dr Gupta in this sense, and many people seem to agree with him.

There are many people who comment on his blogs to reaffirm his message: asking is “essential” also for affection, another basic aspect for a relationship to grow. Without forgetting the macho component that often surrounds this non-practice, as if women do not enjoy sex exactly the same as a man, and in different ways as well.

That is why a sexual education that dialogue, feminist and diverse is so important, because the whole of society depends on it. But do not be overwhelmed, even if sleeping with someone is a political act, perhaps it is that politics is simpler than it seems. Remember: you just have to ask. “Normalize giving and receiving feedback in bed,” as Dr Gupta says.

Penis condition

Penis condition: early warning sign

Experts say the best measure of a man’s health is the amount of penile erection, as a man’s health also affects his erection.

By the early 2000s, it became clear that men with heart disease were more likely to develop erectile dysfunction. But recent research has also revealed that erectile dysfunction in seemingly healthy men may be an early sign of heart disease.

Early warning sign

The Mayo Clinic study involved 1,400 men who had never been diagnosed with heart disease before. Men with erectile dysfunction had an 80 percent chance of developing heart disease within a decade, regardless of whether they smoked, had high blood pressure, were overweight, or had diabetes.

POTENCY TEST

Many men jeopardize their strength and performance with their lifestyle without being aware of it. Take the test and find out if your potency is at risk!

Completing the potency test

The most dramatic increase in the risk of heart disease was seen in men in their 40s who experienced erectile dysfunction. They had twice the risk of developing heart disease compared to men of similar age but did not have erectile dysfunction. The same is supported by another study published in the Journal of the American Medical Association in 2005, which found that men over the age of 55 had a 45 percent higher risk of developing heart disease within a five-year period than those who had erectile dysfunction. experienced.

Hardening of the arteries

Erectile dysfunction and heart disease are common causes of atherosclerosis known as the hardening of the arteries. This means that plaques caused by fat deposits within the arteries harden the walls of the arteries and restrict blood flow. Small pieces of plaque can become detached and, as they flow through the bloodstream, cause obstruction somewhere else. If it happens in the heart, it causes a heart attack, if in the brain, it causes a stroke.

Experts say the disease begins with damage to the endothelium. How does all this relate to an erection?

For the penis to be rigid, it must be saturated with blood, and for this to happen, the endothelium must rest so that the arteries can dilate and blood can flow into the penis.
The arteries leading to the penis are smaller than those leading to the heart or brain. Hardening of the arteries affects the smaller arteries much earlier than the larger ones.

This is why a sexologist in Delhi advises all 45-50 age groups of men who are struggling with erectile dysfunction to have an examination as soon as possible. Timely lifestyle changes such as quitting smoking, eating healthy, and exercising regularly can prevent the development of heart disease.

Many doctors claim from their professional experience that while men have a much harder time transitioning to a healthier lifestyle in the hope of a longer life if they feel they can improve their erectile dysfunction, they are more willing to change.

Different sexual needs as a couple

Different sexual needs as a couple, what should we do?

Sexual relations can be a vital part of a satisfying relationship. But what if only one of you has sexual needs? One in five women is unhappy with their sex life and, in general, only 17% are very satisfied.

There are natural causes that can affect sexual desire, including hormones such as low testosterone in men and women. Low testosterone levels can cause a low sexual drive. Fortunately, a doctor can treat this. Sexual desire may be lower due to oral medications such as stress, cholesterol medications, blood pressure medications and birth control pills can affect your sexual desire. So, if you are taking medication and do not feel like having sex, you will need to talk to your sexologist in Delhi to find out what is happening.

It is necessary to distinguish between different sexual desires between a couple and an infectious disease or substance abuse.  The latter states that he has an insatiable desire to remain sexually active, which can be problematic and stressful in a relationship. Even if there are other points to be considered they cannot be ignored. These include mental and sexual relationships, accepted sex education, religious background, as well as the positive or negative relationships you have with sex. The true relationship you have with your partner can also contribute to the way you interact with them sexually.

Everyone has a natural desire to satisfy their sexual urges, but you can know how much you want or need in your life. It all comes down to communication in all aspects of your relationship, especially with sex.

Different sexual desires

Maybe you want to have more sex than your partner or some other way. It is important to know why you have low sexual desire as it can vary from physical things to other causes, such as stress or unresolved emotional problems. Once you have established common ground with your spouse, you can support each other.

In addition, masturbation is a solution, other intimate alternatives should be sought to engage in sexual activity, such as sex or oral sex.

Don’t worry if your sex drive is low. Take the time to introduce the sex goddess to you. Focus on the journey, not the destination. Embrace sexual desires and the perfect physical experience when you are close to your partner. Also, take turns giving and receiving pleasurable experiences that sex brings to the table or in the room.

Sexual life with a couple can be enjoyed through good communication!

alcohol-sexualty

10 health benefits of having frequent sex with your partner

If you thought that the only reason men enjoyed sex was then here is some insight for you about marriage and sex , Not only would they have positive effects on your relationship as one of the benefits of regular sex, but the health benefits of sex are also enormous.

We all know that one of the most basic reasons to have sex is reproduction, however if we are able to maintain an appropriate frequency of being intimate with our partner, we can benefit in an important way.

So to understand how often you should have sex with your spouse, we need to know how often married couples have sex? is it okay to have sex every day? and how to have more sex in marriage?

A study conducted in 2015 found that while love making health benefits of love is more than obvious, after reaching a certain frequency of sex, the degree of satisfaction of relationships is not affected.

The purpose of this article is to help you understand the health benefits of sex for women as well as the benefits of sex for men.

Women! You can now save money on expensive anti-aging creams, as research proves that one of the health benefits of daily sex with a man is that it can take at least seven years off your face! Thus making the benefits of daily sex even more instrumental.

Likewise, there are plenty of sex benefits for men in their marriage, it can help them burn calories, sleep better, promote happiness, longevity, great health and well-being.

We give you 10 health benefits of having sex with your sexual partner regularly!

1. Slash stress

One of the most important, as suggested by research, suggests that those couples who have regular sex deal better with stressful situations.

During sex, our bodies produce dopamine, endorphins, and oxytocin – all of which help in de-stressing, elevating moods, and promoting desire. Cuddling after sex also lowers the level of cortisol in the body, the hormone that is secreted when you are stressed.

Slash stress

Stress has become one of the most obvious aspects of our adult lives, and although sex acts as a huge stress buster, the mystery is that stress often leads to a further decline in sexual intimacy. So you and your spouse need to make sure that you do not allow stress to ruin your relationship.

2. Lower your blood pressure

Forms of physical contact, as well as intimacy, can significantly improve your blood pressure. Frequent exercise – even if it’s a quickie – can reduce diastolic blood pressure and keep you healthier.

sexologist in delhi

3. Reduce the risk of cancer

Another health benefit of sex is that it reduces the chance of cancer, especially prostate cancer in men. This is mainly because it clears the prostate of toxins that might otherwise attach and later trigger cancer problems.

This is a good reason to have sex with your partner often.

reduce the risk of cancer

4. Increase your immunity

Fight colds and flush with sex! Antigens such as immunoglobulin A are released during activity, which can combat colds and even flu. Releasing more antigens means stronger immunity and a healthier body.

stay fit

5. Sleep better

Suffering from insomnia? You knew what to do! Sex, like exercise, increases your heart rate which then helps the body to relax. Feel-good hormones are released that promote better sleep and rest. This is one of the most important benefits of sex in marriage.

sleep better

6. Get regular periods and clear cramps

Women, if you have irregular periods, it could be due to a hectic lifestyle. Reduced levels of stress can also have a positive impact on your menstrual cycle. More good news: it can even help reduce period pain significantly.

Last but not least, another health benefit of sex regularly not only reduces pain by releasing endorphins, but also increases your tolerance for pain.

get regular periods

7. Prevent a heart attack

Sex is a pleasant cardio. It helps our bodies burn calories and improves the overall health of the heart. Research shows that sex can reduce your chances (by half) of a heart attack or stroke at least three times a week.

The only thing to remember is that sex should remain a frequent activity in this way. It would definitely help you to reduce the chances of a heart attack, however if sex is often held, it can also have a counter effect, causing it to carry blood flow to your heart.

prevents heart attack

8. Drive depression away

While having sex with spouse over time can decrease the tension and excitement of physical intimacy, it can still have some positive effects on your mind. Sex causes your brain to release feel-good chemicals that lift your moods.

The body’s most important antidepressant chemical (as a happy hormone) Serotonin is released during the activity that makes people happy, happy and relaxed. More sex equals more Serotonin & no depression.

drive depression away

9. Look younger and attractive

Having regular sex can make you look younger than your age. Men and women with an active love life enjoy many youth-enhancing effects and appear at least 7 years younger than they really are! In addition, it improves your profession itself.

Perhaps sexual activity releases your body into a chemical substance called pheromones that increases your urge and makes you attractive. It improves your sense of smell, improves digestion, and gives you a healthy skin that is associated with the release of DHEA by the body.

look younger and attractive

10. Track your self-image

People who have sex feel more regularly confident about themselves and their bodies. An important benefit, sex improves your self-esteem and feels great. Regular sex can increase your cognitive functions, and memory performance, which in turn help you to perform better in other aspects of your life.

stay positive

Still envious of the health benefits of having sex with your spouse? Consult Dr P K Gupta, Best Sexologist in Delhi.

couple-satisfaction

16 things men want women to know about sex and intimacy

What exactly does a man want in a relationship and in bed? How good are you in bed?

These are just some of the questions that you can ask yourself.

After all, women want to be the best for their partners, right?

Remember that sex is a learned skill.

It does not mean that you have to exercise everywhere and with everyone, it does mean that you have to know how to please your man in bed and be aware of the things that men wish women knew about sex.

So, if you are competitive and you want to find many ways to please your man sexually, then take it from the guys themselves.

Check out these sex tips from boys for women.

1. Be very careful when handling the man underneath

A man’s penis is super-sensitive after they ejaculate. So, be very careful with handling the man there. Sure, we love the sweet feeling of your mouth after we ejaculate, but please be very gentle!

2. Do not be shy

Great sex advice from men, we honestly can not care if you are sweaty after we do it. This is one of the things that men wish women knew about sex , Do not be shy or make a big deal about it. Considering what a great thing we just did, do not worry about the sweat , It’s nothing.

3. Sex is too tired for us

Sex is too tired for us

So, do us a big favor and take a load sometimes ,

This is one of the things that boys wish girls knew. The missionary position is great, no doubt, but sometimes we also have sore muscles. We would love it if you would take the lead and just drive us.

4. Try different ways to get things done

What men wish women knew is that condoms will make it harder for us to wear like that with our ejaculate ! Por favor! The feelings we have without the condom is different than we have it.

That, that’s among the things men wish women knew about sex , If you want to help us, that would be great too. Add a little more foreplay and you can also try different ways to finish things off as well.

5. We care, really

What does intimacy mean to a man? It means a lot, but that does not mean we do not want to be sure if you are on the pill or not, right?

No ladies, we care and we just want to take care of it. Among the things that men wish women knew about sex , this may be one of the hardest to explain, especially if you are in a relationship.

6. We like how you taste there

sexologist in Delhi

What do boys like about sex? We like how you taste there , Of course we want women to practice safe and basic hygiene, but you do not have to be too self-conscious about what you taste – trust us. We will not go down if it is not right.

7. We can feel it when you are not real

One of the things men wish women knew about sex is that we know, we can feel it when you are not doing it , If you are giving us the head and you do not want it, we know we can do it even I feel. Just tell us – we’ll understand.

8. Do not always wait for us to ask for sex

What boys want in sex is a woman who knows what they want.

Do not always wait for us to ask for sex or to initiate it. Be a woman who knows what she wants and sometimes be aggressive. We love that in a woman – it’s so sexy!

9. We love it when you’re naughty too

intimacy

We find it great when you know how to tease and when you know how to talk dirtyIn fact, it’s one of the top things men wish women knew about sex.

10. Let us know what you want in bed

How to be a good woman in bed?

Simply, please let us know what you want in bed We can not guess, we are not narrators. If you want us to light up your senses and let go of the animal in you, tell us what’s up. Tell us your deepest fantasies. Then we can take action

11. Men also love enlightenment

One of the things that men wish women knew about sex is that men also love enlightenment , We would appreciate it so much if you give us our full and passionate foresight.

12. Some men are shy to ask their partner to try out fantasies

Things that boys like in bed, but not to ask, is to try and pursue our fantasies. Some men are shy or are not too comfortable asking their wives or girlfriends to try out sexual fantasies.

One of the reasons is that we may be abusing you and we do not want that. Although, in reality, things that keep men in bed include hot role-playing games.

13. We love spontaneous sex

sex improvement

Things men wish women knew about sex is that we love spontaneous sex ! In fact, it’s so hot to have sex out of nowhere. We also love doing it in the kitchen, in the bathroom, and anywhere we can do it!

14. We are not always in the mood for sex

Another thing we want women to know is that not every time we are always in the mood for sex , Scared? Do not be. It is not that we do not have problems either.

Sometimes, illness , stress, and even problems can cause us to not have sex – even when you’re so hot.

15. Do your part, please

This is one of the most important things men wish women knew about sex , There’s nothing more disappointing than a woman who does not seem interested in making love, It’s even insulting, that please, if if you’re not in the mood, tell us.

Can you imagine dying to a person who is not interested and at least, bored?

16. Most men would like to try sex games

Sex toys ! Most men would love to try sex games but are a little shy to open up the subject, if you think we like them, please ask us. We would be happy to try it!

This is one of the things that men wish women knew about sex and please think about it.

These things that men wish women knew about sex may or may not apply to you, but in general men should be satisfied as well and it would be greatly appreciated if you take the time to ask about it as well.

After all, isn’t communication the key to a long lasting relationship and even to explosive sex?

For any sexual problems meet best sexologist in Delhi for counselling and treatments. Call +919999925201

Symptoms of sexual problems in marriage

Symptoms of sexual problems in marriage

In married life, sex is a very important part of life. A happy couple must have good sex (higher quality than most). For a family to thrive, parents must be actively involved in their happiness. When sex life is very low it can be a warning sign that there are other problems in a marriage, other than sex.

It is important to consider that poor sexual health in marriage increases the chances of separation in less than a year. In this sense, it is important to consider the symptoms that will indicate that your sexual health is declining significantly, suggests sexologist in Delhi.

Symptoms of low sex drive

  • You have sex once or twice a month
  • Sex becomes more than just a matter of taste
  • He engages in sexual relations only if they are premeditated
  • You do not feel close or intimate with your partner after having sex
  • Your partner’s sexual desires have ceased to exist, and yours is also reflected in their absence.
  • It seems that you are the only one who wants to have sex because your partner is not interested in sex
  • There is no sense of pleasure or selfishness in a sexual relationship with your partner
  • None of you want sex while you sleep
  • Your spouse enjoys solitude and doesn’t want to have sex with you
  • You may enjoy pornography on your own and / or masturbate instead of having sex with your partner

While sexuality is important, research shows that couples who communicate well and share things are more likely to have sex. Before you try to improve your sex life with toys or underwear or sex, work with communication skills and spend more time with your partner.

best foods to boost sex life

The best foods you can eat to boost your sex life

Nutrition is not only important to feel good about your body and lead a healthy life. It is also true if you suffer from erectile dysfunction or are frustrated with your sexual relationships.

A poor diet can not only destroy your goals of leading a healthy life and maintaining your figure but also end your erection. Eating dishes loaded with fat frequently affects the health of your heart, but also your sexuality: the virile member has blood vessels that can also be blocked by cholesterol and other substances. As with the cardiac organ, fats also restrict the flow of blood to the penis, preventing it from hardening when it is ready for action. Obviously, many of these foods can also increase your chances of developing high blood pressure.

It may sound strange, but for Dr P K Gupta, Best Sexologist in Delhi, India, you should treat your ‘little soldier ‘ as if he were “a luxury car”, that is, it is necessary to fill it with the right fuel so that it works without problems and stay like new; Instead of gasoline, all you need is a regular exercise routine and eating healthy foods to keep you strong. This is what experts like him say: eating healthy can increase your testosterone, strengthen sperm, and overload your erection. We have made a compilation with some of them.

The coffee

According to a study conducted by the University of Texas Health Sciences Center on more than 3,700 men, this morning drink has the power to enhance your sex life. Those who drank the equivalent of 2 to 3 cups a day (between 170 and 375 milligrams of caffeine) were less likely to report problems related to erectile dysfunction than men who did not. What is this about? Caffeine triggers a series of effects in your body that help the arteries in the genital area to relax and increase blood flow, producing an effect similar to that of drugs to treat erectile dysfunction like Viagra.

Salmon, egg yolks or horchata

The penis needs vitamin D to be in shape, and these foods contain high amounts of it. A recent study found that this chemical compound increases levels of testosterone, the hormone that enhances your sexual desire. In addition, doctors reveal that having low levels of it can increase the risk of erectile dysfunction. “Without it, the blood vessels cannot dilate, making it difficult for blood to flow to the male organ,” says sexologist in Delhi.

Pistachios, almonds, or walnuts

Are you hungry and don’t know what to put in your mouth? Many will turn to the typical sausage sandwich to satisfy their appetite. Instead, go for nuts. A study in Turkey had 17 men ingest 100 grams of pistachios for three weeks. In the end, all without exception perceived a remarkable improvement in their erectile function, in their ability to feel an orgasm, an increase in libido, greater sexual satisfaction, and better levels of happiness with their life. Pistachios contain a high amount of amino acids that increase the body’s nitric oxide, and like almonds or walnuts, they are a great source of healthy fats, perfect for the heart, and therefore, for the penis.

Legumes and olive oil

The Mediterranean diet is not only good for your heart, but it can also improve your sexual potency. In fact, heart disease is one of the most common causes of erectile dysfunction. Once the cholesterol plaque begins to accumulate in the blood vessels, those of the penis is the first to be clogged. In general, sexologists in Delhi agree that eating more high-fiber foods has anti-inflammatory properties, which help promote healthy blood flow.

Bell peppers, peaches, and spinach

We return to the previous point: vitamin C is essential to have healthy sperm. According to a study by the University of Texas conducted on 75 men, after taking 200 milligrams of this chemical compound daily through fruit, they noticed an improvement in sperm of 15% more than before ingesting the vitamin. This not only meant a higher number of sperm but a higher survival rate and higher energy. According to the researchers, vitamin C appears to have the function of protecting sperm DNA. Of course, oranges are the most obvious choice, but you can alternate them with yellow bell peppers, peaches, or spinach.

How do you control premature ejaculation

How do you control premature ejaculation?

Premature ejaculation affects many men worldwide, it is the most common sexual problem among those under 40 years of age. It is important to understand the physical and mental causes behind the problem, but until this happens, fortunately, many techniques will help to delay or eliminate premature ejaculation.

Take a deep breath!

deep breath

Deep breathing is a form of meditation that often helps control sexual desire and tension leading to premature ejaculation. Superficial, rapid breathing speeds up the pulse, which can cause premature erections and ejaculation.

Try to inhale the air well for 5 seconds, then hold it in for 3 seconds and only then blow it out slowly, again for 5 seconds. If you can continue this rhythmic breathing for 5 minutes, you can take great advantage of it in the bedroom too! In addition, trying to breathe with your partner, paying attention to each other, greatly enhances intimacy.

Masturbate more often!

masturbation

There are practical reasons for this advice: although men have significant amounts of sperm, they are not infinite. The more times you masturbate, the next time you can delay ejaculation longer.

Try interrupted masturbation! The point of this is that when you feel an orgasm approaching, it stops and then, after a short rest, continues to satisfy and stop, gradually getting closer and closer to orgasm, until you can no longer stop. Try pushing this out for 15 minutes, but if you feel your testicles or penis hurt, don’t stop yourself anymore. If you do this exercise regularly, you can experience where the point from which there is “no going back” is. If you feel you are already a master of technique, you can also try it in the bedroom.

Pressure

pressure

Applying pressure to the bottom of the penis – to the same point that helps to delay orgasm during intermittent masturbation – can slightly reduce the amount of erection, thus delaying ejaculation. Once you know exactly what this point is, you can even ask your partner to help you practice this technique.

Kegel practice

kegel exercise

The relatively easy and discreet Kegel exercise is not only beneficial for women. There is no better way to train pelvic floor muscles and strengthen the pubococcygeus muscle (PC muscle). The PC muscle is located between the pubic bone and the coccyx and helps control urine and ejaculation, respectively.

The easiest way to train this muscle is to try to stop urine leaking on the toilet. To do this, you need to use the PC muscle. During Kegel exercise, this muscle should be stretched for approx. 10 seconds, then relax. Perform at least three sequences of exercises in a row, with 10-second breaks between them. You can do the exercise anywhere, anytime, either while driving or in front of the TV. The exercise strengthens the PC muscle so you can delay ejaculation by tightening it near orgasm.

Try new sex poses!

sexual dysfunction in women

Real sex is more than a traditional source of physical pleasure. Try new sex poses or apply tantric techniques during intimate togetherness! You may even find that you last longer in certain poses, ejaculate later. Generally, when the woman is on top, premature ejaculation can be delayed while the missionary pose is avoided.

If you feel close to orgasm, stop the stimulation (e.g., pull out your penis for a short time), stretch your PC muscle, and take a deep breath! Repeat this until the ejaculation compulsion is gone.

Condom

condom

A condom reduces the sensitivity of the penis, so stimulation is less of a problem. Avoid condoms with warm lubricants that provide a warm atmosphere – the more stimulation, the greater the risk of premature ejaculation.

The use of a benzocaine condom, which can delay ejaculation by up to 5 minutes, is highly recommended. These condoms are treated with a mild anesthetic, benzocaine, which helps prevent premature ejaculation by reducing sexual stimulation. Don’t worry, you’ll still enjoy being together. If in doubt, try masturbating first to see the benefits of using it.

If you are allergic to latex, look for a condom based on polyurethane or polyisoprene.

Talk to your partner!

Communication is the basis of any relationship, and when it comes to sex, it is also important. Talk to your partner about premature ejaculation. Tell her if you feel close to ejaculation and interrupt the act for a short time. This can be a great time to pamper your partner orally or manually. If you feel ready again, they can continue making love.

Don’t have unrealistic expectations!

Focus on the joy! Premature ejaculation has no definition given in minutes or seconds. When stressed, it is not only psychologically unhealthy, but can even trigger premature ejaculation. Talk openly and honestly with your partner about your problem and possible alternatives. Remember, sex should be joyful and not stressful.

erectile dysfunction treatment in Delhi

Erectile dysfunction can indicate severe trouble

Did you know that erectile dysfunction can be the first symptom of an unrecognized cardiovascular disease?

The explanation lies in the fact that erectile dysfunction (hereinafter referred to as ED) and vascular disease are a number of common risk factors (eg smoking, hypertension, diabetes, blood lipid disorders, alcohol abuse.). The connection point is the disease of the blood vessel wall, atherosclerosis.

The ED therapy includes real medical success stories in recent years.

The more knowledge and experience is accumulated, the more medical specialties become “interested” in the treatment of erectile dysfunction, which has been shamefully silenced so far.

These specializations include cardiology (cardiology), neurology, and diabetology.

Diabetes increases the development of erectile dysfunction to the greatest extent, smoking is about twice the risk, and fat metabolism disorder also increases the risk of developing ED by just as much. High blood pressure alone increases the risk, but certain medications used to treat it also adversely affect potency.

Recognizing the connection between at-risk groups is of paramount importance when it comes to erectile dysfunction in the sexologist clinic in Delhi. It may reveal previously unrecognized cardiovascular disease, diabetes, and high blood pressure.

If at least three or more cardiovascular risk factors are present in a patient with erectile dysfunction who does not otherwise have cardiovascular symptoms, a detailed cardiac examination is recommended.

As a result, not only will the treatment of Erectile dysfunction become safer, but nowadays, the screening and early prevention of the leading cardiovascular death in our country will also be given more space!

The other part of the patients is already known as cardiovascular patients. Sex is associated with well-known physical exertion. This does not mean that e.g. a patient who has had a heart attack cannot complete her life with sexual pleasures. A risk assessment and the need to take certain medications (e.g., nitrates) can be accurately judged by a proper cardiological examination. If the condition of our heart patients is good, we can safely recommend sex life. In the case of erectile dysfunction, we can recommend the taking of the desired tablet from several types of medicines, so that you can also use your heart medicines safely. The resumption of sex life should be part of the rehabilitation of the cardiological patient.

In high-risk patients (arrhythmias, severe valvular disease), a cardiologist’s decision is also required. In such cases, treatment of the underlying disease is often required as a first step, and treatment of sexual dysfunction should be postponed.

Of course, the complete diagnosis and analysis of ED is still the responsibility of the best sexologist in Delhi, but more and more often a cardiologist should be considered in case of increased cardiovascular risk or complaints.

I encourage erectile dysfunction sufferers to communicate more boldly and openly with their doctors, as their complaints can be remedied with great success these days!

Stigma Surrounding Infertility

‘So Many Live in Silence’ Due to Stigma Surrounding Infertility

“People feel immense pressure to be able to have their own child. Therefore, if there is difficulty having a child or conceiving, people often feel like a failure.”

Infertility Awareness Week is close to my heart. Just over five years ago, I was diagnosed with endometriosis, a chronic reproductive health condition that, among other debilitating symptoms, can cause infertility.

At 27 years old and very much single, I’ve had more conversations than I can count about preserving my fertility, about the impact the ovarian reconstruction I had two summers ago might have on my ability to conceive, and about the high likelihood that I will need a hysterectomy to treat suspected adenomyosis, a disease distinct from endometriosis that grows in the uterine walls.

Almost all of my close friends also have endometriosis. I’ve watched people I love and others in the community experience pregnancy losses and navigate the often traumatic process of in vitro fertilization.

We live in a society that still designates value to people assigned female at birth by their reproductive capabilities, which means infertility is commonly accompanied by feelings of inadequacy and shame.

Sex. Abortion. Parenthood. Power.

Then there’s the outside judgment—like comments about your worthiness as a partner if you’re unable to conceive. Or questions like, “Why don’t you adopt?” But once you’re faced with the reality of infertility, you realize it’s much more complicated than that. For example, people with disabilities and chronic illnesses can be legally discriminated against in the adoption process—meaning that, for many, IVF might be their only shot at starting a family.

But the IVF process itself, like much of health care, is dictated by a patient’s privilege and economic status. IVF is costly, and insurance coverage for it is abysmal, which means that your ability to have a child through IVF hinges on your financial situation. (Only 19 states require insurance plans to cover some level of infertility treatment, and only 13 of those states require IVF coverage, according to the national infertility association Resolve.) LGBTQ couples face added discrimination and financial barriers, as much of the discourse around IVF—and even the way infertility is medically defined—revolves around cisgender heterosexual couples.

Infertility is common, but discussing it remains incredibly fraught. We talked to Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale Medical School, and Dr. Banafsheh N. Kashani, a reproductive endocrinology and infertility specialist, to help demystify the topic and cut through the stigma and taboo. The interviews have been edited for length and clarity.

Rewire News Group: Can you define infertility and what causes it?

Dr. Mary Jane Minkin: If a person is under 35, we usually define infertility as one year of trying to conceive without success (and that means having regular intercourse, at least every other night, at least around ovulation). For a person 35 or older, we usually use six months trying and not conceiving to begin evaluation.

Dr. Banafsheh N. Kashani: There are different causes of infertility, but they can be due to a “male factor” from low sperm numbers or low motility. Alternatively, infertility can be due to a “female factor.” This can be related to an ovarian factor and an issue with ovulation, or egg quality, which often declines as a result of increasing maternal age. Other female factors include an issue with the fallopian tubes being blocked or poorly functioning, or a problem with the uterus or womb which does not allow a pregnancy to implant or develop.

Why are conversations about infertility and pregnancy loss rife with stigma?

BK: People feel immense pressure to be able to have their own child. Therefore, if there is difficulty having a child or conceiving, people often feel like a failure. It’s a sensitive and intimate subject and so many live in silence and do not feel comfortable sharing their stories.

As a provider, I allow my patients to open up and share their stories from the first moment I meet them. I make sure they are so comfortable, that they feel like they are having a conversation with their best friend. This allows patients to finally open up and express all of their emotions, which they had been otherwise holding back. And most importantly, I want them to know they are not alone. Infertility and pregnancy loss are far more common than we think, because so many suffer in silence.

MJM: Indeed, sometimes people do feel a stigma—which they really shouldn’t. At least 10 percent of couples will have significant infertility issues, and we need to support these couples as they go through the process of trying to conceive.

How do the cost barriers to infertility care impact access?

MJM: Fertility therapy can be costly, and its coverage varies from state to state. Just the cost of some of the medications used to help people ovulate (one of the causes of infertility is not ovulating well) can be thousands of dollars.

BK: There are some states that have mandated coverages for infertility testing and treatment, but the majority of states do not. As a result, many couples delay getting tested to determine the cause of their infertility. This delay can have a huge impact, as some forms of infertility are treatable through surgery, medications, or supplements.

Unfortunately, for the majority of couples with infertility, treatments tend to be out of pocket—and some services like In vitro fertilization (IVF) can cost upwards of $20,000. This cost can be prohibitive to getting the proper treatment.

Can you talk a little bit about the psychological toll of infertility? Do you have any suggestions for patients on how to cope with it?

BK: Infertility treatments are hard and take a physical and mental toll on all couples. Not only can there be physical pain as a result of the injections, and bloating and discomfort throughout the process, there is also an emotional burden. The hormone therapies can make people feel more emotional or have mood swings. Additionally, treatments are often described as a roller coaster with ups and downs. All of this can have a significant psychological impact.

My recommendation is for couples to find a support group. Finding support allows couples to talk more openly about their struggles, the many ups and downs of the process, and also hear success stories. These success stories often provide hope that can push couples through the difficult times.

To that point, many of the couples I know dealing with infertility and undergoing IVF struggle with intimacy. Why do you think it’s so common for intimacy to suffer when a couple is going through infertility?

MJM: Going through the infertility process can really take the fun out of having sex. The medicalization can take sex from a loving and fun event to a chore; but it’s always good to still view it as a solid part of your relationship and make it as enjoyable as possible.

BK: Unfortunately, when trying to conceive, there is a lot of pressure to have intercourse and get pregnant that month. We all know that ovulation occurs one day of the month, and that is why there is a lot of pressure to have intercourse around the time of ovulation. But this often puts a lot of strain on a relationship. When sex is scheduled it is less fun, and often partners feel incredible amounts of pressure to perform. This can affect a relationship long-term. Some have described that sex becomes a chore rather than a fun and intimate connection. It’s important to recognize if this change is taking place in your relationship, and make sure to have intimate moments outside the fertile window as well.

When patients start coming to you, what are some of the most common misconceptions they have about IVF and infertility care?

MJM: Many couples don’t know about infertility care. And the first thing to understand is that it’s ideal to start by talking with your OB-GYN provider first, before jumping right off to an infertility doc. Many of the preliminary tests can be done by your regular provider, and they can start doing some interventions.

For example, if you are not ovulating well, there are some oral pills that can be used to help. You don’t have to jump into injectable medications right away. So start with a conversation with your regular provider, and go from there.

BK: Patients are often so worried that seeking a fertility specialist or sexologist in Delhi means they have to have IVF. This is a myth. There are so many ways to naturally optimize fertility, such as through the use of vitamins, supplements, and dietary changes. There are fertility-friendly lubricants, such as Pre-Seed, which can help increase the chances of getting pregnant each month. Also, many worry that treatments are expensive, but there are many ways that treatments can be made more affordable for couples.

Most fertile people do not understand how hard it is to be infertile. No one can truly understand the grief, sadness, and struggles that couples go through when trying to conceive and being unsuccessful.

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