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జడత్వం-నివారణోపాయాలు

జడత్వానికి ప్రధాన కారణాలు మానసికపరమైనవే అవుతాయన్నది వైద్యుల అభిప్రాయం. కొన్ని కుటుంబాలలో వరకట్నాల వ్యవహారాలలో, వివాహాలు, ఆడపిల్లల పెళ్ళి విషయంలో ఇబ్బందులు, ఆర్ధిక సంబంధమైన ఇతర విషయాలు స్త్రీ మనసు మీద ఎక్కువ ప్రభావం చూపిస్తుంటాయి. ఇలాంటి తగవుల వల్ల మగవారిలో కూడా తెలియకుండానే చిరాకు పెరగవచ్చు.

ఇది సెక్స్ సంబంధాల మీద ప్రభావాన్ని చూపిస్తుంది. పెళ్ళయిన వారైతే కొద్దికాలానికి సర్థుబాటు చేసుకుంటారు. పెళ్ళి కాని వారైతే, తోటి వారి విషయంలో జరిగిన విషయాలన్నీ మనసులో పెట్టుకుని స్త్రీ పురుష సంబంధాన్ని ఇష్టపడరు. ఇదే క్రమంగా జడత్వానికి కారణమవుతుంది. కొద్దికాలానికి వారీ విషయం మర్చిపోయినా అంతర్గతంగా మాత్రం ఉంటుంది. వివాహమైతే కొద్దిమంది జడత్వం నుంచి బయటపడతారు. కొద్దిమంది బయటపడరు.

సమస్య వచ్చేది ఇటువంటివారితోనే. సైకో ఎనాలిసిస్ చేస్తే ఫ్రిజిడిటీకి కారణం కొంతవరకు తెలుసుకోవచ్చు. సరైన చికిత్స ద్వారా వారికి సెక్స్ అంటే ఆసక్తి కలిగించవచ్చు. జడత్వం ఉన్న స్త్రీలకి హిప్నాటిక్ థెరపీ ఎంతో ఉపయోగపడుతుంది. సాధారణంగా ఎక్కువ మందికి చేసే చికిత్స ఇదే. హిప్నాటిక్ సజెషన్స్ ఇవ్వడం ద్వారా రతిలో తృప్తి పొందేట్టు చేయవచ్చు.

రతిలో సుఖం పొందడమనేది మనస్సులో కలిగే స్పందనపై ఆధారపడి ఉంటుంది. ఇవే కాక నాడీమండలం తీరు, శరీరంలొని హార్మోన్లు అనే రసాయనాలు కూడా ఈ స్పందనల్ని ప్రభావితం చేస్తాయి. వైద్యులు జడత్వం ఉన్న స్త్రీలకి చికిత్స చేసేప్పుడు ఈ విషయాన్నీ దృష్టిలో ఉంచుకోవాలి. జడత్వం శారీరక కారణాల వలన కలిగిందా, మానసిక కారణాల వల్ల కలిగిందా అనేది పరిశీలించడం కూడా ముఖ్యమే.

ఇలాంటి విషయాలు చికిత్సకు సంబంధించి వైద్యులను సంప్రదించినప్పుడు వారడిగిన అన్ని విషయాలకూ నిస్సంకోచంగా సరైన సమాధానం ఇవ్వడం అవసరం. అలా ఇవ్వకపోతే చికిత్స చేయడం కుదరదు. వైద్యులు జడత్వం ఉన్న స్త్రీలకు చికిత్స చేసే ముందు చిన్నతనం, కుటుంబం, పుట్టి పెరిగిన వాతావరణం ఇలాంటివన్నీ తెలుసుకునే ప్రయత్నం చేస్తారు. అవసరమైతే కొన్ని పరీక్షలు చేస్తారు. వైద్యులకి సహకరిస్తే సమస్య పరిష్కారం తేలికవుతుంది.


స్టాప్ అండ్ స్టార్ట్ పధ్ధతి – 1

శీఘ్రస్ఖలనం నివారణకు ఆధునిక వైద్యులు ఎక్కువగా సూచించే పధ్ధతి ‘స్టాప్ అండ్ స్టార్ట్ పధ్ధతి’. ప్రాక్టీసు ఎక్కువగా చేయడం ద్వారా ఈ పధ్ధతి ఎక్కువ ప్రయోజనాన్ని కలిగిస్తుందని అధిక సంఖ్యాకుల అనుభవాన్ని బట్టి తేలింది.

క్లుప్తంగా చెప్పాలంటే వీర్య స్ఖలనాన్ని ఆపుకోవడమే స్టాప్ అండ్ స్టార్ట్ పధ్ధతి. ఈ పధ్ధతి ఆచరణలో, అభ్యాసంలో రెండు ప్రధాన దశలున్నాయి. ఆచరణలోని దశలేమిటంటే….

1) వీర్యస్ఖలనం జరిగేముందు కలిగే అనుభవాన్ని గుర్తించడం.

2) స్ఖలనాన్ని ఆపుకోగలిగే సామర్థ్యాన్ని పెంపొందించుకోవడం. అభ్యాసం ద్వారా ఈ రెండూ అలవడతాయి. ముందు చెప్పుకున్నట్టుగా ఆచరణలో ఉన్నట్టే అభ్యాసంలోనూ రెండు ప్రధాన దశలున్నాయి. అవి ….

1) పురుషుడు ఒక్కడే అభ్యాసం చేయడం.

2) స్త్రీ సహకారంతో అభ్యాసం చేయడం. పురుషుడు ఒక్కడే అభ్యాసం చేయడం అనే దశ గురించి ఈవారం తెలుసుకుందాము. ఈ దశలో…

1) పురుషుడు హస్త ప్రయోగం చేసుకోవాలి.

2) వీర్య స్ఖలనం కలిగే సమయానికి ముందు అనుభవాన్ని గుర్తించాలి.

3) ఆ అనుభవాన్ని గుర్తించిన వెంటనే హస్తప్రయోగం ఆపేసి స్ఖలనాన్ని నిరోధించాలి.

4) కొద్ది నిమిషాల విరామం తర్వాత తిరిగి హస్త ప్రయోగం చేసుకోవాలి. ఇదే పద్ధతిని మళ్ళీ మళ్ళీ కొనసాగించాలి.

అలా 15 నుంచి ఇరవై నిమిషాల వరకు ఈ అభ్యాసం చేస్తుంటే కొద్ది కాలానికి సమస్య తొలగిపోతుంది. ఇలా కాకుండా కొంతమంది అంగప్రవేశం తర్వాత పురుషాంగానికి ప్రేరణ తెలియకుండా ఉండేందుకు క్రీమ్స్, కండోమ్స్ వాడడం చేస్తుంటారు. ఇది కొంత వరకూ ఫలితాన్ని ఇస్తుంది. అంగానికి ప్రేరణ లేకపోవడం వల్ల స్ఖలనం ఆలస్యమవుతుంది. ఈ విధానం వల్ల దుష్ఫలితాలు కలగవనే చెప్పుకోవచ్చు.


రతిలో బాధ కారణాలు

కొంతమంది స్త్రీలలో రతి వలన బాధ కలుగుతుంది. దీనికి అనేక కారణాలున్నాయి. స్త్రీని బలవంతంగా లోబరుచుకున్నప్పుడు ఆమె అయిష్టంగా సహకరిస్తే మానసికంగా అంతులేని వ్యధ చెందుతుంది. శారీరకంగా ఆమె అందుకు సంసిద్ధంగా ఉండదు. కాబట్టి కొంతమందికి శారీరకంగా కూడా విపరీతమైన బాధ కలుగుతుంది. సాధారణంగా శారీరకమైన బాధ యోనిమార్గం బిగుతుగా ఉండడం వల్ల కలుగుతుంది.

అత్యాచారం వంటివి జరిగినప్పుడు ఆమెలోని అయిష్టత వల్ల యోని రతికి సిద్ధంగా ఉండదు. అయితే కొంతమందికి తొలిరాత్రి ఇటువంటివి ఎదురు కావచ్చు. దీనికి కారణాలేమంటే ...

పురుషుని మీద విముఖత అనేది సాధారణమైనదైతే, ఇక పురుషుని సంపూర్తిగా ఇష్టపడుతూ రతిమీద ఆసక్తి కూడా ఉండి, భర్తకు సహకరిస్తున్నప్పటికీ రతిలో కలిగే బాధ మరొక కారణం. తొలిరాత్రి మీద స్త్రీలకు కొద్దిగా సందేహాలు, భయాందోళనలు ఉండేది ఇందుకే.

తొలి రాత్రే సక్సెస్ కావడమనేది భార్యాభర్తల ఇద్దరి మీదా ఆధారపడి ఉంటుంది. యోని మార్గం బిగుతుగా ఉండడం వల్ల కొంతమందిలో అంగప్రవేశం దుర్లభమవుతుంది. పురుషునికి ఇది మరింత సవాలుగా, అవమానకరంగా మారుతుంది. పరిస్థితిని గ్రహించకుండా అతను బలవంతంగా అంగప్రవేశం చేస్తాడు. ఇలా చేయడం వల్ల యోని దగ్గర వాపు కలిగే అవకాశాలున్నాయి. దీనితో వెంటనే మరోసారి రతికి సిద్ధపడితే అది మరింత బాధాకరమవుతుంది.

ఇలాంటి సంఘటనలతో బెదిరిపోయిన స్త్రీ క్రమంగా రతి అంటే విముఖత పెంచుకుంటుంది. ఇలాంటి సందర్భాలలో నిగ్రహం పాటించడమే మేలు. కొన్ని రకాల ఇన్ ఫెక్షన్ల వలన కూడా రతి బాధాకరంగా మారచ్చు. ఇలాంటి సందర్భాలలో వైద్యులను సంప్రదించడం మేలు. ఇలాగే జెల్లీ వాడేముందు సమస్యేంటో కచ్చితంగా తెలుసుకుంటే ఆ సమస్యకు సరైన పరిష్కారాన్ని ముందే కనుగొనవచ్చు. సెక్స్ సంబంధమైన సమస్యలు సున్నితమైనప్పటికీ చాలా తీవ్రమైన ప్రభావాన్ని చూపిస్తుంటాయి


వేరికోసిల్ – 1

సంతానం కలగడంలో స్త్రీ పురుషుల పాత్ర సమానం. అయితే వివాహమైన చాలా కాలానికి కూడా భార్యాభర్తలు సంతానం పొందలేకపోతే దానికి స్త్రీలే బాధ్యత వహించాలనే భావం భారతదేశంలో వ్యాపించింది. ఇప్పుడిప్పుడే ఈ పరిస్థితిలో మార్పు కనిపిస్తోంది. పురుషులలో అనేక కారణాల వల్ల వంధ్యత్వం ఏర్పడుతుందనే వాస్తవాన్ని ఇప్పుడిప్పుడే గుర్తిస్తున్నారు.

పురుషులలో వంధ్యత్వం ఏర్పడటానికి వేరికోసిల్ ఒక కారణం కావచ్చు. వృషణాల నుంచి రక్తాన్ని తీసుకువెళ్ళే సిరలు ఉబ్బడాన్నే వేరికోసిల్ అని అంటారు. వేరికోసిల్ ఎప్పుడైనా రావచ్చు. 25 నుంచి 30 సంవత్సరాల వయసు ఉన్నవారిలో ఇది ఎక్కువగా కనిపించే అవకాశాలు ఎక్కువ.

వేరికోసిల్ ఎక్కువగా ఎడమవైపు వృషణాలకి వస్తుంది. కుడివైపున రాదని మాత్రం చెప్పలేం. అలా రావడమనేది అరుదు. కొంతమందిలో రెండువైపులా వేరికోసిల్ రావచ్చు. ఇటువంటి వారి వృషణాలు రెండూ పనిచేయక పోవడం వల్ల వీర్యకణాల ఉత్పత్తి తగ్గడమనేది ఎక్కువ. వీరు త్వరగా చికిత్స చేయించుకోవడం మంచిది. వేరికోసిల్ వలన వీర్యకణాల ఉత్పత్తి తగ్గిపోతుంది. అందుకే వారికి పిల్లలు పుట్టరు. ఒక బిడ్డ పుట్టిన తర్వాత వేరికోసిల్ వచ్చినా ఇదే ఫలితం కలుగుతుంది.

వేరికోసిల్ కి చికిత్స ఈనాడు అందుబాటులో ఉంది. వేరికోసిల్ ఉన్న వారు చికిత్స చేయించుకుంటే వారు సంతానవంతులు కాగలరు. వేరికోసిల్ ను నిర్లక్ష్యం చేస్తే మాత్రం నష్టం కలగక తప్పదు. ఇటువంటి వ్యాధులు ఎందుకు వస్తాయనేది చెప్పడం కొంచెం కష్టమే. వైద్యం అందుబాటులో ఉన్నందున వెంటనే చికిత్స చేయించుకుంటే నష్టం కలిగే అవకాశమే ఉండదు. సిగ్గు, మొహమాటాలతో కాలాయాపన చేయడం తగదు. వేరికోసిల్ గురించి మరికొన్ని విషయాలు వచ్చేవారం.


మధురానుభూతి ఎందుకు కలగదు?

సెక్స్ లో పాల్గొనేప్పుడు కొద్దిమందిలో ఎటువంటి స్పందనా కలగదు. ఈ అనుభూతి గురించి వారికి పెద్దగా తెలియకపోవడంతో వారికి సెక్స్ మీద ఆసక్తి సన్నగిల్లిపోయే ప్రమాదం ఉంది. సెక్స్ లో పాల్గొన్నప్పుడు మధురానుభూతి పొందనప్పుడు తనలోనే ఏదో లోపం ఉందని స్త్రీలు భావింస్తుంటారు. ఇదే ఆలోచనలో మానసికంగా కుంగిపోతూ భర్తకు దూరమవుతారు. ఇది సమస్యను మరింత పెంచుతుందని వారనుకోరు. దీనికి నివారణోపాయాల మీద దృష్టి సారించరు.

సెక్స్ అంటే కొద్దిమదిలో అనవసరమైన భయం, ఆందోళన ఉంటాయి. ఇది వారిలోని మానసిక లోపమనే భావించాలి. ఇటువంటి స్త్రీలు సెక్స్ లో పాల్గొన్నా సుఖప్రాప్తి కలిగే అవకాశం ఉండదు. మరికొంత మంది స్త్రీలలో సెక్స్ అంటే పాపమని బాధాకరమైన అనుభవమనే అర్థంలేని భావం పాతుకుపోయి ఉంటుంది. ఇటువంటివారు సెక్స్ కు దూరంగానే ఉంటారు. దీనికి కారణాలు అనేకం ఉండొచ్చు. కుటుంబపరమైనవి, మానసిక పరమైనవి ఇలాంటి కారణాలలో మరీ ముఖ్యమైనవి. కారణాలేమిటో తెలిస్తే చికిత్స చేయడం చాలా సులువు.

కొన్ని రకాలవ్యాధుల వల్ల కూడా సెక్స్ లో సుఖం పొందలేకపోవడమనేది జరుగుతుంది. డ్రగ్ ఎడిక్ట్స్ సెక్స్ లో సుఖాన్ని పొందలేరు.

సెక్స్ పరంగా ఏ సమస్యలున్నవారైనా గ్రహించవలసింది ఒక్కటే. సాధారణంగా ఆరోగ్యవంతులైనవారికి సెక్స్ లో ఎటువంటి ఇబ్బందులూ ఎదురుకావు. ఒక వేళ ఎదురైనా చాలా సులభంగా వాటికి చికిత్స చేయించుకోవచ్చు. శరీరం, మనస్సు కలయికే సెక్స్ లో సుఖానికి పునాది. అలా జరగనప్పుడు సుఖమనేది పొందలేకపోవచ్చు.


రోగులు రతిలో పాల్గొనరాదా?

ఏ వ్యాధితో అయినా బాధ పడుతున్న వాళ్ళు రతిలో పాల్గొనకూడదని, అలా పాల్గొంటే, ఆ వ్యాధులు భాగస్వామికి సోకుతాయనే అపోహ చాలా మందిలో ఉంది. సుఖ, అంటు వ్యాధుల విషయంలో ఇది చాలా వరకు నిజమే. అన్ని వ్యాధుల విషయంలో ఇలా జరగదు.

ఏ వ్యాధులు ఉన్నవారు రతిలో పాల్గొనరాదు, ఎటువంటి వ్యాధులు రతి వల్ల భాగస్వాములకు సంక్రమిచవు అన్నవి చాలా మందికి తెలియవు. గనేరియా, సిఫిలిస్, ఎయిడ్స్ వంటి వ్యాధులు రతి వల్ల ఇంకొకరి నుంచీ సంక్రమించేవే. ఇది చాలామందికి తెలిసిందే. మరి ఏ వ్యాధులున్నవారు పాల్గొనవచ్చు అనేదే ఇప్పుడు తెలుసుకోవలసింది.

మామూలు జ్వరం నుంచి కామెర్లు, క్షయ, గుండె జబ్బులు, మధుమేహం తదితర వ్యాధులున్న వారు రతిలో పాల్గొనకూడదని కొంతమంది భావిస్తుంటారు. మధుమేహం ఉన్న రోగులు రతిలో పాల్గొంటే వారు తేలికగా అలసిపోవడం అన్నది కొంతవరకూ నిజమే. వీరి వల్ల ఇతరులకు ఈ వ్యాధి సోకుతుందనడం మాత్రం అపోహే.

క్షయ వ్యాధిని తీసుకుంటే ఇది అంటు వ్యాధే అయినప్పటికీ రతిలో పాల్గొంటే ఇతరులకు సోకదు. ఇలాంటి అనేక అపోహల వల్ల చాలామంది సంసార జీవితాన్ని నాశనం చేసుకుంటున్నారు. సమస్య ఏదైనా ఆరోగ్యం విషయంలో వైద్యులను సంప్రదిస్తే అపోహలకు ఆస్కారం ఉండదు.


స్త్రీలు-కామకేంద్రాలు

వాత్సాయన కామసూత్రాలూ నేటికాలంలో వైద్యులు శృంగార జీవితంపై పదే పదే ఒక మాట చెబుతుంటారు. అదేమిటంటే స్త్రీలలో బాహ్య ప్రేరణ ద్వారా వారిని సంభోగానికి సమాయత్తం చేయవచ్చని.

ఇది నిజమే! స్త్రీని రంజింపజేయడానికి ఎక్కువ సేపు సెక్స్ లో పాల్గొనాలని, దీనికి తామిచ్చే లేహ్యాలు, మూలికలు, గుళికలు అద్భుతంగా పని చేస్తాయని దేశవాళి, నటు వైద్యులు ఏవేవో మందులివ్వడం మామూలే. వాటిని వాడి యధాశక్తి ‘సంతృప్తి’ పడిపోవడం అంతకంటే సాధారణమైన విషయమే.

ఇక్కడ చెప్పుకోవలసింది ఏమిటంటే మొట్టమొదట దేశవాళి వైద్యులు చెబుతున్నట్టు రతిలో సామర్థ్యాన్ని పెంచేందుకు లేహ్యాలు లేవు. వారిచ్చే లేహ్యాలు పెద్దగా పనిచేయవు. అవి వాడిన తర్వాట ఒక మానసిక సంతృప్తే తప్పితే మరేమీ లభించదు. అందుకని ముందు అటువంటి మందులు వాడడం మానుకోవాలి.

పురుషుడి స్పర్శకు స్త్రీ స్పందించే విధానం ఆధారంగా ఈ వర్గీకరణ జరిగింది. స్త్రీ శరీరం మొత్తం కామకేంద్రమే అయినప్పటికీ, ఒకో స్త్రీ ఒక్కో రకంగా పురుషుడి చర్యలకు స్పందిస్తుంది.


స్టాప్ అండ్ స్టార్ట్ పధ్ధతి – 2

శీఘ్ర స్ఖలనాన్ని నిరోధించేందుకు అనుసరించే పద్ధతులలో ఒకటైన స్టాప్ అండ్ స్టార్ట్ పధ్ధతి మెదటి దశలో పురుషుడు హస్తప్రయోగం ద్వారా స్ఖలనంపై అదుపు సాధించేందుకు ప్రయత్నించాలి.

రెండవ దశలో స్త్రీ ద్వారా హస్తప్రయోగం జరిపించుకుంటూ ఆలింగన, చుంబనాదులతో ఉద్రేకం పొందాలి. స్ఖలనమవుతుంది అనిపించే దశలో హస్తప్రయోగాన్ని నిలుపు చేయమని కోరుతూ స్ఖలనాన్ని నిరోధించగలగాలి.

అలా కనీసం పదిహేను నిమిషాల వరకైనా అదుపు సాధించాలి. అలా సాధించిన తర్వాత మూడవ దశలోకి ప్రవేశించవచ్చు.

రెండవ దశ పూర్తికావడానికి పది రోజులు పడుతుంది. సుమారు పది పదిహేను రోజులలో మూడవ దశలోకి ప్రవేశించిన తర్వాత కూడా స్ఖలనాన్ని నిరోధించేందుకు అభ్యాసం కొనసాగిస్తూనే ఉండాలి.

మూడవ దశ అంటే పురుషాయితం వంటిది. స్త్రీ పురుషుడి పైకి చేరి రతిలొ పాల్గొనడం. ఇలా చేస్తున్నప్పటికీ ఎటువంటి కదలికలూ లేకుండా నిశ్చలంగా, స్థిరంగా ఉండాలి. రెండు దశలుగా జరిగిన అభ్యాసం వల్ల పురుషుడికి స్ఖలనం మీద చాలా వరకూ పట్టు వస్తుంది.

మూడవ దశలో కూడా స్ఖలనమవుతుందనిపించినప్పుడు యోని నుంచి అంగాన్ని వెలుపలికి తీసివేయాలి. అయిదు పది నిమిషాలు ఆగి ఇక స్ఖలనం కాదనుకున్నప్పుడు తిరిగి అంగప్రవేశం చేయాలి. ఈ విధంగా మూడవ దశలో స్ఖలనాన్ని నిరోధించడం అభ్యాసం చేసిన తర్వాత నాల్గవ దశలోకి ప్రవేశించవచ్చు.

నాల్గవ దశ అంటే మరేమీ కాదు సహజ రతి. కదలికలతో కూడినది. గతంలో జరిగిన అభ్యాసాల వల్ల శీఘ్రస్ఖలనం నిరోధించడం చాలా వరకూ సుసాధ్యమవుతుంది. ఇప్పుడు కూడా స్ఖలనాన్ని నిరోధించడం కోసం పది పదిహేను రోజులు కొద్దిపాటి అభ్యాసం అవసరమవుతుందనుకుంటే చేయవచ్చు. చాలామందికి నాల్గవ దశలో అభ్యాసం చేయవలసిన అవసరముండదు. శీఘ్రస్ఖలన నివారణకు మందులతో పనిలేని ఈ పధ్ధతి బహుళ ప్రచారంలో ఉంది.


జడత్వం – నివారణోపాయం – 1

మగవారిలో నపుంసకత్వం వలె స్త్రీలలో జడత్వం ఏర్పడుతుంది. జడత్వం ఏర్పడిన స్త్రీలకు రతిపై ఆసక్తి ఉండదు. నపుంసకత్వానికి చికిత్స ఉన్నట్టే జడత్వాన్ని వదిలించడానికి కూడా చికిత్స చేయించవచ్చు. నపుంసకత్వానికి శారీరక, మానసికపరమైన కారణాలున్నాయి. ఆ కారణాలను బట్టి చికిత్స ఉంటుంది.

జడత్వం అనేది చాలావరకు మానసికపరమైన కారణాల వల్లే కలుగుతుంది. దీనికి కౌన్సిలింగ్ అవసరం. జడత్వం నుంచి విముక్తి పొందడానికి మాస్టర్స్, జాన్సన్ ఒక పధ్ధతి రూపొందించారు. ఈ పద్ధతికి వారి పేరే పెట్టారు.

సుమారు 400 ,మందిపై వీరు రూపొందించిన పధ్ధతి ప్రకారం చికిత్సకు పూనుకోగా 75 శాతం కంటే ఎక్కువ ఫలితాలు కనిపించాయి. మొత్తానికి ఈ పధ్ధతి విజయవంతమైనదిగానే పేర్కొంటున్నారు. మాస్టర్స్, జాన్సన్ రూపొందించిన ఈ పద్ధతిలో స్త్రీకి రతిపై ఆసక్తి కలిగించడానికి ప్రయత్నం జరుగుతుంది.

ఈ ప్రయత్నానికి స్త్రీ సహకారం అవసరం, భర్తపై అనురాగం ఉన్నప్పటికీ వేరే కారణాల వల్ల రతి పట్ల విముఖురాలవుతున్నప్పుడు ఈ పధ్ధతి సత్ఫలితాలనిస్తుంది. భర్త మీద ఏమాత్రం ప్రేమ, అనురాగం లేనపుడు ఈ పధ్ధతి పూర్తిస్థాయి ఫలితాన్ని ఇవ్వడు. ఎందుకంటే ఈ పద్ధతిలో శారీరక సంబంధంపై ఆసక్తి పెంచడంతోపాటు మానసికమగా కోరికను పెంచడం, భర్తకు చేరువ కావాలనే భావనను పెంచడం సమానంగా ఉంటాయి.

మాస్టర్స్ అండ్ జాన్సన్ రూపొందించిన ఈ పధ్ధతి పడక గదికి పరిమితమైనది. భార్యాభర్తలు పూర్తిగా వివస్త్రాలు కావాలి. మానసికంగా వారు సంభోగం పట్ల ఆసక్తి కలిగి ఉండాలి. భార్యకు భర్త తగిన ప్రేరణనిస్తూ ఆమెకు చేరువకావాలి. అంటే కౌగిలింతలుం, చుంబనాదులతో మోహావేశం కలిగించాలి. గోడకు దిండ్లు పేర్చుకుని చేరగిలబడి స్త్రీని దగ్గరకు తీసుకోవాలి. ఇలా దగ్గరకు తీసుకుంటున్నప్పుడు ఇద్దరి

కాకళ్ళూ పూర్తిగా చాచి ఉండాలి. అంటే స్త్రీ పురుషుల జననేంద్రియాలు బాగా చేరువగా ఉండాలి. స్పర్శ బాగా తెలియాలి. క్లేటోరిస్ కి పురుషాంగం చేత ఒరిపిడి కలిగించాలి. ఇలా చేయడం వల్ల స్త్రీలో మొహం కలుగుతుంది. ముందు చెప్పినట్టు అసలు భర్తపై అనురాగం ఉండాలి.


పొందికైన వక్షోజాలు పొందేదెలా?1

సెక్స్ పరంగా స్త్రీలలో ఎక్కువ ఆకర్షణ ఉన్న అవయవాలలో మొదటివి వక్షోజాలే. వక్షోజాల తర్వాతే ముఖ, శరీరాకృతి, రంగు ఇలంటివన్నీ పరిగణలోకి తీసుకోవాల్సి వస్తుంది. నిండా వక్షోజాలున్న స్త్రీలలో సెక్సప్పీల్ పెంచుతుంది. అందుకే సినిమా స్టార్స్, మోడల్స్ ఇతర విషయాలతో పాటు శరీరసౌష్టవం, తీరైన వక్షోజాల కోసం ప్రత్యేక శ్రద్ధ తీసుకుంటారు.

వక్షోజాలు చిన్నవిగా ఉన్న స్త్రీలలో కొంతమందికి ఆత్మన్యూనతాభావం పెరుగుతుండడం సహజమే. వక్షోజాల పరిమాణం మనిషి, మనిషికీ మారుతుంటుంది. ఇది అనేక అంశాలపై ఆధారపడి ఉంటుంది.

వక్షోజాల ఆకృతిని, పరిమాణాన్ని మార్చుకునేందుకు ఎన్నో చికిత్సలు నేడు అందుబాటులోకి వచ్చాయి. అయితే ఇలాంటి చికిత్సలు చేయించుకోవాలనుకునేవారు ముందుగా ఒక విషయాన్ని తెలుసుకోవాలి. వక్షోజాలొక్కటే సెక్సప్పీల్ పెంచవు. ప్రతి ఒక్కరిలో సెక్సప్పీల్ ఒక్కో విధంగా ఉంటుంది. కొందరికి కనుముక్కు తీరులో, కొందరికి శరీరాకృతిలో ఇలా విభిన్నంగా ఉంటుంది. ముందుగా తమలో సెక్సప్పీల్ ఎక్కడ ఉందో తెలుసుకోవాలి. ఆ తర్వాతే శస్త్ర చికిత్సల జోలికి వెళ్ళాలి. కొన్ని రకాల ఇంజెక్షన్లు వక్షోజాల సైజును పెంచేందుకు వాడుతుంటారు. వీటివల్ల కొంతమేరకు ఉపయోగం ఉంటుంది. ఏ మందులనైనా వైద్యుల సలహాలేనిదే వాడడం అనర్థదాయకం కాబట్టి ఇటువంటి ఇంజక్షన్లు వాడే ముందు కూడా వైద్యులను సంప్రదించడం అవసరం. ప్రోగైనాన్ డిపో, ప్రోలుటాన్ డిపో వంటివి వాడుతుంటారు.

ఇవి వాడుతున్నప్పుడు కొన్ని రకాల క్రీమ్ లు కూడా అప్లై చేసుకోవడానికి ఉన్నాయి. ఇటువంటి మందులు వాడడం కంటే కొన్ని సహజ పద్ధతులు అనుసరించి చూడడం శ్రేయస్కరం. సహజ పద్ధతులు అంటే పుష్టికరమైన ఆహారం తీసుకోవడం, కొవ్వు ఎక్కువగా ఉన్న నెయ్యి, నూనెలు వాడడం. దీనివల్ల శరీరంలో అదనంగా చేరే కొవ్వు వల్ల వక్షోజాల పరిమాణం కొద్దిగా మారే అవకాశం ఉంది. అలా మారిన తర్వాత కూడా మీరు అసంతృప్తితో బాధపడుతుంటే అప్పుడు వైద్యుడిని సంప్రదించండి. వైద్యులే మీకు తగిన సలహాలు, సూచనలు ఇస్తారు.

వక్షోజాల పరిమాణాన్ని పెంచేందుకు ఇంజక్షన్లు, మందులు కాకుండా మరికొన్ని మార్గాలున్నాయి. అవి ప్లాస్టిక్ సర్జరి, సిలికాన్ ఇంప్లాంట్స్ వంటివి. దీనివల్ల పరిమాణంలో మార్పు కనిపిస్తుంది. ఇదంతా ఖరీదైన వ్యవహారం. అందరికీ అందుబాటులో ఉండదు. ఖరీదుకు వెరవకుండా ఉంటే అపుడా విధానాలు అనుసరించవచ్చు.


సెక్స్ వాంఛ – శరీరంలో నొప్పులు

సెక్స్ కోరికను అణుచుకున్న వారిలో కొంతమందికి, కొన్ని కొన్ని అపోహల వలన హిస్టీరికల్ గా ప్రవర్తించేవారికి శరీరంలో వింత వింత నొప్పులు వస్తున్నట్టు వైద్యులు గుర్తించారు. వీటిలో కొన్ని సందర్భాలలో నిజంగానే నొప్పులు ఉండగా, మరికొన్ని సందర్భాలలో ఆ నొప్పులనేవి కేవలం మానసిక భ్రమలుగా గుర్తించారు. ఈ నొప్పులు ఎక్కువగా స్త్రీలను బాధించేవే. అలాంటి నొప్పులలో ఒకటి పొత్తికడుపులో నొప్పి. సెక్స్ వాంఛ తీవ్రంగా ఉండి, ఆ వాంఛను బలవంతంగా అణుచుకుంటున్న స్త్రీలలో కొందరికి పోత్తికడుపులోనూ, కింద భాగంలోనూ ఒక విధమైన నొప్పి కలుగుతుంది. వారి కోరిక తీరినప్పుడు ఆ నొప్పులు వాటంతట అవే తగ్గుతాయి. ఈ నొప్పులు తగ్గడానికి విడిగా మందులు ఇవ్వవలసిన అవసరం లేదు.

కొంతమందిలో గర్భంరావడమో, బ్లీడింగ్ ఎక్కువగా కావడమన్నా విపరీతమైన భయం ఉంటుంది. కాళ్ళలో వణుకు వస్తుంది. ఇదంతా హిస్టీరియాకి సంబంధించినవి. ఇలాంటి భయం వారికి కలగడానికి అసలు కారణమేమిటో మనసులో ఉంటుంది. తప్పితే, శారీరకంగా ఎటువంటి లోపాలూ ఉండవు.

వారి మనసులో దాగున్న భయాలను తలుచుకుని మరీ ఎక్కువగా వాటి గురించే ఆలోచిస్తుండడం వలన ఇలాంటి నొప్పులు కలుగుతాయి. మనసులో అంతర్గతంగా ఏదైనా సమస్య ఉన్నప్పుడు, దానికి సరైన పరిష్కారాన్ని కనుక్కోలేని స్థితిలో ఆ వ్యక్తి ఆత్మ విశ్వాసం తక్కువగా ఉన్నవాడైతే అతని మనసు విచిత్రంగా ప్రవర్తిస్తుంది. అటువంటప్పుడు ఆ మనిషి తన అసమర్థతను లేదా భయాన్ని దాచుకోవడానికి ప్రయత్నిస్తాడు. అలాంటి స్థితిలో నుంచే ఇటువంటి భయాలు, నొప్పులు పుడతాయి. దీనివల్ల సమస్య నుంచి తాత్కాలికంగా పక్కకి తప్పుకుని ఎదుటి వారి సానుభూతి పొందుదామని చూస్తారు.

కొన్ని సందర్భాలలో ఈ భయాలు ఎటువంటి రీజనింగ్ కీ అందవు కూడా. ఆ సందర్భాలలో సైకో థెరపీ వల్ల మాత్రమే ప్రయోజనం ఉంటుంది. ఒకసారి మనసు ప్రశాంతంగా ఉంటే మరే సమస్యలూ ఉండవు. దాంపత్య సంబంధాల విషయంలోనే కాదు, అందరికీ నిత్య జీవితంలో ఇటువంటివి ఎదురు కావచ్చు. అయితే దాంపత్య సంబంధాలంటే ఇద్దరి జీవితాలకు సంబంధించినది కావడం, పైగా ఎదుటి వారిని రంజింప జేయాలనే ప్రయత్నంలో మరిన్ని సమస్యలు తెచ్చుకోవడంతో సమస్య పెద్దదిగా కనబడుతుంది.


పొందికైన వక్షోజాలు పొందేదెలా? – 2

వక్షోజాలు చిన్నవిగా ఉండడానికి హార్మోన్ల లోపం కొంతమందిలో ఒక కారణం కావచ్చు. ఇటువంటి వారు హార్మోన్ల చికిత్స చేయించుకుంటే సత్ఫలితాలు కనిపిస్తాయి. మొదటి నుంచి వక్షోజాలు పెరగని వారికి కూడా ఈ ట్రీట్ మెంట్ ఉపయోగపడుతుంది. హార్మోన్ చికిత్స చేసే ముందు వైద్యులు, ఇటు చికిత్స చేయించుకేనే వారూ గమనించాల్సిన విషయం ఒకటుంది.

హార్మోన్లలో లోపం ఉన్నప్పుడే ఈ చికిత్స వల్ల ప్రయోజనం ఉంటుంది. హార్మోన్ల లోపం లేకపోతే ఏ ఉపయోగం ఉండదు.

హార్మోన్ల లోపం ఉన్నప్పుడు దానిని సులువుగా గుర్తించవచ్చు. ప్రత్యేకంగా కనపడేవి కొన్నయితే, పరోక్షంగా ఈ లోపాన్ని సూచించేవి మరికొన్ని. వక్షోజాల ఎదుగుదలలో లోపం, సరైన వయసుకు రజస్వల కాకపోవడం, అండాలు సరిగా విడుదల కాకపోవటం ఇటువంటివాటిలో కొన్ని. ఈ సమస్య ఎదుర్కొంటున్న వారు తక్షణం డాక్టరును సంప్రదిస్తే అసలు కారణం తెలుసుకుని చికిత్స చేయడానికి వీలవుతుంది. వ్యాయామం వల్ల చిన్న చిన్న లోపాలు సరిదిద్దుకోవచ్చు కానీ వక్షోజాల ఆకృతి మార్చడం, పెద్దవి చేయడం కుదరదు.

స్త్రీలు గుర్తుంచుకోవాల్సిన మరో విషయం ఏమిటంటే వక్షోజాల ఆకృతి అన్ని వయస్సులో ఒకే విధంగా ఉండదు. వయసును బట్టి, ఇతర కారణాలను బట్టి మారుతుంది. ఆ విషయాన్ని దృష్టిలో ఉంచుకోవాలి. వక్షోజాలు చిన్నవిగా ఉన్నంత మాత్రాన నిరాశలో కూరుకుపోయి, ఆకర్షణలేదనుకోవడం ఎక్కువగా టీనేజ్ యువతులలో కనబడుతుంది.ఆత్మవిశ్వాసమే అసలైన ఆకర్షణ అని గ్రహిస్తే ఇటువంటి యువతులు పడే మానసిక వేదన తగ్గడమే కాదు, ఆత్మవిశ్వసం తొణికిసలాడుతున్నఇటువంటి వారు ఎదుటివారిని ఇట్టే ఆకర్షించగలరు.


రతిపై స్త్రీలకు విముఖత తొలగాలంటే ….

సాధారణంగా యుక్తవయసులో శృంగారం పట్ల స్త్రీ పురుషులలో ఎవరికీ అనాసక్తి కలగదు. అలా ఎవరికైనా అనాసక్తి కలుగుతోందంటే అది మానసిక, శారీరక ఆరోగ్యాలలో లోపంగా  గుర్తించాలి. పురుషులైతే ఈ విషయంలో ఒక విధంగా తొందరగా నిర్థారణకు రావచ్చు. స్త్రీల విషయంలో అలాక్కాదు.

స్త్రీలకు విముఖత కలుగుతున్నప్పుడు వైద్యులు కూడా ఒక నిర్థారణకు రావడం చాలా కష్టం. స్త్రీలు పుట్టి, పెరిగిన వాతావరణం, పెంపకంతో పాటుగా అనేక ఇతర విషయాలు ఆమెను ప్రభావితం చేస్తుంటాయి.

సెక్స్ అంటే పాపమనే భావాలు స్త్రీలలో చిన్నప్పటి నుంచి పెరిగితే వారు శృంగారం, సెక్స్ పై విముఖత చూపడానికి అవకాశాలు ఎక్కువ. ఇది మానసిక పరమైన కారణాలలో ఎక్కువగా కనిపించేది. భారత స్త్రీలను కౌన్సిలింగ్ సమయంలో సర్వసాధారణంగా వైద్యులు వారి కుటుంబ నేపథ్యం తెలుసుకునేందుకు ప్రయత్నించేది చాలా వరకు ఇలాంటి కారణాలు తెలుసుకోవడం కోసమే.

పాశ్చాత్య దేశాలలో అయితే ఎక్కువగా ఇటువంటి సమస్యలు ఎదురుకావు. మానసిక పరమైన కారణాలలో చెప్పుకోవలసిన మరో కారణం- స్త్రీలను బాల్యంలో ప్రభావితం చేసిన అంశాలు. ఇది తీసిపారేయలేనిదే.

భర్త అంటే ఇష్టం లేకపోవడం ఇలాంటివన్నీ మానసిక పరమైన కారణాలైతే కొన్ని శారీరక కారణాలు కూడా స్త్రీని రతిపట్ల విముఖురాలిని చేస్తుంటాయి.

అటువంటి కారణాలలో మొదటిది పురుషుని మోటు ప్రవర్తన. స్త్రీ ఇష్టాయిష్టాలు తెలుసుకోకుండా పురుషుడు మోటుగా ప్రవర్తించినందువలన కొన్ని సమయాల్లో స్త్రీకి రతి బాధాకరంగా పరిణమిస్తుంది. అటువంటి సమయంలో ఇక ఆమె రతిపై ఆసక్తి చూపదు.


జడత్వం – నివారణోపాయం -2

మాస్టర్స్ అండ్ జాన్సన్ పధ్ధతి ప్రకారం కూర్చున్న పద్ధతిలో స్త్రీ పురుషులు రతికి ఉపక్రమించాలి. ఇలా కూర్చున్న పధ్ధతి నుంచి పురుషాయిత పద్దతిలోకి కొన్ని రోజుల్లోనే మారాలి.

పురుషాయిత పధ్ధతి అనుసరించిన స్త్రీలలో జడాత్వం తొలగి, మిగిలిన స్త్రీల వలె ఆనందకరమైన శృంగార జీవితాన్ని గడపగలుగుతున్నారు.

జననేంద్రియాల వద్ద ద్రవాలు ఊరడం, యోని శీర్షం ఉబ్బడం తదితర లక్షణాలన్నీ కూడా వీరిలో మామూలుగానే కనబడ్డాయి.

రతిలో జడత్వం ఉన్నప్పుడు హిప్నో థెరపీ కొంతవరకూ తోడ్పడుతుంది. హిప్నాసిస్ లోకి తీసుకువెళ్ళి పాజిటివ్ సజెషన్స్ ఇవ్వడం ద్వారా రతి అంటే ఆసక్తిపెంపొందించి, తృప్తి పొందేట్టు చేయవచ్చు.

భార్యలో జడత్వం ఉన్నప్పుడు దానిని తొలగించడానికి భర్త సహకారం చాలా అవసరం. భర్త చాలా ఓపికగా వ్యవహరిస్తూ, ఆమెతో ప్రేమగా మెలగుతూ క్రమంగా శృంగారం లోకి దిగాలి. అదికూడా ఒకేసారి రతిలోకి కాకుండా ఆలింగన, చుంబనాదులతో మొదలుపెట్టి ఆమెలో కోర్కెను రగిలించగలగాలి.

సమస్య మానసికమైనది అని భర్త గుర్తించగలిగితే చాలు. భర్త మొరటుతనంతో ప్రవర్తిస్తే మొదటికే మోసం వస్తుంది. తప్పితే ఉపయోగం ఉండదు.

భర్తమీద భార్యకు ప్రేమ, అనురాగం కలిగేందుకు ఎం చేయాలో, ఎలా మెలగాలో ఆ విధంగా ప్రవర్తిస్తే సరిపోతుంది. కొందరిలో జడత్వం లేకపోయినా, శృంగార భావనలు తక్కువగా ఉండచ్చు లేదా భయం, అనాసక్తి ఇతర కారణాల వల్ల రతికి ఒప్పుకోకపోవడమో, ఒకవేళ ఒప్పుకున్నా అంగప్రవేశం దుర్లభం కావడమో జరుగుతుంది.

దీనిని జడత్వం అని చెప్పలేము. అయితే జడత్వంతో పోల్చుకుంటే ఈ సమస్యను తేలికగా పరిష్కరించుకోవచ్చు.

మానసికంగా ఉల్లాసంగా ఉంటే సమస్యలన్నీ వాటంతట అవే చక్కబడతాయి.


ఎయిడ్స్ ఎంత కాలానికి బయట పడుతుంది?

సాధారణంగా ఎయిడ్స్ అక్రమ లైంగిక సంబంధాల వల్లే సోకుతుంది. మరికొన్ని మార్గాల ద్వారా సోకే అవకాశాలున్నా ఎక్కువ మందికి వేశ్యలు, ఇతర అక్రమ సంబంధాల వల్లే సోకుతుంది. భారతదేశంలో తీసుకుంటే ఎయిడ్స్ వ్యాథిగ్రస్తులలో తరచూ దూరప్రయాణాలు చేసే లారీ డ్రైవర్లు, వేశ్యావృత్తిలో ఉన్నవారే ఎక్కువ.

అక్రమ సంబంధాలు ఏర్పరుచుకునేవారిని ఈ కాలంలో వేధిస్తున్న సమస్య ఒకటే! ఆ అక్రమ సంబంధం తనకు ఎయిడ్స్ సంక్రమింప చేసిందేమోననే భయమే ఆ సమస్య. అక్రమ సంబంధాలు ఏర్పరుచుకున్నవారిలో ఇలాంటి దిగులు, వ్యాకులత వల్ల వారికి నిజంగా ఎయిడ్స్ సోకక పోయినప్పటికీ మానసికంగా దెబ్బ తినడం వల్ల శారీరక అనారోగ్యాన్ని తెచ్చుకుంటున్నారు.

వేశ్యా సంపర్కం వల్ల ఎయిడ్స్ సోకే ముప్పు ఎక్కువే. అయినా ఎయిడ్స్ ఉన్న వారినుంచి కొన్ని సందర్భాలలో ఇతరులకు ఎయిడ్స్ సోకే అవకాశాలు తగ్గచ్చు. కండోమ్ వాడడం ఒక ముందు జాగ్రత్త అయితే మరికొన్ని పరిస్థితులలో ఎయిడ్స్ సోకకపోవచ్చు. ఎయిడ్స్ సోకితే ఎప్పుడు ఆ విషయం బయటపడుతుందీ అనేది ఇప్పుడు సామాన్యులను వేధించే ప్రశ్న.

తొందరపాటుతో తప్పు చేసినా ఆ తర్వాత వ్యాధి సోకిందనే భయంతో వారానికోసారి వైద్యుల చుట్టూ తిరుగుతూ రకరకాల పరీక్షలు చేయించుకునే వారు భారతదేశంలో తక్కువేమీ కాదు. ఎయిడ్స్ విషయంలో వారికున్న పరిమిత పరిజ్ఞానమే వారినలా చేయించడానికి పురికొల్పుతోంది.

నిజానికి ఎయిడ్స్ సోకిన వారికి ఆ లక్షణాలు బయటపడడానికి నిర్ణీత సమయమంటూ ఏమీ లేదు. అది వ్యక్తి ఆరోగ్యం మీద ఎక్కువగా ఆధారపడి ఉంటుంది. ఎయిడ్స్ సోకినా వెంటనే మరణం ముంచుకొచ్చేయదు. బలవర్థకమైన ఆహారం తీసుకుంటూ ఆరోగ్యాన్ని సంరక్షించుకుంటే ఆయుష్షు పెరుగుతుంది.

సామాన్యంగా ఎయిడ్స్ సోకితే ఆ విషయం ఆరునెలలో బయటపడచ్చు. కొంతమందిలో అంతకంటే చాలా ఎక్కువ కాలమే పట్టచ్చు. అందరికీ వర్తించే విధంగా ఒక కాలపరిమితి ఇంతవరకూ నిర్థారించలేదు.

ఎయిడ్స్ లక్షణాల గురించి ప్రధమికంగా తెలిస్తే ఆ లక్షణాలున్నాయనే అనుమానం ఉన్నప్పుడు పరీక్షలు చేయించుకోవడం మంచిది. ఎయిడ్స్ లక్షణాలేమిటి? చేయించుకోవలసిన పరీక్షలేమిటి? అనేది వచ్చేవారం.


జడత్వం – నివారణోపాయం – 3

కొందరు స్త్రీలకి రతిలో జడత్వం ఉంటుంది. దీనినే ఫ్రిజిడిటీ అంటారు.

సెక్స్ సంబంధాలలో ఎటువంటి తృప్తి థ్రిల్ పొందలేకపోవడానికి ఏదో ఒక మానసిక కారణం ఉంటుంది. కొందరికి రకరకాల శారీరక కారణాలు కూడా ఫ్రిజిడిటీకి కారణం.

కాని మానసిక కారణాలె ఎక్కువ. సాధారణంగా చాలా కుటుంబాలలో సెక్స్ గురించి మాట్లాడడం, చదవడం తప్పు అని, సెక్స్ గురించి ఆలోచన కలగడం నీచమనే భావాలు పరోక్షంగానైనా నూరిపోస్తుంటారు.

ఆడవాళ్ళకైతే తల్లులు ప్రత్యక్షంగానే ఎన్నో ఆంక్షలు పెడతారు. జాగ్రత్తలు అవసరమే కానీ ఇక్కడ తల్లులు, పెద్దలు పేట్టే ఈ ఆంక్షలు జాగ్రత్తలకు మించిపోతుంటాయి. ఆడపిల్లలలకు చిన్నతనం నుంచి పెద్దలు పేట్టే ఈ ఆంక్షలు వారికి తెలియకుండానే వారి మనస్సు మీద ప్రభావం చూపిస్తుంటాయి. దాని ఫలితంగా వారిలో సెక్స్ అంటే ఏవగింపు, ఏహ్యభావం కలుగుతాయి.

ఇటువంటి వారు వివాహమైనా మారరు. సెక్స్ అంటే స్త్రీలలో కలిగే ఈ ఏవగింపే జడత్వానికి కారణం అవుతుంది. జడత్వానికి గురైన స్త్రీలలో కొందరు వివాహానంతరం భర్త సహకారంతో దానినుంచి బయటపడితే, భర్త సహకారం లేక, పైగా అతను కూడా తిరస్కారంగా చూస్తే వారిలో జడత్వం పెరిగిపోవడమే కాక విడాకుల వరకు పరిస్థితి తెచ్చుకుంటారు.

ఇలాంటి పరిస్థితి నుంచి బయటపడాలంటే ముందు చేయాల్సింది అసలా పరిస్థితి ఎదురుకాకుండా చూసుకోవడం. జడత్వానికి లోనుకాకుండా పిల్లలకు సరైన విజ్ఞానాన్ని అందించగలగాలి. సెక్స్ అంటే విముఖత కలిగే విధంగా ప్రవర్తించరాదు. వారిలో అటువంటి భావాలు కలగకుండా చూడాలి. భారతదేశంలో ఇలా చేయడమనేది ఎంత వరకు జరుగుతుందీ అంటే…

అసలు జరగదు అనే చెప్పాలి. దీనికి పెద్దలు ఇచ్చే వివరణ ఒకటే. సెక్స్ అంటే మంచిదే అని, మధురానుభూతులు పంచుతుందని పెద్దలుగా తాము పిల్లలతో ఎలా చెప్పడం, చెప్పినా వారు సరిగ్గా అర్థం చేసుకోలేకపోతే అప్పుడు కలిగే దుష్పరిణామాలకు బాధ్యులు ఎవరు అని అంటారు.

ఇదీ నిజమే. అందుకే పిల్లలతో సెక్స్ గురించి మాట్లాడేప్పుడు సంయమనంతో మెలగాలి. అలాగని అసలు మాట్లాడకపోవడం మంచిది కాదు.


దోమల ద్వారా ఎయిడ్స్ రాదు

ఎయిడ్స్ వ్యాధి మీద, ఆ వ్యాధి వ్యాప్తి చెందే విధానం మీద ప్రజలలో అంతులేని అపోహలున్నాయి. దోమల నుంచి, నల్లుల నుంచి ఈ వ్యాధి వ్యాపిస్తుందని చాలా మంది నమ్ముతున్నారు. ఇదే నమ్మకంపై ముమ్మర ప్రచారం చేస్తున్నారు.

దోమలు, నల్లుల నుంచి ఎయిడ్స్ వ్యాప్తి జరగదు. ఇదే విషయాన్ని చెబితే, ‘బ్లేడ్స్ వల్ల, సిరంజ్ సూదుల వల్ల ఎయిడ్స్ వ్యాప్తి జరుగుతున్నప్పుడు ఇలా ఎందుకు జరగదు. ఏవో కొన్ని భయంకరమైన నిజాలు దాచేస్తున్నారు. దోమల వల్ల, నల్లుల వల్ల ఎయిడ్స్ తప్పకుండా వస్తుంది’ అని వారు అంటుంటారు.

ఇంకొంత మంది కొంచెం ఓ అడుగు ముందుకేసి, అలా వచ్చే ఎయిడ్స్ ని అద్భుతమైన మూలికలు ఉపయోగించి మటుమాయం చేస్తామని నమ్మ బలుకుతున్నారు. ఇటువంటి వారి మాటలు నమ్మవలసిన పని లేదు . ఫైలేరియామ మలేరియా వ్యాపింపచేసే క్రిముల వలె ఇది దోమలు తదితర కీటకాలలో ఎయిడ్స్ వ్యాప్తి చేసే వైరస్ జీవించజాలదు. అందువల్ల దోమల నుంచి ఎయిడ్స్ సంక్రమించదు. ఇలా సంక్రమించేదే నిజమైతే ఆఫ్రి కా ఖండంలో సగం మందికి ఈ పాటికి ఎయిడ్స్ వచ్చి ఉండాలి.

ఎయిడ్స్ వ్యాధి గ్రస్తులలో ఒకసారి కండోమ్ లేకుండా సెక్స్ చేసినా ఎయిడ్స్ వచ్చే ప్రమాదం ఉంది. గనేరియా, హెర్పిస్ తదితర వ్యాధులు దీర్ఘకాలంలో ఎయిడ్స్ గా రూపాంతరం చెందుతుందనే అపోహ మరికొంత మందిలో ఉంది. నిజానికి గనేరియా వంటి వ్యాధులు ఎయిడ్స్ వ్యాధిని కలిగించవు. ఈ వ్యాధులు రూపాంతరం చెందవు. ఎయిడ్స్ ఒక ప్రత్యేక వ్యాధి. మొట్టమొదట ఈ వ్యాధిని ఆఫ్రి కా ఖండంలో కనుగొన్నారు. రాబోయే రెండు మూడు సంవత్సరాలలో ఎయిడ్స్ నివారణకు వ్యాక్సిన్ కనుగొనే అవకాశం ఉందని వైద్యులు ఆశాభావం వ్యక్తం చేస్తున్నారు.


ఎయిడ్స్ బైటపడే కాలవ్యవధి – లక్షణాలు

ఎయిడ్స్ వ్యాధి సోకిన వెంటనే బయటపడదు. ఎయిడ్స్ సోకినప్పటికీ బయటపడే కాలవ్యవధి అందరికీ ఒకేవిధంగా ఉండదు. ఇది సోకిన విధానాన్ని బట్టి కూడా వ్యాధి బయటపడే వ్యవధి ఆధారపడి ఉండవచ్చు. మొత్తం మీద చూస్తే గరిష్టంగా 12 సంవత్సరాలలోపు బయటపడుతుంది.

బయటపడిన తర్వాత రెండు సంవత్సరాలలో వ్యాధి సోకిన మనిషి మరణించవచ్చు.

ఎయిడ్స్ వ్యాధి బయటపడక పోయినప్పటికీ ఆ వ్యాధి సోకిన వారితో శృంగారం ప్రమాదకరమైనదే అనే విషయం గుర్తుంచుకోవాలి. వీరి ద్వారా మరికొందరికి ఎయిడ్స్ సోకే ప్రమాదం ఉంది. చిన్నపిల్లలలో మాత్రం ఈ వ్యాధి పెద్దవారికంటే తొందరగా బయటపడుతుంది. పెద్దవారిలో రెండు సంవత్సరాలలో బయటపడుతుందనుకుంటే చిన్నపిల్లలలో రెండు నెలలలో బయటపడే అవకాశాలున్నాయి.

ఎయిడ్స్ లక్షణాలు బయటపడిన వెంటనే మృత్యువు దరిచేరదు. మనసును ఆహ్లాదకరంగా ఉంచుకుని ఆరోగ్యకరమైన అలవాట్లతో, బలవర్థకమైన ఆహారం తీసుకుంటూ జీవితం గడుపుతుంటే జీవితకాలాన్ని పెంచుకోవచ్చు. ఎయిడ్స్ రోగులలో మొదటగా బయటపడే లక్షణం లింఫ్ గ్రంధులు వాయడం, దీని తర్వాత క్రమంగా బరువు కోల్పోవడం.

వ్యాధి మొదటి దశలో కొద్దిగా జ్వరం కూడా ఉంటుంది. కాలం గడిచే కొద్దీ వ్యాధి నిరోధక శక్తి క్షీణిస్తుండడం చేత అంటు వ్యాధుల బారిన పడే ప్రమాదం ఎక్కువవుతుంది. దీనితో పాటు జ్వరం కూడా తరచూ వస్తుంది. అయితే ఇదే లక్షణాలున్నవారందరినీ ఎయిడ్స్ రోగులుగా భావించలేము. ఎందుకంటే కొన్ని సామాన్య వ్యాధులకు ఇటువంటి లక్షణాలు కనిపిస్తాయి. ఎయిడ్స్ వ్యాధిని నిర్థారించేందుకు నిపుణులైన వైద్యుల వద్ద పరీక్షలు చేయించుకోవడం మాత్రమే ఇప్పటి వరకూ అందరూ అనుసరించదగిన విధానంగా వాడుకలో ఉంది.

ఈ పరీక్షలలో ఎక్కువగా చేసేది ఎలీసా పరీక్ష. ఈ పరీక్ష ఇప్పుడు అన్ని జిల్లా కేంద్రాలలో నిర్వహించేందుకు ఏర్పాట్లు చాలావరకు జరిగాయి. ఇంతకంటే త్వరితంగా వ్యాధిని నిర్థారించే పరీక్షల కోసం ప్రయత్నాలు జరుగుతున్నాయి.


వీడీఅర్ఎల్ పరీక్ష – ఫలితాలు

సిఫిలిస్ వ్యాధి నిర్థారణ కోసం విడీఆర్ఎల్ పరీక్ష చేస్తుంటారు. ఈ పరీక్షలో నూటికి నూరు శాతం కచ్చితమైన ఫలితాలు వస్తాయని మాత్రం చెప్పడం కష్టమే. సిఫిలిస్ వ్యాధి లేకపోయినా కొన్ని సందర్భాలలో వ్యాధి ఉన్నట్లు విడీఅర్ఎల్ పరీక్షలో తేలుతుంటుంది.

న్యుమోనియా, మలేరియా వంటి వ్యాధులు వచ్చినప్పుడు, కొన్ని రకాల టీకాలు వేయించుకున్నప్పుడు ఇలాంటి పరిస్థితి ఏర్పడుతుంది. నిద్ర మాత్రలు వాడే వారిలో లెప్రసీ ఉన్నప్పుడు కూడా ఇదే రకమైన ఫలితం రావడానికి అవకాశం ఉంది. కాబట్టి పూర్తిగా విడిఆర్ఎల్ పరీక్ష మీద ఆధారపడడం తగదు. అయితే సిఫిలిస్ తో బాధపడుతున్న తల్లి నుంచి శిశువు గర్భస్థ శిశువుకు సోకడానికీ అవకాశముంది. అందుకని అనుమానం ఉంటే విడిఆర్ఎల్ పరీక్ష చేయించుకోవడమే ఉత్తమం. ఎందుకంటే శిశువుకు సిఫిలిస్ సోకితే అనేక అనారోగ్య లక్షణాలతో బాధపడుతుంటుంది. గర్భస్థ శిశువుకు వ్యాధి సోకితే గర్భస్రావం జరిగే అవకాశం ఉంది.

బిడ్డ జన్మించిన తర్వాత కొద్దికాలానికే చనిపోవచ్చు. శిశువు సిఫిలిస్ తో బాధపడుతున్నప్పటికీ ఆ లక్షణాలు పుట్టిన వెంటనే కొందరిలో కనపడవు. క్రమంగా కొద్దికాలానికి సిఫిలిస్ లక్షణాలు బయట పడతాయి. శిశువు జన్మించిన కొద్దివారాలకి ఈ లక్షణాలు బయటపడవచ్చు. లింఫ్ గ్రంథులు వాయడం, పాలు త్రాగాక పోవడం, నీరసంగా ఉండడం, ఎర్రటి దద్దుర్లు కనపడడం, జననేంద్రి యాల వద్ద పుండ్లు రావడం వంటివి జరగవచ్చు. ఇంకా అనేక లక్షణాలు కనపడతాయి. ఇటువంటప్పుడు వైద్యులను సంప్రదించి, సిఫిలిస్ అని అనుమానం ఉంటే ఆ విషయమూ చెప్పడం మంచిది. సిఫిలిస్ లక్షణాలు మొదటిసారి శిశువులో కనిపించినప్పుడే జాగ్రత్త పడాలి. కొంతమందికి మొదటిసారి ఎటువంటి మందులు వాడకపోయినా తగ్గిపోతుంది. అది పూర్తిగా తగ్గిపోవాడం మాత్రం కాదు. కొద్దికాలానికి వ్యాధి రెండవ దశలోకి అడుగుపెట్టి మరల వ్యాధి లక్షణాలు కనబడతాయి.

తల్లి నుంచి సిఫిలిస్ వ్యాధికారాక క్రిములు సంక్రమించిన శిశువులో అరుదుగా కొందరికి చాలాకాలం వరకు అసలు సిఫిలిస్ లక్షణాలనేవే కనిపించకపోవచ్చు. ఇదేమీ వ్యాధి లేదనడానికి చిహ్నం కాదు. వయసు పెరుగుతున్నప్పుడు ఎప్పుడో మెల్లగా ఆ లక్షణాలు బయటపడతాయి. ఇలాంటి పరిణామాలన్నీ దృష్టిలో ఉంచుకుంటే ముందే చికిత్స చేయించుకోవడం అన్ని విధాలా ఉత్తమం.


పురుషాంగానికి కేన్సర్ ప్రమాదం

కేన్సర్ శరీరంలోని అనేక భాగాలకు సోకుతుంది. పురుషాంగానికి కేన్సర్ సోకే ప్రమాదం ఉందని చాలామందికి తెలియదు. ఇలా జరగడం అరుదు కావచ్చేమో కానీ అసాధ్యం మాత్రం కాదు. పురుషాంగానికి కేన్సర్ ఎందుకు సోకుతుందనేది పూర్తిగా తెలియకపోయినా అపరిశుభ్రత ఒక కారణం కావచ్చునని భావిస్తున్నారు.

పురుషాంగానికి వచ్చే కేన్సర్ రెండు దశలుగా ఉంటుంది. మొదటి దశలో, కేన్సర్ సోకినప్పుడు శిష్నంపై లేదా మరో భాగంలోకి గోధుమ రంగులో మచ్చ ఏర్పడుతుంది. ఈ మచ్చ పెరిగి పెద్దదిగా మారి దళసరిగా తయారవుతుంది. తర్వాతి దశలో కేన్సర్ కంతిరూపం దాల్చుతుంది. కేన్సర్ సోకిన తొలిదశలో అక్కడే స్థిరంగా ఉంటుంది.

శరీరంలోని వేరే ప్రాంతంలో దీని లక్షణాలు కనపడవు. క్రమంగా రెండవ దశకు చేరుకున్న తర్వాత గజ్జల్లో బిళ్ళలు తయారవుతాయి. రక్తం ద్వారా వ్యాప్తి చెందడం ప్రారంభిస్తే శరీరంలోని ఇతర ప్రాంతాలలో కూడా కేన్సర్ లక్షణాలు కనపడడం ప్రారంభమవుతుంది.

కేన్సర్ ప్రారంభ దశలో కొద్దిగా నొప్పిగా, దురదగా అనిపించవచ్చు. చాలామంది ఈ లక్షణాలు గమనించినా పట్టించుకోరు. నిర్లక్ష్యం చేస్తారు. అప్పుడు వ్యాధి ప్రమాదకరమైన రెండవ దశలోకి ప్రవేశిస్తుంది.

మొదటిదశలో గడిచిన కొన్ని నెలల తర్వాత రెండవ దశ ప్రారంభమవుతుంది. రెండవ దశలో పురుషాంగ పూర్వచర్మం గట్టిపడుతుంది. ముందుకీ వెనుకకీ కదలదు. కొన్ని సందర్భాలలో మూసుకుపోయే ప్రమాదం కూడా ఉంది.

తర్వాత గజ్జల్లో పుండు మొదలవుతుంది. ఇదంతా జరగడానికి కొన్ని నెలలు పడుతుంది. పురుషాంగానికి కేన్సర్ సోకితే రేడియేషన్ దెరిపీ ద్వారా వ్యాధిని నయం చేయవచ్చు.

అసలు పురుషాంగానికి కేన్సర్ రాకుండా చేయాలంటే సున్తీ చేయించుకుంటే సరిపోతుందని కొందరు వైద్యులు చెబుతారు.


హెర్ఫిస్ తో గర్భిణీలకు అనర్థం

హెర్ఫిస్ వ్యాధి గర్భిణీలకు సోకితే కొన్ని కొన్ని రకాల ప్రమాదాలు తప్పవు.

మొదటగా చెప్పుకోవలసింది శిశువుకు ఈ వ్యాధి సోకే అవకాశాలు పూర్తిగా తోసిపుచ్చలేనివి. హెర్ఫిస్ మొట్టమొదటిసారిగా సోకినప్పుడు గర్భం ధరించడం గర్భశ్రావమయ్యే అవకాశాలు ఉన్నాయి.

ఈ వ్యాధి లేనివారిలో 10 శాతం మందికి సాధారణంగా గర్భశ్రావమయ్యే అవకాశాముంటే వ్యాధి సోకినవారిలో 50 శాతం మందికి అబార్షన్ కావచ్చు. కొంతమందికి నెలలు నిండకుండానే ప్రసవం కావచ్చు. హెర్ఫిస్ మొదటిసారి వచ్చినప్పుడే ప్రమాదం ఎక్కువ అని కొన్ని పరిశీలనలో తేలింది. ఈ పరిశీలనలోని శాస్త్రీయత మీద నమ్మకం లేకపోయినా ఎక్కువ శాతం అలాంటి ఫలితాలే వస్తున్నాయి.

హెర్ఫిస్ రెండవసారి సోకినప్పుడు పైన చెప్పిన ప్రమాదాలతో పాటు, శిశువు తక్కువ బరువు కలిగి ఉండడం వంటి సమస్యలు ఎదురుకావని ఆ పరిశీలనలలో తేలింది. కండోమ్ వాడితే హెర్ఫిస్ సోకే అవకాశాలు చాలావరకు తగ్గుతాయి. వ్యాధి సోకిన తర్వాత చికిత్స చేయించుకోవడమూ సులభమే. కాకపొతే ఆలక్ష్యమే పనికిరాదు.

అమెరికా వంటి దేశాలలో చాలా సులువుగా చికిత్స చేస్తున్నారు. ఈ వ్యాధికి మందులు ఇప్పుడు అన్ని ప్రాంతాలలో అందుబాటులో ఉంటున్నాయి. ఆయోర్వేద మందులు కూడా ఇస్తున్నారు. ఆయుర్వేద మందుల వలన గుణం కనపడడానికి ఎక్కువ కాలం పడుతుంది. వ్యాధి మొదటి దశలోనే చికిత్స చేయించుకోవడం ఉత్తమం.

కొన్ని రకాల ఆహారపదార్థాలు తీసుకోవడం వల్ల హెర్ఫిస్ తీవ్రత పెరుగుతున్నట్టు కొందరు వైద్యులు అనుమానిస్తున్నారు. మద్యం ఎక్కువగా సేవించడం, మాంసాహారం, మసాలాలు తీసుకున్నప్పుడు వ్యాధి తొందరగా కనపడుతోందని వారు భావిస్తున్నారు.

శాకాహారం, కొబ్బరి నీళ్ళు, పాలు, పళ్ళు తీసుకోవాలి. వేప సబ్బు వాడడం వల్ల ఉపశమనం కలుగుతుంది. హెర్ఫిస్ కి ప్రేత్యేక మందులు వాడితే తప్ప వ్యాధి నుంచి పూర్తిగా విముక్తి కలగదు. వైద్యుల పర్యవేక్షణలో కాకుండా యాంటీ బయాటిక్స్ వాడకం వల్ల ఎటువంటి ఉపయోగమూ ఉండదు.


సుఖవ్యాధులు – హెర్ఫిస్

హెర్ఫిస్ అనే గ్రీకు మాటకి అర్థం – పాకడం.

1730 నాటికే ఈ వ్యాధి ఉందని చెప్పడానికి ఆధారాలున్నాయి. ఈ వ్యాధి వైరస్ వల్ల కలుగుతుందని 20 వ శతాబ్దంలో గుర్తించారు. హెర్ఫిస్ సింప్లెక్స్ వైరస్-1, హెర్ఫిస్ సింప్లెక్స్ వైరస్-2 అనే రెండు రకాల వైరస్ లు హెర్ఫిస్ కు కారణమవు తున్నాయి. హెర్ఫిస్ సింప్లెక్స్ వైరస్-1 అనే వైరస్ వల్ల ముఖంపై, హెర్ఫిస్ సింప్లెక్స్ వైరస్-2 అనే వైరస్ వల్ల జననాంగాలపై పొక్కులు ఏర్పడతాయి.

వ్యాధి లక్షణాలు చూస్తే, సిఫిలిస్ వలె ఉండదు. సిఫిలిస్ మొదటి దశలో పెద్దగా ఇబ్బంది పెట్ట్టాడు. హెర్ఫిస్ అలా కాదు. మొదటి సారి ఈ వ్యాధి సోకినప్పుడు లక్షణాలు తీవ్రంగా బయటపడతాయి. జననాంగం, మొహంపై పొక్కులు ఏర్పడతాయి. మూత్రం పోసుకునేప్పుడు మంట కలుగుతుంది.

జ్వరం, తలనొప్పి, వళ్ళు నొప్పులు వంటి లక్షణాలు కూడా చాలామందిలో కనబడతాయి. సుమారు పది రోజుల్లో ఈ లక్షణాలు తగ్గుతాయి. అయితే అంగంపై వచ్చిన పుళ్ళు నయం కావడానికి 20 రోజులు పైనే పడుతుంది. హెర్ఫిస్ పుళ్ళు ఎర్రగా పైకి ఉబ్బి నీటి బొబ్బలవలె వస్తాయి. వీటిలో ద్రవం ఉంటుంది. సుమారు 11వ రోజు వరకు నొప్పి ఎక్కువగా ఉంటుంది. తర్వాత తగ్గిపోతుంది.

బొబ్బలు చితికిన తర్వాత పొక్కు కట్టి మానిపోతాయి. ఇక్కడితో ఈ వ్యాధి మొదటి దశ పూర్తవుతుంది. ఇటువంటి బొబ్బలే మళ్ళీ మళ్ళీ వస్తుంటాయి. హెర్ఫిస్ బొబ్బలు వచ్చే ముందు కొన్ని లక్షణాలు కనపడతాయి. బొబ్బలు రావడానికి కనీసం రోజున్నర ముందు నుంచీ కాళ్ళలో నొప్పులు వస్తాయి. తిమ్మిరి అనిపిస్తుంది.

హెర్ఫిస్ సోకిందని ఏమాత్రం అనుమానం వచ్చినా భార్యతో కలవకుండా, వైద్యుని సంప్రదించడం మంచిది. గర్భంలోని శిశువుకూ ఇది వ్యాపించే అవకాశాలు చాలా ఎక్కువ. హెర్ఫిస్ ను పూర్వం భయంకరమైన వ్యాధిగా పరిగణించేవారు. ఇప్పుడు ఈ వ్యాధికి చికిత్స చేయవచ్చు.


ఎయిడ్స్ వైరస్ మొండిది కాదు.

 

ప్రజలలో ఎయిడ్స్ వైరస్ కలిగించినంత ఆందోళన మరే వైరస్ కలిగించలేదు. సుమారు 15 సంవత్సరాల క్రితం ఈ వ్యాధి గురించి ప్రజలకు తెలిసినప్పుడు ఎన్నెన్నో పుకార్లు వ్యాపించాయి. వాస్తవాలేమిటో తెలుసుకోవాలన్న జిజ్ఞాస లేకుండా ప్రజలు దానిని నమ్మారు. ఆ నమ్మకాలే భారతదేశంలో ఇప్పటికీ కొందరిని అంటి పెట్టుకున్నాయి. ప్రభుత్వం కలిగిస్తున్న చైతన్యం కారణంగా ఈ మార్పు వచ్చింది కానీ లేకుంటే పరిస్థితి ఇప్పటికంటే ఘోరంగా ఉండేది.

ఎయిడ్స్ వ్యాధిని వ్యాపింప జేసే వైరస్ లక్షణాలు తెలుసుకుంటే ఈ వైరస్ మీద ఉన్న అనుమానాలు చాలావరకూ తొలగిపోతాయి. ఎయిడ్స్ వైరస్ శరీరం వెలుపల, సాధారణ ఉష్ణోగ్రత వద్ద వారం రోజులకు మించి ఎక్కువకాలం బ్రతకేలేదు. 100 సెంటీగ్రేడ్ డిగ్రీల ఉష్ణోగ్రత వద్ద సెకను కంటే తక్కువ కాలం జీవిస్తుంది. ఎయిడ్స్ వైరస్ మొండిదేమీ కాదు.

శరీరంలోకి ప్రవేశించిన తర్వాత ఇది కలిగించే నష్టం వల్లే ప్రజలలో భయాందోళనలు ఏర్పడ్డాయి తప్పితే సాధారణ జీవనం గడుపుతున్న వారెవరూ దీని గురించి ఆందోళన చెందనవసరం లేదు. వైద్యులు చెబుతున్న తాజా విషయాల ఆధారంగా చూస్తె ఎయిడ్స్ కంటే సార్స్ వ్యాధి ఎక్కువ ప్రమాదకరమైంది.

సార్స్ గాలి ద్వారా వ్యాపించే ప్రమాదం ఉంటే ఎయిడ్స్ టో అటువంటి ముప్పేమీ రాదు. (ప్రజలలో ఎయిడ్స్ గురించి భయాన్ని తగ్గించాలనే ఉద్దేశంతోనే ఈ వివరాల జోలికి వేడుతున్నాము కానీ, సార్స్ వ్యాధి అంటే భయాన్ని పెంచడం ధ్యేయం కాదని గమనించగలరు.) రెండు వ్యాదులూ దేశానికి ప్రత్యక్షంగా కలిగించే నష్టంలో మాత్రం పోలిక ఉంది. సార్స్, ఎయిడ్స్ వల్ల దేశ ఉత్పాదకత తగ్గిపోతుంది.

సార్స్ వల్ల ఇటీవల కొన్ని దేశాలలో టూరిజం దెబ్బ తిన్నదన్న వార్తలు మనం చదివాం. ఎయిడ్స్ సోకేది ఎక్కువగా యువకులకీ, మధ్యవయస్కుల వారికీ దేశ ఉత్పాదక ఆధారపడింది వీరివల్లె కాబట్టి, ఈ వ్యాధిగ్రస్తులు ఎక్కువైతే దేశ ఉత్పాదకత సామర్థ్యం దెబ్బతింటుంది.


ఎయిడ్స్ నిర్థారణ పరీక్షలు – రకాలు

 

ఎయిడ్స్ ని నిర్థారించే పరీక్షలలో ఎలిసా పరీక్ష చాలా మందికి తెలిసింది. ఇది కాకుండా ఇంకా అనేక రకాల పరీక్షలు చేస్తుంటారు. వాటిలో ముఖ్యమైనవి … రాపిడ్ పరీక్షలు : డాట్ బ్లాట్ పరీక్షలు, లేటెక్స్ ఎగ్లుటినేషన్ పరీక్షలు రాపిడ్ పరీక్షలుగా చెప్పుకోవచ్చు. రాపిడ్ పరీక్షలు కాకుండా సింపుల్ పరీక్షలు, ట్రైడాట్ పరీక్ష అని కూడా చేస్తుంటారు. వీటిలో ట్రైడాట్ పరీక్ష ఉత్తమమైందిగా తేలింది. 90 శాతానికి పైబడి కచ్ఛితమైన ఫలితాన్నిస్తుందీ పరీక్ష.

హెచ్.ఐ.వి. యాంటీ బాడీల ఆధారంగా జరిగే ఈ పరీక్ష ఇప్పుడు ఎక్కువగా జరపడం లేదు. ఎలిసా పరీక్ష అందరికీ అందుబాటులో ఉండడం, బాగా ప్రాచుర్యం పొందడం దీనికి కొంత వరకూ కారణం. ఎయిడ్స్ వ్యాధిని గుర్తించేందుకు జరిపే పరీక్షలలో పైన చెప్పుకున్నవి ప్రాధమిక పరీక్షలు. ఇవికాకుండా మరికొన్ని నిర్థారణ పరీక్షలు కూడా జరుపుతుంటారు. వీటిలో ఎక్కువగా జరిపే పరిక్ష వెస్ట్రన్ బ్లాట్ పరీక్ష. ఈ పరీక్షకు అయిదువేల రూపాయల లోపే ఖర్చవుతుంది.

భారతదేశంలో కూడా ఇది అందరికీ అందుబాటు లోనే ఉండే ధర. ఎలిసా పరీక్ష కంటే ఇది కొంచెం క్లిష్టమైన కచ్ఛితమైన సమాచారాన్ని తక్షణం ఇచ్చే పరీక్ష. హెచ్.ఐ.వి. వైరస్ కారణంగా శరీరంలోని వివిధ ప్రోటీన్ల తత్వంలో వచ్చే మార్పుల ఆధారంగా ఈ పరీక్షలో ఫలితాన్ని నిర్ణయిస్తారు. ఇప్పుడిప్పుడే భారతదేశంలో ప్రధాన నగరాలలో ఈ పరీక్ష నిర్వహిస్తున్నారు. మొత్తానికి ఎయిడ్స్ వ్యాధిని గుర్తించే పరిక్షలలో ఎలిసా మినహా మిగిలినవన్నీ సామాన్యుడికి అందుబాటులో లేనివే.

ప్రపంచవ్యాప్తంగా ఈ వ్యాధిపై విస్తృతంగా పరిశోధనలు జరుగుతుండడంతో ఎప్పటికప్పుడు కొత్త కొత్త పరిక్షలు ప్రాచుర్యంలోకి వస్తున్నాయి. ఇవేవి ఎలిసా పరీక్ష స్థానాన్ని ఆక్రమించలేకపోతున్నాయి. వ్యాధికి మందు కనిపెట్టడంలో జాప్యం జరుగుతున్న కొద్దీ మరికొన్ని కొత్త రకం పరీక్షలు ప్రజల ముదుకు వస్తూనే ఉండచ్చు. వీటిలో తేలికగా జరిపేవే ఆదరణ పొందుతాయి. ముఖ్యంగా అసలు పరీక్ష జరిపించుకోవడానికి ప్రజలు ముందుకురాని మన వంటి వర్థమానదేశాలలో.


Orgasm...

(a) In some females the sensation builds up from the low point to a peak and then flowing on steadily until the gradual decline which ends in satiety. (b) A female's orgasm as she suddenly breaks off the intercourse either bu swooning or bursting out into tears. (c) The female who requires constant interruption of the sensation. Her partner halts his activity to allow the sensation to drop completely then reinduces it until she again calls for an interruption; this continues until she finally concludes the relationship entirely. Some may regard each interrupted phase as a distinct orgasm.

Actually, this is not the case since the orgasm does not automatically dis- continue itself. In the case of the sustained orgasm is constant. If the husband suddenly introduces addi- tional stimuli while intercourse is taking place then the orgasm goes much higher than the normal. For example, he may have been kissing his partner's lips and decide to kiss her breasts, at this point she will jump to a higher peak, and may even remain at the new height while the breast kissing continues, and then again falling back to the old level as soon as it is continued. It is better practicem however, to interrupt whatever suddenly lifts a woman to a higher peak, and resume it perhaps a minute later. It then comes unexpectedly, it is fresh again, and will induce a new response.

When woman rises to another peak, it can immediately be detected by a deep gasp as this new and unexpected thrill bursts upon her. This is a frequent occurence when the male, during intercourse, suddenly thrusts his penis deeper into the vagina than he has been, and presses it there for a few moments, or experiences orgasm. With reference to orgasms of the individual type, women experience as many as a dozen in a relationship of a about forty five minute's duration, including foreplay; it is probable that there are females who can achieve many more.

The latter, however, are definitely rare; the normal number of orgasms runs from four to ten. A woman of such intense nature is difficult to handle, as has been said before, because, in addition to other reasons subsequently explained, it is impossible to predict exactly how many climaxes she will attain. Her mood is an important factor. As the same individual orgasms place a greater strain upon the nervous system of those women to whom they are peculiar than the sustained type, and nature makes this very clear.

We know that this type of orgasm is generally the result of digital contact with the clitoris. However, once the climax has run its duration, it auto- matically subsides and clitoris momentarily loses its sensitivity. This occurs regardless of whether the male continues to stimulate it. If the finge friction is maintained without pause once the climax has been reached, an involuntary and convulsive series of body jerks immediately siezes the female, warning that the orgasm has completed its course these jerks will continue until the finger is removed from the clitoris. A subsequent orgasm can not be achieved until this is done, and if digital contact be resumed too soon, the jerking will likewise resume.


మూలికలతో ‘ఎయిడ్స్’ తగ్గుతుందా?

ఎయిడ్స్ వ్యాధికి ఇప్పటి వరకూ మందులేదు. ఎయిడ్స్ సోకిన వ్యక్తి ఆరోగ్యాన్ని కాపాడుకుంటే అతని ఆయుర్థాయం పెరుగుతుంది. అందుకే ఎయిడ్స్ రోగులు ప్రధానంగా మానసిక స్థైర్యం, శారీరక ఆరోగ్యం కాపాడుకోవాలని వైద్యులు చెబుతుంటారు. ఇందులో చాలావరకు నిజం వుంది. కొంతమంది వైద్యులు ఎయిడ్స్ వ్యాధిని పూర్తిగా నయం చేయడం సాధ్యమేనని పేపర్లలో పెద్ద పెద్ద ప్రకటనలు ఇస్తుంటారు. ఇలాంటి వారు ఎక్కువకాలం ఆ మందును పంపిణీ చేసిన దాఖలాలు మాత్రం లేవు.

ఎయిడ్స్ కు మందు ఇప్పటి వరకూ కనిపెట్టకపోవడమే వీరి వ్యాపారాన్ని నడిపిస్తోంది. ఎయిడ్స్ నివారణకి నిజంగా మందులేదా? ఈ వ్యాధి నివారణకు మందు కనుగొనడం కేవలం అల్లోపతి వైద్య విధానానికే సాధ్యమా? అనే ప్రశ్న ఇప్పుడు ఉదయిస్తోంది. ఎయిడ్స్ వ్యాధిని కనుగొన్నప్పుడే ఆ వ్యాధి నిర్మూలనకి ప్రపంచంలో అన్ని దేశాలలో పరిశోధనలు ప్రారంభమయ్యాయి. అమెరికా, బ్రిటన్, ఫ్రాన్స్ వంటి పాశ్చాత్య దేశాలలో ఇది చురుకుగా సాగుతుండడం, వార్తలలో కూడా ఆ పరిశోధనల గురించే ఎక్కువగా వస్తుండడంతో చాలామందికి తెలిసింది

ఆ విషయమే.పాశ్చాత్య దేశాలలో జరుగుతున్న విధంగానే ఇండియా, చైనా అంటి దేశాలలో కూడా ఆ దేశాల సంప్రదాయ వైద్య విధానాలను అనుసరించేవారు ఎన్నో రకాల పరిశోధనలు చేస్తున్నారు. అవి పూర్తిగా ఫలితాన్ని ఇవ్వలేదు. అలాగని చెప్పి అసలు ఫలితాన్ని ఇవ్వలేదని మాత్రం అనుకోకూడదు. కొన్ని రకాల మూలికలు ఆశించిన స్థాయిలో కాకపోయినా కొంత వరకూ బాగానే పనిచేస్తున్నాయని తేలింది.

ఆయుర్వేదంలో మయూర శిఖ అనే మొక్క మందుగా పనికివస్తుందని చెబుతున్నారు. ఎయిడ్స్ నివారణకు ఎంత వరకు పనికి వస్తుంది అనే విషయం మీద పూర్తి స్థాయిలో పరిశోధనలు జరగనప్పటికీ వేపనూనె పని చేస్తుందనే ఆశాభావంతో భారత, అమెరికా శాస్త్రవేత్తలు ఉన్నారు. హార్వర్డ్ మెడికల్ స్కూల్ ఈ దిశగా పరిశోధనలు చేస్తోంది.

మరోవైపు జన్యు పరమైన చికిత్స విధానాలపై కూడా పెద్ద ఎత్తున పరిశోధనలు జరుగుతున్నాయి. శాస్త్రీయంగా చూస్తే మొక్కలూ, మూలికలూ ఇచ్చే ఫలితంపై కన్నా జన్యుపరమైన చికిత్సా మార్గమే మేలు అన్నది ఆధునిక శాస్త్రవేత్తల అభిప్రాయం.


ఆనందదాయకమైన సెక్స్ జీవితం కోసం….

స్త్రీ పురుషులలో లైంగిక ఆసక్తి తగ్గటానికి ఎన్నో కారణాలుంటాయి. స్త్రీలలో అయితే ఋతుసంబంధ బాధల వల్ల సెక్స్ లో పాల్గొనేందుకు ఇబ్బందులు కలగవచ్చు. అదే విధంగా మెనోపాజ్ ప్రారంభం అయితే భౌతికంగా సెక్స్ లో పాల్గొనేందుకు బాధలు ఏర్పడతాయి. స్త్రీలలో వయసు పెరిగేకొద్దీ మానసికంగా సెక్స్ అంటే ఆసక్తి కూడా పెరుగుతూ వుంటుంది. కానీ, మెనోపాజ్ వస్తే అంగప్రవేశం సమయంలో కొంత ఇబ్బందులు మొదలవుతాయి. మనసు సహకరించినా, శరీరం పూర్తి స్థాయిలో సహకరించకపోవచ్చు.

దీనివల్ల వారు సెక్స్ పట్ల విముఖత ఏర్పరచుకుంటారు. మానసిక కారణాలు కూడా ఇందుకు కారణం కావచ్చు. వయసు ఎక్కువవు తుంటే ముఖ్యంగా ఏభై సంవత్సరాలు దాటినవారిలో సెక్స్ లో పాల్గొనటం తప్పు అనే భావం మొదలయ్యే అవకాశం వుంది. దీనివల్ల తరచుగా సెక్స్ పట్ల అయిష్టత చూపుతారు. ఫలితంగా ఆ దంపతుల మధ్య స్వల్ప స్థాయిలో విబేధాలు ఏర్పడతాయి.

అలాగే 40 సంవత్సరాలు దాటిన స్త్రీలు భర్తతో అంగచూషణ పట్ల ఆసక్తి చూపుతారు. సెక్స్ అంటే ఎక్కువ ఆసక్తి చూపుతుంటారు. ఈ పరిమాణం పట్ల పురుషులలో అనవసర ఆలోచనలు ఏర్పడతాయి. ఆందోళన పెరుగుతుంది. ఈ పరిమాణం సహజమనే విషయాన్ని గుర్తించాలి. పురుషులలో ఎక్కువ వయస్సున్నవారిలో అంగస్తంభన శక్తి తగ్గిపోతుంది. అతి కొద్దిమందికి మాత్రం దీనినించి మినహాయింపు వుంటుంది.

మొదటిసారి రతి చేసే సమయానికి, రెండోసారి రతి చేసే సమయానికి మధ్య వ్యవధి బాగా పెరుగుతుంది. రెండో అతి ముఖ్య కారణంగా మధుమేహాన్ని పేర్కొనవచ్చు. దీనివల్ల కూడా అంగస్తంభన సమస్యలు ఏర్పడతాయి. అంతే కాకుండా మద్యం ఎక్కువ సేవించేవారిలో, సిగరెట్ అలవాటు వున్నవారిలో కూడా రక్తనాళాల్లో మార్పులు రావటం వల్ల అంగస్తంభన సమస్యలు వస్తాయి.

కొవ్వు తక్కువగా వుండే మంచి పోషక విలువలున్న ఆహారం తీసుకోవటం, తగిన మోతాదులో వ్యాయామం చేయటం ద్వారా, మద్యపానానికి దూరంగా వుండటం వల్ల ఆనందదాయకమైన సెక్స్ జీవితాన్ని అనుభవించవచ్చు.


వీర్యం విలువ

వీర్యం చాలా విలువైనదని, శరీరం నుంచి దీనిని వృధాగా బయటకు పంపకూడదని కొందరు వాదిస్తుంటారు. వీర్య నష్టం వల్ల పురుషుడు శక్తిని కోల్పోతాడని చెబుతుంటారు.

నిజానికి వీర్యంలో ఎటువంటి శక్తిని పురుషునికి ఇవ్వదు. స్ఖలనం జరిగిన తర్వాత శృంగారాన్ని పురుషుడు ముగించేస్తున్నందు వలన బహుశా ఇటువంటి అపోహలు కలిగి ఉండచ్చు. వీర్యం అవసరం ఏమిటి అంటే … స్త్రీ గర్భం దాల్చడానికి ఉపయోగపడుతుంది అనే చెప్పుకోవాలి. ఇక్కడ గమనించవలసిన మరో సంగతి ఏమిటంటే సంభోగశక్తికీ, వీర్యానికీ సంబంధం లేదు.

సంభోగ శక్తి ఎక్కువ ఉన్న వ్యక్తిలో వీర్యం ఎక్కువగా ఉండాలని లేదు. అలాగే వీర్యం ఉన్న వ్యక్తిలో శృంగారేచ్చ ఎక్కువగా ఉండకపోవచ్చు. మామూలు మనుషులు సరిగా అర్థం చేసుకోలేని మరో విషయం ఒకటి ఇక్కడుంది. అదేమిటంటే వ్యక్తుల మధ్య వీర్యం ఉత్పత్తిలో ఎక్కువ తక్కువలు అనేవి సహజమే అనేది. అందరిలో వీర్యం ఉత్పత్తి (పరిమాణం రీత్యా) ఏకరీతిగా ఉండదు. కొందరిలో ఎక్కువ ఉండచ్చు, మరి కొందరిలో తక్కువ ఉండచ్చు.

సాధారణంగా సగటున పురుషుడు స్ఖలించే వీర్యం రెండు మిల్లీ లీటర్ల నుంచి అయిదు మిల్లీ లీటర్లు ఉంటుంది. ఇది వ్యక్తికీ వ్యక్తికీ మారచ్చు. పురుషుడు స్ఖలించే వీర్యంలో ఉన్న శుక్రకణాల వల్ల మాత్రమే స్త్రీ గర్భం ధరించగలుగుతుంది. సాధారణంగా రెండు ఎం.ఎల్. వీర్యంలో 60 మిలియన్ల శుక్రకణాలు ఉంటే స్త్రీ గర్భం దాల్చగలుగుతుంది.

కొన్ని సందర్భాలలో ఇంతకంటే తక్కువ ఉన్నప్పటికీ కదలిక ఎక్కువగా ఉన్న ఆరోగ్యవంతమైన శుక్రకణాలుంటే గర్భం దాల్చడానికి ఉపయోగపడుతుంది. మామూలు వ్యక్తులలో 60 మిలియన్ల వీర్య కణాలుండి, వాటిలో 40 శాతం చక్కని కదలిక ఉంటే ఆరోగ్యవంతమైన వీర్య కణాలుగా గుర్తించగలుగుతారు. కొందరిలో వీర్యకణాల ఉత్పత్తి అసలు జరగకపోవడం కానీ, లేదా చాలా తక్కువగా ఉండడం కానీ జరగచ్చు.

ఇలాంటి వారికి కొన్ని చికిత్సలు చేయడం ద్వారా వీర్యకణాల సంఖ్య పెంచడం సాధ్యమే కానీ, మరీ ఎక్కువగా మాత్రం పెంచలేరు. ఇలా పెంచగలమని ఎవరైనా చెప్పినా అది ఆచరణలో కష్టమే. చికిత్సల వలన కొద్దిగా మాత్రమే ప్రయోజనం చేకూరగలదు. ముందుగా చెప్పుకున్నట్టు శృంగార సామర్థ్యానికీ, వీర్యానికీ సంబంధం లేదు.


మగవారికి శృంగార సామర్థ్యం

మగవారికి శృంగార సామర్థ్యం కేవలం ఒక శారీరకమైన సమస్య మాత్రమే కాదు. అందులో లోపాలు, హెచ్చుతగ్గులు వారి మానసిక ప్రపంచంపై తీవ్ర ప్రభావాన్ని చూపిస్తాయి. శృంగార పటిమ పురుషునికి అత్యంత గర్వకారణం. అది ఏమాత్రం లోపించినా అతను అల్లకల్లోలమైపోతాడు. ఒక వ్యక్తి ఆత్మ విశ్వాసాన్ని దెబ్బతీసే విషయాలలో ప్రధానమైన వాటిలో లైంగిక సామర్థ్యం లోపం ఒకటని ఖచ్చితంగా చెప్పవచ్చు.

పురుషాధిక్య సమాజంలో పురుషులే అన్నింటిలోనూ అధికుడుగా కనపడతారు. బయట ఎంత ధైర్యంగా వున్నా పక్క మీద భయపడే మగవారు ఎంతోమంది వున్నారు. బయట పులి, ఇంట్లో పిల్లిలాంటి సామెతలు ఇలాంటి వారి గూర్చే వచ్చాయి. మిగతా ఏ విమర్శనైనా మగవాడు తట్టుకోగలడు కానీ శృంగార విషయంలో భార్య కొద్దిపాటి అసంతృప్తి వ్యక్తం చేసినా మగవాడు ఎక్కువగా కృంగిపోతాడు. డిప్రెషన్ కు లోనవుతాడు. అందువల్ల సమస్య మరింత ఎక్కువవుతుంది. మగవాడి సమస్య స్త్రీ కూడా అసంతృప్తికి లోనవుతుంది.

ఈ సమస్య నుంచి బయట పడటానికి సెక్స్ థెరపిస్ట్ లు సలహాలిస్తారు. కానీ భార్య సహకారం అత్యంత అవసరం. చాలామంది స్త్రీలు తమ మాటల ప్రభావం ఎలా ఉంటుందో తెలుసుకోకుండానే శృంగారం సమయంలో ఏదో మాట్లాడేస్తారు. నిజంగా మగవాడిని బాధించాలనే ఆలోచన లేకుండానే వాళ్ళు మాటలు అనేస్తారు. చాలా బాధకు గురయినా మగవాడు తన బాధను వ్యక్తం చేయలేడు. కమ్యూనికేషన్ గ్యాప్ ఫలితంగా సమస్య మరింత ఎక్కువవుతుంది. ప్రపంచ ప్రఖ్యాతి చెందిన హాస్పిటల్ లో గొప్ప సర్జన్ ఒక రోజు ప్యాంటు జిప్ దగ్గర కుట్లూడితే కుట్టుకుంటున్నాడు. కుట్లూడేంత విషయమేముంది? అని భార్య సరదాగా అంది. దాంతో ఆయన డిప్రెషన్ కు లోనవడం అంగ స్తంభన సమస్యకు గురవ్వడం జరిగింది. కౌన్సెలింగ్ వలన ఆ సమస్య తీరింది.

పెళ్ళయిన కొన్ని సంవత్సరాలు గడిచేసరికి మగవాడికి ఫ్ర్రి క్వెన్సీ తగ్గుతుంది. భర్తతో అనుబంధం పెరిగే కొద్దీ భార్య ఇన్ హిబిషన్స్ అన్నీ వదులుకుని శృంగారంలో ఫ్ర్రిగానూ, చురుగ్గానూ పాల్గొనగలుగుతుంది. మగవాడి విషయంలో రోజువారీ ఆందోళనలు, పనివత్తిడి, ఆర్థిక ఇబ్బందులు సెక్స్ ను తగ్గిస్తాయి. కొందరు ఇంటికి వచ్చాక కూడా వృత్తికి సంబంధించినవే ఆలోచిస్తూ కూర్చుంటారు. అలాంటప్పుడు భార్య సహకారం మరింత అవసరమవుతుంది. సానుభూతిగా మాట్లాడడం, సెక్స్ ను బాధించే సమస్యల గూర్చి మాట్లాడడం, చర్చించడం, సపోర్ట్ ఇవ్వడం అవసరం. పుండుమీద కారంలా కొందరు అలాంటి సమయంలో మగవాడిని బాధిస్తుంటారు.

భార్యా బాధితుల సంఖ్య పెరగకుండా చూసుకోవలసిన బాధ్యత ఆడవారిదే. ఉద్యోగంలో టెన్షన్ తో కొన్నాళ్ళు సెక్స్ కు దూరంగా ఉన్న ఒక భర్తకి భార్య ఒంటికి నూనె రాసి కొద్ది సేపు మసాజ్‍ చేసి, నలుగు పెట్టి స్నానం చేయించింది. ఆ సమయంలో అతనికి మూడ్ రావడంతో అక్కడే శృంగారం జరిగిపోయింది. కొందరు తరచూ భర్తతో వాదిస్తూ ఉంటారు. ఎప్పుడో జరిగిన వాదనల్ని, ఎప్పుడో జరిగిన ఘర్షణల్ని మగాడు గుర్తుపెట్టుకుని శృంగారం సమయంలో కోపంగా వుంటాడు.

ఒక వ్యక్తి మామగారింటికెళ్ళి వచ్చిన కొద్దిరోజులు సెక్స్ లో పాల్గొనడం మానేశాడు. అనేక సార్లు ఇలా జరిగే సరికి భార్య విషయ మేమిటని జాగ్రత్తగా అడిగింది. మా మామగారింట్లో వాళ్ళు మాట్లాడుకునే విషయాలు అల్లుడికిష్టముండదు. ముఖ్య్ణంగా భార్య బావల గురించి సంభాషణ తరచూ జరుగుతూండడం అతని మనసుని కష్టపెట్టింది. విషయం తెలిశాక భార్య పుట్టింటికి వెళ్ళడం తగ్గించింది. భర్తతో కలిసి వెళ్ళినప్పుడే ఆయనకిష్టంలేని విషయాలపై చర్చలు వద్దని తల్లిదండ్రులకి చెప్పింది. దాంతో అతని సమస్య తీరింది.

ప్రస్తుతం ప్రపంచ వ్యాప్తంగా ఉన్న ఒక ముఖ్యమైన సమస్య చాలామంది మగవారికి శృంగార సామర్థ్యం తక్కువవడం, భార్యకి శృంగారం కావాలనిపించడం. ఎప్పుడైతే మగవాడికి సామర్థ్యం తగ్గిందో భార్య తనని సెక్స్ కోసం డిమాండ్ చేస్తుందనో, లేదా భార్యకు కామమెక్కువనో అనుకుంటూ వుంటారు. మగవాళ్ళ సెక్స్ కోర్కెలు తగ్గడానికి డిప్రెషన్ కు వాడే మందులు, అలాగే అధిక రక్తపోటుకు వాడే మందులు మాత్రమే కాక అనేక శారీరక, మానసిక, జీవ రసాయన కారణాలు ఉంటాయి. ఇలాంటివి కల్గినప్పుడు దేనివలన భర్తకు ఏ సమస్య కల్గిందో గుర్తించడం, చికిత్సకు మార్గాలన్వేషించడం, చికిత్సాకాలంలో సహకరించడం భార్యకు అత్యంతవసరం.

కొన్ని రకాలైన విధానాలు సహజమైనవే అయినప్పటికీ వాటిని అసహజమైనవిగా భార్యలు భావిస్తుంటారు. తేలికగా సమస్య తీరే మార్గాల్ని నిర్లక్ష్యం చేస్తుంటారు. సెక్స్ కౌన్సిలర్స్ ని కలవడం ద్వారా ఇలాంటి సమస్యల్ని అధిగమించవచ్చు. శృంగారం గూర్చి, శృంగార సమస్య గూర్చి, ముఖ్యంగా మగవారి సమస్యల గురించి పరిజ్ఞానం ఆడవారికి చాలా అవసరం. చికిత్సలో సహకరించడానికి, సమస్య పెద్దదవకుండా ప్రవర్తించడానికి ఆ పరిజ్ఞానం ఎంతగానో ఉపయోగపడుతుంది.

మగవాని సమస్యలో అత్యధిక శాతం మందిలో ఉన్నది శ్రీఘ్రస్ఖలనం, కానీ ఎక్కువ బాధకు గురిచేసేది అంగ స్తంభన సమస్య. అంగ స్తంభన సమస్య కూడా 40 ఏళ్ళు దాటిన వారిలో 52 శాతం మందిలో చూశారు. ఫోర్ స్కిన్ సమస్యలు, ప్రోస్టేట్‍ సమస్య, బీజాల సమస్యలు, హార్మోన్ల సమస్యలు, క్రోమోజోముల సమస్యలు, పుట్టుకతోనే జననావయవాలలో లోపాలు, మగవారిలో వక్షోజాలు, అంగంలో గడ్డలు ఇలా మగవారిలో అనేక సెక్స్ సమస్యలు కలుగుతాయి. వీటి గురించి ముందు తెలుసుకుందాం. సెక్స్ సమస్యలు పెరిగాయా? లేదా వాటిని పరిష్కరించుకోవడం కోసం సెక్సాలజిస్ట్ ల వద్దకు వచ్చేవారి సంఖ్య పెరిగిందా అన్నది ఆలోచించవలసిన అంశం.

జనాభా పెరుగుదల, ఆర్థిక ఇబ్బందులు, దేశ ఆర్థిక వ్యవస్థ ప్రభావం మనుషులపై పడి ఆందోళన, డిప్రెషన్ లు అధికమవుతున్నాయి. ఒకరిద్దరే సంతానం అవడంతో ఆడపిల్లల తల్లిదండ్రుల ప్రతిస్పందన కూడా తీవ్రంగానే ఉంటోంది. వివాహ వయస్సు గత దశాబ్ధంలో బాగా పెరిగింది. 30-35 వయసులో కూడా అవివాహితులుగా ఉన్న వాళ్ళ సంఖ్య ఎక్కువవుతోంది. అందువలన సెక్స్ సమస్యల గూర్చి అవగాహన యువతీ యువకులకే కాకుండా వారి తల్లిదండ్రులకు కూడా ఎంతో అవసరం.


పురుషాంగం – పరిమాణం

పురుషాంగం సైజు గురించి చాలామందిలో అవాస్తవాలతో నిండిన అభిప్రాయా లున్నాయి. వారిలోని ఈ అభిప్రాయాలలో వాస్తవమెంతో తెలుసుకోకుండా పక్కవారిపై వాటిని రుద్దేందుకు ప్రయత్నిస్తుంటారు. దీనివలన పక్కవారిలో కూడా అపోహలు ఏర్పడే ప్రమాదం ఉంది. ఇలాంటి అపోహలలొ ముఖ్యమైనవి ఏంటంటే- పురుషాంగం పరిమాణం గురించినవి.

పురుషాంగం పరిమాణాన్ని వర్గీకరిస్తూ ప్రాచీన కామశాస్త్ర గ్రంథాలు కొంతమంది ప్రచురిస్తుంటారు. ఈ గ్రంథాలలో ఉండేదేమంటే పురుషాంగాన్ని పరిమాణం ప్రాతి పదికగా నాలుగైదు రకాలుగా వర్గీకరిస్తారు. ఎక్కువసైజు ఉన్నవారు భాగస్వామికి ఎనలేని తృప్తి కలిగిస్తారని ఆ పుస్తకాలలో వర్ణిస్తుంటారు. తమ వర్ణనకు మద్దతుగా ఎవరో ప్రాచీన మహర్షులు చెప్పారంటూ కొన్ని శ్లోకాలు కూడా రాస్తారు. ఇలాంటి వారి రాతలు యువకులలో భయాందోళనలు పెంచేవిగా ఉంటాయి.

చాలామంది చివరికి తేల్చి చెప్పేదేమిటంటే తమ దగ్గర పురుషాంగం పరిమాణాన్ని పెంచే మందులున్నాయని, వాటిని సేవిస్తే, తాము చెప్పే క్రియలు ఆచరిస్తే పురుషాంగం పరిమాణం పెరిగి తీరుతుందని నమ్మబలుకుతారు. విపరీతమైన ధరలకు ఏవేవో చూర్ణాలు, లేహ్యాలూ ఇస్తారు. వీటివల్ల ఎంతమేరకు ఉపయోగం ఉంటుందో తెలుసుకోకుండానే చాలామంది కొంటుంటారు. నిజానికి స్త్రీని సంతృప్తి పరచడానికి, పురుషాంగం పరిమాణానికి సంబంధం లేదు.

అదే విధంగా పురుషునిలో సంభోగ శక్తికి, పురుషాంగానికీ సంబంధం లేదు. ఎక్కువసేపు సంభోగం చేయగలిగిన వారికి పురుషాంగం చిన్నదిగా ఉండవచ్చు. అంగం చిన్నదిగా ఉంటే సమస్యే అన్నది కేవలం అపోహే. చాలామంది అడిగే ఇటువంటి ప్రశ్నలలో అసలు హేతుబద్దత ఉండదు. ఇలాంటి అమాయకులను కొంతమంది మోసగిస్తుంటారు. సెక్స్ సమస్యలు ఏవైనా తలెత్తితే మోసం చేసే వారి బారిన పడకుండా వీలైనంత వరకూ పేరు పొందిన డాక్టర్లనే ఆశ్రయించడం మంచిది.

పురుషిని కామ సామర్థ్యం, కోరికలు ఎక్కువగా అతనిలోని హార్మోన్ల మీద, గ్రంథుల మీద ఆధారపడి ఉంటాయి. స్త్రీలలో కూడా ఇదే విధంగా ఉంటుంది. స్త్రీ పురుషుల మధ్య ఆకర్షణ కలిగించడంలో హార్మోన్లదే కీలక పాత్ర. కొన్ని గ్రంథులు కూడా కోర్కెలను ప్రభావితం చేయగలవు. పురుషులలో సెక్స్ పరంగా ఎదురయ్యే కొన్ని రకాల సమస్యలకి హార్మోన్ల ఇంజేక్షన్స్ ఇవ్వడం ద్వారా చికిత్స చేస్తుంటారు. దీనితో సమస్య చాలా వరకూ పరిష్కారమవ్వచ్చు. ఏదేమైనా పురుషాంగం పరిమాణానికీ, శృంగార సామర్ధ్యానికీ సంబంధం లేదు.


వెన్నెముక దెబ్బలు – అంగస్తంభన సమస్య

 

అంగస్తంభనమన్నది రెండు రకాలుగా ఉంటుంది. మానసికంగా ఆలోచనలు కలిగినప్పుడు కలిగేది, అంగాన్ని ప్రేరే్పించినప్పుడు కలిగేది. డి-8 వెన్నుపూస కంటే క్రింద దెబ్బలు తగిలినప్పుడు మానసికమైనటువంటి ఆలోచనల వలన కలిగే అంగస్తంభనాలు కలుగుతాయి. దెబ్బలు బాగా పైన తగిలినప్పుడు ప్రేరేపణ ద్వారా కలిగే అంగస్తంభనలు కలుగుతాయి.

వెన్నెముక దెబ్బలు తగిలిన వారిలో 5 శాతం – 56 శాతం మంది శృంగారంలో చురుకుగా పాల్గొన్నట్టు కనుగొన్నారు. అంగస్తంభనాలు కంటే కూడా వీర్యస్ఖలనంలో సమస్యలు కలిగినట్లు చూశారు. భావప్రాప్తిలో పెద్ద మార్పులు లేనట్లు చూశారు. మగవారిలో వీర్యస్ఖలనంలో సమస్యలు కలగడమే కాకుండా వీరుకణాల ఉత్పత్తిలో కూడా సమస్య కలుగుతుంది.

బీజాలలో ఉష్ణోగ్రత పెరగడం ఇందుకు కారణమవ్వచ్చు. అంతేకానీ హార్మోన్ లలో హెచ్చుతగ్గులు కలగవని గమనించారు. వీర్యకణాలలో మార్పులు లేని వారిలో కృత్రిమంగా వీర్యస్ఖలనం గావించి వచ్చిన వీర్యాన్ని ఇన్ సెమినేషన్ చేస్తారు. వెన్నెముకకు దెబ్బలు తగిలినవారు న్యూరాలజిస్ట్ ని కలవాలి. ఆ తరువాత సెక్స్ సమస్యలు కలవారు సెక్స్ కౌన్సిలర్ ని కలవాలి.


సెక్స్ అంటే బోర్ వద్దు…

సెక్స్ పరంగా దంపతులిద్దరి మధ్య సఖ్యత వుండాలంటే ఇద్దరూ సమతుల్యతను పాటించాలి. ఏది ఏమయినా సెక్స్ పరమైన ప్రవర్తనకు, కోరికలకు సంబంధించిన ఎవరికయినా వర్తించే కొన్ని అంశాలను మనం గుర్తుంచుకోవాలి. కొందరు పురుషులు కొన్ని రకాలైన రతి భంగిమల వల్ల సెక్స్ లో త్వరగా స్ఖలనం పొందుతారు. పూర్తీ సంతృప్తిని పొందుతారు.

అదే స్త్రీలకయితే అపరిమితమయిన భావప్రాప్తిని లేదా నాలుగయిదుసార్లు వరుసగా భావప్రాప్తి పొందుతారు. ఈ భంగిమ, విధానం వారికి నచ్చవచ్చు కానీ, భాగస్వామికి నచ్చకపోవచ్చు, లేదా ఇష్టం లేకపోవచ్చు. అయితే ఈ విషయం చెప్పేందుకు సిగ్గుపడవచ్చు. ఇలాంటి విషయాలను దంపతులిద్దరూ మాత్రమె గమనించగలరు. ఇద్దరికీ నచ్చి, ఆనందించగలిగే సెక్స్ కార్యక్రమాన్ని నిర్ణయించుకోవటం వల్ల స్త్రీ, పురుషులిద్దరూ ఆనందించగలుగుతారు.

దీనికోసం భార్య భర్తలిద్దరూ కలిసి ఎలాంటి విబేధాలు లేకుండా మాట్లాడుకోవాలి. అపుడే ఒక ఆమోదయోగ్యమైన నిర్ణయం తీసుకో గలుగుతారు. కొందరు స్త్రీలకూ అంగచూషణ అంటే ఇష్టం వుండవచ్చు, పురుషులకు ఇష్టం లేకపోవచ్చు. ఇదే మరికొందరిలో మరో విధంగా వుండవచ్చు. అలాగే కొందరు స్త్రీలు తమ వక్షోజాలను భర్త తాకటం వల్ల, మృదువుగా నొక్కటం వల్ల ఆనందాన్ని పొందుతారు. కొందరు పురుషులకు ఇది ఏమాత్రం ఇష్టం వుండకపోవచ్చు.

ఏదేమయినా తమ భాగస్వాములు కొన్ని సెక్స్ భంగిమలను మాత్రమె ఎందుకు ఇష్టపడతారో, కొన్ని రకాలైన సెక్స్ పద్ధతులను ఎక్కువగా ఎందుకు ఇష్టపడతారో అడిగి తెలుసుకోవలసిన అవతలి వారికి వుంది. చివరికి తమ తమ ఇష్టాలను ఏ ఒక్కరూ వదులుకోకపోయినప్పటికీ ఇలా అడిగి తెలుసుకోవటం అనేక సందర్భాలలో ఇద్దరి మధ్య సెక్స్ పరమైన విషయాల్లో మంచి సమన్వయాన్ని, సఖ్యతను ఏర్పరిచి, సంతృప్తిని కలిగిస్తుంది.

వ్యక్తుల సెక్స్ పరమైన అభిరుచులు వారు పెరిగిన వాతావరణాన్ని బట్టి, మత, కుల పరిస్థితులనుబట్టి, వారు ఏర్పరుచుకునే నైతిక విలువలనుబట్టి, జీవన విధానాన్ని బట్టి, జన్యువులనుబట్టి మారుతూ వుంటాయి. దాదాపు ఏ ఇద్దరిలోనూ ఇవి ఒకేలాగా వుండవు. కాబట్టి భార్యా భర్తలిద్దరూ ఏంటో కొంత సర్థుబాటు చేసుకోక తప్పదు. వేర్వేరు రకాల పద్ధతులను, భంగిమలను ప్రయత్నించటం ద్వారా దంపతుల మధ్య సెక్స్ పరమైన సాన్నిహిత్యం పెరుగుతుంది. ఫలితంగా అది మంచి దాపత్యంగా రూపొందుతుంది.

వైద్యులు సూచించేది కూడా ఇదే. సెక్స్ లో కొత్త పద్ధతులు నేర్చుకోవటం తప్పుగా భావించకూడదు. నిజానికి దాని వల్ల సెక్స్ అంటే బోర్ తగ్గిపోయి మరింత ఆసక్తి పెరుగుతుంది. ఎవరయినా తమ సెక్స్ బిహేవియర్ ను మార్చుకోదలచుకుంటే అందుకు కొంత సమయం పడుతుంది. ఉదాహరణకు భర్తకు లైట్ వుంటే సెక్స్ చేయటం ఇష్టం… అయితే భార్యకు చీకటిలోనే సెక్స్ చేయటం ఇష్టం. అయితే భర్త కోరిక మేరకు లైట్ లోనే సెక్స్ కు భార్య అంగీకరిస్తుందనుకుంటే ఈ మార్పు క్రమంగా రావాలి.

అంటే చీకటిలో నుంచి బెడ్ లైట్ కు… అక్కడినుంచి పూర్తీ లైట్ కు … ఇలా వుండాలి. మార్పు అనేది లేనప్పుడు మానవుడికి ప్రతి విషయమూ బోర్ గానే వుంటుంది. మనం ప్రతిరోజూ ఒకేరకమైన తిండి తిని, ఒకే రకమైన దుస్తులు ధరిస్తే విసుగు, బోర్ రావచ్చు. సెక్స్ కూడా అంతే…. అయితే ఒకేసారి లోతు తెలియని సముద్రంలో దూకటం కంటే ముందుగా పైపైన వున్నా నీళ్ళల్లో ఈదులాడటం తెలికనే విషయం అందరికీ తెలిసిందే కదా…!


Male/Female The Other Difference

Hormone :Flavour'' One scientist who has been on both sides of the debate, psycho-endo- crinologist June Reinisch recently found evidence to buttress the hormonal argument. Over a period of five years, Reinisch studied 25 boys and girls born to women who had taken synthetic progestin (a male-like hormone) to prevent miscarriages.

When a scientist compared them with their unexposed siblings by giving each child a standard aggression test, she found that progestin-exposed males scored twice as high in physical aggression as their normal brothers – and that 12 out of 17 exposed females scored higher than their unexposed sisters. Reinisch has by no means renounced her belief in the importance of environment. Like many of her colleagues, she suspects that hormones act to “flavour'' and individual for one kind of gender behaviour or another. But how the individual is raised is still an important factor.

As Robert Goy explains: “It looks as though what the hormone is doing is predisposing the animal to learn a particular social role. It isn't insisting that it learns that role; it's just making it easier'' How does the initial flavour come about? Researchers now believe that hormones change the very structure of the brain, Variations in the brians of males and females have been found in many animals, mainly in the hypothalamus and pre-optic regions which are closely connected to the reproductive functions. In those areas males are generally found to have more and larger “neurons'' nerve cells and their connecting processes. Brain Disparity :- Many scientists are now convinced that hormones “imprint'' sexuality on the brains of a large number of animal species by changing the nerve- cell structure. But what about humans? For years researchers have known that men's and women's mental functions are organized somewhat differently. Men appear to have more “laterality'' that is, their functions are separately controlled by the left or right hemisphere of the brain, while women's seeem diffused through both hemispheres. The first clues to this intriguing disparity came from victims of brain damage. Doctors noticed that male patients were much likelier than females to suffer speech impairment after damage to the left hemisphere and loss of such non-verbal functions as visual-spatial ability when the right hemisphere was damaged.

Women showed less functional loss, regardless of the hemisphere involved. Some researchers believe this is because women's brain activity is duplicated in both hemispheres. Women usually mature earlier than men, which means that their hemispherec processes may have less time to draw apart. They retain more nerve-transmission mechanisms in the connective tissue between the two hemispheres and may thus be better able to co-ordinate the efforts of both hemispheres. Men generally do better in activities where the two hemispheres don't compete with, and thus hamper, each other. Although the very mention of differences in ability between men and women causes furor, because it seems to imply superiority and inferiority, in fact the differences among members of the same sex are far greater than the average differences between sexes. Monte Buchsbaum of the U S National Inisitute of Mental Health conducted testes of electiral activity in the brain showing that women tend to have a larger “evoked potential'' than men-an indication of greater sensitivity to certain stimuli. But, he cautions, “individuals can vary over about a five-fold range. The variation between the sexes is only about 20 to 40 per cent'' Singing

Spirits :- It is clear that sex differences are not set in stone. The relationship between hormones and behaviour, in fact, is far more intricate than was suspected until recently. There is growing evidence that it is part of a two-way system of cause-and-effect, what Harvard biologist Richard Lewontin calls “a complicated feedback loop between thought and action' 'Studies show that testosterone levels drop in male rhesus monkeys after they suffer a social set-back and surge up when they experience a triumph. Other experiments indicate that emotional stress can change hormonal patterns in pregnant rodents, which in turn may affect the structure of the foetal brain. By process still not understood, biology seems susceptible to social stimuli.

Ethel Tobach of New York's American Museum of Natural History cites experiments in which a virgin female rat is presented with a five-day-old rat. At first, her response is not focused, says Tobach. “But by continuing to present the young rat, you can get her to start huddling over it and assuming the nursing posture. How did that come about? Obviously, some biochemical factor has changed, When you have the olfactory, visual, auditory, tactile input of an infant for all those days, it can change the blood chemistry'' While researchers are cautious about making the leap from rats to Homo sapiens, it is now widely recognized that, for people as well as animala, biology and culture continually interact.

The differences between men and women havebeen narrowing over evolutionary time, and in recent decades the gap has closed further. Perhaps the most arresting implication of the research to date is not that there are undeniable differences between males and females, but that the differences are so small, in relation to the possibilities open to them. Human baheviour exhibits a plasticity that has enabled men and women to cope with cultural and environmental extremes and has made them-by some measures-the most successful species in history.

“Human beings'' says neuroendocrinologist Roger Gorski, of the University of California at Los Angels, “have learnt to intervene with their hormones'' which is to say that their behavioural differences are what make them less, not more, like animals.


సెక్స్ సమస్యలు కలిగించే మద్యపానం

రిక్రియేషన్ కోసమో, మతపరంగానో, బిజినెస్ డీలింగ్స్ కోసమో ఆల్కహాల్ సేవించబడుతోంది. ఏదో ఒక సందర్భంలో చాలామంది ఆల్కహాల్ సేవిస్తుంటారు. మోతాదు మించి సేవించడమో, ఎక్కువకాలం సేవించడమో చేస్తే ఆల్కహాల్ అనేక సెక్స్ సమస్యలకు దారితీస్తుంది. షేక్స్ పియర్ మాక్ బెత్ లో రాసినట్లు మద్యం కోరికను పెంచుతుంది కానీ సామర్థ్యాన్ని తీసుకుపోతుంది.

ఇంకా అనేక అనర్థాలకు దారితీస్తుంది. ఎక్కువ మోతాదులో మద్యం తీసుకున్నప్పుడు అది కేంద్ర నాడీమండలంపై పనిచేసి అంగస్తంభన కలగకుండా చేస్తుంది. మత్తులో ఎంత ప్రయత్నించినా స్తంభన కలగదు. దానికి తోడు మద్యపానం చేసి సెక్స్ లో పాల్గొనేది సాధారణంగా అక్రమ సంబంధాలే. ఫెయిల్యూర్ వలన కలిగిన అవమానం సెక్స్ సమస్యను మరింత పెంచుతుంది. అది ఆల్కహాల్ వలన కలిగిందని అనుకోకుండా తనలో ఏమైనా లోపం వుందేమోనన్న భయం కలిగి సమస్య మరింత జటిలమవుతుంది.

వయాగ్రా వాడిన వారిలో కొందరిలో మరణం కలిగిందని కూడా రిపోర్ట్స్ వస్తున్నాయి. గుండె జబ్బు ఉండడం, గుండె జబ్బుకు ఇతర మందులు వాడడం, ఆల్కహాల్ అధికంగా సేవించడం, ఎక్కువగా తినడం, ఇవన్నీ వివాహేతర సంబంధాల్లో వాడడం ఫలితంగా గుండెపై భారమై మరణానికి దారితీస్తుంది. ఎక్కువ కాలం ఆల్కహాల్ సేవించి మానేశాక కొన్ని సెక్స్ సమస్యలు కలుగుతాయి.

వాటి గూర్చి తెలియక కొందరు మళ్ళీ త్రాగడం మొదలుపెడతారు. ఎక్కువకాలం మద్యపానం చేసి మానేశాక కలిగే కొన్ని సమస్యల్ని చూద్దాం. సెక్స్ కోరికలు తగ్గడం, అంగస్తంభన మరియు భావప్రాప్తికి సంబంధించిన సమస్యలు స్త్రీపురుషులలో కలుగుతాయి. ఆల్కహాల్ కు బానిస అయినవారిలో 8 నుంచి 59 శాతం మందిలో అంగస్తంభన సమస్యలు, 31 నుంచి 58 శాతం మందిలో సెక్స్ కోరికలు తగ్గడం చూశారు. అలాగే మానివేసిన వారిలో 63 శాతం మందిలో సెక్స్ సమస్యలున్నట్లు చూశారు. మరొక పరిశీలనలో 59 శాతం మంది అంగస్తంభన సమస్య కలిగినట్లు 48 శాతం మంది వీర్యస్ఖలనంలో సమస్యలు కలిగినట్లు చెప్పారు.

ఆల్కహాల్ మానివేశాక చికిత్స కోసం వచ్చిన ఆడవారిలో 64 శాతం మంది సెక్స్ కోరికలు తగ్గినట్లు 61 శాతం మంది భావప్రాప్తి కలగట్లేదని చెప్పారు. ఈ సమస్యలు ఆల్కహాల్ యొక ప్రభావం కాలేయం, నాడులు మెదడుపై ఉన్నందువలన, మానసిక కారణాలైన ఆత్మవిశ్వాసం తగ్గడం, ఆందోళన, కృంగిపోవడం మరియు మెదడు దెబ్బ తినడం వలన ఎదురవుతాయి.

ఆల్కహాల్ శరీరంలో దాదాపు ప్రతి అవయవాన్ని దెబ్బ తీస్తుంది. నాడులకు సంబంధించిన వ్యాధులు 10 శాతం మందిలో చూశారు. అలాగే నాడీవ్యవస్థలో లోపం ఉండి లక్షణాలు బయటకు కనపడని వారు త్రాగుబోతులలో 60 శాతం మంది ఉంటారు. అందువలన సెక్స్ సమస్యలు కలిగే ఆస్కారాలు ఎక్కువవుతాయి. త్రాగుడు మానేయడం, మంచి పోషకాహారం తినడం, విటమిన్ బి కాంప్లెక్స్ వాడడం వలన ఈ లోపాల్ని సరిదిద్దుకోవచ్చు.

అధిక కాలం మద్యం సేవించిన మగవారిలో 70-80 శాతం మందిలో బీజాలు కృశించిపోవడం, పిల్లలు పుట్టకపోవడం గమనించారు. ఆల్కహాల్ బీజాలపై విషంలా పనిచేసి టెస్టోస్టిరాన్ హార్మోన్ ఉత్పత్తి తగ్గిపోయేట్టు చేస్తుంది. ఈ లోపం సరిదిద్దడానికి హైపోథాలమస్ పిట్యూటరీలు ల్యూటినైజింగ్ హార్మోన్ ఉత్పత్తి పెంచుతాయి. కాలేయం దెబ్బ తిన్నందువలన ఈస్ట్రోజెన్ హార్మోన్ పరిమాణం పెరిగిపోతుంది. అందువలన సెక్స్ కోరికలు తగ్గడం, శరీరంపై వెంట్రుకలు తగ్గడం వక్షోజాలు పెరగడంలాంటి లక్షణాలు కలుగుతాయి. ఆల్కహాల్ మానేశాక ఇలాంటివారిలో 25 శాతం మందికి మళ్ళీ సెక్స్ కోరికలు కలిగినట్లు చూశారు. ఆడవారిలో ఆల్కహాల్ అధిక సేవన వలన ఋతుస్తావం సరిగా అవ్వకపోవడం, పిల్లలు పుట్టకపోవడం, తొందరగా ముట్లుడగడం సంభవిస్తాయి. సెక్స్ కోరికలు తగ్గడం, భావప్రాప్తి పొందలేకపోవడం ఆడవారిలో కలిగే సెక్స్ సమస్యలలో ముఖ్యమైనది.


స్ధలనం అయిన వెంటనే మళ్ళీ మళ్ళీ అంగస్తంభనం కలిగించేవి

అంగస్తంభన కలిగేట్టు చేసేవి, స్ధలనం అయిన వెంటనే మళ్ళీ మళ్ళీ అంగస్తంభనం కలిగించేవి, స్ధలనానికి ముందు చాలా సేపు స్తంభన ఉండేట్టు చేసేవి, ఇలాంటి మందులకోసం ప్రపంచంలో అన్ని ప్రాంతాలలో చరిత్రలో అన్ని సమయాల్లో ఎక్కువ డిమాండ్ ఉంది. చైనాలో ఖడ్గమృగాల కొమ్ముకు ఇలాంటి గుణాలు ఉన్నాయి అన్న నమ్మకం కారణంగా అనేక ఖడ్గమృగాలని చంపడం జరిగింది.

ఔషధాల విషయంలో హార్మోన్ల గూర్చి చెప్పుకోవచ్చు. ఈ హార్మోన్లు శరీరంలో తగినంత లేనప్పుడు నోటిద్వారా లేదా ఇంజెక్షన్ల ద్వారా ఇచ్చినప్పుడు పనిచేస్తాయి. లండన్ లో ప్రొ. బ్రిండ్లే అంగంలోకి మందులు ఇంజెక్షన్లు చేసే, ఒక విధానం కనుగొన్నారు. తర్వాత ఇంకో మందుతో ఫ్రాన్స్ లో డా. విరాగ్ పరిశోధనలు చేశారు. ఎలాంటి రోగం లేకుండా ఆరోగ్యంగా ఏ సమస్య లేకుండా ఉన్నవాళ్ళు కావాలని అడిగితే అంగస్తంభన పెంచేవి లేదా స్ఖలనాన్ని అలస్యంగా చేసే మందులు పైన చెప్పినట్లు అంగంలోకి డైరెక్టుగా ఇచ్చేవి తప్ప తక్కినవి దాదాపు లేవనే చెప్పవచ్చు.

ఎందుకంటే ఆరోగ్యవంతునిలో కామశక్తి పెంచే ఔషధాలపై పరిశోధనలు నిధులు లభించకపోవడంతో శాస్త్రీయ పరిశోధనలు అమెరికాలో జరగలేదు. ఏ ఏ మందులకు సైడ్ ఎఫెక్ట్స్ గా కామశక్తి తగ్గుతుందో ఆలాంటివాటిని గుర్తించారు. కానీ ప్రత్యేకంగా ఆరోగ్యవంతునిలో కామశక్తిని పెంచే మందులకోసం ఎక్కువ పరిశోధనలు లేవు. ఒక మందు పనిచేస్తుందా? పని చేయదా? పని చేస్తే ఎలా పని చేస్తుంది? ఇలాంటి ప్రశ్నలకు సమాధానం శాస్త్రీయంగా పొందడం అంత తేలికైన విషయం కాదు.

ఒక మందు కోసం తగినన్ని నిధులు, పరికరాలు కావాలి. అవి లేకుండా, తగినంత ఆధారం లేకుండా ఏ శాస్త్రవేత్తా ఈ మందు పనిచేయ్యదు అని కూడా చెప్పడు. అలాగే పనిచేస్తుంది అని చెప్పాలన్నా తగినంత అధారం, పరిశోధనలు అవసరం. శాస్త్రీయ ఆధారం ఉన్నా లేకపోయినా అనేక పదార్ధాలను కామశక్తి పెంచడం కోసం చాలాచోట్ల వాడుతున్నారు. టెస్టోస్టిరాన్ మగవారిలో మఖ్యంగా దాని పరిమాణం శరీరంలో తక్కువైనపుడు పని చేస్తుంది. డా. జాన్ మనీగారి పరిశీలనలో ఆడవారిలో ప్రాకృతంగా ఉండే టెస్టోస్టిరాన్ హార్మోన్ తగ్గితే అప్పుడు వాళ్ళకి టెస్టోస్టిరాన్ హర్మోన్ ఇచ్చినపుడు శృంగారేచ్ఛ పెరుగుతుంది అని గమనించారు.


అంగంలో ఇంప్లాంట్స్ – 1

 

అంగస్తంభన సమస్యలు ఇతర చికిత్సా విధానాలతో తగ్గనప్పుడు అంగం గట్టిగా ఉండడానికి అంగంలోకి ఇంప్లాంట్స్ ని శస్త్రచికిత్స ద్వారా అమరుస్తారు. మొదటిసారి 1960లో లోప్లర్ అంగంలో ఏక్రలిక్ ఇంప్లాంట్ వాడారు. ఈ ఇంప్లాంట్స్ లో ముఖ్యంగా రెండు రకాలున్నాయి.

మొదటిరకం:- రాడ్ లాగా ఉండే సిలికాన్ ఇంప్లాంట్ ని అంగంలోకి బిగిస్తారు. దీనివలన అంగం ఎప్పుడూ లేచి ఉంటుంది. బట్టలు వేసుకున్నప్పుడు అంగాన్ని కిందకి నొక్కవచ్చు.

రెండవరకం:- ఇన్ ప్లేటబుల్ ఇంప్లాంట్. 1973లో స్కాట్ మొదలగువారు దీనిని ప్రవేశ పెట్టారు. దీనిలో రెండు సిలికాన్ సిలిండర్ లను అంగంలోకి బిగిస్తారు. ఇవి రెండు గొట్టాలు. పంపు ద్వారా ఒక బెలూన్ కి కలపబడి ఉంటాయి. ఈ బెలూన్ నిండా ద్రవం ఉండి దాన్ని కడుపులోకి అమరుస్తారు. పంప్ ను బీజాలలోకి అమరుస్తారు. పంప్ ని నొక్కితే బెలూన్ లోని ద్రవం అంగంలోని సిలికాన్ సిలిండర్ లోకి ప్రవేశిస్తుంది. దాని వలన అంగం గట్టిపడుతుంది.

అంగస్తంభన వద్దనుకున్నప్పుడు వంపు దగ్గర ఉండే వాల్వుని నొక్కితే ద్రవం సిలిండర్ల నుంచి మళ్ళీ బెలూన్ లోకి చేరుతుంది.

కొత్తగా వచ్చిన ఇంకో రకం ఇంప్లాంట్ లో ఈ మూడూ అంగంలోకి ఒకే సిలండర్ లో అమర్చబడి ఉంటా్యి. అవి హైడ్రోప్లెక్స్ మరియు ప్లెక్సిప్లీట్. ఈ ఇన్ ప్లేటబుల్ ఇంప్లాంట్ సహజంగా కలిగే అంగస్తంభనాన్ని ఇంచుమించు కలిగిస్తుంది. కానీ ఈ రకమైన ఇంప్లాంట్ సర్జరీ చాలా ఖరీదైనది (సుమారు లక్షా 75 వేల రూపాయలు) క్లిష్టమైనది. దీనిలో కొన్నిసార్లు యాంత్రిక లోపాలు కలిగితే మళ్ళీ సర్జరీ ద్వారా దాన్ని తొలగించాల్సి ఉంటుంది.


అంగస్తంభనానికి అపోమార్ఫిన్ – 1

అంగస్తంభనానికి అపోమార్ఫిన్. అంగస్తంభనం వెంటనే కలిగించే మాత్రలపై పరిశోధనలు వయాగ్రా విడుదలయ్యాక ముమ్మరమయ్యాయి. అనేక సంవత్సరాలు ఇలాంటి మందుల పరిశోధన నిమిత్తం రీసెర్చ్ గ్రాంట్ లభించక శాస్త్రవేత్తలు ఇబ్బందిపడ్డారు. కేవలం సెక్స్ పై దుష్ప్రభావం చూపే మందులపై పరిశోధనలకు మాత్రమే ఆర్ధిక సహాయం లభించేది.

అందువల్లనే ఎన్నిరకాల మందులు దుష్ప్రభావం సెక్స్ పై పడుతుంది అన్న అవగాహన మనకు ఇవాళ లభిస్తోంది. 1980 లలో అంగంలోకి ఇంజెక్షన్ ల ద్వారా వెంటనే అంగస్తంభనం కలిగించ వచ్చని ప్రొ. బ్రిండ్లే. ప్రొ. విరాగ్ లు గుర్తుంచారు. ఇంజెక్షన్ ల ద్వారా చికిత్స అనేకమంది చేశారు. 20 వ శతాబ్దపు చివరి రోజులలో మూత్రమార్గం ద్వారా ప్రోస్టాగ్లాండిన్ ఈ 1 వాడకం ద్వారా వెంటనే అంగస్తంభనాలు కలిగించే సాధనం విడుదలైంది.

ఇంక ఆ తరువాత నుంచి అనేక కంపెనీలు అంగస్తంభనానికి మందుల పరిశోధనలు ముమ్మరం చేశాయి. గత సంవత్సరం ప్యారిస్ లో జరిగిన వరల్డ్ కాంగ్రెస్ ఆఫ్ సెక్సాలిజీలో ఈ మందు గురించిన వివరాలను కంపెనీవారు అనేకమంది డాక్టర్లకు తెలియజేశారు. ఆపోమార్ఫిన్ మెదడుపై పనిచేస్తుంది. ఇది డోపామిన్ ఎగోనిస్ట్, డి1, డి2 రిసెప్టార్స్ పై ప్రభావం కలిగి ఉంటుంది. హైపోథాలమస్ లోని పారా వెంట్రిక్యూలార్ న్యూక్లియస్ పై పనిచేస్తుంది. నాలుకకింద ఈ మాత్రను ఉంచుకోవాలి. 2 మిల్లిగ్రాములు, 3 మిల్లీగ్రాముల పరిమాణంలో ఈ మాత్ర పనిచేస్తుంది. నాలుక కింద మాత్ర ఉంచిన 13-19 నిముషాలలో దీని కార్యాలు మొదలవుతాయి. వాడినవారిలో 80 శాతం మందిలో ఇది పనిచేస్తింది. 90 శాతం స్తంభనాలు కలిగాయి. ఇది వాడినప్పుడు నోట్లో నీరూరడం, వాంతి వచ్చినట్లుండడం 7 శాతం మందిలో చూశారు. కళ్ళు తిరిగినట్లుండడం , కొద్దిసేపు స్పృహ కోల్పోవడం కూడా అరుదుగా చూశారు. వాంతి వచ్చినట్లుండడం మొదటిసారికన్నా తర్వాత్తర్వాత వాడినప్పుడు తగ్గిందని, కొన్ని సందర్భాలలో వాంతులు నిరోధించే మాత్రలు వాడారని తెలియజేశారు. మాత్ర నాలుక కింద ఉంచిన పది నిముషాలలో కరిగిపోతుంది. ప్లాస్మాలో మందు పదినిముషాలలో చేరుతుంది.

బ్లడ్ బ్రెయిన్ బ్యారియర్ ని దాటుకుని మందు మెదడుపై పనిచేస్తుంది. కేంద్రీయ నాడీమండలంలో ఎక్కువ పరిమాణంలోకి అపోమార్పిన్ చేరి వెంటనే దీని కార్యాలు మొదలవుతాయి. మొత్తం 5000 మంది అంగస్తంభన సమస్యతో బాధపడే వారిలో ఈ మందు వాడారు. ఒక లక్షా ఇరవైవేల కన్నా ఎక్కువ డోస్ లో ఈ మందు క్లినికల్ ట్రయిట్స్ లో వాడబడింది. 2584 మందిలో 2 మిల్లిగ్రాముల పరిమాణంలోనూ, 1331 మందిలో 3 మిల్లీగ్రాముల పరిమాణంలోనూ ఈ మందు వాడబడింది. వృద్దులలో కూడా ఈ మందు వాడవచ్చును. మూత్రపిండాలు చెడినవారిలో 2 మిల్లిగ్రాములకు మించి వాడరాదు. కాలేయ వ్యాధులు కలవారిలో జాగ్రత్తగా ఈ మందు వాడాలి. గుండెజబ్బులు కలవారిలోనూ, బినైన్ ప్రోస్టేట్ హైపర్ ప్లేజియా కలవారిలోనూ, అధిక రక్తపోటు కలవారిలోనూ , మధుమేహం కలవారిలోనూ ఈ మందు వాడారు. ఈ మాత్రలు సెక్స్ కోరికలను పెంచవు. అంగస్తంభనాలను 90 శాతం మందిలో మంచి ఫలితాలు కలిగినట్లు చూశారు. ఈ మందు అమెరికా, యూరప్ లలో లభ్యమవుతోంది. మనదేశంలో లభ్యమవ్వదు. ఇక్కడ విడుదలవడానికి ఇంకా కొంతకాలం పట్టవచ్చును.


ఆధునిక కామ సూత్రాలు – 1

 

దాంపత్య జీవితం గురించి సైన్స్ చెప్పే సంగతులు, ఎయిడ్స్ వంటి వ్యాధులపై సమగ్రమైన వ్యాసాలూ, వివాహాది ఆచారాలలో ఇమిడిఉన్న శృంగార విషయాలు, వాటి వెనుక గాథలు ఇలా అనేక విషయాలు ఇక్కడ అందిస్తాం. అంగస్తంభన గురించి మొదటి రెండు వారాలు వివరిస్తున్నాం …

సంసార జీవితంలో పురుషులు ఎదుర్కొనే ప్రధాన సమస్య అంగస్తంభన. ఈ సమస్యకు పరిష్కారమార్గంగానే వయాగ్రావంటి మాత్రలు కనుగొనవలసి వచ్చింది. అంగస్తంభన గురించి వైద్యులు మొదటిలో భిన్న సిద్ధాంతాలు వెలువరించినా ఇప్పుడు చాలావరకు దీని గురించి ఏకాభిప్రాయానికి వచ్చారు. దాని ప్రకారం చూస్తే పురుషునిలో కామోద్రేకం కలిగిన 10-15 సెకన్లలో అంగస్తంభన కలుగుతుంది. అంగస్తంభన కల్గించడంలో ముఖ్యమైనవి న్యూరో ట్రాన్స్ మీటర్లు. అలాంటివాటిలో వ్యాసోయాక్టీవ్ ఇంటెస్టైనల్ పాలిపెప్టైడ్ ఒకటి.

ఇది అంగస్తంభన కలిగించే కణజాలాల్లో ఎక్కువగా ఉండడమే కాకుండా అంగస్తంభన సమయంలో దీని పరిమాణం ఎక్కువగా ఉంటుంది. ఇదే కాక ప్రోస్టాగ్లాండిన్ ఈ 1 నైట్రిక్ ఆక్సైడ్ లు కూడా అంగస్తంభనలో సహాయపడతాయని కనుగొన్నారు. అంగస్తంభన ప్రక్రియలో మొత్తం నాలుగు దశలున్నాయి …

మొదటి దశలో అంగంలోని సైనసైడల్ గోడలలో ముడుచుకుని ఉన్న స్మూత్ మజిల్స్ రిలాక్స్ అవుతాయి … ఇవి రిలాక్స్ అయినప్పుడు అక్కడ ప్రదేశం పెరిగి దాంట్లోకి రక్తం వెడుతుంది.

రెండవ దశలో సిరలపై వత్తిడి పెరిగి సిరలగుండా రక్తం బయటకు వెళ్ళదు. అందువలన సైనసైడల్ ప్రదేశాలలో రక్తం మరింత ఎక్కువవుతుంది. ధమనుల్లో వ్యాకోచం కల్గి రక్తప్రసారం పెరుగుతుంది. దీనివల్ల అంగం గట్టిపడుతుంది. ఇస్కియోకావర్నోసస్, బల్బోస్పాంజియోసస్ కండరాల సంకోచాలు అంగస్తంభన మరింత ఎక్కువయ్యేట్టు చేస్తాయి.

అంగస్తంభన ప్రక్రియలో ముఖ్యపాత్ర వహించేవి నాడులు, హార్మోన్లు, మెదడు, రక్తనాళాలు, మనసు వీటిలో ఎక్కువ లోపం ఏర్పడినా అన్గాస్తంభానలో ఇబ్బంది కలుగుతుంది. ఇదంతా చదివేప్పుడు ఇబ్బందిగానో, అయోమయంగానో ఉండచ్చు. ముందు ముందు అందించే వ్యాసాలలో ఈ ఇబ్బంది ఎదురుకాదు. ఎందుకంటే అప్పుడు సైన్స్ ఏం చెబుతోంది అన్న విషయాన్ని మరింత సరళంగా వివరించడానికి ప్రయత్నిస్తాం.


వీర్యం – ఏం చేస్తుంది..?

 

వీర్యం చాలా విలువైనదని, శరీరం నుంచి దీనిని వృధాగా బయటకు పంపకూడదని కొందరు వాదిస్తుంటారు. వీర్య నష్టం వల్ల పురుషుడు శక్తిని కోల్పోతాడని చెబుతుంటారు. నిజానికి వీర్యంలో ఎటువంటి శక్తిని పురుషునికి ఇవ్వదు. స్ఖలనం జరిగిన తర్వాత శృంగారాన్ని పురుషుడు ముగించేస్తున్నందువలన బహుశా ఇటువంటి అపోహలు కలిగి ఉండచ్చు.

వీర్యం అవసరం ఏమిటి అంటే…. స్త్రీ గర్భం దాల్చడానికి ఉపయోగ పడుతుంది అనే చెప్పుకోవాలి. ఇక్కడ గమనించవలసిన మరో సంగతి ఏమిటంటే సంభోగశక్తికీ, వీర్యానికీ సంబంధం లేదు. సంభోగ శక్తి ఎక్కువ ఉన్న వ్యక్తిలో వీర్యం ఎక్కువగా ఉండాలని లేదు. అలాగే వీర్యం ఉన్న వ్యక్తిలో శృంగారేచ్చ ఎక్కువగా ఉండకపోవచ్చు.

మామూలు మనుషులు సరిగా అర్థం చేసుకోలేని మరో విషయం ఒకటి ఇక్కడుంది. అదేమిటంటే వ్యక్తుల మధ్య వీర్యం ఉత్పత్తిలో ఎక్కువ తక్కువలు అనేవి సహజమే అనేది. అందరిలో వీర్యం ఉత్పత్తి (పరిమాణం రీత్యా) ఏకరీతిగా ఉండదు. కొందరిలో ఎక్కువ ఉండచ్చు మరికొందరిలో తక్కువ ఉండచ్చు.

సాధారణంగా సగటున పురుషుడు స్ఖలించే వీర్యం రెండు మిల్లీ లీటర్ల నుంచి అయిదు మిల్లీ లీటర్లు ఉంటుంది. ఇది వ్యక్తికీ వ్యక్తికీ మారచ్చు. పురుషుడు స్ఖలించే వీర్యంలో ఉన్న శుక్ర కణాల వల్ల మాత్రమే స్త్రీ గర్భం ధరించగలుగుతుంది. సాధారణంగా రెండు ఎం.ఎల్, వీర్యంలో 60 మిలియన్ల శుక్ర కణాలు ఉంటే స్త్రీ గర్భం దాల్చగలుగుతుంది. కొన్ని సందర్భాలలో ఇంతకంటే తక్కువగా ఉన్నప్పటికీ కదలిక ఎక్కువగా ఉన్న ఆరోగ్యవంతమైన శుక్రకణాలుంటే గర్భం దాల్చడానికి ఉపయోగపడుతుంది.

మామూలు వ్యక్తులలో 60 మిలియన్ల వీర్య కణాలుండి, వాటిలో 40 శాతం చక్కని కదలిక ఉంటే ఆరోగ్యవంతమైన వీర్య కణాలుగా గుర్తించగలుగుతారు. కొందరిలో వీర్య కణాల ఉత్పత్తి అసలు జరగకపోవడం కానీ, లేదా చాలా తక్కువగా ఉండడం కానీ జరగచ్చు. ఇలాంటి వారికి కొన్ని చికిత్సలు చేయడం ద్వారా వీర్య కణాల సంఖ్య పెంచడం సాధ్యమే కానీ, మరీ ఎక్కువగా మాత్రం పెంచలేరు.

ఇలా పెంచగలమని ఎవరైనా చెప్పినా అది ఆచరణలో కష్టమే. చికిత్సల వలన కొద్దిగా మాత్రమే ప్రయోజనం చేకూరగలదు. ముందుగా చెప్పుకున్నట్టు శృంగార సామర్ధ్యానికీ, వీర్యానికీ సంబంధం లేదు.


కామ సంకేతాలు- స్వప్న స్ఖలనాలు

 

క్స్ మీద ప్రచారాల్లో ఉన్న అపోహలలో కొన్ని స్వప్న స్ఖలనాల మీద కూడా ఉన్నాయి. నిజానికి స్వప్న స్ఖలనాలు పురుషులలో చెలరేగే కామపరమైన కోరికలకు సంకేతాలే తప్ప మరేమీ కాదు. అదేమీ అనారోగ్య లక్షణం కాదు. యుక్త వయసు ఆరంభమైననాటి నుంచీ అంటే సుమారు 14, 15 సంవత్సరాల నుంచీ వీర్యం ఉత్పత్తి ప్రారంభమవుతుంది. ఎక్కువగా తయారైన వీర్యం కొంతమందిలో మూత్రం ద్వారా బయటికి పోతుంది. కొంతమందికి స్వప్న స్ఖలనాల ద్వారా పోతుంది.

స్త్రీలలో వీర్యం తయారవడం వంటివి ఉండవు కాబట్టి వారికి స్వప్న స్ఖలనాలు ఉండవు. అయితే స్త్రీలలో కామపరమైన కోరికలు కలిగినప్పుడు కొన్ని స్రావాలు ఊరడం జరుగుతుంది. నిద్రలో స్త్రీలకు సెక్స్ పరమైన కలలు వచ్చినప్పుడు యోనిలో స్రావాల వల్ల తడి అవుతుంది. చాలామంది భయపడేది ఇలా జరగడం నరాల బలహీనత అని. కానీ ఇది నరాల బలహీనత కాదు. అసలు సమస్య కాకపోయినా సమస్యగా భయపడడడం ఎక్కువగా సెక్స్ సంబంధ విషయాల్లోనే కలుగుతుంది.

అసలు నపుంసకత్వం అంతే ఏమిటో సరిగా తెలియక పోవడం వల్ల కూడా చిన్న చిన్న సమస్యలనే నపుంసకత్వానికి సంకేతాలుగా భయపడతుంటారు. నపుంసకత్వమనేది చాలా తక్కువ మందిలో కనపడుతుంది. నపుంసకత్వాన్ని సాధారణంగా రెండు తరగతులుగా వర్గీకరిస్తారు. మానసిక సంబంధమైనది, శారీరక సంబంధమైనది.

ఈ రెండింటినీ చాలా వరకు నయం చేసేందుకు చికిత్సలున్నాయి. ఇలా నపుంసకత్వానికి గురయ్యే వారికన్నా తమకు నపుంసకత్వం ఉందేమోననే అనవసరమైన ఆందోళన చెందేవారు ఎక్కువ. ఇలాంటి భయాందోళనలు వీడనాడితే సుఖమయమైన దాంపత్యానికి మార్గం సగం ఏర్పడినట్టే.


వీర్యకణాల ఉత్పత్తిలో లోపాలు – కారణాలు

 

వీర్యంలో వీర్య కణాల ఉత్పత్తి తక్కువగా ఉండడం వల్ల సాధారణంగా సంతానం కలగకపోవడం వంటి పరిస్థితి ఏర్పడవచ్చు. కొన్ని రకాల వ్యాధుల వలన వీర్య కణాల ఉత్పత్తి తగ్గిపోవడానికి అవకాశం ఉంది. వృషణాలకి క్షయ, కుష్టు, గనేరియా వంటి సుఖవ్యాధులు సోకినా, మరికొన్ని ఇతర వ్యాధుల వల్ల వీర్య కణాల ఉత్పత్తి తగ్గుతుంది. అసలు వీర్యకణాల ఉత్పత్తి ఎలా జరుగుతుందో ఈ వారం చూద్దాం.

వీర్య కణాల ఉత్పత్తి వృషణాల వల్ల జరుగుతుంది. బీజాలలో సుమారు 900 సెమినీ ఫెరస్ ట్యూబ్స్ ఉంటాయి. వీర్య కణాల ఉత్పత్తి జరిగేది ఇక్కడే. వీర్య కణం తయారవడానికి సుమారు 70 రోజులు పడుతుంది. వీర్య కణాలలో ఎక్స్, వై క్రోమోజోములుంటాయి. సంతానం సెక్స్ నిర్ణయించేవి ఇవే. గవద బిళ్ళల వల్ల వీర్యం ఉత్పత్తి తగ్గుతుంది. దీనితో సంతానావకాశాలు సన్నగిల్లుతాయి. ఇలా ఎందుకు జరుగుతుందంటే సెమినీ ఫెరస్ ట్యూబులలోని పొర గవద బిళ్ళల వల్ల మార్పు చెందుతుంది.

గవద బిళ్ళల వల్ల రెండు బీజాలలో వాపు కలిగితే వీర్య కణాల ఉత్పత్తిలో అవరోధం కలుగుతుంది. వెరికోసిల్ వల్ల కూడా వీర్య కణాల ఉత్పత్తి తగ్గుతుంది. బీజాలలో ఉష్ణోగ్రత పెరిగినా వీర్య కణాల ఉత్పత్తికి అవరోధం కలుగుతుంది. బీజాలు శరీర ఉష్ణోగ్రత కంటే తక్కువ ఉష్ణోగ్రత వద్ద ఉంచేందుకు అవి శరీరానికి బయట ఉంటాయి. ఏ కారణాల వల్లనైనా బీజాల ఉష్ణోగ్రత పెరిగితే వీర్య కణాల ఉత్పత్తి తగ్గుతుంది. బీజాలు రెండూ కడుపులో ఉన్న సందర్భాలలో కూడా ఇలాగే జరుగుతుంది.

కొన్ని రకాల హార్మోన్ల లోపం, మద్యం, ధూమపానం, మాదక ద్రవ్యాలకు అలవాటు పడడం వల్ల దీర్ఘకాలంలో దుష్ప్రభావాలను చూపుతుంది. హార్మోన్ల లోపాలు, వెరికోసిల్ వంటివి సంభవిస్తే వైద్యులను సంప్రదించాలి. వైద్యులను సంప్రదించడం వలన పూర్తి స్థాయిలో కాకపోయినా కొంతవరకైనా ప్రయోజనం చేకూరుతుంది. కొంతమందిలొ యాంటీబాడీస్ తయారవడం వలన వీర్య కణాల ఉత్పత్తి కుంటుపడుతుంది. ఇటువంటివారు వైద్యులను సంప్రదిస్తే సరిపోతుంది.


సెక్స్ వాంఛ – శరీరంలో నొప్పులు

సెక్స్ కోరికను అనుచుకున్న వారిలో కొంతమందికి, కొన్ని కొన్ని అపోహల వలన హిస్టీరికల్ గా ప్రవర్తించేవారికి శరీరంలో వింత వింత నొప్పులు వస్తున్నట్టు వైద్యులు గుర్తించారు. వీటిలో కొన్ని సందర్భాలలో నిజంగానే నొప్పులు ఉండగా, మరికొన్ని సందర్భాలలో ఆ నొప్పులనేవి కేవలం మానసిక భ్రమలుగా గుర్తించారు. ఈ నొప్పులు ఎక్కువగా స్త్రీలను బాధించేవే. అలాంటి నొప్పులలో ఒకటి పొత్తికడుపులో నొప్పి. సెక్స్ వాంఛ తీవ్రంగా ఉండి, ఆ వాంఛను బలవంతంగా అణుచుకుంటున్న స్త్రీలలో కొందరికి పోత్తికడుపులోనూ, కింద భాగంలోనూ ఒక విధమైన నొప్పి కలుగుతుంది. వారి కోరిక తీరినప్పుడు ఆ నొప్పులు వాటంతట అవే తగ్గుతాయి.

ఈ నొప్పులు తగ్గడానికి విడిగా మందులు ఇవ్వవలసిన అవసరం లేదు. కొంతమందిలో గర్భంరావడమో, బ్లీడింగ్ ఎక్కువగా కావడమన్నా విపరీతమైన భయం ఉంటుంది. కళ్ళలో వణుకు వస్తుంది. ఇదంతా హేస్టీరియాకి సంబంధించి నవి. ఇలాంటి భయం వారికి కలగడానికి అసలు కారణ మేమిటో మనసులో ఉంటుంది. తప్పితే, శారీరకంగా ఎటువంటి లోపాలూ ఉండవు. వారి మనసులో దాగున్న భయాలను తలుచుకుని మరీ ఎక్కువగా వాటి గురించే ఆలోచిస్తుండడం వలన ఇలాంటి నొప్పులు కలుగుతాయి. మనసులో అంతర్గతంగా ఏదైనా సమస్య ఉన్నప్పుడు, దానికి సరైన పరిష్కారాన్ని కనుక్కోలేని స్థితిలో ఆ వ్యక్తి ఆత్మ విశ్వాసం తక్కువగా ఉన్నవాడైతే అతని మనసు విచిత్రంగా ప్రవర్తిస్తుంది.

అటువంటప్పుడు ఆ మనిషి తన అసమర్థతను లేదా భయాన్ని దాచుకోవడానికి ప్రయత్నిస్తాడు. అలంటి స్థితిలో నుంచే ఇటువంటి భయాలు, నొప్పులు పుడతాయి. దీనివల్ల సమస్య నుంచి తాత్కాలికంగా పక్కకి తప్పుకుని ఎదుటి వారి సానుభూతి పొందుదామని చూస్తారు. కొన్ని సందర్భాలలో ఈ భయాలు ఎటువంటి రీజనింగ్ కీ అందవు కూడా. ఆ సంద ర్భాలలో సైకో థెరపీ వల్ల మాత్రమే ప్రయోజనం ఉంటుంది. ఒకసారి మనసు ప్రశాంతంగా ఉంటే మరే సమస్యలూ ఉండవు.దాంపత్య సంబంధాల విషయంలోనే కాదు, అందరికీ నిత్య జీవితంలో ఇటువంటివి ఎదురు కావచ్చు. అయితే దాంపత్య సంబందాలంతే ఇద్దరి జీవితాలకు సంబంధించినది కావడం, పైగా ఎదుటి వారిని రంజింప జేయాలనే ప్రయత్నంలో మరిన్ని సమస్యలు తెచ్చుకోవడంతో సమస్య పెద్దదిగా కనబడుతుంది.


ఒక్కసారికే హెచ్.ఐ.వి./ఎయిడ్స్ సంక్రమణ పరిస్థితి – 1

హెచ్.ఐ.వి. వున్న వ్యక్తితో ఒకేఒక్కసారి మొదటిసారి లైగికంగా పాల్గొనటం వల్ల హెచ్.ఐ.వి. సంక్రమించే అవకాశం కేవలం 0.1 నుంచి 1శాతం. - హెచ్.ఐ.వి. వున్న వ్యక్తీ రక్తాన్ని పరీక్ష చేయకుండా ఎక్కించుకోవటం వల్ల ఆ వ్యాధి సంక్రమించే ప్రమాదం 90 శాతం వుంటుంది. - హెచ్.ఐ.వి./ఎయిడ్స్ వున్న రోగికి ఇంజక్షన్ ఇచ్చి అదే సూదితో ఇంజక్షన్ ఇవ్వటం వల్ల వ్యాధి సంక్రమించే అవకాశం 5-10 శాతం వుంటుంది. ఇందులో ప్రధానంగా నరానికి ఇంజక్షన్ ఇవ్వటం ముఖ్య కారణం. కండకి ఇంజక్షన్ ఇవ్వటం ద్వారా వ్యాధి సంక్రమణ చాలా తక్కువ.

తల్లికి హెచ్.ఐ.వి. ఆమెకు గర్భం వచ్చి పిల్లల్ని కంటే ఆ పుట్టిన పిల్లల్లో 30 శాతం నుంచి 40 శాతం మందికి హెచ్.ఐ.వి. సంక్రమిస్తుంది. యాంటీ రిట్రో వైరల్ డ్రగ్స్ ఆవిర్భావంతో ఇటువంటి సంక్రమణ 5 నుంచి 10 శాతమే వుంది. హెచ్.ఐ.వి. ఉన్నవారు ఎయిడ్స్ రోగులుగా మారటం - హెచ్.ఐ.వి. సోకినవారిలో 80 శాతం నుంచి 8 నుంచి 10 సంవత్సరాల్లో ఎయిడ్స్ రోగులుగా మారతారు. - ఈ 80 శాతం మందిలో 10 నుంచి 15 శాతం మంది 10 నుంచి 15 సంవత్సరాల తర్వాత ఎయిడ్స్ రోగులుగా మారతారు.

- హెచ్.ఐ.వి. సోకినవారిలో 5 నుంచి 10 శతం మంది 10 నుంచి 15 సంవత్సరాలు తర్వాత ఎయిడ్స్ రోగులుగా మారతారు.

- హెచ్.ఐ.వి. సోకిన వారిలో అయిదు నుంచి పది శాతం మంది ఎయిడ్స్ రోగులుగా మారకుండా దీర్ఘకాలంగా హెచ్.ఐ.వి.తో పుట్టిన పిల్లల్లో ఎక్కువమంది 1-2 సంవత్సరాలలోనే ఎయిడ్స్ రోగులుగా మారతారు.

- యాంటీ రిట్రో వైరల్ డ్రగ్స్ ఆవిర్భావంతో ఈనాడు అత్యధిక శాతం మంది ఎయిడ్స్ రోగులుగా మారకుండా కేవలం హెచ్.ఐ.వి. పాజిటివ్ వున్నా వ్యక్తులుగానే మిగిలిపోతున్నారు. పైగా ఈ మందులు వాడటంతో వారి ఆరోగ్యంలో కూడా గణనీయమైన మార్పులు వస్తున్నాయి.

- మంచి పౌష్టికాహారం, చక్కని అలవాట్లు, పరిమితమైన వ్యాయామం, మానసిక ప్రశాంతత, పాజిటివ్ దృక్పథంలో వున్నవారిలో హెచ్.ఐ.వి. ఎయిడ్స్ గా మారటం చాలా ఆలస్యం అవుతుంది.


Responsibilities And Decisions of Pregnancy And Indications of Pregnancy

Responsibilities And Decisions of Pregnancy :-

Is it necessary to tell teenagers of the detailed process of pregnancy? Probably, yes. Rural populations often have a high rate of early marriages while urban populations, with more liberal upbringing, too have increased number of teenage pregnancies. It becomes imperative than to tell in a simple a way as possible all that happens in the female body as a new life is formed. The investment of the mother in a pregnancy is large and cannot be taken casually. In other words, pregnancy should be a conscious decision and not an accidental episode for women.
Encouraged by the society to do so, a majority of girls grow up to understand womanhood as an urge to bear children. In any individual woman, it is difficult to define this so-called urge to procreate. Sociologists clearly differentiate it from sexual urges. The special social status that a 'mother' enjoys, encourages young women to aspire for motherhood. With a better understanding of the world around them, women have started realising that they are 'creative' and not just 'procreative' individuals in the society, and would like to decide for themselves what womanhood and fulfilment mean to them rather than linking it up with procreational activity as id sone in most of our societies. Apart from social perception of all these aspects of womanhood, there is no doubt that for an individual woman, pregnancy is a rich experience. The bond that forms between the mother and the foetus lasts more than just in the womb and forms the backbone of relationships in the social context.

Indications of Pregnancy

Pregnancy can be detected as a physical change in the mother's body well after fertilisation has taken place. The absence of menstrual bleeding at an expected date is one of teh simple indications of pregnancy, though not a confirmatory one. The level of oestrogen and progesterone at this time is fairly high and causes more subtle changes in the body that can be easily preceived by the woman. There is a feeling of fullness and tenderness in the breasts, with a notable increase in size. Tingling sensation in the breasts and hardening of nipples occurs, as the breast tissue becomes more ductile. The surges of hormones also cause the so-called 'morning sickness', a feeling of uneasiness, nausea and vomiting. The intensity of this feeling is variable and may not happen in all pregnant women. All these indications of pregnancy are not confirmatory and only an actual measurement of hormonal status or physical examination is a reliable measure.
One of the hormones that is produced at early pregnancy is the human chorionic gonadotropin (HCG). Its presence can be detected in the urine sample of the pregnant women. Extremely sensitive and reliable tests have been developed that detect HCG in urine and confirm pregnancy.

 

The period of nine months and nine days counted from the expected date of bleeding of the missed menstrual cycle is the normal duration of pregnancy. This time varies marginally, depending on the physical and physiological status of the mother. On the basis of the changes that take place in the foetus and the mother, pregnancy is considered divisible into three time-frames, each of about three months muration. A continuum of changes spanning through the three trimesters adapt the physiology of the mother to handle the complex process of childbearing.


అంగంలో ఇంప్లాంట్స్ – 2

 

1970లో ఇది మార్కెట్లోకి వచ్చాక 2,50,000 అపరేషన్ లు అమెరికాలో చెయ్యబడ్డాయి. చేయించు కున్నవారిలో 95 శాతం మంది ఈ అపరేషన్ తరువాత సంతోషాన్ని వ్యక్తం చేశారు. కానీ ఒక పరిశోధనలో 75శాతం మంది వారి అంగం చిన్నదైనట్లు, 65 శాతం మంది అంగం సెన్సిటివిటి తగ్గినట్లు చెప్పారు. రతి భంగిమలు అపరేషన్ తరువాత కొన్ని మాత్రమే అవలంభించగలిగినట్లు చెప్పారు. 52 శాతం మంది వీర్యస్ఖలనమప్పుడు సెన్సేషన్స్ తగ్గినట్లు చెప్పారు.

ఇన్ ప్లేటబుల్ ఇంప్లాంట్స్ వాడినవారిలో మొదటిసారి ఇంప్లాంట్ వేసినవారిలో 4.3 శాతం మందిలో, రెండవసారి ఇంప్లాంట్ వేసినవారిలో 10.8 శాతం మందిలో ఇన్ ఫెక్షన్ కలిగినట్లు చూశారు. ఇన్ ఫెక్షన్ లు లేదా ఇతర ఉపద్రవాలు కలిగినప్పుడు ఇంప్లాంట్ తీసివేస్తారు. అంటే ఇంప్లాంట్ ఖర్చు, సర్జరీ ఖర్చు కూడా వృథా అన్నమాట. ఇంక ఇంప్లాంట్స్ ఎన్నాళ్ళు మన్నుతాయి అన్నది కూడా చూడవలసిన అంశం. అమెరికాలో ప్రస్తుతం లభిస్తున్న ఖరీదైన ఇన్ ప్లేటబుల్ ఇంప్లాంట్స్ సుమారు 5 సంవత్సరములు మన్నుతాయి.

ఇండియాలో కొత్తగా సెమిరిజిడ్ ఇంప్లాంట్స్ వచ్చాయి. 15 వేల రూపాయలు వాటి మన్నిక, ఉపద్రవాలు, వాడేవారిలో ఎంతమంది సంతృప్తికరంగా ఉన్నారు అన్న ప్రశ్నలకు సంపూర్ణ సమాధానం రావాల్సి ఉంది. అమెరికాలో ఎప్పటికప్పుడు కొత్తకొత్త పరికరాలు వస్తున్నాయి. అక్కడ పరిస్ధితుల బట్టి ఖరీదు భరించగలిగేట్టు ఉంటుంది. అదే మనదేశానికి వచ్చేసరికి చాలా కొద్దిమంది మాత్రమే వాటిని భరించగలరు. మనదేశ పరిస్ధితులు, ఇక్కడి ప్రజల ఆలోచనావిధానాలు, చూస్తే వీటితో ఎంతమంది సంతృప్తికరంగా ఉన్నారన్నది సందేహాస్పదమే.

ఇప్పటివరకు సెక్స్ సమస్యలతో వచ్చినవారు 45,000 మంది దాటారు. అనేక వేలమందికి అంగస్తంభన సమస్యకి చికిత్స చేశాను. ఒకరిద్దరు మినహా ఎవరికి ఇంప్లాంట్స్ అవసరం పడలేదు. ఇంప్లాంట్స్ నే మొదటి చికిత్సగా కొందరు చెప్తున్నారు. ఇంప్లాంట్ వేసుకోమని సలహా ఇచ్చినప్పుడు రెండవ డాక్టర్ సలహా తీసుకోవడం అవసరం

ఇంప్లాంట్ సర్జరీ వలన సహజంగా అంగస్తంభనకు ఉపయోగపడే కణాలకు నష్టం వాటిల్లుతుంది. కనుక ఇతర చికిత్సా విధానాలేవీ పనిచెయ్యనప్పుడే ఇది చెయ్యాలి. పార్టనర్ కి కూడా సర్జరీ విదానం గూర్చి, సర్జరీ తర్వాత ఎలా ఉంటుందో వివరించాలి. అందువలన సెక్సాలజిస్ట్ ని సంప్రదించి ఆ తర్వాత యూరాలజిస్ట్ చేత ఈ అపరేషన్ చేయించుకోవాలి.


How Men's Organs develop and works

Here now are the details about the sex organs of men. These are a remarkable and complicated system of glands, tubes, and containers designed to manufacture the male reproductive cell, called the sperm, to store it, and to deliver it into the woman's body. A man's most obvious sexual organ is penis, which is usually about the length of a finger, although somewhat larger around. It has a small tube which runs from the bladder down through its centre.

One purpose of this tube is to empty urine from the bladder. The other purpose, about which I shall say more later, is a passageway for the sperm. At birth the end of a baby boy's penis is usually covered by a sheath of skin called the foreskin. It is possible to push this skin back, but often it is removed by the doctor just after the baby's birth. This makes it easier to keep the penis clean. Removing the foreskin is called circumcision.

Under the man's penis hangs a sac of loose, crinkly skin called the scrotum, which contains the two testicles or testes. These oval-shaped glands, each about 1 1/2 inches long in a grown man, are where the sperm, the male reproductive cells, are made. In most men, one hangs lower than the other.

Behind and against each testicle is a storage place, the epididymis really a collection of about half a mile of tiny tubes where the millions of sperm cells are matured as they pass through. Each sperm cell is shaped like a tadpole with a long, thin tail and is so small that five hundred of them placed end to end would take up only an inch. Sperm can be seen only through a microscope. From the epididymis teh sperm cells travel through a long flexible tube, the vas deferens or spermatic duct, toward the seminal vesicles, which are two small storage pouches at the back of the prostate gland.

The prostate secretes thick, milky liquid that mixes with the sperm. This mixture is called semen and is stored in the seminal vesicles, the prostrate, and the upper part of the vas deferens, ready to be discharged through the penis and to start the sperm on its way to the egg cell in the female. When a man is sexually stimulated, a remark- able change occurs in his penis. This change is called erection. It is caused by his body quickly sending a supply of blood into the spngy tissues of the usually limp penis.

The penis then grows firm and erect and increases in diameter and in length, becoming commonly from 5 to 8 inches long in a mature man. It stands out from the body at an angle and is then ready for sexual intercourse. The shape and angle of the erect penis differ with different men.


Understanding about

What can be more important, in fact, than the study of the principles upon which rest the happiness of man and woman, by reason of their mutual relations; relations which are themselves dependent upon character, health, temperament and the social laws.

As is said we need not fear to compare the pleasures of the senses with the most intellectual pleasures, let us not fall into the delusions of believing that there are natural pleasures of two sorts, the one more ignoble than the other:the noblest pleasures are the greatest.

Thanks to Freud and his successors, we now largely believe sexual behaviour and attitudes follow patterns implanted in childhood, when the mind is not impressionable. But here having a limited space in this book, it is of little importance to go into the psychological explanation or believe early influences create a series of conditioned reflexes.

The only important thing is behaviour, to be regarded in a new light suiting to our modern conditions and which would otherwise seem incomprehensible. All this reminds us of contamination and repetition of childhood patterns.

For example, it is normal to be interested in excretion and urination in childhood. The discovery of bodily functions is innocently facinating for a small child. Speaking of children who are much all alike, a girl will prefer to play with dolls whereas a boy will prefer to play with some other objects and toys than the dolls.

It is very hard to prove if the difference is instinctive or acquired. The differences are physiological is true. As is proved to recent researches which indicates that there are actual and quantitative differences in the hormones at an early age. The real differences develop only somewhere near or between the age of 12 and 13.

These are anatomical, physical, mental and emotional. In a girl usually the hip girdle broadens, the breast begins to develop and there is further deposition of fat in the tissue beneath the skin which gives to the female form the rounded contours lacking in the male. Public and axillary hair develops and the menstruation begins.

All these changes may begin as late as sixteen years of age in a girl and be within normal limits. In a boy quite different changes take place. The shoulder gridle broadens, the beard as well as the public and axillary hair develops. The voice changes. The above changes are brought about by substances called hormones.

The period, in which the changes begins in a boy or a girl is called puberty. The next is adolescent age during which mental, emotional and physiological maturity develops. And this is the age during which a growing personality must become completely socialized, so as to take a useful place in the society.

But the training of the sexual part of an adolescent's nature should be and is of importance. It should be looked upon as a previlege and a responsibility and not a problem for elders to guide younger persons in their attitudes toward life/ And its a very big responsibility to show them the right attitudes.


Modern Techniques about ...

Dr. A.A.Brill, the eminent psychoanalyst who translated many of Freud's works, once wrote. "I am compelled to say a few words of warning against those "psychoanalysts'' or rather pseudo-analysts, who preach sex freedom, free sexual expression and similar slogans.

Unfortunately, we cannot prohibit anyone from calling himself a psychoanalyst, but I wish to say that neither Professor Freud nor any of his pupils ever advocated any such pernicious nonsense. As long as civilazation will endure, sex will have to be controlled, and only irresponsible imbeciles believe that one can run riot with sex".

And that wise Omar Haleby said, "In order to perform coitus according to Divine Law, complete knowledge and full mastery are needed of all things concerning man and woman.

"Encyelopaedia of Sexual Knowledge'' difines: "Love-play is not an invention of vicious or detergent people, but a physological necessity, and we must no more hesitate to discuss it than we do other manifesta tions of sexual life'' Childhood curiosity about sex is just childhood curiosity. It is the adult who reads into it with a perverse interest.

If the natural curiosity is satisfied as each question arises, no abnormal interest will develop. Somewhere early in the teens a natural interest in the opposite sex develops, it is quite beyond the power of the individual or of society to eradicate it, or to stamp it out. If handled carefully, it can be directed into a productive channel.

If it is mishandled it can appear in numerous forms harmful to the individual and the society itself. It will be better to direct than to deform it and ignoring it can be suicidal. Some people appear to be afraid that in studying sed in the impersonal attitude of science we rob it of its charm, the mystery, the romance that should shroud it from prying eyes.

On the contrary, we can add a great deal. We explain nothning away. What is explained is just as real as ever. But we are no longer afraid of it. Free from fear and supersition we can put sex to work for the real benefit of mankind. If the sex is properly understood, it helps to mould our altruistic impulses It ought to be the basis of our deep interest in humanity and future generation.

 

So we must use it with all our intelligence. It is the perversities of human nature which arises out of emotional forces and not from the intellect. In the words of Shakespeare "If to do were as easy as to know what were good to do, chapels had been churches, and poor men's cottages princes places''

Therefore, we should know fro our own good that by using the scientific terminology for the sexual organs and process we can reduce the emotional content. But at the same time it can not be entirely done away with. We must remember that by being natural, we might achieve a certain animal level of sexual activity.

But only by applying intelligence to subject we can arise it to a human level. It requires a great deal of tolerance as a part of one's makeup to begin the study of sex. Of any preconceptions will have to be sat aside.

According to the Greek Philosopher Heracitus "We must check our pre-conceptions at the port of entry. When something is said that you find hard to accept, stop for a moment and consider. It is so easy to be rationalist about other's fallacies, but so hard, sometimes, to see our own'' When natural curiosity about sex is denied normal expression,

when such a strong primal instinct is forced undercover, when what you are most interested in must be repressed, when because of social pressures, expressed or implied, you do not dare admit your curiosity of interest even to yourself, you are setting the stage for neurisis.

The above discovery was made by that great Sigmund Freud. These neurotic repressions or conflicts starts from the very childhood. In showing the harm caused by repression, psychiatry has shown us other reasons for the "strict'' attitide towards taken by society. This is a fact that sex is nothing new in the world.

It has been with us since there has been any life above the single-cell stage. The present generation has come a long way since then. Everything is changed now including the significance of the sex. Sex has become something more than the mere process of Reproduction. Reproduction is very essential hence it ought to be studied.


Talk Plainly About Love and ...

After school one day I gave a lift home to a young school boy I was teaching. He had read a book I had written about junior high school, and he asked "mr.Johnson, are you ever going to write another book?''

I told him I planned to write on about sex and that it would be primarily for boys and girls his age. "I'm having a hard time deciding how much to put into it'' I told him. "prehaps you can help me. What do you think people your age want to know about sex?''

"Everything!'' he replied at one and with a sure smile.

And every secondary school child I have talked with since then has given almost the same reply "everything'' So I decided that in this book I would try to tell everything, and to tell it plain language. Bit before we get down to the detailed facts of sex and love, I want you to understand a few general ideas, which will help you to understand the facts better.

Everyone of almost any age is interested in sex, in the difference between boys and girls and men and women, in lovemaking, in what starts babies, and in how they develop and are born. They are interested in questions about sexual behaviour and feelings, about sex outside of the family as well as inside.

Your own interest in these things even though you may find it difficult to admit it to everyone or even to yourself, is perfectly normal. After all, why shouldn't a person want to know all about such an important and universal a thing as sex?

Without it the human race would soon disappear. Also, it effects our most important human relationships and can be one of our greatest pleasures. Many parents and other grown-ups are uncomfortable when they try to talk with boys and girls about sex. Perhaps your parents have talked with you about it; perhaps they have not.

Perhaps, like many adults, they have been brought up to believe that sex is very personal and private. Thus, it is easy to understand why they may hesitate to discuss it with you. A young girl wrote to me once saying that it was difficult for her to get any information about sex from her parents because she was too embarrassed to start asking questions.

She told me that when she finally did get the courage to ask one, her father said, "see your mother''and mother said, "I'm busy'' Perhaps after you have read this book you will be able to ask questions and express opinions more easily, and that will make it easier for your parents to try to answer and to listen to your opinions and give you theirs.

Because people's interest in sex is no natural and so strong, yet because people so often don't want to talk about it, many wrong ideas get passed around. You can help others as well as yourself by learning the facts and by correcting any wrong ideas you may hear.

If you have questions that aren't answered, the only intelligent thing to do is to ask them of a mature person you respect and who knows the answers, preferebly your mother or father, your teacher, clergyman or doctor.

And, of course, there are lots of questions about sexual behaviour that you will keep trying to answer all your life. Many boys and girls don't like to admit there's anything about sex that they don't know. Surely the best policy is to admit you don't know and to find out. Most people will respect you for this.

Sex is a powerful urge. By the time people reach their middle teens, their interest in and desire for sexual activity may be very strong. However, the strength of the sex urge varies from person to person and from time to time, and in many people other interests are stronger.

The important thing for you to know is that sex can be wonderful expression of love between people and can give great pleasure. But it can also cause much suffering if used selfishly or ignorantly. It can create families and bind them together; it can damage and disrupt them. Later chapters will say more about these matters.


Modern Techniques about 2

A girl usually gives one certain sign of puberty, the development of the breasts. At the sign of this the girl should be told all about menstruation and be provided with her own equipment to cope with it. In case the girl's mother or any other female is not with her at a place at the time of menstruation, it will be much better for her to be prepare to cope with the situation.

She should know that it is normal procedure and that it should not cause too much discomfort. Such knowledge will save the girl not only from embarrasment, but she will also subsequent menstruations painful. It is better to have a bath with the warm water if it's possible.

WHAT IS MENSTRUATION?

Menstruation is nothing serious but the weeping of a disappointed uterus. It occurs when the uterus, having pre- pared itself to take care of a fertilized ovum, is not called to do so. The mucous membrane lining the uterus, the endometrium, shreds off and comes away with some bleeding. In menstruation, the amount of blood lost is commonly exaggerated. The average normal amount is one ounce (two table-spoonfuls). More than two ounces is pathological, meaning you should see your doctor if it all happens to you.

This is not to be taken as bad blood, poisonous blood, or getting rid of impurities from the blood. This occurs every twenty-eight days. That is the average. But it may vary from twenty six to thirty-two or three and be within limits of normal. It may last two or three days or four or five days. May be a boy or a girl has been guided sanely through infancy and early childhood, adolescence raises some other questions that must be dealt with.

Some of the vital questions like auto- erotism or mastur-bation, sexual dreams and the so called venercal disease force themselves on the attention of adolescent. They arise because of changes in the consciousness of the individual owing to the functioning of the gonads.

How the hormones do it, they sensitize the nervous system we do not know. But we know for sure that it is the hormones that do so and that they are produced by the gonads is easily demonstrated. For if they are removed in the youth, the characteristic anatomical changes do not take place at puberty and an emotional interest in the opposite sex does not develop


What Men Fear Most About ...

1. Fear of Being different  : Of all questions “Am I normal?'' has probably been the most frequent question. Men want to know if they resemble other males in their sexual behaviour and if whatever they are doing sexually is the accepted, “normal'' way to have sex.

Men with this fear of being different are greatly relieved when told that the concept of sexual “normality'' is utterly meaningless. Rather than waste time in futile comparisons, it is far better for a man to be concerned about whether he's physically hurting himself or someone else with his sexual behaviour, and if he's truly enjoing whatever kind of sex he engages in.

2. Fear of Impotence : If masculine sexual fears were ranked in order of prevanalce, anxiety about impotence would probably be in first place. Ironically, it is this fear itself which is the greatest cause of impotence.

Most men experience sexual difficulties when they've had too much to drink, are exhaused, or have something on their minds and simply don't desire sex/ Unfortunately, their problems have an immediate and visible symptom.

Worse, failure to have an erection on a particular occasion, which sooner or later happens to nearly every man, may bring on a continuing anxiety about the next time. And this can become a self-fulfilling prophecy. There is no possible way a man can will himself to have an erection, but there is something he can do about temporary impotence.

By shifting his focus from the immediate goal – that is, attaining an erection – to the process of mutual excitement – stroking his partner, touching her, maintaining erotic contact – the temporarily impotent man will often attain his erection after all.

While there are some physical causes of impotence, the psychic causes are many and complex. During the past decade, however, Masters and Johnson, as well as other sex therapists, have made great progress identifying and, by the use of various clinical techniques, alleviating these causes.

3. Fear of Premature ejaculation : This problem afflicts men of all ages, and anxiety over possible repetition often becomes another self-fulfilling prophecy. The cause of premature ejaculation is almost always psychological.

The brain gets the signal that release is imminent, but for various emotional reasons the normal inhibiting mechanisms fail. By increasing the frequency of sexual contact, many men are able to delay ejaculation on the second or third attempt.

Naturally, this is easier for very young men, who are able to attain a new erection soon after the first ejaculation, but older men can accomplish the same thing with time and patience. Most sex therapists have demonstrated remarkable success in helping men overcome this problem.

And some men – particularly those with an understanding sex partner – have been able to help themselves by analysing their difficulty, pinpointing the psychic causes, and then learning to exercise control.

4. Fear of failure to perform : A man may show no signs of impotence and heve no difficulty in controlling his ejaculation, yet for him every sexual encounter is an anxiety-producing situation.

Once more, the barriers are psychological. Behing the fear of failure is a fundamental anxiety – the fear of being rejected. Performance anxiety is not an easty problem to overcome. If a man is lucky, his sexual partner will understand if he doesn't perform every time on demand.

The worried man can help himself, too, if he understands that performance doesn't necessarily mean insertion of the penis, since female orgasm can be achieved in other ways.

 


How Woman's Organs Develop and Work

Now let's turn to specific facts about sex. In this chapter I'll tell you about girls and women, and in the one that follows, about boys and men. You may have seen something of the sex life of domestic animals ; you know where kittens and puppies come from and, even if you live in the city, where calves and lambs come from.

You know that a dog is either a male or a female and that it is easy to tell which, and that the same applies to people. Here now are the details about the sexual system of the woman. As I explain to you, refer to the drawings of a grown woman on the following page and to the more detailed diagram of hier genitals - sexual parts.

The ovaries are where the egg cells (ova) are stored. These two organs are inside the lower part of the abdomen, one on either side and are the shape of a flattened oval and about 1 1/4 to 2 1/2 inches long. When a girl baby is born, her ovaries already contain, in a undeveloped form, tens of thousands of of them will matuture during her lifetime.

But the ovaries are inactive until a girl reaches puberty. Then, around the ages of eleven to fourteen, they begin a monthly process which is repeated more or less regularly until a woman reaches the age of forty-five (or possibly younger) to fifty-five.

During these thirty to forty years, every twenty-one to thirty-five days, a mature egg (ovum) is produced by one or the othery ovary. (The ovaries do not necessarily alternate the task) The egg cell is very small. A row of two hundred would be only about an inch long.

The ovum bursts through the surface of the ovary and enters the fallopian tube just next to it, helped by the tube's fingerlike fringes, called fimbria. This process is called ovulation, and ocassionally some women can feel a twinge in the lower abdomen within a day or so of the time it happens, but not always just when it happens.

After ovulation, the ovum is moved slowly down the fallopian tube toward the uterus (also called the womb, pronounced 'woom'). This organ, located between the ovaries, is pear-shaped and about 3 inches long in a mature female who has not had children.

It is muscular and elastic and can grow and stretch to many times this size, The uterus is the organ in which a baby grows until it is ready to be born, and whose powerful muscles help to push the baby out through the vagina into the world.

Every month or so the uterus prepares for a fertilized egg, an egg which may grow into a baby. It creates a nourishing soft webbing, or velvety lining, of tiny, delicate blood vessels - a perfect place for the egg to grow in.

If an egg is fertilized, it has already started to grow by the time it enters the uterus, about three or four days after it left the ovary. However if an egg is not fertilized, it stays alive for only about twelve to twenty four hours after entering the fallopian tubem and then it breaks up and is absorbed into the body.

In this case, the growing place in the uterus is not needed, and the lining, blood, and blood vessels are discarded through the vagina and out of the body. This monthly event is called Menstruation (when a woman says she is 'having period')

 

IN NEXT PART LET'S KNOW ABOUT MENSTRUATION


Menstruation ....

Menstruation is not bleeding in the ordinary sense of the word, although the fluid is red and contains blood, on the average about three tablespoonfuls. Menstruation is mainly the discarding of some blood and tissues that are now of no use.

How can a girl know when she is about to have her first period? The 'timetable' is different for each girl. In both boys and girls, generally somewhere between the ages of nine and eighteen, there occurs a period of rapid growth that we call a growth spurt. It lasts about three years, and during the girl' time of greatest growth, her height increases from 2 1/2 to 4 1/2 inches in a single year.

Girls generally, not always, begin their growth spurt about two years before boys. This means that from the ages of a little over eleven until about fourteen girls go through period when they are. A girl's first menstruation may come at almost any time during her growth spurt, or sometimes even after it is over.

Most often, however, it comes about three-quarters of the way through, and a year after her year of peak growth. On the average - and remember, most people aren't just at the average - about three to four years before a girl's first menstruation bere breasts begin to swell. In most girls, the breasts become noticeable two or three years before menstruation.

A year and a half to two and a half years before, public hair appears above her genitals and, about six months before, other haif appears under her arm. A girl's first menstruation is the sign that she has reached puberty, that she is becoming capable of her part in producing a child.

However, in many girls there is a gap of several months to a year or more between the first menstruation and the first ovulation. In other words, the first menstruation does not necessarily mean that a girl is immediately capable of having a baby.

On the other hand, it is possible for a young girl to become pregnant even before her first menstruation; that is, a few girls may ovulate for the first time before they ever menstruate.

Generally, the first menstruation occurs between the ages of eleven and fourteen. However, some girls menstruate as early as nine, and a few not until they are fifteen, sixteen, or seventeen. No girl need worry because she arrives at any part of the timetable sooner or later than her friends; she is almost certain to be ahead of some and behind others.

If she is worried, it is a simple matter for her to be examined by a gynaecologist - a doctor who specializes in the health problems of women - for assurance that her development is normal, and for any needed treatment if it is not.

When a girl begins menstruate, it means that her body is now maturing, but not for several years will she be mature enough to undertake the responsibilities of marriage and childbearing.

Menstruation marks the begining of adolescence for girl. Adolescence is the period of perhaps eight years during which a girl is neither a child nor an adult, but a person on the way to becoming an adult.

 

 

MORE DETAILS ABOUT MENSTRUATION IN NEXT EPISODE


What Men Fear Most About ... 2

5. Fear of inadequate penis size : A greart many men worry about penis size. This anxiety is based on the common, erroneous belief thata a flaccid penis gains in size proportionately when it becomes erect. Though penises are different sizes in their flaccid state, when erect, they become much more similar. And the irony is that size differences seldom matter much to most women. The real issue is not how large a man's penis is; it's what he does with all of his lovemaking arsenal.

6. Fear of ageing : What many men fear most about ageing is that the time will come when they can no longer function sexually. As Kinsey documented, maless are at their sexual peak when they are about 18. Reasearchers have since made clear, however, that the downhill slope after that age is really a gently lowering plateau which is lifelong. Yet it is commonplace for men literally to talk themselves into an end to their sex lives at some limit they have consciously or unconsciously set themselves – 50, 60 or (if they're optimists) 70. Of men actually impotent at 70, it is questionable how many are made so either by severe physical illness or by their own psychological barriers. There is no physiological reason why a man cannot have erections as long as he lives, provided he is physically healthy.

7. Fear of insatiable demands : Contemporary literature and motion pictures, plus much of the rhetoric accompanying the women's movement, have tended to magnify what was once only a minor problem for men – the image of the insatiable female. The truth is that there is the widest possible variation of sexual needs among both men and women. One of the freedoms liberated women have achieved is the knowledge that their bodies are their own, and that they don't have to give into a man's sexual demands if they don't want to. It would be equally freeing if men who fear the inability to satisfy a partner's demands would understand that they are under no such obligation either. As men and women learn to accept one another as equals and to realize that each has individual sexual needs, this fear is certain to decrease.

8. Fear of latent homosexuality : Virtually every man has read or heard about males who remain unaware of their homosexuality until some crucial event leads them to discover. Among men who feel a strong taboo against homosexuality, this can lead to an intense fear of such an uncharted sexual area in themselves. However, most men who are predominantly heterosexual need not fear that the patterns of their sex lives are going to be overturned. They should remember that in early childhood and adolescence almost every boy has some kind of homosexual contact; yet almost every one of them grows up to lead an undeviatingly “straight'' life.

9. Fear that a wife will become sexually interested in other men : The conventional idea in our male-oriented culture is that the husband is the one who strays, the wife, the one who agonizes over his wander- ings. In many instances today, however, the burden of fear is on the man. The feeling of possessiveness, so much a part of the “macho'' mentality, and the jealousy which inevitably proceeds from this feeling, have caused endless misery and violence. Yet the domineering man who believes he owns his wife, wants no one else to have her, and constantly feels that the infidelity is only a matter of time and opportunity, may be suffering from fears of his own inadequacy. Changing the perspective of this man is essential, and a woman who understands this and works quietly to reassure him has more chance for an equal and happy relationship than one who responds to his jealousy with outrage and anger. Other men, of course, have a different but related problem in this area; they have every intention of remaining faithful, yet have fantasies about other women which will they fail to recognize as perfectly normal. These men fear that they will act out these fantisies with the same inevitability the jealous man ascribes to his wife. Their fear is usually groundless. Both men and women must understand that fantasies can be a rich enhancement of life, not a dread precursor of overt behaviour. Fear and guilt have done more damage to the sexual lives of men – and women – than can ever be calculated, and while most of us understand this, using that knowledge to improve our own lives is often difficult. A woman who truly understands the fears that afflict men, and how disastrously they affect love relationships, can make great progress towards eliminating those fears. Professional counselling may be needed in the end, but responding to masculine sexual fears with understanding and co-operation is the first and most important step, and often nothing more may be necessary. No man or woman lives without any fear. But we can eliminate the groundless fears about sex that impede or prevent the fulfilment of one of our greatest desires.


Women's Desire in Modern Techniques of ...

The above is the psysiological basis for our sexual emotions. If we are to control and direct them we must recognize this. The "Sexual drive'' the force of the spontaneous interest of a boy in a girl or a girl in a boy is very great. If you are honest with yourselves, you know it from your own experience.

Modern advertisers take advan- tage of it and capitalize on it. This power of suggestion and its influence in modifying the sexual drive must not be underestima- ted. Human society and its psychological value is entirely different thing.

Apparent modifications of the sex drive are not necessarily due solely to changes in gonad function. Decrease in or complete loss of sexual desire does not always mean inadequate function of the gonads or excessive sexual desire, increased function. Such changes may be entirely the result or psychical emotional disturbances within the mind of the individual.

When the sexual drive first mekes itself felt, antoerotic experience is so common as to be most universal. Antoeroticism probably preceds interest in the opposite sex. It may be completely spontaneous impulse although it is frequently learned from an older or mere experienced companion.

In boyhood or childhood it may be a pleasurable experience of little true sexual significance. After puberty sexual interest certainly develops and is present desire to give out a sigh of you or move actively in their acts. The husband should be patient and gradually remove her sense of embarrassment.

It is useless to tell such women that the book says she shoud not be embarrassed. As a start the husband might suggest to her that they try the man-supine position.

Or he might suggest switching to the mansupine position in the middle. Also, it might be a good idea to choose a position in which the woman bends and raises her legs so that she is compelled to move naturally. In this way, she will come to realize how much he or even she herself missed the wonderful feeling of the woman performing the movement.

Atleast she will realize how senseless it is to be bashful in front of the man she loves. Thereafter, she is most likely to cooperate with him in their sexual movements. Some women have never heard of a woman offering cooperative movement, but even if they knew, they never realized that it could be so satisfying that it is well worth an initial movement's embarrassment.

A comparatively large number of women unconsiously cooperative in the sex movement only at the moment of orgasm. But some have the notion that it is not nice to move even at the climax and they should lie still.

Woman in Man's Place : - It is often said that the masculine and feminise traits are blended in both men and women. This is quite true. Even the most masculine man has some feminine elements. The feminine traits in the man are proved by his image of an ideal wife.

A woman who is good lover, and a good mother, who can serve as his sister at times. She must be intelligent and an excellent house-keeper, but in bed she must act like a professional women. The reverse can be said of the woman who has masculine traits.

Her ideal husband would be a good lover and father who can be her brother and sweet baby. He must be economically capable and a respectable member of society with a strain of tenderness in his rustic fiber. But it must be noted that in many instances the woman's mascu- line element, as men see it, consists largely of motherly love.

Aside from very feminine women, who are extremely sensitive to shame, most women would at times want to take the men's position and play the leading role in sexual intercourse. If a man takes this desire as arising from the women's ambition to put man under her control, he cannot escape the blame of false prejudice.


Precautions to Girl's in ...

Menstruation can be inconvenient. Some women, half-humorously, even call it 'the curse'. When menstruation starts, many girls use a disposable pad or napkin to absorb the menstrual flow. It is made of cellulose or other absorbent material in a guaze covering and comes in two or three sizes.

It can be held in place along the opening of the vagina by an elastic panty, a belt, or a sticky backing that clings to the panty. Many girls use a different menstrual aid called a tampon or insert. Tampons also come different sizes. They are made of absorbent material shaped into a small roll for easy insertion into the vagina, where they absorb the flow.

Some girls may not at first be able to use a tampon because the entrance to vaginal is partly closed by a membrane called the hymen. (A membrance is a thin, sheetlike layer of living tissue.) However, if they start with a small-size tampon and slowly stretch the hymenal opening, most girls soon will be able to use this convenient menstrual aid.

Many perople mistakenly believe that it is possible to tell whether or not a girl is a virgin (a female who has not had sexual intercourse) by whether her hymen is unbroken or broken. Howeverm this is not a reliable sign, because in many girls an ample opening in the hymen develops quite naturally, or the hymen may even be almost entirely absent at birth.

When a girl is approaching her first menstrual period, she should talk with her mother and get the needed equipment. Sometimes girls and women find the few days before and during early menstruation difficult. They may have abdominal pains or aches in the lower back as the muscles of the uterus contract to discard the undeeded lining.

They may also have headaches or feel depressed and edgy. Tears or temper may come rather easily. Girls can be comforted by knowing that many women feel the same way, that the feelings will go away in a day or two. Sometimes a girl needs the advice of a doctor to help her have a more comfortable menstrual period. It may take more than a year for a girl's menstrual periods to become somewhat regular, but this should be no cause for worry.

In many women, the periods never become entirely regular, and for almost all women there are occasional times or irregularity. A girl should lead her normal life during her period. She may participate in school sports. If she swims, she should use a tampon.

Cleanliness is important during menstruation, as at all other times, and it is helpful if a girl bathes or showers every day and changes the pad or tampon at least every six hours, especially during the time when the flow is full. Usually between ages forty-five and fifty-five a woman goes through a process called menopause or change of life.

At the end of this period, her overies discharge no more eggs and menstruation ceases. It does not mean the end of sexual life - only that she can bear no more children. She can still enjoy sed; in fact, she may enjoy it even more now that there is no possibility of her becoming pregnant.


A Love Nearly Missed

“Is that nice-looking man your grandfather?'' the woman on the beach asked nine-year-old boy. Actually the man was boy's father, a man who fathered his first child at the age of 40. “No'' said the boy “he's my great-great grandfather. He;s over ninety years old, and he rode his bi- cycle all the way here, 650 kilometers'' boy went on, reciting the litany his father and taught him to deflect questions about their family.

The woman fled in embrassment. When boy told his father about using 'the great-great grandfather story again, they laughed and went to play. Boy and his father are unusually close, one of the hallmarks of relation- ships between middle-aged parents and their children. How precious to have a new person to protect and love just when one is supposed to be ending the game. Perhaps, too, middle-aged parents savour the early moments as insurance against events they may miss: graduation, wedding, the birth of a grandchild.

For there is a shadow that falls over middle-aged parents happi- ness. Simply put: there often isn't enough time. Or if their children's achievements are not missed, they carry a special poignancy.

A friend tells me of her gradua- tion, at which she was intro- duced to hell room-mate's 80- year-old father. He had come a long distance, despite ill health. And his eyes shone with pride. He had lived through a midlife dicorce, growing older and becoming more and more lonely; then a miraculous love resulted in a second marriage at the age of 56, and he fathered a child at 58.

This child's graduation was a culmination for him. No one could claim that having a child later in life is all euphoria and savoured moments. And yet the people who do it feel grateful; on balance, they are winners.

These children are growing up with parents who are wiser, richer and more experienced – even if a bit slower, less athletic and more conser- vative. How is this going to shape the children's personalities and world views? For one thing, these youngsters may well be more stable than their peers, reflecting their parents more conservative values.

In addition, overall mental health might be improved, because many middle-aged parents are motivated by an acute sensitivity to mental-health issues. Thomas Greening, a 54 year old Los Angeles psychologist who had the first of his two daughters at the age of 40, exemplifies the late parent for whom mental health is an overriding concern, Why did he wait so long to become a parent?

“Parents transmit their neuroses to children'' he says. “My childhood was filled with deprivation and strain; I didn't want to perpetuate that pattern, I knew, during my twenties and thirties, that I hadn't sufficiently healed my resentments about the past. I was forty before I felt clear, open and generous about the prospect of nurturing another''

Greening's daughters have been the great joys of his life, and he's certain that they've benefited by his waiting. “These girls have grown up in what I think of as a very positive atmosphere for children,'' he says “My wife and I relish our daughters. You watch their openness, and the originality and joy they bring to everything they do, and it brings you back to centre.''

Other couples are postponing the start of their families for economic reasons. They delay raising a family rather than give their children less than they themselves had. Another practical reason for waiting is that older people may have more time to spend with their children and are often more eager to than when they were younger and concentrating on their careers.

Fillmore Crank, a sixtyish man with a perpetual benign smile, found a new beginning with a second wife. When he compared child-raising the second-time around with the first, he discovered that he has more committed as a mature father than as a young one.

“When you're young, you're still attached to your freedom,'' he says “In my first marriage I was always itching to get out of the house and have fun. No more. My wife and I love to be with the kids. There's a stability to this family that young couples don't always have''

These advantages, however, are not achieved without a price. People do lose stamina as they age, and little children can be exhausting. As one tired wife puts it, “Once in a while I wondered if my son was keeping us young or sending us to an early grave'' A problem facing prospective middle-aged mothers is the decline in fertility.

Experts deffer as to how quickly fertility decreases after the age of 35, but it may take months or years for a woman in her 40s to conceive a child. Because infertility is such a daunting problem, women who wait to have children should take preventive measures.

Once a Woman reaches the age of 35, her ability to conceive a child decreases. Yet, according Charles Ledergerber, associate clinical professor of obstetrics and gynaecology at the University of California at Los Angeles,

“Women who monitor their reproductive abilities with a competent doctor have an excellent chance of remaining fertile as they age'' Here's what Dr.Ledergerber recommends :

1. A woman who hopes eventually to have children should get rid of her IUD. An IUD can bring an inflammation that might close the fallopian tubes, thereby causing infertility.

2. If over 30, she should get an annual check-up from her gynaecologist to detect endometriosis (appearance of uterine-lining tissue in the abdominal or pelvic activities) early enough to treat it.

3. Infections also should be treated immediately, since they can cause tubal damage.

4. She should use proper contraceptive techniques so that she never needs an abortion; an abortion may decrease a woman's reproductive health.

Another problem faced by older women who want to bear children is the risk of something going wrong during pregnancy. “Although there are no firm statistics on miscarriage'' says Dr.Ledrgerber “many of the causative factors associated with it – such as fibroid tumors, endo- metriosis, pathology of the ovary or uterus, and chromosome anomalies are likelier to occur in older bodies than in younger ones''

Once an older woman has managed to get pregnant and hold on to her foetus, she must face that women over 40 have a greater chance of giving birth to defictive child. True, most birth defects can now be detected by amniocentesis (a procedure that extracts amniotic fluid from the mother's womb during the 14th or 15th week of pregnancy), and a defective foetus can be aborted.

But this doesn't help those with convictions against abortion. Still, most older women give birth to healthy babies. Prayers are answered. If you watch middle-aged parents in parks and on the street the healthy lined faces smiling into the small incandescent ones – you notice that they exult in their children in a special way.

Their children are the long-sought after prizes of a lifetime. They seem always aware that this love was nearly missed. They were tempted to stay locked in their individualistic cocoons, but they didn't. And there is child, this bright face, like a spot of late summer colour in an autumn field.


FRIGIDITY CAUSED BY MAN

The woman's psychology may differ from those of psychoanalysts.

1. The woman wants to treat the man like a body. She wants to satisfy her motherly instinct. To do so, she must change places with him. With her partner lying on his back, she usually prefers the man supine position in which she lief flat on him and is not too eager for the sedentary position. If a woman prefers the latter posture to the former without her partner's urging, then we may trace her desire to her masculine element rather than her motherly qualities.

2. She doesnot intend to make a woman out of a man, but simply wants to take the man's role and try the initiative in sexual activity. Some psychoanalysts may not necessarily be right in explaining this woman's psychology as her hatred of man, her sadism or her envy of the penis.

3. The woman, at times, wants to display her body in front of the man she lives, especially if she is proud of her figure. By so doing, she seeks his praise and increased love.

FRIGIDITY CAUSED BY MAN

Unhappy First Night :- In her first sexual experience the virgin inevitably feels some pain, which however, can be alleviated by the husband's tender love and care. Impatience, brutishness and inconsideration on the husband's part may give his wife the impression that intercourse means nothing but pain to her. This impression can develop into a deap-rooted fear and eventually cause frigidity.

Man's Sexual Defects :- Incomplete erection, premature ejaculation and a disproportionately large or small penis may cause a state similar to frigidity though it is actually different. The wife may be satisfied with other men without these defects. In the case, the busband needs medical treatment.

Faulty Sex Technique : - The man often tries to improve his techniques without giving any thought to his partner's sexual process. As a result, he may completely ignore her initial sense of shame. Nothing could be more foolish than this. He does not realize that women do not welcome his burriedly learned techniques. He may mean well, but actually he may be creating a frigid woman.


THE PITFALLS OF 'ROMANTIC' LOVE

The Collapse of love, prolonged or sudden, sends couple into emotional turmoil. Hurt, angry and frustrated, one partner recoils and says the words that supposedly end a relationship: “I don't love you any more'' But contrary to popular belief and poets immortal words, this sentence can signal the beginn- ing of a solid bond, one in which intimacy is found. I am not an enemy or romantic love. It makes us all feel good to both express and receive it. But it is frequently vaporous and empty, especially when combined with unrealizable hopes. Live paramours in a Russian novel, partners who pursue this fantasy never seen to find each other. Romantic love – often unrequitted and bittersweet – can confuse the real meaning of caring. Here's why :-

“Love'' is unrealistic :-

A scene with two lovers silhouet- ted on a beach walking hand in hand into the sunset conveys all the idealism of romantics. But people don't live together that way, except on holiday. Rather, they are at close quarters, where they can see each other's pimples, wrinkles and sags. The romantic vision only separates partners further, since they try to grasp a mirage rather than the real person. The dream must be relinquished in order to enjoy the real thing. Finding real love means abandoning the mystique of romantic love. What are the qualities you enjoy in each other? Hold on to those as a basis of contact for both of you. The here and now can bring pleasant experiences. Then love takes on known realities, and liking, caring and sharing become part of intimate concerns.

Love expects too much in return :-

Whether intentionally or not, “love'' seduces couples into making serious demand. He loves her and can't understand why she wants to get away. “Why won't he leave me alone?'' she says. “I can't do anything without him tagging along, and when I don't feel the same way he does, I feel quilty'' Partners in marriage must allow space between themselves so that their relationship can breathe. Caring is letting go, not holding on. There is an undeniable balance in living together and, like the motion of see-saw, one person alone can't make it work. The giving and receiving movement keeps it going. To feel special or important to a companion is the wish of most humans. But to be possessive to the point of paranoia is self-defeating.

Love wants unconditional acceptance :-

“My wife doesn't understand me!'' a husband complained. She sometimes refused sex or was a reluctant participant. Her partner knew she didn't want relations as frequently as he did, but he couldn't tolerate her indifference or lack of desire. What he didn't recognize was that he was expressing his exaggerated expectations that his wife love and accept him unconditionally, and he attached this need to sex. All of us feel that we'll find a partner who will give us everything we've missed in life. Love seduces us into believing that this fantasy will come true.

But the most we can expect is a companion who is compassionate and understanding. One of the important signs of maturity is the realization and acceptance of the fact that no one will ever fully understand. As a pair, you must enjoy and accept what you have, however imperfect, without always demanding more.

Love expects you to be a mind reader : -

Couples are fond of reading thoughts in one another's minds and expect their partners to sense their moods. Deep down, this offends our integrity, love or no love. Yet it is practised daily. A wife greets her husband when he comes home from work and isinsulted because he doesn't comment on her new hairstyle. Instead of asking “How do you like it?'' she expects him to notice it. He is equally irritated because she doesn't see that he's worried about a bad day at the office – without his saying so.

Unless couples learn to be direct about their feelings and desires, communication remains complicated and garbled. Partners stumble and fall over unspoken messages. Love must not tempt us into believing that mind reading is part of living together. Openness brings the cool relief of intimacy.


Frigidity Causes in Woman

Retarded Development :-

Underdeveloped sex organs traced to impaired ovary function generally reduce sexual desire in the woman and lead to frigidity. She should not worry too much because marriage will help her mature and cure most of the slight cases, enabling her to experience orgasm.

Inflammation of Sex Organs :-

Women with parametritis or with inflamed uteri, Fallopain tubes, ovaries and other sex organs will feel pain during sexual intercourse. Unlike inflammation of external organs, internal inflammation is hard to detect and easily overlooked in the early stages. Chronic cases may develop into frigidity. The inflammation may be due to infection with gonococci, and infection with other germs resulting from artificial abortion, childbirth, or contact with filthy fingers. This type of frigidity may occur in women who have never experienced frigidity due to other causes.

Injuries Sustained at Childbirth :-

Frigidity may be caused bu unsatisfactory sexual feeling resulting from improper treatment of the laceration at childbirth or from a loosened vagina following frequent childbirth. However small injuru from childbirth may be, it should be stitched together. Some woman do not allow the physician to stitch the cut. On the other hand, the surgical operation to make a slit in the perineum to facilitate childbirth is no cause for worry as long as the opening is neatly sewn. The operation does not inhibit sexual feeling. In general, the female sense is enchanced after her first childbirth. Some women who have never experienced complete orgasm before, report complete satisfaction after having their first baby.

Emotioal Inhibition :-

Frigidity may be caused by religious or moral inhibition in those who regard sexual relations a sin or a filthy thing. Particularly susceptible to this type of frigidity are woman who remain aloof in the sexual act out of ignorance.

Emotional Shock :-

Frigidity is ocassionally traced to psychological "scars'' latent in one's mind since undergoing some unfortunate sexual experience such as a forced intercourse, sex play in childhood, or provious sexual failure.

Homosexuality :-

Among the various psychological factors responsible for homosexual love, antipathy against the male is most likely to bring about frigidity.

Good Appearance :-

An acknowledged beauty is often strongly self conscious of her appearance. A good looking wife feels that she is not satisfied with her husband because she thinks she could have found a better one. She demands of him sacrifice and devotion, but she refuses to cooperate with him. Thus she is likely to become frigid.

Fear of Pregnance :-

Women who are convinced that they do not want a child whether they have any or not, are likely to develop frigidity. Artificial abortion has reduced the incidence of this type of frigidity but those who have resorted to abortion repeatdely still fall victim as they are anxious to avoid conception for fear of another taxing abortion.


THE PITFALLS OF 'ROMANTIC' LOVE

Love fosters subsevience :-

Traditionally, males were indoctrinated to protect females. This created havoc in marriages by setting up an imbalance; the strong male and the docile female. Neither partner really felt like playing these roles, but both were nagged by the feeling that they had to. Today males and females are starting to accept the fact that they are human, with similar intellects, needs and emotions. Partners may not be equal in talents or tasks, but they are equal in their human needs.

Once this is realized and fairness has been established, a pair will enjoy a sense of unity. When either mate consistently presents himself or herself to the other as frail and helpless, both are heading for trouble. The only kind of love that works allows both partners feel esteemed and important. When a mate cares, the strongest support is provided by a few words and a willingness to listen, not by always doing something for the other.

Love refuses to change :-

“why can't things be like they used to be? Why can'twe go back to the way we were?'' But all the pounding on the doors of time can't bring back one second of past intimacy. Unless companions live together in the now, they cannot live together at all. A couple married two years, both busy with responsibilities and the challenges of unexplored careers, suddenly realized that their relationship had changed. Panic set in.

Quick attempts were made to recapture that lost glow, but the feelings simply were not there. They grieved over the good times experienced in the past, and the demise of their love seemed like a death. Many couples are caught in this bind, never realizing that transitions are not endings, and the new begginings can follow.

Close relationships moult, just as snakes shed skins. Once the husband and wife let go of the past, they learnt to enjoy each other again through a variety of new experiences. Enjoying the present permits a comfortable nostalgia for the old.

Love means I'm always right :-

Many couples expect me to judge whether they are right or wrong in certain specific con- texts. Many of the issues presen- ted are matters of personal pre- ference, rather that those that are intrinsically right or wrong. Both partners are right in the way they feel. Feelings cannot be argued; they can only be accepted or rejected. Partners get in trouble when they fail to separate thinking from feeling.

There can be no arguing about the way they feel, while ideas can be argued. Emotions are tied to self-esteem, and expressing under- standing of another's emotions is the beginning of psychological equality. How important is being right to you? Have you learnt to allow your companion his or her feelings, even though you disagree, perhaps even violently, with the opinion expressed?

Bonds are strengthened when couples can accept each other's feelings without being threate- ned. A mate is allowed angry feelings differing opinions, other freinds, or occasional though- tlessness. Trust each other's behaviour – all the gestures, thoughtfulness, words and deeds – to convey the caring that leads to intimacy. Real caring can be expressed without the need for the constant repetition of “I Love You'' as reassurance. These reasons why “love'' creates problems in a close relationship indicate that it is unnecessary to intimacy. Human closeness comes naturally when it is not confused with or sabotaged by the abstractions of romantic love. When two people come together through kindness, tenderness, liking and caring, they can discover an intimacy that endures.


Apprehensions in Male teens

There is no relation between the size or length of a man's penis and his sexual power, and a penis that is small when limp increases much more during erection than does a penis that is large when limp. Masters and Johnson, two famous scientists who have studied sexual rela- tions in great detail, have said that 'erection is the greater equa- lizer'. But the size of the erect penis makes little difference in sexual pleasure, since a woman's vagina comfortably stretches to accommodate any size penis, and the clitoris and most sensitive parts of the vagina are near the outside, where even the shortest erect penis can easily reach. Most teenage boys and most men have frequent erections, both while awake and while asleep.

These may be caused by thoughts or dreams about sex, by reading or listening to music, by the nearness of a girl or a woman, or merely by the early-morning need to urinate. Most erections end without any dis- charge of semsn when the valves in certain veins open and allow the extra supply of blood to return to the main circulation system of the body. When a discharge of semen does occur, it is called an ejaculation. It comes as a series of quick, short spurts of milky white fluid. In most males, after the ejaculation, the penis rather quickly becomes limp again.

In a mature, healthy man each drop of semen contains tens of thousands of spermatozoa (sperm cells) Hundreds of millions of spermatozoa are contained in the spoonful or so of semen discharged from the penis during an ejaculation. Yet small as it is, each single sperm cell may be capable of uniting with an egg cell inside the female and starting a new human life. Some people wonder if it is harmful for teh semen to travel through the same passage in the penis as that used by the urine, and if semen and urine might get mixed together. There is no such possibility. A special valve in the man's body automatically shuts off the urine while ejaculation is taking place, and the sex glands secrete a special fluid to neutralize any remains of urine before the semen is ejaculated.

How can a boy know when he will begin to produce and ejaculate semen? This event occurs during a boy's adolescent growth spurt, just as the first menstruation does during the growth spurt of a girl. Boys begin and end their growth spurts at very different ages; in fact, some don't begin theirs until others have completed theirs. A boy's rapid increase in height may start anywhere between the ages of ten and sixteen. This does not mean that the boy has reached his full height at thirteen to eighteen, only that the period of extra-rapid increase ends somewhere during that period. In a boy's single year of peak growth he may become 2 1/2 to 5 inches taller.

The first ejaculation of semen comes on the average - there is great varia- tion from boy to boy about a year after his penis and testicles have started to grow noticeably, and at about the same time as his year of peak growth, One of the most reliable signs of approaching ejaculation is the appearance, just above the penis, of public hair, which is at first downy but which gradually becomes darker and coarser, though not straight. Usually somewhat later, hair also begins to grow under the arms.

On the average, three to four months after the first curly public hair appears, the first ejaculation with semen comes, although, let me emphasize again, the length of time varies greatly from boy to boy. When a boy first ejaculates semen, we say that he has reached puberty and is entering adolescence. Often a boy's first ejaculation with semen will occur at night while he is asleep. He may be having a dream and will awaken to find that semen has been discharged on to his pyjamas or the sheet. This is called a notrurnal emission (it means a night-time sending out of semen) or 'wet dream' and is how the body gets rid of surplus semen.

A boy need not feel embarrassed if his mother sees evidence of his emission of semen. She understands perfectly well what has happened and knows that it is a sign that her son's body is now maturing. Just as often, a boy's first ejaculation will come because he has been mastur- bating - rubbing his penis with his hand or against the bed. The change of voice that boys undergo in early adolescence usually begins a few months after puberty, although there is great variation in the time.

The change is caused by a rather sudden increase in the size of the voice box. This a part of the young adolescent's spurt of growth. It is perfectly normal for a boy to reach puberty as early as age ten or eleven, or perhaps not until he's fifteen or sixteen. Boys need not worry about whether they are ahead of or behind their friends. They will almost certainly be ahead of some and behind others. By the time they are twenty or so, there will be very few important differences in development between them. The beginning of ejaculation at puberty does not mean that a boy has become a man. It does mean that he has become capable of making a girl pregnant.


Male Auto - erotism

According to the Kinsey Report, 92% of all males had auto-erotic experiences involving ejacu- lation, and 75% of unmarried men experienced auto-erotism. Masturbation is more cons- picuous among the educated presumably because they marry late and they know that it is not harmful. Those with less education, on the other hand, have less experience in masturbation because they marry earlier and abide by conventional prohibitions. Some men learn from books or from other persons about auto-erotism, but most start after their firse wet dream. As we will discuss later, nocturnal emission, or the wet dream is a physio-logical phenomenon in which superfluous semen is discharged. By employing auto-erotic practices to replace this phenomenon one does not lose anything physically and can prevent the embarrassment of soiling the bed sheet in sudden wet dreams. An element of addiction is present in auto-erotism because the phenomenon of ejaculation is accompanied by a sense of sexual pleasure. J

ust as sexual intercourse practi- sed moderately in marriage contributes to the mind and body and its excessive practice in injurious, so auto-erotism is moderation is beneficial to the mind and body whereas over- indulgence is obviously injurious. What, then, is the criterion of moderacy? Auto erotism falls within the range of moderation if it results in a better feeling in mind and body, improved efficiency, and renewed vigor in study and work. When performed in excess it results in fatigue lingering into the following morning, declining efficiency, and an inability to concentrate.

The wide range in age and difference in stamina among individuals make it impossible to set down any standard fre- quency for auto-erotism. In short, auto-erotism is not harmful if practiced in moderation, and one should never be obsessed with a sense of guilt. Excess auto- erotism obviously results in great psychological harm and is of no benefit. Too much is as bad as too little. In auto-erotism the male attains his objective by using his hand in many cases, or a substitute for the sex organ in fewer cases.

Some physicians claim it is better to use a substitute in a method closely resembling sexual intercourse than to use the hand, because the former makes it easier to adjust to cohabitstion after marriage. But the author thinks masturbation in premarital years had no effect worth discussing on later married life. One thing that should be strictly forbidden is the insertion of a foreign object into one's urethra - either in masturbation or sexual intercourse - for it may become lodged there. Stimulating the utethra in this way is entirely and highly dangerous.

 

 

In next part let's know about Female Auto-erotism


Respect The Heart of Every ...

Respect is not included in the marriage vows. No illustrated books show how to achieve it. And yet it is central to a lasting, satisfying marriage. Yes, respect. It seems a quaint, almost formal, word today. But it's a feeling that successfully married couple mention with impressive consistency.

For her book married people : Staying together in the Age of Divorce, author Francine Klagsbrun interviewed 87 couples who had been married 15 years or more. She hoped to identify the factory that had enabled these marriages to survive and thrive in a time when so many others are expected to end in divorce.

Respect turned out to be a key ingredient. “The vast majority of people I interviewed said, 'I respect him' or 'I respect her''' says Klagsbrun. What is this called respect? It is not the same as admiration. “When you fall in love, you admire the other'' says Dr. Alexandra Symonds, “you look up to someone – much the way a child idealizes a parent''.

Such romantic admiration thrives and even depends on the illusion that he or she is “perfect for you''. That's why it doesn't last. “You come to see that the person you married isn't exactly what you expected,'' says Francine Klagsbrun. “There are differences of personality, of approaches to life, different ways of doing things.''

You can try to change your mate back into your fantasy. But for the marriage to last and grow it's better to agree to disagree, to learn to let each other be. Only by taking this path can you begin to develop real respect towards each other. For respect is between peers. It is for something tested and proven, solid, really there.

“I have one patient whose husband loves sports, especially tennis''says Dr.Symonds. “she would prefer to go to the theatre, or to stay home and read. She could simply say “We have different tastes. Instead, she says “How can he waste his time and money that way?'' she puts him down. The put-down is the chief sympton – and weapon – of lack of respect or contempt. “Contempt is the worst kind of emotion,'' says Symonds.

“You feel the other person has no worth'' We've all seen marriages in which one or both partners attack the other quite savagely in th guise of “It's for your own good'' Any ''good'' is undone by the hostile tone. A wofe nags her husband to be more ambitious and makes him feel like a failure because he prefers craftsmanship of community projects to the competitive business world.

Or a husband accuses his wife of wasting time whenever she gets together with a friend” Why isn't she doing something productive?'' In good marriages partners nurture each other's self-esteem. They may express humorous incomprehension of one another's preferences, but they never make the other person feel like an idiot.

“Marty's idea of a vacation is to go down to the basement on a sunny day and spend time woodworking'' says Dr. Alexandra Symonds of her husband, psychiatrist and surgeon Martin Symonds. But there's fondness in the gibes and firm support for the other's right to be himself.

Respect is expressed in words like. “I don't want to go to the concert, but you have a great time.'' And occasionally, “Sure, I'll come with you. Just don't be angry if I fall asleep.'' Respect, then is appreciation of the separateness of the other person, of the ways in which he or she is unique. These things take time to discover and accept. That's why respect is a quality of maturity in a marriage couples who respect each other are simply saying “You go your way, and I'll go mine''

On the contrary, respect is “what pulls you closer together'', says Klagsbrun. “Often it helps you to learn from each other, to accept the other's outlook and make it part of yourself.'' My husband and I are from different worlds and generations. He is a European survivor of the Second War, 18 years my senior. And sometimes we do clash. But we've learnt to respect each other even for some of the differences that once annoyed us most. As a result, we have grown more alike.

“I've absorbed some of his tendency to take strong stands on issues; he's absorbed some of my tolerance of other's points of view. I've gained a genuine apprecaition for jazz; he can now hear the life in rock 'n' roll. That's the paradox of a good marriage: only by respecting each other as you are do you open the door to change.

The root meaning of the word respect is ''to look at.'' Respect is a clear yet loving eye. It sees what is really there, but it also sees what is potentially there and helps bring it to fruition. Respect is the art of love by which married couples honour what is unique and best in each other.


Men and Women Unite in ...

In Earlier you followed the path of the egg cell out of the ovary, you read about how the sperm cells were made and discharged from the man's penis. Now let me explain how the sperm leaves the body of the man, enters the body of the woman, and perhaps meets the egg.

This process is called mating or sexual intercourse. Another word for it is coitus; and when people speak or write about a man and a woman 'going to bed together', 'sleeping together', 'having sex', 'having relations', 'making love', or sometimes, 'doing it', they are referring to sexual intercourse. If you look up intercourse in a dictionary, you will find that its meaning includes the idea of exchange and communication.

When two people who are deeply in love have intercourse, often they exchange thoughts and feelings; they communicate their love for each other in an intimate and joyous way. Some couples may have sexual intercourse several times a week, others perhaps only once or twice a month, whatever they feel is right for them. Intercourse and preparation for it may take anywhere from a few minutes to half an hour or more.

Different couples may have different styles. The couple might come together and kiss, embrace, and caress each other in all parts of the body. They might speak their love for each other. There are many other ways taht they can enjoy this period of foreplay. After a time, the woman's mind and body are ready for the act of coitus; her vagina becomes wet with a colourless fluid resulting from sexual excitement, Meanwhile, and usually much more quickly, the man moves his penis in and out inside the vagina, and the woman may also move in various ways.

The motions of intercourse cause friction against the concentration of nerve endings in the head of the penis and against similar nerve endings in the very sensitive clitoris. The stimulation of the penis and clitoris is the main physical cause of orgasm in mand and in woman, and it gives both great pleasure.

After a time, each partner may reach the climax of sexual pleasure, called an orgasm, a glorious spasm that is impossible to describe adequately in a few words. For the man, orgasm is the moment when the sperm is ejaculated in a series of quick spurts. During intercourse, it takes place inside the vagina close to the neck of the uterus (the cervix).

For the woman, the orgasm involves a series of muscular contractions of the walls of the vagina. She has no ejaculation of fluid. For both, the orgasm is accompanied by rapid, heavy breathing and other signs of an excitement climax. A man and woman rather seldom experience orgasm at the same moment.

Indeed, some women may rarely or even never experience orgasm. If so, even though they miss a great plesure, they can still enjoy intercourse. Often, some counselling, probably for both the man and the woman, can help her to achieve orgasm. Some Details in next episode


Female Auto-erotism

The rate of female auto-erotism is lower than the male's perhaps because women do not have wet dreams or any phenomenon compa- rable to the discharge of excess semen. But this does not mean that unmarried women do not experience sexual excitation. They do become sexually excited and do practice auto-erotism. Kinsey reports that 58% of all females and 47% of unmarried ones have auto- erotic experiences. As male auto- erotism mostly ends in ejaculation, so a large percentage of female auto-erotism terminates in orgasm. Women derive as much emotional and physical satisfication as men do.

The frequency of its practice varies with age and the indi- vidual. The woman has a far wider choice of methods than men whose erotic zone is centra- lized on the penis. The woman has the clitoris, labia, vagina and breasts - all serving as areas of sexual sensation.The most common method is to gently caress and rhythmically press with the fingers the clitoris and the inner lesser lips.

They are so highly sensitive that a woman will easily experience orgasm. We often hear that women who have masturbated the clitoris before marriage do not easily experience orgasm in sexual intercourse and may even become frigid, but this is erroneous.

If there is any such woman it is because she does not love her husband enough or his unskillfull sexual technique is to blame. Despite her orgasm from self- stimulation of the clitoris, a woman will attain greater phychological satisfaction and experience orgasm in sexual intercourse after marriage as long as she grows up with a healthy mind and body. If discontentment and frigidity in married life can be traced to the wife's auro-erotic experiences before marriage, it is not due to masturbation itself but rather to the sense of guilt and restraint it has created in her. Another method of female auto-erotism is the direct application of pleasure to the entire external sex organ - a method peculiar to women.

A continuous, rhythmic pressure is applied to the entire sex organ with her legs crossed. This pressure may be supported with a pillow of some other object held between the thighs. With the aid of a pillow or some similar object the front-back movement and the rotation move- ment of the hips employed in sexual intercourse can be used. These movements are also occassionally used in male auto- erotism. The front-back movement of the hips enables the woman picture a partner in sexual intercourse. The movement is employed simulta- neously or alternately with the finger caresses of the clitoris and the inner lesser lips.

Hip movement applies over-all pressure on the sex organs, but local stimulation is far weaker and less effective than finger stimulation of the clitoris and lesser lips. Yet, a woman will came to orgasm as quickly as in local stimulation. This proves that psychological excitation is important for the female, as it is for the male, in arriving at orgasm.

A third method is the stimulation of the breasts, especially the nipples. Unlike the male's, the female breasts may be regarded as a sexual organ. Stimulation of the breasts can cause contrac- tion of the uterus. The woman's motherly instinct psychologically helps accelerate sexual excita- tion when the breasts are stimulated. She rarely arrives at orgasm with massage of her own breasts alone, as she cannot enjoy the suction applied by a partner. Consequently this method is often employed in conjunction with other auto-erotic methods.

Thus, compared with the male, female auto- erotism involves more complex methods and wider areas of stimulation. As in the case of the male, the female should never insert foreign objects to stimulate the clitoris and vaginal opening or insert them into the vagina. She should never use objects that are liable to break in the vagina, such as those made of glass. As it is most impossible for her to extract anything that is caught in the vagina, she should avoid inserting any short objects. It is nor rate for a woman to encounter trouble.

The object inserted in the vagina is broken by the enormous pressure applied on it when she arrives at orgasm, or in her ecstatic moment she forgets herself and lets the object slip through her fingers.


How Important Is Intercourse to a Happy Marriage

Megan is 41 and has never had an orgasm. When Megan and John were first married, she enhoyed their sexdual encounters, but now sex has become less important to her. She has never told John that she doesn't have orgasms, and he'd be suprised to know.

* Lisa and Peter rarely find time for sex. But when they go off for a week end or when the children are away, the couple always enjoy intercourse. Then they wonder why sex isn't a regular part of their lives. * Betty and Richard have been married for seven years. During that time their careers have skyrocketed. They travel and are active socially. Compared with the rest of their life, their sex life has become dull. In fact, if someone told Betty she could never have sex again, she says it wouldn't bother her at all.

*Stewart and Caroline are in their late 50s. Stewart had a serioud illness ten years ago and, as a result, is rarely able to have an erection. Although they are tender and loving, they never have intercourse. If you have one of these problems, it may reassure you to know that many happily married couples share your experience.

And despite today's focus on sexual problems, good and frequent sex may not be all that important to a happy marriage. We discovered this when we studied a group of 100 happily married couples ranging in age from their early 20s to their early 60s. As marital and sex therapists, we thought that studying those with happy marriages might teach us something about helping couples who come to us for treatment.

Therefore, we asked for volunteers who felt that their marriages were “working' and who had never sought professional help for their marital or sexual problems. In examining the responses to our questionnaries, we discovered that over 90 percent of the couples had a less-than-perfect sexual relationship.

Yet more that 80 per cent rated their marriages as “very happy'' or “happy''. Almost all of these individuals denied this lack of sexual bliss was a problem for them, and none expressed a need for change. Apparently, a sexual problem is not synonymous with a marital one.

What Sexual problems do “normal'' people have? :-

Among the couples were women who never experienced orgasm, and men who could not get an erection, as well as men and women who found insufficient tenderness in their union. Performance problems were common, The two most frequent were premature ejaculation (more than one-third of the men) and difficulty reaching orgasm (nearly half of the women).

Yet despice the high frequency of these problems, most people told us that their partner's performance was not as important as the feelings they bring or fail to bring to their sexual relationship. For example, even though Richard almost always ejaculates before Betty has become aroused, Betty is more interested in closeness than in orgasm. Only when Richard fails to hold her does she feel “empty, rejected and used''.

The failure to “connect'' psychologically is only one kind of sexual difficulty that can arise in an otherwise good marriage. Most couples find that their sexual encounters are influenced not only by how they feel about one another at the moment but also by job pressures, financial worries, disruptive children and, above all, fatigue.

Moving from a busy life into relaxed moments of intimacy often becomes extremely difficult, even for loving couples. For example, 47 per cent of the wives reported that the “inability of relax'' was significant problem in their sex lives. While lifelong inhibitions, fears and guilt may contribute to tension, it's also hard to adjust to instant intimacy when the bedroom door closes.

Whatever the causes of sexual difficulties, wives appear to be much more vulnerable to them than their husbands. Approximately a third of the women in our study were uninterested in sex, felt that their partner chose inconvenient times or reported that sex turned them off. Men tended to cite problems that implied a continuing interest in sex.

For instance, the two problems, most frequently reported by men were a lack of foreplay and attraction to persons outside the marriage. While 38 percent of the women also reported that too little foreplay troubled them, the other most frequent complaint of the women indicated diminished interest in sex rather than a desire for better sex.

How often do happy couples have intercourse ? :-

Two percent of these satisfied couples reported that they never had intercourse, and eight percent said thay had intercourse less than once a month. Fourty-seven per cent said that they had intercourse two to four times a month, while 31 percent reported a frequency of two or three times a week and 12 per cent reported four to five times a week. Only one couple said they had intercourse every day.

Despite the range, the overwhelming majority of these couples reported that their actual frequency of intercourse was close to their ideal. Apparently the crucial issue for marital satisfication is the ability to work out a pattern acceptable to both partners.

What should you do about sexual problems in a marriage that if otherwise happy? :-

If you wish to revitalize your sexual relationship, communication is critical. It isn't the amount or quality of sexual relations that makes or breaks a marriage, but rather the degree of “fit'' between partners sexual needs and pririties. Such mutuality comes only with communication. Another essential ingredient for change is the commitment of time and energy.

Try to define for yourself and your spouse what your complaints and pleasures are. Many people are unconfortable and shy about making specific requests but open talk and experimentation are vital. No one individual automatically knows what pleases another without adequate feed -back. A decision to seek professional help need not be based on the severity of your sexual difficulties.

Some couples simply need the structure provided by a treatment programme. In addition, experienced sex therapists and marriage counsellors often see approaches to problems that would be difficult for a husband and wife to see on their own.

But unless your partner or you feel particularly unhappy perhaps you shoud leave things as they are. Indeed, the prime conclusion we drew from this study is that sexual difficulties are normal – and se, per se, isn't crucial for a happy marriage.


WET DREAM AND INVOLUNTARY EMISSION

Involuntary emission, unlike auto-erotism, is a phenomenon in which the male involuntarily ejaculates in his sleep to discharge the super- fluous stock of semen. This gives a remarkable sense of pleasure and satisfaction and at times is accompanied by a dream, in which ease the phenomenon is called nocturnal emission or wet dream. The dream is nearly always directly or indirectly related to sex and may be forgotten by the time one wakes.

 

Physiologically, a young mand normally experiences wet dreams or involuntary emissions once in every two or three weeks, but they may occur more frequently. An excess of semen gives tension to the sperm duct, which in turn induces penis erection and eventually causes ejaculation.

A sexual dream is not essential in causing this phenomenon for the dream, if any, occurs instan- taneously in association with the ejaculation. But as with other dreams, the dream seems long to the dreamer. On the other hand, nocturnal ejaculations caused by conditions other than the dis- charge of excess semen are moti- vated by a sex dream. The sex organ stiffens to erection applied in one's sleep, causing a sex dream, which triggers the ejacula- tion reflex. A full bladder may cause the original erection, which therefore does not lead to ejacula- tion unless a sex dream follows.

Whether one has such a dream depends much on his daily attitude and thoughts. Too frequent a wet dream is not normal physiologically. It may be caused by excess sexual stimulation in daytime, by unconscious fingering of the sex organ in one's sleep, or by its stimulative contact with the bedding. One way to prevent wet dreams is to wear paijamas which are soft to the touch and place one's arms outside the blanket.

Involuntary-emission always occurs during one's sleep because the brain's sense of restrain- ing effect weakens while asleep. In performing auto- erotism or sexual inter- course when wide awake, therefore, one must over- come this restraint by a more powerful sexual stimulation that that required for arriving at orgasm in sleep.

Wet dreams and involuntary emission, like auto-erotism are too often misinterpreted. Some confuse the physiological discharge of excess semen with abnormal wet dreams caused by lacivious emotions. Such misinformation is likely to cause a sense of guilt and embarrassment in youths, who may evcn develop self-hate insomnia and a nervous breakdown.

As it is necessary to give an adolescent girl knowledge of menstruation, so it is equally important to inform boys correct- ly of wet dreams, involuntary emission and auto-erotism. Some boys may indulge in auto- erotism to fend off the embarra- ssment of wet dreams. They must be told in easy terms why overindulgence is harmful. Then, they will try to fight the temptation and develop a habit of self control, which will benefit them in their later life.


Men and Women Unite in ...

After the climax of intercourse, a couple who love and understand each other feel especially close and relaxed. They experience a sense of well-being and content- ment together. In othe words, although the physical pleasure of intercourse in intense, much more is involved than mere body. It involves a person's feelings, thoughts, and emotions. If inter- course is undertaken outside of a truly loving relationship between man and woman, one based on the caring of each partner for the other, then it can sometimes hurt one or both of the partners and their relationship.

Within marriage, intercourse strengthens and intensifies the love that man and wife feel for each other. Often the first time a couple have intercourse, the event to which they may have been looking forward with expec-tation of great pleasure is a disappointment. It doesn't turn out to be the ecstasy that each was counting on. For the man, it may all be over too fast; for the woman, it may involve some discomfort, and she very likely will not experience an orgasm, partly because for her, too, it happens too quickly. This can leave her disappointed and frustrated. Sexual intercourse is something that loving couples learn to enjoy more and more as they become more skilled and more aware of each other's feelings.

If a man and woman learn how to tell each other, either by words or by signals that each learns to recognize, what feels good, what they like and do not like, then their pleasure in sex together increases. A man can learn to delay his orgasm until his partner becomes more ready for hers; a woman can learn to show her partner how to help her to have a climax. It is especially impor- tant for the man to remember that stimulation of the area around the clitoris is very important to most women. It is the experience of many couples that motions of the penis and the thrusting stimulation, and couples will want to discover together other ways of stimulation that they will prefer.

It is important, also, for the couple to feel relaxed and comfortable and unhurried together. Many couples do not enjoy intercourse as much as they might because they see it as something to be accompli- shed - an act, even a task, to be performed - rather than a pleasure to be enjoyed. If a woman does not feel like having an orgasm because she is tired, or if a man finds he is unable, from time to time, to keep his penis erect and to ejaculate, it need be no greast thing. A loving exchange of feelings is good even if only one, or neither, of the partners has an orgasm.

You may have seen dogs or other animals mating and wondered whether the position they use the male's penis entering the female from behind - is also used by men and women. Generally it is not. There are many positions in human intercourse, and the most common one is for the partners to lie face to face, with the man above the woman. But couples can enjoy a variety of pleasures by trying out different positions and different ways of enjoying sexual satisfaction.

If a woman wants to avoid difficulty and discomfort for the first time she has inter- course, she may use tampons before hand to dilate- enlarge - the opening in her hymen, or she may enlarge it gradual- ly over a period of time by using her fingers. She should be sure they are clean. In a few women the hymen is so strong and the opening so small that a doctor will think it wise to enlarge the vaginal entrance before the woman has intercourse. This is a simple and almost painless procedure. Often, but not always, the first time a woman has intercourse, the stretching of the hymenal opening may cause discomfort and slight bleeding. This is physically harmless.

 

In other chapter will tell you more about human sex and compare it to sex in other animals, for one is very different from the other, and it is important to understand the differences.


Love at First Touch

“I touched her cheek. It was soft and waxy, like a gardenia petal''

*”I held him close and laughed and cried. Now I believe in miracles.

* “He looked right at me, I fell into his eyes – and in love''

Memories of romantic encounters? No, these women are recalling the moment they first held their newborn babies. Parents have always known the power of the minutes and hours after birth. Now scientists report that this period offers a special opportunity to promote what they call bonding, close enduring attachments.

Since paediatricians Drs. Marshall Klaus and John Kennel of Case Western Reserve University School of Medicine in Cleveland, USA, described the phenomenon in 1972, other studies have supported the idea of a sensitive period during which parents and infants are ideally ready to bond. At delivery the infant is stimulated by his turbulent passage down the birth canal; the unsedated mother is often in a state of high excitement.

They are eager for each other – she to merge her image of the “inside baby'' with the real baby, the infant to resume its safe, warm, gently rocked existence. An infant's expressions of need trigger a physiologi- cal response in the mother. A baby's cry raises the temperature of the mother's breasts, some times causing a sudden dripping of milk.

Attracted by the warmth and milky fragrance, the baby nurses eagerly; the sucking increases the mother's production of oxytocin, a hormone that contracts the uterus, helps expel the placenta and arrests post- partum bleeding. This mutually conforting interaction aids the bonds of mother and infant.

Powerful Element :- Immediately after delivery, the baby is remarkably alert. He will – if kept warm and handled gently- lie quietly, looking around. He will follow a face moving slowly about 20 centimeters above his own. He responds to light, to clicking sounds, to the slightest touch. He turns his head towards a high pitched voice – the tone many parents adopt in talking to their babies – all in his first few hours of life.

It's more true, says Dr. Hugh Jolly of London that a mother needs rest as soon as she's given birth. She needs her baby. “A normal baby should be delivered straight into his mother's arms, where he can be caressed at the breast'' says Dr.Jolly. Caressing – touching all over – is a new mother's natural greeting and one of the most powerful elements in bonding. The delicate ritual of getting to know a baby, says childbirth educator Sheila Kitznger, “is an emotional unfolding''

At first, the new mother holds the baby stiffly, lika a bouquet of flowers. Then, the fingertips, she begins to explore. She traces the contours of the face with one finger, cups her hand around the infant's extremities, strokes the baby's torso with her pain. There's more than relief, mote than pleasure, in the safe arrival of helathy infant; there's ecstasy and kind of claiming, often accompanied by delighted commentary:

“Oh, look at the little mouth, the little nails. Hello, darling, hello'' Magical in itself, this swift getting-in-touch appears to produce prolonged benefits. In one study women are given their naked babies for one hour in the first two hours after birth, On each of the following three days the mothers held and caressed their babies for five hours.

Later, this group was compared with mothers given routine hospital care (glimpses of baby at birth, feeding every four hours). The “early and extended contact'' mothers touched their babies more, were more sooting when the babies cried and were more likely to look into the infants 'eyes during feeding.

Two years later, exchanges between a randomly selected group of extended contact mothers and their offspring still seemed richer; the mothers asked more questions, gave more detailed answers and fewer commands.


Female Intercourse Dream and Orgasm

Ejaculation accompanying sex dreams in the male is expressed by the term nocturnal emission or wet dream. By contrast there is no set term to express the female orgasm in sex dream. Consequently, many men assume that this phenomenon does not exist and women think it is abnormal. Although this phenomenon is experienced far less frequently by the female than in the case of the male, it would be rash to consider it abnormal.

Just as the male can have sex dreams without ejaculation, so the female sees sex dreams as a result of internal and external sexual stimulation. Kinsey reports that 90 percent of women dreamers dream of the opposite sex. Of the 90 per cent one-third dream of sexual intercourse, another third of petting and the remaining third have love dreams that do not concern any physical contact with the opposite sex.

This sharply contrasts with the male dreams, which almost always involve physical contact, notably sexual intercourse. The cause of female sex dreams also differs from that of the male's. Some women have such dreams after auto-erotic experiences, other after petting or intercourse, and a small remaining percentage after contact in homosexual love.

The incidence of male sex dreams is nearly 100 per cent, while the female rate is about 70 per cent. Most male sex dreams are accom-panied by ejaculation whereas 30 percent of the female sex dreams result in orgasm. The more her dream involves physical contact and sexual intercourse, the most she is likely to experience orgasm, particularly as she advances in age. Some statistics say a little less than 40 percent of women having wet dreams experience orgasm, but we may add that wet dreams are rarely seen among young, unmarried women. The female has orgasm in sex dreams far less frequently than the male, her frequency being three or four times a year at the most. As in orgasms resulting from sexual intercourse, those in dream accompany convulsion as well as mucous secretion.


Love at First Touch

Special Bond :-

The father too has a role in bonding. A father who's present during labour and delivery is ripe for a surge of protective feeling “I can't say I felt instant love'' one father said. “But when I held her, wet and beautiful and screaming her head off, I thought I do not want anything ever to hurt this child. To define the special bond between a man and his newborn child, Dr. Martin Greenberg coined the term “engrossment'' a combination of interest, absorption and preoccupation released by early contact.

The reactions of fathers who connect with their babies in that first critical hour support this view. Said one “I was so suprised to see her looking around and gripping. And when I touched her, I felt suddenly I didn't just have a baby; I had a daughter'' Awarness of the importance of bonding is producing notable changes in hospital practices. Fear of infection once converted many nurseries into near fortresses with babies kept in isolation. But, increasingly, hospital maternity care focuses on strengthening family closeness. In light of their bonding studies, Drs. Klaus and Kennell make these suggestions “

* Parents shoud seek childbirth education during pregnancy to help relieve anxiety. The presence of the father during delivery also helps to reassure the mother, making the labout easier.

* The baby, unless in distress, should be laid in its mother's arms as soon as she is ready. The baby is laid skin-to-skin on the mother's abdomen, covered with a blanket, and allowed time to get acquainted before necessary procedures are preformed.

* The new family should be left alone together as soon as possible. If able, the mother should, from the outset, take responsibility for her baby's care, while nurses care for her and serve as consultants.

* The family – including young siblings, if permitted – should visit often. One mother of seven recalls the “richness, serenity and joy'' of those occassions when her husband and children gathered around a new baby.

“I believe bonding occurs'' she says, “not only between parents and child but between the new baby and all those present'' Promoting

Attachments :-

Bonding after a normal birth proceeds spontaneously if mother and infant are together, but two situations present special problems: the Caesarean birth and premature delivery. In both cases the infant may have to be moved promptly for life-saving measures. Often the premature baby is less to meet the parents than a full-term baby delivered vaginally.

The mother of a prematurely born infant first interacts with her baby when it is in an incubator in the strange environment of the intensive-care unit. A woman who's had a Caesarean under general anaesthesia can't take over the baby's care at once and won't see her child for hours. Fortunately, progress has been made in facilitation early attachment after both premature and Caesarean births.

Sensitive physicians threat the Caesarean delivery primarily as a birth, not a surgical event, and admit the father to the delivery room. Dr. Nada Stotland psychiatric consultant with the Department of Obstetrics and Gynaecology offers further suggestions for normalizing Caesarean birth.

A conscious mother can watch the baby being lifted from her body. A mother can hold her baby while she's being sewn up. At the very least, the baby shoud be put where she can touch him. “Mother and baby belong together'' Dr.Stotland insists. Care of premature infants is also changing to promote family attachments. Parents are encouraged to visit the nursery to care for their incubator babies. (These visits benefit both parents and child. Stroking, touching and rocking help the baby's breathing, relaxation and physical development).

Finally, there's the question of adoptive parents. For them, bonding occurs gradually and in many different ways (affected, for instance, by the age at which the child is adopted). “Human relationships are too delicate and complex to be summed up in any cut-and-dried way'' Valmai Howe Elkins, a childbirth educator, cautions. Adds Mercer “Bonding's a real phenomenon and right after birth is the optimal time for it. But human beings are resilient and interact in many ways. Every mother, every infant, is unique; so is the language between them''


6 Points about Men and Women

6 Points about Men and Women

1. A man tends to be more promiscuous in his sexual beha- viour than women. Many men will have sexual intercourse with almost as woman who is willing. Many men will pay women for the sexual favors, as the history of prostitution shows. This probably due both to the strong sexual drive of men and society's attitude that it is all right for men to sow wild oats.

This is not so with women. Pomeroy and Christenson, both associated with the Kinsey studies, have written that the average fourteenyears-old girl (unlike the boy) very often is sexually blank and relatively unresponsive as for as sex per se is concerned. Her interest in boys add her dating behavior is primarily social rather than sexual.

Ehrmann, in his study of premarital dating behavior has shown that in premarital sexual intercourse, a boy will generally accept any willing partner, but a girl will agree only if she loves the boy. As many persons have pointed out, a man gives love to obtain sex, while a woman gives sex to obtain love.

Even with all the growing sex freedom, studies have shown that there is very little promiscuity among girls. Where sexual intercourse does take place before marriage, it usually occurs as far as the girl is concerned with someone to whom she is engaged and or someone for whom she has affection.

 

2. The male sex drive is fairly constant, compared with the female. Her sex needs tend to be periodic and more subject to moods and situations. This often creates difficulties for the married man who is separated from his wife for a week or longer, or for the divorced man or the widower.

This is an aspect of male sexuality that women have difficulty in understanding and accepting. A wife going to visit her parents for a week or longer will make arrangements for her husband to get food, clean linen, have the house cleaned, and such. But it will rarely occur to her that he will suffer sexually. Her most likely response will be : "Let him control himself''

On the other hand, a man has difficulty understanding how many women can tolerate long intervals with little or no sexual activity. The average woman's sex drive is much less compelling. This is partly reflected in that fact that close to half the girls in the Kinsey studies did not masturbate until after age twenty. There are many cases of women who have lived out their lives as virgins and never masturbated.

Wives have much less difficulty than men in controlling their sex needs during separation, as do divorcees and widows. According to Pomeroy and Christensor, even where women have had a very good sexual adjustment, many of them are able to accept periods of deprivation comparatively easily.

Next four Points in other episode ...


Heredity : What is passed ....

Heredity : What is passed on to us by the Sperm and the Egg

Remember that two hundred egg cells placed side by side would take up only an inch ; five hundred sperm cells lined up head to tail would measure the same length. Yet each of these microscopiclly small cells contains many little bodies called chromosomes, which transmit a complicated code of directions.

This code determines the here- dity of the child that will be born if a seprm and an egg unite : the colour of the hair, skin, and eyes  the shape of the nose, intelli- gence at birth ; and the thou- sands of other things that make this human being physically different from all other human beings. You know that children often look like their parents. All the resemblance is carried by the chromosomes in a single sperm and a single egg. For a moment, let's consider in more detail how this code of heredity is carried.

Scientists are making amazing discoveries about this process. In each sperm cell and egg cell, small as each is, there are molecules of a chemical called DNA. Each molecule looks some what like a twisted ladder, weighs about on ten thrillionth (1/10,000,000,000,000) of a ounce, and contains many genes. In the genes of the DNA molecule is stored a set of che- mical directions so complicated that to write them down in English would require several hundred volumes the size of a dictionary.

Every cell in your body contains these molecules. They are so small that if all the DNA molecules in all of the cells in all of the over three billion people now on the earth were piled close together like logs of wood, the whole pile would fit into a cubical box with an edge less than 1/8 of an inch, like this : You might say that, in a sense, all the people in the world in miniature could fit into that little box. The science of heredity is called genetics (from the word gene), and what you are now and will become is determined partly by your genes and partly by your surroundings, called environment. There is more about this in later chapters.


Do Men Really Fall in Love?

For HER report on male sexuality, Shere Hite used the same methods as in her best selling report on women- detailed questionnaires filled in by more than 7,000 men all over. In this excerpt, men discuss their attitudes towards loving and being loved. Do men really fall in love? Vivid quotations from the questionnaries give the answer.

Asked to describe the time they had falled most deeply in love, many men recalled an ecstatic experience :-“It felt wonderful. I went around for weeks and months seeing the world as a plce of beauty and hope, rather than ugliness and despair.'' “It was a traumatic experience that left me almost unable to speak and virtually overcome with emotion. It came about because the woman recognized qualities in me that I had almost lost touch with-of creativeness, affection and desire to reach out to others. She was the catalyst in a period of tremendous change in my life.'' “I was alive again. Falling in love you notice the sky, how beautiful it is. All your senses seem alert''

Many men even described symptoms of heartache more typically associated with women in love :- “There was such a terrible yearning, a sort of heartsickness. I dreamt of her. My appetite dropped off, and I was on the verge of a nervous breakdown'' “It is exactly the same feeling as fear – the pang in the solar plexus, the giddy disorientation, the shaky hands, the wild surmises. What does it mean if one's body responds to dread- and to 'falling in love' in the same way?'' “I found it difficult to think of anything except my lover. I was continually keyed up''

If the feeling was so intense, why then were so many of the men questioned wary and distrustful of their emotions? Some men- tioned that they did not like the feeling of being out of control :- “Before I fell in love, I felt invulnerable-my success or failure in life was defined by the work that I did and by the effort that I put into it. Now I feel that I can be rejected and hurt by her. I hate feeling so vulnerable'' “To be in love is to bed uncomfortable because you are out of control. Women are more willing to be dependent or part of another person. A man wants to keep a separation, keep himself for himself'' “I want the security that she loves me more than I love her. I want control in the relationship. I've been in relationship where I loved her more, and I was in her control. It was awful. Never again''

Worse still was the fear that one might not fully recover from the damange :- “Having been that high, you have further to fall. You survive, but sometimes you are broken inside and never quite the same'' “When my affair came to an end, I retreated into a shell. I found myself avoiding others'' “When my girl-friend broke up with me, it destroyed me. I have never again loved anyone as much as her to this day''

Some men even held themselves back from falling in love :- “Love is such a cruel, irrational emotion that I don't trust it. I've deliberately turned away from women who showed signs of loving me'' “Of course, you do sometimes start to fall in love – but you can always stop before it's too late''

In fact, most men said they preferred a daily, loving relationship to being in love :- “When I was younger, I would have defined love as the initial strong reaction I felt for someone, but now I think it as something that has to be worked at to achieve understanding'' “I love my partner, and she loves me. Iam therefore 'in love'. I am not, however, in an ecstatic, romantic, infatuated, euphoric and slightly unrealistic state that in my teens I called love. My term 'love' means freindship, caring acceptance'' “There are two kinds of love. The first, crazy love, sends you into the clouds. The second comes of knowing someone very closely, of trusting and always feeling at ease with her. It is a relaxed and confortable feeling, not as exciting and heady as the first kind but far more rewarding and secure''

A few men did see real love as something that heppens immediately and unexplicably:- “If I do not feel love for a person right from the beginning, I will never feel it'' “Every once in a while there is that strange, overpowering feeling that makes you want to be with a person all the time. You don't work at this – it's just there'' “I've known both kinds of love. I work at the one in my marriage, but once I experienced the immediate flame over which I had no control. I suspect the former is more loving (maybe healthier), but the flame is real love''

Some men described love they had fell when very young with a great feeling of poignancy. Others mourned the loss of romantic love in marriage :- “During my first year in college, I met a girl who was, and still is, my ideal. My entire world revolved around her, It has been difficult to give or receive the same love since'' “When I was 17 and still a virgin, I was more in love than I have everbeen since. We went on a picnic in the mountains, and bothy of us felt as though we have made love-although our intimacies extended only so far as my resting my head on her lap. I think that first experience of love has coloured all my relationships with women''

Although the majority of the men questioned may have closed themselves off from feeling intense love, a minority did say that they had been profoundly affected by love :- “To find the existence of another person who was dear to me re-awoke a long-buried jou for life, and the desire to give myself to whatever life, through her, had to offer'' “I had the feeling that something in the universe clicked when I met her. I wanted to let everyone know. I wanted to give. I wanted to share''

MEN's first feelings on falling in love were as joyous and ecstatic as women's. But after their initial happiness, most backed off and distrusted the very feelings that had given them such pleasure. Why? “Men are trained at an early age to disregard emotion'' one young man said. Men distrust the vulnerability of love feelings so much that the majority of marriages are not based on them, Most of the men did not marry the women they had been most ''in love'' with, although they emphasized that they live their wives and do not want to leave them.


4 Points about Men and Women

3 For a man to be able to perform successfully in sexual intercourse, he must be stimulated and have an erection. In practically all cases, men will ejaculate and have an orgasm. A woman can perform intercourse successfully without being aroused. She needs only to be willing. She can pretend to climax and there is no way of telling that she is not. The severest complaint of many husbands is that their wives are not sufficiently interested or responsive in the sex act.

 

 

4 In sexual intercourse, a man can heve but a single orgasm at a time. He needs sometime to recuperate before he is able to have an erection and to ejaculate again. Many women are capable of having several orgasms in succession. This upsets the popular notion that men have a stronger sexual capacity than women.

5 A male's capacity to respond sexually is greatest during his teen years. It remains fairly high in the twenties. There after it gradually declines with age. This does not mean that men lose all sex desire. It means that the frequency of response becomes less. However, many men continue to have erections, ejaculations and enjoy intercourse into the seventies and even later.

With females, the situation is quite different. Most women do not achieve the maximum capacity to respond sexually till their late twenties or later. Many women do not respond adequately until after they have experien- ced five years or more of sexual intercourse and marriage. However, a woman begins to respond sexually, her capacity remains pretty much on the same level until her sixties, and in some cases till later on. Thus, we have the situation of a male able to respond sexually at an early age, but gradually declining with age, while a woman's capacity for sexual enjoyment and responsiveness increases with age until it reaches a plateau.

6 One of the basic differences in sex behaviour characteristics between men and women in responsiveness is to erotic stimulation. A man can be stimu- lated sexually by almost anything the sight of a stimulated female, female nudity, sexy pictures, or thinking of a woman or some erotic situation.

But mostly the women are not stimulated erotically, like a man, by nudity or pictures. A woman is aroused mostly by affections, romance, and physical stimulation, which may take considerable time. If a husband wants to arouse his wife sexually, he should begin with gestures of affection for her as a person. This is where a husband and wife are sufficiently realistic to accept the sex behaviour of each other, will soon adjust to each other and enjoy a harmonious and satisfactory sex relationsjip that will put a glow to their relationship.


From Fertilization to the Birth of the Baby

At the man's climax in intercourse, millions of sperm cells, swimming in semen, are ejaculated from his penis into the woman's vagina near the mouth of the cervix. At once, these microscopic sperm, their tails moving rapidly back and forth, begin a journey that takes from one to several hours. In their warm, moist environment, the sperm normally stay alive and are capable of fertilizing the egg cell for two-and-a-half to three days, although sperm may be actively moving as long as a week after they are ejaculated.

Sperm appear to have no sense of direction, and ofcourse they cannot see. They move about rapidly in a random motion, not on a direct route. Some make their way up through the cervix into the uterus. Some of these enter the two fallopian tubes. They proceed up the tubes, where they may meet a mature egg cell travelling slowly in the opposite direction. If they do, they croud around the ovum and bombard its wall until it weakens at one spot just enough to permit a single sperm cell to enter.

At once the cell wall hardens and the other sperm are shut out; the successful one loses its tail; its head joins the nucleus of the egg. The rest of the sperm cells die and are absorbed harmlessly into the woman's body. The moment of joining of sperm and egg is called fertilization or conception; new life is conceived, that is to say, begun. It is important to understand the fertilization will not occur every time a man and woman have intercourse; far from it.

The sperm must arrive in the fallopian tube just when an egg is travelling through it. The sperm must be vigorous and the egg not too ole - that is, not more than twelve to twenty-four hours out of the ovary. It is the sperm cell that determines whether the child is to be a boy or a girl.

The sex depends on which of two types sperm cells enters the ovum. If it is sperm carrying a "Y'' chromosome, the baby will be a boy; if it is an "X'' chromosomem, it will be a girl. Nothing that happens to the mother after fertilization can change the sex of the baby. 


Male Intercourse Anatomy

The external male sex organs are the penis and scrotum, which is the bag containing the testicles. The head, or glans, of the uncircumcised penis is covered by the foreskin. In circumsision, all part of the foreskin is removed. A pasage way called the urethra runs through the penis.

Urine which has accumulated in the bladder leaves the body through the urethra, as does the semsn which is ejaculated at orgasm. The testicle is the male sex gland. It produces the male hormones which help govern the sex drive and are responsible for male characteristics, such as beard, muscular body and deep voice. The testicles also produce the sperm, the germ cells or seeds of future life which can fertilize the female egg, bringing about preganancy.

The testicles hand in the scrotum away from the body's warmth, since a temperature cooler than body temperature is best for sperm production. The sperm enter a large duct, called the epididymis, and continue travelling up through the two sperm ducts. The total trip after leaving the testicle may take several weeks, during which time the sperm mature. The fluids which comprise the semen are secreted mostly by the seminal vesicles and prostate gland.

At the moment of climax, the prostate, which is a muscular gland, contracts and helps to expel the semen, which includes the sperm as a very small part of it. The semen is emitted through the ejaculation duct, a small duct located within the prostate which empties in to the urethra. The urethra, which passes through the prostate, conducts the semen out of the body.

PROSTRATE GLAND AND SEMEN Shaped like a chestnut, the prostate gland surrounds the neck of the bladder at the point where this organ emties into the urethra. Like the testicles, the prostate gland secretes hormones. The secretion consists of a milky alkaline fluid called spermin and a chemical substance with a peculiar adour. At ejaculation the prostate gland contracts and forces this fluind into the urethra. In front of the prostate gland alongside the right and left deferent duct openings, the derferent duct of the prostate gland, too, opens into the urethra.

The prostate gland encases the urethra end and the deferent duct openings of the urethra lie in front of the prostate gland for two significant reasons. First, in the male ejaculation the deferent duct, its enlarged area and the seminal vesicle repeatedly contract simultaneously and build pressure in the urethra to ejucalete the spermatoza with the epididymis secretion and the seminal vesicle secretion, and by the ejaculation reflex the prostate gland contracts and ejaculates its secretion nearly at the same site into the urethra.

The ejaculation is mixed and emitted as perfected semen. Stimulated by the prostate secretion, the spermatoza grow highly mosile. Of the approximately 3 cubic centimeter semen the male emits at one ejaculation, four -fifths comprise the prostate secretion.

The ejaculated sperm total approzimately 200 to 300 million. Secondly, in an ejaculation the prostate gland contracts and presses the urethra at the upper sperm duct opening, which swells and closes the urethra at this point. This prevents retrograte ejaculation of the semen in the urethra or emission of the urine. The different duct opening swells at the moment of erection.

 

 

In next episode let's know about erection and ejaculation


Stop Fighting And Start Loving Again

The argument may start over something as simple as whether to buy an antique lamp. Soon your spouse accuses you of always being indecisive, and you point out that your partner is a hopeless spendthrift. The exchange ends abruptly when you stalk out of the room. Both of you feel resentful and misunder- stood, and both wonder: why do we keep getting into the same arguments over and over again?

Many couples get caught in circles of conflict they hate but can't seem to escape. Now, researchers who study the ways married people communicate are shedding new light on these patterns. They find three common threads. The first is the need to save face. “There is an image of yourself at stake that you feel you must defend, even though you know it isn't going to get you anywhere'' says Linda Harris.In a fight, he calls her a grouch. Her ego comes to her defence, and she calls him cruel.

That attacks his identity, which he must then defend. By now, the incident that triggered the dispute is lost. The second significant factor is misunderstanding: what one partner says is not what the other hears. He asks, “Is that a new sweater?'' He's thinking she looks great.

She replies, “I suppose you feel I've spent too much money again'' “Spouses who recycle fights,'' says Harris, “tend to read meaning into each other's statements that aren't there, or miss meanings that are there. Patterns of conflict are rooted more in the way husbands and wives relate to each other than in any personal flaw.

“Unfortunately, this is seldom the way people caught in the arguments see it. Instead, each partner vehemently blames the other for their problems. The third common characteristic of recurring arguments is that the issue on the surface is seldom what the real discontent is about. One wife and husband were caught in a pattern of arguing known as the “nag/withdraw'' syndrome.

Danger Signals : - Eventually husband got so resentful he'd provoke an argument. “I realize I'm not as orderly as wife'' says husband. “But I didn't want to be reminded of it all the time'' Three sessions with Linda Harris helped them see what they really fought about. Wife acknow-ledeged that what essentially bothered her was her husband's lack of physical attention:

“I wanted more everyday hugs and kisses.'' She had equated her husbands low-key style with how much, or how little, he cared about her. “I think a lot of my nagging was to spark more show of emotion. In fact, it had the opposite effect'' “She had a point'' husband concedes. “I've never given her as much spontaneous affection as she would like. But it's hard when someone is nagging. Since we're quicker to spot real issues now, we don't let tensions drag out'' Sometimes recycled arguments are no more that annoyances, but other times they are real danger signals of an unhealthy relationship, says psychologist John Gottman, “Couples caught in these circles are seldom close; often each partner feels unloved and belittled. But when they eventually face and resolve issues, there's a tremendous relief. Many couples report they feel 'in love again' ''

Taking Stock :- “Most of our hostility focused on how often Bob should play tennis on week-ends'' says Karen. He wanted to play both mornings. She thought they should take turns caring for their two young children. Finally, Karen told Bob she understood that tennis was very important to him and decided to say no more about it. “I listed all Bob's fine qualities and took stock of our marriage. It was too good to sabotage'' A few weeks later, Bob on his own proposed splitting baby-sitting on week-ends, with one morning out for Karen, one for him. This worked well.

Linda Harris says that co-operating or actually giving in when you don't want to, for the good of the relationship, can work wonders in shattering destructive patterns. Evan a small change can help. “If one of you says something new during a recurring argument, the other can't respond in the same old way''. According to Gottman, unhealthy fighters frequently make one of three mistakes :

They are too vague :- We may want more time or attention, but if these needs are only hinted at, they often surface as irritation. It's better to make honest requests such as “I'd like us to spend more time together on week-ends'' rather than “Why can't you even find time for me?'' They make requests in a negative rather than a positive way :- Their words come out sounding like putdowns rather than invitations :”you never ask me about my day'' instead of “I like it when you ask me about my day'' Phrase your complaints in encouraging rather than accusing ways. They don't listen :- Among all the communication skills listening is the most basic; it's also the easiest to learn and can help build trust and respect.

Here's how dialogue runs between husbands and wives who let each other know that they are listening – She : I had a miserable workload today. You're the only one I can talk to about it. He : Yes, but I hear problems at work all day. I don't want to hear more when I come home. She : you heard a lot of problems today? He : yes, I'm really all tired out. She : Okay, why don't you unwind. He : Fine we'll talk about your day. Healthy fighters realize that when they finish a fight, the relationship should be improved. Both partners egos should be intact.

They usually manage this by suggestions resolutions that include generous parts of compromise and creativity. They also realize change takes time. Therapists point out that in any intimate relationship, egos sometimes collide and personal styles grate. But if you establish a comfortable, workable pattern of communication, the relationship will have room for fighting words as well as loving whispers.


From Fertilization to the Birth of the Baby

There is still no simple way for the doctor to tell for sure before birth whether the baby will be a boy or a girl. However, after the egg has been developing for about fourteen weeks, a doctor can by means of a needle with a thin tube in it draw out a small sample of the fluid surrounding the baby (called amniotic fluid). Amniotic fluid contains cells of the baby, cells cast off by the skin or lining of the mouth.

Studying the cells to see whether there are two Xchromosomes or only one X and Y will reveal the sex of the unborn child. However, this procedure involves a small health rist and is not undertaken unless there is some urgent medical reason that requres a doctor to take a sample of the amniotic fluid. One such reason would be to determine if there is a serious defect in the development of the goetus - the growing unborn baby - which might result in such severe mental retardation or deformity that an abortion would be advised.


 

Since the thich lining of the uterus now is needed for the fertilized egg to implant itself and grow in, it is not descarded, and there are no more menstrual periods is usually the first sign to a woman that she may be going to have a baby. However, there are other reasons for delayed or missed periods, such as fatigue, excitement, nervousness, or change of diet or climate.

Therefore, a woman usually shoud wait for a week or two beyond her normal time of menstruation before she decides that she is probably pregnant. Then if her period does not come, she will want to know for sure whether or not she is pregnant. Beginning about ten days after her missed period, a dontor can tell for sure by testing a sample of her urine.

Other signs of pregnancy that some women may show a bit later are enlargement and tingling of the breasts, and 'morning sickness', when they feel sick in the stomach, most often in the morning. Once a woman is pregnant, her ovaries produce no more mature eggs until after the baby is born. Thus, when a woman has intercourse during pregnancy, no egg is there ready to be fertilized by a sperm.


Surprising Facts About Intercourse and Ageing

A newly remarried man told a team of researchers that he is thankful for his wife's “freedom from inhibitions.'' Together they discuss intimate aspects of their relationship. “Our new sexual activities and freedom to explore have been most satisfying,'' he says. What's startling about that? The man is 64, she's 54. “When I look back on the sexual aspects of my marriage,'' says one wife, “I see a picture of gradual growth in sexual pleasures. There may still be new wonders to discover with my spouse.'' She's 60, he's 65, and they have been married for 36 years.

The general opinion in many societies has long been that older people have little or no interest in sex, and little or no capacity for it. Now the findings of a new survey of 4,246 American men and women aged 50 to 93 the largest such study ever made – explodes this myth. The survey shows that most people will, or could, remain sexually active into their 70's and beyond, and that the warmth, excitement and comfort of sexual love will still be important in these years. The survey was conducted in the US by a non-profit product-testing and consumer-information organization, Consumers Union, and is reported. The CU report is full of surprises. The major one :

“What is often called 'the sexual revolution' is going on among people right now.'' Today's older people are far more interested in sex, engage in more sexual activity, value it more highly and are freer in their choice of sexual practices than almost anyone but experts in sexuality and ageing had imagined. A few examples : *Even beyond 70, over half of the women and three-quarters of the men are still interested in sex. * More than three-quarters of married women in their 60s have intercourse with their husbands : they average about once a week. * The great majority of widowed, divorced and never married people in their 50s and 60s are sexually active.

So are half of the single women and three-quarters of the single men in their 70s. Is it possible that so many middle-aged and older people feel and behave in ways, it was thought only younger people did? Or that so many will feel and behave like that when those years are reached? Probably fewer than the CU survey indicates. The people in it were volunteers, many possibly more sexually active than the average. The validity of the findings, then, may depend on how balanced the responses are about less-sensitive topics. In fact, these older respondents – who make up a broad segment of society – indicate they are reasonably well-educated, middle-class.

Therefore it's likely that they are also clese to average in their sexuality. And in one key area the number of older people still having intercourse. Thus the CU survey conveys an encouraging, even inspiring, message. As one 83 year lod woman puts it : “Younger readers will thank you for giving them hope for their old age. Older readers will thank you for bringing their feelings and actions into the open'' Here are some of the most significant findings :

Feelings about love and sex :- Nearly nine-tenths of husbands and wives say their marriages are happy, and nearly half say very happy. Reports a woman married for 38 years : “Istill get a thrill when I see my husband on the street or hear his voice on the telephone. And when he touches me, oh my!'' A 76 year old man says he and his wife fell in love in high school : “Love and dependence on each other have increased year by year and the 'love curve' is still upwards!'' And how do they feel about sex? A large majority of women and nearly all men, from their 50s through their 80s, are still interested in sex – some only moderately but many others intensly. Indeed, in their 50s almost half of the women and two-thirds of the men say their interest is still as strong as when they were 40. Even at 70 and up, only a minority say they have little or no interest.

More to the point, nearly all men and most women in their 50s and 60s continue to view sex as important to their marital or love relationships. Even beyond 70, only one woman in four feel that it no longer matters. How are affects sex drive and sexual powers : Research shows that as we grow older, our sense of taste, smell and sight lessen, and that our capacity for strenuous work or play dimishes. Naturally, therefore, sexual sensations and the ability to perform sexually diminish. Moreover, we've all heard that arthritis, diabetes, heart disease and other ailments common in later years can interfere with sex, making if difficult or impossible; some medications can also cause decreased sexual desire.

The CU report has good news about all these points. It finds relatively little difference between the sexual activity of healthy and ailing people of the same age. Though most people in the survey admit their sexual powers are waning, that dwindling causes far less decline in sexual activity than was the case a generation or so ago. When US sexd researcher Alfred Kinsey (1894-1956) conducted his surveys in the 1940s, he found in a small sampling that considerably more than half of the men and women in their early 70s had given up all sexual activity. In the CU survery, only one man in four and one woman in theree in their 70s have ceased all sexual activity. Only six out of ten married people in their 70s still have regular intercourse (about once every 10 or 11 days), as often as people 20 years younger in Kinsey's time.

Adapting to the sexual changes of age :- Many couples choose morinings for sex, for they have more energy. But even in perfectly healthy people, ageing of the tissues and nervous system results in slower arousal, weaker erectile response, dryness or sensitivity of the vaginal lining and other hindrances to sexuality. For some years, gerontologists and sex therapists have advised older people to deal with these changes by devoting more time to foreplay or even, if necessary, to let it serve as an alternative to actual intercourse. Some older people find that the preliminaries themselves not only yield physical contentment but enable each partner to give and receive tenderness and appreciation.

How continued sexual activity can affect lives and marriages : - Among the CU sampling, nine-tenths of older husbands and wives who still have intercourse call their marriages happy. But two-thirds of the older couples who no longer have intercourse are happily married. Nonetheless, sexual intercourse is less important to maritial happiness than it is in youth. Marital sex isn't a requrement for marital happiness in these years; it just adds to the chances of being happily married. A high percentage of older people remain faithful to their spouses (92 per cent of women; 77 per cent of men), some even when they feel sexually deprived. “Trust and fidelity outweigh the satisfication of fonquest and change of partners that seems so attractive,'' a man of 59 writes.

A 76 year old woman considered outside sex after her husband became impotent, then gave up the idea – explaining, “I have too much respect for him. It isn't important; being together is important'' How about the relationship between sex and general satisfaction with life? The CU report reveals a strong connection. Older people may find that sex is not only a way of being close and expressing love but a source of good feeling about one's self. It gives many of them a sense of vitality, of aliveness.

The CU report ought not be taken by readers as a blueprint of what they should do but only as a picture of what they could do if they wish, assuming they have the capacity. Some pelple in the survey seem relieved to be done with sex: others, who still want sex but whose spouses can't or won't have it, are happily married and reasonably satisfied. But for most older people today, sex is nature's great gift that keeps on giving.


ERECTION AND EJACULATION

The absolute prerequisite for sexual relations for the male is erection of the penis. The penis is covered with a skin extending from the abdomen called foreskin. As its point is the glands, which like the mucous membrane, is covered with a layer of skin highly concentrated with nerves. Under the surface, the penis consists of a spongy body of blood vessels through which the urethra runs. In an erection the spongy body is filled with arterial blood but not with vein blood. This is why the penis is erection has warmth and pulsation.

Erection is caused by : 1. Local stimulation applied to the meatus, glands or foreskin. The stimulatioh is transmitted to the cerebrum, where it is received as a pleasant sensation. By reflex, blood flows in the spongy body and causes erection.

2. Emotional and mental stimulation transmitted directly from the cerebrum. Adult erection is due more often to this cause rather than local stimulation.

3. Reflex from a filled bladder, experienced on rising in the morning. With the erection in sexual excitation, the right and the left glands, opening it to the urethra, and the numerous little mucous glands secrete a small amount of transparent, alkaline mucus and moisten the meatus to facilitate entry of the penis into the vagina. This alkaline secretion neutralizes the urethra, wet with the acid left by urinary passage, and assures safe passage of spermatozoa, which have low resistance to acids. Although this secretion is accelerated by local, direct stimulation from touch during erection, it may be caused entirely by emotional and sexual excitation even prior to erection.

We may even consider that this secretion is initiated only by emotional and sexual excitation. In short, the male may experience erection from local, direct stimulation, but sexual excitation not accompanied by a similar emotion will bot produce this secretion. Those ignorant of sex are likely to misinterpret this phenomenon of secretion as a symptom of premature ejaculation and many worry about it. This is nonsense.

Women, too, should not jump to the conclusion that erection of the penis signifies sexual desire. For instance, the male, even though weak from exhaustion, may experience erection from local stimulation, but lacking this secretion he will not have full coital desire. In such cases, intensified local stimulation will not awaken his sexual urge, but on the contrary, may even cause pain. Erection and mucous secretion from sexual excitation prepare the penis for intromission in the vagina. Following it, the stimulation accelerated by a series of friction reaches its height, and ejaculation takes place by reflex. It is an involuntary reflex, and though he may try, he cannot stop it.


From Fertilization to the Birth of the Baby

Let's go back for a moment to the instant of fertilization.

As soon as the egg is fertilized, it begins to divide and grow as it is moved on down the fallopian tube. As you know, it enters the uterus, and after a while implants itself in the uterine wall. The whole process takes several days. The uterus, as you have read is ready to nourish the egg as it grows.

Later, with increase in size, the growing baby becomes surrounded by two strong coverings and suchioned in fluid. Which protects it from jolts and shocks. The time between conception and birth of the baby is called the period of gestation. The baby grows inside the womb of its mother. This is the period during which the mother is said to be pregnant. In human beings, pregnancy, or gestation, averages 266 days, or about eight-and-a-half months, from the moment of fertilization, and 280 days, or nine months, from the beginning of the last menstrual period.

The baby, first called an embryo, later a foetus, grows by cell division, from one cell at conception to over 200 billion cells at the time of birth. It is nourished by the mother by means of a thick, disc-shaped collection of blood vessels called the placenta. This is connected with growing embryo by means of a long, ropelike cord, the umbilical cord. Through the blood vessels in this cord the embryo receives food and oxygen and disposes of waste products like carbon dioxide, but the mother's blood does not enter the embryo. The embryo manufacures its own blood. The human embryo at first resembles embryos of other animals. For a short time it has the beginning of gills, as in fish embryos, although they are not really gills; later it appears to have a tail; stilla later its body is covered with fine, downy hair.

At four weeks the embryo is about 1/4 inch long (as long as this :- but somewhat curled). It no longer has gill-like ridges, but still has a tail; and it would be difficult to tell it apart from the ambryo of a fish, turtle, chicken, or any other animal. At eight weeks the embryo is about 1 inch long, and it would take about five hundred such embryos to weigh a pound. Even though it is this small, it already has a large-looking head with the beginnings of eyes, ears, a nose, and a mouth. Its heart is now pumping blood through its small body.

At twelve weeks the embryo has made a great spurt of growth and is now about 4 inches long, although it weighs only about 1/3 ounce - about fifty embroys to a pound. At sixteen weeks it has grown to be 6 inches long and weighs 1/3 pound. Its bones have begun to develop, and its arms and legs can move. The mother may now be able to feel the first faint flutter of activity inside her, called quickening. When she feels this she knows with a new certainty that a live being is inside her. By this time the being is called a foetus, no longer an embryo.

At twenty-one weeks the foetus would be about 10 inches long if its legs were stretched out straight, and it weighs about 3/4 pound. Its body is now covered with downy hair. At twenty-five weeks the foetus is about a foot long and weighs perhaps 1 1/4 pounds. It is beginning to lose the hair that covered its body and looks quite a lot like a baby now, except that it is thin and has not yet begun to store up fat. At about twenty-nine weeks - seven months - is is 14 inches long and probably weighs over 2 pounds.

The body hair has all gone. (By twenty-four to twenty-eight weeks the baby has matured enough so that if it were to be born ahead of time it would have a bare chance to live, if well cared for in an incubator, a little, heated, enclosed, box-like bed which keeps a baby warm and protected. Such a baby is called premature, as is any baby born weighing less than 5 1/2 pounds) During months eight and nine the foetus grows rapidly to an average weight of 7 or 8 pounds. At the end of the nine-month gestation period, it is ready to be born, all 200 billion cells of it.


Did You Hug Your Child Today?

It was a perfect spring day. Clusters of honeysuckle sweetened the air and a profusion of lilacs lightened my heart as I drove along a wide, tree-shaded boulevard. Then, suddenly, a bumper sticker on the car directly ahead blasted my serenity.

DID YOU HUG YOUR CHILD TODAY? The bold, red letters challenged. I changed lanes. Minutes later, the bumber sticker reappeared, insisting that I face the question. I shivered as I recalled the rat-a-tat-tat of that mornin's kitchen criticism. “Mark, I told you yesterday that your neck was filthy, and you still haven't washer it!'' Why hadn't I thanked Mark for washing the bathroom floor, unasked? Why hadn't I told him how much I liked his new shirt? “Robert,'' that voice of mine persisted in my ears, “if you had come home at a decent hour last night, you could have got up this morning in time to pack your own lunch'' I had forgotten about the party invitation Bob had turned down last week in order to visit his grandparents.

Clearly, I had not hugged my children that day. And I wasn't really certain about the day before, either. Feeling more like a monster than a mother, I decided to find out how other parents would respond to the question that had shaken me. So, at our next parents group meeting at the school, I printed DID YOU HUG YOUR CHILD TODAY? In huge, capital letters on a blackboard that was in plain view, and waited for the reaction.

Nearly everybody “changed lanes'' pretending not to see the question. Finally, prodded by the few parents who dared to face themselves, we spent the next two hours being scrupulously – and sometimes paingully – honest. Almost all of us admitted that we had not hugged our children that day; in fact, many of us came to see that hugging was not our general style.

We were quick to criticize our children, but slow to compliment them. We often admired them, but seldom expressed our admiration. Bit by bit, we uncovered three reasons why our behaviour as mothers and fathers failed to demonstrate the real feelings we have for our children: 1 A surprising number of us don't know how to hug.

Some still think that a hug is simply an embrace. Not so! I came to realize that I hug Bob when I prepare his favourite dish. And Mark gets hugged everytime his father saves the sports section of the paper when our young mountain climber is away camping. We concluded that a tone of voice can be a hug. So can a smile, a wink, a sqeeze of the hand, a rumpling of hair, a whispered “Good luck'', an arm across the shoulder, a note on the pillow.

2. We may be afraid to hug. Some parents, especially fathers, seem embrrassed by any show of emotion. Even more. However, they are afraid of “spoiling'' their children with praise. Parents often worry about children developing an inflated opinion of themselves, but I have yet to talk with a psychiatrist, psychologist or social worker who doesn't say that a deflated opinion, a week ago, is the prevalent problem.

3. We don't always see any “huggable'' qualities. We have no problem hugging our soft, uddly babies, of course. But babies don't transfer grime from their hands to a towel and call it washing. Or embarrass their parents in from of company. Unmade beds, laundry-strewn floors and deafening rock music are seldom huggable. Small wonder, then, that we parents sometimes become so irate that we can't see the goodness for the “badness''

Fourunately, there are ways to train our eyes so that we behold our children with appreciation and can hug them. One way comes from Professor recently retired who, over the years, encouraged teachers to send a note home every week praising something each child had done. Sometimes the praise came easily. But the child who is hardest to hug usually needs hugging most.

Since Professor wanted every child to appreciated every week, the teachers she was supervising sometimes had to dig deep to find a legitimate compliment. In the digging, however, they found qualities they might otherwise have overlooked. Adapting the approach provides, a way for parents to give a daily-not just a weekly-hug. To be sure, it may be hard to find anything to compliment, but we can if we dig deeper. There is a second technique for hugging children: Be as courteous with your children as you are with adults. Sees that sound elementary? It isn't!

Few of us would talk to our friends without observing the amenities that we routinely deny our children. “Stand up straight'' No tact. “Have you taken a good look at how that shirt looks on you?'' No sensitivity either. My third technique for sqeezing out a hug occured to me when I was at my wit's end with Bob. After telling my good friend that my son had become “throughly inconsiderate, disagreeable, and disorganized,'' I paused for breath. Before I could continue mu litany, she said, “But Bob is such a generous boy, and he's completely undemanding. I wish my Nancy could be more like him, instead of always asking for a new 'something''' “Don't be too hard on Nan,'' I urged. “I've never heard that child say an unkind word about anyone. She's pure honey'' Suddenly, I realized: The way to admire your own children is to imagine they are someone else's. A parent who has lost a child acquires a permanent change in perspective- a viewpoint that offers a lasting message for every mother and father.

“Today, when I see parents impatient or tired or bored with their children, I wish I could say to them, 'But they are alive, think of the wonder of that!' '' A mother wrote those words Her son, had died of brain cancer when he was only 17. “Never'' she declared, “have I felt the wonder and beauty and joy of life so keenly as now in my grief that he is not here to enjoy them'' I intend to commit her words to heart. Any parent who does will never have to change lanes again when confronted with the question: “Did you hug your child today''


Female Intercourse Anatomy

The female sex organs are composed partly of internal organs, the uterus, ovaries. Fallopian tubes which are protected within the abdominal cavity and kept away from direct contact with the male, and partly of external organs such as the vagina and public region, which are exposed to sexual contact. Ovaries and Production of ova :- The female ovaries, homologous to the testicles in the male, lie on both sides of the uterus in the abdominal cavity. The female at birth stores thousands of immature ova in the ovaries. In their growth and maturity, ova differ vastly from the male spermatozoa. As the female reaches puberty, a single ovum matures and is discharged alternately from the two ovaries at an interval of 28 to 32 days.

The ovary secretes two kinds of hormones : estrone and progesterone. Estrone, mainly secreted prior to orulation, promotes the maturing and growth of the uterus and acteal gland as well as the development of the mucous membrane lining the uterus. Progesterone, added following ovulation restrains the oversensitive uterus lining. Therefore, during pregnancy particularly until the placenta forms a lage amount of progesterone is secreted continuously as a natural means of preventing miscarriage.

Fallopian Tubes and Fertilization :- The two Fallopian tubes are long, narrow ducts projecting from the upper ends of the uterus and embracing the two ovaries which lie under the tubes and on both sides of the ovary. When ovulation approaches, the Fallopian tube with a suction pump mechanism shaped like the sea anemone at its end, waits near the ovary and draws in the ejected ovum. By means of the cilialining the tube's inside wall and swaying toward the uterus, the Fallopian tube sends the ovum to the uterus cavity.

The ovum unites with the spermatozoon and fertilizes normally near the expanded area midway in the Fallopian tube. In the female body the ejaculated spermatozoa take at least eight hours to reach the swollen part of the Fallopian tube. The outerr wall of the ovum is agglutinated with hyaluronic acid. When the acid is dissolved by hyaluronitase contained in the sperm, the ovum is prepared to unite with a spermatozoon, which pierces a hole and enters into the ovum.

Its head continues its process of development called cell-division while passing through the tube. Approximately five days later it reaches the uterus and after another five days settles there. Capable of remaining alive for not more than a day after ovulation, the ovum passing beyond the tube's mid-point disintegorates and can no longer be fertilized.

Uterus and Menstruation :- The uterus is muscular structure shaped like an inverted pear about the size of a small egg and is lined with mucous membrane on the inside. The neck of the uterus at its lower end protrudes into the vagina. The upper portion is together with the ovaries and the Fallopian tubes, lodged in the abdominal cavity and is protected by the pelvis. The mucous membrane in the uterus is characterized by a thin layer of fundus adhered to the muscular wall and overlaid with the functional zone.

Upon contact with estrone and progesterone secreted from the ovaries, the functional zone starts growing immediately after menstruation. By the time the fertilized ovum enters into the uterus, its mucous membrane has thickened and is ready to receive and nourish the ovum. If there is no fertilized ovum to settle in the uterus, then all the preparation goes to waste.

After a while estrone secretion decreases temporarily, causing excoriation of the layer. This phenomenon is known as menstruation. At the end of menstruation the uterus lining repeats the cycle of growing and thickening, stimulated by estrone and later by progestrone.

Labia Majoro and Labia Minora :- The female external sex organs are closed from the right and left by the labia majoria (large lips) covered with a thick growth of public hair. The development of the labia minora (lesser lips) and clitoris is not necessarily proportionate to sexual experience in the broad sense of the term - that is, including masturbation as well as intercourse - but depends largely on individual differencdes. With a proper protuberance, the labia majora, together with the labia minora, participate in stimulating the penis in coitus, and at the same time, the lips themselves are stimulated by the penis. The smaller lips do not have hair on them and the left and right lips are not always balanced. Their size and color do not necessarily increase with sexual experience.

 

 

Some Details in Next episode ...


From Fertilization to the Birth of the Baby

In the last three or four months of pregnancy, as the foetus increases in size, things get a bot crowded inside the abdomen of the mother. Of course, the uterus is entirely separate from the stomach (in spite of what little children are sometimes told about the baby growing in its mother's tummy), but as the uterus expands, the bladder and stomach and all the other organs are pressed upon.

That explains why an expectant mother needs to urinate more often than usuas and eats smaller, more frequent meals. It seems a miracle that the remarkable plan of growth for the body was already contained in the DNA of the original fertilized cell. There was a set pettern that could not be changed.

Not only was it determined in advance that what would be born was a human being, and not a mouse or cow or elephant, but also determined were all of the thousands of inherited traits that make a person truly the product of his parents and ancestors.

You may wonder what the effect on the foetus is if the pregnant woman smokes, drinks alcohol, or takes drugs. Studies of these effects are not complete, but it is known that mothers who smoke tend to have smaller babies (this is not to say less healthy ones) than those who do not. Also, when the mother smokes, the heartbeat of the foetus speeds up somewhat.

When the mother drinks alcohol, the baby's movements inside the uterus are slowed down while the alcohol is in the mother's bloodstream, but this does not harm the baby as far as we know. Marijuana also has a temporary effect on the baby but not a harmful one. However, the drug heroin can be very injurious to the baby.

 

As the mother becomes addicted to heroin, the baby also becomes addicted, and after it is born it goes through painful and serious withdrawal symptoms, just as an adult does when taken off the drug. One birth is every ninety or so produces twins, (One in about every eight thousand produces triplets) Twins are formed in two ways. One is that each of the mother's two ovaries releases two eggs.

Thus, each fallopian tube contains an egg, or one tube contains two eggs, and, when the sperm cells enter the tubes, both eggs are fertilized. Each egg becomes seperately implanted in the uterus, and each embryo has its own placenta. Twins who start this way are really ordinary brothers or sisters whose original egg cells just happened to be fertilized at the same time and who were therefore born at the same time.

They may be of the same or opposite sex, and they do not look any more alike than brothers and sisters born at different times. They are called fraternal twins. The other way twins can occur is for the original fertilized cell, after implanting itself, to divide once into two separate parts and for each embryo then to develop independently.

These single-egg twins are always of teh same sex since they were started by the same sperm cell, and ususlly they look so much alike that they are hard to tell apart. They are called identical twins. Much rarer are triplets, quadruplets, and quintuplets, who are usually the products of two or more eggs. Triplets most commonly result from two eggs, one of which divides to produce a pair of identical twins, while the other egg produces a single infant. The famous Dionne quintuplets were thought to be the products of one egg dividing into five parts, all with the same placenta. The Diligenti quintuplets from Argentina appear to have come from only three eggs.

 


What Men Need From Women

Have you noticed? Men and women aren't as different as they used to be. And the majority of women seem to like the prospect of a unisex world – except for one nagging problem: many of today's men, mysteriously, lack a special vibrancy, vitality, gusto, pride that we once recognized as distinctively masculine. “Much is being said among women today about the dearth of vitalo men,'' wrote American feminist Betty Friedan. “I go to a town to lecture, and I hear about all the wonderful, dunamic women who have emerged in every field in that town. But frequently, whatever the age of the woman, she says, 'The men seem so dull and grey now. They're drearym they're flat'''

As reluctant as feminists might be to admit it, there is compelling evidence that men need a clearly defined difference between the sexes. Every human culture, until the late 20th century has provided such a diffference, creating an elaborate and often arbitrary contrast between men's and women's activities, dress and behaviour. In her 1949 classic, Male and Female anthropologist Margaret Mead says there is only one biologically based constant: women's role in all societies includes the bearing, nursing and primary care of children. Otherwise, almost anything goes-as long as it goes one way for women and the other for men.

“In every known human society, the male's need for achievement can be recognized.'' Mead wrote. “Men may cook or weave, or dress dolls, or hunt hummingbirds, but if such activities are appropriate occupations of men, then the whole society votes them as important. When the same occupations are performed by women, they are regarded as less important. In a great number of societies men's sureness of their sex role is tied up with their right, or ability, to practise some activity that women are not allowed to practise. Their maleness, in fact has to be underwritten by preventing women from entering some field or performing some fear'' It is this kind of exclusion of women that modern society no longer accepts.

We recognize the injustice-to- society and women- or barring women's talents from any field of endeavour. But we have not recognized the genuine needs of men that lay behind that exclusion. Men's need to have a role clearly distinguished from women's can be traced to three fundamental differences between boys and girls:

1 A baby boy is different from his mother :- As an infant boy begins to be aware that he is a separate individual from his mother, he must also learn that he is not like her. In Margaret Mead's words, “he must begin to learn to differentiate himself from this person closet to him ... he must find out ... that he is male ... not female.'' The boy must turn away from his mother to find himself. And in doing so, he needs to turn towards images of maleness that are powerful and attracvtive enough to compensate for his mother's enormous power over him.

The boy's need to differentiate himself from his mother has consequences for adult relationships. Men need to get away, into the world of work or the company of other men, to replenish their sense of being men. The trouble is, almost everywhere men go now there are women. According to Richard Robertiello, a New York psychoanalyst, this may be one of the reasons for male depression today. Men have to spend time with other men as companions'' says Robertiello. “That strengthens their masculinity''

2. Men Can't have babies :- To a small boy as to a primitive tribesman, child-bearing is a supremely awesome achievement. He can't do it and girls can, and he needs to know that when he grows up he will be able to do something just as important that women can't do. Since this will have to be cultural, not biological, it is something he will have to do, rather than something he must merely wait for, as a girl waits to grow up and become a mother. Hence, the importance of achievement to men: it is, in a sense, all they have for self-definition. When women, who have something so important and fulfilling to fall back on, complete for achievement with men, it can seem unfair.

If a woman can do everything a man can do and have babies, what use is a man? Fatherhood at its most involved is not the same as motherhood. Women need to allow men something equivalent, something uniquely theirs-if not an activity, then at least a quality, a style, a way of being that the culture honours as specifically masculine and that women admire, but refrain from emulating.

3. Most males are more muscular and aggressive tha most females :_ This is a bilogical difference that most cultures have used as the raw material for a unique male role. It is a difference that shows up early in childhood. Boys engage in more rough-and-tumble play than their sisters, while the verbal and social skills of girls are more highly developed at an early age. Many researcherrs believe that these differences are programmed into a boy baby by the male hormone testosterone. Most boys grow up with an interest in competitive physical activities and tests of their courage and strength that markedly exceeds that of most girls. “It is probable that the young male has a biologically given need to prove himself as a physical individual'' Margaret Mead wrote in Male and Female, “and that in the past the hunt and warfare have provided the most common means of such violation''

Since hunting and war served the survival of earlier societies, these activities were honoured, and provided a basis for men to feel pride in themselves as men. But today “hunting'' broadly understood as the exploitation of nature, and war.'' the nuclear arms race, now threaten survival. Women can help men get in touch with their masculine roots by accepting men's need to be alone together at times and by respecting the father-son bond.

Says Robertiello : “A man needs a woman who will affirm his maculine power, enjoy it, enhance it and get something from it, rather than envy it and try to destroy it'' Some of the classic expressions of male power can be integrated into the compassionate man of the 1980s. For example:- Fighting :- Every man needs to know that he has the courage to defend his wife, his children, his home, his integrity and ideals. This deep knowledge is different from the insecurity that drives some men to look for a fight. But to acquire that knowledge, most males need to find out that they can win a fist-fight or climb a mountain.

Once that confidence is established, it takes the form of a fearless relish in the thought of fighting to defend what is dear. Sports :- Athletics are ritual enactments of territorial defence through physical prowess. As cush, they are harmless celebrations of masculine capacities that helped our species survive. They make men feel good about being men.

Gallantry :- When a man opens a door for a woman, he is making a symbolic statement that his superior physical strength will be used to assist and protect, not harm. Apart from their sexual anatomy, greater muscular strength is men's unique human possession. They should be allowed to use it in a particularly masculine form of support. To these classic expressions of masculinity we need to add two new qualitie that men have learnt in the past decade: the capacity to be friends and collegues with women-and to have truly open, loving friendships with other men. There is an enormous overlap between the sexes. Intelligence, talent, courage, ambition, compassion, emotional vulnerability-all are human qualities that we share. If each sex brings to these qualities a different style and a special flavour, it can only make all of us richer.


Know More About ..

Vestibule and Clitoris

The clitoris, an organ homologous to the male penis, is located at the upper meeting poing of the right and left labia minora. Being the most sensitive among all female sex organs, it gives a plesant sensation at contact. In response to a stimulus it rises and exposes its head like the male glans, though less conspicuously. This difference spurs envy in some women, who assume that the male-endowed with the penis many times larger than the clitoris-is able to induge in greater pleasure. But this is a serious misconception.

The physiological structure may be similar, but the clitoris is highly concentrated with nerves and normally more sensitive than the penis. While the male has only one penis to give him plesant sensation, the female has an array of sensitive organs such as the labia majora, labia minora, vestibule and vagina giving her subtle variations in sensation. Within the enclosure of the right and left labia minora and beneath the clitoris lies the vestibule. The tiny urethral meatus opens directly below the clitoris and still lower lies the vaginal opening.

Tiny openings, as large as needle points on both sides of the urethral meatus, secretes mucus from the glands called skene's glands. Also secreting mucus and located on both sides of the vaginal opening are Bartholin's glands. The mucus secreted from the skene and Bartholin glands is slippery. Like the mucus from the cowper and other glands, they lubricate the male gland. The various mucuses are absolutely essential in coital preparation and their secretion is increased with local stimulation and emotional, sexual excitement. As more mucus is secreted in the female than in the male, the secretion from these glands is more important in satisfying both parties during sexual intercourse.

Hymen and Vaginal opening :-

The hymen, known commonly as the 'maidenhead' is a than fold of mucous membrane partly closing the vaginal opening. It normally permits the entry of a finger but nothing larger. In the initial sexual intercourse it is raptured with some bleeding and pain. It may be torn open naturally through other ways as in sports and auto-erotism. The hymen loses most of its identify after delivery of the first child.

Vagina and Cervix :-

The cresent canal measuring approximately 7.5 to 10 centimeters between the vaginal opening and the uterus is called the vagina. The anterior and posterior walls of the vagina have folds, which is coital friction enhance the stumulation on the male organ. This increases the plesant sensation in the woman as well. The vagina secrets in its lining some lactic acid which increases or decreases in amount with the mesntrual period.

Orgasm and Pelvic Muscles :-

As in the case of male, female orgasm is a reflexive convulsion caused by a series of increasing stimulation caused by the friction from the penis inserted in the vagina. Teh secretion from Bartholin's glands and certcix flows in abundance at this time and gives the impression that something similar to the male ejaculation occurs in the female. Nearing the culmination of intercourse, the female almost unfailingly transmits to the cereberum her mounting sexual exitement as she senses, from stimulation received locally as well as throughout her body, that her mate is approaching orgasm.

The stimulation grows and rapidly nears the climax, and at the moment of ejaculation she herself comes to orgasm. A characteristic noticeble in female orgasms is the contraction of the pelvic muscles. When the muscles lining the vagina contract, they strongly stimulate the penis in the vagina which in turn stimulates the vaginal walls. Two of the muscles produce a powerful stimulative effect, and through practice the female can voluntarily contract one or both muscles in coordination. Skillful contraction of these muscles during sexual intercourse not only stimulates the penis and arouses the male to ecstacy but also enhances the woman's own stimulation. On the other hand, to prevent the penis from becoming flacid following a premature orgasm, which falls short of her desire, she may continously or continually contract these muscles to prolong his erection and time shis ejaculation with her gradually diminishing orgasm.


How a Baby is Born and What a Newborn is Likeకె

In just a little less than nine months after the baby is conceived (the egg fertilized), it is ready to be born. The mother's first signal that the time for birth has come is usually the start of contractions of the strong muscles of the uterus, accompained by a dull ache or sensation of tightening as the contractions increase in power. (All muscles do their work by contracting)

At first there contractions are spaced perhaps fifteen minutes to half an hour apart, but when they begin to come every five to ten minutes, the mother should be taken to the hospital, or the doctor or midwife who will help her with the birth should be called in. (A doctor who specializes in delivering children is called an obstetrician; a midwife is a person, usually a nurse, especially trained to help in childbirth) The muscular contractions are called labour, and a woman who is about to bear a child is said to be in labour.

There is no doubt that giving birth to a child is hard work. It can also be painful, but much of the discomfort can be avoided by the expectant mother who has conditioned her body for childbirth (there are training courses available to help provide this conditioning) and who understands well enough what is happening during birth so that she can help guide the process.

The discomfort of a woman in childbirth is perfectly nutural, being caused by the powerful muscles which push out the baby. Many women prefer to have an anaesthetic, which relieves the discomfort. Other women whould rather be fully conscious while bearing a child, with only a mild anaesthetic or none at all. Understanding what the experience of childbirth involves can relieve fear and anxiety, and this relief helps relad the muscles around the vagina, and particularly the cervix, which must dilate, or stretch, to permit passage of baby.

Understanding makes the mother more relaxed, which increases the ease of the birth and helps spped the arrival of the baby. The average length of labour for a mother producing her first child is between nine and eleven hours from the time the first regular contractions are felt; but some babues come much more quickly, others more slowly. The time for mothers who have already given birth is usually shorter, averaging around six hours.

Usually, during good labour, the covering membranes which enclosed the baby break by themselves, and the water they contained, which had acted as a cushion for the baby, flows out through the vagina. Sometimes labour is progressing well but the membranes haven't broken by themselves. In such cases the doctor uses a little clamp painlessly to pinch an opening so that the fluid will come out and period of labour be shortened. After this 'breaking of waters', as it is called, and toward the end of labour, the baby is rather quickly transported through the vagina and out into the world by a series of pushes by the uterus.

The head usually comes first, and it is usually a tight fit. But at the time of birth the baby's head is compressible enough not to be damaged, and it serves well to open the way for the rest of the body. The doctor or midwife is waiting to guide the head gently as it emerges and to guide the baby out easily as the birth is completed.

After a minute or so, the doctor ties and cuts the umbilical cord. This process is painless, since the cord contains no nerves. Your navel, or belly button, is the small scar that shows where the umbilical cord that linked you to the placenta inside your mother was attached to you.

 

Some more details in next episode


Six Thoughts That Sabotage Marriage

Romantic love makes a good marriage. A man and woman stand cloased in each other's arms watching the sun slowly sink into an iridescent sea. They vow eternal devotion. In time they will descend the hill together, silver-haired, but no less devoted. This picture inspires many people to wed, yet in search of romantic marriage they often end up in not-so-romantic divorce.

Men and women who expect marriage to be a continuation of the ecstasy of their courtship are in for disappointment. Romance thrives on barriers, frustrations, separations and delays. Remove these obstacles, replace them with the everydayness of married life, and ecstatic passion fades. Some couples feel cheated and declare their marriages bankrupt. Romantics ignore the fact grow weary of each other unless they have cultivated common interests and values. Conjugal affection is a slow-burning, heart-warming flame. It cannot exist without kindness, consideration, communication, adjustment to each other's habbits, joint participation in several activities, consensus of values, and respect. Married couple must build up a “common capital'' of acts, habits and experiences that results in mutal acceptance, wothout the impossible illusions of the romantic ideal.

Husbands and wives should do everything together :-

“I don't think it's right for a husband to go one way, and a wife another'' said 44 year old Alf, who insisted that his wife go sailing with him. Marie preffered reading a book on the beach. “Is it asking too much for him to do what he enjoys while I do what I enjoy'' she asked. “But I like doing things as a twosome'' Alf explained. It is not good to pressure one's partner. Instead, offer exchanges. Alf could have said: “It's important to me that you come sailing, and so I promise to do something you enjoy'' Many people feel guilty when they do things, or go places without their husbands or wives. In good marriage, there will be 75 to 80 percent togetherness but also sufficient separateness to permit individual growth and privacy.

Good spouses should make their partners happy :-

One frequent error is to assume responsibility for other people's feelings. If someone believes that happiness is in the hands of another, the tendency is to sit back and expect large portions to be dished up as if it were apple pie. For 15 years Jean catered to Lionel's every whim, trying to make him happy. But Lionel was a malcontent who found fault with everyone and everything. Once Jean understood that it was impossible to make anyone happy, least of all Lionel she became more relaxed and outgoing. When Liones realized that Jean no longer accepted the blame for everything, he started occupying his time more productively. Taking charge of your own gratification and fulfillment increases the likelihood that your marriage will be enjoyable and rewarding.

Husbands and wives should speak and act without restraint :-

After stressing that he had come to see me solely to assist his wife, Velerie, with her problems, Bert invited me to “fire away with any questions.'' I asked him about some of Valerie's claims: was it true that he often yelled at her, and in a temper had thrown a TV set through the window? Had he really flung a cup of hot coffee at his 14 year old stepson? Bert shrugged and said “Well doctor, if a man can't let off some steam at home, he's likely to end up with ulcers or a heart attack'' Bert was expressinjg the sentiments of many. At work people find it necessary to be on their best behaviour; thus home becomes the place to release any pent-up emotions- “let it all hang out'' Instead of tackling the source of their frustrations, they kick the dog, beat their children, abuse their spouses-and see nothing improper or shameful in doing so. Yet attacks generate counterattacks. The most common relationship is “passive-aggresive'' behaviour. Rather than comfort the attacker, the injured person becomes a saboteur. Nora, for example, was extremely angry when Marv lost his temper, but she would never oppose him directly. After one of his outbursts she “accidently'' burnt his dinner and “lost'' his favourite cigarattee lighter. Politeness, tact and good humour all help to create a relaxed and loving home. Treat your spouse with at least as much respect as you would afford a perfect stranger.

True lovers know each other's thoughts:-

How often have I heard people claim: “If he truly loved me, he would know it without being tgold'' This myth is especially prevalent in the area of sexual intimacy. “If he really was sensitive to my needs, it would be unnecessary to tell him what to do'' Or, “When a woman is really in love with a man, she can sense exactly how to please and satisfy him. If she has to be shown how to turn him on, she is not for him'' Nonsense! One cannot automatically experience another person's feelings, regardless of the intensity of devotion; we learn through instruction, by example or by trail and error. It makes sense for marriage partners to each one another how best to get along with each other-say what you mean, mean what you say, and don't expect your spouse to read your mind.

A happy marriage requires total trust :-

One of my friends in college had been married for six months. I noticed that Gary's wife spent a lot of time with another young man, and I commented to my friend that he was asking for trouble. “Oh come on.'' he protestec. “Mike and I have been pals for years. I have a lot of studying to do, so why should I expect Sue to sit at home?'' I pointed out that Mike was good-looking, well-off financially, and available. Gary insisted that he trusted both. Alas, in a short while Sue informed Gary that she and Mike had fallen in love, and asked for a divorce. Most good marriages tend to be based on a tinge of insecurity. To be absolutely certain of a spouse's fidelity or devotion is to take the other person too much for granted.

It is more realistic to believe that one's partner can succumb to temptation. If you regard your spouse as too homely to attract another person, your trust will not generate respect, excitement or satisfaction. On the other hand, if you consider your spouse quite capable of attracting members of the opposite sex if neglec- ted or mistreated inside the marriage, you will increase your own displays of caring and affection that make marriage worth preserving.


Response in Males about ..

Sex Response in Males

The late Dr.Kenneth Walker, M.D., an eminent British surgeon and author of many books on sexology said "Sexual desire in the male is the product of two forms of sexual stimulation. One is the action of hormones secre- ted by the endocone glands and the other is stimulation of the senses'' "These two varieties of stimulation react on and rein- force each other. Only when the endocrine glands are properly balanced in a man sexual desire is likely to be arousedc so that he responds to the appropriate form of sensory stimulations''

A number of different glands collaborate in making the male responsive to sensuous impressions. The most important of these glands are the testicles and the master gland of the whole endocrine system, the pituitary gland. Removal of either of these glands prevents sexual drive from developing in a young person and will ultimately destroy it in an older person. The nerve centres which control and coordinate the changes and reflex movements occuring in the male during intercourse, are not situated, as might be expected, in the brain instead, they are found in the lower part of the spinal cord. These nerve structures are known as the erection centre and the ejaculation centre. The first of them is in control during the earlier phases of the sex acts, and the second during its earlier stages.

What is erection and how it actually happens?

Just under the skin of the penis is a series of small reservoirs resembling rubber balloons. Each of these balloons is fed by a group of veins and has two sets of valves, one for filling, and the other for emptying. The operation of the blood vessels, and valves is controlled by a network of nerves running directly to the spinal cord and brain. The genital "Communications Central'' carries impulses in both directions, from penis to brain and spinal cord and from the central nervous system to the penis.

Even then it is very impor- tant to determine when erection occurs and when it does not. Direct stimula- tion gentle stimulation, of the skin of the penis almost always results in erection. This is a reflex and can occur if the man is asleep under anesthesia, or even paralyzed. No nerve connections with the brain are required; the message goes from penis to spinal cord and back to penis. On the other hand the erection centre is brought into action by stimulations of a sexual nature either from the touching of the sexual organs or from the sensual stimulations reaching a man through the special sense of sight, touch and smell.

All of these uses are capable or arousing sexual desire. Sexual desire is also associated with great emotional activitiy and, according to the physiologists, the headquarters of the emotional life in hupothalamus, that large collection of grey matter situated at the base of the brain.


How a Baby is Born and ...

After the baby is born, the uterus goes on contrac- ting, but less vigorously, and a few minutes the pla- centa and the two cover- ings that were protecting the baby emerge. These are called the afterbirth and are disposed of.

At birth the baby is for the first time on his own, and his first job is to start breathing in air-something he did not need to do and could not do floating in fluid inside the uterus. Sometimes it is helpful for the doctor to suction out the baby's nose and throat with a rubber bulb syringe or a suction machine to make it easier for him to start breathing. After his first breaths he is likely to utter a small, high cry, which is a delightful signal to the mother, that she has produced a child. What an accomplishment! A new life begins. Many boys and girls, having seen babies a few weeks or months old and knowing how smooth and pretty they look, are a bit disappointed and even shocked when they see a newborn baby. (So are mothers and fathers)

Usually a newborn is not at all beautiful, not even pretty. He is wrinkly, splotchy, and often quite red. The baby's face may be swollen and look troubled, stupid, or even worn out, and in general he doesn't seem to be much of an addition to the family. But we have to remember that the process of getting himself born may have been fairly hard on him. However, his colour soon becomes normal, and his skin gets to look more skinlike. In less than a month he will be a lovely, desirable-looking baby, and even a day or two after birth can work wonders.

A newborn can see enough to tell light from dark, but things are blurred to him at first until his eyes get used to focusing. He can taste, and he can feel pain and pressure. He does not like loud noises or the sensation of falling. He quickly learns that the way to get what he needs is to cry. Many babies do a lot of crying during the first month, whether they need something or not.

An activity the newborn does very well is sucking. He has very strong sucking muscles and a little pad of fat in each cheek to help him. He will suck on anything that is put near his mouth. His mother has just the right equipment for him to suck on. At the end of each of her breasts is a nipple, and inside the breasts are glands that manufacture milk and a network of small tubes that bring the milk to the nipple when the baby sucks.

For the first day or two after the birth, the fluid from the mother's breasts, called colostrum, is slight in amount, yellowish, and watery. This is just what the baby needs: it contains some food and also special substances that protect him from possible infections to which he is exposed now that he is in the world. The baby sucks actively even though he doesn't get much, and such sucking stimulates the breast glands to make milk that is more nutritious.

Mother's milk is an ideal baby food: it is clean, safe and digestable, with just the right proportions of protein, fats, carbohydrates, minerals, and vitamins. Being held close and nursing at his mother's breast continues for a baby the feeling or warmth and closeness to his mother that he needs, and it is also pleasant and healthy for the mother too.

There are a good many mothers who do not wish, or do not feel able, to nurse their babies. These babies are fed from a bottle that has a rubber nipple and contains a special formula similar to breast milk, and they grow to be as sturdy and healthy as a breast-fed baby, especially if the mother or father holds the baby in her or his arms lovingly while the child sucks from the bottle.


How to Read Your Partner's Intercourse Signals

John Gordon came home from work not long ago and found his wife Sue dressed up in a long skirt. She greeted him with an enthusiastic hug and announced that she was serving one of his favourite meals – and by candlelight. Instead of complimenting Sue, John responded to her efforts with an angry frown.

When Kathy Price remarked that she was tired and wanted to go to bed early, her husband Bill bade her good-night and settled down to watch television. The next morning there was no sign that Kathy had benefited from her extra sleep. On the contrary, she snapped at Bill because he had forgotten to put the toothpaste back in the medicine cabinet. What was wrong with John Gordon and Kathy Price? Their sex signals were mixed up. Says Dr.Mark Bernstein “John was receiving messages that weren't being sent, and Kathy was sending messages that weren't being received'' John Gordon assumed that Sue's elaborate dinner was part of a plan to entice him into making love to her. That made him angry for two reasons:

He had put in hectic day at the office and was not in the mood for romance. He also disliked being manipulated. “But John's assumption was incorrect'' says Bernstein. “The dinner was a toughtful gesture, not an attempt at seduction. Sue had noticed that John had been looking 'down'. She hoped a festive meal would cheer him up'' Significant Signals :- Kathy Price, on the other hand, wanted to make love to her husband, and her pretext of going to bed early was designed to tell him so.

But Bill didn't get the message. He thought Kathy was really tired, and she ended up feeling hurt and angry. Marriage experts agree that it is not uncommon for couples to experience such breakdowns in their sexual communications systems. Says psychologist Eric Riss “Sex is an extremely sensitive and personal subject. Attitudes towards it vary, moods don't always match, egos are generally at stake. Thus it's not surprising that even the most compatible couples are sometimes turned to different channels''

Most couples express sexual wishes with hints, code words and symbolic acts. “There's nothing wrong with this'' says Riss. “But husbands and wives who use such signals should be aware of how easily they can be misread, misinterpreted or simply missed'' Riss counsel : choose signals that can be clearly recognized as preludes to sexual activity – wearing a particular robe, humming a special tune, talking about a favourite place anything that both partners will recognize and respect. Riss adivices husbands and wives not to conceal their desires out of fear of incurring a partner's disapproval “Take a chance'' he urges.

“An invitation to make love is a compliment. Most partners will be flattered, and although they may not acquiesce on the spot, they will undoubtedly return the compliment before too long'' Marital Hazards :- People who can't or won't send out recognizible sex signals are no less a problem than those who can't or won't recognize clear messages when they are sent. “In some cases the lack of recognition is deliberate'' says Dr. Bernstein. “A partner may prefer to ignore a singnal rather than give a negative response. Or he or she may be angry about something else and the missed cue is a good way of venting wrath'' Typical are a husband and wife who have an argument at the dinnertable. Later, the wife slips into bed clearly ready to kiss and make up, but the husband, brooding about the incident, buries himself in a spy novel.

“This kind of misunderstanding is hazardous to marital health,'' declares psychiatrist and sex therapist Avodah Offit. “The husband would be better advised to talk over and settle the original clash instead of setting up a communications blackout that will only lead to more serious conflicts'' Dr.Offit also urges couples to plan and prepare for their sexual encounters. “The average man and woman are too involved in daily routines to make an easy transition from breadwinner or homemaker to passionate lover'' she says.

“Making a date to make love will encourage both partners to create the right frame of mind. Moreover, anticipating sexual pleasure can add immeasurably to its ultimate enjoyment'' Many husbands and wives fail to respond or respond without enthusiasm to their partners sex signals because they don'tlike the ones they use. Tactful Responses :- Spouses who are averse to their partners sex signals are generally confused about how to change them. Offit's solution: Don't critisize the things you dislike; focus instead on what you prefer'' Dr.Bernstein is convinced that every marriage can benefit from a periodic discussion of the partners sex signals.

“A good place to begin is by discarding all your previous notions of what certain code words stand for'' he says. “Unless you know for certain that I have a headache means not tonight, don't assume that it does. “In his opinion, partners who hide behind such cliches might look for less ambiguous ways of letting their partners know how they feel. A good way to say “No thank you'' with a minimum of bruised feelings, he advises, is to tell your partner that you don't think you can be a very good lover. “A brief explanation like 'The children wore me out today' or “Things were hectic at the office' will help to clarify the situation'' At the same time, Dr.Bernstein insists that it is important to let your spouse know that your disinterest is only temporary. “Why don't we try in the morning?' or 'Let's make a date for tomorrow night' will show that you really do want to be a loving partner, but just not at the particular time'' he says.

For couples who want to update or improve their sex signals, Dr. Offit offers the following advice : “Try the simple words I feel, as in 'I feel like holding you' or “I feel very close to you' Whatever one can communicate from sadness at the brevity of life to joy at being able to awaken together in the morning will reinforce the essential bond that moves men and women towards sexual intimacy'' Husbands and Wives who solve the problem of sexual communications will not narrow the margin for misunderstandings in their marriage; they will also add to their enjoyment of the physical act of love. As Dr. Offit points out, “The initial indication of desire frequently sets the tone for the love-making that follows. When the former pleases both partners, the latter is likely to do the same.


Response in Males about ..

Sometimes the image of a naked woman in a magazine is perceived by the brain, a nerve impulse goes to the penis via the spinal cord, and erection results. Nervous signals cause the filling valves of each penile reservoir to open, blood pours into these distensible chambers. Since these chambers are fixed in place by connective tissue, as they distend the penis becomes stiff and hard. A deliacte system of pressure detectors keeps the pressure in balance at all times so the erection is not too hard and not too soft. While sexual excitement brings about erection of the male organ of the sex, it also causes great activity in the many secondary glands of sex, such as the prosfate.

The lubricating secretions produced by a special variety of these glands facilitate the introduction of the male organ into the female vagina. Penetration is followed by the more active phase of coitus, which is brought to an end by the sudden ejaculation of the semen, a composite fluid to which the testicles, the prostrate and the other secondary glands of sex all contribute their quota. The reflex of ejaculation is brought about by the ejaculation centre in the lower part of spinal cord.

During the earlier phases of sexual intercourse there is steady mounting 'nervous tension' in the region of the erection centre. When this attains a certain intensity, it overflows into the neighbouring ejaculation centre and 'triggers off' the final or ejaculatory phase of the sexual act. After erection has taken place and the penis is in the vagina, the circuits begin to hum sensory receptors within the skin of the penis are locked. As intercourse progresses, a constant flow of nerve impulses races betwwn the sexual organs and the central nervous system, building up and reinforcing itself.

All othe stimuli are integrated into the system. Looking at the sexual partner, touching her, being touched by her contributes to the rapidly building tension. Finally, when critical point is reached in sexual intercourse, the ejaculation is the result. The Urethra is sealed off so urine will not be expelled accidently. Secretions from the prostrate gland, seminal vesicles, and testicles are mixed on the spot.

The man's pelvic muscles contract to hurl the penis deeper into the vagina : stimulataneously involuntary arching of the back drives and entire body forward. At this point consciousness is obliterated and the man looses all contact with the world - except for those few cubic inches of vagina surrounding his penis. A powerful internal pump swings into action squitting a quarter-ounce of seminal fluid into the vagina in about sex consecutive jets.

Few moments later it is all over. On an average there are about 500,000,000 spern swimming in each quarterounce of semen. The average man propels about eighteen quarts of seminal fluid in his lifetime, or nearly one and a half trillion sperm. Therefore he is able, theorotically, to father about 500 times the number of people now living on this planet. Fortunately only one out of 288 acts of intercourse results in impregnation, usually involvsing one ovum and one sperm.


Human Intercourse and Animal Intercourse: Some Major Differences

The main function of sex in nature is reproduction that it, producing babies and carrying on the species, whether the species be birds, b ees, rabbits, hamsters, hippopotamuses, gorillas, or human beings. Nothing in nature could be more important, and that is why sex is so attractive and the drive for it so urgent. However, there are important differences between sex in animals and sex in human beings.

One difference is this; in most animals, copulation or mating usually take place only when the feamle is in heat- that is, as she is ovulating and when copulation will produce pregnancy. When she is in heat, she gives forth a certain scent or other sign which tells the male she is ready to copulate. The male then becomes sexually aroused (he 'ruts' or becomes 'rutty') and the mating takes place. At no other time is the female willing to copulate, and usually only at that time is the male responsive.

Thus, the main result of copulation in animals is reproduction. Of course, animals do not 'know' this. They copulate because they feel an urge to do so. In human females, on the other hand, there is no such thing as heat. Most women usually do not even know when they have ovulated and have an egg that is ready to be fertilized.

They do feel a greater desire for intercourse at some times than at others, but not necessarily at the time when they are most likely to conceive. Women do not give forth any special scent; their bodies do not advertise their readiness, as do animal bodies. Further, the human male is more or less always ready for sexual activity.

There is no definite season when he is 'rutty'. Thus, human sexual desire has relatively little relationship to whether or not a baby is likely to be produced at a given time. Most sexual intercourse between human beings takes place because of the desire, pleasure, joy, and love that are a part of it, rather than because of the need to produce children.


Needed : Help for Battered Women

Flavia couldn't believe it. Her eldest son, Vikram had lost his slipper and as a punishment, her husband had pushed Vikram and his two sisters out of the house. Two hours later, when Flavia opened the door to let the children in, her husband beat her senseless with a ladle.

 

As the horrified children screamed, “Mummy's dead'' their father threw a bucket of water on Flavia's face. It wan then, Flavia says, that she confronted the reality of her problem. The reason she gave herself – that she should put up with such periodic beatings for the children's sake – no longer served. Now, even the children were not safe. Wife-beating, so alien to our image of non-violence and respect for womanhood, is emerging as one of our least recognized and most appalling social problems.

 

Between January and December 1988 the bombay police registered about 240 cases of violence against women by their busbands. “It's sad but true'' admitted Ashutosh Dharmadhikari who formerly worked at the special cell for women and children located at the Bombay police headquarters, “that thousands of similar cases are never reported'' Instead of being a private problem, wife-beating is also becoming a matter of public concern.

Women who leave their homes, as Flavia had to, turn for support to already overburdened assistance programmes. Men who have committed assualt are so rarely reprimanded by the police and the courts that they are free to batter again and again. Children from these homes, unless they receive counselling, often become violent when they grow up or become ready victims.

Revealing Report :-

No one paid much attention to battered women until the early 1950's, when the then Saurashtra State appointed a committee under assembly speaker Pushpaben Mehta to study the high suicide rates among local women. Wife-beating and exorbitant dowry demands were found to be the two major reasons driving women to kill themselves.

Manu Subedar, a Bombay banker who happened to read the report, was aghast at its findings. He opened Bapnu Ghar, India's first shelter for harassed women in 1953 and after three years handed over its management to the State Women's Council. Today, about 40 similar centres for women have sprung up all over the country, mainly in big cities.

Bombay has three shelters which can accommodate about 230 women. In most cases, both partners are legally entitled to the family residence, unless divorce proceedings are under way and a court has ruled otherwise. But many a battered woman is scared that talk of divorce may earn her more beatings, ostracism from society and rebukes from her own family. Our cinema often reinforces such beliefs, portraying to make any sacrifice for his happiness. In most families the husband is regarded as a demi-god and few Indian wives dare think of leaving their spouses.

Police often regard husband-wife feuds as “social work'' or “domestic problems'' and not real work. Rarely do they see couples actually fighting and a man can't be arrested simply because someone is afraid of him. When Flavia went to the police station, the officer on duty told her “Your husband is an educated man. He will not be scared by our warnings because he know we can't do much.

“The police are, by and large, apathetic towards wife-beating cases'' says Flavia who has now separated from her husband. “The force consists mostly of men and some of them are themselves wife beaters!'' Laments a woman who was married to a police officer, “I bore the beatings from my husband for the sake of my child, hoping that things would change'' She waited in vain and today the couple is divorced. “Even if a woman files a police complaint against husband'' says social worked Shailaja Mhatre “her relatives try to persuade her to withdraw it in the name of family honour'' Many women themselves withdraw the complaint if their husband promise that they will stop beating them.


Preliminary Love Play In ..

In sexual intercourse, there is more than stimulation and excitation of genitals. It is therefore an essential part of exotic intimacy that a husband should pay some attention to preliminary love play in preparation for intercourse. While it is true that the entire skin area in human beings is receptive to erotic stimuli, we may enumerate some particularly sensitive areas of skin and body, the so-called erogenous zones; this list should, however, be taken with some reserve and not be considered as a scale of values or a recipe for a sequence of areas to be contacted before and during sexual activity.

For a male it would be better, if he begin his expressions of tenderness by touching first those erogenous areas that are furthest removed from the genital organs. As already told that the plam is an area of the body that is not only a donor but also a receptor of erotic stimuli, particularly by rhythmic stroking, pressure, and kisses. The bend of the elbow are still more excitable like walking arm in arm and the outerside of the thigh like walking close together. Then comes the innerside of upper arm and the hair line on the back of the neck are also the places which can excite a woman's body. The same can be said for the dimple behind the ear. This is the reason many females apply perfume in order to attract the male to this spot. For a more stronger stimuli, the areas of the nect and the upper part of the back upto the blades of the shoulder are perfect places.

The breasts, including the areola and nipple particularly, are most responsive in the majority of women. However, many women find touching the breasts or playing with them unpleasant if their partner begins too soon or too roughly. The waist, hips and lower part of the back including the sacral area, respond to stronger stimuli. The buttocks usually require stronger stimuli but are receptive to delicate stimuli at the transition zones to the back and inner side of the thigh. At the same time touching the delicate skin on the inner side of the thigh has powerful effect on a woman whose excitement has already begun and, provided the touch is gentle and not too premature, it will make her all the readier to open herself to her partner.

Direct stimulation of the genetals embraces the whole frudendal region with variations from almost casual stroking through playful rhythmic touch to intense and continued contact. The lips, the vestibule of the vagina, and the clitoris should all be involved in this play. At this stage when the female partner shows her willingness that she is ready for the union, the man should proceed further but not forgetting to continue his love play.

Erotic zones in male are more sparse than in a female. The only response to stimuli is centred in genitals in man. The female recognises his attempts by stroking his hands, his head, his lips and his hair, arms and legs, to increase the excitement. One should remember that all this may bring a man's excitement to a peak surprisingly very rapidly and cause him to ejaculate, especially if he is inexperienced or has difficulty in holding back for his wife's sake. A wife experienced in love will almost always have a desire to touch the penis and grasp it, and many men find this exciting. However, every woman at first feels shy about touching the penis, and there are many men who do not like to be touched there. This is a matter for matual understanding of the partners, and there is no general rule.


Human Intercourse and Animal Intercourse: Some Major Differences

Furthermore, animal copulation and human intercourse are quite different, as different as animal eating is from human meals. Most healthy animals gobble their food quickly when they are hungry. They aren't concerned with whether the food looks good or they are comfortable with the people at the table. They eat solely because they are hungry. If another animal comes around, they may try to drive the intruder away. But human beings enjoy eating together. There may be interesting conversation; the table can be a centre of affection and pleasure.

According to different national customs, there are different rules of behaviour toward other people; and there can be beauty, too, in the way the food is presented, the way the room and the table are docorated, and how the people look.

Sexual intercourse between a man and woman, as I have said, can be and often is a beautiful, loving, joyous thing. If the couple care for each other, their physical pleasure and sense of deep relationship can give them real ecstasy.

On the other hand, it is not always so, and much depends on how the couple are feeling toward each other at the time and how they feel about their own lives. It depends quite a lot also on their surroundings. That's why I slated that most animal sex is as different from human sex as animal eating is from human meals.

The basic difference between human and animal sex arises out of the facts that I have described. Human beings decide when they are going to engage in sexual activity; most animals have the decision made for them is learned or thought about. Human beings are responsible for their sex life; animals are not. There is great variation in human sex life, variation from country to country, from culture to culture, from gouup to group, from person to person. There is no such variation within a species of animals; dogs mate in the same way whether they are in India, France, Haiti, or the United States.

Animal sex is only a matter of body; human sex involves the personality, the mind, and the emotions - and the upbringing too. And there is yet another major difference. When animals in nature become sexually mature, they begin at once to copulate and reproduce their kind. And when young are produced by animals, the period during which the parents must provide care for them is generally quite short, usually less than a year. For example, with dogs and cats it is only several weeks, whereas human beings are responsible for the care of their young from fifteen to twenty years, or more - longer than any animal.

Even after human beings reach puberty, it may still be eight to ten years, or even longer in our culture, before they are ready to earn a living, establish a home, and take care of children of their own - in other words, to be responsible for the possible consequences of intercourse. This is something that boys and girls need to think about. There's much more to parenthood than having a jolly little baby to love, be loved, and be proud of. Let me repeat; and animal has little sexual freedom; it is limited by its seasons and driven by its instincts to copulate almost automatically. For it, the patterns are all set up in advance; there is little learning or choice. An animal sex life is primarilyfor reproduction.

But men and women have much freedom of choice; they must decide what to do an what not to do; they depend on good teaching and good learning. Men and women are responsible for their choices and decisions: they must take the consequences, good or bad.

Therefore, it is extremely important that they have enough knowledge, sense, and consideration to foresee those consequences and to act accordingly. Thus, human love and sex can result in pleasure and joyous satisfaction. Or the result be a great sorrow and unhappiness, if men and women in their sex lives ares not considerate of each other and do not take responsibility for the results.


Male/Female The Other Difference

Men and Women are different – obviously so in size, anatomy and sexual function. But some scientists now believe that they are unike in more fundamental ways. Men and Women seem to experience the world differently, not merely because of the ways they were brought up in it, but because they feel it with a different sensitivity of touch, hear it with different aural responses, puzzle out its problems with different cells in their brains.

Hormones seem to be one key to the difference – and an emerging body of ividence suggests that they do far more than trigger external sexual characteristics. They actually “masculinize'' or “feminize'' the brain itself. By looking closely at the fundamen- tal processes involved, investi- gators are finding biological explantations for why boys play more roughly than girls. Whether these pshysiological differences destine men and women for separate roles in society is another and far more delicate question. The particular way brains are organized may orient them towards visual spatial perception, explaining – perhaps – why they seem superior at mathematics.

Women's brains may make them more verbally disposed, explaining possibly why they seem more adept at languages. Males of most species appear to be hormonally primed for aggression, pointing – it may be – to the long evolutionary record of male dominance over women. But few of these presumed differences go unchallenged. And whether they imply anything more – about leadership capacities, for example, or that men are biologically suited for the workplace and women for the hearth – is another part of the thicket. The notion that biology is destiny is anathema to many researchers. To them, sexual stereotyping reinforced by a male-dominated culture, has more bearing on gender behaviour than do hormones.

“As early as we find sex differences among babies, we find the culture acting differently towards them'' insists Michael Lewis of the study of Exceptional Children.

Nature vs Nurture :-

The new research has thus revived, in all its intensity, the debate over whether “nature'' or “nurture'' plays the greater part in male-female behaviour. But beneath all the chaims and counterclaims, the sex research- ers are providing fascinating new glimpses into the biology of behaviour. It is widely agreed, for example, that in the majority of animal species, males are more prone to fighting than are females. Biologists trace this to the hormone testosterone, secreted in the testes of the male foetus during critical period in its development.

In 1959, American physiologists Charles Phoenix, Robery Goy, Arnold Gerall and William Young conducted still considered a landmark. When they injected pregnant guinea-pigs with massive doses of testosterone, the genetically female offspring in the brood had both ovaries and male genitalia. When the ovaries were removed and the aberrant females were given a fresh dose of testosterone, they behaved like males, even mounting other females – the gesture of male dominance in many species. Goy has confirmed the effects of testosterone in experiments with rhesus monkeys. Not only is female behaviour partly masculinized by pre-natal testosterone, but the robustness and vigour of males depend on how long prior to birth they have been exposed to the hormone. To see if hormones play a similar role in human behaviour,

John Money studied one of nature's own experiments – children exposed to abnormally high levels of androgens (male hormones) before birth because of adrenal-gland malfunctions. Among other effects, the researchers found that girls born with this disorder exhibited distinctly “tomboyish'' behaviour, seldom played with dolls and began to go out with boys at a larger age than other girls.

The much-cited Money-Ehrhardt research has provided a classic context for the nature-nurture debate. Some scientists maintain that the tomboyish was a clear result of the hormone exposure, and bolster their argument by noting the scores of animal experiments that demonstrate similar effects.

Other criticize the study for failing to emphasize that girls with congenital adrenal hyperplasia do not look like normal female genitals. Thusm they may be treated differently as they grow up, and their behaviour could be more the result of an abnormal environment than of a abnormal blood chemistry.


Techniques in loveplay and

One should remember that the sexual techniques in themselves are meaningless unless a proper emotional relationship exists between husband and wife. This knowledge of sexual techniques is no doubt very important for every married couple and its ignorance not only deprives the couple of marital satisfication but ruins their happily married life. It is often seen that the males are particularly guilty of letting down their wives and do not realize that the sexual intercourse involves far more than the physical union of the husband and wife.

If one of the two is completely devoid of gratification. Here too men folks are in belief that just touching is enough to stimulate their wives as is the case with themselves. As there are wide range of possibilities in the love- play, any individual partnership, recognition and communication will teach the partners what is appreciated nd what not. May be a basic type of approach will emerge with several variations aound it and in the course of time one or other version will come into prominence. But all this depends on mutual understanding. The same can be said of frequency of intercourse and its form. Remember that in every partnership of husband and wife, there develops a specific rhythm of intrercourse, for which there is no general rule and which changes from time to time to suit the wish of one or other of the partners.

This is also true as regards positions adopted in coitus. There are all sorts of possibilities as regards position of the two bodies while the genitals are in contact. Foremost in this position is that of where partners are face to face and it is preferred because they allow visual contact and thus permit the partners to see each other's facial expression. Generally speaking, it is the inexperienced male, without self-control and consideration for his wife who believes in surprise attacks, whether wife likes it or not. A husband should remember that all control, all initiative lies completely within his hands.

The wife can do only one thing of omportance, and that is to relax that too by the mutual help of her husband. Before attempt -ing intercourse, the husnabd should also thoroughly acquaint himself with the genitial region of his wife. He should direct his attention to the construction of the vaginal canal and the location of the hymen, so that direct and not angular pressure may be used against it. Depending upon height and size, it may be necessary for a woman to be placed with her buttocks on a pillow to elevate the extemities, or she may be forced to bend on her knees sharply or even trap her legs about the waist of the male, to mention only a few considerations. These physical peculiarities which the male must study as the women very definitely vary in structure.


Sex Differences Between Men and Women - and Some Similarities

We are now ready to go more deeply into the subject of sex differences between men and women - into human sexuality. Sexuality means more than sex. It means all that goes with being a man or being a woman. It means a person's sexual nature. Authorities who have studied sex differences do not agree on the extent to which they are inborn or are created by the environ- ment, that is, the society we live in. Before we think about differences between men and women, we should remember that there are atleast two great similarities:

First, as human beings, we are much more like each other than we are like any other animal or either sex. We speak and write language, we think complicated thoughts, we can remem- ber the past and project ourselves into the future, we have imigination, we enjoy planning and loving and seeing ourselves as parts of the universe. Both male and female human beings are self-conscious and other-conscious in ways that no other animals are.

And the second great similarity is physical: Again as human beings, both men and women can enjoy varieties of sexual activity and the ultimate sexual pleasure of orgasm with a degree of conscious awareness that animals, as far as we know, do not have. As for the differen- ces, when we compare the sexuality of men and women, it is important to remember that a woman is more than just a non-man, and a man is more than just a non- woman, and that every woman is different from every other woman, and every man different from every other man.

Sexuality in Men :- When a boy has matured sexually, the sexual thoughts in his mind and feelings in his body are quite definite and strong. They may be aroused ata any time and rather quickly, and the arousal may be quite involuntary. The physical feelings are strongest in his penis and may sometimes make him desire an ejaculation. However, most erections end without ejaculation. As boys grow up, many of them come to understand that a sexual experience like intercourse is not something to be sought lightly or selfishly. When it is part of an expression of tenderness and caring, it can be a deeply stirring experience. Boys and men can combine their intelligence, their emotions, and their sexuality to help create relationships based on love, understanding, and caring. Girls can, too. Sexuality in Women :- A woman's sexuality tends to be somewhat different from a man's. Generally her sexual feelings are stirred more slowly, less often, and less sharply than those of men. However, once aroused, her feelings are very powerful and very pleasurable. For a woman, sex is usually a response to love or to a romantic feeling in addition to specific excitation. Also, it is a way to express her love. But she expresses it in many ways besides intercourse.

Thus, women want intercourse less at some times than at others, yet it is expecially important to most of them always to give and receive love and affection as a part of lovemaking. The sexual nature of women helps to make them understanding, considerate, and affectionate, and it is a great force in creating deep and satisfying human relationships. The sexual nature of men can well do the same. Too often a man thinks that a woman reacts - or should react - just as he does; and a woman does not understand the speed and power of a man's reaction.

Understanding their sexual differences and lovingly considering them will help a man and a woman to be happy together. Many years ago it was widely thought that men were supposed to enjoy sex and women were supposed to endure it. There are still some people who believe a woman is not quite 'nice' if she really enjoys sex. But ever since the 1920s people have come increasingly that a man does to a woman or that a woman does for a man. A woman's orgasm is as strong and definite and exciting as a man's ejaculation, and may be even more so. Also, her orgasm may last longer than a man's and she may have several orgasms in rather quick succession, which a man cannot have. Intercourse at its best is a mutual exchange of pleasure.


Reactions of Man In ...

Sexual Reactions

Sexual ignorance in the males is largely the cause of the incom- patibility so prominent these days. Compared sexually with women, nature has certainly bestowed him with advantages. Whereas a male is quickly aroused and satisfied, the female is just his opposite.

Therefore, it is not remarkable that sexual incompability exists as a constant threat, as nature has purposefully encouraged it. All this shows how important is the need for proper sexual adjustment for matrimonial permanance. Surprisingly, as it may seem, from the standpoint of psychology and physical structure, woman is by far the more interesting and complicated of the sexes. Whereas the man, on the other hand, is a relatively simple sexual machine compared to female and headed only in one direction.

So, when a man looks at a woman, he immediately desires her. If he succeeds in wooing her then within a minute he can automatically sustain an erection, and in the very next minute or so he can experience orgasm then after a minute or two he go to sleep with happy dreams all around him. This is all that can be said about a males sex individuality. So, there remains very little to talk about the sexual behaviour of the normal man.

When you think of a man, you have to eliminate erogenous zones except two ; (1) The mouth, and (2) The penis. As with a woman, any area of the male when it comes in contact with that of a woman, will induce desire if at all there is no privacy for them, whereas in a bedroom the same contact may localize itself. A man can be stimulated by a woman's mouth anywhere but by her hand only at the genitals.

Still more when the neck, mouth, breast nipples, waist, Ioin, genitals and inside thigh are responsive only to oral contact. Except when a woman goes out of her way, which she rarely does, to stimulate her husband, the only erogenous zones brought into play are the mouth and genitals. Whereas for a male pre-intercourse excitements comes only from handling the female.

As a rule, the entire male sex is, easily and readily aroused. Any man can engage himself in intercourse, if he spends a few minutes in exploring the female body. Truly a man can experience only one orgasm during a relationship. If the first one is incomplete then only he can have the second orgasm but this can only happen once in a hundred acts of intercourse. It is said that any average man may not be able to feel three double orgasms in his entire lifetime apart a night or a month.

The same consistency is maintained for his satisfaction also and within a minute or less, he is thoroughly cooked may feel exhausted following orgasm and lie completely limp and relaxed, not in a state of emotion but in a state of remperation. Once the excitement of a male has subsided, he will refrain from having any sexual intimacy immediately for the time being. At that moment he can loose all sexual desire for the woman at his side.

Even if he wants to plant a kiss on his partner, this will be an effort and he has to force himself in doing it. Duty takes over the emotion and whatever he does afterwards, is just because he feels his duty. On the top of it he may even wonder why he had done it in the first place, when he feels so calm and relaxed, and wants to be left alone without looking even at his partner who gave him such a pleasure. The average man is capable of restimulation within a period of from fifteen to forty-five minutes.

Sometimes the second orgasm is more intense than the previous one but in general cases it is not so. Since the initial emotional stage is not so high, the second orgasm can be delayed without an effort. Although there are occassions on which every man has indulged the desire for a repeated relationship, such occassions are rare and are deleterious to male health. For a woman, it is natural to desire the repetition and it is the sign that she was not satisfied in the first place.


Homosexuality - Being 'Gay'

Some people prefer sexual partners of their own sex and are not sexually attracted to the other sex (although, like anyone else, they may be attracted to people of either sex in many ways other than sexual) Such people are called homosexual. They often refer to themselves, and are referred to, as 'gay'. Most homosexuals look no different from anyone else unless they choose, as some do at times, to look, dress, and act differently.

The word 'homosexual' means 'having to do with the same sex'. (The first part of the word comes from the Greek homos, meaning 'same', not from the Latin homo, meaning 'man') The opposite of homosexual is heterosexual, 'having to do with the other sex or with both sexes' (from the Greek heteros, 'other'). Homosexuals are called 'straight', as distinguished from 'gay' Female homosexuals are often called lesbians. The name comes from the Greek island of Lesbos, where, in ancient times, many of the inhabitants were women who enjoyed a homosexual way of life together.

There are many people who are not homosexual or heterosexual in the complete sense, but are bisexual (bi-comes from Latin and means 'having to do with two' ). They are people who can go either way, heterosexual or homosexual. People often ask : What causes some individuals to prefer homosexual love and others to prefer heterosexual? Because of the present incomplete state of our knowledge, there is as yet no answer or single theory on which all scientists and doctors agree.

There is fairly general agree- ment, however, that our prefe- rences are for the most part established in the first few years of our lives and have to do with how we are treated by our parents and others very close to us. Some boys and girls when they enter puberty, or even earlier, feel strongly attracted to members of their own sex. For a while, most boys usually much prefer to associate with other boys, and girls with other girls. With some, these friendships are close and intense.

They ocasionally involve sexual experiences such as kissing or caressing, or masturbating together. Such experiences in most cases do not mean that those who participate in them are homosexuals. Most adolescents who engage in them go on to form heterosexual relationships. Sometimes, also, a younger boy develops a special intense fondness for a man, perhaps a teacher or a coach, or an older boy. Some girls experience the same sort of feeling toward a woman or older girl whom they admire. (Such a feeling is sometimes called a 'crush'). It is usually a one-way feeling; the older person probably does not feel the same way and may even be unaware of the special emotion of the younger person.

Ordinarily, after a time; the boy or girl develops other interests and the intense feeling passes. This feeling of warm admiration for a more mature person of the same sex can have a beneficial effect on the development of the character and personality of a younger teenager, if it leads him or her to strive for the admired qualities. It is impossible to say how many people would openly express themselves through a mainly homosexual style of life if they felt perfectly free to do so. Perhaps as many as 10 per cent would, and probably more men than women. As it is, many people know that they are homosexual but feel forced to try to hide it from the rest of the world.

The reason for this is that, commonly, life for homosexuals in the present state of our society is made difficult because so many people unthinkingly condemn homosexuality as strange and abnormal and reject those who practice it. This condemnation and rejection make it difficult for many homosexuals to have good feelings about themselves. Also, it is more difficult for homosexuals than for others to get good jobs or to be accepted as friends by heterosexual people.


Marriage Is Not a 50/50 Affair

I asked a friend recently if he thought he had a 50-50 marriage. “Why, certainly'' ne said.”She does ninety per cent of the cleaning and I do ten per cent' I do ninety per cent of TV watching and she does ten per cent. I suppose that averages out to fifty-fifty'' He was only half-joking. For years we've been hearing about the ideal of the equal marriage. Is sounds nice in theory, but what's today's reality?

In the last 20 years, men have indeed become more involved in family life. According to recent surveys, Ameri- cans men are doing more around the house, and feeling greater psycho- logical well-being and happiness from their families nowadays than from work. Yet they still aren't doing very much, and this is true even when their wives have full-time jobs. On an average, working wives in the US spend 26 hours a week on housework; their husbands spend 36 minutes. (The one household activity that men are likely to do is shopping)

Working women in India, too, do a disproportionate share of the household. What does this mean for the ideal of the 50-50 marriage? Should we women forget about it and leave the men snoring on the sofa? Or should we keep striving for a perfect partnership-and feel miserable when we fail to achieve it? Neither extreme is necessary if two traps are avoided. Trap 1 is the assumption that a marriage can be 50-50 in all spheres, all the time. Marriage is not like that; it changes constantly, like the ocean. You may have the emotional upper hand this week because he is grateful for the long nights you've spent typing his overdue memos, and lose it next week when his favourite sports event is on. Even the most egalitarian marriages aren't 50-50; they're 2-98 this week and 98-2 next week.

Trap 2 is the assumption that all kinds of 50-50 marriages are worthy. In recent years we've heard about several model relationships. There was the togetherness marriage, in which husband and wife shared every activity, decision and waking minute (except whn she was feeding the baby, and he was out with his friends). Then there was the shared-duties model, in which husband and wife divided up every family task (except when he asked to be excused because he didn't know how to cook). And there was the emotional-balance model, in which husband and wife didn't care what each did, so long as they loved each other equally (except whn one was grating on the other's nerves). Well, not all equal marriages are created equal.

Harsh Realities :-The togetherness ideal flopped because it ignored individual preferences. “When mu husband took up photography'' says my friend Grace, “he insisted I join him on his expeditions to photograph buildings, boats, whatever. He even wanted me with him he developed his photos. Have you any idea how boring that is?'' Grace truly wanted to share her husband's pleasure, but it took her-and him-a long time to realize that some joys are solo activities. The idea that an equal marriage meant identical experiences for both husband and wife put a terrific strain on many couples.

The shared-duties model also ran into harsh realities. When my friend Marcie got married eight years ago, she and her husband drew up a meticulous division-of-labout contract. They calcula- ted huw much time each would spend doing various household chores, and when. It drove them crazy and lasted only four months. “I'm pulling about 75 per cent of the household load these days,”Marcie says.

“But he does a lot of things I can't or don't want to do. I haven't forgotten the original dream-I've just revised it a little'' Like togethernessm the shared-duties ideal suffered from rigidity and extreme expectations. But we need not give up the idea entirely.

Sharing Authority :- The motional-blance model collided with problems over power-sharing. As one young woman told a researcher “My husband was brought up in a totally husband-domineered situation. The wife never did anything except to say, 'yes dear'. Women have changed a lot since then, and they aren't going to back again. This has ramifications for everybody's marriage'' It certainly does. There are still some happy, 'yes dear'' marriages, but they are becoming rare, In survey after survey, most American couples report that a “yes dear'' marriage is a recipe for argument, bitterness and frustration.

When decision making and power are concentrated in the hands of one spouse, the other is alomot bound to feel unhappy. How close are we to reaching this form of the 50-50 ideal? Closer than we may realize. In the last decade of inflation and change, many men have been willing to share the economic burden with their wives. They haven't been as happy about sharing authority, but that's changing too. My friend Kathy has been married for 23 yearsm and her marriage could be a barometer of the times. “When we got married.'' she recalls, “I was expected to stay home and be ready to be 'together' with my husband at a moment's notice. We had many aruguments when I wanted to go back to college for a degree in social work; it was an insult to his pride to have a wife who would be working. But by the time my studies were completed, it was okay with him if I worked – as long as I didn't make much money. Later on even that changed. Now I think he'd be happy to let me support him!''

Equality That works :- The problem with the 50-50 marriage ideal lies in the unrealistic notions many people have of it. No two people can split a marriage in half as if it were an apple. No two people can be identical in emotions, interests or responsibilities. And no two people can divide their authorities and skills in some identically 'fair'way. But emotional equality-where both partners feel equality loved, share in family decisions, and feel they contribute equally to the family's well-being-is the kind of equality that really works. What is important in marriages is the spirit of 50-50, with flexibility and give and take-whether in dish-washing, decision-making, child-tending or any other activity of love.


Reactions of Man In ...

Among males passion is a varying element, but is limited to eagerness and to behaviour during the orgasm. The majority of men are reasonably gentle and there actions are moderate. Though there are few, who behave as though they would tear a woman apart, and can cause the bleeding of a vagina. The build-up is a tickling sensation that starts in the head of the penis, seems to run completely up the organ as it gathers a pleasurably intensity and then bursts with a series of convulsive and uncontrollable spurting expansions and contractions as the male sperm ejaculated.

The male exhibits a tendency to accelerate the tempo of his rhythm as a climax approaches in an endeavour to bring it on with a rush. As sson as the spurting has ceased, the male has the desire to relax, and it is this reation, if he succumbs to it, which leaves his partner unsatisfied. Whereas the male now prefers to forget the relationship as quickly as possible, a woman is not averse to and, indeed, prefers, a measure of petting as if to be assured that her husband's affection for her is just as deep as it appeared to be some minutes previously. The thoughtful male, then, will drop off to sleep with his arms around his wife and will continue to hold her close until such time as she is inclined to fall asleep.

This is supposed to be the proper method instead of where a husband turns over on his side and woman deeply resents. A man must check his behaviour not only during but after intercourse as woman rarely complains of it. Like women, man also varies in their behaviour during the orgasm. Some burst into tears and starts sobbing, others shake their head violently and utter cries and some whisper softly.

Watch your actions :-

Failure in sex life in the early years of marriage may be attributed to the husband's lack of understanding of the wife, but later failures can be traced largely to the wife's lack of understand -ing. It is not right for a wife to think that she should be loved and understood by her husband just because she is a woman: She not only refuses to correct her own defects but even believes that the husband who cannot tolerate her defects does not love and understand her. There is the woman, on the other hand, who has no intention of correcting her husband's faults because she thinks she loves and understands him too much to correct him. Neither type of woman sincerely loves or tries to understand male.

Whisphers of love :-

Nearly all women think that love is whispered to women only, and that men do not need to hear the expression of love except in the early period of marriage. The husband certainly does not seek words of love from his wife after that early period. But this does not mean he does not like to hear such words. Though he may feel embarrassed, it is not at all unpleasant. If he does feel uncomfortable, that means his heart is with his wife's unseen rival. During sexual relations, the woman should also utter proper words to love to her lover. Her belief whispers are often rewarded by his passionate caresses. Women are occassionally discontented when sexual intercourse or caresses do not come upto their expectations, but they do not want to make unfeminine demands. In such circumstances, a woman with some sense knows how and when to speak words of love and indirectly stimulate him. But, alas, all she does is to ask him whether he still loves her! Why can she not tell him that she loves him? Instances are too numerous to list here in which this little advice breathed fresh air into the relations of couples.

The happiness of being loved and satisfaction of confirming by spoken words are certainly not monopolized by the female. A senseless woman, or man for that matter, would never think of whispering words of love. Instead, she would blurt ot a string of insults. Even if she may be telling the truth, she has no reason to use insulting expressions if she has understnding love for him. Just as his railleries may cause her to become frigid, her careless remarks may drive him to impotency, decline in erection, premature ejaculation, and weakened sexual desire.


Homosexuality - Being 'Gay'

Those who discriminate against homosexuals in this way are displaying what is sometimes called homophobia; a strong, unreasoning fear of homosexuality. It is not unlike racial or religious prejudice. Despite the effects of homophobia in our society, however, many homosexual and bisexual men and women are happy and satisfied and are managing to make successes of their lives. They are found in all walks of life - the sciences, engineering, construction work, the arts, sports, and business management, to mention only a few. Homosexual leaders and many other use the slogan 'Gay is good'. They have recently organized into hundreds of groups around the country, some on school and college campuses. Together, these groups are known as the gay liberation movement. This movement encourages homosexuals to 'come out' freely to enjoy their style of life, and to fight discrimination against homosexuals.

Gay people feel that they should be allowed to express them- selves just as heterosexuals are allowed to do - by holding hands in public, dancing together at a party, or introducing their family to someone they love. But they find that it takes great courage in our anti-homosexual society for them to do these simple, human things. They say that homo- sexuality is not a problem in itself, but that the problem lies in the bigotry and discrimination that gay men and women facem and they urge all people, straight and gay, to uphold the right of gay people, along with all people, to live in ways that are fulfilling for them.


5 Intercourse Secrets Women Wish Husbands Knew

How can my husband and I love each other so much, yet have such an unexciting sex life? Asked a friend, a school science instructor who, ironically, teaches sex-education classes. Had she discussed the problem with her husband, a physician, to whom she's been married for 12 years?

“I seem to be able to talk to him about everything but our sex life,'' she said at last. “I don't know how to tell him that I need without seeming to criticize'' Women of all educational levels and life experiences voice similar sentiments. “Most married people lack basic information about their spouses sexual preferences,'' says Pamela Shrock, a theriapist.

My own informal survey of 60 wives found a myriad of needs they wanted to share with their husbands. But, as one woman told me, “It's difficult to know how to begin'' Later I talked with six top sex therapists and was surprised at how often they agreed with the wives about what women would like to tell their husbands.

Here are the five most frequently cited “sex secrets'' 1. Great Sex – for a woman – begins with her life as a whole. Most women need good feelings and experiences during the day and in the marriage to have satisfying sex. “Gary just didn't understand this'' says Vicki, 20 and married seven years. “He was under a lot of stress at work and was impatient and withdrawn, not wanting to talk or show any affection. He'd watch TV until midnight, then come in the bedroom and grab me.

If I wasn't instantly responsivem he'd get upset'' How a man treats his wife out of bed can greatly influence her response in bed. Hurtful words, inattentiviness and criticism can make it difficult for a woman to be enthusiastic, passionate lover. This puzzles some husbands. According to sociologist Lynn Atwater, “Women see everything in their lives as interconnected. Men tend to compartmentalizew, feeling that a stressful time can be parked mentally and separated from sexual actions''

“Sexuality and affection can't be compartmentalized'' says Virginia Johnson Masters, a world renowned sex researcher. “Good sex is a continium of closeness and affection'' Noted therapist Ruth Westheimer agrees : “It's important to act loving even when you're not about to have sex. If a husband surprises his wife with flowers or a gift for no particular reason, if he takes the children for a day, this thoughtfulness may improve the couple's sexual pleasure- and the marriage''

Speaking up in a firm but gentle way about hurts can help too. When Vicki told her husband about her need for attention and conversation before bedtime,'' she says. “We talk or listen to music or I might give him a back rub if he's had an especially tough day. Now both of us feel happier and more loved''

2. Many women find talk a turn-on : Good conversation over dinner or while the two of you are relaxing can be an aphrodisiac. Sexual sharing later is enhanced by tender words. A man might tell his wife how much he loves her, might also whisper her name-reassuring evidence that he is mentally with her during sex. Lynn Atwater found that 75 per cent of women she interviewed who had extramarital affairs sought a lover not primarily for sex, but for warmer communication. “One woman knew her lover was impotent, but his tender talk give her something her husband wasn't able or willing to give her'' says Atwater. “For many women, talking and feeling loved are more important than sex,'' says psuchologist Lonnie Barbach, “Especially for a woman busy at home with children, an intellectually stimulating conversation can be a real pleasure''

3. Women, too, have performance anxiety : Studies show that only about 60 per cent of women have orgasm more than half of the times they have intercourse. But many women feel pressure-from partners and themselves-to have orgasms. “People forget that physical closeness with a loved one is sometimes a wonderful pleasure in itself,'' says Westheimer. “Many men believe that a good lover is one who brings his wife to dramatic sexual satisfaction. But these moments, while wonderful when they do happen, aren't always necessary.

“Goal-oriented sex is like setting off on a cross-country trip and focusing on reaching the opposite coast without noticing all the wonders along the way,'' says Barbach. “The goal of sex is to be loving with each other. That's all'' Worry about physical attractiveness is another frequent cause of performance anxiety. “I've gained 12 kilos since we got married ten years ago.'' says Stephanie, 30, a mother of two.

“It scares me to think Dan might find me unalluring. I undress only under cover of darkness'' How can a man reassure his wife? “Don't lie and say she's gor- geous if she's not,'' says Pamela Shrock. “But praise what you do find attravtive-the softness of her skin, perhaps. Tell her that you love looking into her eyes, or whatever you appreciate most about her'' Playfulness can also help. “Many couples are far too serious about sex'' says Dagmar O'Connor, director of sex therapy programist. “They forget to laugh, to have fun. Sex doesn't always have to be an expression of endless, abiding love and passion. It can also be mindless or naughty of funny''


Reactions of Man In ...

Acknowledgement of pleasant sensation

Many a woman does not know how much of a sense of shyness she should discard and how much to retain. Other that offering her body, she may think that she should not lose any part of her shyness. She may have the notion that she is more appealing to her husband by behaving in his way. If the wife insists on this attitude long after marriage, she will not lose her appeal but also will drift permanently from her own orgasm.

Man, who is generally self- conceited, probably will not ignore his wife's feelings at the start of their marriage. But if the husband does ignore the wife's feelings and leads an arbitrary sex life, it is partly because she fails to show any reaction to his efforts to please her sexually. A week or two after marriage, the wife usually senses pleasure from her husband's caresses and stimulation from sexual intercourse even though she may not arrive at orgasm.

Nevertheless, in these early weeks of marriage, she is generally meticulous about her appearance and pretends that she is not enjoying herself. At times, she tries to hide her pleasure by demanding that the lights be turned off during intercourse. Most women think it is more feminine to reply in the negative, "I don't know,'' when the husband asks, "How was it?'' As long as the situation continues, the average man will give up all efforts to enhance her pleasure, and will pursue his own satisfaction exclusively. The more the wife wishes her husband to be consideratem the more sincerely she should respond to his efforts to bring her pleasure.

Her various reactions will not only excite him but will enable him to improve his technique and gain confidence. In acknowledging pleasure, she should surrender to her natural reflexes at times it may even be a good idea to exaggerate response in order to let him know that she enjoys a specific stimulation.

By responding naturally and sincerely she is at the same time enhanching her own pleasure. The sighing words of gratitude and love whispered to him will not only produce tremendous sexual stimulation in him but also strengthen her own sexual excitation.


Some Doubts in Men and Women in..

Masturbation - boys often call it 'jacking off' or 'jerking off' - means rubbing or stroking the genitals in order to have an orgasm. A boy does it by rubbing his penis, especially the head of the penis, with his hand or perhaps with or against some other object; a girl does it by stroking her clitoris or the area around it or by pressing her thighs together rhythmically. Masturbation begins when very young children learn that they get a pleasurable feeling by handling their genitals.

However, it is not limited to the young. Many men and women go on masturbating from time to time throughout the sexually active period of their lives. Both married and unmarried people masturbate, and people can masturbate alone or together, homosexually or heterosexually. Although there is certainly nothing wrong with not masturbating, the person who has never masturbated is an exception. People often talk and write about masturbation as a problem of sex. It really isn't a problem except as thinking makes it so.

Unfortunately, many people believe that masturbation is harmful and are deeply worried about boys and girls who masturbate. This is especially true among people who helong to a religious group that considers it to be a sin. If a young person who masturbates lives closely with others who believe it is evil, he will probably feel guilty and ashamed. And, of course, when babies or very little girls or boys are punished for playing with their genitals, this fixes in their minds the idea that it's a bad thing. Then there are those who say that masturbation may not be so bad if you don't do it too much- whatever that means.

It's really impossible to masturbate too much because when your body has had enough it will no longer respond to such efforts to have an orgasm, However, given the strong feelings most people have about the privacy of sex, it is wise to masturbate only in private. Little children don't know this, which partly explains why they punished for a harmless activity. I think it will be useful for me to state some facts about masturbation just to help remove any fears you or your parents may have. Masturbation is harmless to the body. It does not cause mental illness (although it can be followed by a damaging sense of guilt and shame in people brought up to fear it); it does not lessen a person's later capacity to enjoy sex in marriage. The stories about its causing pimples, circled under the eyes, weakness, or various diseases are just plain myths and not to be taken seriously. Masturbation is a source of sexual pleasure. You get no diseases from it, and nobody ever became pregnant by masturbating. It serves to release sexual tension which otherwise may push people into having sexual intercourse before they are emotionally ready for it or any of its possible consequences. In addition, masturbation can provide an outlet for a person's sexual imagination and daydreaming.

Some boys and girls are very worried about the thoughts they have while they masturbate, and at many other times. They should not be, for sexual fantasies of all kinds are common, more so than uninformed people believe. Masturbation can help a boy or a man learn how to delay his ejaculation and prolong his erection during a period of sexual stimulation.

Then later on, when he is ready for marriage and the intercourse that is such an important part of it, he will be less likely to ejaculate too soon, before his partner is satisfied. Also, masturbation can help a women learn how to achieve an orgasm. She can find what makes her feel good and, when she has learned, she can communicate this to her mate so that both can enjoy the pleasure of orgasm. Many women take years to learn that they can have an orgasm, and some never do. Masturbation can help them to achieve this pleasure earlier.


5 Intercourse Secrets Women Wish Husbands Knew

4. Warm attention after sex can be vital to a woman's satisfaction:- “I some- times feel lonely after sex,'' says Connie. 44, married 21 years. “Paul falls asleep without even saying good- night'' Many women heve complaints like Connie's. Others, whose husbands are loving and attentive after sex, find this a time of sepcial joy. A woman's need for tender moments tends to extend beyond the actual lovemaking. And if a husband can't avoid falling asleep, experts say, he might at least drift off while cuddling her.

It's also important to avoid saying the wrong things at this time. “A mand shouldn't critisize in any way,'' says Barbach. “And the worst time to talk about sex is in bed'' “Wives, too need to be careful about conversations after sex,'' says Steve 39, married 16 years to Felice. “Once, when we'd just made passionate love, Felice asked, 'Did you remember to pay the gas bill?' We laugh about this bow. But it is best if both partners, for a few minutes, shut out the rest of the world''

5. Women need non-sexual touching and tenderness :- “Frank doesn't touch me except in foreplay and sex,'' says Sheila 32. “Sometimes i'd like to kiss and touch just for fun. I don't under- stand why it's so hard for him to do this'' “What's so terrible about touching leading to sex?'' Frank confides later, “Touching Sheila excites me. I would thing she'd see that as a compliment'' This conflict is not unusual. “Women want romance, cuddling, hand holding and kissing,'' says Atwater. “But many women report that their husbands never kiss them-in or out of bed!''

A woman can help a man realize the joy of touching,'' says Shrock. “Practise touching with no sexual goal. Stroke your partner's face and hair, Hold hands, Massage backs. As men experience these sinsations, they may begin to understand, and reciprocate more'' “Couples should also learn to show tenderness in other non-sexual ways,'' says Barbach.

A man may see his wife's cooking as an expression of love. To a woman, just the words 'I love you' may suffice'' Love doesn't make you a mind reader,'' says Shrock. “Love is trusting each other enough to ask openly and answer honestly''

This can take time, a scarce commodity today. But making time for non-sexual as well as sexual pleasure is vital. “Your marriage is the most important relationship in your life,'' says Barbach. “Intimate time must be a top priority. This doesn't always mean making love. It means showing each other, with words, with touch, with thought- ful gestures, that you care. Make dates for time alone. Planning for intimate times together not only makes these moments more likely to happen, but also lets you look forward to the pleasure you'll share together-whatever that pleasure may be.''


Visual Stimulation

Generally speaking, man is more curious than woman. In sexual activity he want's to shun darkness and study the female body. If the wife stubbornly persists in having relation in the dark, the husband will develop signs of discontentment and may come to pursue his own pleasure alone or develop a declining sexual desire for her. Undoubtedly, she can express her satisfaction even in the dark by twisting her body, or emitting sighs, but he will not be satisfied with these responses.

He wants to feast his eyes on the body of the woman he loves and to confirm with his own eyes how she accepts and responds to pleasure. The bedroom should be illuminated properly, but not too brightly although the husband may insist it. This is one time when she should hold on to her veil of shyness. She may see no reason why she should after taking a bath with him or the like. But this is wrong. However firmly he may insist, she should never expose her sex organs before him under a bright light, particularly after giving birth to a child. Women with very little or no sexual experience have little pigment deposit in their sex organs, which thus may appear attractive to the opposite sex.

But after long years of sexual relations, and particularly after childbirth, the pigment deposit discolors the vulva and makes it lose what visual beauty it had. A sensible wife may let her husband fully satisfy himself in his finger play but would never let him scrutinize her organs in detail. Let him picture a beautiful image in his mind. Visual stimu-lation, in sex life is not limited to the problem of illumination, but also involves a woman's clothing and interior decoration of the bedroom. Women's interest in clothes does not end with marriage. In many instances, however, a married woman starts dressing not for her husband but for other parties.

 

The husband is pleased to see his wife well dressed for going out, but his dream is shattered the moment she returns home. She throws off her beautiful clothes, remover her make-up, and returns to the same homely woman. She should realize that the husband likes to see his wife dress beautifully for him even for the short time after he returns home from work. But after six months or a year or so of marriage her efforts to dress for him ceases. She should continue these efforts forever-even if she has to set aside the money secretly for the purpose. And the husband will approve of the secret savings, for it will certainly contribute to maintaining freshness in their married life.

Sexual stimulation of the husband begins as soon as he returns from work. Some women hope to achieve 100 per cent stimulation by sleeping with him in the nude. True, men enjoy watching a strip tease or nude pictures. Men also enjoy undressing women, but this does not mean that she should voluntarily strip herself of her clothes. It is worth giving a try.


Some Ways That Intercourse Can Become a Problem

Automobiles, fire, sex- they all have power. Whether their power produces good or bad results depends on how the power is used. Automobiles are a valuable means of transporta- tion, but they become a problem when they kill over fifty thousand Americans a year, pollute our air, and crowd our cities. Fire is essential for cooking, heating, and many industrial processess, but it becomes a problem when it destroys houses and factories, burns people, or helps launch the weapons of death. And sex, delightful and productive as it is for carrying on the human race, binding people and families together, and giving great pleasure, can also become a problem in ways that are described below.

Sex Used Selfishly :-

Perhaps the most common problem of sex is the misuse of sexual power or attractiveness for people's own selfish purpose without consideration of the others involved. Of course, I am not talking simply about the intense bodily pleasure that comes from orgasm and which is in many ways a self-centred pleasure, although each partner of a loving couple will care about the pleasure of the other.

I am talking about the husband who insists that his wife have sex with him when she doesn't feel like it' about the girl who looks and acts supersexy just to tease a boy and then to humilate him by refusing; about the boy who pretends to love a girl in order to win her when all he really intends to do is make a conquest and build up his own ego;

 

about the young couples who openly display their sexual behaviour even when they know (or perhaps because they know) that it makes their parents or othe older people feel un- comfortable or frightened; about the boy or man who hurries a girl into sexual intercourse whithout troubling to understand her need as a person to feel cared for and loved, and her body's need to be made ready to respond to and to enjoy the sexual experience. Sex is good when it is used considerately and understandingly, with communication; it becomes a problem when people use other people as mere objects for their own selfish pleasure.


Women Who Love Too Much

In the fairy tale :Beauty and the Beast'' a young girl meets a frightening monster. To save her family from his wrath, she agrees to live with him, Eventually, by getting to know him, she over- comes her loathing and even grows to love him. A miracle occurs, and he is restored to his true, princely self.

This seems to underscore a popular assumption that we can change someone for the better through the force of our love, and that, if we are female, it is out duty to do so. When a woman doesn't like many of a man's basic characteristics, values and behaviours, but endures them thinking that if she is only loving enough he'll want to change, she is loving too much. I recognized the phenomenon of “loving too much'' as a specific syndrome of thoughts, feelings and behaviours after several years of counselling alcohol and drug abusere.

Sometimes the patients I interviewed grew up in troubled families, but their partners nearly always came from severely disturbed families. By struggling to cope with their addictive mates, these partners were un- consciously re-creating and reliving significant aspects of their childhood. The wives and girlfriends of addictive men revealed their need for both the superiority and the suffering they experienced in their “saviour'' role. These women clarified for me the incredible power and influence their childhood experiences had on their adult patterns of relating to men.

Women are not, of course, the only ones who love too much. Some men practise this obsession with as much fervour as any woman could, and their feelings and behaviours issue from the same kinds of childhood experiences. However, most men who have been damaged in childhood tend not to develop an addiction to relationships. Because of an interplay of cultural and biological factors, they usually try to protect themselves and avoid their pain through an obsession with work, sports or hobbies. Millions of women choose partners who are cruel, indifferent, abusive, emotionally unavailable, addictive or otherwise unable to be loving and caring.

No one becomes such a woman-a woman who loves too much- by accident. There are no accidents in marriage. When a woman believes that she married on whim, or that she was too young to know what she was doing, it is imperative for her to examine why she choose that particular man.

For she did choose, albeit unconsciously, and often with a wealth of knowledge about him even at the outset. Many women make the mistake of looking for a man without first developing a relationship with themselves. No one can ever love us enough to fulfil us if we do not love ourselves. When in out emptiness we go looking for love, we can only find more emptiness.

Consider the case of Peggy, a divorced single-parent with two daughters:

"My father and my mother separated before I was born, and my mother went to work while her mother took care of us. My grandmother was a terribly cruel woman who would always tell us we were “good for nothig''. Her criticisms made my sister and me try harder to be good, to be worthwhile. My mother never protected us; she was too afraid Granma would leave and there would be no one to take care of us. I remember I used to try to mend things that broke around the house, wanting to save us money and earn my keep somehow.

I married at 18. I met my husband in school. He was lounging against a wall when he should have been in class. I thought, “He looks quite wild; I'll bet I could settle him down.'' I was still trying to mend things. I was miserable from the start, but it took me 15 years to believe that being misrable was a good enough reason to get a divorce. After the divorce, I met Baird. He was tall and very good looking. But he also had an air of coldness about him, I remember telling myself,”That is the most elegant, arrogant man I've ever seen. I'll bet I could warm him up!'' We never did have a good time together. Something was always wrong, and I kept trying to make it right. Our marriage lasted only two months.


Sexual Intercourse And Orgasm

The male and the female unite their sex organs when seeking to release the tension in the sex organs highly distended with blood caused by stimulation. This is nothing but a demand for emotional union with mate. One finds happiness in the happiness of the other. At a certain point in sexual excitement the sex organs in union are further stimulated with a series of messages.

 

As soon as the sexual act is apparaised in the brain as the same of tense emotional enjoyment, there is a reflex action impossible to restrain followed by the ecstatic moment-orgasm. From a series of convulsions throughout the body, the male ejaculates. And while the female experiences similar convulsions, they both enjoy the height of emotional and physical pleasure and drigt into world of ecstacy. This mood quickly dissipates in the male partner but lingers on and only slowly fades in the female.

 

In their contentment and relaxation or exhaustion, they soon fall into a slumber. This series of responses describes the male and female reaching orgasm at the same moment. To do so, harmonious effort is necessary for it is possible only when the male partner expertly leads the female partner and the latter willingly cooperates. Dr.Alfred Kinsey reports that 70% to 77% married women are said to always or most of the time attain orgasms in sexual intercourse. Dr. Kinsey reports that women reach orgasm,

In the 1st year of marriage in 63% of total intercourses

By the 5th year of marriage in 71% total intercourses

By the 10 year of marriage in 77% total intercourses

By the 15th year of marriage in 81% of total intercourses

By the 20th year of marriage in 85% total intercourses

This means that from 23% to 37% of the women do not experience orgasm during their first year of marriage. The fact that nearly all males experience orgasm whereas the majority of females do not is unfortunate not only for the wife but also for the husband.

The male ejaculate and reach orgasm in sexual intercourse regardless of the female's response. But this does not satisfy him as much as when orgasm is experienced stimulta- neously with her. His orgasm is one-sided and is merely satis-faction derived from self-gratifica tion. The female, on the other hand, faces greater perils. The concentration of blood in her sex organs that heve not been allayed over a long period of time from sexual excitement will be injurious to her physically, and the psychological shock she receives may not be subdued. Living in this type of relationship, the female will shy away from sexual intercourse, curse at the male dominance, and be disillusioned after many years of love. The male, too, will undoubtedly be disappointed with such a wife.


Bad Feelings ...

Sex and Bad Feelings Sex becomes a problem when, because of the way they were brought up or because of their experience with sex, people develop bad feelings about it. If boys or girls have been made to believe that sex is evil, that to enjoy bodily pleasures is somehow not nice, then they will feel guilty and unhappy about their sexual desires, and it will probably take them much longer to learn to have a happy and successful sexual relationship.

 

Of course, a couple who love and care for each other can help each other overcome such bad feelings. Another feeling that many people suffer from is that they aren't good enough sexually. Somehow they have come to believe that sex is something to be accomplished, and the more the better. Or they have read too many foolish books and misleading advertisements, listened to too many over-romantic records, and seen too many TV shows and movies based on fantasy and unrealistic expectations, and so have come to believe that if their sex life isn't a constant ecstasy, or if they and their partner don't experience an orgasm every time with heavenly bells ringing, there's something wrong with them.

Or because they, like most people, don't resemble cover girls or Hollywood heroes, they feel that they can't be desirable and attractive and satisfying to the person they choose to love. With maturity, we can gradually unlearn these feelings of inadequacy by coming to understand that the most important thing is the quality of our relationship with the other person, not the shape of our body or the frequency of our intercourse. There are many people who live loving lives together, with sex as an important, but not the only important, part of their lives. These people come in all shapes, sizes, colours, and varieties. But if you expect constant bliss with no effort, you are almost certainly going to feel bad about yourself and your sex life. Adults Who Molest Children in next article


Women Who Love Too Much

Peggy knew nothing about being loved. So strong was her need to replicate the hostile environment of her childhood and continue her struggle to win love from those who could not give it that when she met a man who struck her as being cold, aloof and indifferent, she was instantly attracted to him. Here was another opportunity to change an unloving person into someone who could love her. Once they became involved with each other, she kept trying in spite of teh devastation to her own life. Her need to change him (and her mother adn grand-mother, whom he represented) was that strong. In dysfunctional families, major aspects of reality are denied, and roles remain rigid.

This severely impairs the development of our basic tools for living and for relating to people and situations. It is this basic impairment that operates in women who love too much. They become unable impairment that operates in women who love too much. They become unable to discern when someone or something is not good for them. The situations and people that others would naturally avoid as dangerous, uncomfortable or unwholesome do not repel them, because they do not trust or even know their feelings. Instead, they are actually drawn to the very dangers, intrigues and challenges that others would avoid. Through this attraction they are further damaged, because much of what they are attracted is a replication of what they lived with growing up. They get hurt all over again.

 

Consider Chloe, a 23-year old college student :- When I was young my father hit my mother. He hit all of us kids. I guess he convinced us that we deserved to be beaten. But I knew Mum didn't. I always wished he'd hit me instead of her. I knew I could take it, and I wasn't so sure she could. We all wanted Mum to leave him, but she wouldn't. I always wanted to give her enough love to make her strong so she could get out; she never did. She died of cancer. I haven't spoken to my father since the funeral. I met Roy in an art class. One day he started talking about American women being totally spoilt, and how they just used men. He was dripping whith venom as he spoke, and I thought, “Oh, he's really been hurt'' I began trying to prove to him that women weren't all like that. In less than two months, we were living together. In four months, I was paying the rent and almost every other bill.

 

But I kept trying, for two more years, to prove how I wasn't going to hurt him the way he'd already been hurt, to prove that he was lovable. I got hurt quite a bit in the process, at first just emotionally, then physically. Of course, I felt that was my fault too. It's a miracle I got out.

 

I met a former girlfriend of his, and she asked me, right out, “Does he ever hit you?'' We talked a long time. She got me to go with herr to a therapy group she was in, and I think it probably saved my life. Those women were just like me. They had learnt to put up with incredible amounts of pain, usually starting in childhood. Children inevitably carry the guilt and blame for serious problems that affect their families. Their fantasy of omnipotence makes them believe both that they are the cause of the families circumstances and that they have the power to change them.

A woman who habitually practices denial and control will be drawn into situations demanding those traits. Denial, by keeping her out of touch with the reality of her circumstances and her feelings, will lead her into relationships fraught with difficulty. She will then employ all her skills at helping/controlling in order to make the situation more tolerable, all the while denying how bad it really is. It is not easy or comfortable for us to consideer that selfless behaviour, “being good.'' and efforts to help may actually be attempts to control, to change others. When we do for another what he can do for himself, when we prompt, advise, remind, warn or cajole another person who is not a young child this is controlling.

 

Our hope is that if we can control him, then we can control our own feelings where our life touches his. And of course the harder we try to control him, the less we are able to. So what, then, is the point of “Beauty and the Beast''? It is acceptance – the antithesis of denial and control. It is willingness to recognize what reality is and to allow that reality to be, without a need to change it. Beauty loved the Beast. Therein lies a happiness that issues not from manipulating outside conditions or people, but from developing inner peace, even in the face of challenges and difficulties. Ironically, it is this every practice of acceptance that allows another to change if he chooses to do so. Remember, Beauty did not try to make a prince out of a monster. Because of her acceptance, he was freed to become his own best self.


Sexual Intercourse And Orgasm

Simultaneously orgasm is essential for successful sexual intercourse. Efforts toward this end will not only let her share in sexual pleasures but also enable him to experience greater joy. Different techniques in sexual intercourse should be used for this purpose. During the early refreshing period of marriage, the male generally does not require local stimulation as he is easily aroused in his emotional sexual excitement.

 

Only a short moment of coital activity is necessary to stimulate him to orgasm. His spouse may not experience orgasm at first. She is passing through the learning stages of enjoying sex with self satisfaction from observing him enjoy the use of her body. The absence or lack of coordination in her is not a serious problem. Following this learning period they both will desire more powerful emotional excitement in sex. He will develop a longer staying power during intercourse and allow more time for her to enjoy local stimulation essential for her orgasm.

 

It requires many shades of expression and variations in the caresses prior to and following sexual intercourse, as well as in the positions. To match the slowly developing female orgasm with the male orgasm, the male should guide her during intercourse to sexual excitation with delicate caresses as he selects his sex position to prolong the act.

Until she craves for it, the male should restrain his orgasms or ejaculation. After a while, even when he unexpec- tedly approaches orgasm, she will be able to respond by reflex. The female without the experience of perfect union in orgasm will have it as her goal, but some males do not see much difference between simulataneous and staggered orgasm. They have not yet learned the unfathomable satisfaction they can get from sexual union in orgasm.

 

Once the male experiences this satisfaction, he will no longer complain about having to make efforts to time his orgasm with hers. Union in orgasm demands indispensable prerequisite of deep, mutual, emotional love. On the other hand, there can be no permanent basis for emotional love other than united orgasm in sex life.


Adults Who Molest Children

Another problem of sex is the grown man - or, less often, woman - heterosexual or homosexual, who approaches young boys and girls and seeks sexual contact with them. Such a person might be a stranger; however, he or she might also be a family relative or someone else you know well. If you know that the possibility of these approaches exists, you will be better prepared to deal with them. You can avoid being alone with such a person.

 

Whether you are a boy or a girl, it is always wise for you to steer away from men or women who approach you in an over-friendly manner or who go out of their way to touch you and try to persuade you in a secret way to be alone with them. Perhaps occasionally you have read in the newspaper about a young boy or girl being 'molested' by a man. (Such a person is called a molester - one who molests) This means that the man has used the young person in an attempt to satisfy his sexual desires, perhaps by exposure of his genitals, perhaps by trying to touch the genitals of the young person.

 

People who do this sort of thing are sick and need help, but they are rarely dangerous. If such things as these should ever happen to you, it will probably be a good idea right away to tell your parents, or someone you trust, no matter how puzzled or distressed you may feel. Tell exactly what happend; give a plain report; remember that it was not your fault. If you tell about it in this way, you may avoid being upset by the experience, and you may make it possible for the other person to receive halp and be prevented from troubling other young people. I said it would 'probably' be a good idea to tell about your experience, because in some cases it might not be.

 

Some parents or other adults get much more excited and alarmed about the situation than is justi- fied by the plain facts. You can be reassured that most sexual contacts of molesters are quite minor and brief. This fact, and the fact that molesters seldom physically endanger the young person, are not understood by many adults. It is possible, therefore, for adults to over-react and to make the situation much more distressing than necessary to the young person who has been molested.

 

In next Episode ... "RAPE''


Make Hard Times Work for Your Marriage

Several years ago, a tornado demolished John and Elizabeth's home. He responded by drinking and withdrawing. She developed a phobia about storms and blamed John for not “being there'' when she needed him. Within a year they were divorced.

 

 

About the same time, Robert adn Amy watched their house burn to the ground and then spent five stressful months living in a motel room with their three children. Today their marriage is stronger than ever. What made the difference? Although people get married for better or worse, “worse'' is what tests a relationship. Hard times can make a husband and wife closer than ever-or can rip a relationship apart. Unfortunately, in times of trouble, it's easy to undermine your marriage and jeopardize a crucial source of strength.

Avoid Finger Pointing :-

When something bad happens, most of us instinctively look for someone to hold responsible. And it's your spouce who is likely to be standing right in your line of vision. “When you marry.'' observes marriage counsellor Norman Paul, “you get a readily available scapegoat.'' But as psychiatrist Frank Pitmann says, “There's no way to win against your spouce. You both win or you both lose.'' Often couples find it helpful to think of the problem as something outside their relationship.

Many experts agree that when one person suffers from a serious illness, the couple does better if both treat the disease as a third party they can gang up on. “Instead of saying 'my' cancer, they talk about 'the' cancer,'' says family therapist William Doherty. “Then they can feel united against a common enemy.'' Joining together for a mutual purpose is one of the best ways to keep a marriage intact during a crisis. When one person does have a larger share of responsibility for a problem, both spouces need to acknowledge that burden. “In a cirsis, a spouce doesn't need a cheerleader,'' says Pittman. “We feel closest not to the people who constantly tell us how wonderful we are, but to those who know how human we are and love us anyway.'' During rough times, that sense of being loved despite our mistakes is crucial.

Express Yourself :-

“When spouces don't tell each other how they feel it's as if there's an elephnat in the room that never gets talked about,'' says Doherty. Communication, however, cannot be coerced. Often a predicament pushes couples into an al-too-familiar rut: she thinks he doesn't have feelings because he won't talk about them; he thinks she's too emotional because she won't talk about anything else.

Before putting pressure on your spouce to talk about feelings- and instead of interpreting silence as indifference- remember that sometimes talking is simply too painful. In such cases, couples might seek out groups of people who have been through similiar experiences.

 

One man whose wife was raped withdrew angrily from her. After he joined a group for partners of rape victims, he began to understand that his response was a defence against his own sense of helplessness. Then he was able to share his feelings with his wife. Body language is often more eloquent than talk. One woman whose husband was reluctant to discuss her miscarriage found that when he held her, she could feel the caring that he couldn't express in words.


How To Excite Female?

To begin with, let us consider all the principal "spots of eroticism,'' that is, areas on the female body which have the capacity of stimulte desire when touched by the male lips, hands of genitals. It might be stated first that the entire female body is an area of sexual excitation when caressed carefully by sensitive male hands. Just the feelings of their lovers hands moving softly, gently, and tenderly anywhere about them will create a sensation of comfort and enjoyment in most women.

 

 

This feeling, however, is a general one whichwill improve as attention becomes concentrated upon specific areas whichhave the power to produce difinite thrills of excitement. For example, the ears, the cheeks, the mouth, neck, shoulders, bust, waist, stomach, hips, thighs, genitals, legs, when caressed by the male hands, will all react pleasantly to such a touch. But the hands are as nothing compared with the effectiveness of the mouth, lips and tongue passing over the same areas.

 

The ear always is sensitive and responsive. The tongue chasing about the rim of it or moving within; the hips nuzzling all of it; or the teeth, lips and tongue playing with the lobe of it, have the power to make some women pant, their breath hissing in and out at an unbelievable rate. These women who readily respond to toying with their ears are among the most easily aroused. Rapid panting likewise is the unfailing sign of a speedily aroused and highly passionate woman, a woman who requires a lengthy period for satisfaction.

 

Other women, however, can only momentarily withstand any playing with their ears. While the ensuing sensation is arousing, it is so only in a limited degree, and the result is a sensation more descriptive of the type that produces goes pimples. It has the effect, however, of making them wish to engage quickly in a passionate kiss; usually, immediately upon withdrawing their ear, they will turn their mouth actively upon their partner's.

 

As might be assumed, this type of woman is slower to arouse, though not necessarily less passionate than the other, and will never express her emotion in the rapid panting above described. But the ear is not always immediately responsive where the latter types of woman is involved. It might take a minute, at times, before the precise spot, or the precise manner of toying with it to produce reaction, is discovered,

 

In this case, extending the heat of the breath to the area by a deep, slow exhalation will enhance its sensitivity. Not withstanding, there are occassions also when it fails completely to react.

 

 

This has been emphasized because most men expect an immediate response from anything they may do. If, for example, they start toying with the female ear and their partner manifests no reaction, they immediately assume a lack of sensitivity there, and proceed elsewhere. This is unfortunate, because proper playing with a woman's ear or the adjoining area is one of the various factors of foreplay that contribute to arousing her, and it should not be neglected.

 

 

 

Another Section of The female body in next episode


Rape ....

Newspapers often carry stories of another misuse of sex, that of rape. When a man rapes a woman, he forces sexual intercourse upon her, against her will. Rapists are dangerous, often filled with hate of women. They may use a gun or knife to frighten their victims and threaten to kill them if they scream of struggle. This violent, crues use of sex is a serious crime.

 

 

It may cause the woman who is raped not only to suffer pain and injury, but also cause her to be afraid of sex for a long time. She or her family should without a moment's delay inform the police sho that the rapist may be caught and prevented from hurting others. Tragic and cruel as rape is, it certainly does not mean the end of the world for the girl or woman who is raped. She will never forget it, but she can get over it, and it is especially important that she talk about it with someone, preferably with a skilled counsellor, so that she may be helped. She should also consult a doctor to determine whether she might be pregnant and need an abortion.


Make Hard Times Work for Your Marriage

Accept Differences :- When husbands and wives are able to talk to each other, they are often shocked at how differently they see things. The same event may make one person angry, another depressed, another hurt or frightened. Unfortunately, a response that's unlike your own may seem inappropriate to you. One woman who spent weeks in hospital tending a seriously sick child felt distant from her husband.

 

 

“He was going alone with 'business as usual' while I was a wrect thinking about how we might lose this child,'' she says. In such situations, it;s necessary to talk about your perceptions and give each other the benefit of the doubt. The woman discovered that her husband felt he had to keep things normal precisely because she was so upset. What she perceived as indifference was actually his way of showin support.

 

Be Flexible :- Awareness of a spouse's perspective may make it easier to handle the inevitable changes that an emergency forces on everyday life, such as the reshufilling of routine responsibilities. The hard part is thinking of these new tasks as a challenge rather than a burden. One woman who had cancer became too weak to go out, so her husband took over all the shopping. Rather than being annoyed, he took satisfaction in performing a necessary service, and he gained a new appreciation for his wife's activities.

 

Flexibility also extends to emotions. It's all too easy for couples to become rigid in their emotional roles – he always complains; she's always stoic. Such “typecasting'' can be crippling in a crisis. In one family, where the teenage son had been arrested, the parents were polarized: Dad was the disciplinarian, Mum the comforteer. “Rather than collaborating as parents, they had evolved into opposite positions,'' says psychologist. “Both resented it.

The mother wasn't getting respect from the child, and the father wasn't getting affection. Both partners need freedom to express a wide range of emotions, and may find themselves trading points of view. One day, he'll rail against the injustice of his company's closing while she is reassuring. The next, she may worry about paying the bills while he is comforting. The important thing is that overtime, each is the consoler and the consoled.

 

Be kind to Each Other :- Finally, spouses who endure tough times say how much they love each other-often. “”This is the worst time to assume the other person knows how you feel,'' says therapist. Who finds that partners in healthy marriages actually express their positive feelings more often when circumstan- ces are difficult.

 

 

While emphasizing their positive feelings about each other, these spouses also downplay their negative ones. “Couples have to realize that the problem is not 'us' but the situation.'' Although a quarrel may bring temporary distraction from the real predicament, it also wears down goodwill. Obviously, you shouldn't wait for a crisis to work in these skills. In good times, forgiveness, openess, acceptance, flexibility and kindness will enrich your relationship. In bad times, they will keep your marriage strong- just when you need it most.


Another Section of The female body

Another Section of The female body as responsive as the ear in adding fuel to a woman's emotions is the area about the neck. The most sensitive on the line running directly from the end of the shoulder to the ear, and to a point midway to the throat and midway to the direct center of the back of the neck. In other words, the throat and the section immediately adjoining it, and the area along the back of the neck, are not so sensitive as the area beneath the ear and the hollows found there. A woman will respond to kissing or light movements by the tongue on these sections precisely as she will to the ear, and the technique used to develop the sensitivity is the same.

 

The top surface of the shoulder also contains spots of eroticism that must be determined by experimentation, since the entire shoulder is not naturally an area of sensitivity. How ever, it definetely does contain areas every bit as sensitive as the neck. We all know, of course, that the lips and the mouth, in addition to the clitoris and the vulva, always have the capacity to arouse passion, even assuming all other areas to be insensitive.

 

Consequently, the kiss is the most important factor in foreplay, and he who does not constantly engage in it when his mouth is not otherwise occupied is a sorry lover, indeed. This holds true for every moment of foreplay as well as for the intercourse itself when performed in a position which allows it. There are various types of kisses.

 

Some women, for example, prefer to kiss and be kissed with the insides of the lips. It is a warm, moist, intimate, and exciting exchange. Other women do little kissing themselves and prefer to be kissed, merely cutting of the air with their lips to allow proper suction. Still others may enjoy being kissed on the lower lip; that is, the lower lip is taken between both lips of her partner and sucked and worried by the tongue.

 

For variety, the male may change to the upper lip, but such kisses involve only one of the female lips at a time. Again, there are those women who enjoy a kiss in which the male mouth envelopes both of the female lips, sucking and teasing them lightly with the tongue. Then, too, there are others who prefer always the conventional type: to kiss and be kissed only with the outside of the lips pressed together. Of course, there is nothing too intimate about this type. Except for the fact that such a kiss is sustained longer by lovers, it is the kind normally exchanged between relatives. Variety of Kisses in next episode.


Incest ...

Incest means intimate sexual relations or sexual intercourse between close relatives, such as father and daughter, mother and son, brother and sister, uncle and niece. Almost every society has strong taboos against incest, and it is considered a crime nearly everywhere. The reason commonly given for laws against incest is that any child that might result from such sexual intercourse is more likely to suffer from hereditary diseases than is a child resulting from intercourse between a couple who are not close relatives.

 

 

 

A more important reason for condemning incest is that it often means the explotation of a younger member of a family by an older one in a situation where the younger person is to feels trapped and finds it difficult for those involved to establish healthy sexual attachments outside the family and in marriage. A young person who finds himself or herself being forced or tempted into an incestuous relationship should at once seek help, either from another member of the family or someone outside.

 

Of course, the parents and children in many families express their loving feelings toward each other. These healthy, pleasand, loving expressions are entirely different from the sexual relationships of incest.


How To Excite Female?

http://youtu.be/kdPKBpiNyGw

The most intimate form of all, popular with atleast fifty percent of all women and eighty percent of the highly passionate, is the "French Kiss'' or "Soul Kiss'' as it is most generally called. In this style, both lovers kiss open-mouthed, the female darting her tongue in and out of her partner's mouth while he does the same, both create a continuous movement with their tongues, and the male probably eventually draws his partner's tongue into his own mouth and holds it there.

 

Unhappily, nothing sounds less inviting than the kiss generally, and the "Soul Kiss'' particularly, when brutally described in words. There are women who do not find too much enjoyment in the "Soul Kiss'' and others who part their lips the moment a man leans forward to make love to them.

 

Proper procedure requires that each woman be met in the manner that appels to her the most, since successful sex practice is largely a matter of variety. In addition to the kiss itself if the fervor with which it, as well as love-making in general, is administered. However, it can be stated positively that the great majority of women prefer their lover to be soft and gentle, for the kiss to be tender. There are, neverthless, those who wish it to be fierce almost painful.

 

 

They prefer a rough, nearly bruising pressure by the male mouth upon their lips, when held, they wish to be sqeezed to a poing of breath-lessness. Strangely, with regard to this matter of embraee, many women, even more or less moderate in their passion, have this deisre, while preferring their kisses soft and tender.

 

The majority of women, however, prefer gentleness throughout and it is largely the woman most expressive in her passion who either prefers or easily tolerate a roughness on the part of her lover. The suitable technique for kissing and embracing is something the male must discover for himself by experiment with the individual woman to determine her preference, since it will not necessarilly follow that every highly passionate woman, for expample, desires roughness on the part of her lover.

 

The best procedure to adopt is to assume initially that all women prefer gentleness and tenderness, and determine their precise desires subsequently. While some females will definitely find roughness distasteful, none will object to gentle approach, even though they may prefer a harsher treatment.

 

Another Part of Women's Body in next episode


Language and Intercourse

Sometimes talking about sex can become a problem. This is partly because many people think of sex as 'dirty', and they think that words - especially the short, easy words - and jokes about sex are dirty. Or it may be bacause they feel so strongly that sex should be private, even hidden, that they believe it shouldn't be talked about.

 

 

When you hear people use the expression 'four-letter words', they are referring to words like fuck. This word is slang for sexual inter-course and comes from the Middle English word fucked, meaning 'to strike, move quickly, penetrate'. It has been a part of our language for hundreds of years. The word is objec-tionable to many people, and any sensitive, intelligen user of English should know this. Of course, there is nothing essentially 'dirty' about any word, for a word is merely a symbol for an idea or meaning - a sound or a group of letters.

 

But many words do carry with them strong emotional feelings, especially words having to do with sex, and you should keep this in mind. Otherwise, you may anger and shock people and cause them to condemn you. It is important to consider the feel- ings of others. An even greater problem than talking too much about sex is not talking at all about it, not being able to communi- cate with others about it. To enable you to communicate more easily and intelligently about sex is one of the main reasons I wrote this book. Two other major problems connected with sex are unwanted babies and venereal disease. The next two chapters discuss these problems.


Questions Couples Now Ask About Sex and Marriage

Many of the questions couples ask me have changed in recent years. A decade ago, the first reaction when a marriage hit rough times was, “I want a divorce!'. But today the man and women I talk to are more likely to want permanent relationships. They are also more prone to seek professional help when problems arise. Here are some of the most frequent new questions I hear :

1. My wife and I both work and take care of the kids. How do we find time for sex? The usual response to this question is : hire a baby-sitter and run off to a hotel for a week-end. And there's nothing wrong with taking a mini- vacation from the children and household duties every now and then. But I find that couples who don't have the time and energy to enjoy marital relations when they're in bed together are hardly likely to go away for a week-end of lovemaking. Sex is usually energizing, not exhausting.

 

So, as I hear couples recite the busy schedules that keep them out of each others arms, a line from an old song comes to mind : “I'm in the mood for love, simply because you're near me'' Too many busy couples are never near each other. She cooks dinner and cleans up the kitchen. He helps the kids with homework and pays bills. Later they collapse in front of the television. As newly weds they did the chores together. He was in the kitchen with her – hugging, helping out. When he washed the car, she was there lending a hand. Companionship is vitally important to marital satisfaction. Couples who “can't find time'' for love making should add more togetherness. This will often put them in the mood even when they're tired and have much to do. And there's a bonus: children get a satisfying model for their own marriages. That's a precious gift too few children receive.

2. Why do my wife and I fight so much? Linda and Lyle were suddenly fighting constantly after six years together. When Linda told me that through most of the marriage they hadn't said one angry word, I knew they hadn't been open and honest either. They had been storing up all the aggravations they felt would hurt the marriage if let out. But pent-up anger will eventually overflow.

 

Through counseling, Linda and and Lyle learnt to properly express their emotions. For an half-hour every evening, they aired the day's grievances – without attacking – and also expressed the tenderness they had felt for each other. “I get angry when you borrow my car and leave the petrol tank empty,'' Linda told Lyle in one session. “I'm hurt when I feel you've been inconsiderate.''

 

Instead of becoming defensive, as he once did, Lyle calmly replied, “You mean you wouldn't be angry if I just filled the tank?” “Right!'' Linda said. “I'd feel love and cared for'' “Well, that's what I'll do. Because I do love and care for you,'' Lyle said, and kissed her. Lyle and Linda were dealing with anger in a way that strengthened their marriage rather than tearing it down. If fighting too much is endangering your relationship, try following these “fair fight'' rules: Keep to one topic and don't bring up past grievances.

* Get the fight over as soon as possible. * Don't battle in public. * Never hit each other. * Don't walkout in the middle of a fight. * Don't suggest ending the relationship. The successful marriage is not one in which there are no fights, but one in which fights are turned into opportunities for greater honesty and understanding.

 

Some More Question's in next part ...


Another Section of The female body

Next, and existing at one of the most prominent of the erogenous areas, are the female breasts. The sensitivity of the nipples alone is sufficient to reduce many girls and women to a state of helpless desire. Breast size has no bearing upon responsiveness. A flat-chested womam nay rect more intensely than her full bosomed sister. The breasts, however, vary greatly in sensitivity as an agency of excitation, nor only with respect to individual on occassion with an individual woman.

 

Some women who experience a genital thrill as soon as the nipple taken in mouth will at other times experience practically no sensation other than warmth. The size of the nipple is no indication of sensitivity. Under any circumstances, the fondling of the breasts or the massaging of the nipples is pleasant and comfortable for every woman. Considered from their average condition of responsiveness, it can be said that breast sensitivity ranges from one producing warmth without passion to one where arousal is almost immediate and desire for intercourse at once induced.

 

Although the breasts are responsive to hand fondling, the excitement that arises when they are kissed and sucked in normally a hundred- fold more intense. Such emotion may register itself in a deep, shuddering sigh, in a light of heavy gasping, or in rapid panting, all are attended by closed eyes and an attitude leaving no doubt that the woman so excite- ment has been gripped by a powerful seizure of sexual thrills. Many women react with a violent quivering which so shakes them from head to foot that the vibrations are easily felt, frequently when a woman is very much in a sexual mood, this quivering is produced by kissing alone.

Women who react sharply to breast fondling are definetely in the minority and represent for the most part the highly passion- ate, another large group react exclusively with close eyes and a deep slow breathing. Sensation of enjoyment is immesurably greater in the former, however , and of a quality which may be called intense even in the latter. In either case, both types of women are quickly aroused, although it does not necessarily follow that the latter will be equally expressive in inter- course. Infact, many women who will gasp when the nipple of the breast if taken in mouth are definitely impassive in intercourse and may be only normally responsive in the genital area.

 

The majority of women. however experience only a mild excite- ment from the handling or kissing ot their breasts. Occasionally, the feeling extends itself to the genitals, depending upon the mood of the woman, but more frequently not. At any rate, with respect to such women, the breasts alone could never create an overpowering emotion or even a deep excitement, and are at best merely a contributing factor to the general creation of passion, as are the mouth and ear. Most of the women of this group are also of the individual orgasm type, a detailed discussion of which appers later, and generally are capable of only one or two orgasms unless their capacities are developed. On the other hand, at least one quarter of this group possess an ability for numerous orgasms and a capacity for clitoral stimulation which is quite beyond that suggested by the weak responsiveness of their breasts. The next enorgenous zone is the Waist


Contraception: Preventing Unwanted Pregnancy

It is possible for a couple who have intercourse regularly to have a child every year, or even more often. In such case, if the wife were twenty when she married and if she reached menopause (when her ovaries stopped producing eggs) at forty-six, the marriage would produce more than twenty-five children!

 

There are few couples who wouldhave enough money, physical strength, or psycho-logical stamina to take good care of such a large family, even if they wanted it. Therefore, most married couples practise what is called family planning, contra-ception, or birth control; that is, they decide how many children they think they can provide for and care for and plan how far apart they wish to have them.

 

Then they limit childbirth according to this plan. In recent years, most thoughtful people have come to agree that family planning is a necessity. For many families, the arrival of an additional child may be a tragedy. It means another person to feel, clothe, and care for; and food, clothing, and care cost money often more money than a poor or even a middle-income family can earn. Also, it is sometimes hard on the health of the mother to have another baby, especially too soon after she has had the last one. In addition, in families that are too large to be cared for comfortably, and in which over a long period of years there is almost always an infant who should receice so much special attention, the mother, father, and the other children may all suffer from the psuchological strains.

 

It is usually far better if each baby is assured of a welcome because it is planned for and wanted and its parents feel they can give it the home and loving care that it needs. Usually even more tragic than the birth of another child to a married couple who do not want it or cannot care for it is the birth of child to a young couple who are having sex but are not married and not ready to be married.

 

A baby born of unmarried parents is still called illegitimate, a word meaning 'not according to the law or the rules'. This word is being applied to children less and less these days because, really, it is the parents who should be considered illegiti- mate, not the baby. It is not fault of the baby. It is criminally selfish for a young unmarried couple to engage in sexual intercourse withour using an effective means of birth control. They are taking chances not only with their own lives and welfare, but also with the life of the baby who may be born.


Questions Couples Now Ask About Intercourse and Marriage

3. I think my wife fakes orgasms. Why?

One myth is that women fake orgasms because they don't want their husbands to know they don't enjoy sex. Actually, women sometimes do this for the same reason men occasionally have difficulty in bed. Our culture puts pressure on both to perform sexually on demand, like trained seals. So they perform, and part of the performance for women may be a faked climax if they are too tired or distracted – or if, as frequently happens, they are not receiving sufficiently direct tactile stimulation. If a man thinks his wife is faking orgasm, he should sit down with her one night and give her a slow, sensual massage, with no pressure for sex. He should let the sexual invitation come from her, then ask her to show him, by guiding his movements, how best to please.

4. Why is my spouse jealous? Is there a cure?

After their wedding, Sarah who fell in love with Scott for his intelligence and self-confidence, grew very dependent on him. At first, this made Scott feel protective and manly, but finally he left smothered. By the time they came to me, Sarah was upset because Scott was no longer her dependable protector, and Scott was trying to break away from her. Sarah's jealousy of Scott's attention came from her feeling of inadequacy. The way to raise self-esteem, I told her, is to become more independent. She was afraid to assert her independence at first. Then I got her to try it just once. She went to an afternoon movie, and wasn't home when Scott called to say he'd be late for dinner. He was shocked – Sarah's dependency had annoyed him, but it had also been reassuring. When Sarah returned, she simply said “I had something to eat on the way home'' Gradually, Sarah began to live a life of her own and build up her self-esteem. Today, she has no need to be jealous of his attention. And Scott has found he doesn't really need her dependency to affirm his manhood.

5. My spouse had an affair and now wants me to forgive and forget. How can I?

By the time Thea discovered that her husband, Tom was having an affair, it had been going on for almost a year. Like many victims of infidelity, she felt not only betrayed but humiliated. The first thing I said to Thea applies to anyone whose mate is cheating: “The affair isn't turn fault. You aren't having it. The affair belongs to your partner. You can't turn off his feelings towards someone else. But what you can and must do is decide what result you want from this crisis'' I recommended thoughtful evaluation of the marriage. If you feel the marriage is worth saving, fight for it. Thea decided to try to salvage her marriage – and succeeded.

 

 

One woman I counselled, Emily, concluded her husband could never be faithful and left him. She had financial hardships (most divorced women do), but eventually became a prosperous real-estate broker. If a marriage is to be saved, both partners have to work at restoring trust and communication.

 

To do this, psychologists recommended these rules : * Ask for Positive changes in behaviour instead of attacking negative behaviour. Be specific. * Respo9nd directly to criticism instead of making counter charges * Confine conversation to the present and future. Don't speculate on motives or analyse character. * Listen! When you are trying hard to forgive and forget, remember that many a couple celebrating a 50th wedding anniversary has survived an affair. Take heart.

 

6. After 15 years, our marriage is dull. How can we get the spark back?

That question used to be asked after six to ten years of marriage. Today couples are postponing childbearing, so they are often still contending with young children – a great stress on any marriage – by their 15th anniversary. I like what researchers have to say about successful relationship : love and physical desire wax and wane throughout a lifetime. “This can be accepted, even enjoyed, if partners can communicate. But if a dull marriage is getting to be a habit, heed psychiatrist who says R. William Betcher, who says most people underestimate “the role of play in marriage'' Remember when you first fell in love? You played silly games and called each other pet names.

 

Your love was full of fun and laughter. Then, about the time you became parents, you began taking yourselves very seriously. I've advised many suffering couple to try playing again. It brings partners closer and allows them to express their desires, and even criticize, in ways that don't hurt each other. Sometimes it's not easy to start playing again when you're out of practice. But it's well worth the effort.


How To Excite Female?

The next enorgenous zone as we downward is the waist sexually sensitive primarily to contact by the mouth and lrgely on the area directly above the hips and extending half way to the middle of the stomach. Mouth contact here such as kissing or drushing with the tongue, produces, a definite exciting effect directly upon the genital area, to which all women are subject in approximately the same degree. The groins follow and, being directly adjacent to the genitals, are sensitive to the touch of both hands and mouth. Strangely, in spite of the proximity of the groins to the genitals, the excitement that is induced by contact with that area is not even as great as that induced by caressing the breasts of women who are highly sensitive in that region. On the other hand, with respect to women who are not unduly sensitive is the breasts, the groin area has the invariable capacity to stimulate them.

 

 

We will ignore for a moment the interior and exterior genitals, because such areas are the most important of all, and much is to be said concerning them. Outside of these, only the insides of the thighs and the area directly above the knees remain to be considered.

 

The inside sections of the thighs are particularly responsive to hand caressing and, when run over rapidly by the tongue, from knee to groin, can invoke a high pitch of excitement in both male and female. With respect to that area directly above the knee, it is strange but true that many normal women experience their highest degree of excitation when this area is continuously sqeezed by the hand. It holds more of a thrill for them than mouth, breast, or ear kissing combined, and is sufficient in itself to produce the desire for intercourse.

 

One might imagine that a woman possessing this peculiarity would be a highly emotional type, but she is among the most passive during the sex act. It is interesting to observe that the buttocks, as well as the leg below the knee, are completely useles areas as excitants so far as bedroom intimacy is concerned. Of course, the areas in contact when opposite sexes are clothed will naturally create desire, as when the calves of the leg or the knees are surreptitiously brought together under a table or in other clolse proximity.

This is merely a matter of body contact, any form of which has the power to arouse two peeple who sould like to be intimate but are unable to do so. However, this resolved itself very quickly into more nothingness as soon as the couple are able to adopt the more intimate contact which bed and melity allow. These areas, then, with the exception of the genitals, comprise all the erogenous zones concen- tration upon which by the male cab develop desire in the female. They are sepcific region and every normal woman must be affected emotionally by some of them to a large degree if her partner understands his role. Before preceeding to the genitals, it may be well to recapitulate and reconsider the situation.


Contraception: Preventing Unwanted Pregnancy

There is another urgent reason for family planning. Rapidly increasing population has become perhaps our greatest world problem. As from 1973, there were more than three and half billion people on our planet. At its present rate of increase, the world's population will reach 12 or 14 billion by the year 2010. Thus, before long, the world's resources will not be sufficient to support all the people being born. Indeed, this situation already exists in many conutries, especially in Asia, Africa amd Latin America.

 

Therefore, the job of mankind is to learn how to limit the popula- tion to the number of people who can be well taken care of. One result of overpopulation is over- whelming competition, hunger, and disease. Another result is the overuse and pollution of the limited total supply of land, minerals, water and air that are available to us who live on planet earth. Especially responsible for this overuse are the people in nations with high standards of living like the United States, who consume vast quantities of resources per person.

 

It is estimated that one average American during his lifetime will consume about thirty-five times more of the world's limited re- sources than will the average citizen of India. Therefore, if we really seek a better life for all, especially we who are large consumers, we will strive to have families produce only the number of children for whom they can provide a decent standard of living and whom they can accept lovingly. This will result in a population and consumption of resources that our world can support. For a nation to have a stable population size, families will have to average about two children each.

 

Now that couples are free to choose, we can expect that some will decide to have no children at all, or only one child, while an occasional couple who are mature and strong enough to handle it will choose to have a large family, thus not only main- taining the desired average but seasoning the population pot with people of varied backgrounds and experience. There is also, of course, the possibility, for those who want more children but do not wish to increase the world's population problem, of adopting children.

 

This can be a very rewarding experience for the parents who adopt and for the children who are adopted. Today, the practice of contraception - or birth control - is legal in most countries and accepted by most major religions. The main discussion is about what methods of contraception are acceptable. The Catholic Church has opposed methods which it considers to be 'unnatural' and thus against the will of God. It is important for all people to respect the strong moral feelings of many Catholics on this matter. It is equally important for Catholics to respect the moral feelings of those who favour various methods of contraception.

Today, Catholics see as clearly as anyone the need for family planning and the control of popu- lation and the consumption of world resources. They believe that contraception can be prac- tised without moral wrong in the means used are 'natural'. The big question for them is: What is natural? Knowledge of methods of contraception is part of the information about sex that any intelligent person should have. The essential thing is preventing the conception of a child is to keep a live sperm cell from joining a live egg cell and fertilizing it. Here are the contraceptive methods most commonly used: in next episode.


Why Men Hurt The Women They Love

“No one who has ever known me can believe what I did'' He is 35, with sandy hair, blue eyes and an innocent grin. There is dis- belief in his voice as he tells of beating the wife he loved, chok- ing her unconscious, and, at other times, pushing her face in the mud and holding a kitchen knife to her throat. His voice cracks as he remembers the young children he adores looking on in terror.

 

“How could I do that?'' he wonders now. “people know me as a good man. I own my business. I don't drink, I don't smoke, I don't chase other women.'' He is one of the men of all ages, races and classes who commit the secret crime that can happen next door to any of us: wife-beating.

 

According to one survey in America, a woman is battered by a husband or boy-friend every 18 seconds. And every year, it is estimated that more than a million of these women need medical help. Every day four die. “The violence was hard and fast,'' remembers a 39 year-old man from California.

 

“I realized that I could very possi- bly kill her. And what was really frightening was, I wanted to'' Wife-beating is a crime of rage and of power. “It is a pattern of coercive control,'' explain Susan Schecter, researcher at the Women's Education Institute in New York and author of Women and Male Violence. “One person dominates another, often making her afraid to do what she wants or even say what she thinks.''

 

Many times, the batterer feels he has a right, even a duty, to control his wife. If he has grown up in a violent home, he is more likely to use violence. Between beatings he controls her with shouting, name calling, intimida- tion and other emotional blows. He is haunted by the fear of losing the woman he loves. To keep her, he terrorizes her. It is love gone wrong. In a counselling group for violent one man tells of checking his wife's car mileage daily.

 

There are guilty laughs from the other men; they did the same thing. Another husband, jealous and possessive, disconnected the doorbell so his wife couldn't hear visitors ring. Also in a support group for battered wives, someone asks; “How many of you were accused of having an affair?'' Every hand goes up, though almost all of the women are innocent. Battering is also a crime of tradition. For hundreds of years, husbands had the right to beat their wives. Only in this century did it become illegal in most countries. Yet even today, wife-beating remains the assault for which police don't want to make arrests. “People continue to think of it as a private matter'' says Judge of a family court. “We need to see it as a public concern, too dangerous to ignore.''


How To Excite Female?

We now come to the vulva or genitals. Eliminating those which have no bearing on sexual excitation, at least so far as male contact is concerned, there remain the clitoris, the small lips, the area surrounding the lips, and the vaginal entracne. Of all these, and by for the most important region and organ of the entire female body for inducing passion and effecting sexual gratification, is the clitoris. It is the most important becauese, when every other area of the body is insensitivi to stimulation, the clitoris will not only induce excitement but will also bring about orgasm in the female.

 

No man is or can be a qualified lover who is not throughly familiar with the power and peculiarities of this tiny but powerful organ. There exists in this matter of a clitoris a strong difference of opinion among medical men themselves. Some ragard it as the organ and area most conducive to sexual excitation and orgasm, while others contend that the vaginal entrance and adjacent area and vaginal interior, including the lip of the womb, should properly induce the orgasm. Some also say that any woman who is not sensitive about these regions is impotent - that's to say, incapable of normal orgasm.

 

Since it is generally agreed that an area of high sensivity exists within the clitoris, let us consider its function in sexual activity. A surprisingly large numbers of men and women are completely unaware of its existence, and it is doubtful if many who have heard of it know precisely where to locate it. However, even under normal conditions, it is not difficult to understand why so many men and women are unaware of the existence of this vital organ. Since most men are inclined to approach the genital region of a woman before she is sufficently aroused by foreplay.

 

The clitoris is not in the erected state, and it feels little different from any of the other tissue about the vaginal area. Also, since its location is considerably above the vagina. it passes unnoticed even when erected, because most men concentrate their attention about or within the vaginal entrance. Furthermore, in spite of its sensitivity the clitoris frequently requires minutes of gentle massaging not only to bring it to erection but even to develop sensation. As a result, it is not unnatural that even who are aware of the pre- cise location and of the abilities of the clitoris, having attempted to stimulate it and not meeting with immediate response, assume that the woman in question is not sensitive there and have permanently abandoned it as an erogenous region. Nor does higher education on the part of an individual necessarily indicate knowledge in this connection. There exist college graduates of both sexes who, far from knowing its peculiarities, have never even heard of the clitoris.


Contraceptive Methods Most Commonly Used

The "Pill'' The birth control pill is taken by mouth and causes chemical changes in the woman's body that stop her from ovulating. Thus, no egg is released to be fertilized. One pill a day is taken for three weeks, begining of the fifth day after menstruation starts, and then the pills are stopped for one week, during which time a vaginal flow like menstruation takes place. The pills are usually sold in dispensers that help the woman not to forget to take her pill. Some dispensers contain a pill to be taken every day.

 

Each space in the dispenser for the no-pill days contains a placebo pill, one that contains no chemicals. This makes it even easier never to forget to take the needed pill. Taking pill for only one day, or a few days, has no effect. This pills should be used only when prescribed by a doctor. They are just about 100 percent effective is used properly. Not a single day should be skipped. If it is, other means of contraception must be used until the next menstrual period begins.

 

Intrauterine Devices :- Intrauterine devices, called IUDs, are plastic rings, coils, loops, or other shapes, any one of which in inserted by a doctor in to the flat, triangular cavity of the uterus and which, by means not yet entirely understood, either prevents fertalization or keeps the egg from implanting itself in the wall of the uterus for as long as the IUD is in place.

 

The IUD has a thin plastic thread attached to it that hands down through the cervix so that the woman can feel it with her finger and thus make a regular check to be sure that the IUD has not been expelled. The advantages of the IUD are its very low cost and the simplicity of its use, for once it has been inserted, nothing more needs to be done except for the woman to make an occasional check-up visit to the doctor. It is very reliable, especially when used by women who have had a child and whose uterine cavity is therefore permanently somewhat enlarged and is thus less likely to expel the IUD. The IUD is not quite as certain of success, however, as the pill.

 

Diaphragm :- A diaphragm is a round rubber cap, usually about 2 to 3 inches in diameter, which, before intercourse, the woman places in the vagina so as to wall off the cervix, or neck of the womb, from the main part of the vagina.

 

It prevents the sperm from entering the cervix. It is obtained by prescription only, and must be fitted by a doctor, who instructs the woman how to insert it before intercourse. The diaphragm is used with a special kind of cream or jelly which kills sperm cells. It is somewhat less effective than the IUD.


How To Excite Female?

While this organ is the one upon which orgasm sits for all females, sensation for at least forty per cent of women, if not more is located exclusively there. These women, we shall refer to in the future as the "lowly sensitive''. Regarding this group, the other areas of the vulva, as well as the vaginal interior, are completely insensitive, and where any sensation at all exists there, it is so slight as to be fo no consequence.

 

Most unhappily, nature has committed an oversight here, as she occasionally does, and it is this, in addition to the difficulty more men in delaying orgasm, that contributes almost wholly to sexual incompatibility or lack of sexual satis-faction on the part of the female. Another third, approximatelu, to whom we shall refer as the 'moderately sensitive,'' have only a moderate sensitivity about the vulva, exclusive of the clitoris.

 

While this group is capable of orgasm indepen- dent of clitoral contact with the finger or penis, it relies largely upon a rapid, violent rhythm which sets up a disturbance in the entire genital area. This violent motion, characterized by deep pene- trations into the vagina, also has the power by the force of its drive to bring the area above the penis itself into contact with the clitoris and to create a strong aggrava- tion about the external parts above the vagina which may extend even to the clitoral zone.

 

Such a woman also characteris-tically engages in fierce genital wriggling, even meeting the male in his drive, as if to force the clitoris, and perhaps so doing on occasion, against the male organ and caused the penis to bend. If the male orgasm can be delayed, or rather delays itself long enough - this violent type of male makes no effort himself to exercise control, and movement of this kind will not allow to retarded male orgasm - the woman may have her climax, and it will usually occur simultaneously with that of the male. She may miss it, however, if she is slow to respond or if, following his orgasm, the male does not continue the rhythm long enough for her to reach her climax.


Wife-Beating in India

Few Social scientists have studied wife-beating in India. But the scanty information that exists suggests that the problem, perhaps the commonest form of violence against women, exists in all sections of our society. And, as in the West, most wife-beaters grow up in homes where they or their mothers were physically abused.

 

 

By and large, battered wives get little sympathy in our society. The police normally take action only when the woman is seriously injured. Indeed, so strong is our reverence for marriage that in many cases even the victim's parents are reluctant to let her return to them. There are very few institutions that offers shelter to battered women; a major city like Bombay, for instance, has only three.

 

Consequently a battered wife has few options other than enduring her husband's cruelty. However, she can get a court injunction preventing the husband from entering the matrimonial home. One type of domestic violence unique to India is where recently married woman's husband and in-laws, frustrated at not getting enough dowry, either actually murder her or harass he so much that she commits suicide.

 

These are not isolated cases. To combat this evil, several changes in the law have recently been made. Today, if a woman commits suicide within seven years of marriage and if her husband or his relatives has harassed her during this period, the court may presume that they are guilty of abetment to suicide unless they can clearly establish their innocence.

 

This reverses the normal procedure under criminal las where an acused is presumed innocent until he is proved guilty. Under another amendment, if a woman's husband or in-laws torture her mentally or physically, they can be jailed for up to three years. Typically, husbands blame their wives for the violence. “If only she would change,'' the batterer says. Out of a bottomless need for control, however, he may want an endless list of changes.

 

Often, society also blames victim, asking “Why does she stay with him?'' The answers differ. Some battered women still love their husbands, at least between beatings. Some try to ignore the violence. “I couldn't believe it was happening to me'' a younger wife says. “When the bruises healed, I'd pretend everything was normal.'' As the beating continue, some women lose self-esteem. “He beat my face to a pulp,'' one wife recalls. “Then he pushed me in front of the mirror. 'Look at yourself!' he shouted. 'Who else would have you?'' Fear makes still other women stay. “If you try to leave'' a husband may threaten, “I'll find you and kill you.'' Many of the worst injuries and deaths happen as women try to get away.


How To Excite Female?

Females of this physical temperament usually desire a violent male - a sort of sexual battering ram - and are the strongest in their preferences, evidently having discovered that a penis of average size or less, and a man more reserved in his habits, fails to satisfy her if he allows the clitoris to take care of itself which most men do.

 

She is, however, a type definitely capable of more than one orgasm if properly handled, but she will frequently be denied them with the kind of man she seeks; this violent type of male concentrates too fully upon his own pleasure to give any deep study to here. Neverthless, because they feel the need for such a sexual partner, women of this nature are mentally conditioned to stimulation by a broad chest. knotted arms, and bulging legs. They believe that a man so built is a type of masculinity capable of being a violent lover. He is all of that but, as the partner of many women, he could create a dislike for the sex act.

A great number of women, although definitely the minority, are more fortunate. These will be referred to as the "highly sensitive''. Their entire genital surface is a mass of sexual sensitivity, as is the vaginal cavity itself. Quite obviously, these women have nervous systems which are more highly developed sexually than those of the majority, because the nerve mechanism which exists in the clitoral zone does not extend throughout the entire genital area of a woman - at least, not visibly.

 

One may assume that the area operated sympathetically and that it is a matter of nerve development. At any rate, this minority, in addition to being sensitive at the clitoris, is also highly sensitive about the small lips, the adjacent area, the entrance to the vagina, and the area deep within the vaginal canal at the point where the neck of teh womb protrudes; this is known as the "vaginal vault".

 

Infact, wherever contact by either the hand or penis is made anywhere within this area, sensation starts to flow and orgasm can be reached and sustained without any friction with the clitoris whatever. One might imagine that a women so sensuously constructed could hardly fail to achieve sexual satisfaction and that to do so would be a relatively simple matter. However, such a woman is not without her problems. Her orgasms may be lengthy and require a longer sustaining period for gratification should she be married to a man who exercises no orgastic restraint whatever, she suffers intensely. Conversely, her husband, a man of the best intentions, may not be able to delay his orgasm sufficiently long. She may have desires she is inhibiting, such as oral contact with the genitals, which will be discussed in another section, and is fearful of shocking her husband.

 

As a rule, this highly sensitive type learns strongly and practi= cally without exception to oral rhythm. So, regardless of temperament, sexual incompati- bility may always exist in some way or another. These, then, are all the normal erogenous zones and their varying degrees of sensitivity. We are not discuss- ing purely individual zones, peculiar to some women, which have developed as the result of some psychological factor, only those common to all. It is necessary now to discuss the sexual temperament of women with respect to these areas in responding to foreplay.


Contraception: Preventing Unwanted Pregnancy

Condom :

A Condom is a thin rubber device shaped like the finger of a glove. It is placed over the man's erect penis before intercourse and prevents the sperm from escaping into the vagina. It is often called a 'rubber' or a 'safe'. It is available everywhere without prescription. If the condom is new, and if the man does not use it while the woman's vagina is very dry and not slippery, and if when he puts it on he leaves a small space at the end of the penis to receive the ejaculated semen, and if he carefully holds the condom in place with his fingers and withdraws his penis before he loses his erection so that no semen will spill into the vagina, then it is a very effective means of contraception. Also, there must be no continuation of intercourse without changing condoms. If condoms are carelessly or inexpertly used, they are not reliable.

 

 

Chemicals :

Chemicals include a number of foams, creams and jellies which the woman places in her vagina and which may block or kill the sperm and thus prevent fertiliza- tion of the egg. These are not nearly so effective as the methods described above, even when carefully used according to instructions, but they are better than nothing. They are available at chemists without prescription.

 

Rhythm Method :

The Rhythm Method is a method of birth control based on the possibility of a 'safe-period' before and after ovulation when a woman is not fertile, when she might have intercourse without conceiving a child. The theory is that if a couple have intercourse only during these safe periods, they may succeed, by a 'natural' method, in limiting the number of children they have. However, science has not been able to find an easy and satisfactory way of telling just when ovulation occurs, so that for most women the rhythm method is not reliable.

There is no time a woman may be sure she is absolutely 'safe' during her monthly cycle, except the first three or four days of her menstrual period. The rhythm method has been the only one up to the present approved by the Catholic Church, but high officials are studying this serious question to see if a method of contraception can be found and approved that will help members of Roman Catholic faith. At present, many parish priests leave it up to the conscience of the Catholic couple whether or not to use the pill, and many Catholics decide to follow their own consciences without asking the Church what to do.

 

Withdrawal :

Withdrawal is an old and commonly used method. It requires tha man to withdraw his penis from the woman's vagina just before ejaculation so that the semen is deposited well away from her vagina. The withdrawal method is highly unrealiable because the man may not withdraw his penis soon enough, or his penis, even before ejaculation, may secrete a small quantity of fluid contain- ing sperm. However, it is a lot better than nothing, and it was the method used to bring birth rates down in certain countries of Europe before modern contraceptives were available.


Orgasm ...

Many years ago Sigmund Freud Theorized that women experienced two distinct types of orgasm, vaginal and clitoral. The clitoral orgasm was presumbly based on masturba- tion in childhood and was considered childish and immature. Vaginal orgasm was related to adult sexual organs, and Dr. Freud considered it mature. In his opinion vaginal variety was more intense, more fulfilling experience. All orgasms are created equal and this is the truth. Years of careful observa- tion and analysis involving hundreds of men and women who copulated, masturbated and engaged in nearly every variation thereof, right in the scientific laboratory, have yielded some important answers about female orgasm.

Unless the clitoris participates, orgasm does not take place. This diminutive structure is the centre of every sexual climax. All sexual feelings begins and ends here. An orgasm is an orgasm. Orgasms may vary in frequency and intensity but they all begin and end at the same place - the clitoris. There are two types of orgastic reaction, each peculiar to the female groups as each group requires a different method of handling.

 

The type peculiar to the highly passionate group has been referred to as a subtained orgasm. In a climax of this character, the female experiences a more or less steady sensation of pleasure, enduring over a considerable period as if the crisis reached a certain height and remained there indefinitely, always producing a constant feeling of delight.

 

The type of peculiar to the lowly and moderately sensitive group is described as an individual orgasm because the sensation does nor run on indefinitely, as with the highly passionate. It reaches a peak, remains there for a relatively short period, and then automatically ceases. If the female is capable of more than one orgasm, the crisis occurs again but reaches a lower peak. This time it is neither so long nor intense, automatically ceases, and their abates. This process repeats itself for as many climaxes as the women is able to attain.

 

In any case the first is always the strongest, the peaks of the others always falling lower and lower until, finally the male is no longer able to reinduce the sensation. The female is fully gratified. It is also perfectly possible for a woman who is capable of six individual orgasms, for example, to feel satisfied after the fourth or fifth, though she may unknowingly be capable of more. However, since, the feelings is pleasurable for her at any time, there is no reason why the male should not persist in his efforts to extract from her every impulse of sensation possible before discontinuing the relationship.


Contraception: Preventing Unwanted Pregnancy

Sterilization

Still another method sometimes used by people who wish never to have any more children involves sterilization of either the man or the woman in a way that prevents fertilization yet does not lessen either one's capacity to enjoy intercourse. In men this is done by means of a minor, easy, inexpensive, and harmless surgical operation. A short section from each vas deferens, the tube that carries the sperm from the testicles, is cut and the remaining ends tied. Instead of passing along the tube, the sperm are absorbed int0 man's body. Thus, no sperm are contained in the semen when the man ejaculates. Since the sperm make up only a microscopically small part of the semen, no reduction in the quantity of semen in noticeable. The operation is called vasectomy.

 

Women cah be sterilized by having their fallopian tubes tied and cut by a surgeon so the egg cells cannot pass from the ovarty into the uterus. This operation is called a tubal ligation. At present, it is a more difficult than a vasectomy and must be done in ha hospital, though doctors have developed a technique to do it almost as quickly and simply as a vasectomy. This process is called a laparoscopy.

 

A small incision is made in the navel (so that the scar will not be noticeable) and a miniature telescope is inserted, through which the doctor can see the fallopian tubes. The doctor also inserts an electric cauterizer to burn out a small section of each tube and to close up the ends so that no eggs or sperm can pass. Neither a vascectomy not a tubal ligation interferes with the enjoyment of sexual intercourse; they may actually increase enjoyment because the worry about pregnancy and the need for using any kind of device is gone. Both operations should be considered permanent, although another operation may be performed to undo them. But this second operation has much less than a fifty-fifty chance of suceeding and thus cannot be relied upon.

Abstinence :-

Abstinence means to abstain from - that is, not to have sexual intercourse. However, since sexual sharing is such an important part of couple's relationship and one of the ways that couple have pleasure together and express their love for each other, abstinence is an unsatisfactory method of family planning.


The 'Morning-after' Pill or Shot

If a woman has intercourse unexpectedly without using any reliable means of contraception, there is one last possibility for avoiding pregnancy. It is called the 'morning-after' pill or shot and involves some massive doses of hormones. It is thought that these doses prevent implan- tation of the fertilized egg in the uterus. The doses usually make the woman who takes them very nauseated for a few days, and many doctors don't like to prescribe them. Howeverm they cause no permanent harm, as far as is known. Other methods of birth control are being investigated by scientists and doctors, who feel, almost without exception, that necessary to mankind is a low-cost, easy, sure, safe method of limiting the size of families - and a method that will be acceptable to all. It is important to emphasize that there is much wrong and dangerous information passed around birth control methods.

Some uninformed people try methods that do not work, like douches (squirting liquid into the vagina). Saran wrap, or urination right after intercourse. These methods do not work. The only way for a couple to be certain about a birth control method is to know that it is medically approved by the medical profession and that the product used is approved for birth control by the health aurhorities of the country in which you live.

Fortunately, it is now possible in most cities and in many rural areas for people to receive expert advice on contraception and to obtain the birth control products they need. Organizations like the Family Planning Association and most public health and medical centres provide these services, at no cost if the user cannot pay. No one should be afraid or embarrassed to ask for information about birth control.

For any person who is going to have sex and is not ready to have and care for a child, it is a must. It is interesting that many married couples have used the best methods of contraception with what they intended to be the greatest care, only to find that the wife has become pregnant and that a child is on the way. In rare cases, even vascetomies and tubal ligations may fail. By processes not entirely understood, the cut ends of the vas deferens or the fallopian tubes may reopen and reunite. However, failures of contraception are usually not failures of good methods but failures on the part of the people using them. Birth control can be counted upon to succeed only when used correctly and without haste.


How Intercourse Offenders Lure Our Children

Some years ago my teenage daughter's car broke down and she began walking along a highway in broad daylight. A car with two men stopped. One flashed a badge and claimed to be a detective. “Climb in'', he said offering help, But when she saw dirty clothes in the rear seat, she became suspicious and backed away. The men sped off. They were later arrested for posing as policemen and for raping young women. My daughter saved herself with her instincts, common sense and quick action. But each year thousands of children are less fortunate. As a concerned parent, I set out, after the attempted abduction of my daughter, to develop a comprehensive programme to help prevent sexual molestation of children.

The programme is based on years of research, including interview with hundreds of convicted child molesters, pimps and murderers – who revealed the lures they used to entice their victims. Sex lutes fall into a number of categories. Knowledge of them is so basic to child's safety that they should be taught – indeed must be taught – by every parent. Following each lure is the recommended preventive measure.

 

Affection/Love Lure :- Most people think a molester is a sleazy character, a stranger lurking near a schoolyard, luring children with sweets. On the contrary, 75 to 85 percent of sex crimes against children are committed by some one the child knows, loves or trusts, says David Finkelhor,. Some 45 per cent are relatives – fathers, brothers, uncles, another 30-40 percent are acquaintances – baby sitters, teachers, clergymen, doctors. Prevention :- Question the motive of any adult – even a family member – who seems highly interested in your kids and wants to spend a lot of time alone with them, especially overnight. Rely heavily on your instincts. Monitor and participate in your child's activities in youth groups, summer camps and the like. And stress to your child the importance of telling you about any improper advances made by others. Children from unhappy homes are easy targets. Molesters say these children are so starved for affection, they are easy to seduce. If your children tells you she has been sexually abused (comments may include :He's been fooling around with me'' or “I don't like to be alone with my father), believe her, Experts say children rarely lie about sexual molestation.


Orgasm...

This appears to be nature's method of informing the male that his partner's nervous system has absorbed all it can stand for the moment. A rest of a minute or so with allow the body to read just itself and the thereafter the second orgasm can be clitorally induced by the finger. When completed, this will likewise be followed by the same convulsive jerkings, whereupon another pause must be taken.

 

With the continuation of this procedure each pause becomes longer as the orgasms increase in number, until finally, when the system has absorbed all it can stand for the moment, no amount of pause and subsequent stimulation will enable the clitoris to regain its sensitivity. Contact with it now produces only body twitches or no sensation at all. Intercourse is now completed. Some elaboration is required regarding the pause between orgasms and other approximations.

 

The reader will observe certain time elements marked on the diagrams. These specific times must not be taken literally. It stands to reason that one cannot prepare a timetable which will account exactly for the reactions of every woman. One can describe their reactions because, although numerous, they are limited in number. Time durations cannot be set to the absolute second. The figures given, however, will never be too far from the reaction time of any woman now being discussed, and will give the male a sound basis for experimentation.

 

Further mention should be made of female body twitching, this is just as important a guide to a woman's responsiveness as is the flowing of the secretions previously mentioned. It happens sometimes that digital contact with the clitoris will result in body jerkings even before the first orgasm.

 

This imeediately indicates that the female is being pressed to respond too rapidly. It is true that some fluid may be flowing, but if these jerks occur, the secretion is not yet issuing freely enough, and the clitoris is being forced to stimulation before it is ready. It can also mean that too much pressure is being placed upon it; excess pressure upon the clitoris will not only result in jerking but will also deaden sensitivity completely. It has the effect of paralyzing the nervous mechanism at that spot. The only time that excessive pressure may be placed upon the clitoris is just before the orgasm. A woman feels at that moment as if she wishes the male to push upon it and will strain her body against the finger. Even so, only a firm pressure should be used. Too much pressure, even at this point, will destroy the orgasm even though the female may believe that it will increase it. At any other time, only a light stroking will produce the best result.


How Intercourse Offenders Lure Our Children

Assistance Lure :-

Another very compelling lure used by molesters is asking the child for help. Requests can include directions to a popular landmark, or assistance in carrying an armload packages to the car or house. In 1983, a Colorado man was convicted sexually assaulting six girls, using the ruse that he needed help in finding his lost dog. Prevention :- Tell your child that adults should ask other adults for directions or help. If anyone stops to ask direction, your child should move out of reach and be ready to run and scream for help.

Bribery Lure :-

The age-old lure, bribery, still works. Youngsters may be offered sweets, toys and other rewards. Teenagers are lured with radio or cassette headsets or bicycles. A California man was convicted of molesting two neighbourhood boys who had asked for permission to swim in a pond on his property. The boys were molested by the man after he had persuaded them to take off their bathing suits in exchange for a chocolate bar.

Prevention : The traditional caution still applies, tell your children not to accept gifts from a stranger and to tell you if such an offer has been made. Be alert to new toys or money you can't account for, ask where the items came from.

Ego/Fame Lure :-

Children may be promised a modelling job or the chance to compete in a beauty contest. They are offered a private audition and often told to keep it secret from Mum and Dad. Alison Parrott, an 11-year old star athlete who lived in Toronto was excited when she called her mother to ask permission to meet a man for a photo session. The man had said he was a photographer for a local paper. He proposed that she meet him immediately. Allison's mother was also excited as she gave permission. Alison's body was found two days later in a part. She reportedly hand been sexually assualted and strangled.

Prevention : Accompany your child on his talent pursuits and check the credentials of “talent scouts''. Stress the importance of keeping no secrets-and why.

Emergency Lure :-

The emergency lure is designed to disarm, confuse and worry the child. Some examples “your Mummy is sick and was taken to the hospital. Come with me.'' “Your house is on fire and your mother is locked out. Do you have a key? Hurry''

Prevention: Pre-arrange a plan of action with your child. Stress the following : never go with a stranger. Either call or hurry home yourself to verify that there is an emergency. If uncertain, seek help from relatives, friends or neighbours.

Fund And Games Lure :-

Here, seemingly innocent play leads to intimate body contact. Games might include tickling, wrestling, hiding the coin, or hiding under a cover.

Prevention : Teach your children the difference between a “good touch'' and a “bad touch''. So they'll recognize when a “game'' isn't any more. And common sense should tell parents something is wrong when an adult consistently singles out a child for a playmate.

Magic and Rituals Lure :-

A growing number of children have been enticed into physical and psychological rituals that culminate in sexaul abuse. Magic nd rituals fascinate and brainwash the child into a consenting association, leading to repeated abuse.

Prevention : Discuss the concepts of good and evil at a very early age, so your children are not confused by those who try to mislead them. Be inquisitive if your child begins to reject basic social values, family, country and established religious beliefs. Probe as to how, when and why these adult-like opinions were formulated. Become vigilantly attentive if your child suffers frequent nightmares or lapses into prolonged periods of silence. Be especially concerned if your child becomes absorbed in horror films or publications about the occult.

Pornography Lure :-

In 1987, Richard Bennet was sentenced to eight to 30 years of multiple sexual assaults on one youth. While working at a ski resort, Bennett befriended the boy. He used pornographic magazines and videos to sexually arouse his victim and destroy his inhibitions. Prevention : Keep your home free of all forms of pornography, no matter how harmless a magazine or video might seem- so as not to legitimize this lure.

Heroes Lure :-

A recurring theme in sex abuse is the molester who poses as a childhood hero. Several years ago a Las Vegas sweet-shop owner invited children into his home for a Christmas party. Dressed as Santa Claus, he molested one of the girls.

Prevention: Explain that bad people sometimes try to trick children. Real heroes would never use their fame to harm children, Instruct your child never to co-operate with such a person, but to tell you and the authorities immediately.

Jobs Lure :-

Adolescents, in particular, can be attracted by the promise of a high-paying or interesting job. Interviews for these jobs are often held in secluded locations and are advertised with only a post-office box number. John Gacy, Jr. who killed 33 young men in Chicago, was sentenced to death. Gacy's most effective lure was offering jobs to male teenagers. If the boy brought a parent along to Gacy's home, there was a pleasant interview ending with a vague promise of future employment: Boys who came alone never left: they were told they could start work in a few days, and then Gacy would immediately mention a trick with rope or handcuffs he wanted to demonstrate. The boys not wanting to offend their new employer, would co-operate in the trick, thus sealing their fate.

Prevention : Explain to your child why it is important for you to go along on a job interview, particularly if it is in an unusual location. Simply telling your job-seeking youngster about this lure should put him on her on alert.


Orgasm ...

It has been remarked that an incredible number of married women have never experienced an orgasm. Nothing more clearly demonstrates the ignorance of the male than his awareness of this, because the symptoms of the female orgasm are so obvious. The difficult thing, however, is to describe the sensation to a woman who has never achieved a climax so that she herself can give consideration to its attainment.

 

The problem would become immediately apparent if one were asked to describe a simple headache to a person who has never experienced pain. Consequently, the sensa- tion itself cannot be described except in terms of the sensation with which a woman is familiar in love-making. When all those which are not the orgasm are eliminated, a woman will then know that she has never attained a climax. If one were to attempt to describe the sensation in words, it could be said it starts with a light tickling or tingling sensation at the clitoris which gradually gathers intensity.

 

The tingling becomes sharper and stronger until it seems to cover the entire genital area and finally culminates in a fierce burst of overwhelming, ecstatic, sensation which seems to invade every organ in the genital system and is uncontrollable. This also can be stated positively. Any woman who has ever experien- ced an orgasm will automatically recognize it beyond the slightest doubt.

 

A woman who is at all uncertain has never attained it. It does not resemble and cannot be confused with any other known sensation. It is more individual and distinctive than pain; there are many types of pains, but only one sensation of orgasm. It must in all cases be felt in the genital area. It is not a sensation exclusively in either the heart or head, although the heart may pound wildly, the head may feel like bursting, and the legs may become weak from the drain upon the body's energy.

 

The delight of the sensation is locali- zed and experienced only in the genital area, it seems simultaneously to involve the clitoris and the interior and exterior of the vagina, and it is difficult for a women to determine precisely whence the sensation really emanates. It is not the sensation experienced by a woman when she is kissed by a man of whom she is passionately fond, although that feeling be magnified a thousand times.

 

It is not the fluttering of the heart which occurs when a girl is first embraced by someone for whom she cares. It is not that hollow feeling in the stomach which arises when the legs or thighs of those physically attracted to each other meet under the table or in a crowded car. Nor is it that body hunger experienced by two people when their nakedness is emerged in bed. It is a definite unmistakable and entirely new sensation, delirious, wild and uncontrollable.

 

Beyond this description, the author can add nothing more. The stimultaneous orgasm is attained when both parties reach their cli- maxes at the same time, and it is spoken of as the ultimate in sensation and as being difficult to achieve. Although it is not too often experienced consistenfly, any one who obser- ves the various methods described herein can bring it about with ease. It is ususlly the objective of a man who is associated with a one orgasm woman and to whom it has never occured to condition his partner for more than one. Since most men ignore the helpful qualities of the clitoris and stake everything upon tha ability of the penis, an organ not necessarily equipped for the function it is called upon to perform; and since most women are slow in the build up, it is remarkable that any man can delay orgasm sufficiently long to meet that of his partner.


Contraception: Preventing Unwanted Pregnancy

Quite a lot of research has been done on how reliable the different methods of contraception are, but researchers disagree, and, of course, a great deal depends on how intelligently and conscientiously the couple use the method selected. Out of anuy 100 women having intercourse regularly over a period of a year, how many will become pregnant during that year? Here are the best figures I can get:

 

 

Using no contraceptive at all             80-90 would be pregnant

Using withdrawal                               30-40 would be pregnant

Using rhythm                                     15-35 would be pregnant

Using a recommended foam

according to instructions                    25 would be pregnant

Using condom                                    5-15 would be pregnant

Using diaphragm with sperm

killing cream or jelly                            5-15 would be pregnant

Using IUD                                           3 would be pregnant

Using Pill                                            1/2 (one in 200) would be                                                                      pregnant

Being sterilized                                    almost none would be pregnant

 

When properly used, then, methods of birth control do provide a satisfactory way of having sex without babies, of limiting the size of families, and of controlling the growth of the world's population.

Abortion - When Contraception Fails :-

If contraception fails, or a couple fail to use it, and the woman becomes pregnant, she will have to decide what to do. One of them is abortion - that is, to have the embryo removed by a simple surgical procedure before it has developed far enough to live. Today, when done early in pregnancy be qualified physician in a hosopital or specially equipped abortion clinic, abortions are relatively safe.

 

However, no abortion is minor matter, and abortions later in preganancy present greater chance of surgical complications and often involve an overnight stay in the hospital. If the abortion is performed before the twelth week of pregnancy, the doctor may use a recently developed suction machine which removes the embryo and other products of conception.

Obviously, the sooner a girl or woman reports an overdue menstrual period to her doctor or to a clinic, the better are the chances for less complicated and less expensive care. When abortions are done in secret or illegally, it is almost impossible to check on the qualifications of the doctor or the adequacy of the equipment and procedures. In such cases, abortions may be dangerous and can permanently injure or even kill a woman.

 

There are many people, however, who feel taht it is wrong to terminate even the beginnings of human life. They feel so strongly about this that they even say that abortion is murder, but most people feel that there is a very great difference between removing the products of conception that are growing toward a person, and murder, which involves the killing of an existing person, born and actually living out in the world. In any case, when a girl or woman is considering an abortion, it is preferable that she receive help and advice from a trained and sympathetic counsellor as to whether she should continue or terminate her pregnancy.

Quite often, the decision, eithe way, may affect her emotionally more deeply than she expected it would, and she needs help in dealing with these effects. The counsellor will also see that she gets contraceptive advice so that abortion, if that is her decision, will not be necessary again. Abortion is certainly a very poor method of birth control, even though more and more people are coming to believe that it is better than allowing an unwanted child to be born into what may be for him or her a hostile world.


How Intercourse Offenders Lure Our Children

Many parents believe their children face little danger of being abused, that they are too young to be told of the possibility and that discussing the subject will frighten them unnecessa- rily. The fact belie such attitides, “It's like a fire drill,'' says Anita Montero director of YWCA's Child Assault Prevention Services. “You hope the real thing never happens, but if it does, the well prepared child is more likely to survive.'' The key, experts, is to talk with your children in a calm, yet direct manner, using language they can understand.

 

Dr. James Comer, Professor of child psychiatry says that with very young children especially, “you should tell them that most people are good people who do not harm children, But there are also 'bad' or 'sick' people who will'' As a starting point, tell your children that one should touch them in a way that makes them feel uncomfortable, that each child has a right to keep certain parts of his body private. What general precautions should your child take? Stress “safety in numbers''; ask your child to travel with friends or classmates to school or around the neighbourhood. Emphasize special caution towards drivers of vans; vans have been used in a number of heinous crimes.

Discuss routes the child takes to school. Molesters favour isolated shortcuts that children often use. These should be avoided. My research has revealed that children are often “targeted'' selected by the molester before he moves in. And small children are especially easy prey for any molester who can call the youngster by name. Many parents tag clothes and lunch boxes with the child's name. This allows the molester to be engaging and friendly-disarming the child of apprehension. If you use name tags, place them where they're not apparent to a passing observer.

 

Many victims have described individuals who later violently assaulted them as “weird.'' This description should be a red flag of warning to parents and children. Urge your children to thing about ways of escaping and surviving if abducted. Teach them to counter threats by running and screaming. Most molesters say they will flee if their intended victim runs or calls, :Help!'' A child who follows the threatening person into a car, building or other isolated area through fear or hope that co-operation may save him has lost control of the situation. Then sexual abuse of children is a social time bomb, with the potential for destroying many futures. To stop the victimization of our children, we must educate them. It's every bit as important as the three R's.


Caresses and Byplay

Caresses play a big part in every sexual episode, even those in which the wife participate through loving service with little or no hope of passionate reward. Almost every marriage required such episodes at times, when the male sexpace exceeds the female or emotional upset disturbs wifely responsiveness. After a few years, both parties know almost instantly when there's no chance of making it mutual.  The man shifts his caresses to gentle stroking and titillation of the inner lips and vulva, aimed mainly at helping his wife to relax and become lubircated by natural gland function. The wife ideally directs her caresses at maintaining her husband's excitement and (once she is lubricated and relaxed) speeding his build-up of excitement, aiming to give him full satisfaction without unduly long exertion. Caresses improve your expressive capacity and contribute to both your own and your partner's enjoyment.
PERIPHERAL CARESS
A man's sexual sensitivity is con- centrated largely in his genitals. His own insensitivity to caresses of the arms, legs and back makes it hard for him to realize the widespread body stimula- tions prove quite exciting to his wife. Gentle stroking of the lower legs, climbing gradually to the hips and thighs, may prove a much more apt beginning of sex play than the usual kiss or embrace. Similar petting of the hands, arms and shoulders reaches the breasts just as certainly as the usual neckline approach. Such a beginning generally proves quite apt in marriage, where sex often starts after both partners have donned loose-fitting night attire, but couples who pattern their love play after the patterns of courtship seldom stumble upon it, peripheral caress works out particularly well if you enjoy stroking and explorations or kisses and caresses of easily accessible parts can overlap with the refreshment-and-conversation phase, getting sexual excitement off to a good start before your lips even meet.
ORAL CARESSES
The lightest, most fleeting touch on your lips or tongue generally commands attention. Moreover, the surfaces inside your mouth remail sheltered from firction most of the time. Like a bright light this makes any stimulation seem more keen by contrast. Even a puff of air or the tissue movement caused by slight titillates these supersensitive nerves, and very light contact suffices for most forms of kissing and tongue caress.

 

As sexual excitement builds, parted lips afford opportunities for gentle friction between the inner surfaces of the lips and for advance and retreat explorations with the tongue tip. Full open mouth contact allows other varieties of play, such as tongue to tongue friction, titillating tongue caresses of the inner lip surfaces and roof of the mouth, and gentle nipping of the lips. If you have not perviously tried the more intensive forms of mouth play, you will probably find that the best time for early experimentation is during intercourse itself. A high pitch of sexual excitement makes acceptable many forms of stimulation which might seem dubious or even repulsive in a state of calm. If you and your partener find open-mouth kissing keenly pleasurable when you are fully excited, the practice will seem appropriate earlier and earlier in future sexual episodes, until it becomes an important part of initial excitement-generating play. Caresses you use in moments of keen mutual passion become linked in your minds with sexual excitement and love.


VD : The Diseases of Intercourse

Another problem of sex is Venereal Disease. (The word 'venereal' means 'having to do with sexual intercourse' and comes from the name Venus, the Roman goddess of love.) Sexual intercourse itself doesn't cause VD, but engaging in sexual intercourse or heavy petting with an infected person may give it to you. More people have VD in this country today than at any time in the past fifteen-twenty years. This especially true among teenagers and it is very important for everyone who is sexually active to know about it! There are two main veneral diseases, gonorrhoea and syphilis.

Gonorrhoea

Commonly called 'the clap' or 'a dose', gonorrhoea seldom causes death, but if not treated promptly it can often cause sterility and crippling arthiritis. The disease is caused by the gonococcus germ, which can live only in warm, moist places, such as inside the human body, and it usually gets its start inside the vagina or the penis and the rest of the reproduction tract.

Gonorrhoea is epidemic throughout the world today, being the most common serious infectious disease. It is easy for a man to know he has gonorrhoea, because a few days after he has become infected he will notice a painful burning when he urinates and pus will drip from his penis. Without having a special test, it is often impossible for a woman to know she has gonorrhoea. She may have no easily noticeable symptoms at all, since the gonococcus germs usually live and multiply around her cervix, where the tissue is less delicate than that in the urethra and where no urine, with its acid content, passes over the area. The gonococci usually do not spread to the womans urethra.

Thus if a man knows he has contracted gonorrhoea, he should at once tell any woman with whom he has had sexual intercourse, so that she may be examined at once and treated if need be. If she is infected and not treated, the disease will damage her body, and she may transmit it to other sexual partners.

The treatment is simple :- Usually a few shots of penicillin. This will nearly always cure a person but it will not prevent him or her from getting the disease again. There is no immunity. If gonorrhoea is not treated, the germs often spread throughout the body,
damaging the sex organs and the joints. When the body attempts to repair the damage, it may cause scar tissue to block the sperm tubes and tubules in man, or the fallopian tubes in a woman, preventing the sperm or the egg from getting through. In this way gonorrhoea is a major cause of sterility- the inability to have children - in men and women. Gonorrhoea can also damage the eyes and used to be a major cause of blindness in babies born to mothers who wee infected at the time.

Next episode lets discuss about Syphilis


New Hope for the Childless

New Hope for the Childless

 

 

When Dilip and Usha married, they decided not to have a family right away. They'd wait a few years, they thought, for Dilip to get better job, then have two or three children, a year or two apart. Five years passed and though they had been trying for more than two years, Usha still wasn't pregnant. Each month brought new disappointment.

 

Usha felt she was a failure as a woman. Dilip felt the same about himself as a man-and they were sure they were alone. What Usha and Dilip didn't realise was that they were but one couple among many who desperately want to have children and can't. These men and women are often ridden by guilt, despair and a sense of powerlessness. Indeed, some 15 million young couples in India-an estimated one of then young marriages-are infertile, a substantial minority largely overlooked until quite recently.

 

Why? Because so little was known about the cause of infertility that, according to Dr. Rustom Soonawalla, gynecological surgeon, “Most doctors simply told their patients to leave the problem to nature and everything would be all right.'' Fortunately, that is changing. “Doctors are turning their attention to the barren,'' says Dr. Rama Vaidya, Gynaecologist and endocrinologist. “Modern well-equipped infertility clinics that handle many new cases a year have begun functioning in major hospitals.

Causes and Factors :-

Dr. Vaidya points out that, ironically, today's tendency to delay child-bearing, as Usha and Dilip did, is one reason why childlessness is on the rise. “This early and mid-twenties are peak fertile years for both men and women,'' she says. “A woman's chances of conceiving lessen with age, especially over 30'' Infertility however, can appear at any age and stem from a number of causes. Operations and past illnesses, for example, sometimes create problems' tuberculosis, gonorrhea, a ruptured appendix, can all damage or block a woman's fallopian tubes, thus preventing sperm from fertilizing the ovum; certain childhood diseases can halt sperm production in male and make him sterile; phychological tensions can also make a man impotent.

 

Usha and Dilip, at the urging of family members, sought the advice of a specialist. Tests revealed that Dilip had obstructive azoomspermia, a condition caused by a childhood case of smallpox, in which sperm are blocked somewhere along the tubular system that transports them out of the testes. A simple operation to bypass the blockage soon brought his sperm count to normal levels. Within six months, Usha was pregnant and today the couple are the proud parents of three healthy children.

 

But even when the cause of infertility is correctable surgery by itself cannot guarantee a pregnancy. “Nature takes her own time to arrange the successful fertilization of an ovum by a sperm even in normal couples,'' says Dr. Soonawalla. “In fact, so many different factors contribute to pregnancy, including the elements of chance, that no couple should consider themselves infertile until after a year of regular intercourse.''

 

 

Extensive Tests :-

Persistent infertility problems then require the diligent detective work of medical experts who painstakingly eliminate one factor after another. It's an emotionally taxing and expensive process-often costing many hundred rupees. Yet, for most people the urge to have children is overwhelming, fed in part of the social stigma so often attached to barrenness. “Unsympathetic in-laws will taunt a childless wife to the point,'' says Dr. Soonawalla, “Where the couple gets desperate enough to try almost anything-even religious charlatans'' One of the first thing a qualified doctor will want to find out is whether the couple is actually having intercourse during the 12 to 36 hours each month when conception is most likely to occur.

 

This is usually done by having the woman record her temperature each day by using a special basal body temperature thermometer. By observing when the slight sustained rise in temperature that follows ovulation occurs every several months, the doctor can estimate the time of the next ovulation and then recommend a schedule of intercourse which will coincide with it as closely as possible. Once it is established over six to 12 months that timing is not problem, the doctor will advice more extensive tests. Specialists agree that both partners should take part in testing right from beginning. Why? “Because,'' as a consultant gynaecologist and obstetrician explains, “Studies show that 40 percent of infertility problems can be traced to the husband, 40 percent to the wife and 10 percent to a male-female combination.'' (In the remaining 10 percent of cases, doctors cannot pinpoint the problem) Many husbands initially resist examination and testing. The reason:most man equate fertility with sexual potency when, in fact, a man can perform intercourse normally without producing a single sperm.

 

 

 



BREAST PLAY

A woman's nipple has tissues which stiffen during sexual excitement. This change in firmnes not only signals her state of readiness for meaningful caress but also changes the types can usually be distinguished.

 

 

1. Initial non-erection :-

As long as the nipple and the surroundings pigmented area remain smoothe and soft, any attempt to stimulate the deeper structures of breat tissule generally prove ineffective. Like an apple floating in a tub of water, the milk ducts and other sensitive breast tissues are surrounded by soft and pliable padding in which they instantly retreat upon pressure.

 

While this 'floating action' neutralizes its special nerves and the breast responds to gentle stimulation of its skin nerves only, light stroking and soft kisses build excitement best. Caresses can involve broad areas instead of being confined to the breast itself. Petting motions which start at the shoulder, flank, or back and end at the breast prove quite effective, for instance.

 

So do chains of kisses down the neck and chest to the nipple. If you want to stumulate the nipple itself with your mouth, pucker the lips around it gently suck, then blow, then suck, so that the nipple glides in and out on the moist surface of your lips, or you can trace patterns around the nipple with the tip of your tongu. with it either inside or outside of your mouth. You can then switch to the other breast, perhaps with a chain of kisses along the way, while continuing gentle stimulation of the first-reached nipple by tracing patterns around and cross its still-moist surface with your fingertips. Moisture-lubricated gentle friction, with stimulataneous gentle stroking of arms, legs and torso, generally arouses keen excitement and brings the nipple to reaction quite promptly.

 

2. The firm upword-tilted nipple :-

you might find your wife's nipple tissue already firm and erect before you even touch it. If her ardour has been sufficiently aroused. Otherwise it usually becomes erect after a brief period of petting, kissing and tongue play.

 

The nipple itself becomes firm, tends to tip upward somewhat, and enlarges slightly. Its surface becomes becomes a mosaic of tiny lines and prominences. The pigmented ring of skin around the nipple becomes less nupple, often with tiny prominences nesembling goose flesh. When in this state, the nipple and underlying structures are stiff enough to convey motion from the body surface to the sexually sensitive milk duct and gland structures in the ordinarily sheltered portion of the breast.

 

A whole new range of caresses thus becomes effective. If you draw your plam across a firm nipple with just enough contact to allow gentle friction, like a violinist drawing his bow across the strings, you impart definite vibration to the nipple and its underlying structures. The same kind of action results if you draw a finger across the nipple, or let that structure rest in the groove between two fingers which you then rub to and for on its surface. These caresses work best while the breast if free of lubricating saliva and therefore suit those occasions when you find the nipple erect when your hand first reaches it, or bring it to that state trhough stroking and gentle kissing only.

 

When you have caressed it with open lips and moist tongue, the lubricating action remaining moisture converts this casess into a purely superficial one, still pleasing and exciting to some degree, but not involving the deeper somewhat and pass them across the breast in such a way that the side of each finger strikes the nipple and moves it slightly, then lets it spring back to place as the next finger strikes it. This nipple bobbling action works only when the nipple is definitely erect and firm, but stimulates the milk ducts and other sensitive deep structures quite effectively.

 

You can add variety by changing the direction of hand movement so that the fingers strike the nipple from the top and bottom, from the sides, or from various angles. Or you can get a similiar effcte by bobbling the nipple up and down or from side to side with the shaft of your index finger. For still more intensive stimulation, gently grasp the erect nipple between the sides of your bent index and middle fingers. By moving the fingers alternately to and fro, you can roll the nipple between them.

 

Without changing your grip, you can also rub the tip of your thumb along the nipple's tip, gently scratch the area with your thumbnail, move the nipple in tiny circles (stretching slightly its nerve-ending loaded 'moorings' the central milk ducts), and convery the action to a sort of milking motion by stripping the nipple down with the side of the index finger, relaxing pressure while getting a frest grip, and stripping it down once more.

 

For variety, you can get a similar effect by rolling the nipple, stretching is moorings, or milking it between your thumb and forefinger or between yur thumb tip and the joined tips of your other four fingers. You can also stimulate the erect nipple very effectively with your lips and tongue. You can grasp the between your lips and stretch its moorings slightly in one direction, then another. You can move your lower jaw from side to side to roll the nipple between your lips.

 

You can open your mouth wider, suck the nipple part way in so that it hangs free just inside your teeth, and booble it from side to side or up and down with the tip of your tongue. In the same position, you can rub your tongue tip across or around the nipple in tiltillating, gentle patterns.

 

A slight shift brings the top of the nipple up against the roof of your mouth. You can then roll it from side to side between the tip of your tongue and your palate. Or tuck the tip of your tongue down behind your lower teetch and bring the rougher-textured mid-portion of your tongue into action. Nursing motions, side-to side wobble, and firm pressure with alternate suction and release prove very stimulating. Two other forms of mouth caress ocassionally prove apt you can roll your lips in across your teeth and catch the nipple between them for a somewhat firmer version of the jaw roll and mooring-stretching caresses already described, or you can press the nipple very gently against your upper teeth with your tongue beneath using rolling action or alternate suction and release to cause stimulating motion.

These caresses give somewhat more vigorous stimulation than the others, so that you must use great caution to keep from being over rough. They are especially useful when prolonged nursing has rendered the nipple insensitive, but also serve ocassionally to increase variety of ordinary sex play.

Lets Discuss More in Next Episode ...


Causes and Cure For Siphilis

Syphilis is caused by little corkscrew- like organisms called spirochetes which circulate in the blood stream andu burrow deep into the tissues of the body, where they may lie inactive for years. This disease kills hundreds, perhaps thyousands, of men and women each year, and also causes blindness, heart disease, insanity, and many other ailments. It appears in many forms and stages and can cause most painful surrering. Also, it can be passed on to an unborn child through a mother who has not been adequately treated.

 

Fortunately, as soon as it is discovered the disease can be treated quite easily with large doses of pencillin or other antibiotics. Check-ups including regular blood tests, are essential for some time after treatment to make sure that the disease has been completely eradica- ted. This is not to say that syphilis is no longer a grave problem. It is. For one thing. a person cannot easily recognize syphilis in its early stages because its first symptoms are usually slight or similar to those of several other diseases. The most common symptom is a hard, painless, moist sore called a chancre. It usually appears, from ten days to three months after exposure, at the place where the spirochetes entered the body, in the man usually on the penis and in the woman deep within the vagina, where is cannot be seen.

 

After a short time, from a few days to a month, the chancre disappears without treatment, but this does not mean the syphilis has disappeared. It has merely gone 'underground'. Later it may cause other symptoms: a non-itching rash most often on the plams or soles, or hair falling out in patches, plus a sore throat, low fever, and aching, somewhat like the symptoms of the f'lu'. But these symptoms also disppear, and then the spirochetes spread undected throughout the body, where, over the years, they may damage the organs and cause serious diseases and, not infrequently, death. Many people die of syphilis damage without ever knowing the real cause of their sickness. Most cases of syphilis and gonorrhoea are transmitted by sexual intercourse.

However, it is possible, in rare cases, for a young girl to get gonorrhoea from a warm, moist towel just used by someont who has it, and syphilis can be spread by 'deep kissing' a person who has a chancre or syphilitic mucous patches in his or her mouth. Both diseases can be passed during heavy petting with an infected person. In very rare cases, doctors have been infected with syphilis through a scratch or cut while they were handling a syphilitic baby.
If your remember that venereal disease germs can stay alive only for a few minutes unless they remain moist and at body temperature, you will see how nearly impossible it is to catch VD from such things as a toilet seat or door knob. Almost always, it is contracted from close sexual contact with a person who has it.

 

If a couple have been examined by a doctor to make sure that neither one is infected (and this necessitates a blood test for syphilis and a culture for gonorrhoea) and if thereafter they have sex only with each other, they need not worry about VD. The people most likely to get VD are those who are sexually promiscuous - that is, who are sexually active with a variety of partners. If someone you do not know well is willing to have sex with you, quite likely that person has had sex with other people, too. and your chances of getting VD are pretty high. You should remember that it is almost impossible to tell by a person's appearance whether he or she has VD, and if the person is selfish or not caring, he or she may not tell you about an infection.
One encouragaing thing about VD is that it is quite easily trea- ted and cured. Therefore, if you have any reason to believe you have been exposed to VD infec- tion, you should go at once to a public health clinic or to your own doctor for tests. You need not feel embarrassed, for such tests and any needed treatment are kept confidential. If you have venereal disease, it is important, too, that the person with whom you have had sexual contact also be tested and treated. In all towns of any size there will be a VD. At a special clinic you don't need a referral note from your own doctor in order to attend. Neither do you need an appointment, except in a few of the larger or teaching hospitals.
Treatment which is on an outpatient basis is free and condidential. And you don't be wasting the doctor's time even if you are found to be free from infection. It's better to be a safe than sorry. You may be asked to bring your partner along to the clinic for a check-up as well. If a person is reluctant to warn his or her partner for any reason, perhaps because it was a casual relationship only, a social worker may undertake to do this. 'Contract tracing' as it is known, plays an important part in checking the spread of VD.

There are several other diseases and discomforts from which women having sexual intercourse sometimes suffer. There are so-called yeast infections, and other vaginal infections, which cause itching and burning. There are also urinary infections, which arise because the woman's opening for urine is right next to the vagina and therefore subject to infection. These may cause painful urination or kidney pain (backache).
Both men and women may be afflicted with crabs a kind of lice which get into the public hair and cause itching. If your think you may be infected with any of these diseases, or have any unusual symptoms in your genital area, see a doctor or go to a clinic at once for testing and any needed treatment.


Surgical Correction for Infertility

Surgical Correction :-

Because only a microscopic semen analysis – a simple, inexpensive procedure-can give an accurate picture of a man's infertility, all experts recommend it before starting the wife through a battery of costly and some times uncomfortable tests. In the analysis, the doctor checks the sperm count of a single ejaculation. Though only one sperm is needed to fertilize an egg, the journey through the female reproductive tract is long and hazardous, and immense numbers are needed to assure that even one gets through. Thus, a sperm count of 60 million is “good'' below 20 million means a poor chance of fatherhood.

 

“Variations, however, are very common,'' emphasizes urological surgeon. “Often, easily correctable factors such a mental or physical strain, or even excessively tight underwear-quite common among Indian men-can significantly alter the count'' As in the case of Dilip Patwardhan, when few or no sperm turn up in repeated tests, the doctor may advice a testicular biopsy, a microscopic scopic examination of tissue from the tests. If this reveals that the man's tests are producing too little sperm, then very little can be done. But a normal testicular biopsy like Dilip's implies an obstruction in the tubes leading away from the testes, which often can be corrected surgically. If the sperm count is sufficient, a post-coital test can be determine whether the sperm remain active and ascend promptly through the woman's genital tract. The rest, done a few hours after intercourse, consists of removing a bit of the wife's cervical mucus – fluid secreted by tiny glands in cervix – for examination under a microscope.

 

If the mucus is normal, the absence of sperm or the presence of few or inactive sperm indicates, a male abnormality. If the mucus is thick or hostile, the sperm cannot survive, and the woman must be treated-usually for a local infection. Should both husband and wife be cleared, the doctor will want to determine if the woman is ovulating normally. An endometrial biopsy-the removal of a small tissue sample from the uterine wall – provides this informatin.

 

Next the “patency,'' or openness of the reproductive duct work is examined, usually by instilling a radio opaque liquid dye into the uterus and fallopian tubes leading to the ovaries. The smallest obstruction there can block the ovum's passage to the uterus. Any such blockage shows up on an X-ray screen indicating if and where surgery is called for.

 

Large-Scale Measures :-

A final diagnostic technique provides an inside view of the woman's pelvic area – a hospital procedure calling for placement of a slender, lighted telescopic device through a near-invisible incision in the abdomen (laparoscopy) or a small perforation in the vaginal wall (culdoscopy). This allows the doctor to directly examine the tubes, uterus and ovaries for signs of defects that other tests may have missed.

 

Follow-up surgery gives many women a chance for pregnancy that they never had before. As Scientists probe the secrets of the genesis of human life, the techniques used to combat infertility are indeed bringing new hope to the childless. Today's so-called “fertility drugs'' are an important advice in the treatment.

 

Some women do not ovulate because of a hormonal imbalance, and for them these drugs have been used successfully to coax recalcitrant ovaries into production. Since the drugs jolt eggs to maturity, however, over-dosage can cause the release of more than one egg in a cycle – and result in multiple births if the eggs are fertilized. Also, Doctor says “these costly drugs can trigger a potentially fatal condition called 'hyper stimulation syndrome' characterized by abdominal swelling, vomiting and sometime bleeding ovaries.'' So a woman taking them should have regular gynaecological examinations. Unfortunately, there are few doctors in India experienced in the use of these drugs. In many areas,except in the larger cities, infertility is more like to be treated with mantras than with modern medicine.


BREAST PLAY

The Satiated Nipple :-

With intensive stimulation, the nipple changes its texture once more and becomes soft and easily stretched. Tissue firmness disappears, making caresses which aim at stimulation of milk ducts and other underluing structures ineffective. If further breast stimulation seems in order, you can take either of two tacks. If the time for intercourse seems to be drawing close and you do not want to prolong breast caressing greatly, measures aimed at stimulating the milk ducts through their now-soft covering of skin prove quite effective.

 

If you cradle the breast in your cupped fingers, so that the nipple's tip lies on the palm side surface of your ring or little finger and your other fingers support them milkduct containing tissue at the nipple's base, you can press the side of your thumb into the breast over your index finger and run it down towards the nipple tip. The nipple will stretch much more than you except, so that you may have to shift your grip slightly to permit strokes to react its tip.

 

Stroke down several times. Then try stopping the stroke just as your thumb reaches the nipple itself, with the stretched-out milk ducts and breasts structures caught between it and the under- lying fingers, for an interval of lengthwise rolling caress, with an action like that you would use if rolling a pencil back and forth between your thumb and your fingers.

 

You will find this form of caress most effective if the breast is well lubricated with saliva from previous kissing and mouth play. If you continue milk duct stroking until the breast becomes dry, a further interval of mouth to breast play offers the best way to restore lubrication. The most efective mouth caress of the pliable, soft nipple closely resembles an infant's feeding motions. suction will stretch the nipple out along the roof of your mouth so that you can catch it between your palate and body of your tongue.

 

Suckling motions, side to side or rotary movements of the tongue, and clamping of the tongue tip on the breast so that its nipple can be stimulated with alternating hard suction and release give intensive stimulation. Delightful as these forms of stimulation sometimes prove, they usually give only brief impetus to excitement. If you want to prolong sex play for any appreciable interval, you will usually do better by taking the oppoiste tack instead of using the breasts 'satiation softness' to permit direct stimulation of the milk duct area, greet any softening of the nipple by backing off from intensive stimulation to gentle titillation and erection restoring soft caress. If you keep the nipple in a state of firm erection, you can generally continue to build your wife's excitement and increase her pleasure with breast caresses for as long as you want without satiation effects. When her ardour is fully aroused, you will occasionally find it possible to bring her past the point of orgasm through breast play alone, offering a pleasant alternative to genital caress as an immediate predecessor to intercourse. Stimulation of the erect nipple adds to sexual excitement during intercourse, too, and can be continued at intervals throughout the act.


Intercourse and Social Life

Human beings have been called 'social animals'. They relate to each other in thousands of different ways, some ways that are loving and caring, some that are hateful and selfish. They can help each other and enrich life for each other, or they can exploit - use - each other and put each other down. A part of being a social animal is communica- tion. some people are much better at it than others, and probably all of us could learn to cummunicate more easily and fully than we do.

 

One of the ways we share our thoughts and feelings is with our bodies : through our facial expressions, our gestures, our ways of sitting, standind and moving, through the ways we touch or do not touch each other. We also communicate through words, by what we say to each other and how we say it. Unlike other animals, whose ways of communication are programmed into them by instinct, we human beings learn to communicate. We start learning almost as soon as we born, and we go right on learning throughout our lives.

 

Certainly, in those parts of our lives which involve sex and sexual feelings, communication is most important, but for many people, most difficult. There are many married couples who have lived together for years and yet have hardly ever talked with each other directly and openly about sex and about their sexual feelings toward each other. There is no way to separate sexual life from the other parts of life, although some people try to make such a seperation.

 

Indeed, this book, which talks mainly about sex, may seem to make such a separation. But sex and sexuality are a part of life, a part to accept and live with, to enjoy. Sex in not something from outside that comes in, takes over our bodies temporarily, and then flies off. Some people however, do see sex in this separate way, and they may use this as an explanation, or even an excuse, for sexual actions that are demaging. 'I really didn't want intercourse; the feelings just came and ovewhelmed me.'

 

True, it is possible to be over- whelmed by sexual feelings, but these feelings are a part of our other feelings. It is also possible to deny our sexual feelings, as if they were something bad and apart that should be pushed away or pushed under. We must learn to intefrate our sexual feelings and actions with all the rest of our living. One fact that enriches our social lives is that there are two sexes, male and female. In earlier articles you read about differences between men and women, how some of them are inborn and inevitable, but how in many ways we learn to be 'masculine' and 'feminine' and how in modren life it has become possible for us to be much more free to develop into the sort of people we want to be, not so limited by traditional sex roles.

 

We can enjoy relating to each other as women and as men, and also, even more important, as human beings who share so much in common. The sexual part of a relationship, whether it involves sexual activity or whether it involves only the expression of our human sexuality, can add a delight and pleasure that would be absent if there were only one sex. Differences - those based on sex and those based on age, background, interests, personality, work, language, culture, nationality, and a thousand other things - can be just as important to good, rich relationships as can similarities.

 

Sex cannot be separated from the rest of life, but there are special things to be said about the pleasures and problems of love and sex as part of life. One of the problems of sex that human beings have and animals don't have can be stated quite simply; boys and girls reach puberty (when so many of them begin to have strong sexual desires) before they are old enough to enter into a full and satisfying sexual relationship, to marry, or to establish a family and raise children. There is a period of from eight to ten years or even longer when the sex urge is strong but there is no way to satisfy it that is entirely acceptable to all parts of our society.


Bring Out the Lover in Your Spouse

When my doctor blithely told me six weeks after my first child was born that I could “resume sexual relationships as usual.'' I felt angry. Sex as usual? Life as usual? He had to be joking! My husband and I love our daughter dearly, but her arrival turned our lived upside down. Suddenly all our usual ways of doing things- even the way we felt about each other – had to be altered. Children can bring great joy to a marriage, and they deserve our love and attention. But there is great harm in boxing ourselves into a role of “sexless servants of children.'' We mistakenly thing that the children of course can't take care of theselves, but that the marriage can.

 

When time together as a couple is at the bottom of the priority list, not only do we suffer, but our children suffer too. You can have passion in your love life again if you strike a happy balance between your needs and those of your children. Begin by acknowledging that you are lovers as well as parents. Staying lovers with your spouse is, in fact, essential to keeping harmony in the family. “Romance, on the scale of human needs, may not rank quite as high as food or shelter'' writes author. “But it does not fall much further down – it's one of the things we live for.'' It's easy to forget this. When we become parents, many of us suddenly feel we must be serious, no-nonsense people. But who doesn't desire a little zip in marriage? To create that romance, that spart, the key element is surprise.My husband often makes business trips out of town.We hate to say good-bye and always miss each other. During one trip I was wondering hou I could somehow touch him so far away.

Excitement Investment :-

Suddenly an idea struck, and I called the concierge at his hotel. When my husband walked into his room, the first thig he say was a bottle of wine, a fruit basket and my love note, which said I hope he'd had a nice flight and how much I cared. He was deeply appreciative and not about to be outdone. The next day, I received an airline ticket and a note asking me to spend the week-end with him. My heart soared as I thought of the possibilities. But my brain kept bringing me down to earch: Can I get a baby-sitter on such short notice? I wondered. How can we spend the money so frivolously? Finally, I let my heart do the talking. I called our baby-sitter and told myself that the money was an investment in my marriage, and ultimately in my family. The excitement my husband and I generated from pulling off our tryst was the thrilling as the “high'' we felt when we first fell in love.


CARESSES OF THE MALE GENITALS

Most women hesitate to caress the male genitals early in a sexual incident for fear of either speeding the incident beyond their capacity to keep up or of committing themselves to continuous similar caresses. Actually, a brief flurry of genital caresses early in sex play often produces new interest and variety and virtually never creates any problems. A clutching caress of the penis through a layer of pyjamas or clothes, gentle stroking of the scrotum and upper thigh, or exploration of the genital zone with titillating finger tips generally proves stimulating and exciting at the beginning of sex play or almost any these measures with keen emotion and with reciprocal : cares, from which his wife daws substantial rewards of her own.

 

Genital caresses used in this way, often before the penis has become erect and fully sensitive, can be compared to the caresses of his wife's breast which a husband might give through clothing at an early stage in sex play. They indcate ardent interest, they inspire erotic response, but they do not instantly carry either partner to the state of excitement usually associated with caresses of this part of the body and do not necessitate continuous intensive caress for the remainder of the incident.

 

Genital fondling after excitement has built to the point of full preparations for intercourse fulfils an entirely different role and operates under different tules. Instinct, unmodified by sexual technique, impels the male towards almost instant sexually entrance after ardour has made the penis firmly erect. Most men can only maintain a full, solid erection for two or three minutes without some form of genital stimulations. In instinct- governed intercourse, this stimulation comes from sexual entrance.

 

If either or both parties want to delay sexual entrance more than a minute or two after the male achieves full erection some form of genital stimulation must be provided or else male excitement will begin to fade, causing at best an incident in which both parties receive less than their due because of poor quality erection and diminished response, and at worse a sexual fiasco. However, the period of sex paly can be prolonged, sexual excitement, built to great heights for both partners, sustains male excitement.

 

A woman can contribute more to her own and to her husband's sexual gratitication through sex-play-prolonging genital caresses than by any other sex technique either before, during,or after intercourse. Such caresses must begin within a minute or two of full erection, and must be virtually continuous in order to sustain male excitement. However, they can take a wide variety of forms.


Intercourse and Social Life

Some boys and girls, concerned that they might not be able to have a good sex life later on if they do not use their sex organs for a number of years, ask if these organs dry up or gorw weak with disuse, just as muscled grow weak if they are not exercised. The answer is "No''. Sex organs and muscles are quite different. It is true that there are some people who, when they marry, have difficulty in learning to enjoy sex freely after they have developed the habit, ever since puberty, of turning themselves off sexually every time they felt aroused, but most people who have no intercourse untis they marry find that their sexual power is strong and adequate.

 

In thinking and talking about sexual activity during adole-scence, it is important to remember that adolescence is a process of growing toward maturity. The decisions that boys and girls make will differ with dirrerent people, with the strength of their sex drive, the beliefs and teaching they have been exposed to how they reacted to them, the social situations they are in, and values and convictions they develop. Few people ever find final answers for questions as complicated as those relating to sexual behaviour. Most of us will go on searching and questioning during all of our lives.

 

And it is most likely that we are not going to be willing to behave in certain ways just because we are told to. Most of us will put together the information we have, the values we hold, our idea of the sort of person we want to be, and the things we have been told - and then decide for ourselves. If we are responsible, mature people, our decisions will be made in the light of knowledge of all of the consequences of what we do, consequences good and bad, present and future, for us and for others. If the consequences of the actions are likely to be good for all the people involved - for self, partner, family, community, nation, world - both now and in the future, then perhaps we can say that the actions are moral.

 

If they are bad, and especially if the person performing the actions knows they may be bad and does them anyway, then they are immoral. You can see that there is nothing easy about these definitions of 'moral' and 'immoral'. That is why it is such a good idea to talk over your questions about sexual behaviour, and all other important kinds of behaviour, with people your own age and also with those who have had more life emperience than you have and whose wisdom and judgment you respect.

 

One thing is sure : people's degree of sexual readiness changes as they grow toward maturity. Twelve to fourteen years are vastly different from ,say, seventeen to nineteen years lods. And, of course, the degree of readiness depends on the individual person and his or her interests, circumstances, values, and maturity.

 

Anothe thing is sure, too : some secondary school children are already having sexual intercourse, whether their parents, their schools, or society approve or not. On the other handm many people who have reached adulthood are not having and never have had sexual intercourse. As for how much sex is right to have at what age, there are probably nearly as many opinions as there are thinking people.

 

Here are two opinions, expressed in class by young teenagers whom I have taught, which show the differences there can be even among people the same age, Both were spoken by boysm but I think they could just as well have been said by girls. I write them down to the best of my memory, although I am sure I haven't succeeded in using the exact words of each speaker.

 

The Two Opinions in next episode ....


Superficial skin caress

Just as ordinary touch nerves on a woman's arams, legs, breasts, and abdomen becomes erotically active when she begins to feel aroused, similar nerves in the genitalia help to build male sexual excitement. There are no such nerves in the tip section of the penis, which contains only the types of nerve fibre usually sensitive to pain and to temperature. The foreskin, shaft of the penis, and scrotum are very sensitive, however, and respond keenly to light touch.

 

Touch nerves quickly get used to sustained pressure, so that stroking, patting, and other forms of active caress give much more stimulation than indolent fondling. Gentle stroking along the top and sides of the penis, tracing patterns with the fingertips down from the penis to the scrotum or the crotch, and very light raking these areas with smooth fingernails prove quite effective. Light, rapid drumming motions with the fingertips along the sides, top or bottom of the penis shaft sustain male excitement very well.

 

A similar somewhat gentler motion stimulates the scrotum without disturbing the tender structures within it, and is especially effective when applied from beneath or behind so that the testicles move gently inside. A little later, you can pinch up a bit of thin scrotal skin and roll between yourt thumb and forefingerm or use the same motion with the thin surplus skin of the penis shaft. For ocasional variety, press the penis against your husband's lower abdomen with the flat of your palm and roll it quickly but gently from side to side.

 

Most couples find it hard to stimulate the penis lightly and with constant movement by rubbing it with a thigh, lower abodomen, or hip. Such action sometimes proves possible by using deliberate muscle quiver instead of friction, however. When an embrace presses the erect penis agains the wife's thigh, for instance, she can make the muscles of the area ripple by alternately straightening and bending her leg slightly, or even by alternately pressing her foot agains the mattress and relaxing. Similar action with the muscles of the hip or lower abdomen sometimes adds a few moments of variety to nude or simi-nude embrace.

 

The wife cannot continue such movement for very long without undue fatigue, howeverm and motionless embrace will not sustain male excitement. Light touch and rapid movement certainly can be imparted with the lips, mouth and tongue. Such caresses offer substantial range of variety in sex play and can greatly enliven couple sex life, provided you can overcome certain barriers and constraints.


Views of Young boy and girl about intercourse

One said ... "I think sex is recreation, and it should be enjoyed just like any other recreation. Sex gives big physical pleasure and can help two people communicate deeply with each other. If a girl and a boy know what they are doing - I mean, if they take proper precautions to avoid having a baby, and if they are alert to the dangers of VD - then why shouldn't they have sex? I don't think they even have to be in love. As long as they both want to do it, they should go ahead and have sex pleasure. It's natural. After all, girls and boys talk together, they danche together, they play together, and all sorts of things like that. Why shouldn't they have sexual intercourse together?"

 

The other Said :- "I think the basis for our society is families. And the centre of the family is a married couple who ought to love each other. The couple make a home based on their relationship, and this home brings love and security to them and their children. A great part of the husband and wife's relationship is sex - not all, but a big part. Having sex helps to keep them close and loyal to each other. There's something absolutely special about having sex. I think, even though I haven't had it yet, I'm not going to have it until I get married, and then I'm only going to have it with my wife. I'm not saying that you shouldn't make out some before you're married.

 

That's O.K., if you like each other and it would help you get to know each other. But sexual intercourse - that should be saved for marriage. These two students express two contrasting points of view very well, I think. You may agreee with one or the other, or partly with each, and your views will probably change as you mature and grow older. Certainly, it is natural for boys and girls to be interested in each other and to be interested in sex. If boys and girls get to know each other well, they can learn to understand and appreciate their differences and likenesses, and this is excellent preparation for the future and for choosing a husband or wife if they decide they want to marry.

 

When you think about marriage, it's important to remember that you will marry not primarily a body, but a person - a complex human being with a background of life experience different from yours. The person's body will be important, but not nearly so important in the long run as his or her personality and character. There is certainly no point in hurrying boy-girl relationships along faster than you desire. Most people in their early teens are not yet ready for an intense relationship with a member of the opposite sex. As a matter of fact, a good many boys between the ages of ten and thirteen or even older find girls most undesirable, even if they are very curious about them. And many girls in the same age group find their boy classmates to be loud, awkward, childish, and generally repulsive. That's all right ; it is likely to change in a few years.


Erotic Fantasy of Couples

When Merle turned 35, she and her husband went away together for two nights. “We had terrific time!'' she recalled. “I didn't want it to be over. But you know, you always pay for it in the end'' “What do you mean?'' I asked. “Well, you end up feeling guilty because you had so much fun away from the kids'' she replied. Merle, like many other parents today, carries around with her an unrealistic sense of parential duty thant can put a damper on a potentially enjoyable evening.

 

For some couples, it prevents them from going out together, except to attend weddings, funerals or school meetings. But to maintain romance an intimacy in your relationship, it is crucial that you set aside time to have fun together and not sabotage the occasion with guilt. Not long after the honeymoon is over, and even more so after the kids are born, we fall into a rut of unrealistic expectations, assuming our spouses can read our minds to discover what we really wand and need. When they don't we're disappointed and assume the zest has gone out of our marriage. Real life is not a romantic fairy tale. The baby cries a lot. There are bills to pay and washing to do. No one can be Prince or Princess Charming all the time but you can create an environment that is conducive to romance, and bring out the lover in your lover. We all have faults. So stop blaming your spouse for what he is or is not, what she does or does not do. A happy marriage and sex life are possible. But it takes some courage – to admit when you're wrong, to break down walls that seperate you, to tell your spouse what you really want and need.

Erotic Fantasy :-

One friend of mine felt her marriage was in the doldrums. I asked her, “If you could have a perfect romantic evening, what would it be?'' “I'd send the children to my mother's house and greet my husband at the door wearing something sexy,'' she began. “We'd sit by a cozy fire, then have an intimate dinner. Eventually we'd stroll to the bedroom, give each other a massage and make wonderful love'' “That sounds terrific,'' I told her. “Have you set a date?'' “Are you kidding?'' she replied. “He would think I'd gone crazy. We've been just 'Mum' and 'Dad' for so long'' It took her several days to get up courage to tell her husband about her fantasy.

 

Once she did, she was surprised at how receptive he was. After couples have been married for a while, spouses often get the notion that the hunt is over. They stop trying to make themselves attractive and stimulating. “I never assume that I've caught mu man'' relates a mother of five. “There are so many temptations that I never let got of my efforts to be appealing for my husband.

 

Terrific Antidote :-

“We talk about when we were younger and some of the risks we've taken, like going rafting down a river and making love on the river bank'' recalls mother of two little boys. “That kind of reminiscing sets up for an exciting evening'' Another mother with five children, aged nine to 21, told me, “One night my husband and I were both exhausted. He got into bed before I did. Later I flopped down next to him fully clothed,

 

 

He sat up, startled, and asked “Aren't you going to take off your clother?'' “No,'' I said. “That's your job.'' Her little gimmick generated quite a spark between two tired people. Create a fun evening for yourselvfes in such a way that you become a couple again. One twosome I know studies the wine list and discusses selections they have and haven't tried. My husband and I always start with a toast to our love for each other – and to successfully getting out of the house. Parents need to allow themselves time to have fun – to laugh and enjoy themselves. Feeling and being sexy, creating romantic moments can be a terrific antidote for restlessness and discontent. When couples make the effort to generate enthusiasm in their relationship, they build a powerfully intimate connection, one that invigorates a mature love with a young romantic love.


superficial-skin-caress

If other satisfying caresses can be used quite freely, the advantage of mouth-to-male-genital play is not sufficient to justify the prolonged and expensive psychologic counselling required to trace back and eradicate intensive inhibitions against it. Logically speaking, however, it seems obvious that a wife who brings her husband extra and special gratifications deserves more respect as a woman rather than less. Any husband who desires this type of play must find means of stimulating his wife which continues her build-up of excitement.

 

Since the wife's breasts are out of her husband's reach during this form of play and odour has almost always advanced to point where peripheral caress is inadequatem this usually means continuous stimulation of her genitals with the techiniques described in the next section. If these conditions are met, kissing and other forms of mouth stimulation of the penis often contribute substantial emotional build-up.

 

Light kisses and gentle titillation with the tongue prove most effective when concentra- ted on the shaft of the penis or at the margin of its head. The head itself has no nerves which respond to light touch, and the scrotal area is not apt for such caresses. Placing the lips in light contract with the penis, the blowing to produce rapid vibration of their loose tissues gives a unique sensation.

 

If you feel inclined to take the penis into your mouth and stimulate it with tongue move- ments or by making the lips and inside of the cheeks move against it through air pressures or suction, no harm will be done so long as these stimulations are gentle and are frequently interrupted for other forms of caress. Continuous or intensive stimulations of these kinds can cause a climax and rob you of the ultimate satisfaction of intercourse. Ordinarily however, you only undertake these stimulations when both of you are suspended on a high plane of ecstatic excitement where gentle and continuour caress sustains your state without further build-up, and reciprocal fondling of the genitals with hands, mouth, and tongue prolong a delightful preliminary without in any way curbing ultimate fruition.


Views of Young boy and girl about intercourse

However, it is good idea for boys and girls to have ample opportunities to get to know each other socially, if they want to. There is a lot of room fro friendships between boys and girls in their early teens (but little reason for concern if such friendship doesn't develop.) There is much pleasure to be had from informal parties, dances, picnics and other group get-togethers, with enough activities planned in advance, and with parents helping, and also from hiking, bicycle and camping trips. It is a rare thirteen-or fourteen-year-old who is ready to go steady.

 

A boy and girl who do so at this age may have a pretty dreary and limited life after the first excitement of it. The teens is a good period of life for getting to know many people of both sexes and to know them in many different ways. In typical classes of twelve to fourteen-years-olds there are usually a few boys and girls who get all steamed up about parties and dances, about cliques, about who is most popular, and who likes whom. They - especially girls - seem to be afraid that if they don't start being popular right away and don't become big wheels socially as soon as possible, or in with the most-In group, they may never have a chance.

 

There is no question that their fears are real, but they are not based on fact. I've known many, many boys and girls who were miserable because they weren't making it socially in their early teens who, a little later, or in college became popular and enhoyed real social success. Perhaps the true measure of success is not the number of friendships one has but the quality of those friendships. Many young teenagers can even benefit from learning what it is like to be hurt by not enjoying immediate popularity by having to work to achieve social success.

 

Such experience can teach boys and girls to understand the feelings of others, to be considerate of them, and to do their best to pleae them. In this way they learn that a lasting relationship between people has to be built on more than physical attractiveness and a good line of conversation. The most important parts of the relationship are common interests and mutual consideration.


Urethral caress

Only one of the deeper structures in the penis has much erotic sensitivity: the tube through which both urine and semen flow, knows as the urethra. This tube first nears the body surface in the crotch just behind the scrotum and then courhes along the solid protions of the bodu just above the scrotum and along the entire length of the penis, near its lower surface. If you lay your fingertips along the midline of your husband's crotch benind the scrotum, you feel a firm, muscleslined tube an inch or less beneath the skin.

 

You can catch this tube between your fingertips back and forth along its length as for as the loverlying skin will easily permit. Or you can pass your fingers back and forth across the urethra so that it pops from side to side beneath them: A circular motion combines both effects. These caresses in varying intensity, rhythm and duration suit any stage of the proceedings. For added variety, or if long fingernails make it difficult for you to use your fingertips in this way, try bending your index finger and using the back of its middle segment as a pressure source.

 

If your husband responds slowly during a sexual episode, you may ocasionally want to stimulate the urethra along the length of his still unerect penis. If you place your palm on the lower surface of that organ and press its upper surface fairly firmly against your husband's abdomen, the urethra will be caught between your hand and a supportive backing. Movement to and fro along the length of the organ, from side to side (so that it rolls between your hand and the abdomen) or in small flat circles gives intensive stimulation. The same types of motion with the flats of the fingers rather than the smooth palm often proves still more exciting.

 

Or you can press one finger firmly up into-th bottom surface of the penis at its base and move it very slowly and steadily towards the organ's tip milking the entire length of the urethra between your finger and your husband's abdominal wall. These caresses work best whn alternated with various superficial ones, and also prove very effective after the penis is erect. Prolonged and continuous stimulation of the urethra may lead to male orgasm, but intermittent stimulation of this sort will cause no problems.

 

When the penis is erect, its solid shaft provides supportive backing for the urethra and any firm caress along the organ's bottom surface stimulates this erotically sensitive tube. All of the movements described in the last paragraph can be applied withour pressing the penis against your husband's tummy. You can also drum along the bottom surface of the penis with your fingers. You can alternately clutch and release the organ or grasp it firmly and move your hand back and forth along its length as far as the skin's elasticity permits. Or catch the organ between your two palms, then move your hands reciprocally from side to side, endwise, or in circle as if you were rolling biscuits or other dough. All of these caresses are very exciting to the male, and once you have linked them mentally with the intensive reciprocal measures which often follow, pleasant and exciting for the female, too.try bending your index finger and using the back of its middle segment as a pressure source.


Necking and Petting Between Tennagers

In my experience in schools, I have often been saddened, and sometimes angered, by the cruel way that some boys and girls, more often boys, ridicule class- mates whom they consider different from themselves. Often this ridicule, which includes name-calling, is directed against boys whose physical develop- ment is slower than that of most of their classmated or who are not particularly interested in sports, vigorous phusical activity, and the sorts of behaviour that we too easily labes as 'male'. It is wrong, both factually and morally, to take part in such cruel activities. even though they may not be intended to be cruel.

 

It is wrong factually because it assumes that any boy or girl who is not 'all boy' or 'all girl' is probably going to turn out to be a homosexual, which simply is not so. We usually cannot tell who is going to turn out to be gay and who straight. It is wrong morally because it is cruel, puts people down, and makes them feel bad about themselves. Also, it assumes that there is only one right way to turn out. It is not easy for most of us to be considerate of the feelings, preferences, and personalities of other people all of the time, especially of people we see as different from ourselves, but it is a sign of maturity to show such consideration.

 

I want to say a few words about necking and petting, which you probably have discussed, wondered about, and possibly experimented with. Necking is generally understood to include putting your arms around a person's neck or waist, holding hands, sitting close or cheek to cheek, and light kissing. It is a way of expressing your affection for that person, but it does not involve trying arouse him or her to readiness for sexual intercourse. Petting goes much further and invoves caressing the most sensitive parts of the body, such as the breasts or genitals, and deep kissing.

 

It is the kind of lovemaking that makes a couple ready for intercourse. The term making out can refer to either necking or petting. It's only natural and healthy to feel like expressing your affection for other people by touching them.

 

 

It is a delightful fact that babies and little children crave and needs lots of physical love from their parents or those who care for them, and you have probably many times in the past enjoyed a good hug and kiss from your mother or father - and other relatives, too. There can be a similar sort of enjoyment and warmth in physical contact with a member of the other sex who is near your age. Even so, there are some very important things to be kept in mind concerning such physical contact, particularly by boys and girls in their terms.


Methods of Joint Movement : Intercourse Positions

Methods of Joint Movement :

Greeting Method : Both partners close in and withdraw simultaneously. The stimulation is highly effective, but in-experienced wide movements easily disunite the sex organs at withdrawal.
Pendulum Method : One partner advances when the other withdraws and  vice versa. Complete union is meaningless here, and stimulation is effective only with a slight lag or finesse. It is more difficult to perform than the greeting method.
Alternating Method : One partner rests while the other performs and vice versa. It is not applicable to all sex positions.

SEX POSITIONS :

The human being has the special privilege of being able to assume a variety of positions in sexual intercourse. The male and female who experiences only one or a limited number of positions in their life span are missing much. At the other extreme, those who widely seek strange, unusual positions are, of course, committing serioud mistakes. The different sex positions offer one form of enjoyment in a long married life, a change from habitual boredom, a refreshing interlude. They can be likened to the trumb in a card game. They should be kept in reserve and used sparingly during the early stages.

These positions are not necessarily independent of one another. They should be so used that the performers can readily move into one position from another. By seperating them and selecting only one position for the entire sex act, both partners may experience orgasm but with unsatisfactory results. At times, they may even feel severe pain with orgasm and be dismayed. We are apt to assume that all positions deviating from the so-called normal, or habitual, poistions are abnormal or un-natural, but this is wrong. Physical limitations may prevent employment of some positions, but those sex positions that can be used should be accepted as natural and normal.

The sex positions may be divided into two basic types. The face- to-facve positions and the rear-entry positions. Others are merely their variations and combinations. It is not the purpose of this book to inquire into the name or designation of each sex position. Rather, the author attempts, with the use of dolls, to explain the different positions and how they can be veried during sexual union. The author uses arbitary terms to designate the positions, which threrfore may differ from the conventional terms.

1. Face-to-face positions :

Human beings prefer the position in which the partners face each other rather than the rear-entry positions seen  in animals where male makes contact with female from behind. This is because of our highly sensitive emotion and physical structure. In other words, the human sexual intercourse is more often the ultimate expression of love, rather than a natural instinct for reproduction. At times we want to embrace our loved one in our arms, but we do not stop there, we proceed to kissing and to sexual intercourse. Thus, it is only natural that is facing each other we choose the face-to-face position for coitus. This is the most significant reason.

Also, in the face-to-face position the curve of the vaginal cavity and that of the penis are in an opposite, and therefore complementary direction and thus highly effective in stimulating each other. In this way, the male is strongly stimulated in the glans and female in the clitoris and the vaginal wall.

The face-to-face positions may be subdivided into the following four postures, in which :
1    The female lies on her back.
2    The male lies on his back.
3    The male sits.
4    Both partners lie on their sides.
The standing position is left out from our discussion, because it is not important in married life.

WOMAN SUPINE POSITIONS

The woman supine position is the most popular of all the face-to-face positions. It is easy to perform and natural for both parties because the male is active and the female passive; the male inserts his sex organ and the female accepts it. Along with the side positions it is the most stable position for both partners to reach the climax in sexual intercourse.
Female Leg Position :
The position changes accessible to the female during woman-supine intercourse depend on her leg positions.


Caressing the tip area of the penis

The head of the penis has no ordinary touch or pressure nerves, being supplied only with nerve fibres of the kinds which ordinarily sense pain and tempe-rature. The light stroking and other gentle surface caresses which prove so exciting when applied to the shaft of the penis thus accomplish very little when extended to the head. Caressing of this area must come fairly close to duplicating the stimulations of intercourse, by offering contact or friction against a warm, fairly slippery surface. If your lubricate your palm with a pool of saliva, press it down
upon the top surface of the penis head and move your hand up and down, to and fro or in small circles, you will usually elicit considerable response. This caress can be performed with slow, long movements or with short, rapid ones, but loses effectiveness as soon as the moisture soaks in or dissipates itself.

 

One structure near the penis head deserves special consideration. A small fold of skin containing a few strands of firm connective tissue moors the urethral opening to the peninsula of skin which runs almost to the tip of the penis bottom surface. This structure, which is called the frenulum, contains very sensitive and sexually significant nerve fibres. A great deal of the stimulation of intercourse probably comes from the pulling action of the penis skin on the frenulum. Caresses which produce similar stimulation generally prove keenly exciting.

 

Of the midler or indirect caresses, the simplest is the shaft skin stretch. Grasp between thumb and forefinger a fold of skin from the bottom surface of the penis, an inch or two down from the rim of its head. Gently pull this bit of skin towards the base of the penis, so as to tug on the sensitive frenulum area. Several brief tugs in succession work much better than continuous traction. The caress can be repeated at intervals, interspersed weth other forms of genital stimulation.

 

Direct friction over the frenulum area also intensely excites and pleases a man. Place the pulp of one fingertip or thumb tip just beneath the opening at the end of the penis, and draw it slowly down towards the shaft, making fairly firm pressure all the way. Friction between dry surfaces is even more stimulating than  between moisture-lubricated ones for this purpose. The effective stroke involves only an inch or so, making repeated swipes with the thumb tip easy to execute while the penis itself is held in place with the other fingers. Varying pressure, rhythm, direction of stroking and so forth permits many variations of this caress. You can also apply friction to the same area with your knuckles, catching the penis between them and your husband's abdominal wall or holding in place with your other hand.

 

You can stimulate the frenulum still more intensively by pinching it between your thumb and forefinger, rolling it between these fingertips, or by holding it firmly and moving your finger tips up and down along the axis of the penis so as to stretch the frenulum's attachments first one way then the other. These forms of stimulation generally raise a man to an intensity of sexual excitement which makes for veru prompt sexual entrance. They provide a superb fillip to preliminary fratification and an excellent way to end precoital play when you feel sure that both your husband and yourself are entirely ready for intercourse.


Necking and Petting Between Tennagers

Kissing and caressing can not only bring great pleasure, closeness and good feelings; they may also lead to difficulty. Some boys quickly become so aroused sexually that they lose their willingness to control themselves, and girl may have difficulty in controlling them. It is also just as possible for some girls to become so involved that they, too, loose the will to stop, especially if earlier experiences have taught them how pleasurable sexual feeling is. In other words, if you have not decided for yourself, and in advance of a petting experience, where you are going to stop, or even whether you are going to start, you may find yourself involved in situations where your physical feelings overwhelm you.

 

You may find yourself engaging in sexual intercourse when you would not have choosen to if you had thought about it. When that happens, and yor are unprepa- red, both emotionally and with contraceptives, the long-term results may be tragic. Of course, the situation may be quite different if both partners are physically and emotionally mature enough to manage the powerful feelings and effects of intercourse, if both intend and want to have sex, and both are prepared for it - that is, have communicated with each other long enough and deeply enough so that they understand and consider each other's feelings, and have agreed upon using an effective means of contraception.

 

Each partner needs to be aware of the possibility that some boys and girls may try to 'use' a partner of the other sex - or sometimes the same sex - in order to satisfy only their own needs - needs to feel important, to feel that they have made it or 'scored' that they are keeping up with their friends or competitors, that they will have something to boast about. People whose feelings of insecurity give them a lot of trouble, or who are extremely selfish, may become very persuasive in trying to argue a partner into having sexual intercourse.

 

They may pretend to be in love, or even persuade themselves that they are in love; they may threaten to cut off a relationship unless their partner will 'go all the way' with them; they may try to make their partner feel small or immature or afraid of not going along; or they may say, in effect. 'if you love me, you will prove it by having sex with me.'

 

* A fact to remember about heavy petting is that it is possible - although such a happening is rather rare - for a girl to become pregnant even though she has an intact hymen and has never had intercourse. There is the natural opening in the hymen through which menstruation flows. If, in the course of heavy petting, the boy ejaculates near this opening, sperm may make their way into the vagina even though actual intercourse has not taken place. It is because sperm are such active swimmers that they may cause a pregnancy in a girl who is technically still a virgin.


One Question That Can Save a Marriage

When Stan and Sue Gordon walked into the office of family therapist they thought their 20-year marriage was over. They simply wanted help in living through a divorce. “We love each other, but we can't live together,;; they explained. Before Therapist would agree to bury a marriage with love still alive, however, he asked the Gordons to go home and each answer one question “What is it like to be married to me?'' They were surprised. Obviously, Therepasit didn't understand the problem.

 

Each had a long list of complaints against the other. Sue was sure that evening would be all right if Stan were not so sensitive, so touchy. He was forever running off in a huff and leaving her alone. Stan insisted that he would stay home more if Sue were not so messy andsharp-tongued. Since airing these complaints had only made matters worse, they decided to give Therapist's crazy question a try. A few days later, Sue saw a calender carelessly tossed on the dining table.

 

She blew up. How could Stan chastise her for keeping a messy house when he was always cluttering it up with useless things. “Why did you bring that calender home?'' she yelled. Before Stan could respond, Sue realized that she, not Stan, had most likely left it there. Her instinct was to defend her error by saying, “Even if you didn't bring it home this time, it's just like you.'' Instead she asked herself, “What would it be like to hear what I have just said?'' The answer was obvious, and she told Stan, “That was nasty thing for me to say and I'm sorry'' Stan was startled. It was as though she had taken an unexpected step backwards in familiar dance, and he had to step forward to match her. He was totally disarmed. What once would have become a battle never got started. Over the years, Dunne's question has proved so effective that he has used it as a basis for a published guide to do-it-yourself therapy.

 

Step Number 1 in therepist's programme is to wrestle with the question, whether or not a partner is willing. Too many people make the futile and frustrating effort to change each other. For the Gordon's a messy house became a battleground because each saw it as the other's fault. Acknowldeging that you're part of the problem can work wonders. Therapist likes to describe the marriage relationship as a threesome – I, you and we. The we is similar to a bank account. “If, like Sue Gordon, you start depositing more in the we account, your spouse will try to match you,'' says Therapist.

 

Step Number 2 : Take a personal inventory. List your good and bad attributes. The exercise will help identify negative traits and behaviours in need of change. Seeing positive traits will prevent you from goind overboard with self-criticism. Married only four years, Ann andJim Birmingham were frigntened by the serious symptoms of stress in their relationship. With both of them working, theirs had been an exciting marriage until the arrival of their first child. They agreed from the start that Ann should stay home to take care of the baby, but they weren't prepared for the consequences. Jim was killing himself to make enough money to maintain their life-style, and Ann felt she was sacrificing her own talents to serve an absent husband and a demanding child. T

 

hey were always at odds. When they took a personal inventory, their preceptions changed Jim says, “I saw myself as running into the house always late, and asking Ann how her day had been, then getting on the phone again before she could answer. I had to say 'It must be horrendous to be married to me!' Ann could see a shrew in the making. With Therapist question always in mind, she began hearing her responses to Jim's arrival home - “Well, it's about time!'' - or to his phone call from the office that he would be late getting home - “Not again! You'll have to get your own dinner.'' No wonder he found it more pleasant to wrap himself in work; Ann wasn't much fun to come home to.

 

Step Number 3 is to share your efforts at improvement. Since this involves pointing a finger at one's self instead of the other, it creates an atmosphere for logical discussion, rather than arugument. Once the Birminghams had acknowledged that they shared equal blame for the stress in their relationship, Ann could say to Jim, “I've been getting angry at you because I couldn't handle my own frustrations,'' and Jim could answer, “I know how you must feel; you're doing a great job as a motherm but babies don't pat you on the back''

 

Step Number 4:act on your new knowledge. This is the most important step. The smallest actions can make a big difference when they are based on an intelligent understanding of a partner's point of view. Start with a behaviour that you find easy to change, Then move on to others that are more difficult. It was a major cirsis when Stan Gordon told Sue that he couldn't accompany her to the annual family gathering because he had to work. “I was very hurt,'' she says. “I felt abandoned and angry.

 

Before, I would have wept or raged. Instead I asked, “What is it like being married to me?'' once I put myself in Stan's shoes, I was able to say, “It's okay. I'll drive down alone'' Knowing how much the occasion meant to Sue, Stan suggested they fix telephone dates so he could pay respects to her family. From that point on, the Gordons stopped thinking of their marriage asa terminal. Each time one of them makes an effort to see things from the other's point of view, the underlying love in their relationship shows through.


Caress of the Female Genitals

In the honeymoon period, a woman achieves keen sexual excitement or climax only through stimulation of the clitoris. This small, rod-shaped structure becomes firm enough to be readily distinguished from the surrounding tissues only during sexual excitement, and lies beneath the folds of skin at the front corner of the female opening. Practically all feminine erotic sensitivity centres in it until sexual experience enlivens other areas.

 

In about a year, howeverm the pattern of erotic sensitivity changes. Nerve fibres throughout the female organs tie themselves in with the sexual response. The clitoris, once essential to womanly gratification, can be totally removed without any impairment of feminine pleasure. By the time the joys of the discovery have passed and sexual boredom becomes a real threat, many portions of the female organs respond at least as keenly to caress as the clitoris.

A long time husband can do a great deal to relieve his wife of sexual boredom and add both the charm of novelty and the new excitement of varied sexual stimulations to his wife's enjoyment by breaking out of the pattern of play he learned in the early days of marriage. If you take full advantage of all the erotically sensitive areas around your wife's now-fully-responsive female organs, you can bring her to a high plateau of sexual excitement long before you want or need the culmination of intercourse, and keep on that mutually gratifying plateau for many delightful and love-inspiring moments. Five different areas generally proe worthy of attention.

 

1. The Clitoris :-

Although no longer the only touchstone of orgasmic success, the clitoris remains sexually sensitive throughout married life. Although it tends to be almost indistinguishable from surroundings tissues except during sexual excitement, an aroused woman's clitoris becomes quite irm to the touch and swells to deminsions of perhaps 1/2 inch across and 3/4 inch in length. You can easily find it by following the inner lips forward with your finger until they join, then feeling for a firm rod beneath the thin skind just in from of that junction, still within the protective folds of the fuller 'outer lips' at the female organ's ides.

 

The public bone lies just above and behind the clitoris, giving a firm backing against which you can roll or massage it with your fingertip or knuckle. The layer of tissue which covers the clitoris is rather delicate and sensitive, how- ever, so that a harsh or unlubricated surface may cause discomfort when pressed firmly enough to produce slitorine stimulation. Fingernails should be terminated and fiels, and either saliva or vaginal fluid (available only an inch or two away) used for lubrication if the clitoris zone feels dry. Fingertip massage stimulates the clitoris quite effectively.

 

Catching the clitoris between your finger and the under- lying bone, you can stroke along its length from base to tip or from tip to base, slowly or rapidly one way with interrupted contact from the 'return trip' or back and forth with continuous contact, gently or fairly firmly. The actual tip of your finger proves more effective than its pulp, both because it is harder and because a small caressing part which can run up and down along the clitoris only presses continuously on this fairly deep-lying organ and makes friction only at the body surface. Side-to-side movement across the clitoris can be performed with the pulp of the finger, since the pressure- and-release that comes from 'rolling-pin' action stimulates the whole organ intermittently. This action can be performed near the tip of the clitoris or at its base, where it becomes indistinguishable from surrounding tissue.

The Inner Lips :-

In the unexcited woman, the inner lips are small folds of loose, thin tissue, one at each side of the vagina's frong corner of the vagina, and narrow down until they taper out completely about halfway down the female organ's sides. Intensive sexual excitement makes the inner lips engorge and swell to two or three times their resting size, generally making them pout out between the surroundings folds and present at the body surfaces as an inverted V of tissue along the female organ's frontmost rim.

 

After few months of satisfying cohabitation have fully awake- ned feminine ardour, the inner lips become extremely sensitive sexually. A brief detour to the moist lubrication pools which generally accumulate along the back portion of the vagina's wall helps to prepare the finger for light, preliminary caress-the thin, sensitive skin over the inner lips can easily be overstumulated with harsh, unlubricated contact. Fingernails should be kept well trimmed or filed in preparation for this caress, also.

 

The pulp of the finger, the side of the finger shaft, or the knuckle of a culed-up-index finger makes a good agent for caress. Gentle tickling makes a good start. You can alco elicit keen response by stroking from front to back along one side, then the other. A finger placed just within the female opening and moved in gentle but rapid circles around and around its rim stimulates the inner lips quite keenly.

 

Light stroking can be made even more effective by exposing portions of the inner lips to caress which ordinarily are protected from stimulation by surrounding tissues and which therefore respond vigorously to unaccustomed touch. You can use the thumb and middle finger to spread the outer lips wide and tickle with the tip of the index finder along the base of the inner lips along each side of the organ or along the inner surface of the inner lips at the front rim of the vagina. where the tissue ordinarily lies back against other smooth, unstimulating folds.

 

You can get a similar effect by drawing one of the outer lips upward and to the side with your thumb or with your middle, ring, and little fingers so that the inner lip stands out as a ridge on a flat plain of tissue. Gentle stroking or titillation along either the inner or the outer margin of this ridge then stimulates nerve fibres ordinarily shielded from any friction, and incites somewhat more intensive sensations than you can elicit from friction-toughened structures.

 

Althoug moisture-lubricated gentle stroking of the inner lips will carry almost any woman to a high plateau of sexual excitement and keep her there, brief flurries of more intensive stimulation help to provide variety. As excitement mounts, the inner lips become larger and thicker until you can pick them up between moisture-lubricated thumb and forefinger and stroke down their length with a sort of milking motion. Or you can bend your fingers and catch one liner lip between the middle segments of your index and middle digits; stimulataneously placing your thumb against the clitoris. Gently grinding the inner lip between the two fingers while stimulating the clitoris with rolling pin motions or length wise thumb caresses creates an exquisite combination of sensations

Other areas in next episode ....


Necking and Petting Between Tennagers

* As I have said, there comes an age and degree of maturity and expe- rience, certainly not the same age for all, when some adolescents feel they are ready for heavy petting and when they start thinking and talking about whether or not to have sexual inter- course. Here, while I discussing petting, I want to add a word about the strong desire that most adoles- cent boys, and many girls, feel to experience the full sexual satisfaction of an orgasm. For unmarried people, especially young and immature ones, probably intercourse is not the best way to do this, all things considered.

 

In earlier Episodes I discussed masturbation as a harmless way of acheiving orgasm. There are some couples who masturbate together. If a boy and a girl do engage in this sort of petting to orgasm, it is very important that they be considerate of each other, and especially that the boy understand that his partner may be feeling much less sexually aroused than he - possibly not aroused at all. The girl, on the other hand, should know that what she may have meant to be only a friendly touch may be taken quite differently by the boy - as an invitation to go much further than she wants to go. These differences help explain why knowing how to talk about sexual feelings with one's partner is so important to a happy, healthy and satisfying sexual life.

 

* Boys and girls should not feel pushed into necking and petting, or into intercourse, by their friends or the customs of their group. There are many teenage boys and girls who do not want to engage in physical express- ions of affection or who are quite embarrassed by them. They may want to wait until they have grown up more; they may have other, keener interests; they may not yet feel ready for the emotional effects. Certainly, you shoud not allow yourself to be pressured into sexual activity you do not want just because you are afraid that people will think you are square or not 'with it' unless you are sexually active. Many young people feel deeply, like the second boy I quoted earlier, that they want to save the intense physical expressions of love until they are married, when they can expect to have a lifetime of loving and caring, and of learning together the ways that a couple can give and receive sexual satisfaction.

 

* Another consideration to keep in mind is that many people, especially older people, have been brought up to feel, and still feel deeply, that expressions of affection between boys and girls should be inconspicuous - not public. They consider this simply a matter of good taste. Boys and girls who go against the stan- dards that many people feel are acceptable are likely to make such people unhappy or uncom- fortable, and are likely to be criticized. I have spoken of some of the pleasures and rewards of the sexual side of human social life - and of some cares and cautions that you should exercise. Perhaps, though, you may be thinking, like the first boy quoted in earlier article by me 'Well, when you are old enough to feel like satisfying your sexual drive, why not just find a member of the other sex who is willing and go ahead and satisfy it?' Before you decide on this, here are some more important considerations to think through : The Article in Next Episode


Love, and Stay Loved

It;s Okay,'' said Carol, with disappointment in her voice. “It's not okay, Carol. It's our anniver- sary,'' Paul replied. “But there's no way out of it. You know how important a client she is. I'll try and cut it as short as possible.'' At 6pm Paul searched the hotel lounge. “Attention Mr. Paul Hayes,'' a bellboy called. “You're supposed to go to Room 1404,'' he explained. Paul wondered what the devil his client was up to. “Comein.'' a sultry voice beckoned when he knocked at the door. Paul saw a raven-haired woman in black satin, with here back to him. She then turned slowly and dramatically. “Carol! What are you doing here?'' “Happy anniversary!'' She couldn't hold back the laughter when she saw his face. “I planned the surprise with your secretary. The children are at Mother's and we have the entire night here!'' Still laughing, she kissed him. Carol had, in fact, found one answer to the questions women consistently aks. “How can I keep interested?'' “How can I keep a relationship alive and exciting year after year?'' By reading many books and interviewing scores of couples who have truly intimate relationships – and many who don't – I have found some of the keys to a successful relationship. Having a vibrant, long-term relationship requires :

1 Honesty : You slam the door on the possibility of a meaningful relationship by lying or pretend- ing. If you're faking sexual satis- faction or trying to please your husband by telling him what you think he wants to hear, you're on the wrong track. Preserving the emotional status quo is an insidious trap that many of us fall into. Rather than doing anything that will rock the relationship, many women hold on to patterns that are routine and boring. Love making, vacations, dinner-table conversation become predicta- ble, unprovocative and antisep- tic. If you think you're “pleasing your partner'' by not saying what you want or feel – or saying what you think he wants to hear – you're making a mistake. “At the heart of true intimacy is the truth,'' says a man who cherishes the honesty of his 18-year marriage.

2 Time : - We live in an enormously stressful world where everyone is hurried and worried, and if the moment comes to let the day's worries dissolve, many of us do so by watching television instead of talking with each other in a loving, intimate way. Many people spend more time on reading, or day-dreaming about an exciting relationship than on cultivating one. It can't be said often enough that making love takes time. Spontaneity is a terrific stimulant, but given the realities of the average household, it is clear that planning for lovemaking is almost a necessity. Experts say that taking the time to plot a rendezvous, far from inhibiting sexuality, can actually kindle it. Planned lovemaking can become something to look forward to. Some More Important Points in Next Episode ...


Caress of The Urethra

The Urethra

A bit farther inside the female organ, along the centre of its front or top wall, you will find a narrow, lenghwise band where firm caresses cause intensive response. The base of the bladder and the urethra, which leads from the bladder to the body surface, lie in this area. They contain a rich network of nerve fibres which become keenly sensitive sexually after a few months of marriage. You will never feel or detect the specific structures which make this area sensitive since they lie underneath a substantial layer of tissue and have about the same consistency as the neighbouring organs.

However, you will be able to tell from your wife's response when your caresses stimulate them. The basic urethra-stimulating caress starts with the finger inserted two or three inches into the vagina. By presssing the fingertip frontward against the vagina's top wall, you can catch the urethra between your fingertip and the public bone. Keeping to the exact centre if possible, draw the fingertip outward until you reach the margin of the muscular, washi-board-surfaced vaginal wall. No narm will be done if you carry the caress a bit too far, but you should ease up on any substantial pressure before reaching the easily- hurt inner lips.

 

After you have located the sensitive area in the way, you can vary the procedure with inward strocking pressing the fingertip up against the public bone at the centre of the vagina's rim (starting distinctly inside from the inner lips) and milking the underlying structures upward. Both the urethra itself and the tissues surround- ing it are fairly sturdy, so firm friction cause no discomfort. Side-to-side movement of the finger also stimulates the urethra, but not as effectively as lengthwise stroking. You will ordinarily find one finger much more effective than two for urethral caress, since the sensitive structures lie in the exact midline where the groove between joined fingers tends almost automatically to fall. Slow stroking is just as effective and much easier to manage than rapid titillation.

 

Urethral caress usually proves highly exciting and generally brings a woman quickly to the high plateau of keen enjoyment which many experienced women treasure much more than orgasm itself. At this point, return to gentle titillations of the inner lips and other forms of foundling sustain excitement very well, making continuous urethral caress unnecessary. You usually find this measure best used like booster rockets on an aeroplane, to bring your wife to a high plane of excitement quickly so that other, midler measures can take over and keep her there.


Love, and Stay Loved

3.A Commitment to sexuality :-

In plain language, this means accepting yourself as a sensual being who enjoys giving and receiving pleasure. Convey to your husband that you are truly interested in sex. Many men say their wives are “lukewarm'' or “too inhibited'' about lovemaking. Being truly interested means completely enjoying your own natural, healthy sexuality. For one woman this might mean allowing herself to recognize her impulses for lovemaking instead of subduing them or feeling guilty. For another it might mean summoning the courage to discuss sexual problems in the marriage or allowing herself to explore sexual fantasies with her husband. I've come to believe that some women are born with “the golden touch''. They have an intuitive understanding of sensuality: how and when to touch and move. Those not born with it can learn to develop their own sensibilities to give and receive pleasure. Think about cooking for a minute: without looking at a book, the “born'' cook instinctively knows how to put a meal together. Others have to follow receipes and measure out all the ingredients carefully. Both methods work. What I'm saying is that you can learn to be sensual and convey what you want and need. And this brings us to ...
4. Communication :-

Perhaps the most important tool we have in sustaining a relation- ship is communication-a much more overused but critically important word. “You can heve a 'nice' marriage where there are no conflicts,''  says a sage marriage councellor, “but a good marriage is one on which problems are faced, discussed and dealt with.'' If your can express what you really need and want without fear or shame, your desires are often met with surprising quickness. When fears of failure or rejection are expressed openly, they lose their power to hurt.

 

“I am afraid you'll leave me if I say what I really want'' or “I feel vulnerable and exposed when I do that'' are surprisingly often countered with “I didn't know you felt that way'' Unless you tell your husband how you feel and what you want, how is he to know? One of the greatest problems between two people lies in the assumption that the partner should automatically sense what you want or don't want. Almost nothing could be further from the truth. Countless naunces of physical and emotional feeling occur when you make love. You can becomes sensitive to these changes by carefully reading your husband's physical responses and by revealing your own reactions to various touches and movements. Simple pharses that begin with “I like that'' or “I feels so good when'' give your husband a clear idea of what you want.
5. Overcoming fear :-

For many of us, fear is a well-known bedfellow, and it is fears, according to sexual researchers and therapists, that are some of the greatest impediments to lovemaking. Most men would be surprised to know hou many women are embarrassed about their bodies. We worry about our waists, thighs and almost everything else. In short, one of the strongest sexual fears among women is the fear of not being desirable enough.

 

Many couples make love with the lights off because they're anxious about how they look. We all appreciate perfectly beautiful faces and bodies, but it should be obvious that most of us have to live with our imperfect selves. Feeling comfortable with your own body is simply a prerequisite to feeling comfortable with someone else's. Many women also worry that if they take the initiative in lovemaking, their husbands will consider tham too aggressive, not feminine enough. They are concerned that the man will perceive this as a direct hit on a traditionally masculine role-being the dominant force in a sexual relationship.

 

But most men I interviewed told me that they prefer their wives to take the initiative some of the time. “Some'' is the key word. A wife who says, “I feel seducing you tonight'' is far likelier to get a warm reception than the one who demands action. You may be tempted to say, “But I know these things''. It's true that much of what's here is just plain, ordinary common sense; yet when was the last time you brought your husband breakfast in bed? When was the last time you read a book together? When was the last time you talked late into the night? If there's one message that comes through from couples who have made something very sepcial of their lives together, it's this : set aside the time to understand each other and talk about the things that make your relationship work-and then do them.


Necking and Petting Between Tennagers

Sexual Intercourse, as I have suggested, is for most people a deeply moving experience, not something to be played around with casually. It almost always involvees not only the body but also the mind and emotions - one's deepest feelings. It also involves nature's menas for carrying on the human race. The facts explain why, when a couple have intercourse as an expression to each other, it can bring them even closer together.

 

But when two pleple do not care about each other, they may feel guilty or ashamed after having intercourse. This is especially true of girls. When sexual inter-course is undertaken too lightly, it goes against the customs and moral feelings developed through many generations of our culture. If these feelings are deeply engrained in people as a part of their upbringing, premarital intercourse (intercourse before marriage) may result in their not feeling quite right about themselves, and it may make it more difficult for them, later on, to take part in a good, happy sexual relationship.

 

However, there are no reliable statistics that show that people who have premarital intercourse are more or less likely to have successful and happy marriages than those who do not. True, there are many people who make quite confident statements on this matter- either for or against premarital intercourse- but their statements are more matters of personal belief or of what they think ought to be the case than of what can be shown to be the case, based on facts.

The major religions in the Western World teach that it is morally wrong to have sexual intercourse outside of marriage, although in recent years many churches have relaxed their teaching about this, especially about premarital intercourse. Fortunately, today many churches provide sex and family-life education to help young people deal responsibility with their sexuality. However, if people's religions do teach that premarital intercourse is wrong and they disregard the teaching, they may feel guilty, and this feeling may isolate them from a source of strength, comfort, and confidence that would help them.

Young unmarried people who have sexual intercourse take a risk; the couple may have child, which will very likely be a tragedy for both of them and for the baby, because the parents are rarely mature enough to marry and establish a family. Neither one is ready to earn a living to support a family; both the boy and girl probably should have years of education ahead of the, which marriage may interrupt. If they had waited, they would have been wiser, more stable, and more experienced in life - better prepared to choose a marriage partner and to manage family life. Therefore, if an unmarried couple is going to engage in intercourse, they should do so only after thinking about it and exploring their feelings with great care.

 

It would be best if they were able to find some older and under-standing person with whom they could talk confidentially without fear of being disapproved of or condemned. Such a person could help them think through all the pros and cons. Certainly, if they decide to have sex, they should make careful plans for contraception and not just 'take a chance' by allowing themselves to be swept into it by the emotions of the moment, which may be quite different from the emotions of loving and caring.


When Parents Steal Their Children

Every year thousands of children in Western Europe are kid- napped by a parent in the wake of family separation and divorce. Precise statistics aren't com- piled, but authorities estimate around 2,500 cases a year. Officials believe that at least 20,000 of these children are being held abroad.”Kidnap cases are multiplying,'' says Head of the International Mutual Aid Service at the French Ministry of Justice. “They are a veritable plague, causing an incalculable degree of human suffering.'' When law experts from 29 nations first took up the problem in the Hague in 1976, they called it “legal kidnapping,'' an apparent contradiction in terms but an accurate description of the nightmare it creates for those involved.

 

Here are the stories of three families who have lived through this tragic experience. In 1971, Barbara Williams married salesman Christopher Hancock in Yorkshire, England. Eight years later the marriage collapsed, and Barbara was given custody of their three-year-old son, Lawrence. On June 15, 1981, the boy paid his third visit to his father after the custody decision, and he and his father disappeared. At first there was no trail. Then an unpaid US telephole bill was sent back to England, showing Barbara that her ex-husband had stayed in a Los Angeles motel. In november 1981, she flew to California, where a local detective traced Chirstopher to a mobile-home part, but he had already moved on, leaving no forwarding address.

 

There was little Barbara could do. Until October 1984, under English law, kidnapping by a parent was not a crime, so she could not ask the American police for help. She has spent alot of money on travel, lawyers, detectives and reward notices-in vain. In Cologne, West Germany, Doris Bounaira lives with her two sons Farid 21, and Amin 19. They are the pride of her life. Doris, born in Germany, was a quadrilingual secretary in Paris when she met her future husband, a Tunisian theatre student, 23 years ago. In 1974, when her husband decided to settle permanently in Tunisia, Doris refused to go. Her husband forced her hand by keeping the boys in Tunisia after a holiday. If you want to be with the children, he told her, you will have to live with me. Alone in Cologne, Doris found herself in the impossible situation of many wives of Arab nationals.

 

Traditionally the Arab father decides everything concerning family residence. A mother cannot remove her child from an Arab country without her father's permission, although in Tunisia a mother can exercise her right to custody as long as her residence is within easy reach of the father's home. Doris borrowed money, mobilized the press in Germany and began a long legal battle. By July 1976, she had been granted a divorce and the custodyu of her children by the courts in both Germany and Tunisia. But her ex-husband appealed the Tunisian decision, and the case had to be tried again.

 

Doris hired an influential lawyer and enlisted the support of a well-known politician. On November 29, 1977, the appeals court in Tunis granted her custody and the right stumbling block that makes custody judgements so difficult to enforce in Arab countries: no just her husband, but his family and friends, even the local police, refused to let her have the children. Doris sent a note to her son, Farid, telling him to meet her on the way to school. She picked him up and drove him to a friend's home. When Farid did not return after school, his father alerted the police and gave them the firend's address.

 

The police hauled mother and son off to the police station. Although Doris's papers were in order the police insisted she return the next day. Instead, Doris and Farid caught the first for Germany. In a month Doris was back in Tunisia, filing one more suit against her ex-husband for failure to comply with the court decision to let her take her second son, Amin, to Germany. She won the case and a few days later made her last trip to Tunis airport. As the plane lifted off, she looked at Amin sitting beside her and was swept by waves of exhaustion and relief. It had taken over three years and 13 trips to Tunisia to get back her boys.


Caress of the Female Back Rim and Vaginal Vault

4. The Back rim :- During sex play, you will occasionally find your wife's knee resting upon your body or flank in such a way that you can reach around her thigh and touch her genitals. If you use your middle, ring and little fingers to lift the nearar 'outer lip' out of the way, the smooth soft tissue beneath becomes available for caress. Tickling, gentle stroking, and titillation along the side and rear rim of the vagina affords considedrable feminine delight in this posture, in which many of the more standard caresses prove a bit clumsy.

 

In the supine position, caress of the rear rim works best if your spread the outer lips between thumb and middle finger, leaving the index finger free for tickling, titillation, and stroking caresses. An occasional 'variety' caress which your wife may or may not like can be performed by placing the tips of two fingers an inch or so inside the vagina and pressing the thumb into the skin about halfway between the vagina and the rectum so that the muscles of the pelvic floor are caught in a sort of pincers grip. A quick kneadling motion or rapid side-to-side jiggle stimulates these muscles somewhat like the 'horse-bite' elutching of thigh muscles which most people experience a few times during adolescence. Caresses which sweep all the way around the gaginal rim as discussed under 'the upper lips' stimulate the rear rim quite effectively. In the main, however, this area gives less orduour building impetus than those previously described, and deserves attention only ocasionally and mainly for the sake of extra variety.

 

5. The Vaginal Vault :- During intense sexual excitement, the vagina relaxes and elongates to a very substantial degree. The husband of a fully aroused woman sometimes gets the feeling that he needs a very large object to stimulate the vagina in this state, and that a single finger will probably 'get lost';

 

Actually, a small moving object stimulates the vaginal wall just an intensively as a large one, and allows much more ready development of further feminine gratification. An attempt to fill the vagina with three of four fingers inevitably stretches some structure at its orifice uncomfortably, and does more harm than good. In and out movement, stroking, sweeping, tickling motions, or drumming with the finger against the vagina's top wall prove very effective.

 

Two fingers can be inserted for crawling motions along the vagina's various surfaces, if you are careful not to stretch the organ's sensitive edges, When the vagina is completely relaxed, you can place the back of your thumb against its rear rim and flip the fore finger into its opening over and over again, altering the direction slightly by rocking your hand from side to side. For occasional variety, stroke the clitoris or inner lips with your thumb while continuing side-to-side or forward-directed tickling motions deep inside the vagina with your index finger. Other Famale Organ Caresses Next Episode


Necking and Petting Between Tennagers

A young unmarried couple who produce a child they do not want are not prepared to care for may feel forced into marriage by family or church. They will have to marry in haste and probably not because they have chosen each other as life partners. Their chances of married happiness are small, experience shows. Before log the boy and girl may feel angry at each other for all of the difficulty that has been caused. What may have started off as a happy moment has resulted in a heavy burden that may never be entirely unloaded.

 

 

The divorce rate among such young couples is unusually high - ata least one out of every two marriages within five years. Divorce usually leaves a baby and its mother to struggle alone; and a young father is left with the legal obligation, unless his former wife marries again, to support them in addition to the second wife and the family he may eventually have. If the couple do not marry, the girl often is left without a partner to share the responsibilities of parenthood. Perhapa with the help of her own family, she will have the child and give it adequate care. Perhaps she will place it for adoption. Whatever she does, she is likely to think of it with deep concern all of her life. Some girls, when they become pregnant, seek an abortion.

 

* One other possible consequence of sexual intercourse, especially casual intercourse with several partners, is Venereal Disease. Today, VD is easily cured, but it is also widespread and is causing serious discomfort and damage. Boys and Girls often ask about the effects of alcohol and drugs on sexual feelings and performance. Alcohol does have the effect of reducing a person's self-control and inhibitions.

 

 

A famous cartoon by George Price shows an eager-looking man at a bar standing behind a sexy-looking young woman and saying to the bartender, 'Fill her up!' Evena a moderate amount of alcohol tends to relax people's inhibitions, to make them less likely to say no. However, self- control, especially when a couple is not married and no well prepared or mature, is what both urgently need in a sexual situation. Aside from the lessening of self-control, alcohol, especially if quite a lot is taken, has a depressing effect on a boy's ability to have an erection and to ejaculate and on a girl's ability either to respond to or to reject sexual relations.

 

As for drugs, the situation is complicated. Marijuana may, like alcohol, relax a peson. Some users say that it heightens sexual feelings. It also lessens self-control and may sometimes reduce the ability to have a orgasm. Stimulant drugs, such as 'speed', reduce the ability to perform sexually. 'Heavy' drugs like heroin knock a person out sexually, although they don't knock out his imagination.

 

If you feel that you need the crutch of alcohol or drugs to make sex acceptable or good, you have a problem, and alcohol or drug's won't solve it. What you need is to talk to a counsellor and get some help before taking the risks that sex involves. Alcohol and drugs can make you less able to deal intelligently with sexual feelings. This Chapter has placed more emphasis on the problems and possibly unhappy consequences of sexual activity entered into thoughtlessly and irresponsibly, without communication and preparation, than on the pleasures and deep satisfactions grown in from sexual relationships based on consideration, caring, and love. This is because I am convinced that to manage the responsibilities of your life you need to know both the bad news and the good news about sex and social life. The bad news may take more time to tell, but the good news is certainly the more important.


When Parents Steal Their Children

In 1975 Beatrice met Jose, who had come to Fribourg, Switzer- land months later a girl, Anic, was born. But Beatrice and Jose came from different worlds, and the couple divorced in 1980. Beatrice got custody of the children, with Jose receiving generous visiting rights. A good father, Jose took the children three times to stay with his family in Spain.

But the fourth time, without warn- ing, he left his job in Switzerland and refused to send the children back. Beatrice filed suit in Fribourg and, at the hearing in December 1982, the judge told her that a similar case that had started seven years earlier was still unresolved.

 

At the Spanish consulate in Berne, Beatrice discovered that Jose had not registered their divorce in Spain. Since she was still married under Spanish law, her Swiss custody order was wothless. Beatrice went to Spain twice to plead with Jose. The Lopez house was cold, and the children were unhappy. On her first visit, David, then six, begged, “Put me in your suitcase, Mummy. Don't go home without me'' The second time, he said, “I knew you'd let me down Mummy'' At the end of November Beatrice turned to the Swiss Movement against the kidnappind of Children. They introduced her to one of their members, a Czechoslovak refugee with teh psuedonym of Joseph Melnik, who had helped Soviet bloc dissidents escape to the West.

A committed “freedom fighter,'' he had become concerned about the fate of kidnapped children and had offered the Swiss group his services – and had already managed to bring back 42 children to its members. After Beatrice arrived in Spain for the Christmas holidays, Melnik joined her there. One night after dinner, at his instruction, she slipped three sleeping pills into Jose's coffee. Jose fell into a drugged sleep. The children were whisked into Melnik's rented car for a 14 hour drive across the Portuguese border to Lisbon where they caught a flight to Switzerland. In May 1983 the Court in Fribourg sentenced Jose Lopez in absentia to four months in prison for abducting minors. A month later the case was retried, this time with Jose present, and the sentence was reduced to two months and suspended, conditional on his good behaviour. Beatrice's Spanish divorce became final in January 1984.

 

Many judges and lawyers mistakenly believe that liberal visiting rights are a guarantee agaist kidnapping. But most abductions occur because a spouce misuses visiting rights to kidnap a child. The police are frequently uncooperative in family cases, or give tacit support to their own nationals. Counter-kidnapping has become a serious alternative mainly bacause the law takes so long. Some parents end up on the brink of a nervous breakdown. Other parents are forced to give up because they cannot pay legal, travel and court expenses. But the real tragedy is the suffering of the children, When Farid and Amin came back to Cologne in 1978. Farid barricaded the front door, and Amin was so frightened that Doris had to sleep in his room for several months.

 

David Lopex, now eight, was so emotionally ill that he is still being treated by a psychologist. These reactions are common. Child psychiatrist Ner Littner estimated that 10 to 40 percent of kidnap victims become seriously disturbed. If the problem of legal kidnapping is resolved one day, it will be largely because of the efforts of a few women who have become deeply concerned with this plague. Doris, who founded Children Protection International in Cologne in 1981, has so far handled over 500 cases. The children abroad Self-Help Group in Yorkshire, set up by a British mother whose son was abducted to Kuwait, lobbies Parliament and provides legal advice and psychological support to victims.

 

Thanks to the group's pressure, a new nill, which became law in October 1984, makes parental kidnapping from the United Kingdom a criminal offence. But governments must do more. They are reluctant to grant such groups official recognition or financial help. Laws in most countries remain woefully inadequate. Says Doris Bounaira “We get a bill in Parliament quick as flash barring pronographic films. But a bill against stealing children takes years. We use computers to register stolen cars, but not to register stolen children. “How much longer do children have to wait before the law gives them adequate protection.


Other Female Organ Caresses

Some couples find that caresses of the female genitals with the lips or tongue bring exquisite gratification to the wife and are in no way objectionable to the husband. Such caresses are only appropriate if both partners are throughly convinced (not only in their heads but in there hearts) that no perversion is involved.

 

Mouth-to genetial play gives satisfaction only after several months of sexually successful marriage, because sensitivity does not spread from the clitoris to the inner lips and surface tissues until many sexual satis- fying episodes have linked stimulation of these areas with emotional response. Both partners need to be firmly in the grip of passion before commenc- ing mouth-to genital play, the man because the female organs only become attractive objects of such intimacy when his primitive instincts have been fully aroused, and the woman because it takes ardour generated swelling of the inner lips to bring highly sensitive structures within range of easy stimulation.

 

If you can meet these conditions, and if your wife welcomes such attentions with sufficient enthusiasm that her reciprocal caresses maintain your excitement, a number of mouth-to female-organ caresses might prove gratifying. Draw one or both outer lips aside with your fingers, to expose the linner lips and the smooth, moist tissues of the feminine orifice to easy caress.

 

 

Most husbands find that gentle brushing kisses or tongue-lip stimulation of these structures proves exquisitely pleasing to their wives. You can cause keen stimulation by placing relaxed lips into contact with a highly sensitive area such as the inner lips, then blowing in such a way that your lips vibrate against the sensitive tissues. The inner lips can be gripped between the husband's lips so that side-to-side motion of the lower jaw or titillation with the tongue stimulates them keenly. Or a protruded tongue can be rubbed against the inner lips in various directions, with varying degrees of firmness, and in varying rhythms.

 

Like most intensive genital caresses, these give the greatest gratification when aimed at long- continued transpott on a plateau of keen excitement, with deliberate tapering to milder caress whenever orgaasm seems about to obtrude. If feminine orgasm does not result from these ministrations, however, it can be treated as one of the foothills, not the main mountain. If the wife continues to stimulate her husband and maintain his excitement, a new succession of caresses will usually bring her to a state of keen sexual excitement again in a very short time, and the keen climax of a final, intercourse generated orgasm will write a perfectly proper 'finis' to the episode.

 

Incidentally a husband's saliva may contain germs which cause itching of soreness of the vulva a day or two mouth-to genetal play. Similar problems may develop from use of saliva as a lubricant in other forms of genital caress. Intermittent mouth and manual caress of the breast may soil the fingers with saliva which later is transferred to the female organs by genetial caress. More-severe of protracted infection may tip the balance against mouth-to-genital caress and make worthwhile various precautions against transfer of saliva by way of the husband's hands to the genital zone.


Some Values To Guide You

If you are like most people, your whole life, including your sex life and your experiences with love, will have its ups and downs, its great joys, and its sorrows and regrets. Much depends on how you take what life brings to you and the values by which you make your decisions. I am talking about both your life now, in adolescence, and about your life later as an adult, whether or not you marry, And, by the way, I hope you will not let yourself be hurried into marriage too soon. There are many people who benefit by waiting to get married; and there are many who probably should never marry at all, or who have never found a person as pleasing to them as the rewards of living singly or in a group.

 

An attractive, loving, lovable, older Quaker lady, a member of my Friends meeting, smilingly said to a friend when she was asked why she had never married: 'Well, thee knows, it takes a mighty good husband to be better than none.' We all know also unmarried people sho live full, satisfying lives because they have found that the deep and rewarding demands of a career are more important than the satisfactions of marriage, which might prevent the fullest accomplishment in a career.

 

Questions about career, marriage, and having or not having children, about the conduct of your sexlife, are questions you will be deciding for yourself. All through your life, but especially during your adolescence, you will be searching for your own set of values to guide you, and one of the signs of being mature is to have developed a sound set of values, even though the search of values shoud never stop. I want to end this articles by suggesting six values which may help to guide you as you make decisions about love and sex and life. Some of them, as you will see, I've already spoken about, but they bear re-emphasizing here. The first is the value of information. Correct information - the facts - is better than ignorance or rumour. Sound information makes it possible for you to act responsibly. Ignorance may get you into trouble. The second value is responsibility. If you are a responsible person, you undertake the actions of your life keeping in mind what the results, the consequences, of your action will be - the consquences for yourself and for all the others involved, both now and in the future.


Some Values To Guide You

The third value is control. Sex is a power. Like any other power, it can be used for good or for bad. We all need to learn to control our sexual power so that we use it for good - of ourselves and others. (Two other examples of power where control makes all the difference between benefit and tragedy are fire and the automobile) The fourth value is consideration. We should do what we do while considering and caring for our own needs, feelings and welfare, and for those of others.

 

To be truly considerate of others we need to have enough though-fulness and imagination to put ourselves in their soles - in their skin, as some say. The fifth value is the worth of each individual person. To understand this infinite worth and to respect it, we need to feel our own worth. Self-respect is the beginning of respect for others and for their worth. The sixth value is that of communication. It is good to be able to talk things over with other people. It is good for boys and girls and men and women to be able to talk with each other about their sexual feelings, desiresm and fears.

 

I hope these episodes will help you to do this with your friends and with your parents. Some- times, if you have all read the same articles, the way to communication is more easily opened. And so, a lastword about love and sex. Remember that love is a complicated relationship, and that sexual love is only one part of it. There are other loves: the unreserved support and loyalty found between many parents and their children; the easy comfortable- ness and enjoyment that come from the love of a friend; the zest and stimulation that are a kind of love felt by people who share common tasks, interests, and problems. I know a young married couple who are happy and satisfied together.

 

The wife who is author of an excellent short book called Practical Sex Information (published by Waking Woman Press) expressed the most important aspect of their marriage thus; we are very-best friends' we enjoy each other's company more entirely than anyone else's; we have each other to come home to and tell our adventures in teh big world. We are pretty sure that without this aspect we could have nothing, and that there is nothing else more important in our relationship. When two people have great affection for each other and understand each other well, and when they make a commitment to join their lives and to care for each other through thick and thin, then the sexual part of their love, each for the other, can grow ever more satisfying, joyful, and deep.


What Vasectomy Means to a Man and His Marriage

Less than thirty years ago, few people could understand why anyone would choose to be sterilized. It seemed so extreme, so frightening - ''normal''people, it was thought, would never decide to permanently give up their ability to conceive a child. Vasectomies were especially unacceptable as a method of birth control, not only because most ment assumed contraception was a woman's responsibility, but also because there were so many myths and so much misinformation concerning the operation and its after-effects. When vasectomy was introduced in India in the 1950's as an integral part of the government's national family planning programme, both men and women resisted the idea.

 

Over the years, however, resistance waned. Encouraged by a monetary incentive offered to volunteers, and by the establishment of free and better vasectomy facilities, evergrowing numbers of men turned to sterilization. As a result, the number of vasectomies performed nation-wide jumped from a few thousand during the fifties, to over one million by 1968. What some saw as strong governemnt support of an effective birth control programme, others, doctors and demographers among them, viewed as forced sterilization.

 

In 1976, during the Emergency declared by Mrs. Indira Gandhi's government, a record 6.2 million Indian men were vasectomized. But already feelings against vasectomy were running high and, at least in certain northern states, were held responsible for the fall of the government in 1977. Due to adverse propaganda against sterilization, the new government's support for the programme lessened. So much so, that in the following year the number of vasectomies decreased to 1.9 lakhs.

 

However, since 1980, there has been a steady increase and today about five lakh vasectomies are performed yearly. Perhaps equally responsible for the decline is the still widespread belief that a vasectomy will adversely affect a male, emotionally and physiciologically. Does it, in fact, interfere with sexual functioning and satisfaction? Does a sterilized man feel less potent, less masculine?

 

Doubts and Fears :-

To answer these and other questions, doctors, sex counsellors and therapists  have talked to couples across the country who have chosed this method of birth control. One key finding: almost all men who have had a vasectomy are glad they did. "We have three children and we cannot affort any more'' says Ashok, a young bank clerk, explaining why he had a vasectomy. "Initially I feared that the operation would affect my sexual performance. But a colleague explained that such fears were groundless; he had been sterilized and had suffered no adverse effects'' Such anxieties are baseless: no new sexual problem, for either husband or wife, is likely to arise because of a vasectomy.

 

According to Doctors "A vasectomy usually has no effect on desire or potency and a man's sex life remains unchanged after the operation.'' In fact, many couples find their sexual relationship more relaxed and spontaneous once the worry about birth control or the side effects of contraceptives is removed. In most cases, sexual enjoyment and frequency of intercourse increases. Experts agree it is important that the man should not feel pressured into having the operation. Doctor of Family Planning Association of India says "Ideally, every prospective vasectomy candidate should undergo counselling to ally his doubts and fears about the operation'' MOre important, such counselling serves to weed out the psychologically disturbed - the man who, for instance may use sterilization as a means of getting back at his wife by 'depriving' her of children.'' There is a consensus, too, that vasectomy isn't a good idea if the wife objects to it. It isn't uncommon for a man to be afraid of the operation itself - the possibility of pain, the chance of an accident, a slip of the knife. Actually, a vasectomy is now considered hardly more uncomfortable than having a tooth pulled. Some More Details In Next Article

 


Climactic Caress

Crucial areas of both the vagina and the penis have special nerve supplies, with nerve endings of only two types: the kind normally associated with pain perception and the kind that senses temperature. These nerves lead through several nerve centres and passages within which their fiores freely intermix with those from neighbouring areas. As a husband, you will probably find that the best time to test your wife's response to certain climactic caresses might be during a 'preliminary' orgasm.

 

When in the heat of impassioned sex play you notice changes in her breathing rhythm and involuntary body motions associated with a climax, pinch her three or four times on the upper inner thigh, just beside her female opening. The pinches should be distinct and sharp, just short of what you would expect to leave a burise or sore spot. They can be interspersed with intensive, in and out vaginal caress or performed with the other hand while vaginal caresses are continued.

 

If painful, non-injuring stimulation heightens your wife's climax (as it usually will, if timed correctly), several other forms may prove worth trying. You can rake the inner lower portion of the buttocks and the upper inner position of the thighs with your fingernails while continuing vaginal stimulation with the other hand. Open-handed slapping of these areas is very effective, using force calculated to be stinging but not actually harmful.

 

You can grasp a small tuft of public hair on either the outer lips or the protective fat mound above the organs themselves and alternately tug and release it. Firm muscle-clutching low on the buttock or high on the thigh sometimes proves effective; as does deep massage of the same areas with the fingertips. During intercourse itself similar climax-heightening caresses add extra gratification for both husbands and wives. Slapping, pounding, pinching, and muscle-clutching of almost any part of the body accentuate the climax such measures applied to the areas which share nerve passages with the genital organs mainly the lower portion of the buttocks, the crotch, the upper, inner thigh, and the lowermost portion of the abdomen intensify the delights of orgasm very effectively.

 

In the usual sexual position, a wife can slap her husband's buttocks, pound his back, or reach around to the inner side of his thigh to rake or pinch him with her nails s he undergoes his climax. Pounding, slapping, pinching or nipping of his chest and back at the crucial moment also helps. The husband in this posture can generally pinch or clutch at the low buttock and thigh area while supporting his weight with his other hand. In other positions, he may be able to use a stinging slap or row of pinches to much better climax heightening effect.

 

A word of caution. Married sex always has its ups and downs a few superb occasions, a great many pleasant and satisfying ones, and some disappoint- ments. Climactic caresses raise your horizons considerably by making the superb occassions considerably better. They upgrade and add variety to some occassions which would otherwise seem rather ordinary. But climactic caresses are strictly 'fairweather friends' which can never bring a sexual failure up into the 'satisfactory' range and which are much more difficult to time correctly and carry through on an occasion which is otherwise unexceptional. You can boost a long-predicted, already intensive orgasm into the range of the truly exquisite with climactic caresses, but you should never let such successful use tempt you into making these caresses 'standard'. If you want to enjoy their full benefits, use them sparingly, on already outstanding occassions, and with enough variation as to 'whether' and 'when' and 'how' that they always seem something of a surprise.


On Being A Woman

Growing up is an exciting yet demanding period of our lives. It is possible to debate endlessly about what characterises a human adult and about what 'growing up' really involves. Thought-provoking criteria have been proposed by Dr. Abraham Sperling, a well-known psychologist, that mark adulthood - sexual competence, independence of family, emotional maturity, economic independence, intellectual capability, ability to use leisure productively and an overall philosophy of life. We acquire most of these abilities over a period of time, at our own pace, depending upon the social environment we are rooted in. For most of us reproductive maturity, the first and foremost criterion of adulthood, is achieved relatively unconsciously as a natural course to the end of childhood.

 

Seemingly a continuation of growth, the transition into the adult world involves more than acquiring reproductive competence. It is time for developing an indentity. It is time to forget relationships. It is time to look at the world as adults see it. It is also the time when there is turmoil and crises-more so if you are a young girl. For girls stepping into adulthood, the world is wonder-filled and hostile at the same time. The body changes rapidly in form and function. The people around them respond to these changes sharply. As society makes them aware of their gender roles; a deluge of queries especially concerning sex and reproductive life of adults arises in their mind.

 

Some of these queries are easy to answer, some not, especially as the scientific explanations are a trifle complicated. Many a times questions that concern the lives of adolescents very closely and influence their decisions never get answered clearly, either at school or at home. The rapid physical and mental transition troubles them, leaving them yearning for information that they are afraid or too embarrassed to ask. At times, snubbed by adults for bei9ng overly inquisitive about sex, they probably reach out to spurious literature. Sex educators have a major role to play in the life of most youngsters. Some who are lucky enough to find teachers or adults who answer questions with sensitivity, make a healthy transition into the adult world. Those who fail to get this personalised attention find puberty a formidable time. An informative book may turn out to be a friendly alternative to a sex educator.

 

This book intends to be just that. It is a friendly alternative that attempts to answer most questions related to the reproductive life that confronts the adolescent girl. In order to depersonalise it no question is directly answered but it woven in a background of how all this has been understood, over the years by scientists and clinicians. The first and foremost question most girls ask is what makes them 'females'. This apparently simple question is not easy to answer! An anatomist will have an explanation based on the differences in the parts of the body, a physiologist or a biochemist would answer it as differences in the interplay of chemicals in the body while a geneticist would look for the differences in the genes that boys and girls carry. All of them provide specialised information that is interconnected and important if the differences between the sexes are to be clearly appreciated. Maybe, to begin with, we can look at the explanations that each of them has to offer.


The Procedure and Reversal of Vasectomy Operation

The Procedure :-

In brief, what happens is this: the surgeon first injects a local anaesthesia, then makes a small opening on each side of the scrotum, or one just below and beneath the penis. The sperm-carrying tube, called the vas deferens, is carefully lifted out, first on one side and then on the other, then cut and closed with ligatures so that no more sperm can pass from the testicles into the semen. The incisions are then closed. Although a man still produces sperm, it is blocked off and absorbed into his system.

 

His body continues to churn out the same male hormones it always has, and in the same amounts. Following the opera- tion, the patient is usually advised to take it easy for a couple of days. He may ache, but asprin and perhaps an ice pack are often all that is needed. Once in a while, he may have a more serious side effect, such as an infection, swelling, discolouration, some pain, a blood clot near the incision or a build-up of fluid in the scrotum-all of which are usually easily treated.

 

A vasectomized man can usually resume sexual activity after a week or so, though he should bear in mind that sperm already present in the vfas before the operation could cause an unwanted pregnancy. To avoid problems sexually activity should be postponed until a semen examination reveals an almost complete absence of sperm-usually in two or three months. Otherwise couples should resort to some form of temporary contraception. Vascetomies cost anywhere from Rs.300 to Rs.1,000 depending mainly on the class of the clinic or hospital where they are performed. Public health services, of course, provide vasectomies free of charge.

 

Reversal Process :-

What if a man changes his mind about wanting more children? Doctors usually stress that the operation should be sought only by those who are certain they want no more children under any foreseeable circumstances. But as Dr. Fardoon Soonawalla a Urological surgeon states, "In developing countries like India, where child moratality in rural areas is still high, vasetomized men may wish to have their fertility restored''. Fortunately, such a reversal, whereby the cut ends of the vas deferens are rejoined and opened so that the sperm can once more pass through into the semen, is becoming increasingly possible.

 

Dr. Soonawalla, who has performed more than 500 reversals, says that with new microsurgical techniques success can be achieved in about nine out of ten cases where the vasectomy was performed within the previous ten years. However, the reversal process is a long and expensive one, only a few Indian doctors are adequately trained to perform the operation, and success is not assured.

 

"The ages of the couple and the skill of the surgeon are important factors,'' explains Dr. Soonawalla. "When the reversal is performed within five years, normal sperm counts are achieved rapidly and the pregnancy rate is high. If the interim period is longer than ten years, recovery tends to be slow and incomplete.'' Pathological changes in the epididymis, the coiled tube leading from the testicles to the vas, can affect maturation of the sperm and leave a man infertile in spite of the surgery, warns Dr. Dev Pardanani, professor of the Urology. "Despite past resistance to it, vasectomy will become an increasingly acceptable method of birth control if we can convince our male population it is safe, effective and often reversible,'' says Dr. Datta Pai. Indeed, if the decision to have a vasectomy is based on full information, and if the patient receives prior counselling, good surgical care and careful follow-up services, it can have only positive effects on a man and his marriage.


Art of Intercourse

Successful adjustments of the sexual side of marriage depends on kindness, thoughtfullness, love. Knowledge of the part sex plays in life and in marriage will help us to understand it and gives us some idea of what to expect from it. The act of sexual intercourse itself was essential to the preservation better educated classes, those who do not believe in superstition; have returned to a considerable period of precoild play.

 

But the question still arises how fre- quently one should have inter- course? Is there any harm if one have it too frequently? For a satis- factory relationship in marriage the proper and average frequency of intercourse is three or four times a week, or about twelve to fifteen times a month. The only sumptom that can result from having too many inter- course is nervousness. The best way to recover from such nervous- ness is to have intercourse a little less frequently. In the first few weeks of marriage intercourse will be desired by both much more frequently than it will be later on. And certainly after any prolonged seperation it may be desired more frequently for somedays of weeks before a couple gets back to their average, normal basis.

 

As a matter of fact this desire for intercourse may come in cycles. This same influence of the menstrual cycle creates a desire for intercourse in females. But these cycles are some times of a longer duration in male as well as female. Such longer cycles are prevailent mostly in men and some males feel a little desire for intercourse in such periods. But there is nothing to worry about it as it is very normal. On the other hand desire for multiple orgasm is not uncommon.

 

Some individuals will experience two, three or more orgasms in one period of sexual play female are more prone to desire it. It could be much better if the husband and wife reach orgasm simultaneously. But in cases where it is possible to do so, it is unquestionably a most satis- factory and thrilling experience. At the same time it can be delightful experience of watching the other. If orgasm can bot be attained together, it should be so timed that wife achieves it first, because ejaculation in husband usually brings a rapid subsidence of his erection and capacity to intercourse. Continuation of intercourse for the husband after reaching orgasm may be actually distressing, the sensation in the penis being much too acute.

 

On the other hand, for the wife, the continuance of sexual contact for some minutes after she has attained orgasm may give a continues sensation of pleasure. In the early period of complete sexual contact slow, not too active motion, may be most pleasurable. In the later stages, leading to orgasm, more violent activity for both may be more satisfactory.

 

Always it must be kept under control so that the penis is not completely withdrawn from the vagina or if it is and in some cases complete withdrawal is desired-the positions must be held so that it may be reinserted without difficulty. Nothing must be done which breaks the spell of warm, comfortable joy and satisfaction which should be a part of the experience following intercourse. Where some position in intercourse has been used which permits each to lie quietly and drift off to sleep still in close physical contact, it will be enjoyed by both. In any event it shoud be possible to change position only slightly and then still enjoy the nearness to the other. Points to Remember in Next Article


The Anatomy of Woman Organs

To an anatomist, the reproduc- tive system of women, that makes them very different from men, is a set of organs, all geared to produce the egg and ensure development of the foetus if the egg is fertilised. The primary reproductive organs are the ovaries, a pair of ovoid bodies, about 3.5 cm long, located on either side of the pelvis. The produce the female 'gametes' or the egg and also secrete some important sex hormones. Finger-like projections called the 'fimbriae', partially surrounded the ovary and lead to a narrow canal called the fallopian tubes. About 10 to 12 cm long fallopian tubes open into the uterus, the small 8 cm long muscular sac. The ovaries are loosely attached to the uterus by ligaments. The uterus continues in to a narrow passage known as the cervix, which leads to the vagina, the canal that opens to the exterior.

 

The vaginal opening is posterior to the opening of the urethra (the tube coming from the urinary bladder) and is anterior to the rectum (the terminal part of the intestine). Two fleshy tolds, 'labium minora' and 'labium majora', surround and protect the urethral as well as the vaginal opening. The labium minora and labium majora together with 'clitoris' form the external genitalia of women. All these reproductive organs are well protected by the bony case of the pelvic girdle. Some accessory features of the female body also make it unique.

 

The accessory sex characters that give women a form are the well-developed breasts, a wide pelvis and fat deopsition in certain areas. All these features often aesthetically appreciated, but considered to be secondary, have a definite role to play in a healthy reproductive life. The most striking secondary organ in the woman is the breast. Like in the males, the female breast has pigmented areola surround- ing the nipple. However, unlike the males, both these structures are well developed and the tissue underlying them is made up of circular connective tissue fibres and smooth muscle cells. Supplied with nerves, the breast tissue is sensitive to touch.

 

The dome of the nipple has about fifteen to twenty openings that led to the glandular tissue that produces milk in lactating mothers. The glandular tissue is made up of microscopic structures arranges as bunches of grapes and are called the acini. Ten to a hundred little acini join together to form a structure the 'lobule' while aggregates of lobules are called the 'lobe'. Each mammary gland has fifteen to twenty lobes, each one of the lobes ending as a duct in the nipple. Surrounding this secretory tissue is connective tissue that not only the gland but also lodges the blood vessels that supply the breasts. The breast is an important part of the female anatomy not only because of its glandular function of producing milk but also because of its role in human courtship.

 

More about this later articles ....


How to Maintain An Erotic Marriage

"Hurry!'' Mary Screamed as the medical team rushed into her husband's hospital room. Carl and Mary had brought up children and cats, developed their careers and faced many pressures. But they had never considered a premature end to their life together. "Please hurry!'' Mary yelled again, scanning the bedside monitor for any sign of life. She prayed for just one more chance to love and hold Carl again. Perhaps too late, she realized thier marriage was the only thing in her life with meaning.

 

Now there was no time left. As the medical team worked, the monitor began to show sharp steady- peaks-life had returned. Mary stood motionless, tears in her eyes. "Another chance'', she said softly. "I will never take us for granted again. We will be first, not some afterthought, some social convenience, a pair of people who happed to be together.'' She embraced her husbang and together they cried. Until this moment, Mary and Carl had forgotten to share loving- together, not just living-together. They had forgotten to touch each other, to nurture sexuality and intimacy. They had never enabled their marriage to grwo into something special but had allowed it to become de-eroticized. Through my clinical and counselling work with 1,000 couples. I have developed a system for super marital sex.

 

Most of it concerns marriage of minds and not the connection of bodies - but if the first is achieved, the other will follow. I conducted personal interviews with each husband and wife and the couple together. There were treatment sessions for sexual problems, and five-year follow-up interviews. Here are some of the coments from these couples : "It;s funny how they say that you 'get married'. I mean, you really don't 'get' it, you have to learn to 'do'it. And learning to do it has been the most difficult thing I have ever tried. We never did learn the sex part.''

 

Rule One : Recognize that super sex in marriage is not something you "get'' for nothing. It's something you have to earn over time, by sharing dreams and paying attention to each other more than the job. Sex is more a matter of priorities than genitals. I have tried for years to make our marriage one long affair. We, you know what? She ended up having an affair, all right, but not with me.''

 

 

Rule Two : Never try to make your marriage an affair. Affairs are short, intense, immature imitations of a love that is only possible in lasting, mature relationships. Supeer marital sex depends on making the entire marriage sexual, not separating sex into a category on obligatory marital duty. Mechanically seperating sex from marital love results in a form of "extramarital'' affair within the marriage rather than an "intramarital'' intimacy. Sex with a person other than your spouse has received good coverage. Of the couples I have treated, more than 70 percent of husbands and 40 percent of wives report sex outside their marriages. But seldom do you read that extramarital sex falls short of the intimacy and fulfilment available within marriage. Super marital sex is developed not by variety adventure, mystery and treating marriage as an affair, but by learning the relationship of sexuality to lasting, comforting, fulfilling love.

"I get up. He gets up. I eat. He eats. The kids eat. He leaves. I leave. Reverse it at night. That's it. Welcome to the world of our marriage.

 

Rule Three : Anypary of the marriage this is ignored will disappear-particularly sex. For most couples, the amount of enjoyment they derive from their sexual relationship corresponds with the amount of attention they pay to it. Super sex also depends upon accepting the erotic cycle that emerges between two persons over time. Having sex every Saturday, for instance may be taking advantage of one of your mutual marital cycle days for sexuality, and not a sign of boredom at all. These cycles evolve when partners tune in to each other. All things in life afe cyclical, and super sex results from awareness of, communication about, adn learning from these cycles so that changes can be made together. Take a good "look'' at your marriage. Do you remember why you married this person in the first place? Recall all that has heppened to you together, and what might happen in the future? Try to find excitement from within the marriage itself, the unique combination of the two of you. Cherishing this sense of familiarity will pay a powerful sexual return.

 

"I'd say we sepnd about ten minutes together alone per day. When we finally get to bed for the night, we are too tired to do much'' Another 5 Rules in next Article


Points To Remember In Art Of Intercourse

1. To a certain extent, all newly- weds are sexually more like reechorses than like husband- wife in true sense. They respond violently, but not necessarily in the right direction, to even slight stimulation. Such acts can make a young husband "go off'' before commencing intercourse from forms of play which an old husband almost requires in order to sustain erection. It can cause a young wife's vagina into painful, intercourse-interrupting sparms from degress of roughness. It makes most young couples jittery in future sex relationship and their area of sexual pleasure is completely limited.

2. Changes in the female organs :- The loosening-up of a woman's vagina continues for a considerable period after the honeymoon. Childbirth brings still further changes, and some slight alteration continues through the years. One may, find sex positions in which the penis penetrates at an angle instead of being lined up with the vaginal vault quite comfortable today, even if they caused sex disrupting pain last time.

 

 

In the sme way certain other positions which can tighten the vagina lips, either through the pressure of internal organs upon its exteriors or through changed muscle tone in the vicinity, may prove difficult or unsatisfactory during the early years, but quite gratifying later in the married life. The most notable of these is the wife-on-her-back-with-legs-straight-and-together postures, which most couples disregard an useless or uncomfortable during early sexual explorations, but which often proves the most satisfying posture of all after repeated childbirth has stretched the vagina.

3. Changes in Sexual Sensitivity :- At the start of married life virtually all of a woman's sexual sensitivity centres in the clitoris. Removal of this organ before satisfactory sexual adjustment leaves a woman totally incapable of ever enjoying orgasm. However, other centres of sexual sensitivity quickly come into play with satisfactory sexual experience, so that removal of the clitoris after a year or more of sexually compatible marriage does not interfere in the least with feminine gratification. In the first few years of marriage most women prefer positions and manoeuvres which stimulate the front  corner' of the female opening, (where the clitoris is located) and get little or no stimulation from positions and manoeuvres which titillate the deeper nerve centres on the vagina's front surface or the back ruin of the vaginal opening. A wife's negative response to such techniques gradually discourages their use, and often they go into a passionate ecstacy before development of the responses which make them exquisitely helpful in the later years of marriage

4. Improved Sexual Skills and Response Patterns :-
Anu husband or wife who makes a sincere effort to please his or her partner soon learns a few favourite caresses or positions, finds it out how long preliminaries have to last before the vagina becomes relaxed and moist, and so forth. These basic skills help one to avoid errors and let you tread closer to the mark than was possible in the early days of marriage. Moreover, sexual excitement springs at least partly from conditioned reflex, and the familiar surroundings, overtures, and stimulations of married sex can actually stir sexual excitement. This can go as far as one keeps the sex life sufficiently varied to avoid the catastrophe of boredom. It has been proved that conditioned response plays a big part in sexual excitement.


The Cellular Architecture

While the anatomists describe an over- view of the reproductive system, histologists and cell biologists probe a little further. Organs can be
studied in detail for their cellular architecture by removing them from
the body and processing them further. In human beings, tissues are
obtained by an autopsy or by a biopsy done under special circum-stances.

 

Following a standard protocol the tissues are cut into fine slices, stained and visualised through a microscope. Such a processing and study of the human ovary provides an insight into its structural organisation. Heriphilus of Alexandra in 300 B.C. for the first time described the ovary. Its function could be ascertained only in the 19th century, after the egg as a cell was identified. Much before the histologists tackled it, Regnio de Graaf, a Dutch anatomist, in 1670 suggested that the egg was produced in the ovary and to honout him, the follicle that released the egg is called the "Graafian follicle'.

 

Graaf, however, thought that the follicle itself was the egg. Much later in 1825, van Baer, another scientist, described the ovarian follicle correctly. We now know that the human ovary is a collection of 'follicles'. strewed in stromal tissue, enclosed in the ovarian capsule. At any time in the adult woman, the ovary has follicles (S) in different stages of development. In general, a follicle is a group of organised cells surrounding the developing gamete, the egg cell or the ovum. The inndr layers of cells that nurse the egg are celled the franulosa cells. Both thecal cells as well as ranulosa cells secrete hormones.

 

A mature follicle (L) is much larger than immature ones and has typical fluid-filled cavity, called the antrum. Some follicles fail to mature or ovulate and degenerate within the ovary. Such follicles mature completely and ovulate. With the release of the ovum, the empty shell of the follicle regresses and forms a tissue that secretes hormones for a short time. This tissue is called the corpus luteum, literally meaning 'yellow tissue' and can be seen from the surface of the ovary. If no pregnancy takes place the corpus luteum disappears and leaves behing a scar. To a trained eye all these stages of the follicles are easily visible in a section of the human ovary.


How to Maintain An Erotic Marriage

Rule Four :

The marriage comes first. All other people and events come after the marriage. Children, parents, work and play all benefit most by marital priority instead of marital sacrifice because the marriage is the central unit. The stronger that unit, the stronger the rest of the system. If it is true we reap with we sow, then marriages are in big trouble. If we put as little time into our work as we allow for our loving, we could end up unemployed. A test of more than 5,000 couples in my clinic showed that of available time left to a couple after work, sleep and other constants, less than one per cent of it was spent together.
"I Don't remember how it was before we had kids. They seem to be everything now''

Rule Five :

The kids do not come first! Kids are the best and the worst thing that happens to a marriage. Kid priority can overburden marri- age, resulting in doing for, ins- tead of with, children, applauding only them instead of each other. Until we learn that children are not special, but equal in impor- tance to all of us, we sacrifice our marriage. After all, wasn't one of your greatest wishes that your own parents would be happy? Think of giving that gift to your children.
"We just seem to be out of step. We can't get together on anything, especially our sex life.''

Rule Six :

Use the LOVE technique - listen, observe, verify, empathize. Practise on your spouse at least once a day. Send and receive messages with an emphasis on learning and listening, an emphasis on watching your partner while he or she talks. Employ the technique when important issues are being discussed, trying to get the feeling, not just the words of what your partner is saying.

 

 

"Happiness is when the last child leaves''

Rule Seven :

Better now than never. The super sex marriage is based more on doing than intending. We always seem to be waiting for the time when the ceiling is painted, the kids are well behaved and the account balances. That time will never come. I notice that my couples state this phenomenon in "threes,'' that is, we will make love when 1) the kids are asleep, 2) we are ready for bed, and 3) there is nothing left to do. Not likely! we do not have to live as though there is no tomorrow, but we had better love creatively as though there is only now.
"Just when I got established in my career, he decided to change his. Now he works longer hours, I work, and neither of us wants children. We just don't match up right.''

Rule Eight :

Except constant change. We assume that life's passages will be encountered by each of us at the same time. It just does not work that way. I tell my couples, "Never divorce someone you don't know.'' We must learn to remarry a different and changing person several times during marriage. We should use change to sculpt our existing marriage as an everchanging artwork. The solutions to marital problems are invariably found within each marriage. If I learnt anything from observing these couples and hundreds of others in my clinical experience, it is that marriage has been corrupted by the unquestioned acceptance of the "sexperts.''


Intercourse Hygiene

Sex hygiene should not be confined to married people but is also necessary for adolescents. Neverthless, parents have often refused to draw the attention of their children to such knowledge. Some think only professional women wash their organs carefully. This should not be so. Some claim that washing the organ will stimulate the sensitive parts and may lead yound people to auto-erotism. But this is a superficial view. Auto-erotism is acquired through other causes. In most Japanese men, the penis is fully enveloped in the foreskin until puberty. Later as the penis develops and expands, the foreskin ratracts naturally and the penis head is exposed at all times. If the foreskin is too long, however, the head will remain covered.

And if this state persists long after puberty, a soft, fatty matter called smegma accumulates under the foreskin, and mixed with drops of urine and semen, causes inflammation, which results in irritagion and may even lead some young men to constant auto-erotism. Thus, it is important to keep the penis head, or glans, exposed after puberty, for it not only prevents inflammation but also benumbs the highly sensitive glans with constant friction with clothing, preventing premature ejaculation in sexual intercourse.

 

For reasons of sanitation and preparation for later coitus, young men should form the habit of pushing back the foreskin to accustom the glans to exposure and to remove the accumulated smegma. If the foreskin is too long to permit glans exposure even at erection, a circumcision is necessary. The covered glans not only breeds smegma but reduces sensitivity in sexual intercourse, and delays ejaculation.


In women, too, smegma collects between the clitoris head and prepuce. Female secretion, in most cases, is more profuse than in the male. The secretion, containing caprylic acid, originally has a pleasant smell but as it decomposes it excudes an offensive odour resembling that of spoiled cheese. The clitoris is far smaller than the male glans and is normally covered with a foreskin, so that even after marriage it easily gathers smegma. Smegma also accumulates in the grooves between the prepuce and the large lips and farther below between the smaller and larger lips.

 

The secretion, with its special pleasant smell while it is fresh, can excite the male sexually but produces an unplesant sensa- tion when it collects into a visible, yellowish-white matter which in extreme cases may even discourage the male from his sexual excitation. Women must remember that their organs can be contaminated by urine and menstrual discharge, more easily than the male organs are. The female is more suceptible than the male to inflammation and irritation.
Men and women who are unable to take a bath often enough should clean their sex organs with a wet cotton pad after going to the toilet, young men should clean their penis once in a week or until the foreskin is completely drawn back, while young women should clean their genital parts atleast once in five days. After marriage, however, both husband and wife should clean their sex organs every night before retiring.


The Biochemistry of Women Reproductive System

Closely linked to the follicular maturation and ovulation is the story that psysiologists and biochemists have to tell. The chemistry of the female re- productive tract has been worked out painstakingly over the years. Clinicians, bio- chemists, endocrinologists, biologists and scientists from other disciplines as well have contributed to our knowledge on female reproduction. They have worked on model animals like the mouse, rat, sheep, a variety of primates and on human volunteers and patients. Over the years chemical explanations to what happens during the female reproductive cycle has emerged. An interplay of endocrine factors (secretions of the ductless glands that act long distances on various tissues), paracrine factors (secretions of cells that act on other neighbouring cells) and autocrine factors (secretions of cells that act on themselves) runs the reproductive system.
To put it very simply, the hypo- thalamus, the pituitary and the ovary essentially regulate the reproductive function. The hypo- thalamus is a collection of nerve cell bodies that make and secrete the hormone that triggersthe system. The secretion is a protein called gonodatropin releasing hormone (GnRH) and as the name suggests, causes the release of gonadotropins from the pituitary. The pituitary gland, is connected to it by a local, portal circulation, reaches the pituitary and induces it to release two major gonadotropins - luteinising hormone (LH) and follicle stimulation hormone (FSH). It is possible to measure the levels of these hormones in the blood to measure the levels of these hormones in the blood of women through laboratory tests.
The concentrations of these hormones show typical fluctua- tions throughout the reproductive cycle. A disturbance in their levels may jeopardise the normal function of the system. The pituitary gland, the master endocrine gland, is responsible for a majority of other physiological functions as well. However, only the anterior lobe of the pituitary specialises in secreting the gonadotropins. This part of the gland has special cells called the gonadotropin cells. These cells carry receptors to which GnRH can bind and stimulate the sunthesis of the gonadotropins.

 

The gonadotropins are released in to the blood and travel through the ovarian bloodstream to its tissues. LH binds its receptors on the theca cells to stimulate the production of androgens (interestingly, these are the male sed hormones!). FSH, on the other hand, binds to its receptors on the granulosa cells and induces the cells to produce a set of enzymes that convert the androgens to estradiol, the female sex hormone. Two other hormones, progesterone and inhibin, are also produced by granulosa cells. Progesterone is produced initially by the action of FSH on the granulosa cells, which are later augmented by the binding of LH to the cells. Inhibin, secreted by the ovary, suppresses the pituitary FSH.


Why Don't I Enjoy Intercourse More?

A troubling sexual complaint is what therapists call inhibited sexual desire, or sexual apathy. Many people - especially women - say that their desire for sex is sporadic, negligible or downright non-existent. Unlike performance problems, which are often solved quite simply, therapists find that sexual apathy can be devilishly complex. How do you rekindle someone's deisre for sex? And what is "normal'' desire anyway? The only useful standard is personal: how often do I want sex? And how does my desire mesh with my mate's? There is no single answer, only individual solutions to individual problems. But lost desire is not a lost cause, declares American sex therapist, who says he has helped 80 percent of the couples who have come to him with desire porblems. "Perhaps the clue,'' he says, "is something Dr. William Masters [of the Masters & Johnson Institute] once told me: 'Lack of desire is the only sex problem that can be cured just by offering people an idea.'''
Here are some clues as to where your lost desire may have gone, and how to get it back.

Clue One : Have you been under stress?

"Work stress is one of the major causes of dampened sexual interest,'' says a San Francisco psychologist and author. Men often think of sex as fun or relaxation, but most women regard it as an activity that requires them to be at their best. Chronic fatigue and emotional depletion can rob women of the surplus energy they think they need for making love. Many couples have buried their sexual desire under a mountain of hampedring obligations. "They're so conscientious and bust that they don't schedule sex when they need to,'' says psychiatrist. And they do need to, she emphasizes. It is a common mistake to think sex will happen spontaneously and then to leave no time for it to happen at all. Once couples do set aside time, they may discover that there is desirre after all.
Another sort of stress is experienced by women who have never had an orgasm. "A woman who is constantly struggling to get excited, only to be frustrated, may adapt by losing interest,'' says sex therapist. According to therapist much - if not all - of the stress experienced by a woman with low desire arises from thinking of sex as a command performance. "All the other causes are secondary to the pressure she feels to get 'turned on''' he says. "Typically, a woman feels she must respond in order to exite her partner.'' But therapist counsels any woman who feels this way that "sex isn't a performance - in fact, it can be a way for her to be indulged and babied.''

Clue Two :Is your timing out of sync?

Many men like morning sex, says Dr. Offit. Many women don't. The difference, is partly learned, partly biological and frequentlyu a source of women's sexual apathy. Men often experience a morning erection upon awaken- ing. Some see this as "a call to action,'' as Offit puts it. But women have no obvious pattern of early-morning activity, and many regard the early hours are unsexy. "Romance is candle-light, perfume, a walk under the moon,'' Offit writes. "Morning belongs to children and chores.

 

Not necessarily. Morning can have a lazy sensuality all their own, and sex at dawn can be natural extension of a pleasant, dream-filled sleep. Dr. Offit suggests setting the stage on a week-end, with the children at Grandma's or friend's house. Sometimes night-time sex is problem. "When a woman says not at the end of the day,'' says sexologist. "She may be saying that dinner's over, the kids are in bed and now she wants some time to herself.'' Behind a couple's conflicts over "when we do it'' lurks another timing problem. "The one who initiates sex is often ahead of the other in terms of arousal and interest,'' maintains. "When the man is always the initiator, the woman may never be given enough time to develop desire'' Instead of being concerned about "rubbing the right places,'' says,  we need to focus more on synchronizing arousal.

Some More Clues in Next Article


The Years Of Transformation

Would you like to travel back in time, back to those days of idyllic adolescence, of innocence? Few of us would answer this question with a spointaneous and enthu- siastic 'yes'. Most of us would hesitate, for these years have been trying for a majority of us. The adult would is beckoning and yet is out of reach and childhood is but over. The rapid physical changes are psychologically overwhelming. Girls find themselves in an alarming situation. Reorienting to the world them and meeting the challenges of growing up would be easier if adolescence is seen as a continuation of an ongoing process of living as a woman that started at conception. Informing girls about all that happens to them as they make a transition into womanhood may prepare them to face the adult world with confidence. We hope to do exactly this by describing here the physiology of growing up.

The word 'puberty' is derived from the Latin word pubertas, meaning 'adult stage'. In young girls it refers to the onset of 'vaginal bleeding at definite intervals', known as 'menstrua- tion'. The first menstruation occurs well after other signs of puberty have appeared and is called 'manarche'. Puberty is thought to be the phase during which the individual acquires sexual maturity. However, the beginning of the menstrual cycles does not indicate an ability to conceive a baby. There is a time lag between menarche and fertility. Menstruation in most girls starts before the ovaries are ready to release the ova. This time lag is variable and is often related to the general growth in girls. This means that for fertility not only must the reproductive system be competent but other systems too must mature.

Normal Puberty :-

The progression through normal puberty involves a general spurt in growth. The secondary sexual characteristics become pronoun- ced. The cardiovascular system changes with an increase in size and weight of heart and lungs. The body muscles strengthen. Metabolism is moudlated to meet new energy demands. Puberty has a range of effects-physical as well as psychological-taking place simultaneously and in a relatively short time-frame. This time indeed is demanding yet exhilarating, for metaphorically 'spring is in the air'.
Each one of us pregresses into adulthood at different ages and at different pace. This is because a large number of factors control the exact time and rate of pubertal changes. In terms of chemistry, the end of childhood is mrked by the reactivation of the pulsatile secretion of gonadotropin releasing hormone (GnRH). The hypothalamus-pituitary-gonadal axis that was operative when the foetal ovaries were formed and had settled down to a quiescent phase at about two years after birth, is active once more. The reactivation of these endocrine functions is routed through the central nervous system, the brain and the spinal cord.
As we grow, a little late in our childhood, our perceptions of the world around us change. This conscious awareness of our environment triggers changes leading to puberty. Though it is difficult to pinpoint what exactly triggers the central nervous system, it is the environment and our response to it which decide the exact time of puberty. We seem to grow up when we think we are grownups!


PHYSICAL AIDS TO RESPONSIVENESS IN ART OF INTERCOURSE

A woman who feels rested, relaxed and cheerful generally responds much more keenly to her husband's sexual overtures than on who feels weary, tense or 'blue'. You don't have to take an expensive trip to enjoy
atleast part of this benefit, however. Simply physical measures you can
take right at home generally make you more rested, relaxed, and
cheerful, and in the process aid you in attaining a keenly responsive sexualstate.


Combating physical fatigue :-

A strong preference for 'sex in the morning' usually shows that you respond better after rest. Preference for positions in which you cannot move or take very active part, such as those in which you lie on your side and your husband approaches from the rear, usually point to continual physical fatigue. Muscle cramps during intercourse of muscular soreness and aching which disturb later sleep also point in this direction.
If these signs suggest a physical rather than a nervous or emotional basis for sex-impairing tiredness, you might try these steps :

1. Save energy during the day by sitting on a high stool in the kitchen, rearranging household work to make the most of each trip up and down the stairs, etc.
2. Try an early afternoon nap each day before the frantic meal preparation period begins.
3. Take a long, soaking bath, read in bed, lie down while listening to your favourite records, or follow some other restful pre-bedtime routine instead of trying to keep yourself going through the excitements or other stimulation. Unless you actually fall asleep, drowsiness generally interferes less with sexual response than the nervour fatigue you generate through.


The Menstrual Cycle

What do all these hormones actually do? This can be appreciated better when linked to the reproductive cycle. An adult woman has vaginal bleeding once every twenty-eight to thirty-one days. This bleeding, called menstruation, has been conventionaly thought to mark the beginning of the menstrual cycle. Menstruation, normally, lasts for three to five days. The time till the next menstruation is further divided into two time-frames. This division is based on a single event-ovulation-that takes place ata about mid cycle. The time before ovulation is called the follicular phase and the time before ovulation is called the follicular phase and the time after is called the luteal phase of the cycle.

 

This nomenclature of the phases of the cycle. This nomenclature of the phases of the cycle has built up over time, as we came to understand more about the ovarian physiology. If blood samplem from a normal woman are taken every day through the cycle and the concentration of various hormones in blood is estimated, they show a distinct pattern in each of the phases. Correspondingly the ovary, the uterus and other accessory organs are altered in their fine structure. All these cyclic changes are tuned to support maturation of follicles, release of the ovum and its implantation, if fertilised. A closer look would reveal how this is accomplished.

 

A single pulse of GnRH from the hypothalamus throughout the cycle provides the trigger to maintain the hormonal stimula- tion. A slow build up of LH and FSH concentration takes place in the follicular phase. In the ovary, this causes recruitment of a number of follicles into developmental phase. A cohort of follicles, all differentially responsive to hormonal stimulation, start to mature.

 

The immature follicle, comprising a set of cells surrounding the ovum, grows in size as the cells divide. The cell layer strengthens and the granulosa cells become multi-layered. A protective layer of viscous mucus-like substance, called the zona pellucida, is added to the ovum. Media,-sized follicles, called the secondary follicles, respond to gonadotropins by synthesising estradiol.

 

Sustained levels of LH and FSH in the early follicular phase of the cycle ensure an adequate build- up of estradiol. Estradiol is an interesting hormone, for not only does it act on the ovarian tissue itself, but also affects the secre- tions of the hypothalamus. High circulating levels of estradiol have a negative effect on release of GnRH and in turn, the release of LH and FSH from the pituitary is also affected. A fall in gonadotropins, however, also results in decreasing levels of estradiol. Low estradiol sets the hypothalamus free of the inhibitory signals and GnRH levels can rebuild. Like a thermostat that does not permit an overshoot of temperature, an overshoot of hormonal levels is prevented by the hypothalamic-pituitary-gonodal axis. This excellent homeostatic mechanish, evolved to keep excesses in check, collapses only briefly. And this is what triggers ovulation!

Some More Points in Next Article


Clues For ... Why Don't I Enjoy Intercourse More?

Clue Three :
What's going on between you?

Many cases of low sexual desire can be traced to other problems, often non-sexual, within a couple's relationship. But some- times it's just a matter of desire discrepancey. It is not that there's some absolute scale of desire and he registers too much and she registers too little. Rather, there is a difference in styles or interests, just as there may be disagreement about how to raise children.

 

 

Marc, 29, wanted to make love "at the drop of a hat,'' complained Sharon, 25, his wife of two uears. Sharon was quite satisfied with once a week. Who had the desire problem? It would be wrong to describe Sharon as deficient in desire, says Carol Ellison. In her view, Marc used sex as the only means of addressing feelings such as restlessness, alienation, boredom and affection. What he needed was to find additional ways of expressing those feelings.
Sharon, on the other hand, needed to become more aware of sexual cues and how she responded to them. In the therapy she learnt to become aware of any feelings of tension or restlessness and to notice if such feelings might be associated with sexual arousal. Sometimes, it turned out, she was aroused without even knowing it.

Holly, 28, had stayed home for four years with her two small children. She and her husband, Brian, also 28, had not made love for six months, a situation that Holly considered frightening and 'abnormal''. Yet Carol Ellison thought that Holly's probelm had nothing to do with sex. "Holly saw herself as and educated person who should have had a career. She felt ashamed that she wasn't out working. She refused to have sex because she feared she'd lose that small sense of self she still had.''

To bolster Holly's self-esteem, Ellison recommended that she start working part time and she and Brain become more intimate in other ways, enjoying common interests and acting more affectionately.  Adds Bernard : "people are entitled to have various emotions during a sexual encounter - and that includes feeling depressed, threatened or angry. "If you suppress or ignore these feelings, you may very well be increasing your sexual apathy - because you will be turned off by the situation and produced them. Once you stop feeling pressured to be turned on, you can accept the way you really feel.
Bernard recommends "giving yourseld premission to discuss guilt or anxiety about negative feeling experienced durin a sexual encounter with your partner,'' This can open a dialogue, something that's all too frequently missing in the marriage bed. "This kind of conversation doesn't necessarily end a sexual encounter,'' Bernard emphasizes. "IN fact, it may help it to begin.''

Clue Four :
What's in a pill?

Many prescription drugs are suspected of lessning desire. The list includes sedatives, blood-pressure medications, and relaxants such as Valium. Chronic use of cocaine, marijuana or alcohol may also diminish desire. Can pills cure sexually apathy as well as cause it? Lately, certain vitamins and minerals have been promoted as aphorodisiacs, but there is little scientific evidence to substantiate these claims. The same also holds true of hormone treatments for physiologically normal individuals.

 

The exact relationship between hormone production and desire is subtle, and unclear to scientists.Whatever its cause, lack of desire is often temporary. It can pass when a specific cause - such as grief or anger - fades away, or when you find a remedy on your own. But when a problem is chronic, or affects your marriage, then you may need to see a therapist. "People used to think they had to have a performance problem to consider therapy,'' says Bernard. "But more and more people are turning to professional help for desire problems too.'' And breaking the sexual-apathy pattern, he notes, does not necessarily require prolonged counselling.


Combating nervous fatigue or tension

Have you ever felt 'too tired to do anything but sit' after supper, then been invited to an evening out and regained your energy in an instant? Almost everyone has had this experience often enough to know that most fatigue is compounded out of boredom, nervous tension, and emotional letdown at least as often as it stems from physical overwork. You can combat the 'tension' portion of this recipe quite readily with the programme outlined in the following paragraphs.

 

Learning to relax :- All nervous tension has a muscular element, the control of which helps your nervous and emotional as well as your physical state. You cannot command your, whole body to relax at one time, but you can easily learn to relax one or two muscle groups at once. When you have learned the simple procedure, you can quickly relieve accumulated muscle tension at almost any time. In the process you will keep both nervous and muscular tension from building up, and maintain a much more emotionally responsive state. Lie down in a quiet, darkened room. Hold your neck muscles slightly stiff, moderately stiff, quite stiff, then as stiff as you can make them. Now move backwards along the same scale, from totally stiff to quite stiff, to moderately still, to slightly stiff, to normal - and then one more step in the same direction, towards looseness and relaxation beyond the original base level. Go through this routine three or four times; until you definetely 'get the feel of it' and can relax your neck muscles at will.

 

Now you are ready to relax other parts of your body. Relax your right arm, your right leg, your left leg, your left arm, your scalp, your face, your neck, your back and your tummy muscles. This order- around the clock, then top to bottom - is easy to remember. Do not strive for maximum relaxation of each part: you will relax more throughly in a given length of time by focussing your attention on each part only long enough to loosen its musculature through a single 'ralaxation command', then shifting your attention to the next body part. After three or four 'go-rounds' you will find yourself drifting into a state of highly restful calm which you can easily maintain for sometime.
When you first try-part-by-part relaxation, twenty-minute rest breaks in quiet bedroom work best. After a few weeks, howeverm you will become good enough at relaxing muscle groups that isolation and quiet are no longer necessary. You can sit in straight chair with both feet flat on the floor, place your hands in your lap, let your head loll forward, and relax muscle groups in rotation just as if you were in bed. Even when children are playing in the vicinity or dinner is cooking on a nearby stove, you will find that you can readily relax. After two or three 'go-rounds' lift one hand up to shoulder height and let it fall back into your lap like a limp dishrag. Do the same with the other hand. Then resume part-by-part relaxation, perhaps for two to three minutes. Such brief 'refresher slouches' will definitely help to keep tension from building up, often with startling effects on your disposition, level of contentment, and sexual responsiveness.

 

A few more weeks of practise will improve your ability to relax to the point where a set position and chair-to-bed-supported posture are no longer entirely necessary. Whatever you become conscious of muscular tension you will be able to relax it without interrupting your activities. Part by part relaxation during rest breaks, and in times of stress help to keep nervous tension from building up, and make you more receptive and responsive to your husband's later advances. You can also use deliberate relaxation to relieve certain specific sexual problems, as follows :
A great many women find their responsiveness greatly impeded if they know ahead of time where and when sexual relations are going to occur. They hurry with increasing tension as the crucial moment approaches, until they feel too tired up to respond. If you find this happening to you, just get into bed a few moments early, and try part-by-part relaxation while your husband finished his toilet. Even a minute or two will usually restore your responsiveness if you have learned to control muscle tension thoroughly.


Don't Let These Intercourse Myths Ruin Your Marriage

Despite all that has been written and said about sex, misinforma- tion on the subject is still a major cause of problems between husbands and wives. Twenty- four years ago, in their landmark book, Human Sexual Response, Dr. William Masters and Virginia Johnson exploded commonly held beliefs and made known new facts that enabled many men and women to understand and feel more comfortable about their sexuality. At the time, it was believed that research would usher in a new age in which openness about sex would replace secrecy and ignorance. Yet, today, Masters Jonsson continue to find widely believed misinformation that can damage even happy marriages.

Myth : Women are less interested in sex than men are ...

Given good health and enough time and energy, women can equal or even exceed men in their desire for sex.
Why then is this myth to pervasive? Traditionally, boys and girls have been taught to conform to certain gender roles : girls to be demure and passive, boys to be more aggressive. While that may be changing in today's society, many adult women still feel they should be passive and give less expression to their sexual feelings.

Myth : The harder you focus on your sexual performance, the better it will be ...

There is nothing further from the truth. If you're preoccupied thinking about how you should be moving, where you should be touching, what your partner is experiencing, you will feel little yourself. The best sex, say Masters and Johnson, occurs when you just let things happen and forget about analysing your performance.

Myth : Sex gets boring with the same partner year after year ...

Masters and Johnson believe that there can be good and en- during sex with a lifelong partner. Sexual boredom is frequently the result of not knowing your mate well enough, or investing too little to yourself in the relation- ship. To maintain freshness, both partners may want to try being more adventuresome, some creative and more playful in their lovemaking.

Myth : Good sex happens when you take responsibility for your partner's pleasure ...

"Sex,'' Masters and Johnson point out, "is something two people do with each other. You can't be totally responsible for another person's satisfaction. But, they add, you can heighten your partner's pleasure by responding to the needs he or she communicates to you.

Myth : Men hit their sexual peak at 18 and then go downhill ...

Testosterone, the male hormone that influences sexual excitement, is usually at peak production around the age of 18. However, a man's sexuality doesn't depend on physiology alone. How he feels about himself, his partner and sex in general influences how efficently his body responds to stimulation.
Thus, the older man who is in good health, understands his sexuality and has an interest partner may heve a greater capacity for intimate sensual expression than an 18-year old who tends to focus on sex merely as a physical act.

Myth : Independent, aggressive women make men impotent ...

For the most part, women do not cause impotence in men. A man's impotence has more to do with his own insecurities. But from the male point of vies, the most stimulating partner is one who is sexually involved. The woman who is more apt to contribute to a man's impotence is the dependent one who does nothing sexually for herself or for him other than to be available.

Myth : Sex Should always be a passionate, physical and emotional communion between two people ...

Only a fiction is sex always that way. In real life, it's wild, mild, a peak experience, a hand-holding comfort; it's good, bad and all points in between.
"Making the goal of sex a total emotional communion is, in itself, a distraction,'' says Masters and Johnson. "It can almost guarantee that that kind of experience will not happen.''

Myth : Sex should always be spontaneous ...

Many couple are now discovering that today's busy schedules allow almost no time for lovemaking. "If you always insist on being spontaneous,'' Masters and Johnson point out, "chances are you'll find your sex life dwindling to nothing''


Don't plan sex: that's too contrived. But plan time to be together. Then just let the good times happen.


Emotion-damping twinges

Emotion-damping twinges :

In the early phase of intercourse or during shifts of position, your husband's penis will occasionally cause an abrupt twinge of dis- comfort either by striking some tender struc- ture or by pulling an unlubricated tissue fold. Such a twinge does not amount to much in itself, but often stirs sufficient fear of further discomfort to dampen proper response for the rest of the episode. The next time this happens, pause briefly and try part-by-part relation without interrupting sex contract. If you can relieve developing tension, you will usually be able to proceed without losing ground. In fact; whenever 'something goes wrong' during intercourse, part-by-part relaxation keeps tension from building up and adding to the original problem. Just ask your partner to 'take it easy' for a few moments until you can get 'with him' again, and relax part-by-part for half a minute or so.

Left hanging : - If you fail to have a satisfying climax after becoming substantially aroused, your unreguited excitement leaves you hanging fairly close to climax, your husband can easily restore your emotional comfort by stimulating your genitals until you reach orgasm. If you are 'left hanging' without being quite that far along, part-by-part relaxation will often make you 'all right' without the need for one-sided caress.

Combating blue moods of depression :-

Most people get blue for a variety of reasons, many of them impossible to identify. Extremes of depression - crying when alone, feeling of guilt or futility, loss of appetite, constipation, and disturbed sleep - always deserves a doctor's care. Milder spells of 'the blues' often respond to home measures. Most people have found several effective ways to cheer themselves up when they feel blue. If you can get your husband to buy you a dinner at your favourite restaurant or give you the go ahead on a shopping spree, more power to you! But if you can't, or if you need a bit of help more often than such special events can be arranged. You'll find them quite effective in restoring a cheerful mood (and the emotional responsiveness that goes with it), and can enjoy full benefits three or four times a week without doing yourself the least harm.

Sex Organ Preparation :-

Most wives leave the issue of artificial lubrication entirely in their husband's hands. A woman cannot pause to lubricate after sex play begins, and never knows exactly when her husband will initiate such action. However, the wife should take action in this respect under the following circumstances :

1. If birth-control measures, feminine hygiene preparations or medications prove excessively lubricating, try to find less slippery substitutes. When sexual excitement builds satisfactions through the early stages of intercourse, but the final push to climax proves somewhat disappointing (usually for both partners), suspect excessive lubrication.

2. If surface soreness becomes a problem during a period of unusual sexual activity apply a little jelly, available in most chemists without a prescription, just before commencing sex play. This soothes raw surface nerves without affecting those involved in building sexual excitement and causing a climax.

3. If natural lubricating secretions fail to moisten female organ surface sufficiently for comfortable sexual entrance, jelly, give lubrication plus decreased surface sensitivity. If your apply it before commencing sex play, the active ingredients will soak in before intercourse actually begins and your partner's sensitivity will not be affected.
In marriage, sex is part and parcel of your love. It symbolizes and constantly refurbishes your union. But this inter-weaving of physical communion with interpersonal relationship is a two-wqay street : mixed up attitudes or lingering doubts about your love or about the propriety of its ultimate physical expression can definitely disturb your responsiveness. Reviesing your attitudes on these points often helps to bring out into the open and resolve lingering doubts, fears, and misconceptions, and often proves a real aid to improve feminine nature.


The Menstrual Cycle

Towards the end of the follicular phase of the cycle as the estra- diol builds up, the pituitary res- ponds in a peculiar way. The negative control due to the high levels of estradiol is overcome and a single spurt of LH and FSH is released from the pituitary. This sudden and dramatic elevation of LH is most significant for ovulation and is referred to as the pre-ovulatory LH surge. It is a chemical signal for the follicle to rupture and release the ovum. The LH surge causes a sudden increase in the size of the fluid-filled antrum in the follicle, ready for ovulation. Enzymes that break the barriers of the ovarian wall are released and the ovum is set free into the abdominal cavity.

It can now be appreciated why the pre-ovulatory days of the cycle constitute the follicular phase. Several maturing follicles can be observed in the ovary in this period. During this phase the uterus too undergoes typical changes. The innermost wall of the uterus, called the endo- metrium, thickens. From the fifth to about fourteenth day of the cycle the endometrium is supplied with increasing amounts of blood. Two types of arteries supply the uterus. Long, coiled, spiral arteries supply the superficial layer and the short, basilar arteries supply the basal layer. The blood supply builds up, more arteries are formed, specially in the superficial layers. At menstruation it is the superficial arteries that are shed and cause the blood to flow.

Ovulation marks the beginning of the second phase of the cycle, the luteal phase. In the ovary, the ruptured follicle that has just released the egg heals and its cells change their characters. They form the 'corpus luteum', a tissue supported by the luteinising hormone. That is why LH is called 'luteinising' and this phase of the cycle is called the 'luteal' phase. Bothe estrogen and projesterone continue to be secreted in fair amounts. The corpus luteum is short lived in absence of pregnancy and soon forms a scar tissue. The levels of oestrogen and progesterone in the blood taper off. The luteal phase is also marked by high levels of a protein hormone, inhibin. Together with progesterone, inhibin sends signals to the pituitary to stop producing the gonadotropins. Both progesterone and inhibin levels in the blood are high in women during the luteal phase. Towards the end of the cycle these levels too dip.

The uterus in the luteal phase gears up to receive the foetus in anticipation of pregnancy. With its vascularised walls it is cushion-like and glandular. It swells in response to the oestrogen and progesterone emanating from the corpus luteum. Its glandular tissue secretes another hormone, prolactin. The function endometrial prolactin is not yet understood.The turgidity of the uterus lasts as long as the oestrogen and progesterone levels are high. As the corpus luteum degenerates, the hormonal support to the uterus is reduced and the endometrium starts thinning. The spiral arteries, supplying the outer wall, foil further and eventually collapse. Further breakdown of cells and necrosis of the tissue is encouraged by the local released chemicals, like prostagladins.

 

Finally the endometrial haemorrahages become overwhelming and result in a constant flow of blood. Predominantly arterial, the menstrual flow contains about 25 percent of venoud blood, tisue, debris, prostaglandins and fibrolysins (that prevent clots). Usually lasting for three to fice days, an average of 30 millilitres of blood is lost. Along with the ovaries and the uterus, the other reproductive organs too are affected by the hormonal rhythms in the body. The cervical muscus is markedly thinner when the oestrogen levels are high, just before ovulation. This helps in efficient sperm transfer. On the other hand, when the progesterone levels rise, i.e. soon after ovulation of during pregnancy, the cervical mucus becomes thick and less fluid. The vaginal tissue also responds to the levels of gonadotropins. The vaginal epithelium (the layer of cells lining the vagina) becomes hardened or cornified in response to oestrogen while it thickens and is infiltrated by leucocytes when progesterone is high.

 

The breasts too show cyclic changes. Oestrogen stimulates the mammary duct cells to divide while progesterone causes growth of lobules and alveoli. Often women experience swell- ing and tenderness of breasts about ten days prior to their menstruation due to distension of the ducts and oedema of the tissue.
For a long time, the ability of a single follicle alone to ovulate and of all others to loose out in the race and become atretic has puzzled the biologists. What is it that decides which of the eggs is really ready for release? There has got to be more to the story. As cell biologists probed deeper, it became apparent that not only the hormones but also a number of other local factors, especially from the ovarian tissue, play a role in this decision.


Sex : Keep It Fresh and Fun

You'd be surprised how many people think sex shouldn't be fun! or funny! They lose their sense of humour and adventure as soon as they get into bed. One of the things that puts a real damper on sexual fun is over- involvement with technique. I'm not saying technique isn't important. It is, but it's only part of the picture. Sometimes men and women get so warpped up trying to prove their prowess that they forget to relax, to have fun. They forget that fun and sex belong together. Sometimes it helps to think ahead and make plans. Now, I don't mean kids tucked in by 9.30, clothes off by 9.57, climax at 10.12. What I have in mind is something like this: your husband is out of town on a busines trip. Take friday off from work, drop the kids at your mother's, and hop on a plane. Identify yourself at the front desk, order up some champagne from room service, get into that fancy lingere - and wait. He opens the door and finds a very nice alternative to the evening conference he didn't want to attend anyway.

 

Or consider this from a woman who wrote to me. Her husband had gone to the hospital for some minor surgery. The night before the operation, she talked one of the nurses into letting her borrow a uniform. Into his dark room came his "nurse'' to take his temperature. With what happened next, it would have been his pulse rate. These escapades may sound spontaneous, but they actually took a lot of forethought. One of the keys to keeping sex between the two of you fresh and fun is surprising your partner. In your ctive, crowded lives, you've got to clear a path for spur-of-the-moment adventures. When was the last time you threw a sleeping-bag in the backyard and made love in your kid's tent?

 

Dangerous Monotony :

There's a big middle ground between great sex and psycho- sexual problems that drives many couples to seek profess- ional help. Let's call it the sexual blahs. You know the symptoms: not much preparation; no communication of likes and dislikes; quick foreplay; the same position in the same bed, right before you to sellp; "Goodnight- sweet dreams- are you sure the doors are locked? Like so much in your life, a nice orderly routine. But overtime, that little routine may become a boring routine. That's when the doubts start : "Does she still love me?'' "Is he having sex with someone at the office?'' Of course I'm not recommending variety as a way of saving your life, but it sure will belp break up what can become dangerous monotomy. Try a new position. Maybe it's not for your. If not, say so and move on. It's not the end of the world. And you will have given your partner important messages: that you are open to new ideas, that you will try them out and that if you don't like something, you'll say so.

Arousal Techniques :

Change the times of day you make love; ask yourself what sex would be like on this beach or that sofa, and visualize it. Keep an open mind, and a naughty sensibility-little touches can add immeasurably to your mutual enjoyment. If foreplay comes before sex and afterpaly after, then somebody, wisely must have considered sex a form of play, or run. Too often people forget that lesson when they're actually making love. Every couple has certain arousal techniques in their repetoire. These may include nibbling an ear, stroking, caressing those special places. Yet good foreplay begins long before you get into bed. It may be a well-placed stockinged foot undera a restuarant table, or a well-placed hand during ride home. It could be a breathy phone call when he gets to work. It could be week-long expressions of tenderness and care that have no immediate connection to sex-anything that says he's desirable and you're available, If you can "say'' this playfully, if you can have some fun, too, all the better.


Equally important is the time after you make love. Don't roll over and go to sleep, Don't jump into the shower. During the resolution period after sex- that wonderful "coming down'' feeling- hug, laugh, take a bubble bath together. the next time you're in the mood, you'll remember it; and that memory will start the foreplay all over again. A common saying is that as much as much as 90 per cent of what happens during sex takes place from the neck up. Some degree of fantasy is okay in lovemaking. It can turn up the sexual volume, help you release in your own mind sides of you and your partner that are aggressive, perhaps forbidden.Don't assume they are wishes you want to have come true; do not be afraid of them.And realize that they'll change ovedr the years. Some you'll dismiss; others you'll enhance. Let yourself enjoy them; make them work for you - you'll find them beneficial to your sexuality, and a useful complement to your lovemaking skills.

On my TV show, I once received a phone call that cheered me up for weeks. It was from a grandmother who gave me an abridged history of 50 plus years of married lovemaking. She and her husband had sex on steamers and trains, all over in several houses, and in bed. They'd been making "sex dates'' for decades. Both felt free to take the initiative. And they'd survived occasional problems in bed. But she ended the conversation by saying, "Dr.Ruth, we're still at it.'' I wanted to give her a medal. Putting the fun back in your sex life is not just a matter of new poisitons, or trickier tricks. The secrets to happier, more playful lovemaking are a good relationship, good communication, and open mind, a youthful heart, a spirit of adeventure and a desire to make sex with your partner a lifelong joy.


Ideal Sexual Positions

Ideal Sexual Positions

A new bride's snug vagina limits sex positions to those in which the penis and the female passage line up fairly straight. By the time the standard approaches become old hat, however, this situation has generally changed. Most well initiated and fully aroused wives can comfortably accomodate the penis when inserted from any direction. Decreased vaginal snugnessalso permits easy position shifts during uninterrupeted intercourse, which opens a whole new horizon. Before sexual boredom becomes a problem, you can almost always manage numerous interesting combination of successions of sexual posture.

Preliminary Contact

If you have revelled upon the plateau of ecstasic transport until the further stimulations of intercourse seem necessary, but do not yet feel ready to build towards the final climax, you might find one of the 'halfway house' positions a perfect start. These postures allow some sexual frictions; generally of a rather fresh and different sort, whole still avoiding complete sexual entrance and orgasm-inciting stimulation.

The half-roll position

This position is the easiest 'partial penetration' posture to assume. When you approach the time for intercourse yoy will often find yourselves lying side by side, the wife on her back and the husband on his side. If the wife raises the knee which is farther from her husband, then rolls the lower part of her body partly towards him so that her thigh rests upon his flank, she brings her organs within range. Intercourse need not begin immediately, since this position allows both partners to caress and fondle each other in a wide variety of ways. His free hand can follow the inner surface of her thigh to her female organs, which are fully exposed to caress. Her upper body lief spread out before him, with breasts inviting  his hands and mouth. Kissing and mouth-to-mouth play also prove appealing in this posture.


When genetial contact seems desirable, an inch or two of the penis can be easily inserted into the vagina where gentle motions carry you to a higher plane of excitement than can be reached through sex play alone. These stimulations can be supplemented with constant fondling and caress to sustain both of you on the plance of ecstatic transport for a much longer period than you could otherwise arrange. Penetration is too limited to carry intercourse into its final stages in this position, but you will find that you can easily shift to anothe posture whenever you wish.

 

Some More In Next Article


Menstrual Discomfort

While scientists look into the molecular mysteries of woman- hood, at a mundane level, being a woman translates into a phy- siology and often psychology governed by the ovarian cycles. During most part of the cycle the woman is unaware of her physiological state. The menstrual bleeding occuring regularly once every twenty-eight to thirty days is the only simple indicator to the woman of the changes taking place in her body. However, many women experience discomfort during a specific phase of their cycle. These problems are often minor; sometimes, however, they do require medical attention. In general about 75 percent of the women report physical or emotional discomfort in the pre-menstrual period. Most of these discomforts are transient and vanish with menstruation. In some women the pre-menstrual condition is so distressing that it takes the form of a mental illness known as the 'pre-menstrual syndrome', or PMS for short. Symptoms of PMS vary widely, each woman feeling the stress to a different extent. Clinically, the severe form of PMS is diagnosed on the basis of teh following symptoms:

1 a marked depressed mood with a feeling of extremely poor self-esteem
2 anxiety, tension and a feeling of being on edge
3 a feeling of vulnerability, sadness and an increased fear of rejection
4 marked increase in irritability and anger
5 a decrease of interest in routine activity of work
6 a decline in commintment and concentration at work place
7 a feeling of letghargy and lack of energy
8 a transient change in food habits, marked over-eating and appetite for sweets
9 sleep disturbances, over-sleeping or inability to sleep
10 physical symptoms like breast tenderness, headaches and joint or muscle pain
11 a feeling of bloatendness and weight gain

One or more of these symptoms bother most women. If the symp- toms are moderate and do not disturb one's normal life they are best ignored or controlled by a little counselling. However, if the symptoms are severe then clinical advice is of immense help. The exact cause of pre- menstrual disturbances has not been clearly understood. These are not because of hormonal disturbances. It appears that the normal ovarian cycle triggers biochemical events in the central nervous system (the brain and the spinal cord) to give rise to complex psycho-neuro-endocrine events which precipitate as emotional and behavioural disturbances. It is rather tricky to treat conditions of PMS. Counsellors advice a more planned lifestyle to women who find their problem unberable. Moderate but daily exercise with a diet containing less salt and sugar is advised. Stress management courses, self-help books and group therapies are also known to be of benefit. Therapeutic doses of vitamins and calciu, are prescribed. Severe cases may require treatment with antidepressants.

The other menstruation related problem faced by women is abnormal uterine bleeding. This may occur because of variety of reasons. Genital tract lesions, infections, trauma or tumours can cause abnormal bleeding. Dysfunction of the thyroid, the liver or kidney can also be associated with unexpected uterine bleeding. All these conditions require special clinical attention. A common type of uterine bleeding that is not related to any pathological condition but affects women since their adolescence to pre-menopausal time is 'dysfunctional uterine bleeding'. This problem is often associated with anovulatory cycles.

 

Dysfunctional uterine bleeding occurs under two conditions. 'Breakthrough' bleeding occurs when the uterine wall increases under the influence of oestrogen beyond its capacity to maintain its integrity. Light bleeding occurs intermittently at unexpected times. The second condition under which bleeding occurs is due to a sudden mid cycle drop in the level of oestrogen. This is called 'withdrawal bleeding'. Bothe the conditions are not only a cause for inconvenience to the person but also lead to anaemia as the haemoglobin levels fall due to unwarranted bleeding. Both require immediate medical attention and can be successfully treated by hormone therapy and iron supplementation.


The New Tyranny Of Intercourse

What part does sex play in the breakup of marriage? Clearly that is a complicated question. So complicated, in fact, that two of the best minds of our century, Bertrand Russel and Sigmund Freud, seem to have got it all wrong. Both men believed that undue sexual restraint, brought about largely by ignorance as well as social custom, caused a great deal or pain in married life. Both looked about them and saw their fellow men deeply riven by an  unnecessarily rigid code of sexual conduct. Both would have warmly greeted a swing of the pendulum in sexual matters. Neither could have anticipated that when the pendulum finally did swing, as it has in our day, it would swing so hard as to threaten to smash through the clock's cabinet.

The good fight that such thinkers fought against ignorance, inhumane restraint and hypocrisy in sexual life has been won-but the triumph has resulted not in greater freedom but only in greater licence, which is not at all the same thing. Where Freud once stood, solid in his learning, compassionate in his philosophy, today stant the "sexologists'' sniggering about "fun sex.'' Where once Bertrand Russell stood, knight of scientific reason, in constant combat with unnecessary human cruelty, believer in sexual liberation, but always within standards of decency and consideration for others, now stand the clinicians of the genitallia, eyes to camera lens, electronics plugged in, preparing another blow-by-blow account of the clitoris or prostate in action.

Nerve centres, glands, protuberances, engorgements, contractions. The sexologists do not talk about humab behaviour but about the behaviour of human sexual apparatus. Such qualities as privacy, modesty, shame, fidelity fall outside the realm of their discussion, long ago replaced by such terms as fore-play, fore-pleasure, high-frequency impulses, ejaculation. Sex becomes, as Aldous Huxley once desctibed it, "a maniac struggling in the musky darkness with another maniac.

Altered Emphasis :-

Yet the sexologists have found a ready audience. Ideas through time and vulgarization, get boiled down and twisted into different shapes. In this way, Frued's campaign against undue abstinence form sex - a campaign that never went beyond imploring society to ease up a bit - has come, over the years, to be translated into the notion that sexual activity is in itself a form of health; the more one has, the healthier one is. From this point of vies, the good life is the life lived almost exclusively for and through, the genitals. It is very easy to attack the sexologists, to demonstrate that where they are not sleazy they are shallow. Yet however we may deplore them, we still feel a compulsion to keep an eye on their various goings-on. Who can tell, maybe one day they will discover a vertebra that, properly pressed, massaged, licked or lapped, will send lovers into prolonged nirvana. Meanwhile, their presence hovers about bedrooms everywhere, their instructions firmly lodged in the minds of lovers.

Perhaps nowhere is more asked of sex than in marriage, yet perhaps no other institution is less able to deal with the modern sexual imagination, the ideal of which is variety and multiplicity. But in marriage - theoretically, atleast-one person must seve where multitudes are forbidden. One's wife must be not only a good mother, cook and housekeeper, but a terrific sex partner. One's husband must not only be a good father, provider and companion, but give full satisfaction at night. Old dogs are under the constant obligation to learn new tricks. Sexual satisfaction is looked upon as a right-demanded by those not receiving it, shattering to those unable to give it.

High Priority :-

Thus, sex looms large today. Never before has it been considered so much a sine qua non not of the good life but of life itself. Sex has become no less than a form of modern salvation, a means of transcending the dreariness of day-to-day existence, and as such it is capable of enormous destruction. It cannot stand the weight being put upon it. Once, people suffered sexual shortcomings in their partners and, while these shortcomings might be difficult to live with, they were nonetheless generally deemed endurable. If love was there to begin with, making love posed no great problem. Sex itself had not yet become a highly compartmentalized activity like high-jumping. Medals were not yet handed out for performance' people did not as yet feel so clearly deprived, as they would later, if the sexual side of their lives fell somewhat short of The Arabian Nights.

Cause or Effect :-

Rollo May, psychiatrist and writer, has discussed at length the effects of our enlightenment in sexual matters and concluded that the emphasis on technique in sex "makes for a mechanistic attitude towards lovemaking, and goes along with alienation, feelings of loneliness and depersonalization.'' But the interesting question is whether the emphasis on technique in sex is a result of alienation and depersonalization, or whether it brings about these phenomena.

 

The correct answer is probably that both are true; one falls into technique, into sex itself, to put off ar at least alleviate the terror of loneliness; then, because sex, no matter how sophisticated the technique, cannot achieve this monumental task, the loneliness and the terror that accompany it grow deeper. In the process, tenderness is wrenched from sensuality, instead of the two flowing together; sex becomes copulation pure and simple; and we are more slaves to our bodies than perhaps ever before.

Where ideally marriage shoud put an end to men's and women's sexual strivings, where ideally marriage ought to be a relationship in which tenderness and sensuality flow together, each strengthening the other; in practice it seems less and less frequently to work out in this way. How else can one explain all the adultery, all the sex manuals for married couples? When one thinks how far we have travelled, it is difficult to ward off a sense of despair at the opportunity missed, For, instead of deepened and enriched relationships, instead of shedding guilt and developing inwardly, we have today the "Bedroom Olympics'' with the accompanying tyranny of performance, unreal expectations and misplaced salvation. There was nothing of particular value in the old sexual code of repression for repression's sake, and much that was harmful. But once the old code was banished, how much better off we would have been if married couples had been able to affirm sex for what it can be at its best-a source of pleasure and delight, and a means of potentially deepening and enriching their relationship.


Secrets of Staying Together

As a psychiatrist and family therapist, I often spend my days listening to the details of other people's love affairs. To better understand why someone would be willing to risk so much for so little, I recently interviewed 100 couples who came to me because one or both partners had become involved outside the marriage. My survey - more informal than scientific - is supported by my own observations during 28 years in practice. From the background, I have observed that infidelity is the primary disrupter of families, the most dreaded and devastating experience in a marriage, and the most universally accepted justification for divorce. There are a few family problems to which we devote more attention. Yet there is a lot of nonsense in the popular mythology about what causes infidelity and how to handle it. The most harmful misconceptions show up in advice columns, in popular magazines and even in some books on marriage therapy. They are :
Fallacy : Most people have affairs. US surveys in the past few years tell us that about 50 per cent of husbands and 25 to 35 per cent of wives have been unfaithful. Infidelity in over half of all marriages is a lot of infidelity. But the figures are misleading. Many adulterers have only one affair, and much of the infidelity takes place in the last year of dying marriage. Adultery is far less common in intact marriages. Most marital partners are faithful most of the time. In fact, the surveys also show that the large majority of those questioned believe strongly in marital fidelity, certainly for their spouse and generally for themselves. Even if monogamy is not always achieved, it remains the ideal.

Fallacy : An Affair can be good for a marriage and can even revive a dull one.
Occasionally an affair may help solve a problem by forcing it into the open, but, in fact, it's no more likely to help a marriage than some other major crisis, such as the house burning down or the baby dying. A fine watch may be repaired by kicking it, but that seems risky. The truth is, most affairs do great damage. Overall, 53 of the 100 adulterous marriages I surveyed ended in divorce. This is spite of the couple's decision to seek counselling and my own best efforts to help them. By contrast, it is unusual in my practice for non-adulterous marriages, to dissolve.

Fallacy : The Lover is sexier than the spouse.
Since an affair involves sex, it is often assumed that the affair is about sex and the lover is either very attractive or some kind of sexual athlete. In many experience, lovers are not necessarily younger or more attractive than the spouse; nor is the affair necessarily about sex. Thrity of the people I surveyed, for instance - half men and half women - acknowledged that their sex lives at home were perfectly adequate. It was not sex but a lack of intimacy that had compelled them to have an affair. Many of those I talked with told me their decesion to cheat on their partners was largely motivated by anger. Twenty-five in my survey were angry about some aspect of their spouse's behaviour or were retaliating for affairs their spouses had started. Interestingly, even those who seek out such relationships may become uneasy at the motivating emotions. The reasons for affairs are complex and varied. Most of them have to do with problems the person having the affair is experiencing rather than the desirability of the "other'' man or woman.

Fallacy : The less said about an affair, the better.
People involved in affairs like to convince themselves they are doing their loved ones a favour by hiding the unpleasant truth. I feel this is unrealistic. Spouses usually knows when they are being lied to - they just don't know what the truth is, and if it is bad enough to lie about, they suspect the worst. Honesty is the central factor in intimacy. Even the smallest lie can have terrible implications. In the cases I've seen, lying about an affair only made things worse. Many marriages end in the wake of an affair, but far more end in an effort to maintain the secret of the affair.

Fallacy : After an affair, divorce is inevitable.
Certainly, an affair can trigger a crisis in marriage. After any crisis, a marriage may - with a lot of work and pain - recover, or it may become worse. There are people who would find it impossible to live in a blemished marriage, and there are marriages in which the unfaithful spouse remains on probation or under punishment for decades after the affair.  As in every other aspect of marriage, it all comes down to communication. If there is one conclusion I can draw, it's that monogramy works. It isn't rare - it's practised by most people most of the time, and always has been. It isn't difficult - anyone can do it, and only the smallest sacrifices are involved. Monogamy isn't even dull - living without lies and secrets opens you up to being known and understood, and that isn't dull.
If people would only trust each other enough to work towards honesty and intimacy within their marriage, then may be they could do what everybody wants to do, and most unfaithful spouses are afraid to try; live together happily ever after.


Between Thighs Friction

A wife with a rounded figure has sufficient padding on her upper thighs to meet in the middle when her legs are straight. Tissue folds around the hips are so arranged that only a small space remains between the female organs and the thighs in this position. The head or shaft of the penis more than fills this space, making several varieties of mutually stimulating sexual friction possible. In assuming these positions, you want to be sure that the tip or shaft of the penis lies between the outer lips and rubs against the inner lips or clitoris. When the husband makes first contact, his wife should part her legs slightly until he has settled the top surface of his organ into the groove.

 

In face-to-face postures, the husband should adjust his position by moving his body straight upward along an axis parallel to his wife's so that the top of the penis presses firmly against her organs. Then she 'closes the ring' by bringing both her legs down straight, and adjusts the degree of arching in her back until the position of her pelvis brings the inner lips and clitoris into snug contact with the passing shaft. Both partners get more stimulation by letting the shaft of the penis rub along the front of the female organs with its tip always at the body surface (but between the thighs) rather than by inserting the tip.

 

Body movement should aim at drawing the shaft of the penis forward and back in such a way that it rubs against the innerslips without the penis tip ever entering the organs. When ready to commence fully-fledged intercourse, the husband can draw back until the tip of the penis passed the vagina's rear rim. Sexual friction can be continued without full penetration if desired, and the husband's position gradually adjusted downward on an axis parallel to his wife's body until the organs line up for increasing contact depth.

Between the thighs friction generally works out best in the face-to-face, both partners on their sides version. As a means of prolonging ecstatic transport before mounting excitement carries you towards a climax, it has the advantages of letting both husband and wife remain relaxed and keep both hands free for simultaneous breast and body caress. The transition to fully-fledged intercourse in several stages of increasing penetration is also easiest to manage in this posture. However, the same general approach also works in at least three other positions, husband on top with his legs apart; wife lying flat upon her husband's body with his legs somewhat seperated; and husband approaching from the rear. The wife's legs must be together and straight in all postures, of course.


primary amenorrhoea, secondary amenorrhoea, anorexia nervosa

Another abnormal situation related to menstruation is 'amenorrhoea' or absense of uterine bleeding. When girls experience no menstruation well after their age of puberty, they are said to have 'primary amenorrhoea'. On the other hand, women, who have had no- rmal menstrual cycles but experience an absence of menstrual bleeding for about three cycles, and are not pregnant are said to have 'secondary amenorrhoea'. The causes of these conditions can be several and need careful clinical assessment. The most common cause is chronic absence of ovulation. The second most common cause is hormonal imbalance caused by dysfunction of the hypothalamus and/or pituitary gland. Failure of ovarian or uterine function or thyroid dysfunction can also cause amenorrhoea.

An unusual psychogenic repro- ductive disorder, called 'anorexia nervosa' can cause amenorr- hoea, especially in adolescent girls. These youngsters have an obsession for dieting and a constant fear of weight gain. They are highly tense about their achievements and have an obsessive behavious pattern. Very often this pattern of behaviour can be traced to childhood traumas associated with sexual abuse or an extremely dominating and insensitive parent. Another situation where girls have amenorrhoea is when they exercise intensely. The type, duration and intensity of exercise plays an important role in assessing this form of amenorrhoea. Relatively high incidence of amenorrhoea is found in girls participating in highly competitive sports events, like running. A complex condition, amenorrhoea, must bot be ignored and should be treated medically.
In general majority of the women have normal ovarian cycles from puberty to menopause, i.e. from the age of twelve years to fifty years - a span of about thirty-five to forty years. For healthy indivi- duals, menstruation is regular, with marginal discomfort, which in no way disrupts normal routine. To ensure continued reproductive health, the sex educators stress on personal hygiene. Immediate disposal or washing of material used for absorbing uterine bleeding has to be taught to youngsters, the most important message being that personal cleanliness is the most effective way of avoiding rashes and irritation of external genitalia and of keeping away infections.

Many youngsters report aches in the lower abdomen during menstruation. If transient and berable, with no additional symptoms, these discomforts do not require medical attention and are best ignored. A good dies with an ample dose of calsium and iron are known to relieve youngsters of minor discomforts or tiredness normally experienced during menstruation.
There is no doubt that the reproductive health begins with understanding of what it is to be a woman. Yet, to understand what womanhood is all about, it is important to trace the molecular and developmental history of the girl child in the mother's womb. A lot goes into making of a woman in these formative months!

Important Stages of Menopause In Next Article ...


What Not To Tell The One You Love

Widely held belief about love and marriage is that partners should be totally open and honest with each other. We think that it is a sign of trust and genuine sharing to hide nothing from the one we love. But suprisingly, many marriage therapists and other experts in human relationships doubt that it is genuinely loving, wise - or moral - to be totally honest. On the basis of clinical experience and psychological expertise, they say that at times there are certain thoughts and feelings that you should keep to yourself or even live about, if you truly love your partner. Do you know what - and what not - to tell the one you love? And when? Test your own wisdom about love and honesty by answering these questions. Then see the conclusions of this distinguished panel of experts: Dr. Ellen Berman, Evelyn Duvall, Albert Ellis, Ray Flower.


1    Mrs. A is 30 centimeters shorter than her husband, she says to him, "I'll bet you wish I were one of those tall girls with long, slim legs.'' She's right, but should be admit it?
2    Mr. B eats too fast and talks with food in his mouth. This exbarrasses his wife in company. Should she tell him?
3    Mrs C has little interest in sex. She believes this results from a naturally low sex drive, not from a physical or emotional problem. Sorrowfully, she says to her husband, "I'm sure you wish you had married someone sexier.'' It's true, but what should he say.
4    In front of friends, Mrs. D comments on Mr. D's meekness in dealing with salesmen, neighbours, his boss. She has a point, but he's humilated and angry. Should he tell her?


5    Mrs E is bothered by Mr E's single-handed control of their money and his refusal to share any homemaking chores. She know he's not selfish but merely old-fashioned. Should she tell him annoyed she is by his attitude.
6    At the beach, watching the young singles, Mr. F feels envious; he wishes he were one of them. His wife says "A penny for your thoughts'' Should he admit he misses his bachelor days?
7    Mrs G enjoys sex with her husband only when she closed her eyes and imagines that he's her favourite film actor. She feels ashamed about doing so. Should she tell him?
8    Mr H had a brief secret affair. It's over, but he remains deeply guilt-ridden. He longs to tell his wife all and ask her forgiveness. Should he do so?


9    Miss I and Mr J are planning to marry. She never told him that in her teens she had an abortion. Should she tell him now?
10    Mr K has never revealed to his fiancee, Miss L, that in his teens he had a homosexual relationship that lasted several months. He is oppressed by guilt at not having told her. What should he do?
11    Mr M. a wodower, has asked Mrs N, a divorcee, to marry him. In a moment of great intimacy she whispers, "Do you love me as much as you lover her?'' He doesn't. Should he lie?
12    Mrs O has inoperable cancer and will probably die within the year. Mr. O is extremely depressed at the prospect of life without her and finds it painful to keep these feelings to himself. Should he unburden himself to her?


Some More In Next Article


The Lock And Swing Positions

If you try to open new sexual horizons for yourselves throughy varied sexual positions, you will frequently want to shift from one posture to another without losing the incident's impetus. Knowing that this is possible generally gives you confidence to try new approaches since you can go back to familiar procedures if the novel ones don't work. Moreover, capacity to shift positions allows you to enjoy early in intercourse many postures which do not permit reciprocal couple movement and still share mutual movement in the final climax, which comes very close to 'javing your cake and eating it too'.

Whenever you want to change postures withour interrupting intercourse, switch first to 'straight ahead' total penetration, with the penis going directly into the vagina and inserted up to the hilt. If the wife is fully relaxed, this will cause no discomfort or difficulty whether the husband is in front of, beside, or behing her. Unless they are already face to face, they should then use the 'swing position' to get there. The wife raises both legs and bends her back until her knees are as close to her shoulders as is comfortable, bringing her body in to a position exactly like that it would assume if she were standing and trying to pick up something off the floor. She may find that grasping both ankles helps to make this posture comfortable, although no great strain will be involved anyway in the very brief time she needs to sustain it. Her husband 'rears up' by raising his upper torso, generally supporting his weight with his arms, until his chest will clear his wife's heels and calves when he swings his upper body past her legs. Using the still inserted penis as a pivot, point he then turns his body into a new relationship with here.
Once in face-to-face posture, the wife can let her legs fall into a completely comfortable position. Her knees should still be raised with her low back bent forward sufficiently to keep penetration absolutely complete. Her husband should place both hands behind her hips and pull them towards him strongly enough to lock her lower body into fixed relation with his, whilce she can cross her ankles behind his hips and use her arms to steady his upper body in its relation to hers if she wishes, This is the 'lock position' which allows you to move from place to place on the bed, roll from 'wife down' to 'wife up' postures, and even move from chair to bed or make other short shifts of location without interupting the incident.

Many couples hesitate to use the 'lock position' because the wife has had occasional twinges of pain attributed to 'hitting bottom'. They picture the penis penetrating the end of the vagina and causing serious injury. However, the vagina's dimensions very during sexual excitement just as the penis do. and the degree of relaxation a sexually experienced wife achieves before her husband makes sexual entrance almost always allows full penetration without discomfort or injury. The twinges of pain blamed on a short vagina almost always stem from some other source except perhaps in a few women who have had their wombs removed completely by surgery. In any case, you can be sure that if full penetration during assumption of the 'lock position' causes no discomfort, rolling or moving about in it will cause no harm. When you are in the right place with the right person on top, you can use the 'swing position' again if necessary to get back into any posture you might desire.



Menopause

Just as the beginning of the menstrual cycle is a critical transitional state, the permanent cessation of menstruation, called menopause, too is a sensitive and important stage in a woman's life. At about the age between forty-five to fifty-five years, women enter the non-productive phase due to loss of ovarian funciton. As mentioned earlier, women are born with a limited stock of ova that are not replaced when shed once every month. Over the span of about thirty-five to forty years of reproductive life this stock of ova gets depleted, resulting in altered ovarian activity.

A couple of years prior to the last menstruation the woman can recognise changes in herself called the climateric. This pre-  menopausal phase with an altered pattern of menstrual cycle is because of the decrease in the hormones released from the ovary. At menopause, levels of FSH in the blood are high while those of oestrogen and inhibin are low. Such a hormonal profile causes a number of physical and psychological discomforts in a woman. Organs or systems that were fine tuned by oestrogen have to readjust to lowered levels of the hormone and this manifests as a major menopausal change.

*    Effect of the Brain : Lowered levels of oestrogens affect centres of the brain that regulate body temperature. Menopausal women experience a sudden and intense feelings of heat passing over the body. This feeling, called 'hot flush' lasts for a short time. Hot flushes are at times accompained by profuse sweating and sleep disorder.

*    Effect on lower genetial tract :The lower genital tract is lined by epithelial tissue which is maintained by oestrogen. This inner lining progressively thins, accompained by decrease in lubrication and shrinkage of the organs, especially the vagina. This makes intercourse painful to menopausal women.


*    Effect on Cardiovascular System : In general, oestrogen has a beneficial effect on the cardiovascular system as it controls the plasma lipid biochemistry. Lowered oestrogens in menopausal women change the lipoprotein profiles and make them susceptible to high blood pressure and other cardovascular problems.


*    Effects on the Skeletal System : One of the most profound consequences of menopause is increased susceptibility to fractures, back aches and spine related problems. In pre-menopausal woman, the bone tissue undergoes a natural cycle of formation, calcification and resorbtion such that the bone tissue is maintained at a steady state. Lowered oestrogen levels trip this balance in favour of bone resorbtion, cause the bone tissue to become porous and fragile. Called osteoporosis, the situation is of major concern in post-menopausal women.
J

ust as adloscents have to adapt to adult realities, post-menopausal women have to readjust to old age physiology. This transition may be traumatic and often associated with severe, unberrable depression or othe mood disorder. It is possible to ease the symptoms by suppliing oestrogen orally, as injectable or by vaginal route. This is known as hormone replacement therapy (HRT). This therapy is of short-term benefit, as its prolonged use seems to heighten the chances of breast and uterine cancer. Recently, new drugs for post-menopausal women that act selectively on oestrogen receptors, preventing osteoporosis but having no adverse effect on breast and uterus are under clinical trails. An effective measure of limiting post-menopausal osteporosis is by increasing calcium in the diet. Increase in calcium intake during adolescence when bone formation is taking place is also seen to help in limiting age-related bone fragility.


What Not To Tell The One You Love

The Modern view holds that there should be no secrets or lies between intimate partners. The panelists took more complicated but common- sense position that the circumstances determine whether total honesty is wrong or right. Karl Scheibe pointed out that "fidelity to another person requires discretion, tack, protection, kindness, forbearance and sensitivity.These requirements are more complex than the simple principle of always telling 'the truth'.'' On the other hand, lies and secrets can easily create distance between partners. One must carefully weigh each case.
Here's how tha panel applied these principles :

1    Mrs. A can't do anything about the fact she's a short. For Mr.A to reveal his feelings would hurt her. Mr.A may have to elaborate the truth to meet his wife's needs. Ray Fowler suggests an answer: "If I wanted someone like that, I'd have married someone like that. I didn't - I married you, and I love you as you are.'' Several panelists said that Mr.A should stress the qualities in his wife that mean more to him than long legs.

2    Almost all panelists agreed that Mrs. B should tell Mr.B how she feels about his eating habits. Several suggested that they're faults he could correct, with good results for both of them. But as Ellen Berman pointed out, "The really tough part is how and when to tell. Not at an intimate, vulnerable moment. Not when the other person is already 'down.' Not in the middle of an ugly fight.'' Robert Whitehurst stressed that "she should time it when he can handle it, when, he's feeling good about himself and the two of them.''

3,4 and 5   In all three cases, the problem is one of a flaw in the relationship that might be corrected or compensated for. Mrs.C may be wrong that her sex drive is naturally low. Her husband ought to tell her how he feels and suggest that they seek professional help. Her sex drive might be increased or, as Albert Ellis noted, she might discover that "she could more enthusiastically and adeptly try various sex acts that will both of them more pleasure.'' But Ellis warned that telling such a truth is a good idea only if the wife is rational and realistic: "If she's a strong self-blamer, he had better keep quiet.''

Nearly all panelists agreed that Mr.D should tell his wife how her public criticism makes him feel, though carefully choosing how and when he does so. Angrily expressing resentment often yeilds only a pitched battle.

 


Mrs.E may get her husband to relax-and share-his control of the family finances if she tells him how she feels without making it an all-out attack. As for getting him to lend a hand with household chores, Evelyn Duvall commented : "She should suggest one simple task she would like him to do, then express her appreciation for his help.'' And take it from there.

6    The panel disagreed on this one. Several said that it was fine for Mr.F to have private thoughts about being a young single as long as they didn't affect his wife's wellbeing or his feelings for her. There's a difference between secrecy and privacy, and no matter how intimate two people are, each deserves some private space. Most of those who said Mr.F should tell the truth said he should do so in a harmless way. Marcia Lasswell's suggestion: "He could say, 'I wish I were eighteen again'
7    Mrs. G should not tell about her sexual fantasies. Frederick Humphrey commented : "Sexual fantasies of this kind are often devasting to the other partner. Let Mrs.G enjoy her fantasies-privately.''

8    Most panelists said that Mr.H should either bear the burden of his guilt about his affair or seek professional help. It could be unwise and unfair to shift his burden on to his wife. Tilla Vahanian commented: "Although the truth is rarely as painful as the barrier created by secrets, if the only reason to reveal some- thing is to unburden oneself without regard to the impact on one's mate - as in this case - staying quiet may be more responsible.'' David Mace added: "The ethic of honesty must always be subservient to the ethic of love. Where the confession of sexual infidelity might be devasting to the partner, the unfaithful partner should discuss the matter with a counsellor who can help him or her decide whether to confess.''

9 and 10    In both cases, many panelists felt that the truth need not be told. But one panelist said that the secret of the homosexual experience might have some bearing if Mr.K still has homosexual yearnings. Then the truth should be told to avoid future problems.

11.    Nearly all panelists felt that Mr.M should not tell Mrs. N cannot change the situation, and the truth can only hurt her. Many said that Mr.M should say that his love for his wife was different from his love for Mrs.N and that there's no way to compare them.

 

12    This may be the most difficult case of all. Most panelists felt that Mr.O should tell Mrs.O how he feels, but some felt strongly that he should not tell her the full extent of his misery. Said Marcia Lasswell: "He ought not add to her burden- but she'd think something was wrong if he showed no apprehension or sorrow.'' Karl Scheibe was more empathatic: "He should do all in his power to make her last year as happy as possible. She'll understand taht he'll be grieved. He needn't make her share the full force of his pain.''


Face-To-Face Positions and The Pillow Trick

As an act of love and the sacrament of a relationship, intercourse generally seems more 'natural' in the face-to-face postures. The fact that you can talk to one another, look at one another, caress one another, and lie in one another's arms makes the whole thing seem more personal and intimate. Face-to-face postures make the wife feel more like an equal party in the act instead of like 'someone it's being done to, not a participant'. Moreover, the fact that she can move fairly freely in most face-to-face positions makes the added stimulations of reciprocal action available, while most approaches from the side or rear keep her motionless and passive.

Assuming for the moment that the wife lies on her back with her husband approaching from directly above her, let us see what the effect of various back and leg position has upon the stimulations of intercourse.

The Pillow Prick :-

If the wife keeps her legs down flat on the bed and tucks a pillow under the small of her back so that it supports her spine in a position which increases the depth of its normal hollowness, her pelvis tips considerably towards the rear. This brings the clitoris into firmer contact with the shaft of the bormally entering penis. A slight headward shift of the husband's body increases the amount of friction on the clitoris even more. If he further allows his trunk to drop parallel to hers, letting as much of his weight as she can comfortably tolerate actually rest upon her upper abdomen, clitoris stimulation becomes quite intense.

Aside from variety for itw own sake, this position serves several special needs. A woman with a high-placed or relatively insensitive clitoris can often attain much keener stimulation in this way than with any other position, at least until her feminine responsiveness has been fully awakened by repeated satisfying incidents.

Almost every woman who attains orgasm much more readily through finger stimulation than through intercourse has a high or insensitive clitoris and will benefit from legs-down, arched-back postures until full responsiveness has been established. No amount of sexual activity will get her over this hump as long as stimulation of other areas occur during intercourse and stimulation of the clitoris only before and afterwards. Surprisingly few episodes of total satisfaction will suffice to make all forms of intercourse gratifying for her, however, and an unvaried routine of pillow-trick episodes need not be carried out for more than a few weeks to make lifelong differences in her pattern of responsiveness.

The pillow-trick position also serves a special need during the first few sexual episodes after childbirth. Most obstetricians make a small cut along the rear margin of the feminine opening during delivery of a baby to permit delivery without execessive stretching of the tissues. This area often remains rather sore for several weeks after delivery, and may give an occasional twing of pain for some time after that. The pillow trick concentrates sexual friction along the vagina's front rim and spares the more sensitive rear margin until healing is comfortably complete.

Finally, the plump woman who has difficulty in pleasing her husband after repeated childbearing because of lax tissues may find this position very helpful. The pillow trick snugs up the female organs in their contact with the penis, especially if the surrounding tissues are well padded with fat.


The Formative Months

The Formative Months

There is more to the story of what makes a woman a physical form and a complex chemistry. There is a genetic basis to the female gender. And this part of the female identity is a little tricky to understand. For a glimpse into this female form a journey through the molecular mazes of the cells must be undertaken. Well beyond what the human eye can see, the chemical events taking place within our cells have been impossible to visualise. Over the years scientists have built up a picture of what happens in our cells on the basis of inferences drawn from well-planned, ingenious experiments. How gender is established in the early embroyonic stages has also been pieced together. In a sense, we were doing a far simpler job of telling a story in retrospect, in a few words describing what took decades to work out.

The sex of an individual is determined by the genetic information carried in each of the cells of the body. We inherit this information from our parents in the form of a set of molecules, the deoxyribonucleic acids (DNAs). These molecules carry the code that the cellular machinery can decipher and give each cell the characteristic chemical and physical identity. The stretches of DNA (the genetic material) that act as units controlling the formation of protein molecules are known as 'genes'. All the cells of our body (except for the mature red blood cells, RBC's) carry the DNA molecules complexed with proteins as thread-like structures, enclosed in a sub-compartment of the cell called the 'nucleus'. These molecules can be visualised easily in the dividing cells when stained with a dye and seen under a microscope. They appear as rod-like structures that are called 'chromosomes'. Each of our cells has twenty-three pairs of chromosomes. And one of the pairs decide the sex.

Sex Chromosomes :-

The pair of chromosomes that decide the sex of an individual are called 'sex chromosomes'. In a woman the two sex chromosomes are identical, relatively large and are called the 'X chromosomes'. In men the pair is non-identi- cal, with one of the chromosomes being much smaller and which is called the 'Y chromo- some'. The remaining pairs of chromosomes are referred to as sutosomes.

 

Using blood cells of a person, a stained preparation of chromosomes can be made and observed under a microscope. Further, the chromosomes can be photographed and classified. A simple analysis of this nature is called 'karyotyping', whereby X and Y chromosomes can be easily identified. Interestingly, a lot of information carried by the X chromosome is important not only for sex determination but also for survical. Both the sexes must have a X chromosome. Women, being endowed with two X, carry genetic information of the X in a double dose.

 

A simple cellular mechanism compensates for the excess. In each woman, during the embryonic stages one of the Xs is inactivated. Any one of the two Xs, chosen randomly, forms a tightly-coiled structure. This intricate coiling inactivates the X and the information it carries is almost inaccessible to the cellular machinery. Interestingly X inactivation occurs in all cells of the body except in the germ cells. X is not inactivated in the germ cells as it has a major role to play in sex determination. This inactivated X can be easily identified and visualised under a microscope. In a simple scraping of cells obtained from the inside of the cheek, a deeply stained dot is seen in the nucleus of about 30 per cent of the cells. This is the inactivated X and is called the 'Barr body' (so called after its discoverer Barr). The Barr body is absent in men. In case more than one Barr body is seen in the cells of a person, it indicated the presence of an abnormal number of X chromosomes. The Y chromosome too can be visualised by appropriate staining of the chromosomes.

The sex of a baby can be determined by using these techniques of sex determination. For prenatal diagonosis the foetal cells can be collected by the method of amniocentesis or by chorionic villi sampling for a karyotype analysis.
The genetic sex of an individual is determined at conception. Men produce two types of sperms, some containing only X chromosomes while others containing the Y chromosomes. Women produce only one type of eggs, all of them containing one X chromosome.

 

When fertilisation takes place, the sex of the foetus is decided on the basis on which type of sperm happens to have fertilised the egg. If the X-carrying sperm fertilises, the foetus is a girl with XX complement of the sex chromosomes. If, on the other hand, the Y-carrying sprem fertilises the egg, the foetus is a boy with XY chromosomes. It is important to note that normally the changes of getting a boy or girl are equal at conception.


The Story of AIDS : Introduction

Tracing the history of AIDS is like unravelling a mystery story. This story also begins with "A long time ago, there existed an agent- which came to light only in the 1980s'' AIDS-acquired immune deficiency syndrome - is a condition in which the in-built defence systems of the body break down completely. This phenomenon is gradual, but ultimately leads to total depletion of a very important cell component of the immune mechanism. Those affected aree thus unable to combat commonly known diseases like pneumonias, diarrhoeas, tuberculosis (TB) and even common colds; ultimatelu, they die due to one or another of these infections. Beacuse of the varied nature of these diseases, called 'AIDS associatede', 'AIDS related' or "AIDS indicator diseases' (including cancers), AIDS has been identified as a syndrome rather than a single clinical entity. This means that AIDS patients show several signs and symptoms whihc occur together at the same time.

AIDS was recognised for the first time in the USA in 1981. At that time, it was mainly associated with either of the two major indi- cator diseases. (1) an unusual type of pneumonia caused by a protozoan parasite, pnuemo- cystis carinii (2) a cancer mainly of teh skin called Kaposi's sarcoma, which was rarely seen in people under 60 before the advent of AIDS. These diseases, with various combinations of other common infections, were first noted in young and active men who had been otherwise quite healthy. All of them shared a sexual life-style that was different; they were men who had sex exclusively with men. In other words, these men were homosexuals, coloquially called 'gays'. Since the syndrome was first recognised in them not only in the USA but subsequently in Europe and Australia, it was called gay related immunodeficiency or GRID.

 

A little later, cases of AIDS were identified among drug addicts, especially intravenous drug users (IVDU). Most of those found to be affected with AIDS started dying and thus the peculiar combination of sex and death attracted and gave rise to many myths and misconceptions.

 

Earlier also, civilisations had witnessed devasting global epidemics or pandemics: for example, bubonic plague in the 18th century and the Spanich flu in the 19th century which had globally killed millions of people within a short period. AIDS however appeared to be different. AIDS also killed those affected surely though slowly. But, because of the early stamp of homosexuality and IV drug use among those who dies, the patients with AIDS (PWAs) were not called AIDS patients (like cancer patients) but were termed victims. This word implied a kind of helplessness; a feeling that these patients were being sacrificed due to some ritual performed by them or under other such conditions. Perhaps, the word 'victim' was applied to show that these persons were sacrificed because of the 'wrath of God'.

Soon enough, however, there came to light another group of AIDS patients who had no peculiar life-style or risky behaviour. This group consisted of persons (children and adults) who had received transfusion of blood or blood products. When more and more women got AIDS, it was found that children born of these women developed AIDS. All these persons were also identified as victims, but now, they were qualified as 'innocent' victims so as to discriminate between the 'guilty' ones. It is best to avoid such a negative moralistic approach which imparts a sense of helplessness to patients with AIDS.

With the widening of people 'at risk' of contracting AIDS and also involvement of many countries of all the continents, the earlier complacency gave way to panic. Panic, because although it was already recognised by scientists that some infectious agent could be responsible, there was no known measure available for stopping further spread of this yet unidentified agent.


Abnormal Sexual Differentation/Development

Sometimes this seemingly simple process of genetic sex determination may fail to occur normally, and the baby is born with an abnormal set of sex chromosomes. The effect of such situation is devastating.

 

 

When an abnormal sperm carrying no sex chromosomes fertilises a normal egg then the baby is born with 'Turner's syndrome' (named after H.H.Turner, in 1938). One in 2,700 babies is born with such a problem. Often undetected a birth, the diagnosis of Turner's syndrome is made at adolescence when the individual fails to attain normal puberty. A typical short stature, a webbed neck, shield-shaped chest with wide-set nipples sets the person apart from others. A karyotupe analysis reveals the presence of only one X. Unfortunately little can be done except for hormone treatment which is recommended for growth of bones and attainment of height.

 

An equally serious problem arises when an individual has an excess of sex chromosomes. Most commonly encountered cases are those that have an X in addition to the normal XY complement. These individuals diagnosed as 'Klinefelter syndromes' (named after J.E. Klinefelter, in 1942) are males with poorly developed testes and enlarged breasts. There are a variety of sex chromosomal abnormalities that can arise during fertilisation and early development. Unusual cases may be mosaic with some cells with one X and others with an extra X. These individuals too fail to attain puberty. Some patients do improve with hormone therapy.

 

Careful studies of sex chromo- somes abnormalities provide some insigths into the role of X and Y in the development of sex. X seems to be important for fertility in both men and women. Genes present on the X control ovarian development and both the X chromosomes are necessary for normal gonadal growth. (Females with XO complement are often sterile). The presence of Y chromosome determines the male features. (Klinefelter with multiple X is a male as the Y chromosome is present). Following these arguments, the role of genes on the X and Y in gonadal development has been worked out to the molecular level. While most genes on the X chromosome are important for functions other than sex determination, some are essential for early gonadal development in men and women. The Y chromosome carries the testis determining genetic information. The presence of Y initiates embryonic testis formation, while its absence (as in normal females) leads to formation of ovaries. Genes that play a role in gonodal development are not restricted to sex chromosomes. Some genes are present on other chromosomes as well. A well-regulated expression of these genes is most important for normal gonadal development.

 

The human embroyo has no distinct sex organ until it is about five-weeks old. Just a little later a set of cells destined to form the gonads can be located as a thickening called the 'gonadal ridge' or 'gonadal crest'. In female embryos these cells eventually form the supporting tissue in the ovary, the granulosa and the thecal cells. Interestingly, the germ cell, the cell that gives rise to the ovum, originates in an entirely different embryonic region, i.e., the gut. These extra embryonic cells, destined to form the ova, migrate, moving through the tissues, probably guided by the chemical cues, to the genetial ridge. On reaching their destination, they settle down and multiply to form the mass of fonadal tissue.


The 'usual' And Moderate Legs-Up Posture

The 'usual' position

With the wife's knees raised a few inches and spread to accommodate her husband between them a couple can achieve the widest possible variety of reciprocal movement and caress. The husband almost has to support the weight of his lower body with his knees to gain purchase for his own movements, leaving his wife's hips free of any crushing encumbrance.

He usually supports part or all of his weight on his elbows, atleast until the climax is quite near, so that her breasts remain accessible to continued and varied caress. The wife has good purchase for hip movements, both hands face, and wide areas of her husband's body available for caress. Her posture does not tire her and allows intervals of rest if necessary - an important factor in married sex, which often comes at the end of a wearisome day.
Even when you begin to feel bored with the 'same old procedure', the 'usual' position has a rightful place in many episodes. You can get considerable variety into its sexual frictions with measures described in the next chapter, and will find its reciprocal action hard to duplicate in most of the 'variety' postures. Especially as the climax nears, you will want to assume this posture, which permits both partners to express their feelings in paroxysms of mounting movement and caress.

The moderate legs-up posture :-

If the wife brings her knees higher, she finds a position in which her thighs fit comfortably alongside her husband's flanks. Her heels lift off the bed before she reaches this posture, but she can keep her legs comfortable and gain traction for some body movement by letting her calves rest upon his buttocks or bu crossing her ankles behind his hips. This position also proves extremely comfortable if both partners roll to one side after assuming it, since the wife's thigh usually fits into the hollow of the man's flank without being pinched or crushed.

Since the moderate legs up posture lines up the penis almost exactly with the vagina's orifice, it allows absolutely complete penetration of a type which usually proves quite satisfying to the wife. The husband can also reach and massage the clitoris with his finger or thumb during intercourse, adding an extra fillip of stimulation.

 

Only the vagina's natural anugness makes any husband-gratifying pressure on the penis, however. Natural snugness sufficies in the early years of marriage, but decreases sharply with motherhood and continuing sexual experience.

 

By the time their sex life needs revitalizing most couples still find the moderate legs up position useful mainly as means of letting the wife catch up without pushing the husband into a climax, since it is much more exciting for the woman than for the man. The variation in which the couple rolls to one side in this posture is also useful because it lets you rest physically before the final climax without losing excitement. Without some such ulterior motive, however, the husband will seldom find this position very satisfactory.


Discovery of the Causative Agent

The major ingredients in solving a mystery is to find out who are affected. amd also, how and why. After this, one can pin down what caused the event, i.e. the entity responsible for the myste- rious event. It was, perhaps, fortunate that AIDS occured during the initial phase in the economically developed industrialised countries like the USA, France and other countries in western Europe. The much needed infrastructure and expertise already existed in these countries. The result was that several questions pertaining to who were affected. why and how could soon be answered partially, if not fully.

After many attempts to incrimi- nate several known agents, scientists realised that the infec- tious agent mainly responsible for AIDS must be a virus that might be 'new' to science. The syndrome was recognised in 1981, and by 1983, scientists in France discovered the AIDS virus and showed that it was indeed 'new'. In 1984, virologists from the US also published their report revealing a virus to be the causative agent.

 

At first, different names were given to the AIDS virus by the French and the American workers, and, there were great differences of opinions and debates regarding the question of priority between the two nations. Ultimately, the international committee on the Nomenchature of Viruses intervened and the name human immunodeficiency virus or HIV was accepted. However, the controversy regarding whose virus was used in the manufacture of diagnostic reagents and such other issues of patent rights have not totally subsided even now.

Recognition of AIDS as a new disease does not mean it was entirely a new syndrome. In fact, immunodeficiencies of three types had been recognised earlier. Genetic or hereditary deficiency is passed on from parents to the new borns in the form of a defective gene. This does not allow the full complement of immune mechanism to function in these persons. The second type is that induced by doctors, in certain circumstances. For example, before transplanting organs such as kidneys, doctors deliberately induce immunodeficiency so as to prevent the receipients from rejecting the transplants. In addition to the genetic or hereditary one and that induced by doctors, the third or acquired immunodeficiency was also known to exist earlier. Indeed, it was especially recongnised in African countries and other tropical, economically developing countries like Asia, including India. These were, however, mostly attributed to old diseases caused by parasites, compounded further by nutritional deficiencies (including malnutrition), all of which are commonly encountered in these countries. The AIDS, as identified in 1981 in the USA, was caused by a newly recognised retrovirus called HIV and therefore it was different. The fact that evidence of HIV infection was not obtained much earlier, imparted its own distinction of newness to AIDS.

Suggestions and ideas on where the AIDS virus could have originated first have led to a raging controversy including allegations of racism as described in a later articles. Hypotheses ranging from absurd to plausibel have been put forth indicating probable involvement of tetrovirus of animals, particularly monkeys. Among the various attacks and counter attacks, words of wisdom had been spoken by some in an attempt to diffuse the situation. Among the most relevant ones are the words from Kenneth Kaunda, the the president of Zanbia, who had already lost one son to AIDS. He stated : "What is more important than knowing where this disease came from is where it is going''


Abnormal Sexual Differentation/Development

At the fifth week after gestation the gonads are alike in the male and the female foetuses and are referred to as 'indifferent gonads'. In the male foetuses the Y chromosome synthesises special protiens, the 'testis-determining factor', that causes the indifferent gonads to develop into testis. These proteins are coded by a set of genes called the SRY genes. In absence of Y, in the female foetuses not much change takes place at this point of time. By six weeks of gestation the male foetuses, ahead of time in gonadal development as compared to their female counterparts, already have a testis. No such hurried development takes place in the female foetus. The ovaries develop at a steady pace along with a set of tubes called the "Mullerian ducts (named after J.Muller, the German anatomist)

Care a set of embryonic structures that develop along with the gonads in both the male and female foetuses. In males, as the testis develops, a substance called the mullerian tube inhibiting factor (MIF), is produced by the testicular cells. In the presence of this factor the Mullerian tubes regress and another set of embryonic tubes called the 'Wolfian tubes' (named after C.F. Wolf, the German embryologist), form the male accessory organs. On the other hand, in the female foetuses, in absence of MIF, the mullerian duct gives rise to fallopian tubes, uterus and the upper part of the vagina. Further, absence of the sex steroids, the androgens, in the female foetuses causes the regression of the male embryonic features and the female external genitalia are formed. In the male embryos the presence of androgens stabilises the male organs, leading to the formation of the male external genitalia.

The foetal ovaries that began developing at fifty to fifty-five days of embryonic development are identified as definite structures is the tenth week after conception. The ovarian tissue develops with the cells specialising to support the ova. The granulosa cells from an eight-to-twnety-week-old foetus produce an increasing amount of enzyme that converts testosterone to oestrogen. Until eight weeks of gestation, the external genitalia of both sexes are identical. By twelve to fourteen weeks of gestation the external genitalia are fairly defined and distinct in the two sexes. The chemistry of sex is slowly being established. The hypothalamus, the pituitary and the goenads develop chemical dialogues.

This is a critical phase of sexual development and the foetus is susceptible to environmental influence. Most important is the influence of the drugs and the hormones taken by the mother at this stage of pregnancy. Unnatural modulations of teh developing endocrine system can cause lasting problems. A modified gonadotrophin releasing hormone level can cause permanent damage, such as the formation of an amboguous genitalia. Failure of the foetus to acquire normal gonadal sed, either because of chromosomal abnormalities or because of environmental factors that disrupt development, is of concern. In case of the former, a choice of medical termination of pregnancy can be offered if the defects are identified well in time. Abnormalities caused by environmental factors can be avoided by carefully monitoring the intake of pregnant mothers, especially in the first three months of pregnancy when the foetal organ formation is in full swing. In these months exposure of the mother (and the foetus) to drugs, hormones or radiation can cause irreversible damage, some of it affecting sexual development.


The Maximum Legs-up Posture

If the wife lies on her back in the moderate legs-up posture, then raises her legs still further while her husband 'steps across' one with the corresponding arm, then repeats on the other side, the couple reaches another stable posture. The wife's heels rest on the husband's shoulders and the natural recoil of her stretched leg muscles almost supports his weight, the balance of which rests upon his arma. Slim or average-weight woman generally find this posture both comfortable and highly stimulating. Most husbands find it satisfying too. In fact, in many parts of the world, this is the 'usual' position, the legs-down postures seldom being used.


Any woman who responds keenly to the urethral caress described in the last chapter will usually gain substantial gratification from the maximum legs-up posture, which directs the thrust of the penis strongly against the vagina's front wall. Since this area becomes sexually sensitized only after some months of gratifying sex life, many couples who found this posture unsatisfactory in their early days of experimentation get keen pleasure in it on any 'second honeymoon'

If childbirth or years of sexual activity have relaxed the vagina until its natural snugness no longer stimulates the penis much in the usual or the moderate legs-up postures maximum legs-up posture often proves a real boon. In this position, the penis enters at such an angle that the top of its tip rubs firmly along the vagina's top wall and the bottom of its shaft presses snugly against the female organ's bottom edge. These stimulations do not quite match those which the husband receives from a highly active wife in teh 'usual' position, but they generally exceed the gratifications available from a relatively motionless wife in any othe posture.

Although the maximum legs-up posture gives both partners some varieties of stimulation which no other posture extends, it also deprives each of them of certain other gratifications. The wife's hips and legs are held stationary in this position, making it imppossible for her to make the usual type of sexual motions. Kissing and other forms of mouth play are impractial. The husband needs both arms to support his body and cannot caress his wife's breasts or body during intercourse. These drawbacks generally keep it off the top of the list, but certainly should not cause it to be scratched entirely.

A few wives find the use of this position marred by an occasional spasm of vaginal pain, usually attributed to 'hitting bottom'. Actually this problem may stem from an unusually long or sharply angulated protrusion of the womb into the vagina. The male organ glides along the vagina's front surface in this posture, so that it often strikes the protruding womb segment. Pain results; not from impact against the relatively insensitive womb, but from stretching of the cuff of vagina through which it normally protrudes. Since the structures involved are located fairly far up the female passage and exactly in the centre of its front wall, a moderately asymmetrical position which directs the penis thrust slightly to one side usually prevents further difficulties.


How HIV/AIDS can Spread

The word epidemic is generally applied to an infectious disease which affects many individuals around the same time at a certain place. The time and the place are the most important determinants. If an epidemic of the same disease is seen almost all over the world, then it becomes a pandemic; for example, the occurence of pandemic influnenxa around the world at the same time. AIDS was recognised first in the USA and Africa and subsequently in most industrially developed and developing countries of the world. No country of the world seems to be free of it. AIDS has indeed established a pandemic situation.

Epidemiological studies to understand the why and how of the AIDS pandemic are important. A correct understanding of the evolution of an epidemic situation in a particular region in generally expected to help in formulating measures for prevention. Epidemiology has contributed significantly and is currently contributing substantially to the knowledge of HIV and AIDS. As a matter of fact, within the first 18 months- a full year before AIDS virus was recognized as the cause - and, two years before HIV tests became available, epidemiological investigations led to several beneficial public health measures. Those at high risk of AIDS, called risk groups, were recognised; routes of the disease spread were identified and even recommendations were made to reduce risks by behaviour changes.
As a first step to determine how an epidemic develops or is evolving, it is crucial to define the disease under investigation.

 

As defined by the Centres for Disease Control (CDC)of the USA: "AIDS is a disabling or life threatining illness caused by human immunodeficiency virus (HIV) characterised by HIV encephalopathy, HIV wasting infection or without certain diseases due to immunodeficiency in a person with laboratory evidence for HIV infection or without certain other (known) causes of immunodeficiency. (These other causes will be mentioned in other episodes). The emphasis was thus placed on associated diseases which help to identify a patient with AIDS. In 1987, the definition was revised by expanding this list and including many diseases as indicators of AIDS. Within a few years, however, doctors realised that many other infections such as those causing gynaecological problems in women should also be included. In fact, at one point of time or another, infections associated with many different systems of the body are likely to occur.


Abnormal Sexual Differentation/Development

Hermaphoroditism is seen in many forms and degrees. Disorders of sexual development are diagnosed either immediately at birth or at puberty. At birth, when a baby is found to have the ambiguous external genitalia, then the gender identity is established by chromosome analysis. When genetic sex is different from the genital sex, the condition is called 'pseudohermaphrodi-tism'. Male pseudohermaphrodites have the normal set of chromosomes with XY as sex chromosomes. Yet, the genitalia may be feminished to different extents. This could be because of deficient androgen production or abnormal responses of the foetal tissue to androgens. Defect in synthesis of or response of MIF can also cause such defects.

Female pseudohermaphroditism also has apparantly normal genetic sex. Ovaries and uterus may be normal but there is virulisation of the external genitalia. At times, the reproductive function is possible in female pseudohermaphrodites. Excessive exposure of the foetus to androgen is recognised as a cause of this condition. Abnormal androgens can be produced in the foetus itself due to defective adrenal glands. Inherited metabolic disorders can also produce excessive androgens. At times the foetus is affected by the increased circulating androgens in the mother. This is either because she has taken it as a hormone preparation or because of the unfortunate presence of an androgen secreting tumour.

When babies are born with sexual development defects it is a medical and social emergency. While complete clinical evaluation of babies for other defects as well are to be done immediately. On the basis of clinical investigations appropriate sex can be assigned to the babies and the parents can be counselled to rear the baby accordingly. Such tragedies are however rare and most babies are born with normal genetic as well as gonadal sex.

Once the gonadal sex is established, there is little that happens in terms of sexual growth until puberty. The ovaries in a normal pre-pubertal girl do not release gametes. Though the sex hormones are produced in some quantity, their modulation with respect to each other is yet to be established. The accessory sexual organs show steady but little growth. No psycho- logical gender identity is preceived in these childhood years. And when it is perceived, a rapid set of changes in the body are triggered, ushering the individual into puberty. Rearing children in a conducive socaial environment. And as the critical stage of sexual development-the puberty-approaches, social and cultural factors play an increasingly important role. Youngsters expect psychological support and understanding of parents at this crucial stage in their life. At times disorders of reproduction are linked to insensitive surroundings during the transitional stages of sexual maturity.


Asymmetrical Positions In Intercourse

Asymmetrical Positions :-

In the early days of marriage, a wife almost automatically keeps her two legs at the same height, so that her husband approaches from straight ahead. The snugness of the vagina makes straight ahead entrance more comfortable, and the extra stimulation of the midline occupying clitoris makes straight-on-fictions more pleasing.

Unfortunately, most couples never break this pattern. Asymmetrical postures add variety to sexual frictions while still retaining all the advantages of the familiar symmetrical approaches, once full sexual awakening has enlivened feminine sensitivity throughout the genital zone. You can add freshening novelty to your sex life while still enjoying the case of mutual caress, the mutual movement, and the intimacy of face-to-face contact by simply raising one or the other of the wife's legs somewhat farther than the other and making appropriate adjustments in technique. And each of these postures add two new variations, since you can get completely different frictions by changing right for left.

One leg straight, one in the 'usual' position :-

With one of the wife's legs down flat on the bed and the other raised some- what, both partners enjoy substantially different sexual frictions than those experienced 'straight on'. At the beginning of its thrust, the penis rides against one inner lip. As the penis tip moves up the vagina, its shaft swings over towards the centre of the female organ's rim, sweeping across the inner lip and engaging the clitoris. Meanwhile, the male enjoys slightly snugger vaginal contact, together with whatever active movement his wife provides-generally quite a bit, since she has more room and much better purchase in the position than in the pillow-trict or both-legs straight postures.The husband can use either of two approaches in this position. He can keep both knees between his wife's legs, which makes him approach at a slight angle (since her extended leg crowds his knees out from the straight-ahead spot)

This slight angulation not only alters sexual friction, but also puts him in an almost ideal position for kissing and caressing her breasts during early intercourse. Or he can throw one thigh across his wife's straight-out leg, and approach straight on. In this case couple usually rolls slightly towards the wife's straight thigh against the bed. In this position, the fixed thigh acts as a source of freedom for the wife's movements, which falls on the straight leg's hip. The wife moves in an entirely different manner when she uses the position than when she digs in her raised leg's heel, and alternation or combination of the two movements gives a greater variety of sexual frictions than in possible in the 'usual' posture.

One leg straight, one raised to flank height :-

when the husband's weight holds one of his wife's thighs firmly fixed against the bed, the muscles with which she usually moves that thigh propel her pelvis instead. You can use this fact to overcome the principal disadvantage of the moderate legs-up posture the fact that the wife cannot move his hips very well in it while still permitting the full penetration and intensive stimulations it affords. After sexual entrance in the 'usual'position, the wife straightens out one leg as far as is comfortable and bends the other until its thigh cradles itself comfortably in her husband's flank. They both then roll towards the straight leg side until his weight rests firmly enough on her thigh in immobilize it. This firmly planted body part then gives purchase to her instinctive body movements, and also allows a considerable variety of other 'action'. Any movement she makes which would ordinarily bend, turn, or straighten her hip will now move her body instead, and the same time send ripples throughs the thigh muscles upon which her husband's body rests. With a little practice, she can achieve various gyrations which combine with her husband's in-and-out movement to create a virtual symphony of varied stimulation.

One leg 'usual', one raised to flank height :-

A simpler but somewhat less novel way of adding feminine movement to the moderate legs-up posture simply drops one leg from its flank-cradled position back to the 'usual' heel-on the bed-for-better posture. The couple can then roll slightly towards the more raised thigh if desired, so that the free leg's hip has a bit more room to move.

 

One leg moderate, the other maximum 'legs ups' :-

The wife raises on leg all the way so that its heel rests on her husband's shoulder, but leaves the other thigh cradled in his flank. This twists her body just enogh that her husband's penis tends to a veer to one side of the uterus as it slides up the vagina's front wall, and prevents any spasms of discomfort which might have occured in straight on action. The husband has to support most of his body weight on his arms, since he lacks the symmetrical support of his wife's leg muscle recoil. Wives who have not had such spasms of pain generally have no strong preference between the symmetrical and asymmetrical legs-up postures, and use this position solely for the sake of extra variety.


Couples Inverted Positions Of Intercourse

You will probably benefit substantially in other ways than through the pleasure of the epi- sodes themselves from occasio- nally having intercourse in one of the wife on-top positions. The inverted postures gives the wife the chance to vary couple position until she finds the exact tupes and degrees of pressure which give her the most stimulation. This guides the husband in his choice of exact position in other postures. Inverted postures leave the husband with both hands free and with ready access to every part of his wife's body, which encourages him to explore the art of intercourse accompanying caress. Perhaps most important of all, inverted postures teach the wife to combat her natural tendency towards enraptured inactivity during paroxysma of sexual delight. In the inverted positions, the wife has to continue movement throughout her climax or 'lose out''. She usually finds that continued activity enhances her own pleasures as well as her husband's. When she applies this discovery in other postures, couple sex life takes a giant stride.

You will probably find it easier to get into the inverted postures by making sexual entrance with the wife below, assuming the lock position described above, and rolling over. This auto- matically brings you to the equivalent of the moderate legs up posture, with the wife's thighs cradled in the husband's flanks. In the inverted posture, the position gives the wife considerable purchase for movement by bringing her knees and feet into contact with the bed. The wife can lean of back to increase pressure of the penis tip on the front surface of her vagina or slide downward to bring the shafrt int ocontact with the sensitive structures at the vagina's frontward edge. She can produce in-and-out movement by bouncing up and down and other frictions by moving her hips. The husband contributes mainly by caress, since his wife's weight immobilizes his pelvis and his hips.

After rolling into inverted position, the wife can also straighten out her legs and rest her knees upon the bed between her husband's thighs. The wife usually needs to keep her legs a few inches apart in order to keep from angulating the penis too sharply, and sometimes finds contact easier to maintain if the husband tucks a small pillow underneath his hips. Both partners can continue substantially to sexual frictions in this posture if they do not try to 'steal each other's thunder' the effective movements are not at all like those used in the same position by the other partner.

The wife makes no effort whatever to support her body weight with her arms, letting her body rest full-length upon her sturdy spouse. She digs her toes into the mattress for extra purchase, and slides her whole body headward along her husband's truck as far as the elasticity of their tissues permits, leaving the penis to emerge part way from the vagina through being 'left behind'. When she relaxes, tissue recoil brings her back into the original position, and brings the penis back to its former depth. Both partners can add to this basic movement by rocking the pelvis and twitching the sex organs, as well as increase stimulation with both hands by bodily add climatic caresses.

The asymmetrical position in which the wife has one thigh cradled in her husband's fland and the othe leg down straight between his thighs offers another completely different set of sexual frictions. The wife's bent leg takes most of her weight off of her husband's hips and makes it easier for him to make rocking movements, and the wife can vary her pelvic action tremendously by alternating or combining the movements of the two postures described above.


Incubation Period And How HIV Spreads

Incubation Period :-

The virus of AIDS, called human immunodeficiency virus (HIV), infects persons but does not produce illness for a very long time. This interval between the exposure to virus (HIV infection) and the manifestation of the disease syndrome, i.e. AIDS, is called the incubation period. HIV-infect persons generally remain overtly healthy during this period although they may harbour the virus in the blood. They, infact, act as carriers of HIV and can infect others.
The average incubation period is estimated to be around eight to ten years for adults. It is generally much shorter, around 18 to 24 months for children. When we speak of HIV, it would generally mean infection without disease. It is estimated that about 50 per cent of infected adults will develop AIDS within ten years of exposure to HIV. Ultimately, however, majority of the infected adults will progress to AiDS. The ratio between the numbers of HIV-infected persons and AIDs cases gives an idea of when the virus might have been introduced in a country. A high ratio generally indicates an early stage of teh epidemic, that is preponderance of HIV-infected persons who have not yet progressed to AIDS.

How HIV Spreads :-

HIV is an infectious disease but is not easily transmitted through the environment, e.g. from air, water, food, etc. Thus it is not a communicable disease like common cold, influenza, measles or polio viruses and other infectious agents. The virus enters the body in three major modes. The most important mode is having sexual intercourse with an infected person. The virus can be transmitted from men to men, men to women and to a slightly lower extent (two to five times less) from women to men. The virus transmission is facilitated when either partner has other sexually transmitted diseases (STDs). Genital ulcers and other infections such as syphilis could act as co-factors, aiding and abetting the AIDS virus.
The second mode is through transfusion of HIV-infected blood or blood products or through infected blood in needles, syringes and other such instruments. These include needles, and syringes shared by intravenous drug users and those which might be reused by doctors/nurses for injections without proper cleaning and sterilisation. The third way is the transmission from and infected mother to her newborn.
Although HIV has been detected in several body fluids, it is infectious mainly from blood, semen and viginal secretions. For instance, very few virus particles have been detected (even by sensitive techniques) in saliva, tears and breast milk. Since an infant can consume about 800ml to one litre of breast milk per day, there are chances that it might get infected through this route. However, various advantages of breast milk which make an ideal baby food should be weighed agains this small chance of transmission. In any event, saliva and tears are not consumed in such large quantities and thus are not considered likely to spread the virus of AIDS.
Just as important, or perhaps even more important, is to know how the virus does not spread among people. The fact that HIV cannot enter the body through most of our normal activities are emphasised. Among these are included hugging, kissing, eating, drinking, swimming, working and travelling together. One question often asked by people is whether AIDS virus can be transmitted through bites of mosquitoes and other insects. Fortunately, experiments by artificially infected mosquitoes showed that unlike the malaria parasite of dengue virus, HIV has neither a life-cycle nor does it multiply in mosquitoes. The doubt that mosquitoes may take blood of an HIV-infected person and may act like a 'flying needle' has also been removed on epidemiological grounds. Studies in a large number of households of PWAs or HIV-infected persons in Africa revealed that transmission to an uninfected person occured only through sexual partners. Childrend and other adults in the households remained free of HIV, despite having casual contacts with HIV/AIDS patients and despite the large  number of mosquitoes in the environment.


Some factors play a major role in initiating puberty in girls

Some factors that do play a major role in initiating puberty in girls have been identified. Genetic predisposition often decides the age of menarche. This is apparent when ages of attaining puberty of mothers and daughters, siblings or twins in compared. General health and nutritional status greatly influence the pubertal age. Well-built and adequately nourished girls attain menarche much faster, say, at a younger age of about eleven to thirteen. Undernourished girls attain puberty much later, at about fifteen or sixteen years of age. Menarche in moderately obese girls is earlies than in girls who have less deposits of fat and are lean.

Delayed menarche is often observed in athletes. Weight does not seem to account for the variations seen in the age for menarche. In girls belonging to underprivileged classes, where they are often deprived of a good diet, menarche may be delayed. This often turns out to be a blessing in disguise for it allows girls to have some time for themselves, for menarche is a strong impetus to marriage. In city dwellers, tensions in life and a heightened awareness ushers girls earlier into puberty than their rural counterparts. Girls belonging to populations staying in warm, sunny climates tend to attain puberty earlier than in those staying in colder climate. Apart from these general factors, some pathological conditions may also alter the pubertal age.

Onset and progression of puberty is a unique process for each one of us, more so because of the variety of factors that influence it. It becomes difficult to generalise what constitutes a normal puberty. However, in a clinical situation when assessment of normal puberty is to be made some criteria are taken into consideration, keeping in mind the possible normal variations. The criteria most commonly used are based on maturation of the secondary sexual characters. Tanner proposed this scheme of assessment of pubertal changes in 1962. Other schemes of assessment based on radiographs of bones and teeth are also used. Psychologists find it inadequate to base their assessment on physical parameters alone, and often develop their own indices for their purpose. While these measures may turn out to be very useful, they are best used in combination with physical measures for a complete picture. Tanner's classification, being simple, has found wide acceptance.

Tanner classified puberty into five stages based on different observable changes in sexual characteristics, like development of breasts (called thelarche) or growth of a typical pattern of public hair (called pubarche). If thelarche is taken as a criterion for assessment of puberty, five stages of progression of growth can be well defined. On an average thelarche spans over four years, starting at ten years of age. These four years can be divided into four developmental time-frames.

Stage I is the pre-pubertal stage with no development apparent in the breast tissue. In stage II (the bud stage) the subareolar breast buds are formed. Shortly after there is a typical increase in breast size but not much change in contours is seen. Further enlargement of areola and papilla with secondary mound over enlarged breasts with contours is the stage IV of thelarche. Soon the mature breast size and coutour is attained and marks stage V. All through the stages of thelarche the gonadal tissue also matures. Thelarche is due to the build-up of oestrogen secretions by the maturing ovarian tissue.

Almost simulataneously the development of typical pattern of public hair takes place. Pubarche or development of public hair begins in a majority of girls a little after initiation of breast development. Puberty on the basis of pubarche can again be classified into five stages. Stage I is pre-pubertal with no public hair seen. Stage II is characterised by development of sparse and straight labinal hair. By stage III typical dark, coarse and curly hair develop to cover the pubis. In stage IV the almost adult pattern but a little less of public hair is seen, while in stage V the adult inverted pattern of public hair emerges. These changes span approximately two-and-a-half years, starting at about ten years of age. Menarche or the first menstruation occurs just as stage V of thelarche and pubarche is attained, about two years after the onset of breast development.

The menstrual cycles immediately following the menarche are irregular and anovulatory. This means that though there is menstrual bleeding, no ovum is released. It takes about two to three years for the pattern of the cycles to set to a typical one. In a normal young woman this pattern, with accompanying regular ovarian changes, is well established by the age of eighteen to twenty-one years and continues till menopause, unless interrupted for a short time by pregnancy.


Inverted Positions Of Intercourse

Finally, many couples find the inverted posture extremely stimulating for both partners when assumed with the husband sitting up instead of in bed. The chair used for the purpose should have a well-padded or pillow-cushioned seat, since the husband will slouch down enough so that his weight rests on the base of his spine. Its height should allow his feet to rest firmly on the floor without an uncomfortable line of pressure at the seat's frond edge, and the back should be sturdy enough to withstand considerable thrust. You can roll from the bed to a nearby chair in the locked position after sexual entrance, or make entrance while on the chair.

At any rate, the wife winds up stradding her husband's upper thichs with the penis inserted about halfway, facing her husband who has slumped down into the chair slightly to bring his hips forward into range. The wife can hook her heels around the back legs of the chair and impart to and fro motion to her pelvis by pulling her body towards his, then letting it recoil. She can rock her pelvis towards and away from him or wriggle from side to side. She can reach almost every part of his body with her hands, and can kiss or fondle him in a variety of ways.

The husband imparts in-and-out motion by bounching his wife upon his lap, not the traditional hip movements. He can titilate her clitoris and inner lips, her breasts and her buttocks, with his hands. The combination of ready caress and varied sexual motion makes a sustained period of ecstatic transport almost always possible, with a fitting climax available either through continued chair bound action, or by a lock-position swing back on to the nearby bed.

Almost every couple who uses the inverted position correctly finds it a very worthwhile variant. Some wives, however, sit directly on the penis instead of some- what in front of it, making the posture ineffective. The wife should slide her hips back three or four inches from the locked-position spot before commencing action in this posture, leaving herself room to move, have some leverage for action, and increasing the pressure of the shaft upon her organ's inner lips. She should not try for maximum penetration or intensive pressure: the stimulations of this posture stem from its wide variety of movement and caress, and from its gentle, almost titillating contract rather from forceful thrust.


Persons at High Risk of Contracting AIDS

From the above it should be clear that only certain situations are likely to facilitate the spread of AIDS virus. Most important among these are those with risky lifestyles or risk behaviours, e.g. female prostitutes (now a days termed commercial sex workers), male homosexuals and, of course, the people who have sex with multiple partners including strangers, whether male or female. The reason is that whilst even a single sexual encounter with an HIV-infected person may transmit the virus, chances of transmission increase with the frequency of sexual intercourse with many. All teh above-mentioned groups of people with a promiscuous life-style were called high risk groups, but this term is not applicable to recipients of blood and blood products. In general, therefore, the term high risk situation should be preferred.

Scientists from the World Health Organisation (WHO), particularly those in the global programme on AIDS (GPA), have been active in compiling and disseminating global information. As a part of the programme, they had determined efficiency of different modes of transmission and the percentage of AIDS cases recorded in the world for the respective mode.

 

Tyoe of exposure

Efficiency per Single exposure

Percentage of global total

Blood transfusion

>90%

3-5

Perinatal

30%

5-10

Sexual Intercourse

(Vaginal)

(Anal)

0.1-1.0%

 

70-80

(60-70)

(5-10)

Injecting drug use

sharing needles, etc

0.5-1.0%

5-10

Health care -

needle-sticks, etc.

<0.5%

<0.01

The data summarised in Table reveal blood transfusion to be the most effective (more than 90 per cent) and sexual intercourse to be much less so. However, the proportion of AIDS cases was much higher for heterosexual transmission because it is a natural everyday event as compared to blood tranfusion. Unfortunately, among the recipients of transfusion are highly vulnerable individuals who have to depend on continued administration of certain blood products throughout theri lives.

 

These are people with hereditary diseases such as thalassaemia and haemophilia. Because of the frequent administration of the requited blood products, they face a risk situation on receipt of infected blood products. The risk is reduced, if not totally eliminated, if manufacturers follow standard good practices laid down for the manufacture of blood products. Babies of HIV-infected mothers also face a high risk situation. HIV infection is not transmitted to all infants of the infected mothers; it is estimated to be passed to about 20 to 40 per cent of infants. No definitive study has been carried out in India so far, but the number of HIV-infected mothers is increasing.

Global Patterns of HIV Infection :-

Epidemiological studies carried out during the early period of AIDS indicated three broad geographical patterns of HIV in the world, as shown in Table. India falls into Pattern III countries where the virus was introduced or began to spread much later (almost a decade later) than in the countries of Patterns I and II. Developments which occured since then indicate that expert for this initial delay in spread, India on the whole seems to follow the Pattern II countries.

In the earlier stages, it looked as if a particular concentration of AIDS cases occurred among the moneyed, the urbanised 'upward' community. This feature was clear in the Western world where homosexuals were mainly involved. Even in African coun- tries, where the heterosexual mode of spread was most common, this socio-economic and urban-rural difference had been commented upon.

 

 

Pattern - I

Extensive spread of HIV began in the late 1970's/early 1980s.

Homosexual males and IV drug users have been the predominantly affected populations, but heterosexual transmission increasing.

Pattern - II

Extensive spread of HIV began in the mid-to-late 1970s/ early 1980/s. Heterosexual transmission has and continues to predomine

Pattern – III

Introduction and/or extensive spread of HIV did not occur until mid-to-late 1980s. Extensive spread of HIV is now being documented in several countries in South-east-Asia, but the prevalence of HIV, in most countries classified within this pattern, remains relatively low.

Countries in Asia are included in Pattern III, where HIV was introduced late. Although the number of cases of AIDS in India is low, it is likely to increase very fast in the near future

 

Later, however, minorities and particularly the poor communities with low levels of education were increasingly recognised to be affected in the developed world. In fact, the current trend is stabilisation of the spread of HIV/AIDS among the risk groups first to be recognised, with a rapidly rising spread in the latter. In the Pattern II countries, especially in Sub Saharan Africa, AIDS and HIV infection are increasingly being recognised in remote rural areas also. In the present global context when a commercial soft dring or a bath soap can reach isolated villages, the presence of infectious agents like viruses should not cause any surprise.


Harmonal Changes During Puberty

All these apparent changes in the body at puberty are a manifestation of a chemical upheaval, triggered by a yet unknown signal from the environment. This signal starts from a train of hormonal release. To begin with, the dormat pituitary-gonadal axis is switched on and spurts of GnRH are released. This in turn stimulates the release of LH and FSH from the pituitary. The amount of GnRH and the frequency with which it is released settles the ratio of the amounts of FSH and LH. In early puberty a lot more FSH is in circulation as compared to LH. This helps the ovaries to mature. A little later a surge of LH occurs and its amount exceeds that of FSH in circulation, and the ovarian cycles get slowly established.

The accelerated growth seen in puberty depends not only on the levels of sex hormones but also on the levels of other secretions. Increase of the growth hormone (GnRH) from the pituitary marks the early stages of puberty. Rapid changes in height and weight are because of increased levels of the growth hormone in circulation.

Together with the sex hormones, the growth hormone supports the rapid physical changes occuring at puberty. Helping the growth hormone in promoting growth is another important factor, called the insulin-like growth factor (IGF-I) secreted by the liver. A high level of IGF-I is in circulation during early puberty. Girls with delayed or precocious puberty have abnormal levels of growth hormone or IGF-I. The levels of these growth-promoting secretions are modulated by sex hormones.

Another secretion that plays a role in sex maturation is secreted by the adrenal glands. Much before the definite pubertal changes are initiated at about the age of six to eight years, the adrenal gland secretes the steroid androgen in increased amounts. The heightened level of androgens in the blood is a preamble to the maturation of the ovary and is called the adrenarche. In response to adrenarche a spurt of growth is seen in the long bones of the body. Few axillary hair and public hair also appear. These adrenal steroids continue to rise at puberty. Though adrenarche is important for normal puberty, it is an event independent of puberty.


Entry From The Side Or Rear Intercourse Position

Dr. Sims, who was one of the world's first specialits in female organ surgery studied the various positions in which he could examine and treat his clients. He concluded that the most comfortable posture which allowed access to the vagina was 'Sims position'. which many hospitals use occasionally to this day. The woman lies on one side and draws the upper leg up so that its knee rests on the bed opposite her hip, exposing her female organs quite freely to approach from slightly above and behind.

When used for sex instead of surgery, the Sims position provides the male with easy access and the female with relaxed comfort. The wife's striaght leg may have to be drawn up slightly to make room for her husband's knees, or the husband can place one knee on each side of it and make entrance at a slight sideward angle. The wife remains almost entirely passive in this posture, being unable to move and almost entirely passive in this posture, being unable to move and almost unable to reach any caressable part of her husband's body.

She generelly gets relatively little passion-generating stimulation either from genital friction (which is concentrated on the least sensitive parts of her organ) or from caress (since both her breasts and the accible parts of her genitals are up against the bed). However, the husband can satisfy himself quite fully while making almost no demands upon her energy. For incidents undertaken specifically to meet his needs, especially if the wife's inability to respond with passion seems from fatigue or recent illness, the Sims position often works quite well. This posture also proves entirely comfortable in the latter stages of pregnancy when most other positions crush the wife into a state of breathlessness.


Pubertal Problems

A majority of girls undergo the transformation to adulthood without specific problems. However, in some, puberty is either delayed or is much before time. Both the conditions require medical advice. Treatment for disorders of puberty is given after careful clinical evaluation and it varies according to the exact cause of the problem.

In genreal, puberty is considered to be delayed if there is no evidence of breast development by about thirteen to fourteen years and there is no menarche by sixteen to seventeen years of age. Most of the firls diagnosed with 'delayed puberty' turn out to be normal, with the delay being due to their physiology and constitution. However, in some cases pathological problems turn out to be the cause of pubertal disorder. Abnormal development of the structures derived from the Mullerian ducts in the foetal stages may result in abnormal puberty.

 

The most common condition in this category of disorder is when adolescent girls have normal secondary sexual features but do not menstruate. Another set of disorders of puberty is because of abnormal development or function of the ovary. At times chromosomal abnormalities as in Turner's syndrome may be the cause of such a condition. Delay in puberty may also be because of genetic abnormalities that cause sex hormone deficiencies. Several other pathological conditions, like abnormal thyroid gland function or disorders related to the central nervous system have been indentified as cause of delay in sexual maturation. All these problems require immediate medical attention.

Some girls, on the other hand, experience onset of puberty before eight years of age. In general, keeping in mind the normal variation of pubertal age, such girls are said to have precocious puberty. This condition may be because of premature activation of the hypothalamic -pituitary-gonodal axis due to some pathological condition. Precocious puberty can be also due to premature adrenarche or intake of steroids. Treatment for precocious puberty usually focuses on delaying the progression of development of secondary sexual characteristics and curbing accelerated growth of bones.

A problem often encountered by yound women is excessive facial hair or hair on regions of body not normally found in women. Such a condition is called 'hirsutism'. Hirsutism is not a disease but a condition causing cosmetic disfigurement arising out of increased androgen production. Facial hair, hair between the mammary glands, abdominal hair, hair on upper legs and temporal balding are characteristic features of hirsutism.

Hair that respond to sex steroids are located in public area, axillae, lower abdomen, thighs, legs, arms and chest. The follicles of these hair remain dormant until the steroids build up a puberty. Androgens initiate and stimulate the growth of hair. Oestrogens, on the other hand, retard the effect of androgen. Androgens in women are secreted by adrenal glands and the ovaries. The androgens in normal women are carried bound to a transport protein, with only one per cent of androgen free in circulation. In hirsute women a lot more unbound androgen is in circulation. Such a situation may rarely arise because of a pathological condition. More often an imbalance of other hormones is closely linked to androgen excess. Medical treatment to hissutism involves hormone therapy that inhibits further growth of hair. The pre-existing hair, however, have of be taken care of by mechanically removing them. Permanent removal of the hair can be done by electrolysis.


The Convalescent's And Kneeling Wife Posture

The Convalescent's Posture

If both husband wife lie on their sides facing in the same direction with their knees partly drawn up, the husband can easily make sexual entrance from the rear. The wife necessarily plays a passive role in this posture, but, can obtain passionate gratification from it if she is properly aroused. Her husband can stimulate her with caresses of the clitoris, inner lips, buttocks and breasts as well as with sexual frictions, and can make those frictions, fairly effective by directing his thrust (after entry) towards the vagina's front wall instead of straight.

This posture makes the least physical demands upon the man of any which can give him satisfaction, and also is the least demanding for the wife of those from which she can expect to derive impassioned joy. Many couples find that they can obtain reasonable sexual satisfaction in this posture when one or the other would be unable to participate in more vigorus marital encounters because of heart disease, recent illness or operation, unusual fatigue, and so forth.

The kneeling wife posture :-

If the wife kneels on the bed with her legs slightly apart, then lowers her chest until it touches or nears the mattress, her husband can radily insert his penis from behind her thighs. She may need a pillow or two beneath her chest to let her breathe freely. Ordinarily the husband kneels upon the bed between her legs, with his trunk either upright or bent. He can also stand at the side of the bed if she backs over to its very edge.

This postures permits intercourse during menstrual flow with little or no mess, and often 'opens the season' two or three days before a fastidious wife would otherwise indulge. The woman generally uses internal protection, inserting a fresh tampon shortly before the beginning of sex play. The increased blood flow through her organs during sexual excitement will temporarily increase flow but this generally creates no problem after the heavy inital days of a period, Sex play generally proves perfectly satisfactory with the tampon in place, with genital caresses concentrated opon the inner lips and the vaginal rim rather than upon deep-lying structures. The wife assumes the kneeling, head-down position with the tampon still in place, and either she or her husband pulls it out into a property positioned towel just before he makes his entrance. After intercourse, she applies an external pad or towel before she rolls over or stands up.

The kneeling, head-down posture has no effect upon the likelihood of pregnancy in normal couples, but occasionally benefits couples who have been unable to conceive.


Evolution of HIV/AIDS Epidemic In India

Like most countries in Asia, India is included in the pattern III distribution of HIV disease. In April 1986, for the first time, HIV seropositivity was recorded amonhg ten female prostitutes in Tamil Nadu. Important landmarks of AIDS/HIV in India are presented in Earlier Table. Although late to begin, within five to six years all the known modes of viral spread have been identified.

In early 1990, an explosive epidemic of HIV in north-eastern States of India was recognised among thousands of intravenous drug users. The virus might have started late, but is racing rapidly to create a large-scale epidemic situation, especially in some metropolitan cities of our country.

Important Landmarks of HIV Disease in India

 

Period

Event

April 1986

First cluster (ten prostitutes) of HIV seropositives detected in Madras, Tamil Nadu

May 1986

First Patient of final stage disease detected in Bombay, Maharashtra (recipient of unscreened blood transfusion during cardiac surgery in USA)

Dec 1986

First seropositive male detected from STD clinic in Tamil Nadu

July 1987

First seropositive blood donor in Vellore, Tamil Nadu (retrospective detention subsequent to the recipient's illness)

July 1987

Also spouse to spouse tranamission (the same donor's wife)

Oct 1987

Detection of a seropositive infant (born to the above-memtioned parents)

April 1988

First indigenous case of full-blown HIV disease in an Indian

Jan 1989 onward

Evidence of HIV antibodies in indigenously produced blood products.

Evidence of exposure of HIV among a high proportion of donors used by commercial manufacturers followed by a government ban on production.

July 1989

Government gazette notification for mandatory screening of blood donors for freedom from HIV antibodies

Jan-Feb 1990

Recognition of a cluster of seropositives in IV drug users in north-east India

 

We may also Add:

Jan-Feb 1990

Important issues concerning hospital practices arising out of an incident of embalming a body of a patient of HIV disease

Jan 1989 to date

Emergence of a highly responsible press on the AIDS scene in India

July 1992

Constitution of the National AIDS Control Organisation (NACO); at State levels also

 

Ours was among the few countries whihc started surveillance to detect HIV infection at a time when the number of AIDS cases was very low. However, because of compla- cency and lack of inplementation, the cost-effective strategy of sero-surveillance followed by education and intervention programmes directed only to those at high risk situation never took off.

Yet another landmark, selective introduction of 'mandatory screening' of blood donors, was also carried out too errratically to be meaningful. The latest landmark is the setting up of the National AIDS Control Organisation (NACO)


Into A Relationship

Growing up is central to our existence and touches all spheres of our activities. Most of all it changes relationships. Teenagers wake up to a new social order with people around them providing clues to their expected 'gender based roles' in the society. In other words, the anatomical identity of a girl is reinforced by cultural factors to develop a so-called 'feminine identity', with a behaviour pattern generally acceptable in the social context. The genetic factors that give the physical gender identity together with social and cultural environment, the epigenetic factors, in which the adolescents are brought up, mould the sexual orientation of an individual.

This often plays a major role in all future interactions with the opposite sex. The peer group and parents have strong influence at this stage. Very often girls get social feedbacks that curb their activities as compared to boys and need to aggressively assert themselves to find self-esteem. Amidst this confusion as the transition to adulthood is completed, a heightened awareness of the opposite sex emerges. An urge to forge emotional bonds is felt. Sometimes depending on permissibility of the society, friendships with the opposite sex are formed which may develop into lasting relationships.

Most societies have evolved a moral code for relationships between the two sexes. Scientists often talk of it as socio-biology of reproduction. Human sexual behaviour no doubt has a genetic basis that ensures procreation activity, but unlike in other animals, human relationships extend far beyond reproductive needs. This is so because control of sexual urges is not essentially due to hormonal surges (as in othe animals) but is taken over by the cerebral cortex, the part of brain well developed in humans.

 

This escape of reproductive behaviour from rigid hormonal controls has added a new dimension to human sex its function is no longer strictly procreation but is a pleasurable experience that helps forming strong partnerships. Inadvertently, this lasting relationship between parents provides a secure and conducive atmosphere for the next generation and in the long run proves to be advantageious as it ensures sustained parental care. Family units in most societies have evolved around this basic theme as it provides the best chances of survival. Polygamy and rape, though they exist in all societies, are considered aberrations that disrupt, in a biological sense, the welfate of the next generation.


The Twisted-Trunk Posture

The wife lies on her side with both legs drawn part way up, then turns the upper part of her body until whe is facing straight towards the ceiling. Her husband kneels just towards the foot of the bed from her buttocks and makes entry from behind, with his body lying crosswise to her hips but straight above her trunk. From this position, he can completely change the nature of his wife's sexual stimulation simply by shifting his hips slightly to one or the otherside. If he swings his hips towards her knees, he brings the shaft of the penis snug against the inner lips and clitoris.

If he swings towards the buttocks, he thrusts the penis tip against the urethral-caress area at the front of the vagins, while in midposition the penis goes straight in for maximum penetration. At the same time, this posture tends to arch the wife's body slightly in a way which brings her breasts almost level with her husband's head. Continued mouth-to-breast play throughout intercourse, combined with finger tiltillation of the other breast, buttock massage, caress of the almost-exposed inner lip, and climatic pinches or slaps of the inner thigh and crotch afford the husband many opportunities for pleasing his spouse. All these novel stimulations plus the intimacy and advantanges of face-to-face contact from the waist up make this by far the most wife-pleasing of the rear-entry postures, and the breath of freshness it gives more than towards the wife-weary or sexually bored husband for breaking out of his rut.

Positions chosen to meet a special need usually must be used from beginning to end. A few convalescents or fatigued husbands will shift to a mutual-movement posture for the final conclusion after 'saving themselves' through most of the incident, and some mothers-to-be can stand a crushing conclusion after a gentler early phase. But the positions you adopt to avoid menstrual mess, to keep a partner without stamina from having to overdo, to spare an injured back, to permit the husband some gratification when the wife feels uninspired, or to make sex possible in spite of a stiff joint or bulky bandage cannot be changed once you begin.

Unless circumstances dictate a certain posture, however, a succession of several positions help to keep your relationship fresh and gratifying. A truly accomplished and confident couple aims to reach and sustain a state of ecstatic transport before even considering orgasm. Postures which give continually more intensive stimulation, of continually varied sorts, with continyally renewed and refreshed caresses of different body parts, can sustain ecstatic excitement for many minutes beyond the time when one constant sort of stimulation would have had to build to a climax-generating point. If you like preliminary contact, the half-roll position leads quite naturally into an asymmetrical one with one leg straight and one partially raised. The wife moves against some burden of her husband's weight in this posture, and might soon want a rest.

The lock and swing positions let you shift into a posture she will find restful, like the twisted-trunk posture, and then permit you to swing back to the 'usual' or some other face-to-face posture for a mutually active climax. Note also the ease of going from the rather strenuous maximum legs-up posture to the restful twisted trunk or convalescent one, ane the wealth of variety you can add simply by using asymmetrical positions. A simple sideward rall may change the source of action altogether, bringing fresh muscles as well as novel stimulations into play by using an immobilized thigh as the point of purchase for feminine movement instead of the back or the heel.

Given a gradual climb of sexual excitement prior to sexual entrance, the start of intercourse need never give a missile-launching blast to male excitement. You can start in a posture which allows gentle movement with continued breast and clitorine caress to prolong the state of ecstasy before your final surge. Shift to a posture chosen for freshness if you wish, perhaps one whihc neither of you would rate as 'best' but which adds novelty. You can always change to a position in which you both can take full pleasure before the occasion ends.


AIDS Cases In India

The first case was reported in May 1986. The source of infection was tracted to blood tranfusion during a coronary bypass surgery in the USA, prior to the introduction of HIV screening in that country. The second case was associated with a blood product given to a haemophilic patient, again in the USA. This, and the fact that some more cases of AIDS were recognised in foreigners at the time, led to some complacency arising out of a misconception.

AIDS was considered as a 'foreign' or 'their' disease, not likely to affect 'us' Indians. Soon, however, AIDS began to be recognised among Indians exposed to risk situations in India. For instance, in January 1990, there were 12 cases in foreigners and 32 amongst Indians; chances of missing AIDS among the former were much less. After more than two years, i.e. in early 1992, only one more case was added to the foreigners category, while the number of AIDS cases in India had more than tripled. What is more worrisome is the fact that an overwhelming majority of AIDS patients have been between 20 to 40 years of age. They are the most productive group, enonomically and reproductively, a fact which imparts an extraordinary significance to AIDS. The cases of AIDS officially recorded by 1992 are presented in below table.

 

AIDS Cases In India

 

Male

Female

Total

Indians

75

28

103

Foreigners

10

03

013

Total

85

31

116*

 

  • Total AIDS cases in India upto 31 July, 1992 reported is 221 including 207 Indians and 14 foreigners

 

Probable Source of Infection in India

 

 

In India

Abroad

Heterosexual promiscuity

49

16

Homosexual contact

Spouce of AIDS patient/seropositive person

0

2

01

0

Blood transfusion

18

03

Blood Product infusion

05

01

Intravenous drug addict

08

0

Total

82

21

 

There is a reasonable doubt among most people regarding the official figures. It is believed that only a fraction of the actual number is officially being recorded. Because of the very wide differences between the States, it is indeed difficult to estimate whether five to ten per cent of the actual cases or only one to two per cent are included.


Coitus

The first coitus is a physical and emotional landmark in a woman's life. During puberty the external genitalia in girls matures, becom- ing progressively conducive to the sexual act. The labia majoria develops as a fold of fatty tissue. The labia minoria is covered with a layer of mucus membrane and joins the inner surface of the labia majora. Clitoris develops as a sensitive projection, containing copious blood supply and nerves.

 

The vestibule that is enclosed by the labia minora has four openings - the urethra (opening of the urinary tract). the vagina (the opening of the reproductive tract) and two other openings that lead to the glands that secrete lubrication fluids. A thin mucus membrane, called the 'hymen', covers the vaginal opening. Varying in thickness it may be non-existent in some women. At first coitus there may be bleeding because of the rupture of the hymen. However, as there are variations in the hymen anatomy, the bleeding that follows its rupture is variable and may be totally absent in some women.

In general, sight and touch of women's breasts, buttocks and vulva arouse men while buttocks and genitals of man arouse most women. A strong emotional component along with physical proximity leads to desire to have sexual intercourse. In man, the most obvious sign of sexual excitement is erection of the penis which enlarges in length and diameter.

At erection, a dramatic increase in the flow of blood to the penis approximately doubles its length and stiffens it so that it can enter into the partner's vagina. For the woman physical excitment is characterised by increase in size of clitoris. The lips around the vaginal entrance become softer and thicker. At this time two small glands lying near the vagina secrete a fluid that lubricates the vaginal opening and makes the entry of the penis easy. If the man attempts to introduce the penis before the vaginal area is lubricated, coitus may be painful to the woman. Therefore, a sufficient foreplay to arouse the woman is necessary if the intercourse has to be a pleasurable experience for both the partners.

Sexual responses of women have been studied objectively and have been found to be variable. While no concrete generalisations can be made, on the basis of scientific observations of physiological changes four stages can be identified. The first is the 'excitement stage', characterised by increased blood supply to the labia minora and an increased sensitivity of the clitoris. There is an increased blood flow to the breasts as well, as is seen by the increase in toughness of the nipples. The stage 'plateau stage', characterised by muscular contractions that press on the clitoris and the vaginal structures.
During sexual intercourse the male thrusts his penis in and out of the partner's vagina. For a man as orgasm approaches, he is aware that ejaculation will occur. Three to six expulsive contractions of the muscles at the base of the penis contract, leading to spurting out of the fluid called 'semen'. During this period tha man may clasp his partner tightly ans as the climax passes the penis becomes limp. The woman also feels corresponding responses. A reflex stretch mechanism and the contraction that preee on the clitoris, vulva and lower vaginal area lead to the third stage, the 'orgasm'. An orgasm is a feeling of intense pleasure for both men and women. A woman's orgasm like in man is associated with jerking of thigh and pelvic muscles. Some women experience rigidity during orgasm.
The fourth stage is the 'resolution stage' with events related to subsiding of the orgasm. All changes in the genital organs and other parts of the body (breasts, abdominal and thigh muscles) that experienced a surge of blood flow return to normal form at resolution. Energy consumins, the sexual act results in conception if the woman has ovulated at about the same time. The sexual act during menstruation is somewhat undesirable for the tissues of the reproductive tract are in a fragile stage and are prone to infections.
Masturbation is stimulation of the genitals by fingers. It does not cause any physical harm and is often part of experiments with their sexuality in adolescents. However, it is considered to be an unclean habit. Coitus, on the other hand, is a far more satisfying, intense emotional experience and a pbysical expression of warmth between two individuals. When enjoyed with consent and respect for each other, such physical encounter goes a long way in binding partners in long-term relationships.


HIV-Infected but Otherwise Healthy Persons

By the end of March 1992, a total of 13,48,965 persons were screened and 7,272 (5.39/1,000) were confirmed to be HIV-infected. Of these, the largest number (46.97 per cent) was in persons having multiple hetero-sexual partners. IV drug users, though located in a restricted area in the north-east of the country, constituted the second largest group (19.77 per cent), followed by blood donors (16.78 per cent). The details are here under :-

Details of Seropositive Individuals Detected

 

Number of Persons screened

13,48,965

Number of Persons seropositive

7,272

Seropositivity rate (per thousand)

5.39

 

 

Break-up of Seropositives

 

Male

Female

Total

% of total

Heterosexually promiscuous

1,291

2,125

3,416

46.97

Homosexuals

10

0

10

0.14

Relatives of HIV patients

29

42

71

0.98

Suspected AIDS cases

83

31

114

1.57

Antenatal mothers

0

27

27

0.37

Blood donors

1,179

41

1,220

16.78

Recipient of blood/blood product

128

37

165

2.27

Patients on dialysis

24

5

29

0.40

IV drugs users

1,387

51

1,438

19.77

Others

612

170

782

10.75

 

Total

4,743

2,529

7,272

100.00

 

Homosexuality, especially sodomy being a congnisable offence in India, the extent of men having sex with men is not known. It is generally believed that about four to five per cent of men between 15 to 50 years of age might be homosexual. In actual number, this figure is certainly not insignificant. Limited surveys in Bombay show that about four to five per cent of male homosexuals are HIV-infected.

Official and unofficial reports, point to Bombay, Pune and many districts in Maharashtra to be most affected. The most frightening feature of this epidemic is its imminent occurence among infants born of HIV-infected mothers. Nearly one per 1,000 females tested in antenatal clinics had been found to be infected. These females came from ordinary, middle-class families in Bombay and were not supposed to have any known risk behaviour.


Sexual Problems and Unusual Sexual Behaviour in Women - Lesbianism

Sexual Problems :-

Sexual problems can occur in both men and women. Inadequate commitment to a relationship, overwork and fatigue, disease and ill health,  guilt or fear due to prior experiences can manifest as sex problems. In women four such conditions are commonly encountered :


1)    Inhibited sexual desire : Women with this problem do not wish to enjoy sex and may even find the idea of sex revolting or fearful.
2)    Lowered libido : Women with lowered libido may have normal sexual desires but in reality fail to be stimulated by the partner and are unable to participate with pleasure in a sexual relationship.
3)    Orgastic dysfunction : Women may fail to reach orgasm, whatever may be the stimulation. Some women may reach orgasm independent of their partners and do not suffer from this problem as popularly thought.
4)    Painful sexual intercourse : Some women find sexual intercourse painful and are never able to find pleasure in a sexual relationship. Such women may try to resist entry of the penis in the vagina by tightening the muscles around the vaginal opening.


All the above mentioned problems can be successfully resolved by taking professional help. It has been recognised that total ignorance about sex as well as over-concern about performance impede normal sexual behaviour. A positive attitude, active communication with the partner and his co operation go a long way in overcoming sexual problems effectively.

Unusual Sexual Behaviour in Women - Lesbianism

While a majority of women are sexually attracted towards men, about 5 per cent women feel sexually stimulated by women. They are homosexual and are called lesbians (the name is derived from a Greek island, Lesbos, where groups of homosexual women lived). During normal sexual development, adolescents are emotionally close to friends of their own sex with whom they share thoughts and problems. As girls grow, these friendships wane and a new attraction is felt towards boys. However, in some cases girls continue to be attracted by the members of their own sex and form intense emotional bonds and physical relationships.

These homosexual girls indulge in mutual masturbation and do not want any other form of sexual gratification. While there is evidence to suggest that some are genetically predisposed with parents can decide the sexual inclination of girls. Poor relations between two parents also influences children and this may surface as homosexuality because such girls fail to develop trust in boys. Most homosexual girls live a contended life with a partner of the same sex. However, social unacceptability of this behaviour adds to anxiety and insecurities of these women. Social tolerance of this uncommon sexual behaviour would go a long way in helping women to live the life they have chosen voluntarily.


MALE MOVEMENT - Superficial Titillation - The violin bow effect

A man can stimulate his wife's organs with his penis in several completely different and distinct ways each of which is particularly appropriate to certain positions and phases of their relationship.

Superficial Titillation :-

Titillating sexual contact seems like teasing in the early days of sexual adaptation, mainly because both partners (especially the wife) have not yet developed the emotional linkages needed to derive plesure from such contact. After the inner lips have become sensitized and the husband has learned to associate his wife's embrace in certain postures with the prospect of fulfillment, however, many couples like to linger ocassionally in the middle ground between sex play and full-contact intercourse.

 

The half-roll position discussed in the preceding chapter generally proves particularly apt, but any posture which rubs the tip portion of the penis against the inner lips or vulva can be used, including the pillow-trick and 'usual' ones. The husband should adjust his position of these postures so that the tip of the penis is drawn up snug against the female opening's top edge, distinctly within the cleft made by the fuller, skin-covered outer lips. Very short to and fro movements will tiltilate the inner lips and clitoris in this position. A couple already in a state of ecstatic transportation can vsually hold themselves on the plateau for an extra delightful interval in this way. If both continue active caresses of othe body parts as well.

The violin bow effect :-

You stimulate your wire quite keenly when you draw the shaft of your penis across the sensitive upper edge of her female organ. This type of friction at this particular site brings her sexual sensations unmatched by othe action. You can use it in most sexual positions, but especially in the pillowtrick, usual, and asymmetrical face-to-face postures or the twisted trunk rear-entry posture. A similar effect is possible in the kneeling wife posture, but is slightly less stimulating because the penis enters 'upside down' with its soft bottom surface rather than its firmly erect positions in contact with the woman's sensitive tissues.

Like the violin bow rubbing a string, which gives just as loud a note when moved slowly, shaft-to inner-lip friction, stimulates just as keenly whether movement is slow or fast. However, the first inch or so of either an inward or outward stroke gives very little of this type friction, since the inner lips initially move along with the shaft instead of being rubbed by it. After these highly sensitive folds have been turned all the way in or out, further movement in the same direction stimulates a stretched-out, extensive surface both which friction and vibration.

For practical purposes, then, you can increase the amount of stimulation which you give to your wife in any position which permits friction of the peni's shaft against the front rim of the vagina by
1.    Sliding your body headward to increase pressure on the sensitive parts.
2.    Using Long strokes, both inward and outward.
3.    Slow motion, especially in the midphase of each stroke.

Some husbands stimulate their wives most effectively with a sort of 'stutter movement' giving a quick motion at the begining of each inward or outward stroke (to turn the wife's innerlips in the 'right' direction) followed by a long, slow movement the rest of the way. Others find slow movement on a regular rhythm easier, especially if the wife is making reciprocal movements of her own. But rapid movement in positions offering this variety of stimulation almost always sppeds the male climax without giving either partner as much satisfaction as the long, slow stroke.


Geographic Distribution and the Spread of HIV

As per the AIDS Programme Officer for the Government of India, three major epicentres of HIV infection have been identified in the country. These are Bombay, Madras and Imphal. From Bombay and Madras, the infection is spreading through migrant workers, truck drivers and paid blood donors to many other areas. Multi-partner heterosexual life-style is the major culprit in the spread.
Imphal, in Manipur is responsible for spreading infection through contaminated needles and syringes which are shared by drug users. The easy availability of a pure form of (white) heroin from the notorious 'golden triangle' through Myanmar (Burma) border is mainly responsible for the spread.

The different ways in which infected men can spread the virus are shown in below figure. They are much more likely to spread the infection than infected women, both due to biological differences as well as frequency of and variety in the modes of transmission. For example, a single infected migrant worker can pass the virus to several prostitutes/call girls, by donating blood (if not screened effectively) and also to his wife in rural area and ultimately to his unborn child.


In conclusion, it should be emphasised that the epidemic of HIV is evolving in an explosive, exponential way. This means that two HIV-infected persons become four and then 16, 256, 65536 and so on. No wonder, those in the know are crying out that high priority be given to control of HIV/AIDS before it reaches an irreversible situation.


Fertilisation

The procreational aspect of sexual relationship is as important as its function in emotional binding. The semen ejaculated is held in vagina close to the cervical opening. The sperms, about twenty to 300 million in number, soon start journey up the reproductive tract to the site of fertilisation. Aggressively motile, sperms survive in the cervical mucus for a maximum of four to six days. The cyclic changes in the cervical mucus, in response to hormones, aid transport of sperms. just before ovulation, with increase in oestrogen, a large amount of cervical mucus is produced. This mucus has a special feature. It has bundles of mucin, a fatty substance that is arranged in a parallel array. This arrangement of mucin in the cervical mucus helps unidirectional movement of sperms. In other phases of the ovarian cycle, arrangement of mucin is in the form of a network. Sperms trapped in this network have mobility.

The outpocketing of the cervical wall stores the sperms for a short time. Highly motile sperms forge to the uterus. Once within the uterus, the sperms have more help. The contractions of the genetical tract and the flapping of the hair-like projections, the villi, of the uterine wall push the sperms towards the fallopian tube. The spermatozoa are at the end of their journey as they enter the fallopian tube. The number of sperms that reach the fallopian tube is much smaller than those that were present at the lower end of the reproductive tract. There appears to be a selection mechanism that ensures the normal and highly motile sperms to make it to the fallopian tube.

 

All through their way up the female genital tract, the sperms are exposed to a changing chemical environment. In response to this changing milieu sperms too undergo the final physiological maturation and acquire the capacity to penetrate the egg. This newfound ability to fertilise is called 'sperm capacitation'and is most important for successful fertilisation. Of all the sperms that are released in the reproductive tract, only one penetrates the ovum, The rest die off and are removed by the body as debris.

Fertilisation, the event that grants a new life to the ovum, is a systematic, well-regulated process. The ovum, about 150 to 200 microns in diameter, is released alternately from each of the ovaries every month. just like the male germ cells, the egg cell too has been preparing bio-chemically for fertilisation. Unlike the sperms, the process of egg maturation is initated very early in development. It begins in the girl embryo with the cells destined to become the egg cells, starting a special type of cell division, called 'meiosis'. Most of our body cells divide by a process called 'mitosis', where each of the daughter cells formed is identical. On the other hand, the germ cells undergo a special division called meiosis, where the daughter cells formed are non-identical.

The number of chromosomes at the end of meiosis in each of the daughter cells is half that of the original cell. During meiosis, exchange of genetic material takes place as well and the cells formed are genetically different. Meiotic division in the females is started before birth and a part of it is completed as the egg is released from the ovary. Of the four cells formed at the end of meiosis only one is the egg. The other cells are called 'polar bodies'. The last polar body is formed at fertilasion as the egg completes its maturation. Gern cells formed are thus haploid. After fertilisation, the haploid set, from the sperm and the egg together, form the diploid set of chromosomes of the new individual.


The Urethral Prod Effect

In the maximum legs up position, the twisted-trunk posture (when the male's approach is angled to direct his thrust against the vagina's front wall), and in some phases of chairbound intercourse, the tip of the penis presses firmly against the sensitive area described in our discussion of the urethral caress. This highly sensitive area actually begins just within the vagina and extends about halfway up its length. The key structures lie rather far beneath the organ's inner surface, however, so that gentle frictions of the type which stimulate the inner lips do no good at all here. The practical guidelines are as follows :

1.    In postures permitting this particular type of stimulation, moderate penetration often proves more effective than full depth. In the maximum legs-up posture, for instance you will probably find that strokes which carry the tip of teh penis from just within the vagina to about half or two-thirds of full insertion stir more response than deeper ones.

2.    Only a short, sharp stroke will press the penis tip into the vagina's front wall deeply enough to stimulate the urethral area strongly. More gentle action lets the penis glide along the female organ's surface without prodding to sufficient depth for full efficiency.

3.    Only the inward stroke is effective, so that withdrawal can be slow and gentle. In almost any posture which drives the tip of the penis directly into the vagina's front wall, the best male action usually proves to be a series of either regular or irregular prodding inward jolts with a slow recovery to strating position. Slow recovery helps you to draw back almost to the vagina's rim, leaving just enough penetration to be sure that you do not slip out of the passage. The far-out starting position makes the next inward stroke extra efficient.

4.    The sensitive structures lie exactly in the midline, so thrusts should not be directed at a slant or off to the side in an effort to provide variety. If this type of friction seems ineffective (especially in the twiseted trunk or asymmetrical postures), you may find that moving your hips slightly to redirect thrust closer to the centre of your wife's organ corrects the problem.

In any posture which brings the shaft of the penis into snug contact with the vagina's front rim, the husband can stimulate his wife's clitoris fairly effectively with a special type of sidewise friction. In effect, he catches the clitoris between the underlying public bone and the shaft of his penis as the latter slides or rolls across that sensitive organ. This type of friction exicte the wife more in early marriage than later on, when the clitoris has become relatively less important through emergence of other sensitivities. It has one characteristic, however, which makes it useful throughout marriage; it excites the wife while offering the husband little or no climax accelerating stimulation. When the wife seems to have fallen a bit behind in the build-up of sexual excitement, this manoeuvre often helps her to catch up. Here is the technique.

1.    The husband, wife, or both should shift positions if necessary to bring the top of the penis shaft very firmly against the vagina's front rim. The pillow-trick posture and inverted posture with the wife's legs between her husband's make such contact automatic.In the 'usual' posture, the asummetrical postures, and the inverted thighs-cradled-in-husbabd's-flanks postures, the wife may have to increase the hollow of her lower back (so that her pelvis tips backward) or the husband may have to shift his body a few inches headward.

2.    Using the top of the penis shaft near the organ's base as a sort of rolling pin, the husband moves his hips from side to side of (in the inverted posture) grasps wife's hips with both hands and pushes them back and from one side to the other.

3.    In postures allowing stimulation of the inner lips with the gentler action, you may get better results by making one side-to-side swipe across the clitoris at the end of each slow 'violin bow' stroke instead of continuing rolling-pin action constantly.


The Viruses And The Tests

What Are Viruses?

Viruses are the tiniest living beings recognised so far. They are too small to be seen under an ordinary micro- scope. The below Figure gives an idea of the comparative smallness of the viruses. They can only be visualised after extremely high magnification, made possible with an electron microscope. Viruses are called fitrable, because they can pass through special filters which are used to keep away small germs, such as bacteria.

 

In contrast to other living organisms including bacteria-commonly called germs-viruses possess only one type of nucleic acid, namely deoxyribo nucleic acid (DNA) or ribonucleic acid (RNA) Normally, the genetic (hereditary) information is passed from DNA (the basic genetic material in a cell) to the RNA, which serves as an intermediate for the manufacture of proteins. Proteins are essential for survical as they are ultimately responsible for all functions performed by a living cell and thus a whole organism.

Having only one nucleic acid, viruses have evolved to use the machinery of the host cells which they infect. One can almost say that they hijack certain cellular mechanisms for their own purpose of replication (multiplication).

 

Unable to have a free, independent existence, they are the 'true' parasites at the genetic level. In nature, viruses infect almost all living beings, including plants, animals, and, even bacteria. They can be propagated in a laboratory only in living intact plants/animals or in the cells grown in tubes or flasks (in vitro cell cultures). The animals or their cells need to be susceptible in order to permit viruses to grow. The cells may be called permissive cells.


Fertilisation

The egg cell (ovum) also prepares for fertilisation by synthesising a number of proteins that help the sperm penetration as well as the immediate events that follow. The ovum has a thick coat of protein, about 20 microns thick and is called the "zona pellucida.''

Embedded in this layer of protein are a few lingering ovarian follicular cells that form the structure called 'cumulus'. At ovulation, the ovum released in the body cavity is soon picked up by the 'fimbrae' or the finger-like projections of the funnel-shaped end of the fallopian tube and pushed down the lumen of the fallopian tube. Chemically conducive for both egg and sperm the fallopian tube is the site for fertilisation.
The molecular events that lead to the union of the egg and the sperm are continuous, but can be categorised into definite steps. Attempts have been made to understand each of these steps as such information is important for fertility control as well as for tacdkling infertility problems. The first step is recongnition and establishment of contact between egg and the sperm. Special molecules that are important for their primary contact have been identified on the surface of sperms and eggs. These molecular interactions are so important that blocking them can stall fertilisation. Manipulating these molecules is the theme that has been actively considered for contraceptive protocols.

The sperm body carries the nucleus, the genetic matter that is to be deliveredc into the egg at fertilisation. The sperm head is made up of a vesicle or sack called 'acrosome' and is loaded with enzymes. At fertilisation, as the sperm head and the egg membrane come in contact, the acrosome bursts, spilling its enzymes over the egg wall. One of these enzymes (acrosine) eats awat the thick protein coat of the egg, thus exposing its surface to the sperm. Even before the acrosome bursts, another enzyme disperses the cumulus freeing the egg of the cells holding it. With bursting of the acrosome, the inner membrane of the vesicle is exposed and it is this membrane that merges with the egg membrane. Once again several molecules, like 'bindin' have been identified that form the actual points of attachment between the egg and sperm membranes. With this membrane contact there is a rapid redistribution of ions across the egg membranes that makes it impermeable to any other sperm.

The fertilisation proceeds with the chromosomal material carried by the sperm entering the egg cytoplasm. As the male and the female genetic material intermingle, the polar body separates from the egg cell and almost simultaneously the fertilised egg divides into two. Still in the fallopian tube, the 'conceptus' divides rapidly, forming a ball of cells. By the fourth day after fertilasation this mass of cells has moved into the uterus and is called the 'morula'. In some cases transport to the uterine cavity does not take place and results in a condition called 'ectopic pregnancy'.

Under normal circumastances the uterine wall is a cushion-like tissue with profuse blood supply and is ready to receive the conceptus. Under the influence of hormones the uterus has become glandular and is flushed with uterine fluid. The morula divides in the uterus for three to four days to form the 'blastocyst'. The blastocyst, freely floating in the uterine tissue, is a fluid-filled ball of cells with distinct inner mass and outer cellular layer.

 

A little later the inner mass of cells forms the embryo proper, while the outer cell mass, called the 'trophoblast' forms the placenta. At implantation, the trophoblast invades the uterine wall and about five to six days after fertilisation the embryo is firmly embedded into the uterine wall. By fourteen to twenty-one days the trophoblast cells form contact with maternal circulation, while the inner mass of cells begins life as an embryo.

 

The woman's body now gears up for a new role - that of the mother! Dramatic changes in her overwhelm her, especially if she is young. Understanding and care is expected of the partner and form the society around. Sex may be considered as a casual activity, specially in a liberal frame of mind, but definitely pregnancy and childbirth is not! For that matter sex too is not all that casual - contraceptive care should be taken to avoid an unwanted pregnancy and hygiene should be of utmost consideration to avoid a host of sexually transmitted infections. More about it a little later!


Genital Twitches In Intercourse

The muscles discussed in conjunction with 'seminal retention' interwine around the roots of the penis in such a way that their motion transmits itself all the way to the organ's tip during a firm erection. You can learn to snap-or twitch the erect penis without moving any other part of your body by sharply contracting those muscles. The next time you urinate, try to cut off the stream in the midst of voiding. The muscles you contract will not move the penis in any way while it is not erect, but those same muscles will definitely twitch the entire organ if contracted during intercourse.

In the same way, the muscles which contract when you try to pull your testicles straight up towards your body will make the erect penis move. After a few moments of practice, you will find that you can twitch the erect organ quite easily by giving your body these seemingly unrelated commands. When using this technique during intercourese, keep these points in mind.


1.    The genital twitch duplicates the action of orgasm and is particularly effective when your wife is eitheer in the course of or approaching a climax.
2.    The genital twitch works best when the penis is deeply inserted and still, either during a deliberate pause, during deep insertion in an invested position, or at the end of a long, slow 'violin bow' stroke.
3.    A run of several twitches in quick succession stirs much better response than a slower, longer-continued series.


Retroviruses, Oncoviruses, Spumaviruses, Lentiviruses

Retroviruses : HIV belongs to the family Retroviridae which has three sub-families (Detailed Table Under); retro means 'back', 'in reverse direction'. It applies to the one backward step taken by all retroviruses. They are all RNA viruses, but are able to convert RNA into DNA, the basic genetic material. They do this with the help of a unique enzyme, called reverse transcriptase, which is RNA-dependent DNA polymerase. In contrast, other RNA virus families make proteins directly from their own RNA, helped by permissive cells.

 

Retroviruses

Oncoviruses or transforming viruses (causing cancer)

Rous sarcoma virus (chickens)

FeLV (feline leukaemia virus)

BLV (bovine leukaemia virus)

HTLV-I (human T-leukaemia virus, Type-I)

HTLV-II (human T.luekaemia virus, Type-!!)

Spaumaviruses or foamy viruses

SFV (simian foamy virus)

BSV (bovine syncytial virus)

FCFV (feline syncytiumpforming virus)

HNPCV (human nasopharyngeal carinoma virus)

Lentiviruses or slow viruses

EIAV (equine infectious anaemia virus)

CAEV (caprine arthritis encephalitis virus)

Visna/Maedi virus (in sheep)

BIV (bovine immunodeficiency virus)

FIV (feline immunodeficiency virus)

HIV (human immunodeficiency virus)

SIV (simian immunodeficiency virus)

 

Oncoviruses : Cancer causing viruses constitute the largest sub-family having members affecting all vertebrate species. During 1980-1981, Dr. Robert Gallo and colleagues from the USA isolated and characterised the first human oncovirus (retrovirus) and named it T cell lymphoma/leukaemia virus (HTLV). Later, they identified yet another similar virus and called these as HTLV-I and HTLV-II.

Spumaviruses : These are not yet associated with diseases of man or animals. They only cause a foamy effect in cell cultures grown in test-tubes.

 

Lentiviruses : These are the classic slow viruses recognised in many animal species. They are highly species-specific in nature and are transmissible only to closely related game of hide-and-seek with the immune system of the infected hosts, leading to a slowly developing multi-system disease.


Female and Reciprocal Movement In Ideal ఇంటర్కోర్సే Position

A wife always benefits by actively conferring her favours in intercourse instead of letting herself be 'used'. When in the grip of passion, she wants and needs to express herself with body movement and caress, besides enjoying the extra stimulation generated be her actions and her partner's response to them. When giving herself in service to her husband's need, active attempts to please put her in a role of self-effacting feminine love, while passivity makes her feel either inadequate or abused.

Either way, she gains substantial emotional advantages by being a highly alive, willing participant instead of the mere object of her husband's attentions. These benefits deserve every bit as much emphasis as the mechanics of feminine action. Perhaps you will find the following discussion of specific wifely manoeuvres more acceptable if you constantly remind yourself of the emotional significance of active physical participation.

You will understand the effect of any given movement upon sexual friction much better by ignoring the fact that the female organ has depth and thinking of its outer edge as a penis-encompassing ring. So far as the wife is concerned, feminine movements only affect stimulations at the female organ's rim. The positions which permit reciprocal couple action do not allow urethral-prod or surface titillation, and any genital twithches her husband utilizes will occur independently of her efforts, leaving only the sensitive vaginal edge to be affected by her movements. So far as the husband is concerned, an angle of entry which rubs its tip against the organ's opposite wall, so that sexual frictions as a whole are always proportionate in variety and extent with those derived from the vagina's rim.

A simple experiment will help you to see the effect of feminine movement upon sexual frictions. Hold a pencil in one hand and your wedding ring in the other. Place the eraser at the end of the pencil through the ring while it is lying on a table-top orother level surface. You can move this ring without lifting if off the table in such a way that it bumps against the pencil. Perhaps by very delicate manoeuvres you can rub the ring sidewise or aroung the pencil to some extent. However, you cdan create very little friction (and practically none with manoeuvres a woman can manage in bed when we start applying these notions to sex). As long as there is no simultaneous in and out movement, the ring hardly rubs against the pencil when you tip it move it from side to side, top to bottom, or in any other way.

Now pick up the ring in one hand and the pencil in the other. Move the pencil in and out of the ring while making these same movements. You will find that moving the ring in such a way that various portions of its rim press against the pencil while the latter is in motion creates considerable and varied friction. However, note the timing required for maximum effect : The extremes of (feminine) ring movement cause the most friction when they coincide with the middle phase of (masculine) pencil movement. If the action is suncopated, so that the male movement begins when the female is at its midpoint and the female movement begins when the male is at midpoint, any variety of tipping up and down, or sidewise motion becomes much more effective.
Next, check the effect of different rhythms. Tip the ring twice or move it in two up-and-down or sie-to-side cucles as it travels the length of the pencil. Try three or four cycles per stroke and add tripping action to the other sorts. You will find that the frictions generated differ substantially in type and degree with each rhythm change or movement combination. In particular, you will note that the nature and site of friction changes constantly undre these conditions. Since each nerve fibre in your sexual appratus reacts most keenly to the start of stimulation, this continual alteration makes for exquisitely gratifying frictions when these prncil-ring lessons are translated into action.


Indications of Pregnancy - First Trimester

The first trimester, lasting up to fourteen weeks, is a period of rapid changes in the mother's body. The hormones, oestrogen and progesterone, are produced in the initial stages by the ovarian tissue and later by the placenta. Under sustained influence of these hormones, the uterine environment conducive to supporting pregnancy is built up. These hormones also cause the typical changes in the breasts that are indicative of pregnancy.

Progestorone, in general, reduces movement of all smooth muscles. As a result, the digestive tract is sluggish and women often complain of constipation during pregnancy. Constricted muscles that separate oesophageal contents from the stomach also relax, causing food and stomach juices to be regurgitated into the oesophagus, giving a feeling of indigestion and heartburn. In some women this problem lasts throughout the pregnancy, as long as the progesterone levels are high. The kidneys too respond to hormonal changes in early pregnancy by functioning more efficiently. The bladder fills with urine faster than usual and pregnant women need to pass urine more frequently.

The first timester is considered critical for a normal embryonic development. The cells are rapidly dividing as well as undergoing the complex process of differentiation to form various tissues and organs. Within the first eight weeks of pregnancy, internal organs such as the heart, lungs, kidneys, the brain and the digestive tract are formed. The embryo is distinctly human in form and is now referred to as the foetus.

This period of embryonic deve- lopment is very sensitive to environmental influences. A number of malformations seem in the baby can be traced to abnormal development in these early stages (fifth to sixtieth day) of foetal life. Exposure to radiation, drugs or infection can leave a lasting impact on development. Factors that cause malformations are called 'toratogens'. A large number of such factors have been identified and should be avoided by women, especially in early pregnancy.

By the end of the embryonic stage the placenta is well formed. The cardiovascular system of the foetus is different from that of a new-born baby. The foetal circulation bypasses the lungs as the placenta takes up the respiratory function. The placenta and the foetus are connected by three blood vessels, two arteries and a vein, that together form the 'umbilical cord'. The nutrients reach the foetus via the placental circulation.

The placenta also acts as a barrier and keeps unwanted chemicals from crossing over to the foetus. This placental lifeline grows in size with the foetus, weighing more than the foetus in the first trimester. The foetal development however, soon overtakes the placental development and the placenta weighs about a fifth of the baby at the end of the pregnancy.

Second and Third Trimester In Next Article


Human Immunodeficiency Virus (HIV) and Related Lentiviruses

HIV was first discovered by Barre Sinoussi, Montagnier and colleagues at the Institute-Pasteur, Paris, in 1983. It was named Lymphadenopathy associated virus (LAV). In 1984, Popovic, Gallo and co-workers established cell lines (cells grown in tubes or flasks) which could be permanently infected with their (at least they thought so at the time) isolate of AIDS virus. Keeping in mind the only known human retroviruses (HTLV-I and HTLV-II), they named the new virus as HTLV-III. For a long time there after, the virus of AIDS was identified by a long and rather awkward nomenclature : lymphadenopathy associated virus (LAV)/human T lymphotropic virus-III (HTLV-III).

Controversy about the name was finally settled by the International Committee for Nomenclature of Viruses. The virus was recog- nised as a lentivirus and was given the name of human immunodeficiency virus (HIV). The virus seems to have mereged from the unknown, but has now made itself known all over world. There have been many speculations regarding the origin of the virus but nothing definite has yet been establi- shed, as can be seen from a later discussion. In 1985, a different though related virus; called HIV-2, was isolated in France (obtained in a laboratory) from a Portuguese man suffering from AIDS.

The first type, HIV-I, is prevalent in most of the industralised Western world, including Australia and New Zealand and also in Asia, Americas and Central of Western Africa. However, some serological evidence of the activity of HIV-2 has been recorded in many countries including India (especially in the Bombay-Pune region). However, HIV-2 has not yet been isolated from India whilst there have been several records of isolation of HIV-1.
Among the related lentiviruses are those isolated from horses, sheep, cattle, cats and monkeys. The ones from monkeys, called simian immunodeficiency viruses (SIVs), are most closely related to HIV, particularly HIV-2, though they appear to be more distant relatives of HIV-1.


Women Hip Action In Intercourse

If a wife feels the urge to increase sexual frictions by body movement, she generally rocks her hips forward and back in rhythm with her husband's stroke. This action gives both partners some extra gratification, but can be made much more effective in several simple ways.

 

Syncopate the rhythm :

As explained above, the combination of feminine rockig action with masculine thrust gives much more friction if teh end of one person's movement occurs in the middle of the other's.

Multiply the rhythm :

If the husband takes very slow violin-bow strokes, the wife has plenty of time to make two or three motions to each inward and outward movement of his. Even relatively gentle motions which you can keep up for a long time without tiring and tremendously to sexual frictions when timed in this way.

Improve your purchase :

A wife who tries to move her hips on a soft bed sometimes feels like a man on an icy slope who slips back one step for every two he climbs. A lot of her strength is wasted as her heels dig into the mattress on each, push, making much less movement than her efforts deserve. In the 'usual' position, a simple remedy is available ; she can put her feet on her husband's calves and take purchase directly from his body, so that every inch of movement changes her position in relation to his. A slight roll to one side, so that the husband's weight immobolizes one of the wife's thighs against the bed and makes it a point of purchase, also proves effective, giving the same effect as some of the asymmetrical positions.

Sliding down so that the wife can take purchase from the firm foot of the bed instead of the soft mattress may work out well if the furniture's design makes this position comfortable for both partners.
Of course, some of a woman's sexual movements are made with trunk muscles rather than with the legs. If the upper part of her body is held in fixed relationship with her husband's, the muscles of her abdomen and back move her hips quite effectively. She can lock her arms aroung her husband's chest and draw her upper body snug against his thus giving purchase for every bend and twist of her body.

Or she can draw his down upon her body so that his dead weight crushes her upper body into the bed- a measure which is especially apt during a climax, when the intensified grasping respiration of orgasm ususlly keeps the wife from suffering any breathlessness from chest pressure. Such upper body 'squashing' greatly enhances the effectiveness of the wife's instinctive movements at climax, and adds substantially to both partner's pleasure. The husband must relieve her of his burdensome weight as soon as her climax has passed, of course, even if his own conclusion is still in process.


Second And Third Trimester In Pregnancy

Second Trimester

The second trimester is somewhat pleasant for the mother. The uterus swells to accommodate the growing foetus and imparts a mild bulge to the mother's abdomen. Pregnancy is obvious externally and is physiologically more established, giving the mother a more confident frame of mind. The discomforts of early pregnancy are very much reduced and there is a feeling of well being. The blood volume of the mother is increased by 40 per cent and there is a marked improvement in the circulation with an increase in the number of maternal heart beats. This hightened flow of blood gives the mother a healthier look, the skin is glossier with an improved muscle tone. Pigmentation increases and can be seen obviously in the darkened nipples.

The mother for the first time feels the movement of the baby. Often mistaken for gas movement in the stomach, the first movements are difficult to identify. The foetus, growing rapidly, has acquired almost half its term length by the fifth month. The pathetically thin foetus of the fourth month slowly acquires form as a layer of fat is deposited under its skin. A couple of weeks later the baby's skin, covered with fine hair, is seem. By now the foetus is freely floating in the fluid that surrounds it and the fluid is called the 'amniotic fluid'. The foetus often gulps this fluid and adds a small amount to it as drops of urine. The development of the foetus can be monitored by the non-invasive technique of ultrasonography. For a normal foetus, its chronological age matches its developmental age as seen by using the ultrasonography. In other words, growth retardation or malformations can be identified by this technique.

Third trimester

The last trimester of pregnancy extends from the twenty-ninth week after fertilisation till the birth of the baby. The mother's systems are under the influence of high levels of human chorionic gonadotropin, oestrogen and progesterone. The nervous system, under the influence of these hormones, is tuned to plan for the impending birth of the baby. Placid and a trifle drowsy, most of the time the mother's mental activities are centred on the rapidly growing baby in her womb. The muscular system responds to circulating progesterone.

The muscles and ligaments all over the body are softened. Cervical, uterine and the pelvic muscles too get sfotened and become more elastic as they need to accommodate the growing baby. In the last ten weeks of the pregnancy the lower part of the uterus stretches to make place for the baby's head while the canal of the cervix is plugged by the mucus that keeps out infections. With the baby occupying considerable space within the body there is often pressure felt on the lungs and bladder by the mother. Discomfort and feeling of tiredness marks the last days of pregnancy. Delivery is often seen to follow a spurt of energy felt in this period of exhaustion.
As the baby grows in size its mobility is restricted and it is forced to settle down in one position. Most babies are positioned with their head downwards and are born head first. This is called 'cephalic presentation'. Some babies settle down with head upwards and are likely to be born bottom first. This is called 'breech presentation.' Delivery in cephalic presentation tends to be far easier than in case of breech babies. In either case the baby descends into the pelvic cavity as the delivery approaches.


Viral Structure and Morphology Of HIV/AIDS

Viral Structure and Morphology

The structural model of HIV reveals it to be a sphere containing RNA as its genetic material. Morphologically, HIV is classified as lentivirus according to the manner in which bud from the cell membrane. Highly magnified AIDS virus on a human T-helper cell.

HIV has a very complex genome. It is even more complicated than that of other known retroviruses. The eight to ten genes express structural and regulatory proteins. The former constitute the viral structure. The major internal structural protein has a molecular weight of 24,000 and is called p24. The p17 (p18) core protein covers the internal surface of the envelope. T%he envelope is a two-layered lipid or fatty coat. The lipid material is derived from the outer membrane of the host cell acquired during the budding process.

The envelope proteins have attached sugar chains and are thus called  glycoproteins (gp). The knob-like structure is gp 120; the one which sits on the membrane is called the transmembrane glycoprotein identified as gp 41 on the basis of the molecular weights. The main precursor envelope protein is gp 160. Envelope proteins play important role in the initial attachment to the host cell and in other early events. Therefore, most of teh vaccines developed against HIV has focused on them. There are, in addition, several regulatory proteins which are produced by the regulatory genes of HIV. Some of these help to enhance HIV production while others regulate it in a negative manner.

Tests for Laboratory Diagnosis :

We first go to family phisicians or general practitioners (GPs) with complaints of illness. They diagnose the nature of the illness making use of their knowledge and experience. This is called clinical diagnosis on which depends what medicines are prescribed, in what form, etc.
Sometimes, doctors resort to laboratory diagnosis in order to determine the nature of illness, especially to differentiate it from other similar illnesses. Laboratory diagnosis is particularly important in detecting diseases with serious helath implications or those with long latent period. HIV/AIDs is indeed one such disease and hence the need for laboratory diagnosis.


Childbirth

For the mother going in 'labour', as the name suggests, it means a lot of work and energy expenditure. The uterus that contracts on and off throughout pregnancy, now contracts more definetly and strongly enough to be felt by the mother as pain. The onset of strong uterine contractions marks the beginning of labour. Foetal hormones, again corticosteroids, are said to play a role in starting off uterine contractions. Further labour is sustained by hormones secreted by the mother. Chemicals, called 'prostaglandins', cause strong uterine contractions. Muscular contractions in the later stages of labour are supported by the hormone 'oxytocin', secreted by the mother's pituitary gland.

The first phase of labour is geared towards dilation of the cervix. With every spurt of dilation the baby slips further, causing pressure on the maternal organs. Towards the end of the first phase of labour, the cervix is completely dilated and the uterus, cervix and vagina are in continuity forming the birth canal. The amniotic sac usually ruptures by this time and the amniotic fluid rushes out of the vagina.

The second stage of labour begins with the muscles that form the top of the uterus, called the 'fundus muscles', beginning to contract slowly. The contraction of these muscles thrust the baby downwards with a strong push. The baby receiving the pressure from oneend manoeuvres by rotating its head slightly to fit into the birth canal. With every muscular contraction the baby approaches the vulval cleft. Finally as the head is seen emerging, the shoulders of teh baby negotiate through the birth canal. A single contraction pushes the head out, with the baby facing the mother's hip. The next contraction pushes the rest of the baby out, and it draws its first breath! In the third and final stage of labour, the placental tissue that has detached from the uterus is pushed out. The umbilical cord made up of the pulsating blood vessels is redundant as the baby starts breathing on its own. As the blood vessels stop pulsating, the cord is tied and cut, with no pain to either the mother or the child, as the cord does not have nerves.

As birth, the baby is covered with a white fatty coat called the 'vernix caseosa'. This greasy material protects the baby from skin infections. The baby is also able to fight other infections duu to the mammary secretion by the mother and which is rich in antibodies. In the first few days after childbirth the breasts produce a yellw fluid, called the colostrum which is rich in proteins, some of which are antibodies. Glycogen stored in the foetal liver provides the sugars required until the milk synthesis begins in the mother's mammary tissue. Soon, in response to suckling, enough milk for the baby is produced.


Room To Move In Intercourse For Woman

A woman who feels desire for extra sexual stimulation during intercourse almost automatically seeks extra penetration. She instinctively presses her organs towards her husband and simultaneously draws him towards her. She yields herself to him, and takes pleasure in his working of his will upon her.
There is nothing wrong with this instinctive approach, except its sameness in every incident.

 

 

Continued mutual movement throughout the climax gives completely different and equally intensive sexual sensations, and helps to keep married sed from becoming routine. Squashed hips are hard to move, though, and the wife who wants to continue activity needs to get her husband to give her a little room. Drawing his chest down snug against here accomplishes this end indirectly;

in order to move his own hips with his chest down, he almost has to raise his lower body up on his knees, syncopated rhythm automatically leaves the woman room, since she makes her movements before her husband reaches the zenith of his stroke, provided the husband continues long, slow violin-bow strokes instead of letting instinct drive him into quick, deep ones with virtually no 'backswing'. The male and female sexual roles almost demand that the husband be left in at least nominal command of each incident, so that the woman should rarely order him to change his rhythm or approach, but she can usually induce him to slow down, back off, or use longer strokes by offering the kind of cooperation she knows he will enjoy.


Whole-Body Movement Of Woman In Intercourse

Sexual friction results from movement of your genital organs in relation to your partner's body, not your own. In many postures the wife produces extra friction much more easily by moving her entire body in relation to her husband's than by rocking her hips. The most effective source of sexual friction in the chairbound posture, for instance, is up and-down movement of the woman's body, achieved mainly through the husband's 'bouncing his wife on his knees'. She can add to the movement by 'posting' as if she were riding horseback, lifting with her thighs in rhythm with his movements, but contributes very little by hip-rocking or other instinctive motion.

Her movement relative to her husband's body causes considerable friction, however, even though her trunk is motionless. In the same way, a great deal of sexual friction in bed-bound marital encounters comes from movement of the woman's entire body in relation to her husband's. A woman lying on her back with her husband on top might just as well be sandwiched between two sets of balls bearings so far as the range of movement required for sex is concerned. The tissues beneath her skin have enough elasticity to allow several inches of effective movement without any motion at the skin surfaces. You can easily demonstrate this fact by lying on your back and pushing yourself towards the head of the bed as far as the skin will stretch, then towards its foot. Your head will move at least two or three inches in relation to the bedstead. Since your husband takes purchase from the mattress during intercourse, the crucial parts of your body obviously move just as far in relation to his.

Whole body movement serves as the woman's main contribution to sexual friction in several sex postures. Take, for example, the pillow-trick posture in which the wife's legs are straight and flat upon the bed. This position leaves little room for hip action, but the wife can still add considerably to sexual frictions with whole-body movement. She can use strong leg muscles by sliding down until the balls of her feet rest against the foot of the bed or by placing the balls of her feet on the tops of her husband's arches, then pushig her body headward and allowing it to recoil. Or she can grasp his upper arms or body and move herself up and down along its axis by arm movements. This approach proves quite effective for a short time, although it is too tiring to continue for very long.

In legs-up postures, the wife almost cannot make the instinctive type of hip rocking motions. She can make whole--body movements quite effectively, however, especially in the maximum legs-up posture, which hooks her heels over her husband's shoulders. Although this posture sounds very clumsy and uncomfortable, in actual practice the husband's weight almost exactly counter, balances the natural recoil of the wife's leg muscles, suspending her hips in a sort of floating action which allows side-to-side and up and down movements of wide range and intensity. The key to effective wifely movement in this posture is simply to use the heels as the stationary point.

Some More Points In Next Article ...


Suggestions For Teenage Pregnancy

Over millions of years all these events have evolved to take place naturally with little support. However, complications can easily creep in. Both mother and child are in a precocious position at childbirth and undoubtedly require special care. Neglecting minor difficulties felt by either the mother or the baby during childbirth may turn out to be fatal. The vagina or the cervix may need suturing as it is expanded during delivery and may tear. If required, forceps are used to pull out the baby. Often surgery, the caesarean section, is required during delivery, making life a little more difficult for the mother.

The birth of a baby evokes celebration in most societies. An event that networks relatives and friends, it is a watershed in the life of parents. The mother has been preparing for this event throughout pregnancy, more so in its last few weeks. For the baby it is going to be a sudden change in the lifestyle - the challenge of a hostile environment in which it must learn to live. The baby too has been preparing for this event. Most of the baby's preparation for birth is orchestrated by corticosteroids-the hormones secreted by its adrenal glands. In response to this hormone a store of glycogen builds up in the foetal liver. This store is going to provide it nutrients in the first few days after birth. The baby's lungs too respond to corticosteroids and prepare to draw the first breath. Babies born prematurely are often unprepared with nutrients and require a support system to survive.

A well-timed pregnancy is a creative, enriching experience for the mother. The baby born is a source of immense joy to the family, shared and celebrated. However, pregnancy and childbirth become a traumatic experience if the mother herself is too young to physically and psychologically go through it. It is, therefore most important that a woman makes a conscious choice of the prospective father. Teenagers who undulge in casual sex and fail to use contraceptives may be saddled with unwanted pregnancies that may prove unmanageable. At all costs such a situation should be avoided. It is not very difficult to do so if the teenagers are provided with adequate sex education and are made to understand that their decisions must be made with an utmost sense of responsiblity, for pregnancy is a serious affair!

Pregnancy among Teenagers :- Married or unmarried, when teenaged girls have unprotected sex and get pregnant they require a little more care and concern than what they would if they were a little older.

1.    Social concerns :-

Girls marrying young are often under pressure to prove their fertility and become pregnant before they are ready to care for a baby. This often cuts short their employment opportunities, which makes them a financial burden on the family or forces them to work when their health is compromised. In the case of unmarried pregnant girls, the social stigma is often so unbearable to the family and the girl herself that desperate steps like abortions with the help of untrained personnel is attempted. Such attempts often cause complications, like haemorrhage, uterine perforration, cervical or vaginal tear leading to dire consequences, even death. Even when there is family support the teenager with a child is forced out of normal social interactions and finds life rather difficult.

2.    Physical concerns :-

It is now well documented that child bearing before twenty years of age is a helath hazard for both the mother and the child. Pregnant teenagers run a high risk of two major complications - toxamia and cephalopelvic disproportion. In the former, the pregnant girl develops high blood pressure and oedema, especially in the last trimester of pregnancy due to retention of salt and water in the tissues. Proteins may be lost through the urine. If left untreated this may lead to convulsions and haemorrahages that are fatal to the mother and the child. Cephalopelvic disproportion arises because the pelvis of the girl has not yet attained the size and shape required for childbearing and delivery. The foetal head is relatively large and the girl may have a very strenuous and complicated labour. Retarded foetal growth and premature delivery are also major problems of teenage pregnancy.


Specific Tests For HIV And Serological Markers And Confirmatory Tests

 

 

Diagnostic Tests Available for Routine or Research Use

Indirect/Serological Methods :

- Detection of antibodies (EIA and others)

- Detection of antibodies to different viral proteins (Western blot, RIPA. Confirmatory tests)

- Detection/measurement of neutralising antibodies

 

 

Direct/Virological Methods :

- Detection of viral antigens (ELISA for p24 core antigen)

- Detection of viral RNA and proviral DNA (many tests including polymerase chain reaction [PCR] among them)

- Virus cultures (isolation of the causative agent from blood and other tissues/organs)

The Above table are listed specific diagnostic tests which are available for routine or research use. In general, these tests can be divided in two categories : indirect or serological tests and, the direct or virological tests. When blood is taken out of the body, it has a tendency to clot, i.e. to get coagulated; it leaves behind the watery portion which is called serum. Tests which are carried out on the serum (plural sera) are generally called serological tests. The resulting response of the host (seroresponse) could be termed either to be seropositive or seronegative.

Serological Markers :

Various viral proteins described above act as antigens, meaning as foreign to the immume system. Therefore, the host's immune mechanism is activated to produce antibodies to fight these foreign antigens (further details in coming articles). Antigens and antibodies circulate in the blood; after separating the serum from the cellular portion of the blood, serological tests are carried out to detect their presence.


Serological markers according to the time of their apperance are shown in above figure.  Within two to four weeks after exposure to HIV, viral particles and/or the major core antigen (p24) could be detected in the blood. During this phase, antibodies are not detected in the blood.  This initial phase of HIV infection without detectable antibodies, but with the virus (antigen) transiently present in the blood, is known as the window period. Estimates on the length of time between exposure and seroconversion (from seronegative to seropositive) varies widely; the range is estimated between six weeks to six months (average, around 45 days).

An important point should be emphasised in relation to anti-HIV antibodies. In many viral diseases (e.g. poliomyelitis, mumps) the presence of the antibodies means immunity of protection against that disease. In contrast, in HIV disease, the detection of specific antibodies (whatever the test method) is taken as the evidence for the presence of the virus of AIDS. Thus, persons with HIV antibodies are not considered immune, but in contrast, as carriers of HIV. They are able to transmit the virus to others sexually or through their blood or, in the case of pregnant women, to their infants.


Antibody tests are generally identified as 'indirect methods' because they detect a product of an immune reaction to the causative agent. Tests to isolate (obtain) and/or detect the causative agent or, its products (antigens) are included among the 'direct' methods. Several indirect or antibody tests have been developed and still more are continuously coming out in the market. The first antibody test, called enzyme linked immunosorbant assay (ELISA or EIA), was commercially available in industrialised countries in 1985.
These have been employed since then in routine diagnosis, particularly for screening of blood donors. The assat employs an enzyme conjugate which gives a colour signal resulting from the reaction between specifically bound enzyme and a substrate. A photograph of the ELISA plate with some information is reproduced shown in above figure. Over the last few years, EIA have been developed which use components/reagents vastly improved in quality from those used in the 'first generation' tests. Since ELISA is the most commonly used test in blood banking services, most commercial kits tend to be so sensitive as to pick up even some 'false positive' samples. Interpretation could be difficult, and in several instances, confirmation is needed.

Confirmatory Tests :

Western or (immuno) blot test is the most widely applicable confirmatory test. The name western does not arise from the geographic (industralised) region. It came about from the scientists ingenuity, both in developing this new technology and in naming the tests.


A man called Southern devised a method to identify DNA fragments; the test was referred to as southern blotting. Later, some other scientists developed a similar technique but for RNA. Although their names were different, the technique was known as Northern blotting. As it generally happens, soon thereafter an immunoblot to identify various proteins (polypeptides) was described. This came to be known as Western blot. HIV/AIDS has imparted to this last test an extraordinary importance. In above figure, some information on the test is presented.


In addition to this, there are other confirmatory tests, but they are much less known. These also require some specialisd reagents/equipment and are therefore not very widely accepted. One of these is called immunofluorescence assay (IFA). It uses a specialised dye which fluoresces under a special microscope and can thus point out where viral antigens or antibodies are located. Another good confirmatory test, called radio-immuno (precipitation) assay (RIA or RIPA), is also available. However, it requires very specialised facilities to use radiosotopes, which are not commonly available.


In countries where laboratories can afford to use the Western blot, it is found to be the confirmatory test of choice. In fact, it has often been called the 'gold standard' and frequently employed for comparative evaluation of various newly developed serological tests. Interpretation of Western blot is, however, still debatable especially reagrding how many bands and for which particular structural antigens should be taken as positive


Whole-Body Movement Of Woman During Intercourse

In the inverted postures, whole-body motion offers the only means by which the wife can provide much in-and-out friction. She can rear up to lift herself a few inches off her husband's hips without breaking sexual contact, than settle back into position. If her legs are down straight, she can dig in her toes and move her body headward then footward by alternately stiffening and relaxing her leg muscles. In the asymetrical postures, the wife generally has one foot well-placed to give her purchase for whole-body movement even if the other leg is throughly pinned to the bed by her husband's weight. There is enough 'give' in the thigh tissues that whole body movement will still 'leave her husband behind' and cause added sexual frictions.

In the more usual positions, whole-body movement mainly serves two special needs. First, it offers a means of eontinuing mutually active sexual friction when physical fatigue makes hip and trunk motions difficult. If you push your body towards the head of the bed as far as it will go without moving your skin along teh sheets, then allow it to recoil to its former position, you impart perhaps two inches of movement in relation to your husband's body. Try to move your genitals two inches by hip and trunk action, and you will instantly see how much more physical effort is required. You will often find that whole-body movement gives both you and your partner all the stimulation you need at some stages of intercourse and still lets you rest the muscles you will use during the climax.

Second, whole-body motion combines very well with hip action to give intensely pleasing sexual friction. A little experimentation 'on your own' will show you how this works. Lie on your back in the 'usual' position. Observe the movement of your genital area during the following manoeuvres: first, rock you hips forward without pushif off with your heels, using trunk instead of leg muscles to impart motion. Second, push with your heels to shift your body headward along the bed as far as you can move by stretching your skin instead of permanently shifting its position on the sheets.

Third, rock your hips hackward. Fourth, dig you heel into the mattress slightly to pull your body back down towards the foot of the bed. Your genitals will have moved in a square pattern with up-and-down and lengthwise elements perfectly designed to harmonize with yuour husband's diagonally directed thrust. When you apply this combination of wholebody and hip movement during intercourse, one motion will blend with another to make your genitals move in and up-and-down rotary fashion. Match one such movement with each inward of outward movement of the penis, or (if your husband uses long, slow violin-bow strokes to give enough time) make two or three revolutions for each male thrust. You will find the sexual frictions produced in this way much more pleasing both to your husband and to yourself than the instinctive hip-rocking movements alone.


Modern Women On Planning Well

In the last fifty years, feminist movements have not only brought women to the forefront in education and employment but have also altered the way women look at their sexuality. The relatively liberal views have thrown up new challenges that need to be handled with a sense of responsibility. As we shed our 'puritan' views, the teenagers are forced to handle complex relationships of the adult world, often on their own.

Moreover, as the grip of religion and association of morality with sex loosens, the young must draw their own lines of permissibility. A lack of knowledge about sex and contraception may lead to painful experiences that youngsters may find impossible to handle. While familial support helps teenagers to handle the new found, almost compulsive, attraction to the opposite sex, objective awarness can help build confidence to make the right decisions that ensure a healthy life. Knowing all about contraception is an exercise in this framework, It must be appreciated that clear and candid discussions alone would lessen the confusion that exists about contraception.

Interestingly, misconceptions about contraception have existed for a long time. An illegal abortion was a major method of family planning and is still confused with contraception. In the earlier part of the 20th century as advances in medical practices that controlled mortality were established, the need for birth control measures became evident. In the latter part of this century, family planning services became an important part of medical practice. Different societies have taken their own time to accept morally and politically the need for contraception and implement it in real terms.

Today a number of clinics in India, government supported as well as private, successfully implement family planning programmes that reach out to the people. It is only our ignorance that keeps us away from benefiting from these programmes. Decisions taken in utmost privacy are based on knowledge and easy availability of family planning facilities. And it is this bit of information that we elaborate here.

Most societies have developed a conde of conduct to limit childbirth. A legally accepted marriage after the age of eighteen in girls with a stress on illegitimacy of childbearing out of marital bonds somewhat ensures that maternity is postponed. At the rist of sounding 'puritanist', it is worthwhile emphasising that teenagers who follow this social rule strictly for delaying pregnancy (and possibly sex) ensure reproductive health. Pre-marital teenage sex that often leads to unwanted pregnancies, not only finds no social sanctions but also puts the girl's newly matured reproductive system through undue stress which may have lasting effects.

A woman conceives when intercourse takes place around the time she ovulates. For the two events to occur un unison, in an average woman with active sex life it takes about two to three months. The probability of getting pregnant is maximum if the coitus takes place two days before or after ovulation. The sperms are viable for only about forty-eight hours in the fallopian tubes. A simple way of avoiding pregnancy is to abstain from intercourse on the these days. In practice the problem arises as there are no easy indications of ovulation. There are, however, some parameters that can be monitored with some effort to help in making a guess about the day of ovulation. The mucus in the cervix at the time of ovulation is profuse, clear and watery, at other times it is cloydy, yellow or a white, sticky discharge.


Other Simpler and/or Rapid indirect Tests And Quality Control and Interpretation of Serological Tests

Diagnostic tests, which can give results in minutes instead of hours, have also been developed and evaluated. Some of these do not even require instrumentation and are therefore very useful in areas where instruments (such as ELISA readers) are not available, of if available, cannot be maintained. Several of the rapid tests have a potential for being used in emergency situations, for example, screening blood for immediate transfusion. One drawback is the high cost of such kits.

Tests have been developed based on the principle of antigen-antibody agglutination; one such, namely SERODIA (from Fugirebio Inc:, Japan), has been found to be very useful. It takes about a few hours (three to four hours) but requires no instrumentation. It is very sensitive and therefore requires an additional test for confirmation. Some commercial houses have produced 'Use Yourself; type of very simple kits to be directly used by the end users. as in the case of pregnancy tests. There is, however, a reluctance in the U.K. and USA to allow this test because it is feared that positive results without any support from doctors and counsellors may lead to undersirable consequences.

Among indirect testing is also included a special test applied mainly for research and in vaccine studies. This measures neutralising (N) antibody in circulation. N antibodies combine with the virus and thus neutralise it to prevent its replication. As mentioned earlier, in HIV infection even N antibodies are not always protective. This is because the AIDS virus is found to change rapidly even within the same person, thus avoiding neutralisation. By the time antibodies appear fro this 'changed' virus, the devious HIV might have modified once again thus evading neutralisation.

Quality Control and Interpretation of Serological Tests :-

In view of the medical and particularly social significance of a seropositive result, extreme caution is required in the performance of the various serological tests and their interpretations. The aim should be to obtain accurate results so that a correct interpretation can be made. A 'false positive result is potentially tragic and should be preventable before conveying to the concerned person. On the other hand, if 'false negative', the infected person may continue to infect others through high risk behaviour. Quality control at every stage of testing should be introduced; similarly, proficiency of those carrying out the tests should be checked periodically.

Interpretation of ELISA is also very important. Since most kits are made so as not to miss any real positive, these are made so as not to miss any real positive, these are very sensitive in their reactions. A serum sample which gives a positive indication at first testing is called ELISA reactive. It should be repeated, preferably using a different kit. Onlyh repeatedly reactive sera are considered seropositive.
Not only medical and social but even ethical, legal and economical issues are implicated in testing; these aspects including pre-test and post-test councelling are discussed later.


A Strength-Snugged Vagina and Vaginal Movement During Intercourse

A Strength-Snugged Vagina

Finally, a woman can add considerably to the intensity of sexual frictions by deliberately strengthening and contracting the muscles in and around her vagina. Like the muscles her husband uses in the genital twitch, muscles in the vaginal area automatically contract in waves during a sexual climax. These muscles are semivoluntary, like those you use in swallowing, and ordinarily go into their act only as a part of instinctive sexual response rather than on command. Like using swallowing muscles, you can learn to contract vaginal muscles with sufficient ease to let you exercise and strngthen them and perhaps with sufficient facility to permit deliberate genital movements during intercourse.

Strong muscle tissue in and around the vagina's walls increases both your capacity to please and your own sexual response. Howeverm very few couples have a sufficiently rapid sex pace to provide, through intercourse alone, the exercise these muscles need if they are to reach maximum strength. Most wives find that they can definitely improve couple sex life within two or three weeks by taking this simple exercise.

While sitting in a relaxed posture, try to lift and constrict the female opening 'as if you were trying to pick up marbles with it'. Hold tight for a slow count of three, then relax briefly. Repeat five times. Follow this routine three times a day, which you will find very easy to do in view of the fact that you can use almost any spare moment at home or away, without anyone else having an inkling of what you are doing. After you have achieved maximum strength, perhaps in six to eight weeks, you can maintain muscle tone by performing this exercise only once a bay.

Vaginal Movement During Intercourse :-

Once you master the art of contracting the vaginal muscles, you will find that a run of short, sharp 'lifts' during intercourse gives your husband substantial extra satisfaction. This move- ment is particularly helpful in adding life to intercourse in postures which allow relatively little feminine hip motion. Like other wifely contributions to sexual friction, it is usually quite effective in conjuction with long, slow masculine strokes. Howeverm this action also may supplement the vigour of your husband's orgasm if used during his final flurry of activity. As he starts towards climax, six or eight short, sharp 'lifts' often bring him a much keener orgasm than would otherwise be possible, and also often help to increase any coincidental feminine response.


Rhythm And Barrier Methods

Rhythm Method :-

Observant women, over a period of time, may be able to approximate the time of ovulation by monitoring the cervical discharge. The other parameter that can be monitored is the basal body temperature, which raises around mid cycle and peaks at ovulation. These methods of detecting ovulation are more commonly used under clinical conditions rather than by women as a routine. Instead, women tend to follow the rule of the thumb that works very effectively-intercourse should be avoided between the tenth to the ninetenth day after menstruation. This is the time when ovulation is most likely to occur. Particularly in women with regular menstrual cycles, this method of contraception, popularly called the rhythm method, words well more so when other methods are used for additional protection.

Barrier Methods :-

A number of contraceptive practices can be classified as 'barrier methods' for they are based on creating an effective barrier between the meeting of the egg and sperm. One of the most popular methods is the use of condoms. It is believed that a reputed physician in the court of Charles II. Dr. Condom, invented a sheath that was ijpermeable and used it to prevent ferrilisation.

The earliest known condoms were crude and made of the caeca of sheep or other animals. Skin condoms were replaced by less expensive ones made of vulcanised rupper in the late 19th century. In 1930 major technical improvements resulted in condoms made of latex. Today, condoms made of a thin, stretchable latex film, unlubricated or lubricated by spermicidal jelly, are flooding the market. Available without prescription, easy to use and effective, condom use has gained popularity not only because it acts as a berrier to sperm entry but also substantially reduces chances of venereal infections (sexually transmitted diseases).

Condoms are specially good contraceptives for lactating women as neither the intra uterine device not the hormonal contraception is advisable until six months after the baby is born, A rare side effect of the use of condoms is an allergic reaction that may develop, causing temporary skin irritation in the penis or the vagina. Such cases are relatively rare and may cll for switch to alternative contraceptive practices. In spite of its effectiveness  condoms may not be used, for in a male-dominated society the onus of contraception falls by and large on women. Feeling less responsible for long-term consequences, with a misconception of 'enjoying' the intercourse less is a condom is used, a man often refuses to cooperate, more so if there is no formal commitment or poor understanding between the partners. It then becomes imperative that the woman uses the device that acts as a barrier to fertilisation.

Conntraceptive practices in women have evolved around blocking the fertilisation by chemical or physical barriers in the vagina. Historically a host of substances including a variety of gums, leaves, seed pods, half lemons, bath sponges, powder puffs or even a child's rubber ball have been used. Today vaginal barriers include the 'diaphragm' made up of fine latex mounted on a thick rim; 'vault caps' made up of plastic that fits the vaginal vault; cervical caps pessaries- made of rubber that fit snugy over the cervix. These devices need to be fitted by a trained person, not necessarily a physican. Over a period of time the woman may learn to use the devices on her own.

Recently polymethane pouches that act as female condoms are avalable. These devices are somewhat clumsy to use; slippery and expensive. Though not popular, availability of such a device is a revolutionary idea for it helps the woman to protect herself against sexually transmitted diseases as well as an unwanter pregnancy. Effective use of vaginal contraceptives requires that the woman is well aware of her anatomy and is disciplined enough to insert the cap or the diaphragm before every intercourse. Relatively cumbersome, for a few women vaginal contraceptives are a good choice.

On the other hand, chemical barriers to fertilisation in the form of spermicides have gained wider acceptance. Easily available, convenient for couples who have frequent, unplanned intercourse, spermicides can be effectively used with practically no side effets. Sperms as tiny cells are vulnerable lot and depend heavily on their local chemical environment to function normally.

Scientists have studied in detail the biochemistry of sperm behaviour, their motility and ability to penetrate the egg. Over the years a number of simple chemicals have been indentified that disrupt fertilisation. Spermistatic agents (chemicals that check sperm mobility) and spermicides (chemicals that kill the sperm) can be classified in to three broad categories. The first category of these chemicals is electrolytes that simply disrupt the sperms osmotically. The second category of chemicals are the inhibitors of enzymes that are important for sperm survival. And the third category of chemicals are surface acting agents that affecft the surface membrane of the sperms. These chemicals, though they enter the circulation of the woman through the vagina, have never been shown to have any adverse effect. Few who report local irritation soon after use are advised to discontinue the use of sperm gels.


HIV Direct Tests And Situation In India

HIV Direct Tests

Diagnostic tests dealing with isolation of the virus either from blood or other tissues and organs or detecting the presence of the virus or its products (proteins/antigens) are called direct tests. Among antigen detection, p24, the major core antigen appears first. Antigen detection kits are also based on the same principle as EIA, but they are very expensive. Furthermore, the test is not routinely applicable as the antigen is present only in the very early phase after exposure. HIV antigen again appears in the circulation, coincident with the drop in antibodies to this antigen. This stage coincides with the progression of HIV infection to AIDS. Therefore, p24 antigen testing becomes a useful prognostic marker. This phenomenon, which is regularly seen in patients in Pattern I countries is, however, not significant among patients in (Pattern II) African countries. Its significance yet remains to be determined in India.

Isolation of the virus from HIV-infected and AIDS patients is a useful research tool, especially in the development of vaccines. It helps in characterising and comparing HIV strains obtained from different situations and in different regions. The virus(es) from Africa are genetically different from those in USA. On the other hand, isolates from the IV drug addicts are reported to be different from the virus strains isolated from HIV/AIDS patients who became infected through the sexual route. The latter differences have been noted among the strains isolated from the same region in Thailand.

Detection of viral RNA and complementary DNA has mainly been employed for research purposes. A more recently developed test, called polymerase chain reaction (PCR), has the greatest potential not only in research but also for routine use in some special conditions. The test can determine RNA-the genetic material of HIV - and also, the proviral DNA. The extracted material from blood or other sources is amplified tremendously so as to yeild sufficient amounts which are then identified by using certain 'primers'.

Situation In India -

In India, ELISA is the most widely used test with Western blot as a confirmatory test. During the early phase of the epidemic, this strategy worked out satisfactorily. However, with the increase in the number of seropositives, the expensive confirmatory test now needs to be performed on a much larger number. Therefore, alternative strategies should be developed on the general principles recommended by the WHO, But, keeping in mind our culture and socio-economic conditions.

Yet another urgent need is to develop strategies for the diagnosis of various AIDS associated infections, including opportunistic infections. At present, there are more centres/laboratories to carry out serodiagnosis of HIV/AIDS as compared to those engaged in diagnosis of viral diseases such as herpes viruses, or for sexually transmitted and parasitic diseases. This situation should be rectified because many of these diseases are not only preventable but curable and, therefore, should be identified and tackled in time.

The below pictures depict the life-cycle of HIV within a human cell. The genome of the viral RNA transcribes DNA with the help of the reverse transcriptase. This DNA gets circularised and gets integrated into the host cell DNA in a 'proviral form'. Some of the DNA can also remain unintegrated form, Later, the proviral DNA makes the required proteins using the cellular machenery of the host (under the viral demands) to form viral particles. Finally, the virus 'buds' through the host cell membrane-picking some cellular component in the process-and emerges as mature HIV which can infect other cells.


Origon of HIV and Natural History of AIDS

In the introductory chapter, a breif mentoin was made about various hypotheses proposed to explain the origin of AIDS and the human immunodeficiency virus. It was concluded that it would be more useful to know where the virus was going rather than where it came from; this holds ture even now. However, with the passing of time, the heat - if one may say so - is off; the time is right for examining objectively, several scientifically plausible hypotheses. These might help us assessing if not ascertaining the origin and the evolution of AIDs. Answere obtained might help in controlling AIDS but, more importantly, could guide us in investigating epidemics of other 'new' viral diseases which might occur in future.

When did it all Start ?

There seems to be a consensus that ther retrovirus caused sundremo, i.e. AIDS is new. The question is, "How new?'' In other words, if the late 1970s were taken as the era of AIDS, did cases of AIDS occur in pre-AIDS era? Scientific literature indicates that AIDS did occur in pre-AIDS era, but since the cases happened sporadically ther were probably missed.

Retrospective serological studies on stored sera from some countries in Africa (sera were collected to study othe viral diseases) showed a number of them to be HIV seropositive during the mid-1960s. In the US also, at least one case of AIDS was suspected to have occured in 1968. AIDS was also suspected in seaman and his family from Norway. Subsequently, it was shown that one serum from Zaire collected 1959, was seropositive for HIV-I. The hypothesis based on African origin of AIDS seemed to be supported by this evidence. But in 1990, came the information about a seaman, this time from Manchester, England. The man had died in a hospital in 1959 with probable AIDS. Compelling laboratory evidence for HIV was provided in this case employing the sensitive technique of PCR.

The question as to where AIDS could have started remains uncertain. But, one fact abot when it might have started has emerged: it could have started between the 1940s and 1950s, clearly two to three decades before it was finally recognised as new. Could Aids not have occured earlier? The possibility exists and the answer depends on whether human sera/tissues collected prior to 1940s would be available for testing.

Proposed Hypotheses :-

Several hypotheses have been proposed to explain the origin of the AIDS pandemic. Some of these have been strange and soem even offensive. Sir Fred Hoyle, a former Astronomer Royal, postulated that the virus came from the outer space! On the other hand, there were allegations against a certain country concerning 'gern warfare'. In the present (post-glasnost) circumstances, the idea of bacteriological warfare may seem embarrassingly silly; but, at the time, these allegations had to be refuted at length by the other countruy. Among the offensive ones was the suggestions about the alleged use in some countries in Africa of monkey blood for sexual stimulation! The male blood for males, and blood of female monkeys for females inoculated directly in the public area, in the thighs and back, was supposed to have transmitted the virus.

On the other side were some plausible, even logical, suggestions made on scientific basis. Most of these also referrd to the monkey connection due to the close family relationship with HIV-2 of some simian isolates. Of particular relevance to us in India was the isolation of a simian immunodeficiency virus ( SIV MAC) from a rhesus monkey (Macaca Mulatta), the monkey of the old world in Asia, including India. However, antibodies were not found in any rhesus caught in the wild.

Later investigations indicated that this ( SIV MAC) was probably acquired by the rhesus monkeys kept in captivity in USA along with other monkeys who might have been infected. African green monkeys who might have been infected. African green monkeys caught in Kenya and Ethiopia had yielded a retrovirus ( SIV AGM). These monkeys and also wild mandrills from Gabon showed no illness themselves but carried the virus in the wild also. The monkey business continued; another isolate ( SIV SMM) was obtained from sooty mangabeys-a species indigenous to west and central Africa. This supported the possible origin of HIV-2 with this simian species, since HIV-2 is prevalent in west Africa. HIV-1 was nevertheless different; it could not have evolved from these simian strains. Therefore, the search for the 'missing link' for HIV-1 continued. At last, a virus sharing some common properties with HIV-1 was found in chimpanzee in Gabon. The virus was called SIV CPZ. It became a likely candidate to explain the origin of HIV-1 (this Gabon connection is further discussed)


Separation From Intercourse - Post-Coital Caresses

Post-Coital Caresses

For the man and woman who have reached orgasm together without much time leg, it suffices to embrace or kiss after intercourse. further stimulation is unnecessary for them, unless they are starting all over again. Generally, orgasm suddenly awakens the man to reality while the woman wanders in ecstacy for some time. The husband, wishing to go to sleep soon after the act, should not forget that his wife lingers, in the mood and does not want abrupt seperation. The finishing touch to intercourse is given by the husband with post-coital caresses motivated by his deep love and understanding.

The man awakening from orgasm envelops her in an atmosphere of sweet beauty with soft words of love and gratitude while kissing her gently or passionately on her lips, her closed eyes, her neck and her breasts. In response, the woman drifting in her lingering orgasm would be filled with happiness and gratitude to her loved one and keep the fire of passion burning. In the meantime, the rhythmic, voluntary or involuntary contraction of the woman's pelvic muscle jelps keep her partner in sweet rapture and prevent the penis from shrinking rapidly.

Soon, they fall into a pleasant sleep with their sex organs in union. But when orgasm is not reached simultaneously - mostly when the woman achieves orgasm after the man - he should give his partner more aggressive, post-coital caresses. However, these efforts seem to be too late, for both partners should rather have concentrated their efforts on achieving simultaneous orgasm. Following simultaneous orgasm, the man should remember not to insist on peristent caresses, which may be taken as an unwelcomed favor. Such caresses may arouse the woman to a desire for more intercourse, which he can hardly comply with.

Repose

Unless she is pressed under the weight of her partner, the woman usually wishes to sleep with the sex organs united a long as possible. An inner-spring mattress is ideal for this purpose. The side, face-to-face position may be most suitable for repose, but the participants cannot remain in this position for a long period on an extra-irm mattress. On the other hand, a too springy bed causes the hips to sink so that it is not suitable for sexual activity. Sleeping in union cannot last longer than an hour, after which both partners prefer to sleep separately. But before going to sleep, they should clean their sex organs.

 

Sexual Relations In Pregnancy In next Article


Intra Uterine Devices

A set of similar methods that a woman finds far more convenient to use is the intra uterine device or IUD. The use of IUD is based on a simple observation that any foreign body in the uterus prevents pregnancy. While there is evidence that IUDs were used even in pre-literate human societies, R.Ritcher of Poland designed one of the earliest user-friendly IUDs with two threads to facilitate its easy removal.

E.Grafenberg in Germany and Norman Haire in Britain devised the next set of IUDs made of a coil of silkworm thread secured to a silver wire. In 1962, the first plastic IUD that could be inserted without dilating the cervix wad devised. These devices were inserted by dilating the cervix. In 1969 J.Z.Zipper and collegues observed that metallic copper and zinc worked well as IUDs. Today millions of women use IUDs or a variety of shapes and sizes, made of varied substances.

How IUDs prevent pregnancy has been tricky to find out. Certainly they do not modulate hormonal secretions. There is substantial evidence to suggest that the presence of IUD alerts the cells that defend the body, a special type of white blood cells. These cells destroy and conspectus that is formed. In other words, though fertilisation may take place, pregnancy is prevented.

IUDs can therefore be used as emergency post-coital contraceptives. In generel, IUDs can be inserted at any time of the menstr4ual cycle, preferably immediately after menstruation as insertion is easier and pregnancy is definetely ruled out. To avoid any complications of infections, the sterile IUD must be placed in the uterus with a clinical procedure carrried out unhurriedly under aseptic conditions. The woman can be taught to feel the threads in the cervix to check that the device is not expelled.

Rarely, pain or bleeding is experienced in the first twenty-four hours after IUD insertion but that can be controlled. There is a strong possibility of heavy bleeding during menstruation following the IUD insertion. This can be lead, especially in low-income groups, to anaemia. In case the IUD has been inserted inappropriately, perforation and infection leading to complications may arise. Long-term presence of IUD does not appear to alter the uterine environment as the outeer cellular layer of the uterus, which in direct contact with the device, is sloughed off in every menstruation. Theoretically, the IUD is an ideal contraceptive, free from prominent side effects, completely reversible and with low failure rate. In spite of some complications that may arise out of infection, expulsion of the device or due to heavy bleeding, it has found wide acceptance. Some women, however, do not find these side effects acceptable and have reached out for other contraceptives.


Origon of HIV and Natural History of AIDS - Postulates for the Missing Link

A characteristic of the lentiviruses is the species specificity. This means that the cat (feline) lentivirus can infect only cats, the horse (equine) infects only horses, and so on. The only animal lentiviruses considered to be the closest family members to HIVs are the ones from the non-human primates, i.e. the simian viruses (SIVs). These features suggested two possibilities for the origin of HIVs, viz. (i) HIV might have arisen out of a simian source subsequent to a cross-species transmission, i.e. it might have jumped from monkeys to men, or (ii) the virus may have been present in the human population but may have gone unrecognised. Let us examine these two hypotheses separately and also (iii) in combination.

(i) Cross-species Transmision : Assumining that both HIV-1 and HIV-2 had somehow entered the human population from non-human primates, the likely origin for the former is the simian virus from the chimpanzee (SIV CPZ) and, for the latter (HIV-2) it is the virus from sooty mangabeys (SIV SMM). Being the closest non-human primates, chimpanzees have always been helpful for experimentation with human viruses. Thus, the close relationship between HIV-1 and the SIV CPZ could be expected. A recent explanation seems reasonable and has a logical and scientific basis.

Records show that during malaria studies undetaken in the 1920s and 1930s, attempts were made to pass the monkey malaria parasite by infecting humans with blood from chimpanzees and (in smaller number) mangabeys. It is recognised that at least 34 persons (prisoners) received injections of fresh blood from 17 chimpanzees; at least two persons were given sooty mangabey's blood. These data, however, are not very conclusive: a scientist associated with malaria tranamission studies later in the sixties denied that such direct experiments were ever undertaken in the US on prisoners.

Yet another suggestion, which at a first glance also seems probable, is that the monkey virus could have jumped into humans together with the poliovirus vaaccine: live poliovirus vaccine is produced in monkey kidney cells and hence the suggestion. However, there are many doubts raised against this hypothesis, one of these being that it explains the origin of only HIV-2 and not HIV-1. A paper in March 1992 of the reputable British journal, Lancet, relates some interesting information. It confirms that even if a few (50 to 100ml) such retroviral particles were to be present in the live polio vaccine, it would not infect children, particularly as the vaccine is given orally. An interesting alternative suggestion is made by this author. It refers to the possible use of much larger (and continued) does of the live polio vaccine by adult male homosexuals. In 1974, a doctor in the US proposed its use as protection against recurrent herpes virus infection and, therefore, it is probable that the monkey virus entered humans through polio vaccine. However, in absence of any evidence, this hypothesis remains only an interesting thought.

(ii) Unrecognised Presence in Humans : AIDS in the pre AIDS era was not recognised as 'new', probably because in the 1940s many other infections and malnutrition could have combined to produce AIDS-like syndrome. Even in the economically developed countries, the environmental conditions in the forties and fifties were inferior to those prevailing in the seventies and eighties. Thus HIV-1 like retro  virus (eg) might have been present as a low grade infection in some humans but might have gone unrecognised. Tests to determine the effect of T cells, especially CD4 positive cells, were not available.

Several factors could explain how this slow smouldering might have ended in a raging fire; in other words, an explosive epidemic which was recognised as new only in 1981. Increase in sexual promiscuity, emancipation of gays (no more fear of the law) in the Western world, rapid air-travel, massive use of blood transfusion (especially in African countries), unscrupulous trade in blood/blood products and selling of organs, and the increasing use of drugs (including IV ones) were some of the majot factors. Indeed, times had changed; people had become sexually more permissive. Other sexually transmitted diseases (STDs) were on the rise but were ignored. Ultimately, the price had to be paid with the emergence of the pandemic of AIDS.

(iii) Hypothesis based on Combination of (i) and (ii) : This seems an attractive hypothesis, based on the knowledge that many birds and animals including humans carry certain elements of retroviruses in a hidden (latent) form. Such 'endogenous', incomplete (defective) retrovirus-like elements might have been present in the human population somewhere. These elements could also be passed vertically, i.e. from the mother to the offspring. But they remained hidden in some cells, waiting for a chance to get help.

If a monkey/chimpanzee retrovirus crossed the species barrier and infected the same cells of individuaals harbouring some such defective retrovirus, the two might combine. The resultant virus, scientifically called a recombinant, might have arisen. Although the two components were non-pathogenic, the recombinant turns out to be potent and is thus able to infect and spread into human cells. Scientists believe that chimpanzees/monkeys could have, at some time, infected humans with HIV-1/HIV-2 like viruses, Transmission by chance could have occured via bites, scratches, or though some rituals with monkey blood. (details in further articles)


The Range of HIV Disease

The Range of HIV Disease

The natural history of an infectious disease concerns with how an organism survives in the infected host, produces the clinical symptomatology and the final outcome. Infection with HIV produces a very varied and wide-ranging clinical picture (spectrum), having at one end a mild flu-like illness and, on the other, full-blown AIDS. Following the exposure to the virus, events that occur in infected hosts are mild, mostly silent. Stages of progression of HIV infection to full-blown AIDS are shown in above picture.

Acute HIV Infection :

Approximately three to six weeks after exposure to HIV, some individuals (ten to 15 per cent) develop an acute, flu-like illness. This acute phase may be accompanied with fever, sore throat, joint and muscle pains, and other non-specific symptoms. This illness is on the whole so mild that it passes off as unremarkable at the time, and certainly not remembered much later. At the end of this phase, the majority of the infected persons develop anti-HIV antibodies which are detectable in the blood. Therefore, this acute phase is also called seroconversion illness.

This early-phase mild type of illness (which resembles several other cute viral illnesses) is the main reason why some scientists - especially an American retrovirologist, Prof. Peter Duesber - have initiated a controversy concerning HIV not being responsible at all for AIDS. However, the peculiar nature of HIV and, in fact, all retroviruses (reverse transcription), combined with various epidemiological features have convinced most scientists and doctors that HIV is indeed responsible, although many other (infectious and non-infectious) factors may be aiding and abetting in provoking the progression to the final stage, namely the full-blown AIDS. These are described in the Further Articles.

Asymptomatic Stage :

Following the acute phase, whether recognised or not, infected persons enter an asymptomatic stage of HIV disease; they remain healthy, with no signs and symptoms of any illness. As mentioned earlier, they are considered to be potential virus carriers, meaning thereby that they are able to infect others via their blood or sexual fluids.

Persistent Generalised Lymphadenopathy (PGL) :

Some of the HIV-infected persons pass through this stage clearly while others do not. During the stage, infected persons exhibit obvious enlargement (swelling) of glands (lymph nodes) present in the neck and armpits; except for this, the patients may look and feel normal. The swelling of the glands is a defensive response of the infected individuals brought about by their immune mechanisms. Since this type of response could also occur in other conditions, it is difficult to diagnose AIDS at this stage also.

AIDS Related Complex (ARC) :

Infected people during this stage begin to show constitutional (related to the body or mind) signs and symptoms. AR$C covers a wide range of the disease. Actually, this stage was considered significant for diagnosis of AIDS mainly at the time when specific laboratory diagnosis was not available. ARC is diagnosed in a person who has a continuous (for three months or longer) low grade fever and who has lost more than ten per cent of the body weight or has persistent diarrhoea; other symptoms could be extreme loss of energy, night sweats, etc.
In the developing countries with poor nutrition and a heavy load of other infections, all these signs and symptoms could occur due to some other cause(es). Therefore, diagnosis of HIV/AIDS would still be difficult. Generally, however, a physician will request a specific laboratory diagnosis to be made if there is a suspicion that the patient might have encountered a high risk situation for AIDS.

Acquired Immune Deficiency Syndrome (AIDS) :

This is the last stage of the HIV disease spectrum, At this stage, the infected patients develop one of more disease(s), mostly arising out of opportunistic infections or cancers. Some infectious agents - parasitic, bacterial, viral and fungal - remain silent, unexpressed in the body. They grab the opportunity to manifest themselves and cause illness when the body's resistance (immune system function) is depressed. They are called opportunistic infections/diseases. This also applies to some malignant cells kept under control by a strict immune survillance system. Once the system weakens or fails, the cells take the opportunity and grow as opportunistic cancers.

Most of the opportunistic diseased can be overcome by persons with intact immune mechanism; however, in patients with AIDS, they become life-threatenins because the body's defence has markedly declined due to the depletion of a particular type of CD4 positive T-helper cell (a type of lymphocyte) which plays a key role especially in cell-mediated immunity. It is now established that the HIV disease is a chronic illness; its duration (survival time) depends on many influencing factors including nutritional, other infectious agents, and, of course, on prompt recognition and threatment of opportunistic infections. The average (median) time elapsing from the initial infection to the development of disease is currently estimated to be about ten years.


Sexual Relations In Pregnancy

The question is often raised as to whether pregnancy increases or decreases sexual desire. Physiologically, the blood-congested sex organs of the pregnant woman should promote her sexual desire. The elasticity of the vaginal wall noticeable especially in early pregnancy gives the male a special stimulation. The female attitude toward sexual relations during pregnancy may be divided into three categories. The female belonging to the first group feels more settled as a wife when she becomes pregnant. With this sense of stability and the rise in her physiological sex desire she experiences an orgasm previously unknown to her. This is particularly true in the early months of ones first pregnancy. She can enjoy herself partly because she is freed from the preacutions for birth control. However, she should avoid excess stimulation in sexual intercourse and hold down its frequency. The husband should refrain from deep intromission.


In the female falling under the second group, motherly love is awakened as she becomes pregnant, and it suppresses sexual desire. Awakening of mother-consciousness is generally noticeable in women who feel the fetal movement in the middle period of pregnancy. They tend to discourage their husbands from the act. Most women in this group are frigid prior to pregnancy. Because of their anitipathy to sed and sense of guilt, sexual intercourse to them means only perpetuation of the race. Some believe in superstion and seriously fear they may have a lascivious or feeble minded child if the child's head is struck by the penis during intercourse performed while pregnant. They may also be worried about habitual, premature childbirth of miscarriage.With the exception of those who are actually troubled by habitual, premature childbirth or miscarriage, the woman who tries to isolate herself from sexual relations is not acting wisely in keeping pace with her husband. If the wife insists on refuesing him, she should make up for it in other ways.

The female in the third group is in the advanced stage of pregnancy. The vaginal walls during this period are too soft for sexual intercourse so that both parties hardly feel any stimulation. The pleasant sensation in so reduced that she loses interest in intercourse. In late pregnancy when the uterus expands she feels languid and generally exhausted.

Aside from those who have habitual miscarriages and premature childbirths, pregnant women should reed the following precautions :


1    Sexual intercourse shoud be restricted to an average once a week up to the firth month of pregnancy, three times monthly to the eighth month, twice monthly in the ninth month and none in the tenth month.
2    The sex position should be changed with the advance of pregnancy. As a rule, the man should refrain from deep intromission and violent movements while the woman should not participate in cooperative movements.

3    Stimulation of the woman's sex organs should cease and be replaced by caressing of her breasts. Breast stimulation may contract the uterus, but if she is accustomed to it before pregnancy, should not cause miscarriage or premature birth. Stimulation of the breasts during pregnancy particularly suction of the nipples prepares them for nursing the baby. Sucking strengthens the skin of the nipples and draws them out.
In late pregnancy the fingers should never be inserted in the vagina for stimulation.

4    When the husband asks for more than the limited frequency or when the wife feels no desire, she shold handle the situation tactfully instead of rejecting him abruptly. While performing mutual stimulation she should gradually change the subject of their conversation and dissipate his sexual desire. If this does not work, she should be thoughtful enough to lead him to ejaculation only with her caresses. At times, it may be necessary to use the oral genitat position. As mentioned earlier, he should keep his sex organs clean fro the purpose but she should not worry about swallowing his semsn, for it does no harm. The point is, these act, may be difficult without her deep love for him. Her efforts to pleasse him, in turn, will make him realize a new her profound love for him and he will look upon her with eyes of gratitude. If stimulation of the penis is impossible for some reason, or if he insists on sexual intercourse, she may employ the rear-entry side position. To quicken his ejaculation she may contract her buttock muscles rhythmically and intensify stimulation of the penis.
In short, by using some tact, a pregnant woman can and should comply with her husband's sexual desire without compromising her own health. By so doing she will completely win the emotional and physical love.


The Pill

Another well-accepted method of contraception is the 'pill'. The possibility of modulating the woman's reproductive physiology by using chemicals to ensure that no pregnancy takes place emerged as we understood more about ourselves. As early as in 1912, Australian physiologist, Ludwig Haberlandt, mentioned the possibility of 'hormonal sterilisation'. It took years for scientific knowledge about ovarian hormones and their role in ovulation to build and for a commercially prepared hormonal preparation to be available.

Interestingly it took the courage of frail Margaret Sanger, who had made history by pioneering the opening of birth control clinic, to initiate the making of the first ever oral contraceptive. Later, the Searl Company marketed the first 'pill', called enavid, made of norethynodrel and mestranol, the two steroids that resembled ovarian hormones. Several types of hormonal compositions are now available as user-friendly oral contraceptives.

In general, the 'pill' is a preparation of progesterone and/or oestrogen. Taken together (combination pill) or in a phased fashion, the preparation inhibits ovulation in women. How it does so is easy to understand. The circulating steroid hormones have a 'feedback' effect on the hypothalamic secretions, which in turn inhibit prodution of the luteinising hormone and the follicle stimulating hormone. In absence of these two hormones, neither maturation of ovarian follicles nor ovulation takes place. This happens as a normal process when a woman is pregnant and has high levels of steroids in circulation. Steroids taken as the 'pill' mimic the endogenous steroids and not only suppress ovulation but also alter the character of the reproductive tract such that implantation becomes unlikely.

Steroid preparations today can be available as four kinds of pills :
1    progesterone only pill - a daily dose of progesterone to be taken for twenty-one days;
2    combination pill - of oestrogen and progesterone - a dose of identical tablets to be taken on consecutive days for twenty-one to twenty-two days;
3    a biphasic pill - where oestrogen and progesterone is taken in definite but varying concentrations for twenty-one days;
4    progesterone tablets follow sequential preparation - with oestrogen tablets.

Modern pills are progesterone only or combined pills with low levels of oestrogen and progesterone. This makes the pill readily acceptable as it substantially reduces the side effects. In general pills are available as a packet of twenty-one tablets. One tablet a day needs to be taken, starting from the fifth day after the beginning of the menstrual bleeding.

 

 

For effective contraception it is essential that the woman remembers to take the pill daily. If she does forget, it is recommended that an additional pill should be taken the next day. For more omissions, an additional method of contraception is advised to avoid any rist of conception. At the end of the course, the next set of tablets should be started after a gap of seven days. During this period there is bleeding because of withdrawal of hormones and for the woman it is an equivalent of menstruation.

In many societies, women during menstrual bleeding are considered 'impure' and not permitted to participate in religious functions during the time. Women, keen to find a way out, often use hormones to regulate bleeding by taking hormonal preparations. While no physiological effects of such use is apparent, it indicates an irrational acceptance of the 'impure' state of menstruating women by women themselves. This acts rather negatively on the psychology of teenaged girls, reinforcing poor self-esteem. On the other hand, there are others who feel that this may introduce the use of pill in traditional societies with a positive overtone.


Disease Manifestations

Diseases accepted as indicating immune deficiency related to HIV are shown in above picture. Frequently, the first presenting illness, that is the disease which makes patients seek help from doctors, are those of skin and oral cavity. Skin diseases often start with excessive itching and progressively become so severe that they "drive patients almost crazy''m as commented by a specialist.

Among the various skin manifestations, Kaposi's sarcoma (an opportunistic cancer) is the best known. It is, however, suspected to be caused by yet another sexually transmitted (viral) agent.
Amont the organs, lund is one of the most affected. Breathing difficulties due to pneumonia, phlegm and blood in the sputum and chest pains are common features. Infection of the gut leading to gastrointestinal symptoms is particularly common in poor environmental conditions.

The nervous system is also affected and has a wide range, from dementia (deterioration in mental condition) to AIDS encephalopathy (inflammation of the brain), to abscesses and cancers of the brain.
Geographical differences have been noted for several AIDS associated illnesses. For instance, the parasite Pneumocystis carinii pneumonia is most frequently seen in patients in the industralised Western world, while in

Africa and other countries of Patterns II and III, bacterial pneumonias are more common. Similarly, tuberculosis associated with HIV is much more common in the countries of Patterns II and III (including India), whereas other member(s) of the same group of bacteria-mycobacteria a typical variety - is most frequent in the countries of Pattern I.
In recent report from Rwands in Africa showed HIV to be highly prevalent among patients visiting skin disease clinics. Diseases had a particularly poor response to treatment. Kaposi's sarcoma (KS) - a cancer of the skin and some internal organs - is most common among male homosexuals, especially in the Pattern I countries. In India, KS has so far been rare, whether associated with AIDS or not.

During the first years after recognition of AIDS, most clinical definitions had disregarded disease manifestations in women. Perhaps, it was because men with HIV outnumbered women in the developed countries where most of the definitive studies were made. Now that women have also been affected in large numbers, many investigations have been conducted on women, especially to include gynaecological findings. Several recent studies have shown clear gender differences in the clinical status and organ involvement. For example, more men (53 per cent) suffered from skin diseases than women (32 per cent). In contrast, more women (43 per cent) had genito-urinary conditions as compared to men (14 per cent). Scientists feel that many such gender and geographical differences are more likely to reflect differences in the mode of exposure and dosage of the virus, environmental conditions and, of course, the general well-being and immune status of the infected petients.

Paediatric AIDS : A positive diagnosis of AIDS is particularly difficult in the children although many similarities exist between adult and paediatric clinical manifestations. HIV-infected children develop numerous bacterial, parasitic and fungal infections. In countries of Africa and Asia, the struggling economic plight combined with inadequate food and numerous infections further enhance the deadly effect of HIV. AIDS in children can be divided into two patterns of disease progression. Infants showin illness before the first year and rapidly progressing to death, usually within seven to ten months from the diagnosis of AIDS. Children who show symptoms only after two years or so, develop aa disease course more like that seen in adults. In addition to receiving HIV from their infected mothers, children can also get HIV through infected blood or unsterilised needles and syringes.

Clinical Course and Manifestations with HIV-I and HIV-2 The clinaical picture of patients infected with HIV-1 is similar, though not identical, to that presented by those infected with HIV-2. Many studies arecord slower and less aggressive course of disease with HIV-2 as compared to HIV-1. According to a study made over a period of six years, persons infected with HIV-2 are ten to 12 times less likely to develop AIDS than persons infected with HIV-1. On the other hand, a few investigations show no marked differences between the manifestations of the two viruses. Since such studies have only recently been initiated, it will take some time before the question of variation between the clinical outcome of the two viruses will be resolved satisfactorily.


Intercourse Life After Childbirth

Some women who were previously incapable of orgasm often experience it in their early pregnancy and most of them are cured of frigidity after the first childbirth. The reason seems to be largely phychological. She no longer feels any sexual restraint as she secured a stable position as a wife, gained the happiness of having a child, deepened her love for her husband through the child, and got rid of much of her sense of shame by undergoing the ordeal of childbirth.

Despite her enlarged vagina, the woman after her first childbirth gains more satisfaction in her sex life. This fact goes to prove that she is not dependent solely on local stimulation but is largely subject to psychological influence. When a lacerated perineum is stitched together after childbirth, the vaginal opening is prevented from expanding or even made smaller than when no stitching is required. Thus stitching may prove beneficial to both husband and wife. In the first post-childbnirth coitus he must not forget to treat her to abstain from intercourse at least during the first six weeks after childbirth. If necessary, the indirect method as used during pregnancy should be applied as an outlet for the husband's bottled-up desire.

The vaginal cavity may be enlarged by childbirth but this cannot be helped. Air may drift into the enlarged vagina depending on the sex position, especially those in which the woman's legs are raised, and produces a sound of pressed air when the legs are closed. If this unpleasant sound interferes with the enjoyment of sexual relations, surgical intervention may be necessary. But this operation is not recommended for women expecting more children for a less elastic-vaginal wall may complicate delivery.

Some of the more common problems regarding sexual relations after childbirth are reduced sexual desire of the mother and interference by the infant. The new mother devotes so much of her energies to her newborn child that she finds herself exhausted after a day's work and when the child is over a year old she is afraid it might suddenly wake up at night  and catch her in the midst of her coital act. She may develop sexual nervousness from it. By neglecting descipline and letting the child have his own way she is constantly pushed around by him. With improper childcare and the additional burden of household chores, she has little time or energy to devote to her sex life. Thus as soon as she goes to bed, her only desire is to get some rest and sleep. Some husbands point out their disappointment as they find their wife snoring in the midst of the sexual act.

This disappointment is comparable to that of the newly wed wife, who often complains of her husband starting to snore with his mouth wide open, as soon as he satisfies himself. But the difference is that the husband's disappointment may have more far-reaching effects than the wife's. The threat of the children's interference in the parent's night life may lead to inhibitions more in the wife than in the husband which in turn may cause frigidity. Some bold parents are not disturbed by the presence of a child during intercourse. But they should note that this may have an unfavourable effect on the child.

If the child cannot be placed in a separate room, he should at leaset sleep in a separate bed and the parents should use a sping mattress to prevent any noise from disturbing the sleeping child. Here is another thing to be remembered about sex after childbirth. By contracting the pelvic muscles, especially those of the vaginal opening, the new mother can reduce the enlarged vaginal opening and cavity and she further can add wider variety to her sex life. This contraction is possible through practice and offers a desirable stimulation to the male.


Side Effects Of Contraceptive Pills

Modern pills do have some side-effects-few are negative while others are positive. As the pill inhibits ovulation, taking the pill substantially reduces discomforts that women face due to ovulation, such as the abdominal pain. Pre-menstrual feeling of nausea or fainting and tension have also been reported to be relieved. Increased adrenal gland secretion during puberty causes inflammation of sebaceious glands that erupt as acne. High oestrogen in circulation in women who take pills counteracts the acne formation. Likewise, a type of hirsutism caused due to increased levels of androgens is totally or partially resolved. Women using pills also report enhanced libido and a general improvement in the life situation. This, of course, may be due to the relaxed disposition women experience once contraception is taken care of.

The pill, on the other hand, does have some disturbing effects. The breast tissue is extremely sensitive to circulation hormones. Fullness of breasts is reported by women using progesterone preparations while oestrogen users report soreness and tenderness. One of the most irritating side effects of oral contraceptives is the gain in weight due to fluid retention, somewhat maximum in the first six months of use of the pill. At times women complain of headaches, especially migraine, after the first use of the pill. In response to oestrogen in circulation, excessive secretions from the uterus also have been reported. Increased pigmentation or less tolerance to contact lenses have been associated with the pill too. All these effects are minimal with the use of lower doses of steroids. Therefore, despite these side effects, the pill is a popular method of contraception. Moreover, the positive effects of the pill overshadow its negative effects.

Pills, however, should be taken with care under medical supervision in cases where the woman suffers from pre-existing diseases like hypertension, diabetes or liver dysfunction. A question whether the pill causes cancer has been studied extensively. The relation between oral contraceptives and cancer is complex and is related not only to the effect of the circulating hormones but also to the changing pattern of childbearing and lactation. Theincidence of some cancers like ovarian cancers has been reported to be decreased in women using oral contraceptives. On the other hand, incidence of benign liver cancers has been reported to increase. Chances of breast cancer do not seem to be significantly effected in women using oral contraceptives. In general, the risk factor is not sufficiently large to discourage the use of the pill.

Contraceptives already Available or under Active Investigation

1    Implants for women : Various types of removable progesterone implants can be conveniently inserted under the skin and are effective for one to five years. Biodegradable implants are also under investigation.
2    Injectable in women : Injectable progesterone that caan be given every two to three months is popular now. Injectable combinations of progesterone and oestrogen to be given once a month are also available.
3    Vaginal delivery systems : Vaginal rings releasing a progestin that can be self-inserted and worn at a stretch for three months is available.
4    Vacines : Injectable vaccine against human chorionic gonadotropin (hGC) that can be given as a single injection followed by boosters every two to three years is under investigation.
5    Post-coital method : Combination of anti-progesterone (RU486) and prostaglandin given orally and as vaginal suppository or injectable or tabled (prostaglandin) is found to be effective in terminating pregnancy in the first eight weeks of pregnancy.



The Enigma of AIDS : HIV versus the Immune System

Every living being has an efficient mechanism to protect against a disease which facilitates to develop 'immunity' against that disease. This is achieved with the help of an efficient 'immune response' which depends on a coordinated attack of a variety of cell types. In general, it is called the defence mechanism, whereby an army of specialised cells forge a battle against any invader. 'Active immunity' is acdquired by an 'infected' individual through his/her body's own effort (e.g. in response to natural infection or vaccine). In contrast, 'passive immunity' is transferred to an individual in the form of ready-made antibodies collected from persons already immune to that disease.

Components of the Immune System :

Various cellular components implicated in the human immune system are shown in the figure above. Bactgeria, viruses and various such 'unwelcome' micro-organisms invade the body after overcoming the 'first guards' of the body. These are the skin and mucosal surfaces (mucous membrane is the lining of different cavities of the body open to the exterior, e.g. oral cavity or the mouth). Once the germs have sneaked in, they roam around and attack (infect) their favourite target system, namely, respiratory, gastrointestinal, etc.

Macrophages :

Within the body, the first encounter of the foreign invader is with macrophages and their precursors called manocytes. Macrophages are highly mobile cells which may be termed 'scavengers' because they clean up the system by engulfing the invaders in an attempt to get rid of them. This process of engulfing the particulate invaders is called phagocytosis. Macrophages are very mobile, a property which enables them to reach virtually every corner (tissue) of the body of the infected individual.

Lymphocytes :

These are white blood cells which play a very important part in the immune system. There are two major groups: the B cells (considered to have originated from the bone marrow), and the T cells which originate from the thymus gland.

 

 

B Cells :

These are lymphocytes which are responsible for the 'humoral'arm of immunity (described below). On encountering antigens, some of the B cells begin to replicate their own kind and then secrete antibodies which circulate in the bloodstream. Other type of B cells are called 'memory' cells. They are so-called because they have been 'primed' to retain the memory of an antigen. The cells remain silent and get 'activated' only when they encounter the particular antigen; they then produce an accelerated (secondary) antibody response.

T Cells :

During foetal life, 'stem cells' - the original cell type - migrate to the thymus gland. There they pass through certain phases and ultimately emerge as 'mature T cells'. They enter the circulation (blood) and concentrate in the spleen, mucosa and lymph nodes (glands), where they are most likely to encounter foreign invaders (antigens).

The T cells constitute the cell-mediated immunity (CMI). There are two major subgroups among the T cells. Those which carry CD4 cell surface protein are called CD4 cells. They are known as helper/inducer T cells shown in the above picture. The second type are those bearing CD8 marker and are termed cytotoxic/suppressor T cells. As these names signify they perform more than one function. However, these functional distinctions cannot be made on a routine basis but require specialised techniques.


Some More Details In Next Article ....


Intercourse Life After Gynecological Surgery And After Menopause

Intercourse Life After Gynecological Surgery :

A woman may fear that her sexual desise will decline following a gynecological surgery, such as the removal of the ovary or the partial or total removal of the uterus. A tumorous ovary can be removed without affecting one's sexlife as long as the other ovary is healthy, for ovulation, menstruation and hormone secretion will bot be upset. No change will be brought in her sex life of hormone secretion, either, by removal of the cervix affected by myoma. Yet, some women who have undergone this surgery complain of diminishing sexual desire. Just because menstruation has stopped after having the uterus removed, they jump to the conclusion that secretion of hormones has also stopped. They think they are no longer women. Thus they lose confidence and imagine that their desire is weakening.

Complete removal of the uterus may result in a temporary shortening of the vagina but it will expand later and cause no trouble to her subsequent sex life. It is also rash to conclude that one no longer feels the impact on the cervix during intercourse. The surgery cannot completely eradicate her sense of impact on the cervix, which is actually felt by the pelvic peritoneum in the abdominal cavity.
One caution to be heeded is that a woman who has had her uterus removed should refrain from the man-supine position for a few days following the operation. Ligation of the Fallopian tube does not affect her physically in sex life. If there is any effect, it is purely psychological.

Intercourse Life After Menopause :

When ovulation, and consequently menstruation stops a woman is no longer capable of conception and childbirth. This however, should never be intersepted as a decline in sexual desire. A woman can usually tell that she is reaching the so-called change of life because menstruation becomes irregular before it ceases. Menopause occurs between the ages of 40 and 52.
A woman who interprets menopause as the beginning of the end of her sex life may experience a reactionary rise in sexual desire only for a short period, but faced with the imminent threat of a bleak future she feels an inhibition which possibly leads to frigidity and may even create physical disorders commonly seen in women of this age bracket.

It is optimistic woman who feels she has been freed from 'these monthly troubles' that can keep up her sex life without much of a setback.
It is wrong to think that sex life in and after middle age is harmful-both for men and women-to long life. Moderate sex life not only helps activate metabolism, which being to decline at middle age, but also has a psychological advantage in that it maintains youthful feelings and efficiency in daily work.The woman who had no means other than physical, to retain her husband's love will plaster her face with hormone cream and spend much of her time getting hormone injections, in an effort to stay young, but instead she is risking various adverse effects.

It is about this time of a woman's life that she dresses in the latest fashion quest of vicarious youth and seeks a place in society to escape from her sense of instability.A sensible woman, who knows whe is bound to grow old, will take preventive measures while she is young to arrest her facial and physical deterioration as far as possible, and will try to induce her husband to feel the need for her sexually. She should spare no effort to sustain hislove as she should arouse in him deeper affection than that in her thirties. The husband must not forget that he is ageing with her, too. An elderly husband is attracted to a woman younger than his wife not because of her youth but because of his interest in a refreshing sex life.

The wife knows only of receiving love but nothing of giving love will lose hi, long before her menopause. It is wrong to think that sexual activity is stereotyped. It is also wrong to blame the husband for failing to breathe fresh air into their life. In the years following the honeymoon the couple should cooperate on an equal footing in retaining freshness in their marriage. They must know how and when to use their trump. From middle age on, they should remember they can find enjoyment in bed talk before intercourse or before going to sleep. Caressing does not have to be followed by intercourse.
After a long marriage, the husband's love for his wife depends increasingly on the emotional aspect; the same applies to the wife.


Emergency Contraception

There are times when contraception becomes an emergency. In unfortunate circumstances, such as rape or accidental failute of other methods of contraception (broken condom or displaced cervical caps), there is need to block a pregnancy. A single unprotected intercourse in the middle of the ovarian cycle can cause pregnancy and it is absolutely necessary to use a post-coital contraceptive to avoid it. The most common method is the 'morning after pill' a combined oestrogen-progesterone preparation given immediately and repeated after twelve hours. Post-coital hormone therapy aims at rendering the uterine wall non-receptive to implantation. It also interferes with normal functioning of the corpus luteum and inhibits the ovum transport. Post-coital hormonal contraceptives are effectively only if used within seventy-two hours after unprotected intercourse.

Delayed post-coital contraception can be effected by using IUDs. A device must be inserted, within five to seven days after intercourse, to be effective. As mentioned earlier, IUDs act by interfering with implantation. Anti-progesterones, like mifepristone (RU486) that block progesterone action and prevent implantation, can be administered in the later part of the ovarian cycle. The choice of these contraceptives should be made depending on the physiology of the woman and in consultation with the doctor.

At times despite earnest contraceptive efforts, pregnancy may take place. An unwanted pregnancy is traumatic to the mother and often children born out of unwanted pregnancies do not get the attention they deserve. It is therefore advisable and often acceptable for the woman to abort the foetus. Some societies have accepted abortion as a legitimate method of limiting the size of the family. Termnination of pregnancy before the twnetieth week of gestation, starting from the first day of the last menstrual period is medically and legally accepted definition of an abortion. Abortion done during this period is considered safe for the woman.


Antigen Recognition, Presenting Cells And Other Components

 

Antigen Recognition :

Both B and T cells are armed with the mechanism to recognise and respond to foreign invaders. There are, however, differences in the way they go about it. The antigen receptor for B cell is the antibody molecule which is anchored in its membrane. It recognises antigen in a direct way. The T cell antigen receptor is quite distinct from the antibody molecule. It does not recognise the antigen directly. It can bind to a foreign antigen only if the antigen is appropriately processed and presented by cells which are called antigen presenting cells (APC). Yet another complex feature is that the function of T cells is dependent on a specific manner of antigen presentation. In general, the CD4 cells recognise antigens presented in association with the class II histocompatibility antigen (HLA), while the CD8 cells depend on antigen presentation in association with HLA class I. The HLA antigens are hereditary components of these cells.

Antigen Presenting Cells (APC) :

Cells of monocyte/macrophage lineage, which act as scavengers trough phagocytosis, also act as APC. Another cell of the same lineage, called dendritic cell (figure above) resides in the skin, mucosal tissues,lymph nodes and the spleen. The fact that antigens are encountered first and also most (frequently) in these areas, has imparted a very important role as APC to the dendritic cells. B cells also act as APC, particularly efficiently when activated.

Other Components :

In above mentioned figure are also shown NK cells which are lymphocytes known as natural killer cells. As the name suggests, they are potent killers, destroying infected as well as cancerous cells. In contrast to the CD8 positive cytotoxic T lymphocytes (CTL), NK cell function is not governed by the APC's or HLA restriction. Thus, together with phagocytic cells (macrophases), the NK cells constitute a very important 'non-specific' arm of the immune system.

On the other side are cytokines which are solube proteins released by various cells. These act as chemical messengers transmitting signals to their particular targets. The two important cytokines produced by the CD4 lymphocytes are interleukin-2 (IL-2) and IL-4. The former is required for the growth of T cells and the later, both for T and B cells. Cytokines not only perform a variety of functions, but also have an intricate regulatory network of interactions.

As depicted in above mentioned figure, CD4 T cell is the single most important component of the immune system. In fact, it influences functional capabilities of all other cells of the immune system. With such a complex system, it should be obvious that a proper balance of all the components of the defence mechanism, including the solube messengers (cytokines), is essential. Maintenance of a coordinated and effective immune response is thus a crucial element in any individual's well-being. That this balance is totally disturbed in AIDS is a tragedy. HIV appearsto be the major villain though it is aided and abetted in the task by other agents which are called
co-factors.


Medical Termination of Pregnancy (MTP) And Sterilisation

Medical Termination of Pregnancy (MTP):

An abortion can be induced chemically or by mechanical methods. Under no circumstan- ces should the abortion be tried without the help of a medically trained person. Here we refrain from giving details so that any attempt made on the basisof theoretical information is discouraged. Needless to say that an attempt by an untrained person may lead to serious complications that may turn out to be fatal for the woman. Done in consultaion with a clinician abortion is a short procedure that can be carried out extremely safely and requires almost no hospitalisation. Often women suffer from a sense of guilt and morbidity following an abortion. Counselling helps under these conditions. Medical termination of pregnancy is an extremely private decision of the woman and needs to be taken by her alone. Very often this fact is not appreciated and there are social pressures that force a woman to decide against her will. Strictly speaking, abortion is not a contraceptive method and is an eventuality when all other methods of contraception have failed.

Sterilisation :

The choice of the contraceptive method for youngsters centres around it being user-friendly, effective and reversible. Most contraceptives developed so far are reasonably effective an reversible. The method that is most effective but with uncertain reversibility is surgical sterilisation. Not of direct use to the adolescent as a contraceptive, this method is worth mentioning as ithas gained ready acceptance among couples who have completed their family.

Female sterilisation is achieved by surgically creating a barrier in the transport of the ovum to the fallopian tubes. Several surgical procedures of doins so are possible. The most simply an commonly used procedure is to ligate or cut the fallopian tubes. Often surgery is recommended almost immediately after the birth of the baby; it isconvenient and requires no extra hospitalisation. Of course, male sterilisation is far simpler to do and requires no hospitalisation. Both male and female sterilisations are reversible but often there are instances where successful reversal is not achieved.

Ideally, the choice of a contra- ceptive is an informed decision by a woman taking into confidence her partner. Often the choice is limited by the availability of medical facility. As the girl becomes a woman, to know about what choices she has, prepares her for the decision she will need to make quite on her own. A balanced decision, under prevailing social circumstances reduces psychological pressures that a woman faces as she chooses her reproductive lifestyle.


Intercourse During Menstruation

Sexual Intercourse during menstruation is commonly considered taboo. This assumption is based mostly on the deep rooted supersition and Buddhist precepts on the uncleanliness of menstruation. Here, let us consider the problem from the medical viewpoint :

Aside from psychological stimultion, women's sexual desire in most cases is stirred naturally with the congestion of the sex organs, as evident, for example, ater taking a bath. For this reason it is only natural that sexual desire rises a few daysbefore andthroughout menstruation, when the sex organs ae congested. But on account of the unpleasant- ness and possible pain duing the period, she suppresses her natualy developed sexual desire. Even if she does not feel the unpleasantness, she suppresses her desire just because she is in her menstraul period. Consequently, many women refuse sexual intercourse during menstruation but desire embraces and caresses. Such stimulation may have some effect on the uterus but not so much as to cause increased menstrual flow.

Some men feel a strong sexual desire for women in menstraution, but many husbands, married for same time, secretly let but sighs of relief upon learning of their wife's menstruation, which they take as a period of rest for themselves. But as the menastrual period drags on for five or more days, not a few of them wish it were over. These men often ask whether they abstain throughout the entire period, and if not what precautionary measures they should take.

We should consider the following factors concerning the congestion of sex organs, which lasts for several days during menstruation.
   By intensifying blood congestion by sexual intercourse menstrual flow may increase. This excessive congestion, though temporary, may cause pain in the lower abdomen and hips.

 

2    The continuously congested sex organ plus the menstrual blood offers an ideal condition for bacterial multiplication. If the woman has any bacterial before menstruation, they may multiply and strengthen during the period. For example, a chronic case of gonorrhea may lie dormant at other times, but become active during the menstrual period. on the other hand, germs may be transmitted through sexual intercourse during menstruation. Doderlein's bacili, which normally combat these harmful germs in the vagina, are helpless during menstruation.
3    As the congested organs, swollen with blood, are vulnerable to damage, the vagina walls could be scratched during sexual intercourse.
Thus, couples who insist on sexual intercourse during the wife's menstruation should thoroughly understand the possible harms and cooperate in preventing them. Here is some advice for such couples :

(1) For sexual intercourse immediately preceding menstruation they should not use the sexual movements and positions that may have a strong impact, especially on the uterus. Otherwise, she may have an earlier menstruation, a larger flow than normal, and may feel pain in her lower abdomen and hips.

(2) As a rule, they should refrain from the sexual act when there is a large menstrul flow. If it cannot be avoided, they should select such positions as the rear-entry side position where intromission is relatively shallow and violent sex movements are prevented.
(3) For sexual intercourse during menstruation, both should wash their sex organs, adjacent areas and fingers, with hot water. In this way, they can reduce the chances of bacterial infection. It is wrong to rely solely on condoms, which may give protection for the male, but not to the female. There is no guarntee that they are cleaner than the carefully washed penis. Besides, they may give strong friction to the vaginal walls and cause inflammation.

(4) Stimulation of the sex organs during menstruation should be confined to the external areas. The fingers should not be inserted into the vagina.

(5) Sexual intercourse may be performed when the blood discharge temporarily stops toward the end of the period.


Immune System Under Attack of HIV

The crucial importance of the CD4 cell in mounting an effective immune response has been described earlier article. This is the very cell that HIV has chosen as its major target. The entire immune system-not only the infected CD4 cells-ultimately come under the attack of HIV. No doubt, during the very early phase of HIV infection, an effective immune response is mounted against HIV since CD4 and various other cells are not much affected.

In most acute viral infections, such a response is enough to eliminate the virus from the system. In fact, thereafter, in many viral infections, 'memory' cells which are present in an 'immune' individual remain on an alert. If and when they encounter the antigen again, they produce antibodies (secondary) very fast, get rid of the virus and thus maintain the immune status.

 

If this happens with many viruses, whydoes HIV behave diffrently? It appears that HIV and other chronic virus diseases establish a very close relationship with certain cells. They hide into these cels so that antibodies circulating in the blood are unable to reach and 'neutralise' the viral effect; HIV can thus establish latency. However, the virus waits for an opportunity to get out and infect other cells. This happens when the virus carrying cell is 'activated' and starts producing cellular products that the virus can utilise for its own replication. Significantly, the HIV-infected cells get 'activated' when they need to fight other infectious agent(s) which enter the area. In other words, other infections help the virus of AIDS to replicate by appropriating for itself the host's cellular mechanism.

The three important immune responses of humans to HIV are shown in above figure. As soon as the virus undergoes maturation and 'buds out' of the cell membrane(App.1) the specific antibodies in the blood attach to the (virus) particles in an effort to eliminate them (neutralising antibodies). This leads to a see-saw battle between the virus and the antibodies. In excess of antibodies, the virus will be ineffective. In addition to the antibodies, i.e. humoral immune mechanism, the cell-mediated immune arm is very important. HIV can spread from cell to cell without getting into the bloodstream where antibodies can neutralise it. Therefore, CMI has to get into action by alerting the concerned mechanism. As explained in above picture, killing of infected cells takes place by two specific immune mechanisms : names, cytotoxic T lymphocyte (CTL) killing by CD8 receptor positive T lymphocytes and antibody dependent cellular cytotoxicity (ADCC) by the NK cells.

The virus, devious as it is, has yet another mechanism for its counter-attack. It changes its antigen-especially the outside envelope antigen-so that the modified one can escape detection by the already formed antibodies. By the time antibodies to the 'changed'antigen appear in its escape from the attack by the humoral immune system. in these circumstances, the role of CMI is crucial against HIV.
In addition to the CD4 cells, HIV can also remain hidden in macrophages and dendritic cells. Thus it affects all the cells which are most important, especially in cell-mediated immunity.


Awareness Of Intimate Concern of woman health

In most societies women carry a greater procreational burden than men. Not only are pregnancy and infant care consi- dered natural responsibilities of women, very often the onus of providing for all that is required to bring up a family falls on women. Man, however, is a very important part of a woman's life and procreational experience. Very subtly, but surely, the reproductive health of a woman strongly depends on the partner. Cooperation and understanding between the partners is not only important for a healthy relationship but also for her reproductive health. For an adolescent girl it becomes imperative to understand reproductive hygiene an communicate well on this matter with her partner. Failure to do so can cause very serious health problems.

The society in general is obliged to provide health facilities to young women, not only as their right as individuals, but also because, as prospective mothers their health is directly linked to the health of the next generation. Likewise, with a sense of responsibility girls must be aware of what disrupts their reproductive welfare. Many family health care centres do provide facilities for counselling that help youngsters specially. The urgency to do so is felt because the last two decades have been marked by an upsurge of the deadly disease called the acquired immunodeficiency disease (AIDS), very often sexually transmitted. Millions of women over the world suffer from AIDS; many of them because they failed to be cautious in their choice of a partner. Carrying the disease through pregnancy, and childbirth, women have borne the brunt of the problems. Maybe, part of our fight against AIDS and some other diseases will be won if adolescents learn to take care of themselves. This chapter spells out some important aspects of reproductive health.

To understand the care required for reproductive health it must be appreciated that the female reproductive system is vulnerable to a host of infections. Bacteria, viruses, protozoans and fungi, all find easy access into the body through the vaginal opening. The body's immune mechanisms have made provisions to fight all possible infections, including those of the genital tract. The mucus that lines the genital tract is an important protective lining that not only keeps away microbes from direct contact with the cells but also contains chemicals and cells that can kill them. Cells of the immune system that engulf any foreign invaders and eliminate them patrol the mucus and the cells that from the outer wall of the reproductive tract. In addition any micorbe that enters the bloodstream faces an organised team of cells that specially identify it, produce defence proteins (antibodies) that coast it and eventually help kill it by initiating its lysis. Despite this elaborate defence the genital tract does succumb to some infections. A majority of them could be avioded if adequate sex education and information were made available.

Although medical advances have reduced the burden of infectious diseases, the sexually transmitted diseases continue to be a major helath concern all over the world. Sexually transmitted diseases (STD), earlier referred to as veneral diseases, are spread by organisms that primarily infect the reproductive tract and are transmitted from one person to the other during sexual intercourse or from mother to the child during pregnancy or childbirth. At times, they spread as epidemics, often undetected, either because of poor reporting or because of unavailable medical facilities. The stigma attached to the disease makes matters worse as the patient does not approach the clinician unless there is severe discomfort. In the era of AIDS these diseases are of major concern as STDs are now known to enhance the susceptibility of a person to AIDS.


Autoantibodies, FunctionaL Loss of CD8 CTL and Cytokines, Growth Factors and Cancers

Autoantibodies,

This then is the intricate attack of the virus of AIDS which, from the beginning, has been posing a challenge to scientists. At first, a simplistic view was taken to explain the virus armament. It was thought that immunity is affected because of the direct effect of HIV on the crucial CD4 cell. This was also the explanation given for the marked depletion of this cell which coincided with the progression of HIV to AIDS.

That things were not as simple as believed at first, became obvious when more studies were undertaken. It appeared that there were qualitative changes during the early phase which went unnoticed. Later studies led some scientists to hypothesise that AIDS pathogenesis was not due to a lack of immune response but probably resulted from too much of a (certain kind of) response. It was shown that B cells of the infected individuals produced antibodies not only to the 'non-self' viral proteins but, in the process to overcome these produced antibodies also to certain 'self', i.e. autoantibodies against the body's own cellular antigens. Antibodies to lymphocytes and even against histocompatibility antigens have been found in AIDS patients. This has been attributed to the similarity in a fragment of HIV envelope antigens (gp 120 and gp 41) with a part of the human HLA. It has been realised that much greater complexity is involved in the immune response to HIV. Not only the disturbance in CD4 functions, but in the functions of antigen presenting cells (macrophages and dendritic cells) were noted. Although the virus does not seem to damage these cells directly, the functional ability of these cells appears to be impaired.

FunctionaL Loss of CD8 Cytotoxic Lymphocytes (CTL) :

Another feature that came to light concerned the CD8 cells called cytotoxic/suppressor cells. Using specialised markers, a defect has been found specifically in the killing function. Although there is not much of a quantitative change, i.e. the absolute number of CD8 cells may not be affected, a qualitative change is noted. These CD8 cells are incapable of CTL function of killing the virus-infected cells; instead, the majority of these cells act as 'suppresor' cells, further diminishing the immune system. Marked reduction is also noted in the number of NK cells which perform a very important function of killing cells which are cancerous or are infected with HIV.

Cytokines, Growth Factors and Cancers :

Investigations on the soluble chemical messengers (cytokines) also revealed changs, which could be pathogenic, i.e. disease producing. It has been recently realised that HIV-associated cancers like Kaposi's sarcoma was probably due to chronic activation of the system, and the release of a cytokine that could act as a growth factor. Thus, the cells would keep on growing in an unregulated manner leading to cancers.
Similarly, cancers of B cells, called B cell lymphomas, have also been attributed to a cytokine that acts as a growth factor. NK cells, which in normal circumstances kill cancer cells, are themselves depleted and functionally almost defunct. This in brief and simple terms is how HIV may cause AIDS; or, in other words, HIV pathogenesis.


Erection and Sexual Desire & Impotency and Oral-genital Contact

Erection and Sexual Desire

Erection of the penis is absolute- ly essential for sexual inter- course. However, after a few years of marriage, the husband's erection is not always accom- pained by a desire for inter course. The wife by this time has learned how to make the penis erect. As soon as she accompli- shes this, the wife much too often urges intercourse. She assumes erroneously that the erect penis signifies sexual desire. Caresses may cause penis erection but this does not necessarily arouse an immediate desire for intercourse, unlike in the case of spantaneous erection. In most cases, longer caresses are necessary before his sexual desire is sufficiently stirred. Just as the newly-wed wife was stimulated into sexual desire by her young husband's love talk and caresses, so-now after some time of marriage-she should like wise stimulate him sexual desire.

If he forces himself to perform sexual intercourse without being sufficiently stimulated, it is harmful to his health both physical and mental. This is why the wife should not coerce (Persuade (an unwilling person) to do something by using force or threats.) the husband into intercourse until he takes the initiative at his own volition. If necessary, she should lead him in the sex movements after sexual union. Without sexual desire he is merely lending his penis, so that it is likely to shrink fast. But if he is full stimulated, he then will take the aggressive role.

Impotency and Oral-genital Contact :

It is possible for a perfectly normal husband to become temporarily impotent depending on his mental and physical conditions in the course of a long married life. After trying all conceivable ways to stimulate him, the wife may fail to have sexual union or may find the penis slipping out soon after sexual union. Her movements, too, may not help him retain his erection.  When this happens, she should let him rest. It is harmful for the man to be forced. The husband on the other hand may take his occasional failure in erection as chronic impotency and lose confidence. The wife;s hiding will only push him to chronic impotency.
Strangely enough, temporary impotency can occur despite desire for sexual intercourse. However desperately the wife may try, she cannot coax him to penile erection easily with her caresses. Temporary impotency is often caused by physical fatigue or emotional depression. But one can still desire sexual intercourse even with worries and fatigue. To have a complete erection under these conditions he must have a powerful, sexual stimulation to overcome them.

A reliable and effective way to deal with temporary impotency when sexual desire is present is oral-genital stimulation. During the long years of sexual experiences the husband and wife should not blindly reject oral-genital stimulation. Some psychologists say people may employ this type of stimulation to satisfy their animal instincts, but the author does not think this is all. As long as the kiss is an expression of love, kissing the sex organ can be considered a powerful expression of love. We should not take it too seriously, or regard it as an indication of sadism or masochism. Love expressed by oral genital contact must be accompanied by a profound emotional love, otherwise the parties concerned will surely have a lingering sense of guilt. It is only with sincere, emotional love that they can purify the sex organs, which also function as excretory organs.

Here again as emphasized repeatedly, both parties must thoroughly wash their organs before relations. In mutual oral-genital contact, both partners have the satisfaction of performing simultaneously, but they have little choice of varying their stimulation. The husband, especially lies in an inconvenient position, for his nose comes near the anus. For this reason consecutive kissing in turn may be preferred. By placing his face between her legs and stretching his body he can caress her breasts and at the same time apply oral genital stimulation. This position allows his more freedom and variation than the mutual oral genital position. On the other hand, the woman, in turn, places the upper part of her body on the lower part of his body. This enables her to apply a variety of methods.


Vaginal Bacterial Infections in Women

One of the most common STDs is syphilis. It is a chronic infection caused by Treponema pallidum, a tiny spiral shaped bacterium, about 5 to 20 microns in length, 0.25 microns in width with characteristic two to twenty coils. These organisms enter the body through any microsocpic trauma of the reproductive tract during the sexual intercourse.

In women the primary infection causes ulcers on the vulva or the cervix. These ulcers with typical hardened margins are painless and are called 'chancre'. Venereal syphilis progresses in three stages : the first two stages being infective. The first or the primary stage develops ten to ninety days after infection. During this stage the patient does not feel ill and the chancre heal within twenty-five to forty days. The secondary stage develops after two to six months with a generalised eruption on the skin. The patient has discomfort, slight fever and headache. A majority of patients if untreated progress to the late or the tertiary stage. At this advanced stage of the disease the patient suffers from blindness, difficulty in hearing and general symptoms of early aging. In extreme cases there may be damage to the nervous system and disfiguring due to lesions, called 'gammas' on the body.

In general, any ulcers on the genetial tract are considered to be syphilitic and need to be investigated immeditely. Bacteriological investigation can be done to identify Treponems. Serological tests such as the veneral diseases research laboratory (VDRL) test or the rapid plasma reagin (RPR) can be done to check presence of specific antibodies in the blood. Further, microhaemagglutination T pallidium (MHA-TP) or the fluorescent treponemal tests can be done to confirm the diagnosis. Cheap and highly effective treatment for syphilis is available in the form of benzathine penicillin. Unfortunately, there is no vaccine against syphilis as Treponema is difficult to grow under laboratory conditions.  Recently, however, the DNA sequences of Treponema have been worked out and will provide information about it that can be used to develop a vaccine.

Syphilis can also be tramsmitted from the infected mother to her child. Treponema can cross the placenta after about four months of pregnancy.  The foetus my die of severe infection or be born with congenital syphilis. It is possible to prevent such a tragedy by treating the infected mother during pregnancy, especially in the first sixteen weeks.

Another microbial infection of major concern is gonorrhoea caused by Neisseria gonorrhoeae or gonocococus. Sixty million people across the world have been estimated to be infected by gonococcus. Interestingly, unlike in men, women have mild symptoms of the disease.

 

Some women may complain of painful urination, vaginal discharge, abdominal pain and fever. In the majority of women no major discomfort is felt and often the patient does not feel the need to see the doctor. However, in an untreated patient the infection may progress to the fallopian tubes, leading to a condition called pelvic inflammatory disease (PID). This is one of the major causes of sterility, ectopic pregnancy or chronic pelvic pain in women.

Diagnosis of gonorrhoea is based on identifying the gonococcus in the genital tract secretion. The bacteria can be seen clearly in the white blood cells. Confirmed cases can be treated with ease with a single dose of penicillin. However, some penicillin resistant strains of Neisseria may have emerged and patients require treatment with other anti-microbial agents. Attempts are being made to develop a vaccine against gonorrhoea but it seems to be a long way to go before a successful vaccine becomes available.

Chlamydia trachomatis is another bacterium that is transmitted sexually. It isan intracellular parasite. A worldwide estimated incidence of women aged fifteen to forty infected with the bacteria was 46.38 million in 1995, with a majority of cases reported in South and Southeast Asia. Pregnant women carrying the infection pass it on to their babies. Again it is possible to treat the infection successfully with an anti-bacterial agent.


Does HIV cause AIDS?

Earlier a reference was made to Prof. Peter Duesberg, who started a controversy that HIV is not the cause of AIDS. Because of this attitude, he had at first been ignored or ridiculed by several virologists working with HIV. Later, however, it appeared that some scientists includig the discoverer of the AIDS virus, Dr. Montagneir, had joined him in this campaign. After several press releases and TV interviews, it was decided to hold an "Alternative AIDS Conference'' in Amsterdam to precede the International Conference on AIDS being held at Amsterdam from 19 july, 1992.
Interestingly enough, the press in India also gave more publicity to this event than that generally given to international conferences on AIDS being held every year. Therefore, it is important to briefly describe the outcome of this 'Alternative AIDS Conference' held on 14 May, 1992. According to a report by John Maddox, editor of the weekly Nature, it seems that "Duesberg's arguments gained no new ground at the Conference''.

In fact, Maddox sums it all in his title : 'Rage and Confusion from Paris pointed out that statistics for Africa used by Duesberg were hardly such as to sustain the conclusions drawn from them. Maddox concluded : "For the rest, last week threw up little in the way of science'' He mentioned about a report showing striking similarities in the behaviour of the immune system in syphilis and AIDS and wondered if syphilis is just another co-factor. The important message as given by Montagnier was that HIV is a necessary but not, without a co-factor, a sufficient cause of AIDS.


Forms of Sexual Intercourse

Sexual intercourse is a series of friction between the male sex organ (penis) and the female sex organ (vagina). The leading role in the intercourse is not monopolized by the male. The author divides the various positions for sexual intercourse into the following categories :
                                           Leading Role


Face-to-Face Positions :
Woman-Supine Positions            Male
Man Supine Positions                 Female
Sedentary Positions                    Female
Side Positions                             Male
Rear-Entry Positions :
Woman Prone Positions             Male
Man-Supine Positions                Female
Sedentary Positions                   Female
Side Positions                            Male

As seen above, the male and female have an equal share in dominating the act of coitus. Yet the positions in which the woman is more active are not wodely accepted. The female lead the male in the less popular sedentary positions, whereas, the male controls the more commonly practiced positions. The sedentary positions are not suitable for inducing orgasm. The face-to-face, woman supine positions, on the other handm give greater advantages to the male than the positions favoring the female with the leadership.

In short, the leadership in sexual intercourse for the male or the female is determined by the position selected, and it is a gross error to assume that the male normally takes the active role; the female should remember to respond to his desires to coordinate their movements. The male, too, should allow-willingly and without hesitation-the female to lead him, is she so desires. The husband should not think his wife is lacking in feminine qualities just because she asks to lead the act once in a while. It must be remembered that the party who takes the leading role in the sex act can readily obtain the described stimulation. It is only natural for the female at times to attempt it.


Protozoal Infections

Just as bacteria cause infections that are transmitted sexually, another set of single-cell organisms, the protozoans, too can be the cause of the infection. Trichomonas Vaginalis is a prozoan with a distinct tail-like organ used for mobility (called the flagella) that causes trichomonasis. The organism varies in size but can be identified with ease because of its flagella. It primarily infects the vagina. The patient complains of an offensive, thin, yellow discharge.

There may be reddening of the vulva, the vagina and the cervix with vulvovaginal irritation. The infection can be confirmed by microscopic examination of the vaginal smer stained specifically to detect infective organisms. If present, the active parasite with its characteristic movements cannot be missed. Trichomonasis can be treated with anti-microbial agents. It is important to examine the partner and prescribe the same treatment even if the protozans are not detected so that no reinfection takes place.

Fungal Infections :

Fungal infection too are transmitted through sexual contacts. A yeast like fungus, called Candida albicans, can be harboured in women without any signs or symptoms. Usually infected women complain of a vulvovaginal itch or irritation, more so pre-menstrually with vaginal discharge and discomfort in urination. On examination, slight redness or swelling of vulva and a white discharge adnering to the vaginal wall can be seen. Confirmed diagnosis depends on the actual observation of the fungus.

The treatment is rather simple, involving local application of anti-fungal agents. It is most important to step up hygiene so as to avoid auto infection from the bowels or reinfection from the partner. It is recommended that the vulva should be kept cool, clean and dry by wearing cotton undergarments rather that synthetic ones.
Most of the STDs can be avoided by following simple hygienic conditions of bathing and washing the genitals. Unhygienic conditions not only cause infections affecting the reproductive tract but also lead to some irritating infections, like scabies. Scabies, caused by mites (Sarcoptes scabiei) or public lice (Phthirus pubis), are transmitted during intimate body contact, as in sexual intercourse and can be avioded by adopting clean habits.

Prevalence of STDs detected by Papanicolaou (PAP) Smear

 

STDs

Family Planning Clinic

o IRR** (%)

Commercil sex

Workers (%)

Trichomonas

6.5

10.7

Monolia

6.2

4.6

Clamydia

9.5

10.2

BV*

13.8

41.2

HSV

1.6

3.2

HPV

4.4

17.0

Multiple STDs

4.5

32.0


* Bacterial vaginitis                ** Institure of Research in Reproduction

 


Women Viral Infections

A set of viral infections too are transmitted sexually.  A most common infection is that of the Herpes simplex virus that causes painful lesions on or near the vulva or/and the cervix. If not treated the episodes last three or more weeks. A majority of cases reported are infected by a special strain of the virus called the Herpes simplex virus type 2 (HSV-2). Many patients have recurrent episodes that result not only in discomfort but cause morbidity and psychological trauma.

A serological test can be done to confirm the Herpes infection. Antiviral treatment does help in decreasing the duration of symptoms of the disease and hastens healing of the lesions. Early detection and treatment prevents recurrent episodes. A vaccine for Herpes is being investigated with a positive outcome. However, it will take time for it to be readily available and in the meantime prevention by careful choice of partner and use of condoms can be the only way to check and spread of infection.

Another viral infection that has been of concern is by the Human papilloma virus (HPV). It has been estimated that in young, sexually active women about 50 per cent are infected by types of HPVs that have a possibility of developing into cancer. The viruses essentially cause genital warts that may eventually develop as fatal cervical cancers. Control of HPV infection is therefore an important public health issue. The vaccine against HPV is actively investigated and the prospects of getting a prophylactic as well as therapeutic vaccination appear to be fairly bright.

Some viral infections that do not have a primary effect on the genital tract are also transmitted by sexual contact. Hepatitis B virus is one such virus. It primarily infects the liver and causes jaundice that often is fatal. Though often not classified as STD, hepatitis infection is a matter related to reproductive hygiene. Howeverm of all the known viral diseases that are sexually transmitted, the most potent one that is taking form of an uncontrollable epidemic is AIDS. It is caused by the human immunodeficiency virus (HIV).

Diagnosed first in 1980 the  disease had galloped across the globe, spreading mainly due to sexual contacts.  Millions over the world have been estimated to suffer from AIDS, 50 per cent of them being women. Estimates of patients with AIDS by end of 1997 in Sub Saharan Africa (20,800,000) and South and Southeast Asia (6,000,000) are alarming and depressing. To think that many will be dead in the near future when such a spread of the disease coud  have been substantially curbed with a little education and awareness in the populations, because the major mode of infection has been unprotected sexual contact!

HIV infection is seem to be common in homosexual males and drug abusers, especially those who take injections and often share the needles. It is seen to be common also in a set of patients who require repeated transfusions as they suffer from an inherited blood clotting disorder caled 'haemophilia'. Heterosexuals who indulge in multiple partners and have unprotected sex are also at a high risk. Women at risk are professional sex workers, especially those already infected with STDs.

Pregnant women are relatively at less of a risk. However, if infected the pregnant woman transmits the infection to the baby. A lactating, infected mother could also pass on the virus to the baby through milk. The disease is not transmitted through casual contact at all. However, as the fear of sure death looms large, the stigma of carrying the infection is immense and the patient is socially isolated. This is rather unfortunate as misinformed relatives or friends shirk any contact with the infected and add to the miseries of the patient who requires care and understanding. The virus really does not get transmitted easily; it must encounter specific cells of the body to lodge itself in them.

The HIV is a spherical virus about ten-thousandth of a millimetre across. It has an outer protective lipid layer with proteis afloat in it; interestingly, some of them are of human origin. This coat also has the recognition molecules that act as passwords to let them in into specific cells of our body. Just below the outer coat is a layer of protein thatin turn encloses the 'core' or the capsid. Within the capsid is the genetic material of the virus, a molecule of ribonucleic acid (RNA) shown in above figure. When the virus encounters a human cell it cannot enter unless it can bind to a molecule called CD4. Several types of cells in out body have CD4 molecules on their surface, specially the cells that defend the body. The primary target of the HIV, therefore, are the very cells that defend the body against infection. That is what makes HIV deadly!


Some More Details In Next Article


Suspected Co-factors of HIV

As has been explained earlier, HIV remains in a latent state for long periods in certain cells. These are the cells likely to be acvtivated by infectious agents or other stressful conditions. Among the various co-factors, other sexually transmitted diseases (STDs) are known to facilitate transmission and spread of HIV among people at risk. A very long list of agents like viruses, bacteria, parasites or mycoplasma (and/or their products) have all been associated some time or other with HIV as a co-factor responsible for AIDS.

At present, each AIDS expert or virologist seems to offer his own 'pet' as a co-factor. For instance, Montagnier banks on mycoplasma (a germ which is neither quite lika a bacterium nor like a virus), while Gallo, the virologist from USA, opts for viruses of herpes group and also the human retroviruses. With more work being done in newer areas where cases of AIDS have increased, it seems that we need not look for the one and the same co-factor in all cases of AIDS. As a matter of fact, immune response factors described earlier should also considered important in the pathogenesis (immunopathology) of AIDS. One such important one is the genetic marker, i.e. a certain HLA type present in an individual and antibodies against them.

HIV may not be the sole direct cause of AIDS; could it be considered as an opportunistic infection? As stated in the introduction, acquired immunodeficiency like syndrome has not been uncommon in tropical, economically developing countries of the world. The syndrome might have been attributed to 'old' parasitic diseases, complicated by viral'bacterial/fungal infections, and further compounded on sub-populations of CD4 or CD8 cells were not carried out (even now, these studies are not carried out routinely), it is not possible to comment on the nature of immune deficiency. Some of the recent developments lead to an interesting concept. Could it be that some different, retroviral-like agent not yet identified, could have been responsible for this old-fashioned acquired immunodeficiency? 

At the July, 1992 International Conference on AIDS in Amsterdam, several reports were presented of patients with AIDS but without evidence of HIV infection. In these circumstances, HIV could be listed as an opportunistic infection. Perhaps, it is 'more equal' than some other opportunistic infections on an analogy to the Orwellian Animal Farm.

Recently, there has been a particular report of an HIV negative 66-year old female patient of AIDS, from whom a 'new'type of retrovirus, called by the authors human intracisternal retrovirus, was identified. The same was also recognised in the patient's 38 year old daughter, who had no manifestations of the disease. This is personally important, because, at the 1988 International Conference on AIDS, this author, together with co-workers from the National Institute of Virology (NIV) at Pune, had reported (Abst. No. 1132) identification of intracisternal A particles of a retrovirus in an asymptomatic pregnant prostitute from Tamil Nadu. The prostitute, who was among the first  recognised custer of HIV seropositives had become pregnant later. At the time of her delivery, however, she had become HIV seronegative. Because of the difficulty of growing this agent, we have not been able to get it genetically charaterised, but there is evidence that it produces p24 antigen.

Scientists believe that such particles - similar to that described as human intracisternal retrovirus - have been reported in a few cases, but so far, there is no evidence that they cause the disease.
Yet another interesting finding arises out of the genetic analysis-using PCR technique made on a large number of HIV-strains isolated from many different countries and from different sources. Surprisingly, this study revealed not two broad types, but, five distinct families. The unexpected finding was that the 'epicentre' (origin) was in the African country, Gabon. Without referring to the allegation about revival of racism, let us examine this debatable finding scientifically. Debatable, because Gabon has one of the lowest "AIDS infection rates'' among the nations of Africa.

Let us examine this interesting finding strictly from the viewpoint of the origin of the virus and not of the disease, AIDS. While describing the origin of HIV we mentioned that a virus obtained from a chimpanzee was closer to HIV-1 and could well be the 'missing link'. Where did this virus come from? Yes, from Gabon.
Also recall the hypotheses described in earlier chapters (i) cross-species transmission (from monkeys/chimpanzees to man); (ii) unrecognised presence in humans, and (iii) combination of (i) and (ii). The last hypothesis stated that some 'endogenous' incomplete (defective) retrovirus like elements might have been present in the human population somewhere. These elements could also be passed vertically, i.e. from the mother to the infants. Imagine this to be happening in Gabon. The only HIV-1 like chimp virus and also HIV-2 like simian viruses present in Gabon could have jumped the species barrier in some person(s) harbouring the human intracistrnal retro-virus.

The resulting recombinant virus with a pathogenic potential could have gradually evolved into the 'slow' HIV-like virus. From this epicentre, it could have spread to other areas. In fact, a highly defective HIV-1 strain isolated from a healthy Gabonese individual with an atypical Western blot has also been reported. It may not be difficult to check if persons in Gabon carry some endogenous, defective strain hidden in their cells. Perhaps, these IAP - like particles may actually be contributing to protection, thus yielding one of the lowest rates of AIDS in Gabon among the countries of Africa.
In the final analysis, we may conclude that it is the last staw that breaks the camel's back above picture. But, does it have to be the same straw in every AIDS case, everywhere and every time?


Female And Male Intercourse Movements

Male Intercourse Movements :

Front-back Movement :

The male moves forward and backward from upper rear to lower front in the face-to-face positions and lower rear to upperfront in the rearentry positions. Within the limits of the sex position he can move to the right and the left in addition to the front-back movement and twist his hips in a circle or are to add variety.  He is free to determine the speed and depth of his movements, but it does not necessarily mean that fast and deep front-back movements give the best results in stimulation.

Such movements should be reserved for the last moment when the man is ready to arrive at orgasm. A more desirable movement to enhance his bliss is the gentle, deep thrust and swift withdrawal or the alternating movements of several shallw, fron-back movements and several deep, front-back movements. The gentle thrust arouses her expectation and the front-back movements prod her impatience.

Close Rotation :

This is a movement of agitation. The sex organs are united and the sex act is performed with the external sex organs pressed closely together. The couple derive strong, satisfying sense of closeness.

 

Close Pressure :

The sex organs in union are pressed together. This position is useful for resting with sex organs in coition and at movements of orgasm.

 

 

 

 

Female Intercourse Movements :

Front-back or Up-down Movement :

In her attempt to take the initiative the female may find it difficult to perform her role satisfactorily. In the face-to-face, female above positions the female must support the front-back movements from the lower rear to the upper front with her arms and legs. She is usually not successful because she tries, like the male, to press toward his sex organs instead of withdrawing from him. The front-back movement from lower front to upper rear usually dislodges the sex organs.

She normally fails in imitating the male front-back movement with the hips. Until she is accustomed to three more elaborate movements, she should practice the straight-line movement including the upper half of her body. Depending on her posture, the woman moves up and down in the front back movement, but there is less fear of disjoining the union if she tries moving from lower rear to upper front.

She will need more experience than the male to determine the speed and depth. She can stimulate the male effectively by advancing quickly, and gently withdrawing. Through practice she may employ not only the simple straight movement but also the oblique straight line from the right and left as well as the movements in an arc or circle drawn with the skillful twist of the hips.


Viral Infection of Women

The mucus linings of our body, including the lining of the genital tract, have some cells called the dendritic cells. These carry the CD4 molecules on their surface and are probably the ones that first let the virus into the body during sexual contact. The mucus linings also have other immune cells patrolling the tissues, called the macrophages or the CD4 bearing cells. The virus targets these cells as well. The principal target of HIV however, are the 'helper T lymphocytes' that help other cells launch an attack against infective organisms. Once within the cells, the virus after a complex sequence of events, makes more of its kind. Replicated viruses force their way out of the host cell by bursting it and freely traverse through the bloodstream, targetting more susceptible cells. Havoc is initiated within.

In the early stages of infection the patient is essentially asmptomatic. A little later, mild influenza-like symptoms, fever with muscle aches, is experienced by the patient. At this stage the virus is in abundacne in the blood and transmission to other persons is easy. The number of helper T lymphocytes in the body dips dramatically. The body, however, puts up a fight against HIV as it would for any other viral infection. Other lymphocytes that kill virus infected cells are put into action. Cells producing antibodies too are stimulated and now the infection can be detected by serological tests that check for specific antibodies against HIV. Though within three weeks the symptoms disappear, in most cases the virus makes a permanent home in the host. In about six months time the virus is somewhat settled in the body; the patient continues to be in general good health. This choronic phase may last eight to ten years with a slow but steady decline in CD4 bearing cells. The apparent good health is deceptive as the virus is crippling the immune system and making the patient eventually 'immunodeficient'; hence the name AIDS.

Once the T lymphocytes count dips to an ultimate low of about 100 cells per cubic millimetre from an original count of about 10,000 cells per cubic millimetre, the virus load in the body shoots up. The patient can be expected to have full-blown AIDS. The body unable to defent itself succumbs to unlikely, opportunistic infections that become the cause of death. Uncommon skin cancers like kaposi sarcoma or infections by pneumocystis carinni that cause fatal pneumonia or toxoplsmosis catch on. In general, a patient typically survives HIV infection for ten to eleven years. In some the disease gallops and they dis within a year; some howeverm survice the onslaught for a period ranging from eight to twenty years.

Complex drug strategies have been evolved for treatment of AIDS. A large number of drugs attempt to sabotage the replication of the virus with the cells by acting as inhibitors to various viral enzymes. To achieve best results clinicians attempt the highly active antiretroviral therapy (HAART). This consists of multiple drugs treatment with a strict time regime. Antiviral therapy has side effects that become a major concern as the therapy proceeds. All these problems become acute when pregnant women or children have to be treated. Further, the possibility of developing drug resistance is ever worrisome. There is no doubt that in case of AIDS, prevention is far better and simpler than cure.

Prevention by vaccination against the HIV has been the dream that has led us to invest immense amounts of money and time in research. While several vaccine stratergies have been worked out the vaccine has remained as elusive as the HIV. As we wait for a reliable vaccine it appears that a change in behaviour will go a long way in curbing the infection.


How to Survive though HIV-Infected

Imagine a sick bed in a very poor, respectable household. A doctor is examining the patient and then tells the father/mother/son/daughter that the patient's condition is very serious. But, there is still hope for a  cure if the patient is given a particular medicine in time. The relative is in trouble as there is no money to spend on such an expensive medicine. Somehow, with difficulties and some added debt, the said medicine is procured. The patient receives a few capsules and is on the way to recovery. A few days more, and the person has fully recovered. This scent, often depicted in our films, could well describe how effective an antibiotic can be. Fevers, pneumonias, many other illnesses caused by bacteria are normally curable when the right kind of antibiotic is taken appropriately.

Unfortunately, there is no such magic bullet antiviral for HIV. Infact, in the majority of virus diseases, drugs are used to treat symptoms rather than specific viruses: something for headache, or vomiting and nausea; even antibiotics to prevent 'secondary' bacterial infections. Many antivirals hae been developed and several are used effectively, particularly against influenza and some herpes viruses. However, these are quite expensive and not easily available in India.

Anti-HIV Drugs :

No other infectious disease has attracted greater attention of scientists and manufacturers of life-saving drugs than has AIDS. Each year, more drugs and other agents with immunity-boosting properties (immunomodulators) are developed for the first phase of testing. Many are abandoned as being no good, while a few enter a further phase of clinical trials. Some of these are carried still further in larger trails. As with bacteria, some drugs produce resistance in the virus of AIDS and therefore become infective. In bacterial diseases, resistance develops especially due to injudicious, improper or incomplete use of antibiotics.

The first drug to pass through the US drug control and the one most commonly used in HIV/AIDS is called AZT (zidovudine). It does not cure patients but helps them to live longer. However, it does produce several undesirable side-effects. After a continuous treatment, HIV can also become resistant to AZT. Therefore, despite very heavy expenditure, AZT is not the complete cure for patients with AIDS.

 

Early blockers of HIV-cell interaction

Sulphated polysaccharides / polymers (e.g. Dextran sulphate), CD4. Especially as immunoconjugates, monoclonal antibodies peptides

Inhibitors of reverse transcriptase

HAPT derivatives: Acyclovir, AZT, Carbovir, dd1, ddA, ddc

Suramin derivatives : Foscarnet, Ribavarin, TIBO derivatives

Viral protease inhibitors (inhibits gag-polfusion cleavage)

Synthetic peptides

Myristosylation and glycosylation inhibitors

Castanospermine, DNM (deoxynojirimycin)

Immunomodulators

Natural : Interferons (especially alpha), Interleukin-2 colony stimulating factors

Synthetic : Several used (e.g. Pentoxifylline, MIMP)

Miscellaneous, mainly herbal

e.g. Glycerrhizin, Polyxylan, Prunellin, Trichosanthin (TAP 29)

 

Some Anti-HIV Compounds/Agents *
*This list is illustrative and not meant to be exhaustive.

 

A large number of antiviral agents having different properties have been developed. These are associated with a particular stage of HIV life-cycle when intervention is possible Shown in above table. The use of traditional herbal medicines are encouraged by the World Health Organisation (WHO) and some of the remedies provided by China have yielded encouraging results. In India, systematic studies have not been carried out either with the newly established antivirals or with our traditionally known medicines.

A practical approach is to combine antivirals with immunomodulators, the former to interfere at an important stage of the HIV life-cycle, and the later to build up the immune system of the infected individual. Among the latter, CD4 molecule insoluble form-not on cell surface-is introduced in blood circulation. Interferons-substances with some non-specific type of antiviral action and some growth factors are also being tried.



Some commonly made statements about menstruation and scientific explanations

The discrimination against female child is not a phenomenon only of the Asian countries. In several parts of the world women experience 'gender apartheid' of varying degree. Reputed scientific studies suggest that although women can survive better than men in all ages, in reality, severe social disadvantage reduces their survival. The social handicap that women encounter is sometimes very subtle, woven into the cultural fabric as do's and don'ts or as myths. Un reasonable practices that are oppressive for women are perpetuated under the name of religion or tradition.

A majority of these myths and misconceptions, devoid of reality, are reinforced from childhood through adolescence so that women grow up never to question them. A large number of these social rules humilate and discriminate girls and lower their poor self-esteem that percolates into the way they think. The subtle inhibitions seen even in educated women who want to achieve their best is often because of the diffidence they have imbibed during social interactions in their adolescence. A large number of myths and misinterpretations centre around anatomy of women, menstrual cycle, sex and fertility, pregnancy and childbirth. Only through a scientific description of all aspects of womanhood can we dispel, very explicitly, some of the myths. It could help girls break the unseen barriers and see themselves as human beings, as individuals and not as puppets performing their 'gender' roles to fulfill the expectations of the society.

In order to be more specific we have taken a set of statements commonly made about girls in a very casual manner and go unchallenged but leave a mark on the minds of youngsters. We have attempted to present the logical reality of woven with peripheral information on the basis of science today. There is no doubt that the list of myths and misconceptions is large and takes different forms in societies. We have limited ourselves to reproductive health matters.
Some commonly made statements about menstruation and scientific explanations are given below :
Myths :
1     Women are impure during menstruation
2    Women lose impure blood during menstruation
3    Women who participate in religious functions during menstruation have repeated     abortions.
4    Pickles and jams made by women during menstruation go sour.

Fact :

There is no scientific basis for any of the above statements. Women are, in general, in good helath during menstruation and can participate in any activity. The menstrual blood is not impure by any scientific definition. 'Purity' of an individual is a relative term which even most religious find difficult to define. Any religion is expected to integrate the contemporary knowledge and make statements that do not discriminate against women for their natural physiological processes. This is not easy; however, for the time being it is enough to assert that there is no reason to feel inferior or impure during menstruation. Their is no statistical data to show that women who participate in religious activity have repeated abortions or that jams and pickles get sour if prepared during menstruation. Many women prefer to carry on these traditions as these are legitimate reasons for obtaining exemption from specific work. While it is an individual's decision to follow the tradition or not, it would be wrong to perpetrate the feeling of being dirty or impure in a natural physiological phase of womanhood.


Drugs for Opportunistic Infections

On the one side are various difficulties in finding out a miracle cure for HIV/AIDS, while on the other side of the coin are the variety of opportunistic infections which become life-threatening, each of which requires appropriate therapy and management. It seems that for a long time to come, the survival time and comfort of patients will depend greatly on therapies (cures) which are specifically directed against individual opportunistic infections. At least in some developed countries, work in identifying the important opportunistic infections (OI) and developing appropriate strategies for their treatment are being worked out. Attempts to develop newer curative agents have also been taken up. A spin-off will be availability of effective drugs against a large variety of certain fungal and parasitic infections (worms, protozoa and others).

As described earlier the nature and types of Opportunistic Infections vary in different regions. Tuberculosis is so far found to be the most frequently associated disease with AIDS in India as in several countries of Africa. Among AIDS associated enteric (intestinal) infections, severe diarrohoea is caused by bacterial and more particularly parasitic agents. Although these were not common in the industrialised developed countries before the advent of AIDS, a large number of case reports of such AIDS associated diseases have now been published. In contrast, although they might have been prevalent in our country, a parasitic agent like cryptosporidium, attributed to causing diarrhoea in AIDS patients, is being described in association with AIDS. In contrast, another parasite, of the respiratory system, pnuemocystis carinii, seems to be less frequent in the developing countries as compared to the Pattern 1 countries. Here again, intensive search has not been made to look for this parasite in India.

 

 

THREE TYPES OF IMMUNODEFICIENCY

 

 

GENETIC

INDUCED

ACQUIRED

From Partients to Babies

Caused by treatment with certain drugs organ transplants cancer treatment etc.

Environment in poor tropical countries carries many infections in air water and food.

These and many other sexuality transmitted diseases (STDs) can act as co-factors aiding and abeiting the AIDS virus

It is essential that we develop our own data bank of these infections by collecting information available on opportunistic infections which occur due t immunosuppression induced by doctors (Shown in above table). It is imperative that a list of these infections and strategies for their treatment and prevention are prepared in time before they overwhelm us.


Too Quick Ejaculation - How to Cure?

Most men complaint of too quick ejaculation. This is also called as premature ejaculation and specifically when orgasm and ejaculation occur persistently either before or just after the beginning of intercourse. The speed of ejaculation is directly linked to the sexual intensity arousal in the brain. The more sexually excited the individual becomes, the more rapidly does ejaculation occur. It is common, for example, that men having their first sexual encounter with women reach rapid orgasm and ejaculation due to teh intense and unaccustomed degree of sexual excitement.

As a result, first sexual experiences are likely to be something of a disappointment because of their very short duration. It is only with increasing practice of intercourse that control of sexual excitement develops, and, with it, control of ejaculation speed. Similar difficulties may recur in the experienced made after prolonged periods of abstention from intercourse, through illness, for example, or seperation from a wife.

Fear is only rarely a primary cause of precipitate ejaculations; more commonly this leads to difficulty in getting, or sustaining an erection. Early ejaculation is so common in the inexperienced male in early marriage as to be considered normal, and it tends to be exaggerated if the female partner is equally inexperienced and slow to reach sexual climax. Most males, after a period of two or three years, however, learn to control the rise of excitement during love-play, although it is said that three-quarters of average males still ejaculate within two minutes after penetrating the female.

This sort of rapid ejaculation becomes a problem when, as in a small number of males, it becomes persistent and every attempt at intercourse is frustrated by ejaculation and orgasm either before penetration, or a few seconds afterward, which may leve the female unsatisfied and frustrated sexual arousal. The condition can sometimes be so precipitate as to lead to childlessness through inability to have effective sexual union.

In all such cases mild degrees of precipitate ejaculation can be overcome by the male training himself to delay ejaculation through concentrating on nonsexual topics or fantasies during foreplay. Drugs such as alcohol are often advised but of little use in delaying ejaculation ; more often than not, they lead to erection failure. Similarly, the use of condoms or anesthetic creams applied to the penis to reduce-sensuoud impulses are of little value. The reason for this is that intense sexual excitation often arises in the emotional centres of the brain. It is notdue to heightened sensitivity in the genitals.


Some Myths And Facts About Eve Teasing And Rape Of Women

Myths :

1    Only girls who dress provocatively get eve teased or raped.
2    Women enjoy and fantasise about rape.
3    There is nothing much left in life once a woman is raped; she is better     off dead.

Fact :

Eve teasing is seen to be more common in societies where communication between the two sexes in inhibited and where women's status is poor. It has little to do with how girls dress; the so-called properly dressed girls too get eve teased. 'Provocative' dress is a relative term and is dependent on local cultural factors. Most societies have evolved a tradition of dress code that suits the climate and way of life. Any deviation from the code takes time to become acceptable. At times such deviations are considered 'provocative', specially in the period of transition where a society is slowly adapting to new inputs. Some societies are more open to changes than others and youngsters need to adapt to their surroundings for their own welfare.

Legally eve teasing in any form is a crime. Unfortunately, it can be rarely proved and hence, almost never gets reported. Reducing eve teasing is not a simple proposition, for it means a change in the way women are thought of  in a society. Very often where a woman is considered as a 'commodity' her basic human rights are violated with ease. This percolates as eve teasing to various extent. Empowering women in the society, physically (by teaching them self-defence tactics) and socially (by building up ethos tha discourages any sexual assault) is likely to reduce eve teasing.

Rape on the other hand is not about sex but a crime or violence. Rape is a sexual aggression performed under threat to a woman's life. Mere provocative dress does not lead to a crime of this dimension. Rarely wrong messages may be conveyed during courtship leading the partner to assume sexual consent. Such a situation can be avoided by being explicit in a relationship. Sad incidences of rape may occur (especially of minor girls) by unsuspecting members of their own family. The onus of protecting the girl child against sexual aggression is on the parents to a large extent and the society in general.

Like any other crime of theft or murder, sexual crimes too can be avoided if certain precautions are taken. Avoiding late nights with unknown or little known company, refraining from visits to isolated places with or without partner does ensure safety. It should be kept in mind that boys too can be sexually assaulted and are as vulnerabe as girls. Girls are often made to feel guilty of sexual crime against them. Family support that thinks otherwise is a great help in such circumstances.

It should be clearly understood that rape is a rare event that can happen to anyone. As after any other violent accident immediate medical attention is necessary; whether the victim deciedes to press charges or not, a medical examination to avoid STD and pregnancy must be done. Psychological trauma to the victim is tremendous and help of a psychologist may be necessary in addition to strong positive support from friends and family.

Sensitive citizens and feminist groups are of help to deal with the social-legal aspects of rape. This helps to relieve the trauma and reinstate the victim by encouraging her to start normal activities. Needless to say, as in the case of any other severe injury, the rape victim may never heal completely, but can learn to live very happily. It is therefore absolutely wrong to say that there is no fruitful life for a raped woman. Likewise, it is wrong to assume that women enjoy or fantasise about rape. Women do fantasise about sex but the idea that an act of utter violence can be enjoyed is absurd and is a myth perpetuated by the male-dominated society to justify violence.


Management of HIV/AIDS Effected Patients

Prevention of the spread of HIV infection and proper management of patients with AIDS are the two most powerful tools to fight HIV/AIDS. Prof. V.Ramalingaswamy, the former Director General of the Indian Council of Medical Research (ICMR), has repeatedly stated :
        "To care for patients with AIDS is a duty
           To prevent AIDS is a responsibility.''
It may be emphasised that many disease conditions in AIDS can be treated, and with proper management, PWAs can live as normal a life as possible atleast between their illnesses. AIDS should therefore be treated like other chronic diseases and every attempt should be made to improve the quality of life.

Avoidance of other infections is a very important intervention because these are the very factors that induce an asymptomatic HIV-infected individual to progressively develop AIDS. This is because, as explained earlier HIV is harboured in a special cell (CD4 positive T cell) which plays an important part in the immune system. These are the very cells that get activated to fight infectious agents when they enter the system. The activated cells make cellular products that are appropirated by HIV for its own replication. In other words, precautions should be taken to avoid infections of all important systems. Starting with skin and oral hygiene, infections of respiratory and gastrointestinal systems should be avoided. This means no exposure to people suffering from pneumonias, TB, flu and even common colds and, of course, avoidance of contaminated water and food.

Various herpes viruses, syphilis, gonorrhoea, genital ulcers and all such sexually transmitted diseases should strictly be avoided by practicing safer sex as discussed in a later articles. This is an extremely important intervention measure. In fact, even repeated exposure to HIV may also accelerate the dormant HIV to AIDS progression.

Balanced and adequate diet is absolutely essential as it is increasing being recognised by PWAs intelligent enough to appreciate the need. For instance, Arthus Ash, the tennis star who suffers from AIDS- acquired through blood transfusion-stated that any time he does not feel like eating, he mentally recalls the picture of a totally emaciated AIDS patient and thus forces himself to take adequate nutrition to avoid, as long as possible, such an eventually. Nutritional deficiencies can themselves affect the immune system; and thus, proper nutrition including the use of vitamins is very important. Diarrhoeas are of frequent occurence. Effect of certain drugs could result in nausea and vomiting on the one hand and skin allergy any hypersensitivity, on the other. Diet shoud be modified during these periods, but adequate nutrition should again be restored once these conditions subside.

Avoidance of tobacco, alcohol and other non-prescribed drugs is also essential. These substances add insult to the injury, which has already taken place in AIDS patients. Rest including bed rest during the periods of acute illness (due to other ifections including opportunistic infections) and, exercise on a regular basis during the interim periods also help the patients in maintaining a proper mental and physical balance. Stress and strain including mental tension should indeed be avoided. Stress, distress and a variety of psychiatric illnesses are increasingly being associated with immunosuppression. Interdisciplinary collaboration has established psychoneuroimmunology as a new field with emphasis on the elusive mind-body connection.

In other words, adoption of positive health practices and a positive approach will go a long way in arresting the progression of HIV to AIDS.In conclusion, it is essential for the patients partners, relatives, friends, and the community in general to provide all the necessary support to AIDS patients. It is equally important to avoid causing any undue stress through isolation and stigmatisation.


Methods To Prevent Premature Ejaculation

But by far the best effective method to control too quick a ejaculation is for the male to learn to control his rate of sexual arousal. In most males, this is learned through increasing the frequency of intercourse in the first or second years of marriage, during which time the female learns to achieve sexual climax more rapidly. One should also know that when precipitate ejaculation persists, however the method of stimulation of the penis outside of  the vagina can help the male learn to delay orgasm and ejaculation both.

This also involves the female partner manipulating the penis by hand until the male becomes excited and feels that orgasm and ejaculation are about to take place. The procedure is ; then abruptly stopped and sexual excitement allowed to decline. Ther upon, the procedure is repeated to just before climax, then stopped to allow relaxation, after which the whole process is repeated, Learning to thus control ejaculation may enable the individual to prolong sexual excitement and delay ejaculation during actual intercourse. These methods may prove effective in bringing about ejaculation control in cases that are not too serious or of too-long duration. In cases thatare not too serious is rooted in a severe disorder a slow process may be of help.

Prolongation of the coital act is important to both husband and wife in order for both to reach climax but not necessarily at the same time. For the wife to reach complete climax, it is usually necessary that she be aware that her husband is nearing on the highest point in has own responses. Some wives need to feel the impact of the seminal fluid against the vaginal wall or the neck of the womb in order to enhance their sensations. Even if they are unaware of the ejaculation of seminal fluid, awareness of climax on the husband's part serves to lead to their own climax.

By far the more universal reaction is that the wife percieves the mounting excitement of her husband and responds by reaching the highest point of her own physical and psychological reactions. It is for this reason that coitus interrupts, withdrawal just before ejaculation, is usually unsatisfactory for both partners.


Some Myths And Facts About Hymen And Oral genital, Masturbation, Sex during menses Myths

Myths :

1    A woman is not a virgin if her hymen is broken.
2    Girls should not perform physical exercises because that breaks their     hymen.
3    Pregnancy cannot occur with intact hymen.

Fact :

The hymen is a thin membrane that stretches over the opening of the vagina. It has perforations of varying sizes and in each woman the pattern of perfortion is different. Some women have unperforted hymens that need to be surgically ruptured to allow the flow of menstrual blood.  In some women the hymen is totally obliterated. The hymen can be broken by digital manipulation or insertion of a tampoon (sanitary pad that can be pused into the vagina).

However, there are only few reports of hymen tearing due to vigorous exercises even, like horse riding or bicycling. Such events have been rare and girls need not be held back from any activity for this reason. Given the variation in anatomy of hymen it is wrong to link it with virginity . Unfortunately in societies where virginity is considered a virtue, a girl with broken hymen carries an unjustified stigma of being of questionable character. Ideally, in a good relationship no physical evidence should be necessary to prove virtuous behaviour of the partner. Further, an intct hymen does not guarantee virtuous behaviour of girls anyway. On the other hand, as in most women the hymen is perforted, sperms can pass into the vagina and to the fallopian tubes if the semen ejaculation takes place near the vagina and pregnancy can occur even if the hymen is intact.

Myths :

   Oral genital sex is abnormal
2    Masturbation is harmful
3    Sex during menses and pregnancy is prohibited

Fact :

In a good relationship sex is a physical expression of emotional bonding. There are no rules to follow in the sexual act as long as the partners are comfortable with each other. With consent of each other any form of sex, that both find agreeable and satisfying, including oral genital sex can be enjoyed. There is nothing abnormal about oral sex. Likewise various postures during coitus that in no way are physically disadvantageous to either of the partners and are enjoyed with mutual understanding are also a normal part of sexual behaviour. The important aspect in this relationship is the respect for eah other's wishes and willingness to accept each other.

Masturbation too is not a harmful or abnormal practice.  Bothe men and women alone or together do indulge in masturbation. Nonetheless, it is considered to be an unclean way of enjoying sex that is often not satisfying.

As long as both the partners are comfortable, sex during menses is not prohibited. However, it must be borne in mind that during this period the chances of transmission of infection (like HIV) is high. Use of condom is recommended to take care of such possibilities. Similarly, there is nothing against having sex during pregnancy if it causes no discomfort of any sort to the woman and there is no medical advice against it. If the latter is the case, then it should be followed strictly to avoid any complications that could jeopardise the pregnancy.


Progress in the Development of AIDS Vaccine

Progress in the Development of AIDS Vaccine

Since the days of jenner, who used a vaccine against smallpox, vaccines have become a powerful tool in the fight against infectious diseases. In the absence of any antibiotic like pencilin-the magic bullet - control of viral diseases through vaccinations is one of the most, if not the most, effective intervention. Having conquered a large number of communicable diseases through environmental improvement, the industrialised world turned their attention to controlling others with vaccines. Environmental measures included safe sewage disposal, plenty of water including sage drinking water, reduction in overcrowding, elimination of disease vectors like flies, mosquitoes and othe insects, improvement in nutritional status and overall personal hygiene. Indeed, it should be emphasised that any programme of immunisation will not be cost-effective if these environmental factors are ignored.

Commonly Used Vaccines :

Smallpox vaccine used as per the global strategy developed by the World Health Organisation (WHO) brought about a spectacular achievement, namely, global eradication of smallpox. many childhood diseases like diphtheria, tetanus, polio, measles and mumphs hve been conquered through effective immunisation programmes. All these vaccines have heen effective because these agents affect human beings only. They also elicit an immune response which is long lasting and resembles natural infection. In contrast, some infectious agents have properties which make development of vaccines against them very difficult.

When is a Vaccine not Effective ?

Certain properties that characterise infectious agents are contrary to the generation of effective vaccines. In above table are given four such properties together with their respective examples. Variation in antigen has always been difficult to overcome. Influenza viruses are known to show the antigenic variation, so that every few years the world faces a pandemic due to 'new' variant. The New variants are also incorporated along with other serotypes in the manufacture of influenza vaccine. On the other side are the common cold viruses (rhinoviruses) which have more than 90 serotypes. This is the main reason why attempts to develop effective vaccine against common cold has failed so far. HIV, the AIDS virus, is a new addition to this list. In the case of HIV, a greater complexity is involved because antigenic variation has been recorded not only in geographical regions but even in the same individual.

The second property is regarding extra-human source of the virus in nature; again, influenza viruses fit the bill. In nature, there are influenza viruses which infect animals (horses and pigs) and birds, particularly ducks. Given an opportunity, these viruses with different antigenic structures could combine and emerge as a 'new' serotype to cause a pandemic. On the other side is the rabies virus (hydrophobia virus) with dogs as the major host maintaining the chain of transmission.

Since human to human transmission of rabies virus is rare, they may be considered only as tangential hosts. In these circumstances, rabies virus needs to be controlled in the natural host (especially dogs) by vaccines so as to reduce or eliminate the chain. In contrast, HIV spreads through a chain of transmissions within humans . There is neither a need nor definite evidence regarding HIV reservior in animals. Nevertheless, the fact that the AIDS virus itself might have originated from monkey viruses (explained in earlier articles) lends some support to the possibility of a potential animal (simian) reservoir.

The third property, that of integration of viral genetic material into the host cell genome, has been well recognised for HIV as for the hepatitis B virus. The process of integration has been presented in earlier articles. The virus can hide in some cells where antibodies cannot reach them. The last and perhaps the most serious factor interfering in the development of an effective vaccine against HIV is its property of infecting the very cells which are crucial to the smooth running of the immune system. This feature combined with the fact that autoantibodies are found in AIDS patients have led some scientists to caution against undue enthusiasm for AIDS vaccine. At the same time, there is determination to overcome all these difficulties.

Further complicating these difficulties is an additional one related to anti-HIV antibodies. There is evidence that HIV also includes antibodies that enhance rather than stop the spread of the virus within a system. 'Enhancing' antibodies instead of neutralising antibodies have been reported in HIV-infected macrophages by several workers; but as yet, no clear information is available regarding its function within the body of infected persons.


Some Myths And Facts About Use of Contraceptive Devices, Breast Feeding and Breast Cancer

Myths :

1    Use of Contraceptive devices reduces sexual enjoyment.
2    Use of Contraceptives causes sterility.
3    Surgical sterilisation reduces libido and causes other health problems.

Fact :

Majority of contraceptive users do not report of any reduction in enjoyment of sex or libido. Lubricated condoms, on the other hand, have been reported to give enhanced sexual satisfaction. Innovative condoms of various colours and flavours are available that are expected to be stimulatory. In general, IUDs too do not in any way interfere with the sexual activity. Pills as discussed earlier have been seen to relax women that premits enhanced sexual activity. Contraceptive methods other than surgical sterilisation do not affect fertility.

These methods (barrier, IUDs or the pill) are used to space pregnancy and do not affect fertility once they have been discontinued. As discussed earlier, normally the use can ensure total comort and good health. Surgical sterilisation if done under good clinical conditions rarely causes any other health problems. As neither tubectomy nor vasectomy interferes with hormone action, there is no chance of there being any change in libido. On the other hand, both the partners, free from fear of unwanted pregnancy, have a better sexual interaction.

Myths :

1    Women with well-developed breasts can feed their children better.
2    To look feminine breasts can be enlarged by using harmless chemicals.
3    Any lump or pain in the breasts is a sure sign of breast cancer.

Fact :

As mentioned earlier, the breasts in women are made up of secretory tissue and connective and adipose tissue. The breast volume is essentially because of adipose and connective tissue and large breasts are not a direct indication of secretory activity. The amount of connective tissue and hence size of the breast varies from person to person and is largely determined by genetic factors.

Teenaged girls have dense parenchymal glandular tissue that progressively diminishes with age. There may be a slight difference in the size of the two breasts, which is normal. Pre pregnancy size of breast is no indication of its secretory function; however, development of breasts during pregnancy may correlate to lactational activity. Breast development is a complex process influenced by several hormones and growth factors. It has been observed that an increase in the size of breasts could be attained by a silicone implant, which is an envelope of silicone in the form of a semi-permeable membrane inserted in the breast tissue. Women who are conscious of the erotic function of the breast opt for it but unfortunately develop silicone toxicity syndrone and immune dysfuntion sundrome because the body's defence mechanism acts against the implant. Cosmetic manipulations of the body, though seemingly tempting to teenagers, are very often hazardous to health and are best avoided. It must be recognised that the chemistry that works in a happy relationship is very often not skin deep and does not depend on looks alone.

The hormone estradiol has a major role to play in the growth and development of secretory as well as connective tissue of the breast. The histology of the mammary gland undergoes cyclic changes during the menstrual cycle. In the luteal phase, with high estradoil in circulation there is an increase in the glandular tissue. With increase in blood and lymph supply the increase in breast volume may be event upto 40 per cent. A number of benigh diseeases of the breast, like fibrocysts or pain are related to oestrogen escess and significantly lower ratio of progesterone to estradiol in the luteal phase. During pregnancy and lactation fibrocystic changes in the breasts often decrease and pain too may be much less. Palpable as nodules, all fibrocysts are not cancerous and hormone therapy can give relief. However, any palpable mass in the breast must be taken serioulsly and investigated to rule out cancer.

Cancer :

Ovarian cancer :

Older women and women who have never had children have a high probability of developing ovarian cancer. Women with family history of ovarian cancer are also at high rist as there is a gene known to be responsible for ovarian cancer. Few clear indications of the lesion are experienced by the patient. Enlarged abdomen and vague digestive discomfort mayt be indicative and diagnosis can be confirmed by sonography. Treatment includes surgical removal of one or both ovaries, uterus and fallopian tube. Chemotherapy or radiation therapy are also of help.

Uterine cancer :

Cervical cancers are common in women who have multiple partners and in women who have intercourse before the age of eighteen. Cigaratte smoking and STDs also increase the risk. Cancer of the uterine wall (endometrial cancer) is commonly seen in women who have early menarche or late menopause or are suffering from hypertension and obesity. Women who have never been pregnant or have been exposed to oestrogen  are also at risk. Abnormal uterine bleeding and pain are warning sugns that should be investigated. A papanicolaou (PAP) smear test can confirm a diagnosis. Surgery, radiation or chemotherapy is the presently available treatment.

Breast Cancer :

This is the most commonly seen cancer in women. Early menarche, late menopause and not having children increase risk of breast cancer. Women with family history of breast cancer are at high risk as they are likely to have inherited the mutation of the genes, BRCA-1 or BRCA-2 that cause the lesion. Breast cancer can be detected early by self-examination or by regular mammograms. A painless of painful lump in the breast, change in colour and texture of the breast or niples, discharge from the niples should be investigated for cancer. Surgical removal of breast, radiation and/or chemotherapy is of considerable help, specially if cancer is detected early.


Viral Vaccine Strategies

The major function of a vaccine is to induce/prime the body's own mechanism so that the immune system can put up an effective fight on encountering the same agent. This should include appropriate responses from all the components of the immune system. Most commonly used 'classical' viral vaccines had been of two types.

Live virus which was attenuated enough to reduce pathogenicity-1 was used effectively as a vaccine against smallpox, yellow fever and poliomyelitis. The underlying principle is not only to have sufficient antigens to provoke immune response but also have the virus multiply within the host so as to give long-lasting immunity. A major concern for using such a vaccine for HIV is the potential danger that it may induce latency and may even 'recombine' with another retrtovirus resulting into a pathogenic virus. Although a few scientists are still engaged on the development of 'live' attenuated vaccines, extreme caution has to be applied to such studies.

The second type is the 'killed' virus vaccine, wherein the virus is inactivated. It means that the viral agent can act only as an antigen having lost its ability to replicate. Killed vaccine for poliomyelitis (Salk vaccine) has been used in many countries where poliomyelitis has been effectively controlled. In the early stages of development, due to incomplete inactivation, some residue of live virus remained which had serious implications. Even with the vastly improved technology available now, the possibility of such an occurence with HIV vaccine has all the serious consequences. However, AIDS vaccines following inactivation by irradition or some chemicls are still being developed.

Jonas Salk, the developer of killed polio vaccine, has advocated a strategy of giving killed HIV vaccine to indicviduals already exposed to HIV but who have not yet developed any illness. The principle behind it is that the long lncubation period between infection and the development of clinical AIDS may be due to an immune response to the initial infection which persists with health and wanes with disease. If this response can be boosted, it may be possible to reduce the viral burden, prevent the development of the disease syndrome and also reduce the infectiousness of the virus.

In fact, more manufacturers are attracted to develop 'therapeutic' vaccines, that is to say, for treatment of already infected persons, rather than the 'prophylactic' vaccine used for prevention of infection. A recombinant vaccine using the envelope component of HIV-1 seems to have given encouraging results as reported recently. Jonal Salk is now emphasising that smaller doses which induce a good cell-mediated immune response is likely to be more effective than those given in larger doses to induce antibodies in greater concentration.

 

Vaccine Type

Vaccine components

Live (attenuated) virus

Although considered risky, research into the use of live, but weakened, HIV is being conducted. Such research is directed to accomplish attenuation; HIV 'deletion mutants' i.e. Bits of the genetic material, are removed from the total genomic content of HIV and are being explored

Killed (inactivated) virus

The genetic material of HIV is destroyed with chemicals ()e.g. Formalin or radiation while the structure of the whole virus is left intact. Both irradiated HIV vaccines and chemically inactivated HIV vaccines are in development

Synthetic peptide (subunit)

Protein components (peptides), more or less identical to HIV antigens, are biochemically synthesised in the laboratory

Recombinant (subunit)

HIV antigens are produced by inserting the corresponding gene(s) into a convenient vector. Vector systems can be used whereby a vector (e.g. Vaccina virus) displays HIV antigens on its surface

Microparticle-based

(limposomes and ISCOMs)

Certain laboratory constructs can maximise antigen presentation. Liposomes-microspheres whose composition closely matches that of cell membranes-can enhance the immunogenicity of teh antgens they carry, e.g.ISCOMs (immune stimulating complexes)

Idiotype-based

Antibodies (idiotypes) that recognise an HIV antigen can themselves elicit the production of antibodies (anti-idiotype antibodies). When introduced into humans antibodies to these anti-idotypes antibodies will recognise and bind to teh anti-idotypeaantibodies, but more importantly, they will bind to HIV

Virus-like particles (subunit)

Pseudovirions or virus-like particles (VLPs) take advantage of the particle nature of certain self-assembling viral or yeast proteins. Hepatitis B virus particulate and the yeast protein, Ty, are two VLPs in advanced developmet stages.

In view of the abundant precautions needed for AIDS vaccines, most of the approavhes have been directed to the use of non-replicating antigens or frangments of HIV considered important in protection. Peptides, i.e. fragments carrying relevant stretches of amino acids, have been synthesised biochemically; these are non-infectious. Genetic engineering (DNA recombinant) is a sophisticated technique whereby corresponding viral genes  are inserted into suitable vectors. These are biologically active carriers of antigens. The 'foreign' antigenic material is expressed and exposed on the surface of the vector thus activating the immue sustem of individuals receiving the 'recombinant' material. It is beyond the scope of this book to cover all the vaccine developments. For those interested, some major technical developments have been listed in above table.

Despite difficulties, enthusiasm to take up the chllenge is obvious. Designing and development of effective AIDS vaccine will not only mean one of the most significant scientific/medical achievements with tremendous monetary gains. However, possibe litigations and consequences of losing astronomical amounts as compensations have also acted as deterrent in some cases. Certain recent happenings described in next article.


Some Hints On Increasing Fertility

The heartache, anxiety, and disturbance in couple relationship which result when much-wanted pregnancies do not occur certainly deserves as much attention as those which result from unplanned conception. Several measures have proved helpful to couples facing this problem.

Rhythm in Reverse :

Concentrating intercourse during the most fertile time of the woman-month makes pregnancy considerably more likely. The most fertile moment usually occurs fourteen days before the first day of the next menstrual period. Knowing your own usual cycle length, you can easily figure out when your next menstrual period should start, then counting back fourteen days. When you are deliberately trying to get pregnant, try to have intercourse at least once or twice during the two or three days centred on that date.

Fully-Ripened Sperm :

Sperm cells developing within the male organs usually take seventy-two hours to develop full strength of movement and peak ability to survive. Couples with a very rapid sex pace often have intercourse too often to allow sperm to mature fully. A three day holiday from intercourse before the woman's most fertile time solves this problem.

Sex Position :

Although couples with full fertility cannot substantially influence conception by choice of sex position, couples with sex borderline fertility often can concieve more readily in a special position. During intercourse the wife kneels on the bed with her chest resting on the bed or mattress (with a pillow arranged to aid breathing if necessary). Her hips are much hire than her head in this position, so that the force of gravity tends, to straighten out any tipping or kinking of the uterus.

This gives sperm easier and direct access to the upper birth passages. Her husband approaches from the rear, with his body upright. Intercourse in this position deposits the sperm quite close to the mouth of the uterus, and puts gravity to work in keeping the spermatic fluid within the vagina. After the male climax, the wife lies on her stomach for half an hour or so to allow the sperm extra opportunity to swim up the reproductive canal. Thus sperm of borderline number or strength get a little help on their way to meet the egg cell in the upper birth passage.

Bicarbonate of soda :

The vaginal juices ordinarily contain rather strong acids which kill sperm cells on contact. These acids usually disappear for a day or two during the woman's most fertile period. Since the entire fertile period lasts at least three days, however, you can substantially prolong the period when conditions are ideal for fertilization by neutralizing vaginal acids before intercourse. A douche containing a quart of warm water and two teaspoonfuls of bicarbonate of soda, which you probably keep among your baking supplies, often helps. Use a douche tip small enough to be entirely comfortable. Lie in the bathtub and let the solution run in from a reservoir about eighteen inches above the level of your organs. Hold the lips of the female organ closed so that the solution blows up the vagina like a balloon and gets into all its folds and creases, then release to allow the solution to escape. Repeat several times, until the solution is exhausete. Intercourse should follow within an hour or so.


Some Myths And Facts About Pregnancy and Infertility

Myths :

1    Pregnancy is just a normal physiological process that does not require any special     care.
2    Pregnant women should eat less to ensure that the baby is not overweight and     difficult to deliver

Fact :

Though pregnancy is a normal process, it is a special physiological state of the woman which requires conscious care for the welfare of the mother and the child. In general, responsible behaviour of the pregnant woman, sufficient intake of food (especially rich in protein) and appropriate physical work ensures the health of teh woman and her foetus. Less eating during pregnancy leads to anaemia or other malnutrition-related complications. Maternal malnutrition endangers the normal growth and development of the foetus. Difficulty during childbirth is not because of overweight babies alone but often due to other transitional physiological or anatomical factors.

Myths :

Infertility is usually because there is something wrong with the woman
2    If the woman cannot bear a child she is a curse to the family and the society

Fact :

A couple may not have children because of several factors, anatomical as well as physiological. Either of the partners may have a problem and to ascertain what really is impending fertilisation, it is necessary to check them both. It is not true that the defect lies in the woman; there are equal chances of the man being infertile.

No matter which of the partners has the problem, facing it together and seeking appropriate assistance is important. Blaming each other making the partner feel guilty only aggravates the situation. Infertile woman or, for that matter, man is no curse for the family or society for there are many roles in the society other than procreational. In many societies, it is not unusual to find couples consciously opting out of childbearing and yet lead a fulfilling life. Moreover a number of technologies are now available to help overcome infertility. Unfortunately if there is no success after the use of assisted reproductive technology, then adoption is an option that turns out to be vary satisfying. Infact, assisted reproduction is somewhat a morbid procedure that couples would like to avoid and instead actively opt for adopting a child.


The 'Downs' in the Development of AIDS Vaccine

Genetic and antigenic variations in HIV-1 have created major problems in vaccine production. Those advocating the use of a 'cocktail' vaccine-a mixture of several different viral strains-also feel bogged down as they encounter a number of major and minor variations. The recent findings that AIDS-like illness seems to occur in the absence of HIV but with all other established characteristics might further retard the progress.

Experimental animal models are very useful in understanding the various mechanisms and in assessing the safety and the efficacy of vaccines. The life-threatening nature of AIDS compels HIV vaccine developers to use appropriate animal models before undertaking trails in humans. The chimpanzee, though not ideal, is still considered the best model for trails with HIV-1 vaccine. Chimpanzees are not only very expensive, but they are not available in large numbers; hence a search is on for other animals models.

Scientists have turned their attention to monkey models using simian immunodeficiency virus. Several groups had reported very encouraging results in such models which also showed protection when the immunised macaque monkeys were challenged with the original wild virus. Because of the high cost of securing and maintaining a large number of monkeys, these workers had not kept all the required experimental controls. Recently, however, a team of scientists from UK included some of these controls and, to everyone's surprise, revealed some startling findngs!  The 'control' macaque who had been administered 'normal human cell component' without the virus also produced immunity. The sensational item was that two of the four 'controls' were also protected against the challenge; this was attributed to them developing ten items as much antibody against the normal human T-cell component, even though not infected with the virus. This challenge which is used to prove the efficacy of a vaccine is a very important step. A vaccine is considered efficacious when all (or the majority) of the immunised animals survive, while all (or the majority) of non-immunised animals (called controls) die of the disease produced by the 'challenge' virus.

If, as we had seen earlier, AIDS is indeed an auto-immune disease, the findings of anti-cell antibodies in the monkeys should not be a surprise. Confusion creeps in when one begins to think how and why the monkeys resisted the strong challenge of the virus.
The other side of the coin is where developers of AIDS vaccine use the chimpanzee as a model animal, especially for HIV-1 serotype. The difficulty here is to have the right type of the 'challenge' virus (HIV-1) in sufficiently large stocks so as to standardise the test as is done for testing other viral vaccines. The task was entrusted to a virologist. He started to make a large stock but had many difficulties. Finally, after several months of work, he tried out the stock. To his and co workers surprise, it was found that he had not ended up with the virus he stated with.

What he now had was the virus from Gallo's laboratory which he had used earlier and which and somehow contaminated his stock. Embarassing indeed for those engaged in the development of the vaccine for AIDS. But also interesting when one traces the history of Gallo's virus to find out that it was 'reportedly contaminated' by the virus strain received by him from Montagnier in Paris.

The French were feeling elated, but not for long; it was discovered that even their virus strain was not the one they had started with, but was contaminated by a human immunodeficiency virus which was obtained from a different AIDS patient. Al these go to show how quickly a fast growing strain of the AIDS retovirus can overtake a slow growing one in the laboratory and cause all kinds of confusion. This feature also sounds a warning to all those engaged in virological investigations on AIDS to take abundant precautions against such an eventuality. Yet another obstacle in AIDS vaccine development is the concern about 'enhancing' antibodies explained earlier. It would be counter productive if a vaccine were to induce more of this type of antibodies in the place of neutralising antibodies. Until all these 'downward' developments are resolved, it is difficult to predict the availability of AIDS vaccine in the near future.

Situation in India :

In India, where still have to control diseases which are easily preventable by vaccines which are cheap and adequately available, it is difficult to envisage the control of AIDS through a specific AIDS vaccine. Perhaps, it would be more important to understand the impact of various 'opportunistic infections' on HIV and AIDS and also attempt to prevent and control as many of them as possible. For the present, the only vaccine which seems to be cost-effective against AIDS is IEC, viz. information, education and communication/counselling.


When Should You Become Concerned About Fertility? Tips for Pregnancy

A normally fertile couple who use no birth control measures and have intecourse whenever the spirit moves them start a pregnancy in about ten months on the average. However, the laws of probability have a good deal to say about exactly when conception will occur. Ten months is, average, but two years is common and three years far from rare. Unless advancing age makes the situation unusually urgent, you should not worry about failure to get pregnant for some time. The home measures described above are worthwhile if you are anxious to have a youngster. But the situation is neither so grave as to cause concern nor so pressing as to call for medical examinations and care until three years of unhampered marital relations have failed to initiate pregnancy.

After three years of unsuccessful attempts to conceive, thorough medical examination of both partners is worthwhile. About half of the coupies who have been infertile this long prove to have difficulties which can be corrected. The other half occasionally have children later, but have a sufficiently remote change of doing so to begin thinking about other ways of building a family, such as by adoption. A great many couples use birth-control measures for a few years, then find that pregnancy does not occur promptly when they decide that the time is ripe. If this happens to you, do not let guilt feelings or recrimination add their burdens to the problem of infertility itself.

None of the birth-control methods discused above cause infertility once you stop using them. Fertility may decrease with the passage of time or with progression of otherwise undetectable disorders, so that it is wise to start having your family as soon as you find it convenient. Family-spacing measures do not themselves cause this problem, however, and you should not blame yourself for it. In most cases, people who experience difficulty having a child when they stop using birth-control measures would have had just as much trouble if they had tried to reproduce right at the start of their marriage, with no one whatever at fault.

Pregnancy :

To increase the chances of a wife's pregnancy, precaution should be taken to time intercourse in order to coincide with the most fertile days. The most fertile day is considered to be 13th day following the onset of menstruation, counting the first day a one. Set that day as the target day and then do not have intercourse for four days preceding it. On the target day, have intercourse twice, as close in succession as you can. If she does not conceive that month. try the 12th day of the next month, the 14th day of the following month, and the 11th, 15, and 10th day of subsequent months. Repeat this timed-intercourse series, which will take about a year, and if at the end of that she is still not pregnant then a thorough sterility test is suggested.


Infertility Problems and IVF-ET, GIFT Macromanipulation of gametes procedures

Inability to conceive after about one year of unprotected sex is a matter of concern and is considered as infertility. Evaluation of infertility and specific identification of the problem can be done by physical examination and biochemical tests of the couple. Both the partners need to be equally involved in consultation, as there are equal chances of either of them having a specific problem. Moreover, no matter who has the problem, this is the time of emotional understanding and supporting each other. A majority of infertility problems are due to four common causes :

1 Problems related to fallopian tubes : A block of the fallopian tubes due to prior infection or surgery impedes fertilisation. Tubal blocks due to infection can be resolved by treatment with antibiotics; in some cases microsurgery is of help.
2 Problems related to ovary : Infrequent ovulation because of cysts in the ovaries, emotional stress or major illness can cause infertility. Thyroid dysfunction can also affect ovulation and can be treated through hormone therapy.
3 Problems related to the uterus : Uterine environment that is hostile to sperm mobility can cause infertility. Abnormal quantity or quality of cervical mucus due to infectioj, narrowing of the cervical canal due to blockage or due to prior surgery, abnormal shape of the uterus or cervix can impede sperm transport. Antibiotic treatment or use of vaginal creams can overcome these problems. Minor corrective surgery is sometimes recommended.

4 Male factors : Abnormal sperms or low sperm count in the semen is one of the major causes of infertility. Sperm counts may be temporarily lowered due to a variety of factors such as poor diet, excessive alcohol or smoking, drug abuse, prostrate infection or exposure to radiation or chemicals. Hormonal treatment to improve sperm counts or artificial insemination is of help to overcome these problems.
Counselling, help of the gynaecologist and support from the partner can help overcome infertility problems easily. There are new technologies now available in the form of 'in vitro fertilisation' and 'assisted reproductive technoloies' to help infertile couples. Depending on the specific problem faced by the couple, appropriate manipulation of the gametes or embryo can be carried out to ensure pregnancy. More about this elsewhere.

In 1978 Dr. Patrick Steptoe and Dr. Robert Edwards reported the first baby born following 'in vitro fertilisation' and initiated the era of hope for a number of infertile couples. In India, Dr. S.Mukherji in Calcutta and Dr. Indira Hinduja and Dr. Anand Kumar in Bombay successfulluy launched the technological breakthrough. Several clinics for assisted reproduction have been developed in the country. Some of the major technologies now available have been briefly listed below. The choice of the technology the couple can use, depends essentially on the cause of the infertility.

1    In vitro fertilisation and embryo transfer (IVF-ET) : If natural fertalisation fails, it is possible to carry it out under artificial conditions in a test-tube or a perti dish. This called 'in vitro fertilisation'. The woman is given hormones to stimulate the follicles and the growth of the follicles is monitored by checking the hormonal levels in the blood. At the appropriate stage of maturation, eggs are collected with the use of a 'laparoscope' or by transvaginal sonography. The egg is then kept in a petri dish and mixed with the sperms to allow fertilisation. The embryo is allowed to develop to about four-to-eight cell stage and then transferred by inserting a catheter into the woman's uterus. IVF-ET is most commonly recommended for women who have blocked or damaged fallopian tubes. The success rate of pregnancy by IVF is low and is a stressful experience for the couple, more so to the woman as her physiology is modulated aftificially.

Gamete intra fallopian transfer (GIFT) : This is modified IVF procedure. The ova and the sperms are collected and together placed in the fallopian tube by a clinical procedure. The fertilisation and transport of the embryo to the site of implantation in the uterus occurs as a natural process. This technique is recommended in cases of unexplained infertility or when cervical and uterine factors impede fertilisation.

 

Micromanipulation of gametes : Microscopic procedures have been developed to manipulate eggs and sperms to circumvent barriers between them for fertilisation. These greatly reduce the number of sperms required for in vitro fertilisation. Among the battery of techiniques are :
1    PZD or partial dissection of the oocyte membrane (zona pellucida);
2    SUZI or subzonal sperm insertion;
3    ICSI or intra-cytoplasmic sperm injection.

Intra uterine insemination (IUI) or artificial insemination (AI) : These procedures are performed if teh semen is poor in sperm count or the sperm motility is abnormal. The ovarian follicular development in the woman is monitored by ultrasonography. When a mature Graffian follicle is observed, within twenty-four to forty-eight hours about a million or more processed sperms are injected into the uterus by a catheter. These reproductive  technologies and other allied procedures have led to:

(1)    Ovum donations : In women when ovum cannot be produced due to irreparable ovarian dysfunction, ovum donated by another woman can be used in the IVF-ET procedure.
(2)    Sperm banking : Sperms collected from donors (or husband) can be preserved at low temperature (cryopreserved) and used to fertilise the egg as and when required.
(3) Surrogate motherhood : It is possible to stimulate a woman hormonally and induce pregnancy by IVF-ET, using donor eggs and donor sperms. In other words, it is possible to 'hire a womb'. It is also possible to become a 'surrogate mother'
(4)     Post-menopausal pregnancy : One of the major outcomes of the assisted reproductive technologies is that it is possible to hormonally prime a post-menopausal woman and induce pregnancy by IVF-ET, using donor egg and sperms.
(5)    Pre-implantation genetic diagonosis : This technique is extremely useful in cases couples who have a high risk of having an abnormal baby. It involves the removal of a single cell from an in vitro fertilised embryo and its genetic analysis, using modern molecular biology techniques to identify the presence of defective gene.
All these techniques have an emotional and social impact and have to be carried out by conditional consent and total cooperation of the partner.


BIRTH CONTROL, Calculation of Menstrual Cycle

For the sake of the children, who are to shoulder responsibilities in the coming generations, as well as for their own benefit, the parents should not have children without serious consideration for their future. But once we have a child we are obligated to raise him with care, so that he will grow up as a helathy, cultured, and respected member of society. The state should improve social conditions so that young people may find a place in society where they may best display their ability. The need for family planning for the happiness of the couple, their children and community is evident. The principal means for family planning, then, should be fertility control (to prevent sperm from uniting with ovum) rather than artifically induced abortion; which should be regarded as a secondary means.

As, the more often pregnancy is terminated by artificial means, the more likely spontaneous abortion is to occur in the next pregnancy. And the more often spontaneous abortion is repeated, the greater the chances of miscarriage and premature birth in each suceeding pregnancy. In other words, if a woman aborts artificially too often, she will eventually develop a habit of miscarriage or premature birth, thus running a risk of not being able to have a baby when she wants one. Especially for women who have never had a child, resorting to artificial abortion is a most toughtless and nearsighted act ignoring their future happiness and jeopardizing their health. One should bear in mind that fertility control should always come first and abortion is the last resort.

The womb is not a temporary repository for the fetus to be discharged prematurely but a place where it is nurtured and developed over the full period of pregnancy. This should never be forgotten even though modern sex life is, and should be considered separately from procreation. Artificial abortion is not only unnatural but may even give the uterus a tendency of not been able to carry the fetus to full maturity.

Determining the Period of Conception :
Easy Way To Calculate :

According to Dr. Ogino's world recognized theory, ovulation occurs during the five-day period between the 12th and 16th days before the anticipated menstruation. In a woman with a 30 day menstrual cycle, as shown in the chart above, ovulation takes place sometime between the 16th and 19th days counting from the first day of menstruation. But it must be remembered that the sperm can live for three days. If coitus is performed on the 12th, 13th or 14th day from the first day of menstrua- tion, or during the supposedly "safe'' period, there is still a possibility of fertilization - for the sperm may survive into the ovulation period. On the other hand, if intercourse is performed on the 20th day, or the day after the ovulation period, there is still a possibility of conception - for the ovum lives for a day.

Therefore, to calculate the "safe'' period, the sperm's life should be added to the earlier portion of the ovulation period and ovum's life to the latter portion of the ovulation period. Thus, in a 30day menstrual cycle, as shown in the above chart, the safe period in the earlier half lasts until the 11 day, and that in the latter half starts on the 21st day. It is noted that thefirst digit of both days - 11 and 21 - is the figure "one''. This regularity applies to all menstrual cycles, as shown in the above table. In the 32nd day cycle, for example, the no-conception period continuies until the 13th day in the first half and begins on the 23rd day in the latter half. For the 28 day cycle, the figures are the 9th day and the 19th day. This makes it very easy to memorize one's own sterile period.

In short : to obtain the last day of the first-half safe period, subtract 19 days from the menstrual cycle ; and to obtain the first day of the latter-half safe period, take 9 days from the cycle. The safe period discussed above does not guarantee 100 per cent protection from conception. Some women report failure after strictly observing the safe period. The reason is that the menstrual cycle is subject to variation. By taking statistics of her menstruation for a year, a woman will notice that the first day moves up or down a day or two. And a single day's difference may prove fatal to her contraceptive efforts. Consquently it is a good idea a day or two for a possible early arrival of menstruation.

If the record shows that the shortest cycle lasts for 26 days, the longest for 32 days, and the normal for 30 days, it should be assumed that the first-half safe period will continue until the 7th day. This means that if menstruation lasts five days, the safe period following it would be only two days, shattering the common belief that the three days after menstruation are safe. In some cases the sperm may live more than three days, further reducing the safe period. This period, however, should be regarded as relatively, not absolutely, safe because the arrival of menstruation is subject to unexpected changes. The above method to determine the first-half safe period is most ideal, but to apply this method to the atter half safe period entails much waste. For example, a woman whose normal cycle is 98 days, minimum cycle 25 day maximum 31 days, will carry the first half safe period until the 6th day and the latter half safe period after the 22nd day, consequently allowing an extremely long fertilization period.


Some Myths And Facts About Girls Get Married At An Early Age

Myths :

1    Procreation is the most impotant part of a woman's life
2    Women are physically, physiologically and psychologically tuned to rear and care for children
3    Girls should be married at an early age, otherwose they are unable to adjust in the society and are a burden to the family
4    Girls must choose simpler careers as they have a lot of reproductive responsibility

Facts :

There is no doubt that pregnancy and childbirth are creative and satisfying aspects of womanhood. It is also true that women physically and mentally take upon themselves the responsibility of child care. However, there is much more to a woman's life than procreative activity. Gender roles reinforced through childhood, the role-model girls follow often decide how much the women take up as their job. Very often a disproportionate amount of responsibility is pushed on to women in the name of their being tuned by Nature to do so. It is being increasingly recognised that men have an equal part to play in child-reating and Nature in no way has endowed them with less instinct of care. Likewise there are important roles, other than childbearing that a woman can play in the society.

Legally girls can marry after eighteen years of age. Marriage before this age can lead to health problems as the girl is neither biologically or emotionally mature enough to handle sex and childbirth. Although menses may be initiated at the age of eleven to fourteen years, the cyclicity of the ovarian cycle is achieved only after two to three years and the womb is strong and mature enough to carry the foetus a couple of years later. Ideally, girls should bear children only after twenty-one years of age. Marrying girls at an early age leaves them vulnerable to not only health problems but to social issues in a male-dominated society. Denying girls the time for education or for learning of skills that can give them desired employment makes them dependent and a burden on the family. On the other hand, empowering girls to be self-sufficient makes them an asset to the family and the society.

Women today can choose a variety of careers; however, in most situations they do face subtle discrimination due to their family commitments. In fact, most working women, rural as well as urban, stretch their mental and physical resources to utmost to prove their abilities in the male-dominated society. This overbuden often reflects as health problems, specially as age catches up. At times women face unrecognised morbidity and even define lack of illness as good health.

Several studies have demonstrated that such socio-economic problems are not solved by confining women to lighter professions but are resolved by empowering women to solve their own problems. When women occupy decision-making positions at various levels, at home, in the community, at work, in choosing their partner and most important in planning and spacing  childbirth, a number of health issues do get taken care of. If women are recognised as individuals with qualities different from men, sharing equal responsibility and power in the society may not be a distant dream. It is surely a dream of all adolescent girls awaiting fulfillment.


Information, Education and Communication/Counselling (IEC)

"knowledge is the most democratic source of power''
                                                                  - Alvin Toffler

In his recent book Power Shift, Alvin Toffler (the author of Future Shock) presents an expanded definition of knowledge. He includes data, images, informations as well as attitibes, values and other symbolic products of society - whether 'true'. 'approximate' or even 'false'. He states, "All of these are used or manipulated by powerseekers, and always have been. So too are the media for conveying knowledge, the means of communication which, in turn, shape the messages that flow through them.'' Toffler points to the fundamental differences between knowledge and other lesser forces. According to him, as he calls them 'force' (coercion) is finite. There is a limit to how much force can be employed before we destroy what we want to caputure or defend.  This concept of knowledge is truly applicable to prevention and control of HIV/AIDS.

From what we can gather, there could be two policy responses: (1) mandatory (forced?) testing followed by isolation of HIV seropositives: it was tried in Goa but with poor result and seems to have been modified; (2) the second is the integration approach wherein testing is voluntary and follows strict confidentiality. In other words, persons who are HIV infected are not descriminated against in any way.

Perhaps, the first policy might have worked, if we had some premonition (a vision?) of HIV visitation, much before it actually happened. Perhaps, we might have successfully spotted the few virus carriers and isolated (quarantined) them. Perhaps, we might have given proper care without undue discomfort to them or the society. Cuba seems to have followed this with some success.
The reality was that we woke up too late. By that time (1985-86), the invisible virus had already created an epidemic situation. Therefore, the isolation approach would not only be unethichal  but also impractical and most uneconomical. Add to it, the complication of a long, indefinite incubation period and we face an impasse. Isolation for how many and for how long? Who bears the expenses for the increasingly large number of HIV-infected people? The major hurdle would be that it would indeed be counterproductive and as explained by Toffler, in the long run, would destroy what we wish to defend.

In contrast, the second policy helps in empowering people of all groups and ages, especially 13 to 30 years olds, and the marginalised* groups, through programmes of information, education and communication/ counselling (IEC); this knowledge, as defined by Toffler, is not finite. It does not get used up but, in fact, can generate more. Attitudes and approaches to life or lifestyle differ  from one generation to another. This is called the generation gap; similar gaps exist between the rich and the poor. However, the greatest gap exists between the armed and the unarmed, the ignorant and the educated. Appropriate knowledge can narrow this gap.
* Incompletely assimilated and denied full social acceptance and participation by dominant groups in the society.


Condom, Condom and Sexual Sensation, Deceptive Thickness and

Condom :

The condom, a cylindrical receptacle made of a thin film of rubber to encase the penis in sexual intercourse, is the only contraceptive used by males. It is highly effective but is often shunned chiefly by men who have misconceptions about it. In fact, there is nothing more widely known and yet more misunderstood than the condom.

Condom and Sexual Sensation :

Many men seriously think that the condom reduces sexual feeling. This is understandable - for however thin it may be, it prevents direct contact. But actually, there is very little difference in local stimulation whether one uses the condom or not. With a blindfold over his eyes, one will hardly be able to distinguish between direct stimulation through a condom.

Deceptive Thickness :

Many men explain "Expensive condoms are so thin that you can hardly tell the difference. But cheap ones are too thick and no good''. In certain cases the higher priced condoms are more lucid and looks thinner and have a smoother touch. But as a matter of fact, condoms are deceptive and the only difference is in their transparency.

Some Misunderstanding :

The condoms, when used properly, should not create any difference in the female sexual sensation. Yet some women claim they do not feel their partner's ejaculation when the condom is used. Without it, the explain, they feel the vagina grow warm and wet from ejaculation. This is all wrong and such persons are probably victims of misinformation by sex literatures.

As a matter of fact, the cervix, cannot sense heat or pain. It may be burned or cut with a scalpel without pain. The tapping sensation from the male sex organ is conveyed to and sensed by the peritoneum. Also, the mucous membrame of the vagina is sensitive to stimulation by heat. Consequently, if anything is felt from ejaculation it is in these parts but not in the cervix. But it is an exaggeration to say one can feel the semen's warmth or wetting, for the area receiving it is already as wet and warm as the small amount of semen ejected there.

As the climax nears, the penis is distended by the high concentration of arterial blood, so that its temperature rises higher than that of the ejaculated semen. At the same time a similar phenomenon of blood concentration occurs in the female. The sudden expansion of the male sex organ accelerates it, the vagina becomes as warm as the male sex organ and the stimulation from friction intensified by the distended penis augments the warm sensation. Also, Bartholin's glands secretion in the female prior to the male ejaculation increases in proportion to the female excitation. These changes are sufficient to make her feel wet inside, and it makes no difference whether the semen is trapped in the condom. Moreover, a woman cannot possibly tell the slight difference at any rate while she is in the midst or orgasm or nearing it.


Some Medical Surgeries Description

Amniocentesis : a procedure by which a small amount of amniotic fluid (the fluid bathing the foetus in the uterus) can be removed, using a needle and a syringe. This procedure is done under local anaesthesia. Chromosomal abnormalities can be detected or the foetal condition assessed by testing the amniotic fluid.
Biopsy : removal of the tisue for diagonostic purpose. The tissue can be further processed to check pathological changes.
Colposcopy : a procedure to examine the cervix through a special magnifying instrument called the colposcope.


Cone biopsy : an operation to remove the cone-shaped tissue from the lower part of the cervix for diagnostic purposes.
Cutery of cervix : superficial burning of the lower end of the cervix. This is done by use of heat (electrocautery) or by freezing (cryosurgery)
Culdoncentesis : the procedure in which a needle attached to a syringe is inserted through the upper vagina into the abdominal cavity to aspirate the fluid. Blood drawn into the syringe is indicative of ectopic pregnancy.

D&C (dilation and curettage):  minor surgery to widen the cervical opening (dilation) and superficially scraping the tissue (curettage)
Endometrial aspiration : a procedure for removing the cells lining the uterus for diagnostic purposes.
Hysterectomy : surgical removal of the uterus including the cervix.
Hysterosalpingogram (HSG) : an X-ray of the uterus and the tubes showing their internal appearance that helps in detecting blockages.
Hysteroscopy : a procedure to examine the inside of the uterus.

Laparoscopy : an operation performed through a small cut at the navel.
Laparotomy : an operation performed through a small cut in the abdomen.
Mammogram : X-ray of the breast; it helps to diagnose breast cancer.
Mastectomy : a surgery for removal of breast.
Myomectomy : surgery of the uterus to remove benign growth of fibroids.
Oophorectomy : a surgical procedure to remove one or both ovaries.
PAP smear : a scraping of the cervix is taken and the cells are observed after appropriate staining. The technique is named after Dr.Papanicolaou who first described it. Abnormal cells seen in PAP smear help in clinical diagnosis of various infections and of cancer.

Salpingectomy : surgical removal of the fallopian tubes.
Sonography : a non-invasive technique using sound waves to visualise the internal organs.
Tubal Ligation (or sterilisation) : surgery, resulting in blocking of tubes by trying them with thread or suturing them, or by using clips.


Concept of IEC

In the last week of january 1988, a historic, unprecedented meeting took place in London. It was the World Summit of Ministers of Health from 148 countries along with health experts; the first occasion when a single disease syndrome was discussed at that level. From this meeeting emerged a historic statement- the London Declaration. One of the statements included in this declaration is most relevant to the IEC concept : "In the absence at present of a vaccine or cure for AIDS, the single most important component of national AIDS programme is information and education.''

 

Five basic elements are important in formulation of IEC programmes for prevention of HIV/AIDS:
1    Accurate information about AIDS, the difference between HIV infection and AIDS, how HIV spreads and also, how it does not. There should then be specific information targeted to identified groups as to how HIV/AIDS can be prevented.

 

2    Scientific information in clear, unambiguous terms (preferably in local language) on human sexuality, especially to eliminate myths and misconceptions.
3    Information to enable enjoyment, at the same time, control sexual and reproductive behaviour and practicies so as to prevent STDs including AIDS; in accrodance with prevailing cultural and social values and ethics.
4    Sensitivity to develop a positive, sympathetic and non-judgemental attitude to HIV-infected persons and PWAs (relevant to counsellors)
5    Appreciation of individual human rights and an ability to sustain a balanced view of individual rights versus protection of the public.


HOW TO USE AND TEST CONDOMS.

Do not inspect condom immediately before coitus :

Some times a wife gets dejected watching a husband tests the condom by blowing tobacco smoke into it. Remember! the pre-coital atmosphere has great bearing on the act to follow. That is why both partners should avoid creating a discouraging atmosphere. If a husband must test his condoms, he should inspect them at once long before use. Do not blow cigarette smote into condom to find pinholes, as they are likely to deteriorate because of smoke remaining in them. Pinholes usually occur in the depression between the tip where the semen accumulates and the main body of the condom and rarely in the lowest part. It is not necessary to unroll each condom and inspect the lower end. It suffices to inspect it by holding it against the light without unrolling it. Placing it on a sheet of black paper makes inspection easier.

Precautions :

A suprisingly large number of men do not know how to use the condom properly. This is why many complain of reduced sex sensation, or even of failure in birth control.

Apply condom in the middle of intercourse :

Some semen may leak even before ejaculation. In successive intercourse, particularly, there is always the danger of semen leakage as long as one does not urinate in between each session. Leaked semen should be distinguished from the mucous secretions which lubricates the penile glans prior to coitus and originates mainly from Cowper's glands and other small glands, which do not contain semen.  A newly married man generally reaches ejaculation in a fairly short time, but after a while he will take a longer time and will come to know how much sexual friction will lead him to ejaculation. Thus, he will learn the right time to use the condom. By that time, the male sex organ will be thoroughly wet with the abudant mucous secretion from the Bartholin and other glands in the female sex organ. It is much easier to wear the condom on a wet penis than on a dry one preceding coitus.

If the woman secretion is inadequate he must rely on other media such as jelly or saliva to wear the condom. But the man should be blamed for poor secretion in the woman. If the condom is used when the vagina is not sufficiently lubricated, he will distinctly feel a disagreeable friction because of inadequate contact of penis and condom, while the woman on the other hand may even feel pain.

The condom may be tied at its base :

The common belief that the male sex organ does not vary between individuals as much as the female sex organ does is not necessarily true. There are individual differences in the length and thickness of the distended male sex organ the length averaging 12 centimeters (4.8 inches), the circumference at midshaft 11 centimeters (4.4 inches) as well as in thickness of the base. Consequently the condom may fit snugly as the penis base for some and may be loose for others.

Many worry about the condom slipping off during intercourse. This can be prevented by tying a ribbon around the base of the condom, which will not only keep the condom in place and but also have an added stimulative effect. The knot placed at the top will help stimulate the clitoris. The tied condom further enables the penis to be held in the vagina without fear of semen flowing out and into the female sex organs. Various kinds of condoms have appeared on the market recently. Some have extra-large openings, others have narrower, and still others contain jelly at the tip.

How to wear the condom :

The important thing is to keep the air of the tip. This can be achieved by either or the following methods:
1    While pinching the condom tip with the fingers to press the air out, place the condom on the penis and unroll it.
2    Blow the condom tip inside out, twist it, place it on the penis, and unroll the condom. As this method takes more time, it is advisable to have the condom blown inside out previously and kept ready for use.

Combined use of jelly and condom :

Any man whose penis does not fit snugly in the condom, or who insists on wearing it from the beginning of sexual intercourse, is advised to apply jelly on the penis surface before putting on the condom. Also, a thin layer of jelly should be applied to the outside of the condom if the woman's secretion is insufficient. For better assurance a generous amount of jelly should be applied thickly on the tip of the penis. After all this precaution it is hardly necessary to insert jelly into the vagina for added precaution.
Withdraw condom with penis after coitus : Now and then, a careless man will withdraw his penis and leave the condom in the vagina. As a result the semen may spill out of the condom and may flow back into the vagina.

Women should draw thighs together :

To hold the penis in union a long time after ejaculation the woman should draw her thighs together. Since her orgasm lasts longer, the vagina continues convulsive contraction even after the penis starts shrinking. Consequentl, she must pull her thighs together to prevent the semen from flowing back into the vagina.
Clean seperately after coitus : The man and woman should use seperate tissue paper or towel to clean off mucus after coitus. If the same tissue/towel is used to clean the vagina after cleaning the penis, as many couples do, there is no sense in using the condom.


Puberty ....

Puberty (PEW-bur-tee). You say puberty with the most emphasis on the first part of the word, PEW. Puberty is the time in your life when your body is changing from a child's body into an adult's body.

Female Puberty Changes : A girls go through puberty, their breasts develop, and they begin to grow public hair, as well as hair on their underarms. They also get taller, and fat tissue begins to grow around their hips, thighs, and buttocks, giving their bodies a curvier shape. Our bodies change quite a bit as we go through puberty. We grow taller. Of course, we grow taller all throughout childhood. But, during puberty, a girl goes through a growth spurt. She grows taller, at a faster rate, than she evel will again.

There are a number of words in this book that we think you may not have heard before. When we first use these words, you'll find a pronunciation key at the bottom of the page. We will always use capital letter to indicate which part of the word to empgasize when you say it out loud. And we use "uh'' in the pronunciation guide to indicate the vowel sound that rhymes with the "uh'' in "huh''. See, for example, "vulva,;; "testicles,'' and "urethra''. Remember that you don't pronounce the "h'' in "uh''. We also use "ih'' to indicate the vowel sound that rhymes with the "e'' in "edit''.

During puberty the shape of our bodies changes. Our breasts begin to swell and to blossom out from our chests. Our hips and thighs get wider. We take on a more rounded, curvy shape. Soft nests of hair begin to grwo between our legs and under our arms. Our skin begins to make new oils, which change the very feel and smell of us. While these changes are happening on the outside of our bodies, other changes are happening on the inside.

For some girls, puberty seems to take forever. For others, these changes happen so fast they seem to take place overnight. They don't really happen that quickly, though. Puberty happens slowly and gradually, over a period of many months and years. The first changes may start when a girl is quite young, or may not begin until her teen years. No matter when puberty starts for you, we bet you'll have lots of questions about what's happening to your body. We hope this book will answer those questions.

"We'' are my daughter, Area, and I. The two of us worked together to write this book. We talked to doctors and read medical books. And we talked to many women and girls, too. They told us what happened to them during puberty, how they felt, and what questions they had. I teach classes in puberty, and together Area and I do workshops on puberty for kids and their parents. The kids in my classes and the mothers and daughters in our workshops alwats have lots of questions. They also have lots to say about puberty. Their quotes appear throughout these pages,* so, in a sense, they helped write this book.
* To protect their privacy, we changed the names of the girls and women who were kind enough to let us quote them.

I first began teaching puberty and sexuality classes back in the days when dinosaurs still roamed the Earth (well, nearly that long ago). Back then, sex education wasn't taught in very many schools. I had to invent my lesson plans from scratch. I decided to start off my very first class by explaining how babies are made. This seemed like a good place to begin. After all, during puberty, your body is getting ready for a time in your life when you may decide to have a baby.

I didn't think I'd have any problems teaching that first class. "Nothing to it,'' I told myself. "I'll just go in there and start by talking to the kids about how babies are made. No problem.'' Bou, was I wrong! "id hardly opened my mouth before the class went crazy. Kids were giggling, nudging each other, and getting red in the face. One boy even fell off his chair. The class was acting weird because to talk about how babies are made, I had to talk about sex. Sex, as you may have noticed, is a very big deal. People often act embarrassed. giggly, or strange when the topic of sex comes up.


Legal, Ethical Issues and Dilemmas

In general terms, law is expected to ensure social justice to protect society while ensuring order, support for fundamental human rights and, at the same time, preserve and protect the public good. Ethics on the other hand is a series of guidelines derived for a specific group to ensure their correct and good behaviour in respect of their professions or workplace. It is related to colleagues and other persons that they come in contact with during the performance of their (professional/ workplace) duties and activities. Since an element of good versus bad is involved, ethics is associated with morality. Thus, an action may be perfectly legal and yet be considered immoral by a certain group of people. Ethics, in very simple terms, is a moral code of contact.

 

It might seem that overall, 'medical ethics' conveys that it is the power conferred to cure and control. It is desirable to replace the word 'power' with the word 'knowledge'. All medical, paramedical, technical, nursing and other staff providing health care are called health care workers (HCWs). According to Dr. Eustace J.de Souza, Executive Director, F.I.A.M.C.,
Bio-medical Ethics Centre, Bombay, every HCW should follow three primary ethics.
*    The ethics of LOVE
*    The ethics of TRUTH
*    The ethics of DO NO HARM.

To heal the sick, alleviate suffering, promote health and prevent the spread of the disease are components of the first. HCWs should maintain strict confidentiality regarding patients illnesses and informa- tion imparted in confidence during consultancy. At the same time, they should respect patients rights and give the correct information about their health status. The 'do no harm' ethic is obviously important. It should also include taking all sensible safety precautions to prevent the spread of infection.

A basic concept is developed in HIV prevention, that is called 'universal precaution.' It is neither practical nor ethical to test every single patient for HIV. Blood and sexual fluids are the major vehicles carrying the virus. Therefore, the best policy for HCWs is to handle every single blood specimen (sexual fluids if handled) with care and precautions as if it were infectious. This means that a habit needs to be inculcated so as to control the spread of the virus.

Patients rights were mentioned earlier. They also have obliga-tions. A very important ethic for them is 'do no harm'. They should not perform any negligent act that can spread HIV/AIDS to others. In fact, Section 269 of the Indian Penal Code has a provision for negligent act likely to spread infection of disease dangerous to life.

This is punishable with imprison- ment extending to six months, a fine or both. This Section was provided during the British rule to protect against plague, cholera, etc. It is understood that this was also implemented. There is also a Section 270 which mentions 'malignant act likely to spread infection of disease dangerous to life' with imprisonment of two years or a fine or with both. The three basic tenets of ethics should also be applicable to patients spouses, family members, community and society. There is a need for provision for anti-discrimination. No person should be discriminated in education, employment, housing, travel or any community services or benefits on the ground of his or her HIV positive status. Here too, dissemination of information and imparting correct knowledge may be more beneficial than a legislative measure alone which is implemented infrequently.

The one legislative measure urgently needing enforcement concerns mandatory screening of all blood donors of HIV and hepatitis B virus, irrespective of whether they belong to the category of professional/paid or voluntary donors. This intro- duces an ethical issue regarding 'informed consent' of these donors. It should not be difficult to ensure that every donor is made aware that HIV screening will be done routinely before the blood can be accepted for transfusion. The condition for compulsory testing should be incorporated while giving licences to all blood banks including the vast number of small, private ones.

There should be appropriate and, if necessary, separate legislation regard- ing manufacture of blood products including mandatory testing of their paid donors. At the same time, techni- cal recommendations made by the national authority should be scientifi- cally and technically sound and equiva- lent to the international standards. There is also a need to encourage and support manufacture of indigenous products of good standard quality. Many of these are required continuously for the survival of patients suffering from blood disorders, such as haemophilia and thalassaemia.

Dilemmas arise in blood banks and hospital services. In blood banks, the ethics regarding disclosure of HIV status to the respective blood donors is, as a rule, not followed. The reason is that a single ELISA reactive blood unit is descarded without confirmation. In views of this somewhat incomplete testing (with the main objective of safety of recipients in mind) no donor is informed for the fear that the result might be 'false positive' and may create unnecessary panic in a truly uninfected individual. If, however, the person is in fact infected, but is not informed, he/she may continue unsafe sexual practices and may add to the chain of transmission. 'To tell or not to tell' is indeed a dilemma. If a patient refuses to inform his/her spouse of his/her HIV-seropositive status, should the doctor do so, thus breaking 'confidentiality' or, should he remain silent and thus place the other partner at risk?

Yet another dilemma in hospital emergency services confront doctors. After large-scale accidents or due to emergency requirements to treat severe bleeding (during delivery or some surgery), unexpectedly large number of blood units may be required. A situation may arise leaving no time for screening of blood donors. Should a doctor give unscreened blood with a potential danger to the recipent, or should he play safe and refrain from transfusion of unscreened blood? What order of priority should he/she allot between requirements of those who are HIV-infected and those who are not? This and many such dilemmas will increasingly face our doctors who will have to play God.


What Is Pessary, How to Insert, Precaution in Insertion and When to Insert

Pessary :

Some birth control counsellors ignore the condom and advise the use of the pessary, but the pessary is secondary to the condom as a contraceptive. The pessary should be used only as a last resort. The pessary is a metal ring covered with a film of rubber far thicker than the condom rubber. Yet, it does not affect the sex feeling because it merely covers the cervix.

How to Insert Pessary :

(1) Press the rim of the pessary to an oblong shape with the thumb and bend middle finger and hold a stretched index finger along the length of the rubber part so that the finger tip is set against the metal rim. It may difficult as the beginning to place the index finger within the rim but this can be achieved with practice.

(2) Place one foot on a low stool (left foot for righthanded person) and lean slightly forward. Sprea the vulva wide open with the left hand, insert the Pessary (with rubber face against vagina's upper wall) until the thumb prevents further insertion, then twist the hand so that the palm faces up. At the same time, press the rubber face flat against the vagina's front wall and push as far in as possible.

(3) Release the thumb and push the pessary in deeper in the direction of the arrow (toward anus), while firmly holding the rim with the tin of the index finger and pressing the finger against the vagina's rear wall.

 

 

(4) Stretch out the middle, ring and little fingers in a way to cover the anus with them, and while still holding the index finger's tip against the ring and pressing the finger against the vagina's rear wall, push the pessary further in toward the anus. Now, most of the pessary is in the vagina. Any part of it remaining outside may be pushed in by pinching that part with thumb and index finger and pushing it in while turning the rings. Finally, using the index finger, while pushing the outermost part of the rim inward, push it up (in the direction of the arrow) and hook it onto the inside of the pelvic bone (depression in vagina's front wall)
Insert the index finger once more into the vagina to check whether the pessary is properly placed on the cervix. Also move the index finger over the rim of the pessary to see whether it is evenly inserted. If not raise or lower the rim to straighten it.

Precaution in Insertion :

When to Insert - It is not advisable to insert the pessary immediately prior to intercourse as it destroys the mood. A wife should predict intercourse and insert it in advance.

Use Jelly :

Both the inside and outside of the pessary and the rim should be coated with jelly before insertion. After its removal the pessary should be washed up with soap in lukewarm water, wiped dry, powdered liberally and stored for future use. The pessary should be used only after consultation with a physician and after receiving a physical examination. Repeated use of the pessary and jelly may result in vaginal inflammation.


Sexual Intercourse

The word sex itself is confusing. Even though its a small word, sex has a lot of meanings. In its most basic meaning, sex simply refers to the different bodies males and females have. There are lots of differences between male and female bodies. The most obvious is that males have a penis and a scrotum, and females have a vulva and a vagina. These body parts, or organs, are called sex organs. People have either male or female sex organs and belong to either the male or female sex. The word sex is also used in other ways. We may say that two people are having sex.

The word sex is also used in other ways. We may say that two people are having sex. This usually means they are having sexual intercourse. As we'll explain later in this chapter, sexual intercourse involves the joining together of two people's sex organs. Intercourse between male and a female is also how babies are made. We may say that two people are 'being sexual with each other'. This means they are having sexual intercourse or are holding, touching, or caressing each other's sex organs. We may say that we are feeling sexual. This means that we are having feelings or thoughts about being sexual with another person.

Our sex organs are private parts of our bodies. We usually keep them covered. We don't talk about them in public very often. Having sexual feelings and being sexual with someone aren't usually classroom ropics either. If I had half a brain in my head, I would have thought about all this before my first class. I would have realized that coming into a class room and talking about sex, penises, and vaginas was going to cause a big commotion. After that first class, I caught on real quick. I decided that, if we were going to get all silly and giggly, we might as well get really silly and giggly. Now I start my classes and workshops. I also give everyone red - and blue - coloured pencils.

The sex organs on the outside of the body in a grown man and a grown woman you can see in the image. These sex organs are also called the genital, or reproductive organs. We have sex organs on both the inside and outside of our bodies. They change as we go through puberty.


Target Groups and Modules for IEC

 

In CARC Calling of Jan-March, 1990, Dr. Indira Kapoor the then Director, Government of India, Family Welfare and Research Centre in Bombay, presented a very useful outline ragarding education and counselling for AIDS prevention. Four major target groups were identified and modules were proposed for each group separately. These are not only informative but extremely useful in the present context. Therefore, they are reproduced in Tables A, B, C, D, E and F Hereunder.

 

 

TABLE – A

GROUP 1 : PROFESSIONAL GROUPS

Type of group (professional groups/key trainers : medical, paramedical and non-medical)

Objectives (specific objectives will depend on the role in the field of AIDS preventive education as each discipline is a separate one and has specific job responsibility)

Stress on (content details of groups would differ from one discipline to another)

Persons/groups

responsible-trained key-trainers from

Methods of training

Doctors (Including G.P.s and family physicians.)

- Nurses

- Dentists

-Lab. Technicians

- Para-medical workers

- Traditional healers

- Traditional dais and midwives

- Social workers

- Teachers

- Committed voluntary workers

- Youth leaders

- Religious leaders

- Others

The main objectives can be :

1 To have in-depth orientation on cause, spread and prevention of AIDS and related diseases.

2 To develop positive attitude towards HIV/AIDS patients, so as to ensure their proper care.

3 To understand psycho-social aspects of human sexuality

4 To sensitise and educate clinicians to the effectiveness and benefits of counselling

5 To be able to act as a successful key-trainer for providing preventive AIDS education to other groups.

6 Ability to discuss sexual matters in a frank and unembarrassed manneer.

7 To develop non-judgemental attitudes

8 to impart complete and full knowledge about use and advantages of sex education in prevention of veneral diseases/STDs

9 To have basic skills in communication and counselling

10 To understand the fact that prevention is a public health problem and needs multi-pronged attack by all disciplines and at all levels

General (for all)

1 Skills to handle HIV+ve/AIDS cases with compassion, care and understanding.

2 Understand the psycho-social aspects in counselling AIDS patients.

3 Types of sexual behaviour

4 Range of normality in sexual behaviour

5 Psychological aspects of abnormal sexual behaviour

6 Guidelines on safer sex

7 Issues of confidentiality

8 Blood transfusion only in absolute need

9 Pre-and post-test counselling

Medical & Paramedical group:

1 Recognise clinicaql symptoms

2 Take sensible precautions when treating AIDS patients

3 To follow proper sterilisation procedures when giving injections

4 Prevention of accidental spread- self and others.

Non-medical :

1 Promotion of counselling skills.

2 Greater awareness of how behaviours are changed.

3 Rehabilation of patients

4 Dealing with the un-infected spouse

- Medical college faculty

- Hospital and clinic administrators

- Private practitioners and family physicians

- Staff of other training institutes, e.g. Nursing and social science institures. Any committed voluntary agency/workers

- Para-medical and non-medical health workers

- Medical and social science staff of blood banks

- Medical and social science staff of factories and industries

- Medical and social science staff in Dept. Of Tourism

- Medical and social science staff in hotels

* Lecture discussion with video films, filmstrips and slides.

*Seminars.workshops

* Case history discussion

* In-service orientation training with skill demonstration for specific objectives

* Special manuals on AIDS and HIV

 

 

 

 

TABLE – B

Group 2.1 : GENERAL POPULATION

 

Type of groups (adult population)

Objectives

Stress on (for effective prevention, parents must be reached before and after they become parents)

Persons'groups responsible-trained, key-trainers from

Methods of education

- Young population

- Parent groups

- Community groups

- Religious leaders

1 To provide full knowledge about STDs including, AIDS, its spread, prevention and type of morbidity

2 Change the attitude of social stigma attached to STD

3 To understand the dangers of promiscuity in sexual life

4 To increase knowledge about safer sex and use of condoms

5 To demand use of sterile needles, syringes when receiving injection and/or blood transfusion

6 To avoid tattooing and scarification, if instruments not properly sterilised

7 To understand and appreciate the need for sex education for younger population

8 To understand the necessity of regular health check-ups with investigations

1 Advantages of happy married life and its positive effects as role-modelling for adolescents and teenagers in the family

2 Regular and corrrect use of condoms

3 Advantages of a monogamous relationship

4 Dangers of self medication, treatment with spurious drugs

5 Dangers of casual sexual

encounters

6 Motivate for sex education to younger group

7 Importance of selected antenatal blood test in pregnant mothers

- Welfare agencies

- Mahila Mandals

- Government Agencies

- Responsible citizens

- Religious organisations

- Counselling agencies and centres

- Social clubs

- Health and welfare organisation

- Family physicians and general practitioners

* Mass media, T.V., radio, newspaper, films, etc

* Public lectures

* Informative discussion and talks in small groups with relevant audio visuals

* Small informative booklets and leaflets

* Posters for awareness

* Individual guidance with audio-visual aids

 


Sex and You - Sexual Instinct Dominates Life

The two basic most powerful instincts of all forms of life are self-preservation and reproduction. We are all well aware of the intense and all-powerful urge for life. Man will undergo any suffering or sacrifice in order to continue to live. Even the very old and feeble  hold on to life desperately. The other instinct, the instinct of reproduction, is not always so frankly and honestly acknowledged. The belief in sex as a mysterious, dynamic and all-pervading force of life has its protagonists as well as opponents. Some deny or denounce it completely. Some religious, cultures and self styled "moralists' have tried to belittle sex and make men and women feel ashamed about teh sexual side of life. In modern India, for example, the word sex is not considered a respectable word and is not mentioned in plite society. Any display, mention or reference to sex in mixed company is considered vulgar and is frowned upon.

From a strictly biological point of view sexual intercourse is nature's method for the continuance of life. It is necessary in life is to continue. Sexual reporduction is an advanced step in the evolutionary scale. The simplest forms of life reproduce through the fission method, where the object grows and divides itself into two and continues to multiply endlessly in this manner. Without the sexual act all forms of higher life could not be reproduced and would abruptly come to an end. To ensure reproduction nature has made sexual intercourse the most exciting and pleasurable experience of life.

Sexual Instinct Dominates Life :

The influence, dominance and constant pressure of the sexual instinct on our daily life is all-pervading. Man's preoccupation with woman is almost total. All advertising and display designed to attract attention chiefly employ the female figure for appeal. We are constantly aware and responsive to the opposite sex. The greatest single determining factor in human life is sex. Our actions from infancy to old age are dominated and motivated by it. Those who attempt to ignore teh sexual side of life when dealing with the subject of life as a whole cannot be honest. It would be an attempt to bypass the most vital force affecting and influencing life, simply because it is a difficult and delicate subject. Sex is not only the most  initimate and vital aspect of human life, it can be equated with life itself. Sex is the source of life.

Sexual attraction is the healthy urge which a member of one sex feels for a normal, healthy member of the opposite sex. The act of reproduction can take place between any two normal members of the opposite sex. Nature has done a perfect job in making the sexes alive, aware and ever conscious of each other. The magic of the sexes is strong, exciting and irresistible. There is no bliss greater than the all-powerful union between man and woman. There is no pleasure so eagerly sought after by man as union with a beautiful, loving woman.


The Male Sex Organs, Circumcision

The Male Sex Organs :

Once everyone has copies and colored pencils, I hold up the picture of the male sex organs. I tell the class that the sex organs on the outside of a man's body are the penis and the scrotum. The kids in my class still giggle like mad or fall off their chairs in ambarrassment, but I don't pay much attention. Using my vest kindergarten Lady voice, I say, "The penis itself has two parts: the shaft and the glans. Find the shaft of the penis and color it with blue and red stripes.'' Now everybody gets very intent on the coloring. Some are still giggling, but they do start coloring. Why don't you color the shaft in, too? (Unless, of course, this book belongs to someone else or to a library. One of the people we most admire is a librarian. We would be in very got water if labrarian thought we were telling people to color library books.)

Next I ask the class to find the small slit at the tip of the penis and circle it in red. This is the urinary opening. It is the opening through which urine leaves the body. There's usually less giggling by now. The urinary opening is small. The class has to pay more attention to the coloring. Then we color in the glans itself. I usually suggest blue, but color it any way you want. "Red and blue polka dots for the scrotum,'' I tell my class next. The scrotum is a loose bag of skin that lies beneath the penis. Scrotal sac is another name for the scrotum. Inside the scrotum are two egg-shaped organs called testes, or testicles. Then, I explain that the curly hairs on the sex organs are public hairs. I have the class color them as well.

Finally, we come to the anus. This is the opening through which feces (bowel movements) leave our bodies. The anus isn't a reproductive organ. But it's nearby, so you might as well color it, too. By the time the class has colored in the different parts, I've said the word "penis'' out loud about twenty-eight times. Everyone is used to my saying this and other words that aren't usually said out loud in classrooms. My students no longer have to go crazy each time I use these words. Besides, the pictures look funny. Everyone is laughing. Laughter makes it easier to deal with embarrassed or nervous feelings.

Circumcision

Circumcision is an operation that removes the foreskin of the penis. The foreskin is part of the special skin covering of the penis. The operation is usually done when a baby is only a few days old. Most males in this country have been circumcised. But there are also many that still have their foreskins. If a boy has not been circumcised, his foreskin covers most or all of the glans. When a male baby is born, the foreskin and glans are usually attached. sooner or later, the foreskin works itself free. By the time a boy becomes an adult, if not sooner, he can retract the foreskin. This means he can pull it back over the glans and down the shaft of the penis. You may be wondering why people have their sons circumcised. Maybe you have other questions about the operation. If so, you'll find more information about circumcision in further articles.


Limitations of Homosexuals

The homosexual isindeed a pathetic figure. His awareness and appreciation of the beauty and magic of the opposite sex and his ability to participate in the act of procreating life is lost. The wonder and joy of the opposite sex is denied to him. In their frustrations and inadequacy, homosexuals turn upon their own kind seeking an unnatural outlet for the sexual instinct. The perversions and tyranny of the instinct of sex are frightening and degrading. Sex is perhaps the greatest provacator of human emotions. When this powerful instinct is warped it causes the most awful abberations in human nature.

There are some basic facts that we need to understand about sex. The instinct is exceedingly powerful and begins to make its presence felt very early in life. Science has not yet been able to identify the exact age of the awakening of this instinct, but all indications point to the fact that sexual awareness comes almost at birth. By four the instinct is sufficiently pronounced and by the age of puberty it is well developed. The problems and pressures of sex are very complex and disturbing during the adolescent period and guidance and help available at this time is usually insufficient understanding and control to guide the instinct. They usually face these bewildering days alone. Many mistakes are made during this period which may seriously curtail its fullest enjoyment.

Sex is generally associated with youth and most people believe that between 14 to 24 years one experiences the most intense passion. But actual studies disprove this simple belief. It has been found that human beings have a lifelong capacity to enjoy sex and it is most satisfying during the years 23 to 55. With skill, technique and proper control the enjoyment of sex can even be anhanced during the later years of life. Sexual practices which interfere with the reproductive process are biologically unsound and harmful. Monks, nuns, spinsters, bachelors, and permanent homosexuals are all, in a reproductive sense, aberrrant. Society has bred them, but they have failed to return the compliment. A study of the celibate population in France showed that their mortality rate was nearly double that for married people. There were twice as many in asylums and hospitals as patients. Celibacy evidently creates problems, both for the individual and the state.

In our times there seems to be an unseemly interest in sex. It has become the hottest selling product. Sex-charged literature and pornographic material find the best market. A wild, promiscuous wave seems to be sweeping the world and all are secretly enjoying this new freedom and titilation. In a way it is right, for too long sex has been shrouded in mystery and sin. A young person speaking enthusiastically on the subject said that sexual freedom is a very unique achievement of modern times. For the first time man has been able to overthrow sexual inhibitions and is free to enjoy and indulge his greatest and most powerful urge.

This generation would be naive to believe that it has discovered something new and wonderful about sex, unknown and untried by all the generations before. The freedom, abandon, promiscuousness, lasciviousness and perversions of sex in all possible forms have all been practised before. Out generation cannot claim any frame or originality in this matter. The blatant exploitation of sex in the balmy days of teh mighty Roman empire are too well-known. The orgies of sex, its enjoyment and exploitation reached giddy heights during the days of the Roman empire. People still remember with wry amusement the sexual abandonment of the people of Sodom and Gammorah and the story in the book of Joshua of how, when the two angels visited the city, the people lusted after them. Poor Lot offered his beautiful virgin daughters to the crowd so that they may spare the angels.

In Greece the beauty, grace and worship of the perfect body reached its zenith. Greek sculptures of the human body are still unsurpassed in their beauty and perfection. The theme of sex and its appreciation and enjoyment attained an all time high in ancient India. The carvings in the temples of Bhubaneshwar, Puri and Khajuraho are breathtaking in their boldness, zest and abandon. The sheer beauty, grace and variety of sexual poses and modes of intercourse in life size figures is shocking and exciting in its daring display. And yet there is a beauty and dignity in all these daring poses which leaves one profoundly impressed.

The enjoyment and bold participation in sex which ancient India achievfed as depicted in his temple sculpture of some thousands of years cannot be easily surpassed. Sex play and love-making became a highly developed art. Ancient India literature such as the Kama Sutra, Kokshastra, Kama Kalpa and Ananga Rana are recognised the world over as the most exhaustive literature on sex. These writings study the subject of sex with a thoroughness and scientific detachment which the Western sexologist has not yet displayed.

 

The popular modern western literature on sex often over-emphasises the mechanics of the sexual act. The Hindu literature and sculpture on love and sex is exceedingly rich and wide. Vatsyayana, the great Hindu mystic and author of the famous Kama Sutra, the treatise on sex, maintained that sex is an essential as food for the happiness and well-being of man and woman. He considered sex the greatest gift of God and gave detailed instructions and guidance for its full and proper use.


Some Slang Words for the Penis and Testicles

I have another reason for getting the kids to color these drawings. It helps them to remember the names of these organs. If you just look at the drawings, the names of the parts may not stick in your mind. If you spend time coloring the parts, you have to pay attention. You're more likely to remember their names. These are important parts of the body. It's worth a little effort to learn their names. While everyone is coloring, we talk about slang words. People don't alwats use the medical names for these body parts. They sometimes use slang words.

The boys in the back row of my very first puberty class were walking dictionaries of slang. Whenever I said "penis'' or "vagina'' out loud, their brains would buzz and hum with dozens of slang words. It was too much for them to keep to themselves. Leaning out of their seats, they flapped their arms, playfully punching each other. Gleefully, they whispered these "bad'' words out loud proved into fits of wild giggling. Some of them were actually rolling around on the floor. Soon, the entire class was totally out of countrol. "Maybe,'' I thought, "I'm not cut out for this line of work.''

I might have given up teaching puberty classes then and there, but I had a sudden brainstorm. I turned to the blackboard and started to list all the slang words that were flying around the classroom. I encouraged the whole class to add to the list. Soon the blackboard was covered with slang words, and the clas was calm enough for us to go on. I'm not exactly sure why this works, but over the years, I've learned that it does. The best way to keep these words from disrupting the class is to bring them right out in the open. So while we're coloring, kids call out slang words and I list them on the blackboard. Here are some of them:

                Some Slang Words for the Penis and Testicles

Penis :

cock           peter        tool
dick            dong        frankfurter
prick           dingus     thing
schlong      dork         pecker
wee-wee    meat        dinky
wanger       pisser      penie

Testicles :

balls           cujones
nuts            things
eggs           bangers
rocks          hangers
jewels         stones
cubes         seeds
After we've listed them on the board, the class talks about these slang words. We discuss which words we'd use with a friend, with a doctor, or with our moms. We also talk about people's reactions to slang words. Some prople object to these words. They may get upset if they hear you using them. You may or may not care about upsetting people in this way. But you should at least be aware that many people find slang words offensive.


Phalic Worship

Sex worship has been practised in many ancient cultures and religious and one can easily understand the reason for it. Sex creates and maintains the continuity of life. The sexual instinct is considered to be the evidence of the vast creative power which sustains the universe. According to the Puranas, the sacred writing of ancient India, the Supreme Being, when creating human beings, split himself into two, thus becoming male and female. The phallus is the symbol of life and creativity and in many ancient and modern temples all over India lingam (phallus) worship is freely and reverently practiced. The idol is made in the shape of a low pillar supported in a round shallow base, depiciting the divine male and female organs in union.

There is nothing indecent or crude about phallic worship and no promiscuity or sexual activity is attached to the ceremony. The lingam worshippers are a pure and pious Hindu sect. Sexual symbolism in devotion is not, howeverm peculiar to the Hindu. The Songs of Solomon in the Bible abound in sexual symbolism and graces of the beloved's neck, breasts and thighs. Christ is considered the Divine Bridegroom and the Church is bride. The mystics of Islam, the Sufis, display the same preoccupa- tion with sex in their devotional concepts.

Several schools of Hindu thought believe that an erotic sentiment is a necessary part of devotional worship. Lord Krishna, one of the most powerful deities of the Hindu pantheon is known as the God of Love. Some of the most memorable incidents about him tell of his escapades with the gopis. Women found him totally irresistible. He is described as a very habdsome person with a strong and beautiful body. Lord Krishna taught his followers that a well lived worldly life is more noble than renunciation and asceticism. The present western interest in the Krishna cult is significant.

Sex has played a glorious and turbulent role in human affairs and will continue to do so. Some sincerely believe that the forbidden fruit of life was sex. Our age and time has not discovered anything new. In fact, we are going back to many practices which were used thousands of years back and were abandoned because they did not promote human happiness and welfare. The relationship of man and woman is complicated by the extreme intensity of their sex instinct. If the quality and complexity of human sexuality is understood better, we are better able to manage and enjoy it.


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