Tuesday, August 19, 2008

Birth Control

What is birth control?

Birth control is any method used to prevent pregnancy. Another word for birth control is contraception (say “kon-truh-SEP-shun”).

If you have sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having periods yet or you are getting close to menopause. Each year, about 85 out of 100 women who don't use birth control have an unplanned pregnancy.

The only sure way to prevent pregnancy is to not have sex. But finding a good method of birth control you can use every time can help you avoid an unplanned pregnancy.

What are the types of birth control?

There are many different kinds of birth control. Each has pros and cons. Learning about all the methods will help you find one that is right for you.

  • Hormonal methods include birth control pills, shots (Depo-Provera), the skin patch, the implant, and the vaginal ring. Birth control that uses hormones is very good at preventing pregnancy.
  • Intrauterine devices (IUDs) are inserted into your uterus. IUDs work very well for 5 to 10 years at a time and are very safe. And the Mirena IUD contains a hormone that can help with heavy periods and cramping.
  • Barrier methods include condoms, diaphragms, and sponges. In general, these do not prevent pregnancy as well as IUDs or hormonal methods do. To help a barrier work better, use it with a spermicide, a chemical that kills sperm.
  • Natural family planning (also called fertility awareness) can work if you and your partner are very careful. You will need to keep good records so you know when you are fertile. And during times when you are fertile, you will need to skip sex or use a barrier method.
  • Permanent birth control (sterilization) gives you lasting protection against pregnancy. A man can have a vasectomy, or a woman can have her tubes tied (tubal ligation). But this is only a good choice if you are sure that you don't want any (or any more) children.

For hormonal or barrier methods to work best, you have to use them exactly the way your doctor or the package instructions say. Even then, accidents can happen. So it is a good idea to keep emergency birth control on hand as backup protection. You can buy “morning-after pills” called Plan B in most drugstores if you are over 18.

How do you choose the best method?

The best method of birth control is one that protects you every time you have sex. And with many types of birth control, that depends on how well you use it. To find a method that will work for you every time, some things to think about include:

  • How well it works. Think about how important it is to you to avoid pregnancy. Then look at how well each method works. For example, if you plan to have a child soon anyway, you may not need a very reliable method. If you don't want children but feel it is wrong to end a pregnancy, choose a type of birth control that works very well.
  • How much effort it takes. For example, birth control pills may not be a good choice if you often forget to take medicine. If you are not sure you will stop and use a barrier method each time you have sex, pick another method.
  • When you want to have children. For example, if you want to have children in the next year or two, hormone shots may not be a good choice. They can make it hard to get pregnant for several months after you stop them. If you never want to have children, natural family planning is not a good choice because it often fails.
  • How much the method costs. For example, condoms are cheap or free in some clinics. Some insurance companies cover the cost of prescription birth control. But cost can sometimes be misleading. An IUD costs a lot up front. But it works for years, making it low-cost over time.
  • Whether it protects you from infection. Latex condoms can help protect you from sexually transmitted diseases (STDs), such as HIV. But they are not the best way to prevent pregnancy. To avoid both STDs and pregnancy, use condoms along with another type of birth control.

If you are using a method now that you are not happy with, talk to your doctor about other choices.

What health issues might limit your choices?

Some birth control methods may not be safe for you, depending on your health. To make sure a method is right for you, your doctor will need to know if you:

How can you get birth control?

You can buy:

  • Condoms, sponges, and spermicides in drugstores without a prescription.
  • Plan B emergency birth control in most drugstores without a prescription. But you do need proof that you are 18 or older.

You need to see a doctor or other health professional to:

  • Get a prescription for birth control pills and other methods that use hormones.
  • Have an IUD inserted.
  • Be fitted for a diaphragm or cervical cap.

Some pharmacists will not sell Plan B or fill prescriptions for birth control pills. If this happens to you, ask for the location of a pharmacist who will.

 

Lots of Sex May Prevent Erectile Dysfunction

It's the 'use it or lose it' principle!

Frequent sexual intercourse may cut down on a man's chances of developing erectile dysfunction, Finnish researchers report.

"This is the same as any other part of the body. It's what we in vascular surgery refer to as the 'use it or lose it' concept," said Dr. Hossein Sadeghi-Nejad, an associate professor of urology at UMDNJ New Jersey Medical School Hackensack University Medical Center. "Sexual activity will promote maintenance of normal erectile function down the line."

The report was published in the July issue of The American Journal of Medicine.

In the study, led by Dr. Juha Koskimaki, from Tampere University Hospital's Department of Urology, researchers collected data on 989 Finnish men aged 55 to 75 years old.

The researchers found that men who said they had sexual intercourse less than once a week had twice the risk of developing erectile dysfunction, compared with men reporting having sexual intercourse once a week.

Among men who had sexual intercourse less than once a week, there were 79 cases of erectile dysfunction per 1,000 men. That number dropped to 32 cases per 1,000 among men who said they had sexual intercourse once a week, and it dropped even further, to 16 per 1,000, among men who said they had sexual intercourse three or more times a week, the researchers reported.

The frequency of morning erections was not associated with the incidence of moderate erectile dysfunction, the researchers noted.

However, the development of complete erectile dysfunction could be predicted from the frequency of morning erections. Among men with less than one morning erection a week, the risk of developing erectile dysfunction was 2.5-fold greater than among men who had two to three morning erections per week.

"Regular intercourse has an important role in preserving erectile function among elderly men, whereas morning erection does not exert a similar effect," Koskimaki said in a statement. "Continued sexual activity decreases the incidence of erectile dysfunction in direct proportion to coital frequency."

Sadeghi-Nejad said there is a scientific basis for this finding, and it also has implications for rehabilitation of patients after prostate cancer treatment.

"What is very hot these days is what we can do to rehabilitate people who develop erection problems after prostate cancer surgery or radiation therapy," Sadeghi-Nejad said. "Anything you can do to increase oxygenation in the penis will help get patients back to normal."

If one can naturally engage in behaviors that increase blood flow to the penis, it will have a positive effect in preventing erectile dysfunction, Sadeghi-Nejad said.

Sadeghi-Nejad noted that the study only addressed intercourse, and not masturbation. "This is essentially the same concept," Sadeghi-Nejad said. "Anything you can do to bring blood to the penis is beneficial," he added.

What Men Should Eat Every Day

Typically, men think about their health at one time—during a crisis. But the problem with that wait-and-treat approach is that men are constantly responding to health emergencies rather than preventing them.

 So what's the prescription for better men's health? After a few small adjustments your body can almost take care of itself.

 If you are struggling to get your body in top condition, Dr. Mehmet Oz and Dr. Michael Roizen say there are 11 things a man should eat every day—or nearly every day—to keep things running smoothly.

Fruits and Vegetables

Fruits and vegetables provide essential vitamins and minerals that will keep your body healthy. Foods rich in magnesium like beets, raisins, dates and soybeans are especially important because they'll keep your bowels moving regularly. Dr. Roizen says a man should eat about five handfuls of fruits and vegetables a day.

Fiber

A man should shoot to get about 25 grams of fiber in his diet every day. You can reach this goal through foods like artichokes, lima beans, soybeans, grapefruit, certain berries and whole grains.

Dr. Oz says that eating whole grains isn't just the latest craze—they offer multiple benefits to health, including achieving proper poop. But first you need to read the label. When you're buying bread, make sure it says "100 percent whole grain" or "100 percent whole wheat." If the label says something else—like "7-grain" or "multi-grain"—it may not be whole grain.

One of Oprah's favorite whole grain choices is steel cut oatmeal for its crunchy texture. To reach your goal for fiber, the USDA recommends eating at least three servings of whole grains a day.

Folate

Dr. Oz says you can significantly reduce your chances of getting cancer by eating foods rich in folate—you should get about 800 mg a day. If you don't take it as a supplement, you can find folate in orange juice, spinach and other leafy green vegetables.

"Folate decreases arterial aging, decreases blood pressure and decreases cancer rate," Dr. Roizen says. On labels, look for the words "folate" or "folic," he says.

Tomato Sauce

As well as being good for the heart, tomatoes decrease risk of arterial aging, heart disease, stroke, memory loss, impotence, and wrinkling of the skin, Dr. Roizen says. And tomato-based products contain lycopene, which has been shown to fight cancer.

But to really reap the benefits, you can't just put a few slices of an heirloom tomato in your salad. The best way to get the positive effects is by eating 10 tablespoons of tomato sauce a week. "It takes 165 raw tomatoes to equal 10 tablespoons of tomato sauce," Dr. Roizen says. "So it's much easier to have tomato sauce."

Dr. Roizen adds that it doesn't matter what kind of tomato sauce you have, "as long as it's cooked, and you eat it with a little olive oil and a little healthy fat because it's much better absorbed with it."

A Handful of Nuts

Dr. Roizen says walnuts and almonds are excellent for health. And not only are walnuts and hazelnuts excellent sources of heart-healthy omega-3s, but if you eat nuts before sugars (in dishes like pasta or corn on the cob), the fat in the nuts will slow your stomach and help your body most effectively process that sugar.

One thing to remember is to keep nuts refrigerated so they don't oxidize.

Baby Aspirin

If there's a true magic pill, Dr. Oz says it could be baby aspirin. "It's cheap and easy to take aspirin," he says. "Aspirin has many, many helping elements. It helps your skin, it helps about anything you can imagine. It has some potential risks if people have sensitive stomachs. But for cancer, you've got to be on it."

A man over 35 should take two baby aspirin—or 162.5 milligrams—every day. It can reduce his rise of arterial aging by 36 percent.

Fish

In recent years, there has been a lot of conflicting information about eating fish. On the one hand, fish is consistently regarded as a terrific source of low-fat protein. On the other hand, there are persistent concerns about mercury and other environmental impurities.

Dr. Roizen says you just have to remember a few great fish—tilapia, salmon, flounder, cod and mahi-mahi—especially if they are wild caught. And not only is salmon a great source of protein, it has the added health bonus of being full of omega-3s, which are important for a healthy heart.

According to Dr. Roizen, you should eat a serving of these fish three times a week.

Eight Glasses of Fluid

Dr. Roizen says that it is important to drink eight glasses—or about 64 ounces—of fluid every day. "It helps move the poop and gives you better hydration. It actually cuts down on wrinkles, too, because you hydrate your skin when you take it internally."

Red Wine

"Red wine has a chemical in it called resveratrol, which is a very strong antioxidant that's also been shown to be heart-healthy," Dr. Oz says.

Why red and not white? "Red wine has the material from the skins of the grapes [which provides the resveratrol]. The white wine has that skin stripped away. So if you're going to drink wine and you're going to take the hit on calories, drink red wine."

Coffee

Men will stand up and cheer for this next Dr. Oz tidbit—coffee is actually good for you in reasonable amounts.

Coffee actually has been shown to reduce liver cancer and to be effective with—or with symptoms of—Alzheimer's and Parkinson's diseases, Dr. Oz says. "So there are a bunch of different places where coffee can play a role. The reason it got a bad name is because it does have side effects, for example, migraine headaches and heart palpitations. But if you're not having them, coffee is reasonable."

Did we mention it's good for those bowel movements, too? Dr. Oz suggests 24 ounces of coffee a day is a rational amount for one person.

Milk or Vitamin D-Fortified Orange Juice

The calcium in milk is obviously good for bones—any man with a mother has heard that one. But the other important ingredient is vitamin D, which is a cancer-fighting agent. While your body can actually get this vital nutrient from the sun, if you live north of Los Angeles or Atlanta, you won't get enough vitamin D in winter and you'll need to supplement it. A glass of milk or fortified orange juice a day should do the trick.

Why Men Fall Asleep After Sex

Seven things most men don’t know about their sexual health

 

Sex and sleep

According to Dr. Billy Goldberg, co-author of Why Do Men Fall Asleep After Sex?, there is little direct evidence explaining why men fall asleep. However, the chemicals oxytocin, prolactin, gamma amino butyric acid (GABA) and other hormones all contribute to “that roll-over-and-snore feeling” because they facilitate sleep.

“A man’s body chemistry changes after orgasm. The biochemical prolactin is released, physically altering his body and making him very tired,” says Dr. David McKenzie, a sex therapist in Vancouver, Canada. 

Further, exertion during sex and after climax depletes the muscles of energy-producing glycogen, which leads to sleepiness. Since men have more muscle mass than women, they’re generally sleepier after sex.

Men’s libido goes up and down

Think PMS is only for women? Think again. Your monthly peaks and valleys are triggered by changes in testosterone that affect your mood, libido, energy level, beard growth and sperm count.

According to research by naturopathic physician Dr. Marcus Laux, men have more energy, a greater sense of well being, lower body weight and less need for sleep during the peak of their cycle. The valleys bring apathy, indifference and the tendency to magnify small problems into big ones.

“If you keep track of your personal cycles, whether it’s shifts in energy levels, mood or sex drive, you can anticipate changes,” says Laux. “Then, you can take advantage of the times you’re at your prime and better cope when you’re not feeling your best.” 

Your penis is a barometer of overall health

Dr. Mehmet Oz, co-author of You: The Owner’s Manual, calls it your “dipstick” because it reveals the health of your other body parts. The physical mechanisms that send blood to your brain, heart and kidneys also inflate your penis. If it’s not standing tall, you may have arterial problems.

“A man’s lack of interest in sex is a big red flag that something is out of balance. Up to 25% of men have a low-to-no sex drive,” says Dr. Laux. “It could be even higher, as men don't talk about low libido.”

The possible causes of restricted blood flow include diabetes, endocrine disorders, heart and vascular problems or kidney diseases. “But,” says Laux, “don't rule out fatigue, psychological factors, relationship issues, poor nutrition, insomnia or lack of exercise.”

Disrupted sleep decreases erections

If you’re struggling with obstructive sleep apnea (OSA), you’re at risk for sexual dysfunction. OSA is a sleep disorder that affects 18 million Americans—many of whom go undiagnosed—and causes sufferers to stop breathing dozens of times per hour.

OSA disrupts rapid-eye-movement (REM) sleep, which is when men routinely experience erections. Decreased REM sleep means fewer REM erections, which affects sexual health. “It’s possible that men need to experience REM erections in order to maintain optimal sexual functioning,” says Dr. Charles Atwood, associate director of the University of Pittsburgh Medical Center's Sleep Medicine Center. 

“If you have erectile dysfunction, you should get tested for OSA,” he advises. “Men who are diagnosed and treated for OSA often see an improvement in sexual functioning.”

Eco-friendly transportation could damage your testicles

Whether you’re bicycling to reduce your carbon footprint, save money on gas or get fit, make sure you’re cushioned properly. Cycling doesn’t cause male infertility, but it can lead to testicular damage, impaired sperm functioning and erectile problems. Urological surgeon Vinod Nargund from St. Bartholomew’s and Homerton Hospitals in London found that mountain bikers are more affected than road cyclists.

Dr. Nargund lists the potential problems of prolonged cycling: abrasions, chafing, damaged hair follicles and bruising. Sweating may cause skin problems and a general soreness.

Symptoms to watch for include genital numbness, erection problems and skin irritations. To stay healthy, wear shorts with protective padding. Make sure your seat is also padded, and adjust its position so it doesn’t put pressure on your groin.

Varicocele can cause male infertility

Infertility affects one in six couples, and male factors contribute to at least half of all cases. According to the Center of Reproductive Medicine at Cornell University, the most common identifiable cause of male infertility is varicocele, or enlarged veins in the scrotum. Another possibility is a blockage in the reproductive tract. 

Simply being older also affects your fertility. Recent research from the Eylau Centre for Assisted Reproduction in France shows a connection between men over age 35, lower pregnancy rates and higher miscarriage rates. Keep your sperm strong by eating nutritiously, exercising regularly and decreasing your stress level.

Big news

An average penis length of five erect and three flaccid inches is normal for men—that’s significantly smaller than what most men think is normal. 

“Generally, every man (and woman) believes the ultimate in sexiness and masculinity is to have a larger-than-average penis,” says sexologist Dr. Trina Read. “The fact is, men with large penises often find it difficult to find a partner who is comfortable having intercourse and giving oral sex.” 

During intercourse, penis size has little to do with partner satisfaction. Most of the sensitive nerve endings are concentrated close to a woman’s vaginal opening—which means a penis of any size can be highly pleasurable.

“What most women really want is technique,” says Dr. Read. The upside? A man who masters his technique in bed may get away with falling asleep right after sex.