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Male impotence, or erectile dysfunction, is the inability to maintain an erection for a long enough time to have sex. A man who suffers from impotence may be unable to have an erection altogether, be unable to maintain it for more than a short period, or may be able to have an erection sometimes and not at other times. Approximately 10 to 15 million American men suffer from some form of impotence. The good news is that it is easy to understand and can be treated in all age groups.
To understand impotence, it helps to have a basic understanding of how an erection happens. The penis has a large amount of spongy tissue, through which blood vessels run, and some muscle. When a man is sexually stimulated through touch or mentally, nerve signals trigger a flow of blood from arteries into the spongy tissue in the penis. This tissue becomes engorged, making the penis erect. When an erection subsides, muscles in the penis contract, effectively squeezing the blood of the spongy tissue through veins. If there is any interference with the nerve signals or blood flow that cause an erection, impotence may result.
In the majority of cases, male impotence has an underlying cause. Diseases like diabetes, alcoholism, and kidney disease may affect both nerve signals and blood flow. Surgery or injuries to the bladder, prostate, and male urethra may cause nerve damage. Cardiovascular disease or other diseases of the blood vessels may interfere with blood flow. Nerve signals may be altered due to psychological reasons including anxiety and stress.
How does one deal with impotence? Going to a doctor is the first step, because this may help identify an underlying medical condition that should be treated. Exercise may reduce impotence in older men. Other lifestyle changes, such as quitting smoking and losing weight may also help.
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A Radical Prostatectomy is a major operation which entails the removal of the prostate gland, a section of urethra which runs through the prostate, the seminal vesicles, and tying-off the vas deferens, along, generally with a margin of other tissue surrounding the gland. The bladder has to be 'purse-stringed' back down in order to reattach the urethra, and an 'anastomosis' is created at that point. The surgery generally destroys one of the sphincter muscles which control urinary retention, and incontinence is a common side effect, along with the impotence created by the removal of the erectile nerves, and possible injury to any remaining nerves, as well as penile arteries and other musculature. It takes a fairly long recovery period before any normalcies return.
Because the prostate is what produces the semen, losing ejaculatory capabilities is a given for this surgery, and possibly the TransUrethral Resection of the Prostate (TURP), or TransUrethral Needle Ablation of the Prostate (TUNA) procedures as well. Those are done by going in throught the end of the penis, and are far less impacting, and much more minor procedures than the radical operation.
The general understanding is that the term "radical" is employed when cancer is present. In rare cases, open prostatectomy is conducted for BPH, the benign enlargement of the prostate that interferes with urnination. It is my understanding that open proastatectomy for BPH is only done when the prostate has grown to an abnormally large size and TURP would be dangerous.
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Viagra is now not the sole cure to impotence. A number of medications have come up that claim to curb this disease called erectile dysfunction. These drugs belong to the class of PDE-5 inhibitors. The drugs promise effects like increased blood flow to the penis and better penis enlargement. Some even claim to be herbal. All these medicines act in different ways to heighten the sexual pleasure.
Impotence occurs when the male is unable to sustain the erection long enough to enjoy the sexual intercourse. In some cases, it is difficult even to achieve an erection. This condition can be caused due to a physical injury or due to a psychological trauma. The shock affects the nerves and reduces the blood flow in the penis.
Levitra is one of the drugs that help to control this disorder. This FDA approved drug has been tested on thousands of men in about fifty clinical trials. The results were positive and showed that the medicine could treat diabetes and prostrate cancer as well. However, the drug also causes certain side effects. The most common reactions are headache, flushing and a runny nose, but all the reactions are mild and disappear quickly. Some uncommon but dangerous effects can be a prolonged erection that continues for hours together and inability to differentiate between the colors blue and green.
Levitra works in a simple manner. It relaxes the muscles and the blood vessels in the penis, thereby inducing an erection. The drug has to be taken orally once a day. One dosage produces an erection long enough for the patient to have sexual intercourse. An important fact to know about the drug is that it does not stimulate sexual urges, nor does it cause an automatic erection. The patient still needs to have a sexual arousal before achieving an erection. It is also not a permanent cure for impotence. The effect of the drug subsides after the intercourse.
Levitra is said to be better than its predecessor Viagra. Another such drug is Cialis. The effect of this drug is supposed to be strong enough to last for 36 hours at a stretch.
The advent of these drugs has proved to be a boon to the victims of erectile dysfunction. The drugs were such a breakthrough, that they earned their inventors a Noble Prize. A prescription is required to purchase these drugs. Prescriptions can also be filled on websites and the drugs bought through online medical stores. A relevant question here is how long can a person thrive on these drugs. It is advisable to consult physicians for frequent usage of the drugs. One can also go for other surgical treatments like penile injections and vacuum tubes.
The condition of erectile dysfunction is hard to cure. The PDE drugs have a made a difference to millions of sufferers. While some enlarge the penis and others relax muscles, the effect of these drugs is the same. An important thing to note is that the advent of these drugs is fairly recent and the long term effects are unknown.
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The common term frequently used for conjunctivitis is "pink eye." However, this term is only properly used to refer to conjunctivitis which is caused by a viral infection of the eye. What we will target here is allergic conjunctivitis, its causes, and some treatments.
Allergic conjunctivitis is caused when the mast cells (part of the body's immune system) in the eye react to allergens which the body's immune system deems to be foreign to one's body. There is a large number of mast cells in the eyes, which makes them a common location for these types of allergic reactions.
The allergic reaction causes a release of histamines, which is the immune system's way of counteracting the allergen. What follows is enlargement of the blood vessels in the conjunctiva (a thin membrane which covers the white of the eye and the inside of the eyelid).
Symptoms of allergic conjunctivitis may include, but are not limited to, slight swelling of the area around the eyes, redness, itching, and tearing (crying). One may also experience nasal symptoms such as congestion, sneezing, runny nose, and itching. While other forms of conjunctivitis may affect only one eye, the allergic form generally manifests itself in both eyes.
There are five different types of allergic conjunctivitis. These are:
1. Seasonal Allergic Conjunctivitis (SAC): This is the most common type of the five listed here. It usually occurs when the seasons change and is caused by airborne allergens such as tree, weed, and grass pollens, as well as many different types of mold. Quite often those who suffer from this eye affliction also have allergic rhinitis, also know as "hay fever." This is often the source of SAC.
This form of allergic conjuntivitis can be treated with over-the-counter (OTC) medications, as well as prescriptions.
2. Perennial Allergic Conjunctivitis (PAC): PAC can occur year-round and is frequently cause by pet or animal dander, dust mites, feathers, and other like substances. Although this form of conjunctivitis can occur all year long, the symptoms may be more severe during seasonal changes. The symptoms are very similar to those of the seasonal form.
Again, this type of allergic conjunctivitis can be treated by OTC and prescription medications. One may also avoid pet/animal dander and feathers to lessen the chances of "attacks." The use of an air purifier indoors can also provide relief from irritants which may cause this allergic reaction.
Although untreated bouts of seasonal or perennial allergic conjunctivitis rarely lead to long-term complications, they can cause serious problems with other parts of the eye. One can develop an inflammation of the iris, or colored part, of the eye. Please seek appropriate treatment for both of these
3. Vernal Conjunctivitis: This a chronic form of conjunctivitis which occurs most frequently during the spring and fall seasons. It can cause permanent damage to one's vision, making it one of the two most dangerous forms of allergic conjuntivitis.
Vernal Conjunctivitis is more likely to occur in males than females, and has both allergic and non-allergic forms. An eye-care speciaist who also specializes in allergies should be able to pinpoint and treat this form of conjuntivitis most effectively.
4. Atopic Keratoconjunctivitis: This is a form of allergic conjunctivitis which is associated with atopic dermatitis (also known as eczema) of the eyelids and face. The symptoms include those of seasonal and perennial allergic conjunctivitis, as well as a stringy or ropy discharge from the eyes.
This form of allergic conjunctivitis first manifests itself most frequently in persons in their teens and early 20's. It may also occur in persons who have a history of allegies, especially allergic rhinitis and/or asthma.
As with Vernal Conjunctivitis, Atopic Keratoconjunctivitis left untreated can cause permanent damage to one's eyes.
5. Giant Papillary Conjunctivitis: This form of allergic conjunctivitis is most frequently associated with the use of contact lenses. It is believed to be caused by an allergic reaction to proteins which may adhere to the surface of the lenses, prosthetic devices used for the eye, or sutures used in eye surgery.
The indications of this form of allergic conjunctivitis can be bumps which occur on the insides of the eyelids. It may also have non-allergy related causes.
These last three types of allergic conjunctivitis are best treated by an eye-care specialist. It is not advisable to treat these with any OTC products unless so advised by your physician.
In fact, it is best to consult a physician or specialist before treating any eye affliction with O-T-C medications. While they may provide short-term relief, it is not always wise to treat one's eyes without first knowing the exact cause of the allergic conjunctivitis, and the most effective and safest form of treatment. Misuse of OTCs can cause other eye ailments or damage which may or may not be reversible. So always consult the appropriate health care professional before treating yourself.
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Alan Pease, author of a book titled "Why Men Don't Listen and Women Can't Read Maps", believes that women are spatially-challenged compared to men. The British firm, Admiral Insurance, conducted a study of half a million claims. They found that "women were almost twice as likely as men to have a collision in a car park, 23 percent more likely to hit a stationary car, and 15 percent more likely to reverse into another vehicle" (Reuters).
Yet gender "differences" are often the outcomes of bad scholarship. Consider Admiral insurance's data. As Britain's Automobile Association (AA) correctly pointed out - women drivers tend to make more short journeys around towns and shopping centers and these involve frequent parking. Hence their ubiquity in certain kinds of claims. Regarding women's alleged spatial deficiency, in Britain, girls have been outperforming boys in scholastic aptitude tests - including geometry and maths - since 1988.
On the other wing of the divide, Anthony Clare, a British psychiatrist and author of "On Men" wrote:
"At the beginning of the 21st century it is difficult to avoid the conclusion that men are in serious trouble. Throughout the world, developed and developing, antisocial behavior is essentially male. Violence, sexual abuse of children, illicit drug use, alcohol misuse, gambling, all are overwhelmingly male activities. The courts and prisons bulge with men. When it comes to aggression, delinquent behavior, risk taking and social mayhem, men win gold."
Men also mature later, die earlier, are more susceptible to infections and most types of cancer, are more likely to be dyslexic, to suffer from a host of mental health disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), and to commit suicide.
In her book, "Stiffed: The Betrayal of the American Man", Susan Faludi describes a crisis of masculinity following the breakdown of manhood models and work and family structures in the last five decades. In the film "Boys don't Cry", a teenage girl binds her breasts and acts the male in a caricatural relish of stereotypes of virility. Being a man is merely a state of mind, the movie implies.
But what does it really mean to be a "male" or a "female"? Are gender identity and sexual preferences genetically determined? Can they be reduced to one's sex? Or are they amalgams of biological, social, and psychological factors in constant interaction? Are they immutable lifelong features or dynamically evolving frames of self-reference?
Certain traits attributed to one's sex are surely better accounted for by cultural factors, the process of socialization, gender roles, and what George Devereux called "ethnopsychiatry" in "Basic Problems of Ethnopsychiatry" (University of Chicago Press, 1980). He suggested to divide the unconscious into the id (the part that was always instinctual and unconscious) and the "ethnic unconscious" (repressed material that was once conscious). The latter is mostly molded by prevailing cultural mores and includes all our defense mechanisms and most of the superego.
So, how can we tell whether our sexual role is mostly in our blood or in our brains?
The scrutiny of borderline cases of human sexuality - notably the transgendered or intersexed - can yield clues as to the distribution and relative weights of biological, social, and psychological determinants of gender identity formation.
The results of a study conducted by Uwe Hartmann, Hinnerk Becker, and Claudia Rueffer-Hesse in 1997 and titled "Self and Gender: Narcissistic Pathology and Personality Factors in Gender Dysphoric Patients", published in the "International Journal of Transgenderism", "indicate significant psychopathological aspects and narcissistic dysregulation in a substantial proportion of patients." Are these "psychopathological aspects" merely reactions to underlying physiological realities and changes? Could social ostracism and labeling have induced them in the "patients"?
The authors conclude:
"The cumulative evidence of our study ... is consistent with the view that gender dysphoria is a disorder of the sense of self as has been proposed by Beitel (1985) or Pfäfflin (1993). The central problem in our patients is about identity and the self in general and the transsexual wish seems to be an attempt at reassuring and stabilizing the self-coherence which in turn can lead to a further destabilization if the self is already too fragile. In this view the body is instrumentalized to create a sense of identity and the splitting symbolized in the hiatus between the rejected body-self and other parts of the self is more between good and bad objects than between masculine and feminine."
Freud, Kraft-Ebbing, and Fliess suggested that we are all bisexual to a certain degree. As early as 1910, Dr. Magnus Hirschfeld argued, in Berlin, that absolute genders are "abstractions, invented extremes". The consensus today is that one's sexuality is, mostly, a psychological construct which reflects gender role orientation.
Joanne Meyerowitz, a professor of history at Indiana University and the editor of The Journal of American History observes, in her recently published tome, "How Sex Changed: A History of Transsexuality in the United States", that the very meaning of masculinity and femininity is in constant flux.
Transgender activists, says Meyerowitz, insist that gender and sexuality represent "distinct analytical categories". The New York Times wrote in its review of the book: "Some male-to-female transsexuals have sex with men and call themselves homosexuals. Some female-to-male transsexuals have sex with women and call themselves lesbians. Some transsexuals call themselves asexual."
So, it is all in the mind, you see.
This would be taking it too far. A large body of scientific evidence points to the genetic and biological underpinnings of sexual behavior and preferences.
The German science magazine, "Geo", reported recently that the males of the fruit fly "drosophila melanogaster" switched from heterosexuality to homosexuality as the temperature in the lab was increased from 19 to 30 degrees Celsius. They reverted to chasing females as it was lowered.
The brain structures of homosexual sheep are different to those of straight sheep, a study conducted recently by the Oregon Health & Science University and the U.S. Department of Agriculture Sheep Experiment Station in Dubois, Idaho, revealed. Similar differences were found between gay men and straight ones in 1995 in Holland and elsewhere. The preoptic area of the hypothalamus was larger in heterosexual men than in both homosexual men and straight women.
According an article, titled "When Sexual Development Goes Awry", by Suzanne Miller, published in the September 2000 issue of the "World and I", various medical conditions give rise to sexual ambiguity. Congenital adrenal hyperplasia (CAH), involving excessive androgen production by the adrenal cortex, results in mixed genitalia. A person with the complete androgen insensitivity syndrome (AIS) has a vagina, external female genitalia and functioning, androgen-producing, testes - but no uterus or fallopian tubes.
People with the rare 5-alpha reductase deficiency syndrome are born with ambiguous genitalia. They appear at first to be girls. At puberty, such a person develops testicles and his clitoris swells and becomes a penis. Hermaphrodites possess both ovaries and testicles (both, in most cases, rather undeveloped). Sometimes the ovaries and testicles are combined into a chimera called ovotestis.
Most of these individuals have the chromosomal composition of a woman together with traces of the Y, male, chromosome. All hermaphrodites have a sizable penis, though rarely generate sperm. Some hermaphrodites develop breasts during puberty and menstruate. Very few even get pregnant and give birth.
Anne Fausto-Sterling, a developmental geneticist, professor of medical science at Brown University, and author of "Sexing the Body", postulated, in 1993, a continuum of 5 sexes to supplant the current dimorphism: males, merms (male pseudohermaphrodites), herms (true hermaphrodites), ferms (female pseudohermaphrodites), and females.
Intersexuality (hermpahroditism) is a natural human state. We are all conceived with the potential to develop into either sex. The embryonic developmental default is female. A series of triggers during the first weeks of pregnancy places the fetus on the path to maleness.
In rare cases, some women have a male's genetic makeup (XY chromosomes) and vice versa. But, in the vast majority of cases, one of the sexes is clearly selected. Relics of the stifled sex remain, though. Women have the clitoris as a kind of symbolic penis. Men have breasts (mammary glands) and nipples.
The Encyclopedia Britannica 2003 edition describes the formation of ovaries and testes thus:
"In the young embryo a pair of gonads develop that are indifferent or neutral, showing no indication whether they are destined to develop into testes or ovaries. There are also two different duct systems, one of which can develop into the female system of oviducts and related apparatus and the other into the male sperm duct system. As development of the embryo proceeds, either the male or the female reproductive tissue differentiates in the originally neutral gonad of the mammal."
Yet, sexual preferences, genitalia and even secondary sex characteristics, such as facial and pubic hair are first order phenomena. Can genetics and biology account for male and female behavior patterns and social interactions ("gender identity")? Can the multi-tiered complexity and richness of human masculinity and femininity arise from simpler, deterministic, building blocks?
Sociobiologists would have us think so.
For instance: the fact that we are mammals is astonishingly often overlooked. Most mammalian families are composed of mother and offspring. Males are peripatetic absentees. Arguably, high rates of divorce and birth out of wedlock coupled with rising promiscuity merely reinstate this natural "default mode", observes Lionel Tiger, a professor of anthropology at Rutgers University in New Jersey. That three quarters of all divorces are initiated by women tends to support this view.
Furthermore, gender identity is determined during gestation, claim some scholars.
Milton Diamond of the University of Hawaii and Dr. Keith Sigmundson, a practicing psychiatrist, studied the much-celebrated John/Joan case. An accidentally castrated normal male was surgically modified to look female, and raised as a girl but to no avail. He reverted to being a male at puberty.
His gender identity seems to have been inborn (assuming he was not subjected to conflicting cues from his human environment). The case is extensively described in John Colapinto's tome "As Nature Made Him: The Boy Who Was Raised as a Girl".
HealthScoutNews cited a study published in the November 2002 issue of "Child Development". The researchers, from City University of London, found that the level of maternal testosterone during pregnancy affects the behavior of neonatal girls and renders it more masculine. "High testosterone" girls "enjoy activities typically considered male behavior, like playing with trucks or guns". Boys' behavior remains unaltered, according to the study.
Yet, other scholars, like John Money, insist that newborns are a "blank slate" as far as their gender identity is concerned. This is also the prevailing view. Gender and sex-role identities, we are taught, are fully formed in a process of socialization which ends by the third year of life. The Encyclopedia Britannica 2003 edition sums it up thus:
"Like an individual's concept of his or her sex role, gender identity develops by means of parental example, social reinforcement, and language. Parents teach sex-appropriate behavior to their children from an early age, and this behavior is reinforced as the child grows older and enters a wider social world. As the child acquires language, he also learns very early the distinction between "he" and "she" and understands which pertains to him- or herself."
So, which is it - nature or nurture? There is no disputing the fact that our sexual physiology and, in all probability, our sexual preferences are determined in the womb. Men and women are different - physiologically and, as a result, also psychologically.
Society, through its agents - foremost amongst which are family, peers, and teachers - represses or encourages these genetic propensities. It does so by propagating "gender roles" - gender-specific lists of alleged traits, permissible behavior patterns, and prescriptive morals and norms. Our "gender identity" or "sex role" is shorthand for the way we make use of our natural genotypic-phenotypic endowments in conformity with social-cultural "gender roles".
Inevitably as the composition and bias of these lists change, so does the meaning of being "male" or "female". Gender roles are constantly redefined by tectonic shifts in the definition and functioning of basic social units, such as the nuclear family and the workplace. The cross-fertilization of gender-related cultural memes renders "masculinity" and "femininity" fluid concepts.
One's sex equals one's bodily equipment, an objective, finite, and, usually, immutable inventory. But our endowments can be put to many uses, in different cognitive and affective contexts, and subject to varying exegetic frameworks. As opposed to "sex" - "gender" is, therefore, a socio-cultural narrative. Both heterosexual and homosexual men ejaculate. Both straight and lesbian women climax. What distinguishes them from each other are subjective introjects of socio-cultural conventions, not objective, immutable "facts".
In "The New Gender Wars", published in the November/December 2000 issue of "Psychology Today", Sarah Blustain sums up the "bio-social" model proposed by Mice Eagly, a professor of psychology at Northwestern University and a former student of his, Wendy Wood, now a professor at the Texas A&M University:
"Like (the evolutionary psychologists), Eagly and Wood reject social constructionist notions that all gender differences are created by culture. But to the question of where they come from, they answer differently: not our genes but our roles in society. This narrative focuses on how societies respond to the basic biological differences - men's strength and women's reproductive capabilities - and how they encourage men and women to follow certain patterns.
'If you're spending a lot of time nursing your kid', explains Wood, 'then you don't have the opportunity to devote large amounts of time to developing specialized skills and engaging tasks outside of the home'. And, adds Eagly, 'if women are charged with caring for infants, what happens is that women are more nurturing. Societies have to make the adult system work [so] socialization of girls is arranged to give them experience in nurturing'.
According to this interpretation, as the environment changes, so will the range and texture of gender differences. At a time in Western countries when female reproduction is extremely low, nursing is totally optional, childcare alternatives are many, and mechanization lessens the importance of male size and strength, women are no longer restricted as much by their smaller size and by child-bearing. That means, argue Eagly and Wood, that role structures for men and women will change and, not surprisingly, the way we socialize people in these new roles will change too. (Indeed, says Wood, 'sex differences seem to be reduced in societies where men and women have similar status,' she says. If you're looking to live in more gender-neutral environment, try Scandinavia.)"
