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From vary long time in India, sex in marriage is often something which is brushed aside and joked about. But now we have to take this matter seriously because this is deeply related with our marriage, love, health and vary important for a healthy vibrant relationship.
Marriage and sex problems can easily arise in a marriage where these things are not given the priority they deserve. How much importance is placed on them depends in part on each partner's views and personality. For some people the idea of a sexless marriage is unthinkable. For others, it may be a trade off in an otherwise happy relationship. The key of course, is making sure that both partner�s views are in synch.
Sexual problems in marriage should never be waived off or made fun of. Your spouse may be self-conscious of the issue already, and highlighting it unnecessarily will not help resolve the problem. Instead, married couples need to work together to create solutions and, if necessary, accept reality.
However, some people who experience sex problems like erectile dysfunction, hormonal imbalance, loss of desire due to a temporary condition (such as illness or pregnancy), inability to achieve orgasm, premature ejaculation etc, find the impetus to maintain their marriage very difficult.
Having an active, sexy marriage helps couples to feel connected at a deeper level, beyond words and ideas and day to day problems. Having difficulties in the bedroom is definitely something to talk about and should be resolved as quickly as possible.
In the-fast changing social scenario setting out new standards for man-woman relations, the Honorable Supreme Court of India on 21 March 2006 ruled that a wife can seek divorce for husband�s sexual incapacity and his failure to consummate the marriage due to such a physical handicap.
However, if you are having problems, you may want to seek professional help, so need not to worry about this because, now a days a few good sex clinics are there, those are giving all the services like consultation, examinations, diagnosis, sex counseling for couples and singles, sex therapies and treatments of sex problems to get you out of these sex problems and have the best possible sex life.
Further more, statistics show that most people who attend some kind of sexual therapy from qualified doctors can actually improve their marriage as well as their health. Almost 93% of those who have undergone sexual therapy have significantly improved their married life.
Marriage experts agree that healthy sexual activity can save marriage from divorce (divorce due to sex problems). Getting sex help isn't something you need feel embarrassed about, especially if it leads to the best possible sex life.

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OK, so you want to have a baby. Your chances of succeeding are excellent: About 85 percent of all couples who try to conceive will do so within one year. (After one year, couples are considered infertile.) Twenty to 22 percent will get pregnant within the first month of trying. There are some obvious rules to this game. The first is that you and your partner need to have sexual intercourse, with the penis in the vagina. The penis must ejaculate inside the vagina, depositing sperm near the cervix, the mouth of the uterus. In addition, intercourse must occur at or around the time of ovulation. There are also a lot of misconceptions and old wives' tales surrounding this issue. For example, it is not necessary for the woman to achieve orgasm in order for conception to occur, according to Paul A. Bergh, M.D., an assistant professor of obstetrics and gynecology in the Division of Reproductive Endocrinology at Mount Sinai Medical Center in New York. Bergh explains that the fallopian tubes, the tubes that carry the egg from the ovary to the uterus, actually draw the sperm inside, coaxing them to unite with the egg. This occurs with or without orgasm, he says. The following tips will help increase your chances of getting pregnant. Also refer to "When and Why to Seek Help" for a list of conditions that should prompt you to see a doctor before your year of trying is over. Good luck!

Get a physical.

Before spending a year trying to get pregnant, it's a good idea to have a thorough physical examination, according to Sanford M. Markham, M.D., an assistant professor of obstetrics and gynecology at Georgetown University Medical Center in Washington, D.C. "Make sure that there aren't any physical problems, such as masses or cysts in the pelvic area," he says. "Your doctor should also treat any low-grade vaginal infections that you might have. He or she should also check for sexually transmitted diseases." Other conditions that can interfere with pregnancy are ovarian cysts, fibroids, and endometriosis, an inflammation of the lining of the uterus, Markham says.

Have sex around the time of ovulation.

The woman's egg is capable of being fertilized for only 24 hours after it is released from the ovary, according to Richard J. Paulson, M.D., an associate professor of obstetrics and gynecology and director of the In Vitro Fertilization Program at the University of Southern California School of Medicine in Los Angeles. The man's sperm can live for between 48 and 72 hours in the woman's reproductive tract. Since sperm and egg must come together for an embryo to be created, a couple must try to have sex at least every 72 hours around the time of ovulation (see Extra! Extra! - "Methods of Ovulation Prediction") in order to hit the mark, Paulson says. "Every 48 hours is even better," he says. However, he adds, the man should not ejaculate more frequently than once in 48 hours, since that may bring his sperm count down too low for fertilization.


Men should ejaculate every two to three days.

Along with the advice to have sex no more often than once every 48 hours, men should also try to ejaculate at least once every two to three days throughout the month, says Bergh. Men need to keep ejaculating to keep up their sperm supply, he adds.

Maintain a healthy lifestyle.

The best way to enhance your chances of getting pregnant is to maintain an all-around healthy lifestyle. This goes for both men and women, says William C. Andrews, M.D., executive director of the American Fertility Society and professor of obstetrics and gynecology at Eastern Virginia Medical School in Norfolk. "A healthy lifestyle will also help ensure the quality of your offspring," Andrews says.

Try to eliminate stress.

"There is little doubt that severe stress will interfere with reproductive function," says Paulson. "At the simplest level, stress will take away your libido. At the extreme, the woman may stop menstruating. Although studies in men are lacking, it is quite likely that a similar effect may occur."

Keep the testicles cool.

Exposure to extreme heat can be the death of sperm--literally. (That's why the testicles are outside of the body--to keep them cool.) Bergh's advice for maintaining the proper temperature is to wear boxer shorts (if you find them comfortable) and to avoid hot tubs and whirlpools. Taxicab and truck drivers will benefit from the use of a beaded seat mat that allows air to circulate. "There was an old Indian fertility ritual where the men used to dip their testicles in cold water," says Bergh. "They had the right idea." Varicose veins in the testicles can also interfere with temperature regulation. If you have these, see a urologist, Bergh suggests.

Take your time in bed.

It's not a bad idea for women to stay lying down for half an hour after sex, to minimize any leakage of sperm from the vagina, says Markham. Although staying in bed for a while may not make a tremendous amount of difference (sperm are strong swimmers), it certainly can't hurt. "Just stay in bed and take it easy," he says.

Try elevating the hips.

Placing a pillow under the woman's hips after intercourse may prevent sperm leakage, says Bergh. Although this is not proven to have any effect, it can do no damage, he says.Don't smoke. Smoking has been shown to lower men's sperm count and to impair fertility in women, according to Paulson. "There is nothing that has been looked at that smoking has not had an impact on," he says. His message is clear--don't do it. Also, if a woman does become pregnant, cigarette smoke--even in the first few days after conception--may be harmful to the developing embryo. So, the sooner you can quit, the better.

Eliminate alcohol and drugs.

Hormones can be thrown out of balance with drug abuse and high alcohol intake, says Paulson. This holds true for men and women. Even marijuana smoking can impair fertility. "Marijuana smoking has been associated with increases in prolactin, a hormone which can cause milk secretion from the breasts of both men and women. This can have deleterious effects upon reproduction," he says.

Eliminate medications.

Many medications, including common over-the-counter analgesics, can impair fertility, according to Markham. "A lot of things can inhibit ovulation and conception," he says. "It can be helpful to eliminate all medications." Be sure to check with your doctor before discontinuing any prescription medication, however.

Avoid lubricants.

Certain gels, liquids, and suppositories for lubricating the vagina may impair the sperm's ability to travel through the woman's reproductive tract and fertilize the egg, according to Markham. He recommends consulting a physician for a list of those that are not detrimental.

Try the missionary position.

This is another old wives' tale that can't do any damage and may do some good, according to Bergh. The missionary position, with the man on top, seems to be a good position for minimizing sperm leakage from the vagina.

Don't ruin your sex life.

One mistake many couples make is worrying so much about being able to conceive that it takes over their lives, says Andrews. "Don't be too mechanistic about it," he warns. "With a reasonable frequency of intercourse, a loving couple will tend to hit the right day. People sometimes make it an ordeal, rather than an expression of love. It can become so stressful that it is counterproductive."







PREMENSTURAL SYNDROM

PREMENSTRUAL SYNDROME - 11 Ways to Ease the Discomforts

You've heard the joke before. A woman flies off the handle at work or at home and everyone around her chimes in with, "It must be that time of the month again." The joke, of course, misses the point that women, at times, actually do get upset by their demanding husbands, whiny kids, and stressful jobs. For some women, however, the joke holds more truth than they'd like to believe. For these women, "that time of the month" really is a period of emotional imbalance, anger, depression, and anxiety. Situations that they normally cope well with suddenly become insurmountable. And the energy and health they enjoy most of the time give way to fatigue, achiness, and weight gain almost overnight. These women have what is known as premenstrual syndrome, or PMS, a condition that has no known cause and no complete cure. But research into the topic has brought about several theories as to what may make some women more vulnerable to PMS. "The two most widely held theories, neither of which has huge support, include an ovarian hormone imbalance of either estrogen or progesterone and a brain hormone change or deficiency," says Harold Zimmer, M.D., an obstetrician and gynecologist in private practice in Bellevue, Washington. Zimmer stresses that no single cause of PMS has ever been proven and that much of the research is contradictory. Whatever the cause, the symptoms can include anxiety, irritability, mood swings, and anger; indeed, these symptoms occur in more than 80 percent of women who suffer from PMS. Other symptoms may include sugar cravings, fatigue, headaches, dizziness, shakiness, abdominal bloating, breast tenderness, and overall swelling. Much less common are depression, memory loss, and feelings of isolation. The symptoms, and their severity, vary from woman to woman. "Symptoms are definitely cyclic, and that is one of the main criteria for diagnosing this condition. And the symptoms generally disappear with the onset of the woman's period," says Phyllis Frey, A.R.N.P., a nurse practitioner at Bellegrove OB-GYN, Inc., in Bellevue, Washington. "It's often the emotional symptoms that bring people in to the doctor," she adds. As for what you can do to relieve the discomfort of PMS, there are several home remedies. And according to Zimmer, the home remedies probably work as well as, or better than, the medical remedies available. Here's what you can try:

Maintain a well-balanced diet.

Include lots of fresh fruits and vegetables, starches, raw seeds and nuts, fish, poultry, and whole grains. "It is just sort of common sense dietary measures," says Zimmer.

Go easy on sugar.

Your cravings for sugar may be strong during this time, but giving in to the sugar craving may make you feel even worse and can intensify your feelings of irritability and anxiety. To make fending off your sugar cravings a little easier, try keeping healthy snacks readily available and keeping sugary foods out of the house--or at least out of your reach. If you can't give up the sweets completely, try eating only small amounts at a time, and opt for things like fruits or apple juice that can help satisfy your sugar craving and provide nutrients.

Eat small, frequent meals.

You don't want to go long periods without food because that can potentially intensify your premenstrual symptoms as well, says Zimmer.

Avoid alcohol.

Both Zimmer and Frey stress that alcohol will only make you feel more depressed and fatigued. Alcohol also depletes the body's stores of B vitamins and minerals and disrupts carbohydrate metabolism. It also disrupts the liver's ability to metabolize hormones, which can lead to higher-than-normal estrogen levels. So if you need to be holding a beverage at that party, try a nonalcoholic cocktail, such as mineral water with a twist of lime or lemon or a dash of bitters.

Cut down on caffeinated beverages.

These include coffee, tea, and colas. Caffeine can intensify anxiety, irritability, and mood swings. It may also increase breast tenderness. Try substituting water-processed decaffeinated coffee; grain-based coffee substitutes such as Pero, Postum, and Caffix; and ginger tea.

Cut the fat.

Eating too much dietary fat can interfere with liver efficiency. And some beef contains small amounts of synthetic estrogens. Too much protein can also increase the body's demand for minerals. Opt for smaller servings of lean meats, fish or seafood, beans, peas, seeds, and nuts. Use more whole grains, rice, vegetables, and fruits to fill out your meals.

Put down the salt shaker.

Table salt and high-sodium foods such as bouillon, commercial salad dressings, catsup, and hot dogs can worsen fluid retention, bloating, and breast tenderness.Practice stress management."Learning to control and reduce your level of stress has a great effect on reducing the symptoms of PMS," says Zimmer. Try joining a stress-management or stress-reduction program at your local hospital or community college; learning biofeedback techniques; meditating; exercising; or doing anything that helps you to relax and cope with stress.Try not to plan big events during your PMS time."I don't like to encourage my patients to plan their lives around their menstrual cycle, but if they have the option of planning a big social event at some time other than their PMS time, it would help them out to do so," says Zimmer. "The increased stress of the event will only make the PMS symptoms worse," he adds.

Exercise aerobically.
"Besides being a great stress reducer, aerobic exercise triggers the release of endorphins (the natural brain opiates) and produces a 'runner's high,'" says Zimmer. "Good forms of aerobic exercise include running, stair-stepping, bicycling, or taking an aerobics class," he continues. "The social environment of a health club can also make you feel better by encouraging you to interact with other people," he adds. He also goes on to say that increasing the pelvic circulation can help to rid the body of some of the bloating associated with PMS. Try to exercise for 20 to 30 minutes at least three times a week. If you are too fatigued to exercise during the actual PMS period, don't. Doing so the rest of the month should help in itself.

Talk it over.

Try to explain to your loved ones and close friends the reason for your erratic behavior. "One of the biggest stresses on a woman during this time is family. And it's not only the stress of feeling bad when she flies off the handle at someone, but also of having to apologize for her behavior later on," says Zimmer. He recommends enlisting the aid of your family and close friends by asking them to understand what the problem is and to realize that when you lash out at them you are not as in control as you would like to be. "If your child is really acting out and yelling at you for something during your PMS time, you might remind him that this is not the best time for him to be getting you angry. Hopefully, he'll see this as his cue to go outside and play," Zimmer explains. "You have to walk a fine line, though, and not begin using PMS as an excuse to be nasty to people," he adds. If the emotional symptoms are causing problems in your relationships, consider getting some counseling from a mental-health professional. Ask your physician to refer you to someone.

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The Ads make it all seem so simple. He can't get an erection so he takes the medicines and comes back in the same romantic mood. What the Ads don't show you: The painful distress a woman can experience when her man suffers with Erectile Dysfunction(ED).Most of the Women internalize things - they tend to blame themselves first, thinking it's because they have done something wrong, or that they are no longer attractive to their partner. In fact, the first thing a woman thinks when a man can't get an erection is that it's her fault, and nothing could be further from the truth. ED, is medically defined as the inability to achieve or sustain an erection long enough for sexual intercourse. Although many women and men as well continue to view ED as a sexual issue, but it may be because of physical conditions such as diabetes, high cholesterol, or even the earliest stages of heart disease. Even more often, it can be the result of certain medications used to treat these conditions, particularly some high blood pressure drugs. Unfortunately, a lack of education about the causes of ED are frequently behind a woman's self-blame, as well as her increasing anxiety, and sometimes, even feelings of hurt and anger when the problem occurs. Most women usually start with a line of questioning that often has some anxiety or hurt to it. She may suspect her partner is having an affair, or that he just doesn't find her desirable anymore, so she begins to hint around at these possibilities. The end result: The couple can stop communicating altogether - not only in the bedroom, but in all aspects of their relationship. And that can only make problems worse for both partners. Don�ts for Woman: If you suddenly buy some sexy new clothes - well, that's only going to put more pressure on him, and it's not going to help the ED one bit so don�t do it. Don�t� stroke him harder . As such, the more and the harder you try, the worse it's going to be for him - and for you - when it doesn't happen. Do�s for Woman: The most important is to remember it's not your problem and you're not the cause. You have to treat this the way you would any other non-life threatening issues in your relationship, and just calmly discuss it. If you put it in the context of a physical problem and not a sexual one, most men will be less likely to 'shut down' or shut you out. Also important, to let him know that you have enjoyed the physical part of your relationship together, and that you miss it. Suggest him to visit to a good qualified doctor along with you or may go alone for the treatment because this is a vary important issue of your married life. This is the time to treat him as your best friend - to be warm, to be friendly, to let him know that you care about him, that he is desirable, that physical closeness is important.

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The World Heart Day was there and we all were discussing about heart but we should also try to understand the relation ship between Erectile Dysfunction (E.D.) and The Heart.

At first we should under stand about E.D. Erectile dysfunction is one of the most common sexual disorder effecting men. This distressing condition can destroy a man�s ego and threaten happy relationships. Erectile dysfunction is nothing but a condition, wherein a person has difficulty in getting and /or keeping an erection. It affects about half of all men aged 40 to 70 years and one third men below 40 years of age.

It�s not really a new thing that there is a relationship between vascular disease and erectile dysfunction, but recent studies are telling us that those suffering from impotence may be up to three times more likely to have a heart attack. Another study found, problems in the arteries of men with erectile dysfunction, which has implications not only for heart attacks, but also strokes. These findings make it more important than ever for men to see qualified doctors when they're experiencing problems with intercourse.
Historically, the biggest challenge in the fight against impotence hasn�t been a lack of treatment options. It�s been getting men to visit qualified doctors in the first place. Experts say that less than 50 percent of men living with impotence see the qualified doctors in this regard.
A man may see some improvement simply by making some simple lifestyle changes such as reducing alcohol intake, exercising more often, having healthy food or quitting smoking. These may sound a lot like �heart-patient recommendations,� but it goes to show just how significant the link between erectile dysfunction and heart disease really is.
Reduced blood flow to the penis and nerve damages are two of the most common causes of erectile dysfunction. Hardening and narrowing of the arteries (atherosclerosis) can reduce blood flow throughout the body and lead to impotence. High levels of blood sugar associated with diabetes�another risk factor for heart disease�may damage small blood vessels and nerves throughout the body, which can impede blood flow or nerve signals necessary for erection.
In the majority of cases, erectile dysfunction can be successfully treated. We have effective treatments that can be tailored to a couple�s lifestyle and needs. It is not an inconsequential �problem� or one that will simply go away, so it shouldn't be brushed off�especially considering the other implications.
So the conclusion is that, the impotence is not related with your bed room or your married life only, it is related with your �life� (The Heart) and if you face any type of lack in your erection or sex life it should be taken care seriously and should never be ignored.

Vascular Surgery: Time For Recognition
DR GAURAV SINGAL M.S,DNB (VASCULAR SURGERY), FIVS(DUSSELDORF, GERMANY)
SENIOR VASCULAR SURGEON AND CHIEF
INSTITUTE OF VASCULAR SCIENCES,IVY HOSPITAL, MOHALI, INDIA
Answers to problems in vascular surgery, like the refinement of diagnostic techniques and the development of biologically better small arterial substitutes, are slowly emerging. But what has so far eluded is independent recognition of vascular surgery as a separate specialty.
In a historical perspective, these problems are not unexpected. For centuries, even millennia, medicine was an undivided unitary segment of human interaction with the hostility of nature. There was no conceivable reason to parcel out the meager factual cargo that encompassed the knowledge of diseases and the (usually fruitless) attempts to deal with them.
A physician was a person whose identity was sharply defined within an unchanging circle of activity. It was only in relatively recent times (some 300 years ago), that the first dichotomy appeared in this image: the recognition of a new type of physician who used his or her hands in treating disease, that is, the surgeon. A veritable deluge of change came as medicine assumed the aspects of science no more than 100 years ago. Internal medicine and surgery assumed sharply distinguished silhouettes during the last 50 years; their further fragmentation has resembled a chain reaction.
This process has forced each subdivision of the large entity of medicine to face the same problem of defining its identity, as we now see in vascular surgery. Elemental and vitally important questions arose: Is the existence of the new subdivision justified by the goal it seeks to achieve? What exactly is the scope of its legitimate interest? Who is entitled to enter it? How does one acquire this entitlement?
The difficulties do not lie only at clinical level; a mundane concern also enters the picture. The practitioners of the parent discipline instinctively resent the contraction of their territory. The interests of the new specialty often conflict with the aspirations of other fields that have been newly created.
The need for the very existence of new branches is often questioned. All these historical conflicts have afflicted the birth and growth of vascular surgery.
Everyone knows about heart diseases, but very few know about vascular diseases. In fact, vascular disease kills and cripples almost as many Indians as does a heart disease or cancer. The sheer magnitude of the problem of vascular disease in India is staggering.
Although there is no accurate vascular registry, the fact that there are over 25 million diabetics in the country is just a small pointer to the vast numbers of the undiagnosed vascular cases. Patients having severe vascular diseases have been treated for low backache and arthritis for years.
It is only the onset of peripheral gangrene which brings to light the fact that arterial pulsations have been absent for long periods of time hitherto unnoticed. Even after diagnosis, the only treatment for these unfortunate cases has been amputations, which leaves the primary vascular problem unsolved. The lack of awareness of the disease is so acute, that even some cardio-vascular surgeons have never heard of a separate, independent vascular surgery department or a vascular surgeon leave aside general practitioners. A truly tragic situation indeed!
From the beginning, the existence of independent vascular surgery as a specialty was challenged by the Medical Council of India (MCI), as in India it is still considered to be a part of the broad speciality of cardio-thoracic-vascular surgery (CTVS). To the exception MCI has granted Madras Medical College, Chennai to start the MCh training programme in vascular surgery, but unfortunately the facility can only be availed by the surgeons of the state, thereby denying valuable training opportunity to the surgeons from rest of the country.
However, all the hope is not lost for vascular patients in India. Thanks to the effort of National Board of Examination (NBE), New Delhi, which understood and realised the magnitude of the problem. With a vision and mission in 2001, the NBE started a two-year fellowship programme in peripheral vascular surgery and hence giving a separate independent recognition to this subject. Presently, this course is available in only three major cities and because of its popularity has been converted into a full fledged 3 years program from 2008 onwards. Not only this Sri chitra institute Trivandrum has also started the Mch program in vascular surgery from 2008 onwards.This suffices to say the growing popularity of this speciality in medical fraternity.
Inspite this, the picture is not clear. Cardiac surgeons in India still claim themselves to be the best vascular surgeons also. No matter, as in reality there operative vascular work is less than two per cent and their CTVS training is focussed only towards cardiac surgery. Infact the approach, diagnosis and therapy of vascular diseases is very much different from the approach to a patient with heart disease.
No reason to blame them .Infact what is required is a separate recognised, independent vascular surgery department, which can take care of peripheral vascular system.
Not only that, to confuse and complicate the issue further we now have general surgeons, thoracic surgeons and general surgeons with some experience in vascular surgery, all claiming to do vascular operations. Now even cardiologists and radiologists are claiming themselves in the race of treating and eliminating vascular diseases.
This conceptual puzzle kept many hundreds of surgeons in resentful confusion for years. Time, however, slowly but surely has begin to sort out this confusion. Hospitals concerned with their professional standing are increasingly inclined to grant vascular privileges to new staff members, only if they are certified by the MCI or NBE as having special or added qualifications in vascular surgery.
The image of the vascular surgery is gradually acquiring formal recognition .Time is not far away when this speciality will get its due and will go on to serve the ailing community.