Online Medical Consultation Here to Stay.
Being in General Practise for thirty years or more has, as you can imagine, thought me a thing or two about people and their relations with doctors. Here are some of the things I learned:
• People often don’t trust doctors but are afraid to challenge them. They are afraid to ask for a second opinion.
• People often don’t understand doctors or what they are trying to tell them.
• In the confusion of the consulting process people find it difficult to concentrate on what the doctor is saying. Therefore, they may afterwards appear to be almost deliberately non-compliant.
• For reasons perhaps known only to them, people can withhold vital information from their doctor or simply not tell the truth. This may render the entire consultation worthless.
• There are some things that all of us may find impossible to talk about face to face with another human being. Sexuality may be one such subject.
Given all these natural fault lines that appear in many doctor-patient consultations, it occurred to me that the Internet might be the perfect medium through which to allow people augment and redress this often flawed process. Online medical consultation is not designed to and never will replace the traditional doctor patient physical interaction. It can however bring clarity and lend valuable support to this process. When a person commits to Online consultation they:
• Have the required time and space to concentrate on their complaints and symptoms.
• Are less inhibited about discussing difficult topics.
• Are not afraid to argue their point of view.
• Are less inclined towards untruthfulness.
• Have the time and space to absorb all that is being said to them.
• Can seek clarification until they fully understand their diagnosis and its implications.
Whether we like it or nor, and personally I know many doctors who don’t like it, people will use the Internet to try and diagnose and even treat their own illnesses. Or at the very least will go to their doctor pre-loaded with a lot of Google information and misinformation. The Internet has now irrevocably infiltrated the doctor-patient process. It is up to us in the profession to try and make this development as innocuous as possible.
For more information about Online Doctors and e-Consultations please visit: www.doctorrynne.com
Showing posts with label female sexual problems. Show all posts
Showing posts with label female sexual problems. Show all posts
Monday, August 8, 2011
Major Breakthrough in Treating Female Sexual Dysfunction
Major Breakthrough in Treating Female Sexual Dysfunction.
This low level of male hormone in post-menopausal women can give rise to many undesirable consequences. Indeed it is now suggested that testosterone may be the “missing link” in the management of menopausal symptoms not otherwise responding to standard HRT. To date this in the main consisted of oestrogen and progesterone. Included here are hot flushes, depression, osteoporosis and the sexual dysfunctions of vaginal dryness, dyspareunia, anorgasmia and low or no libido.
Testosterone for the Lady.
Dr Andrew Rynne.
People naturally associate the hormone testosterone, also called androgen, with men. It’s what makes us so nasty, so aggressive, so driven, so bald, so hairy and so sex mad. Isn’t that so? What very few people don’t realise though is that testosterone also plays a vital role in female sexual functioning. To be healthy, a woman needs to have androgen levels of approximately one tenth of that of young men. This they produce in their ovaries and adrenal glands. It plays a part in many things of which sex drive or libido is but one.
It may go against the grain to associate testosterone with femininity. After all, in the main when compared to men, women are gentler, better at empathising, more intuitive and more patient than men with their raging testosterone. So how could they possible need this stuff that enjoys such bad press? Recent studies have shown that post menopausal women not only lack oestrogen and progesterone but testosterone as well.
This low level of male hormone in post-menopausal women can give rise to many undesirable consequences. Indeed it is now suggested that testosterone may be the “missing link” in the management of menopausal symptoms not otherwise responding to standard HRT. To date this in the main consisted of oestrogen and progesterone. Included here are hot flushes, depression, osteoporosis and the sexual dysfunctions of vaginal dryness, dyspareunia, anorgasmia and low or no libido.
So how much testosterone replacement do ladies need? The quick answer is not a lot. At most her optimum levels of androgen will be from one seventh to one tenth of that of men. So, if a man requires on average 50mg of testosterone delivered daily via a gel call Testogel, then a woman’s requirement will be one tenth of this or 5mg of testosterone daily. A handy way to think of this is that if a man uses one tube of Testogel every day then the same tube of gel should last a woman one week. A little “toothpaste” sized smear on the inside of her forearm every day should do the job nicely.
Doctors who “approve” of testosterone replacement therapy for women are still thin on the ground and some of those like to try and make things complicated. Blood tests, for example, to measure the levels of testosterone that a post-menopausal woman might have, are largely a waste of time and money. They contribute not a jot to the diagnosis. Likewise, expensive specially compounded “female” testosterone replacement therapy will do a lot more for the doctor’s bank account than it will for client’s wellbeing. There is nothing wrong with existing pharmaceutically manufactured androgen gels as given to men.
It is in practise quite simple. All you need do is ask yourself some simple questions: Do you have post-menopausal symptoms not relieved with standard HRT? In particular, do you have sexual dysfunctions like vaginal dryness and loss of libido? If the answer to this is “yes” then try some testosterone replacement therapy at a does of about one tenth of that for a man? Did that improve things for you? If yes then continue if no then discontinue. Now, isn’t that nice and simple? Why complicate things?
To find out more about Testosterone treatments available for women please visit www.doctorrynne.com
Monday, May 23, 2011
Loss of Libido in Young Woman.
Loss of Libido in Young Woman.
What do you make of this? How would you advise? About a week ago, in my Allexpert.com slot, a young woman from South Africa wrote to me as follows:
“I have been thinking of asking for professional help for a while, because there seems to be a serious problem that I just can’t ignore. I am 32 years old, married for 7 years to a man two years my junior. Together we have four lovely children.
The problem started to appear after I started my third pregnancy and lately I just can’t handle it anymore. I do not want to have sex. I do not feel the need to. If I do it does not happen more than 2 or 3 times a month. Yesterday I realized that the mere thought of having sex disgusts me! I feel ashamed and insufficient to satisfy my husband who has been complaining about it recently. What’s the matter with me? I am a young vibrant woman. I take care of my appearance and I know that men like me, but something has stopped working properly. Please, please help me!”
First of all what sticks you about this questioner as odd, or as possibly the root cause of her problem? And secondly, what further information would you like to have before reaching a conclusion and offering some sound advice? Let’s deal with the second question first. When I hear of loss of libido in a woman the first thing I think of is clarity – what exactly does the questioner mean by loss of libido. The second thing that I think of is could some medications be causing this. I wrote to her therefore as follows seeking some clarity:
“Hi there Ruth, thanks for your question. When you say loss of libido do you mean loss of interest in all things sexual – no desire, no urge, on sex drive? Or is it a case that you do have these things but that you are not responding – you have so-called Female Sexual Arousal Defect?
I also need to know if you are on any form of birth control including the IUCD and if you were ever on any antidepressants?”
Her answers to these questions were revealing in their own way. No she was not on any form of BC, not now or ever and she was never on any antidepressants. As to the first part of my question; her problem was indeed a pure loss of libido and had nothing to do with response. While answering this Ruth also let it slip that she had a full time job!
This of course underlined and re-enforced my first impressions as to what exactly was going on here. Now we have a young woman aged 32 with four young children, obviously talented and well educated and holding down a full time job and not on any form of birth control! And she wonders where her libido has gone to! When I was first reading through her question I was thinking of all sorts of fancy footwork like hormone assay and possibly testosterone replacement therapy for women. But on more sober reflection the answer was far more pedestrian.
Four small children, under the age of seven, no matter how lovely they may be, is draining enough God knows. Now add onto that a full time, and I would guess a fairly onerous job and you are approaching human limitations. On top of that we have a young woman not on any form of family planning such that any sexual activity with her husband exposes her to the risk of further pregnancy and she is wondering where her libido has gone to!
Moral considerations aside, I think Ruth is going to have to give some serious consideration to possible a permanent form of family planning – vasectomy or tubal ligation or, less satisfactory, Marina Coil or implant. Once she has her fertility under some kind of control she should consider taking a break from her work and/or from her parenting duties. What Ruth may desperately need is a quiet week in the country somewhere. Then perhaps she will discover where her libido had vanished to.
What do you think? Please leave a comment.
Monday, April 18, 2011
The Folly of the Fertile Period.
The Folly of the Fertile Period.
The logic is, to say the very least, fatally flawed. People hold off starting a family or even getting into a relationship, until they are in their early thirties. They want to advance their careers first and a pregnancy could, at least heretofore, have throw a spanner in the works of career advancement. That’s all very understandable and laudable of course. Far be it from me to start passing judgements on these difficult and very personal decisions that we all had to make at some stage in our lives.
But here is where the flawed logic starts to click in. One day, people who have been postponing their first pregnancy for years, sit down together and decide that it may be time to start to “try” for a pregnancy. Typically such a couple may be in their early to mid thirties. Now, for some inexplicable reason, a certain urgency and immediacy seems to grip them. It’s not enough that they should discontinue whatever form or forms of family planning that they have been relying on up to this. No. In addition to this they often seem compelled to “maximise” their chances of success by confining their coital endeavours to certain times of the menstrual cycle; to the so called “fertile periods” and to adapting sexual positions also thought to help the cause along.
There are at least three serious problems with these flawed strategies. Hardly a week goes by but that I would not encounter some of them in my Internet Sexual Dysfunction Practise. The first problem is that there is no such thing as a “fertile period”. Therefore, confining sexual activity to certain times of the month, in the expectation of maximising ones chances of pregnancy, is largely a waste of time and effort. Yes, there is of course a time of ovulation but both sperm and ova can live for days and day each side of this event. Correct me if I’m wrong here but to my knowledge there is no statistical evidence to support the notion of a “fertile period”. The fact of the matter is that a pregnancy can occur at anytime during the menstrual cycle.
“Going for a pregnancy” by confining sexual activity to certain “optimal times” in the menstrual cycle also has a negative effect in that it raises the bar of anxiety all round. Suddenly love making is no longer just that. Now it has become a clinical chore and a challenge – something that needs to be done, not because it’s an end of itself but rather because it will produce a result. This is exactly the bedroom atmosphere that is designed to discourage a woman from becoming pregnant and a man from functioning properly – not the other way around.
I had a letter the other day from a young man living in Saskatoon. He writes: “ Dr. Rynne, I'm a 26 year old male recently married almost a year ago and me and my wife have been trying to have a baby. My penis works great when she is not fertile but during the few days she is and there is \"pressure\" to perform my penis sometimes goes limp or cannot ejaculate. It has progressively gotten worse. It started out doing it towards the end of sex, today was the worse, after having sex last night my wife came home on her lunch break and we tried but my penis would not get hard. (Which has never happened before) It seems to me that this only occurs when there’s pressure to perform. I feel terrible because I feel like I’m dropping the ball on us getting pregnant...please help!”
Does this man not say it all? I rest my case.
The logic is, to say the very least, fatally flawed. People hold off starting a family or even getting into a relationship, until they are in their early thirties. They want to advance their careers first and a pregnancy could, at least heretofore, have throw a spanner in the works of career advancement. That’s all very understandable and laudable of course. Far be it from me to start passing judgements on these difficult and very personal decisions that we all had to make at some stage in our lives.
But here is where the flawed logic starts to click in. One day, people who have been postponing their first pregnancy for years, sit down together and decide that it may be time to start to “try” for a pregnancy. Typically such a couple may be in their early to mid thirties. Now, for some inexplicable reason, a certain urgency and immediacy seems to grip them. It’s not enough that they should discontinue whatever form or forms of family planning that they have been relying on up to this. No. In addition to this they often seem compelled to “maximise” their chances of success by confining their coital endeavours to certain times of the menstrual cycle; to the so called “fertile periods” and to adapting sexual positions also thought to help the cause along.
There are at least three serious problems with these flawed strategies. Hardly a week goes by but that I would not encounter some of them in my Internet Sexual Dysfunction Practise. The first problem is that there is no such thing as a “fertile period”. Therefore, confining sexual activity to certain times of the month, in the expectation of maximising ones chances of pregnancy, is largely a waste of time and effort. Yes, there is of course a time of ovulation but both sperm and ova can live for days and day each side of this event. Correct me if I’m wrong here but to my knowledge there is no statistical evidence to support the notion of a “fertile period”. The fact of the matter is that a pregnancy can occur at anytime during the menstrual cycle.
“Going for a pregnancy” by confining sexual activity to certain “optimal times” in the menstrual cycle also has a negative effect in that it raises the bar of anxiety all round. Suddenly love making is no longer just that. Now it has become a clinical chore and a challenge – something that needs to be done, not because it’s an end of itself but rather because it will produce a result. This is exactly the bedroom atmosphere that is designed to discourage a woman from becoming pregnant and a man from functioning properly – not the other way around.
I had a letter the other day from a young man living in Saskatoon. He writes: “ Dr. Rynne, I'm a 26 year old male recently married almost a year ago and me and my wife have been trying to have a baby. My penis works great when she is not fertile but during the few days she is and there is \"pressure\" to perform my penis sometimes goes limp or cannot ejaculate. It has progressively gotten worse. It started out doing it towards the end of sex, today was the worse, after having sex last night my wife came home on her lunch break and we tried but my penis would not get hard. (Which has never happened before) It seems to me that this only occurs when there’s pressure to perform. I feel terrible because I feel like I’m dropping the ball on us getting pregnant...please help!”
Does this man not say it all? I rest my case.
Monday, April 4, 2011
Hormone Replacement Therapy
Bioidentical Hormone Replacement Therapy.
On the contrary in fact. Wren and his colleagues conducted a double-blind, randomized, controlled trial on a “natural” chemist concocted progesterone cream and found that it had no effect and was not bio-available. Therefore women using this preparation while also using oestrogen are receiving no protection from developing endometrial cancer.
Ever since the results of the Women’s Health Initiative study into the safety of HRT were published in 2002, people have sought safer alternatives to synthetic pharmaceutical drugs. That this should have happened is understandable. This massive study showed that women taking prescription or synthetic HRT were at an increased risk of developing breast cancer, stroke and blood clot, than were women not on such treatment.
The increased risk was small but real. Of 10,000 women not on HRT one could statistically expect 30 new cases of breast cancer to develop among them every year. If a similar group of 10,000 women were studied, only this time looking at those taking prescription HRT, one could expect 38 new cases of breast cancer to develop among them. Eight extra cases out of 10,000 women -- not very many but real nonetheless.
From this relentless yet understandable quest to find safer alternatives to synthetic pharmaceutical grade HRT has sprung an alternative industry that is a strange mixture of cult, religion and quasi-science. This is medical pseudoscience. At its heart is a Holy Grail of products called Bioidentical Hormones -- a largely meaningless term designed to impress and reassure all those attempting to Google their way to perfect health.
In establishing a religion it is always useful to instil fear at an early stage. To do this Bioequivalentologists call on the results of the Women’s Health Initiative study and talk about prescription approved HRT causing cancer, stroke and blood clot. All of which is correct of course. However there is an inference here is there not? In saying that there is an increased incidence of breast cancer for those taking FDA approved HRT it is inferred that there is no such increased risk for those taking unapproved, unproven concoctions compounded by the local chemist. Yet there is not a shred of evidence that that is the case.
On the contrary in fact. Wren and his colleagues conducted a double-blind, randomized, controlled trial on a “natural” chemist concocted progesterone cream and found that it had no effect and was not bio-available. Therefore women using this preparation while also using oestrogen are receiving no protection from developing endometrial cancer.
As with any other religion it is a matter, not of science but of faith. All you are asked to do is to believe that Bioidentical Hormones are safer, better and more effective than their FDA approved pharmacological counterpart. This is, if you will, a central tenet of this religion, an article of faith. Bioidentical Hormones, individually run off by an approved (of course) Compounding Pharmacists are superior to those produced by an FDA approved Multinational Pharmaceutical Companies. You do not have to prove anything or produce any evidence in support of this. Like all good religions, all that is required of you is that you make an Act of Faith.
We need a few evangelists and a liturgy too of course. We need a few Gospels according to Celebrity if you like. So we are given scribes Suzan Somers and her Sexy Forever: How to Fight Fat After Forty to be follower by Hormone Balance Made Simple by Dr John Lee and for a little bedtime read you may have The Natural Superwoman by Dr Uzzi Reiss. Now parade all these authorities out in front of a global TV audiences on a regular bases and have Oprah Winfrey and Dr Christian Northrop nodding sagely in the background and you have a potent blend as good as any Bible or Koran or Torah, being beamed across the planet.
How about a little hocus pocus then as well while we are at it, a little voodoo perhaps? Yes, Bioidenticalology has that too. They call it Saliva Hormone Assay. This is to appear to bring a bit of science to the party. The only problem is that, like most things to do with this subject, it is pseudoscience. Hormone levels in saliva are notoriously unreliable, expensive, bear no relationship to serum hormonal levels and throw no additional light on the diagnosis of menopause. Patients might feel reassured by them and doctors may feel justified in charging additional fees for them but that is as far as it goes.
Now lets create a few devils, lets get a few Lucifer’s around here – the personification of evil if you like. All religions have that don’t they? How about Horse’s Urine? Doesn’t that sound nice and nasty, kind of evil if you like? Well the next time you are riveted to some Bioidentical devotee rabbiting on about Natural Hormones check your watch and see how long it will take her to mention Horse’s Urine. What she will fail to mention is that the estrogens produced from non-vegetable sources, as for example equine estrogens, are converted in the human body into human estrogens, they are in fact Bioidentical at their point of action. In any case most prescription HRT is manufactured from vegetable sources such as the yam the so-called “natural” source the Bioequivalentologists would like to claim as their very own.
Another useful hate figure for this religion is the Multinational Pharmaceutical Industry. And while I’m no apologist for them, it is a bit rich I think to be wagging a finger at them while at the same time eulogising the activities of a network of compounding chemists and saliva analysers who collectively also constitute a similar Multinational Pharmaceutical Industry. The only real difference is that the former are required by law to comply to stringent rules and regulations while the latter are free to do whatever they like.
At the end of the day the choice is yours. I carry no brief for anyone. Which would you prefer? To visit a doctor well versed in the art of hormone replacement therapy for women. To take under professional supervision a range of substances manufactured to strictly enforced GMP, proven in clinical trials to be absorbed into your body, proven in clinical trials to be effective, proven in clinic study to have a definitive range of dangers and made from “natural” ingredients.
Or would you perhaps prefer to trust a zealot and have your saliva analysed? Would you then take the word of some stranger in an unregulated laboratory to diagnose your menopausal condition? Would you then be happy to commit to a range of substances compounded without supervision or regulation, with no established bio-availability, no proven efficacy, no definitive range of dangers or side effects and made from the self same “natural” ingredients? Now you tell me.
Saturday, April 2, 2011
Hormonal Replacement Therapy for Women - Do women need testosterone
Hormonal Replacement Therapy for Women.
Do women need testosterone?
Dr Andrew Rynne.
Up to the year 2002 hormone replacement therapy or HRT was almost standard treatment for all post-menopausal women suffering from symptoms of falling female sex hormone levels. Up to then, testosterone was not considered a female sex hormone of any significance. In the past ten years there have been some quite dramatic developments.
What are the most frequent symptoms of Menopause?
(1) Frequent hot flushes.
(2) Night sweats.
(3) Vaginal dryness making sexual activity difficult or impossible.
(4) Loss of libido and mild depression.
(5) Hair and skin dryness.
(6) Weight gain unrelated to over-eating.
(7) Slowing down and eventual cessation of menstruation. Erratic menstrual periods.
What hormone levels fall at time of menopause?
All female hormonal levels, including testosterone, fall around the time of menopause but the ones that cause the most symptoms are oestrogen, progesterone and testosterone. Testosterone is a steroid androgen hormone produced by the ovaries and adrenal glands. During early adulthood women produce testosterone at about 10% the rate that men do. As with men also, their levels of testosterone fall as they get older such that by menopause, or shortly thereafter, their testosterone levels fall to zero or near zero.
Testosterone levels in women.
Testosterone is now thought to play an important role in female libido and sexual response. Not all women, by any means, will experience a fall in their sex drive or function as a result of declining testosterone levels. Some however will and it is important to know that these women can be helped and need to be helped.
Can these be replaced?
Yes, all three hormones can be replaced. In the case of post hysterectomy, oestrogen can be given alone since endometrial cancer is no longer a possible side effect. Otherwise a combination of oestrogen and progesterone are usually chosen since oestrogen given alone carries a greater risk of endometrial cancer. Testosterone, so often forgotten, can now be given alone or in combination with either of the other hormones.
What are the treatments for menopause?
The most effective treatment for menopausal symptoms remains hormone replacement therapy. If you have not had a hysterectomy this will involve a combination of oestrogen and progesterone and perhaps testosterone. If you have had a hysterectomy, because that removes the danger of endometrial cancer, the estrogens alone or in combination with testosterone, will be your treatment of choice.
In 2002 the preliminary findings of the Women’s Health Initiative study were reported to a fanfare of alarming publicity. The bottom line was often misinterpreted in attention grabbing headlines like: HRT CAUSES BREAST CANCER. However, it might be useful to understand exactly what the study did in fact report:
Among 10,000 women taking oestrogen/ progesterone combination HRT for one year there were eight extra cases of breast cancers when compared to a similar group of women not receiving HRT over one year. The initial study did not show any extra deaths among the HRT taking women.
Other facts that sometimes hysterical reports on this study failed to mention was that there was a decreased incidence of bone fracture and of bowel cancer among the HRT group. And also there was a 15% reduction in the incidence of breast cancer among women who were on oestrogen only HRT – that is, post-hysterectomy women.
There were 38 cases of breast cancers among the HRT group compared to just 30 cases among the non HRT group. The question then that a woman needs to ask herself is this. Are the benefits of my taking HRT such that they outweigh the increase in the risk of developing breast cancer? This question needs to be answered in the calm light of day and not be unduly influenced by devotees on either side. Is the risk versus benefit ratio correct? Are my menopausal symptoms such that to be rid of them would be well worth the risk of being one of those 8 in 10,000 women for whom this treatment might cause breast cancer?
To add even more worry to this vexed question The Women’s Health Institute study also showed an increased risk of developing heart attach and stroke among the HRT group of approximately the same increased rate of some 10 extra women per 10,000 on treatment. Again this figure needs to be looked at in a balanced fashion for what it is and risk/benefit ratio needs to be weighed up.
What about Natural or Bioidentical HRT.
Much play has been made in recent years about the virtues of naturally occurring hormones as distinct from the synthetic ones. Indeed a major industry has grown up around this very topic. Some very fashionable and famous women have thrown themselves behind the argument in favour of “naturally occurring” HRT. Unfortunately though, this is invariably accompanies by far more hyperbolae than clinically proven fact, anecdote rather than study. The problem is, search as you may, there are no published studies that I am aware of, that actually prove that naturally occurring hormones impart any benefit over the synthetic ones and may do not carry the same efficacy.
Summary.
Hormone replacement therapy (HRT) for women today remains every bit as valid and as useful as it always has been. It has now been extended to considering the addition of testosterone to oestrogen and progesterone. As always, care must be exercised and this therapy should only be embarked upon under medical supervision and advice. In our present knowledge so called “Bioidentical” HRT offers no advantage over their synthetic equivalents and indeed may not be as effective.
Article by Doctor Rynne: http://www.doctorrynne.com/
Sunday, March 6, 2011
Anorgasmia, Causes and Treatment
Anorgasmia - For Women who cannot Orgasm through intercourse.
It is estimated that as many as one in four women suffer from this sexual difficulty. Not being able to orgasm during intercourse can put a real strain on your daily life, as well as your sex life. Before too long your inability can spiral into a major problem that you feel you'll never find a cure for. It can make a woman feel utterly inadequate and miserable. Her sex partner also will often incorrectly blame himself and this can make matters even worse.
Like so many sexual dysfunctions, Anorgasmia often elicits very little understanding and even less sympathy. So what if you can't have an orgasm during intercourse? Therefore it must it is very easy to feel that no one fully understands what you are going through, or is prepared to take your problem seriously. Searching for a quick fix it is likely that you will have considered the many pills, exercises and devices available both online, and in some cases, as a prescription via your GP.
Anorgasmia is defined as the sustained inability to reach orgasm through sexual intercourse while not having any trouble when alone through masturbation. It is a complex multifaceted problem involving all aspects of a relationship both physical and emotional. In may be caused by something as simple as depression or stress or a lack of physical fitness. Or it can be caused by something more complex like premature ejaculation in the man, distrust, anger or inadequate sexual stimulation.
Lack of communication and faking orgasms are other major issues often found in conjunction with Anorgasmia. Women may find it easier to lie and to pretend to have had an orgasm rather than run the risk of hurting his fragile ego or of having him, perhaps unfairly, blame himself. A history of sexual abuse or exploitation or one of a repressive upbringing are other areas that need enquiring into.
Finding that solution, tailor-made to address your specific needs, can be a challenge. Too many people think that by just throwing tablets at it, female Anorgasmia can be cured. If you are already taking SSRI antidepressants then these need to be discontinued before any progress can be made.
Dr Andrew Rynne.
Dr Andrew Rynne is a medical practitioner and writer. He has thirty years experience in treating Sexual Dysfunction in men and women.
Thursday, February 24, 2011
Sexual Health Treatment - Is online the way to go ?
Is Online Counselling the Next Wave?
So you have a problem and you need to discuss it with a professional? Your marriage is on the rocks, you have become phobic, you are getting panic attacks, you are worried about one of your children's sexuality, you have just lost a loved one, or you have suddenly developed erectile dysfunction. What exactly your problem is does not really matter. The point here is, you need to discuss it with a professional that you trust and you need to find some resolution. There is a degree of urgency to all of this.
So what do you do next? Well, traditionally you would 'shop around'. You would ask a trusted friend if they could recommend someone or you'd ask your GP for a referral, or you would simply go through the Golden Pages and see if you could find the service you are looking for. Then you would ring up and make an appointment and wait for the day to come along.
Eventually you take a half day off work, assuming your boss allows it, and off you go and sit in a waiting room for half a hour before going in to discuss your intimate problems with a perfect stranger. It is not easy now is it?
But wait a minute! Is there not now another way - what about the Internet? The idea that the Internet could be used as a conduit for Counsellor/Client sessions still meets with considerable resistance from the professionals. As if they feel threatened by the very idea, they immediately start raising all sorts of objections. How does the Client know whom they are dealing with? Internet Consultation does not allow for the therapist to pick up on the subtleties of body language or the nuances in speech. And what about confidentiality they will ask?
While some of these objections may have validity, others are somewhat spurious and are common for all forms of counselling be they over the phone, head to head on through the internet. One way or the other, it is my firm belief that, whether you like it or not, the Internet is going to play a major role in delivering quality-counselling services in the coming years.
Take Erectile Dysfunction as a model for online consultation if you will. Here I can immediately see that there are some distinct advantages to this way of doing business over the more conservative traditional head-to-head model. Chief among these I would list:
(a) Men do not like talking live to another about their erectile dysfunction. So, if they can't get help through the internet they may never get it elsewhere.
(b) Completing a detailed medical questionnaire online allows the client, maybe for the very first time in their life, to focus in on their problem. This of itself can be therapeutic.
(c) Research has shown that people are more likely to be truthful and accurate when alone and away from head to head encounters.
(d) In receiving a diagnosis and advice online, the client has a better chance of absorbing all the details of the consultation than he would if it were being delivered to him verbally.
No doubt, this topic will remain a controversial one for some time yet. I agree that the Internet can often be a den or rouges and thieves. Nevertheless, equally it can be an extremely useful and powerful tool. It is up to all of us to make it an honest and safe place to do business. One area that has hardly been touched yet is in the realms of psychotherapy. Watch this space.
Please visit http://www.doctorrynne.com/ for more information
So you have a problem and you need to discuss it with a professional? Your marriage is on the rocks, you have become phobic, you are getting panic attacks, you are worried about one of your children's sexuality, you have just lost a loved one, or you have suddenly developed erectile dysfunction. What exactly your problem is does not really matter. The point here is, you need to discuss it with a professional that you trust and you need to find some resolution. There is a degree of urgency to all of this.
So what do you do next? Well, traditionally you would 'shop around'. You would ask a trusted friend if they could recommend someone or you'd ask your GP for a referral, or you would simply go through the Golden Pages and see if you could find the service you are looking for. Then you would ring up and make an appointment and wait for the day to come along.
Eventually you take a half day off work, assuming your boss allows it, and off you go and sit in a waiting room for half a hour before going in to discuss your intimate problems with a perfect stranger. It is not easy now is it?
But wait a minute! Is there not now another way - what about the Internet? The idea that the Internet could be used as a conduit for Counsellor/Client sessions still meets with considerable resistance from the professionals. As if they feel threatened by the very idea, they immediately start raising all sorts of objections. How does the Client know whom they are dealing with? Internet Consultation does not allow for the therapist to pick up on the subtleties of body language or the nuances in speech. And what about confidentiality they will ask?
While some of these objections may have validity, others are somewhat spurious and are common for all forms of counselling be they over the phone, head to head on through the internet. One way or the other, it is my firm belief that, whether you like it or not, the Internet is going to play a major role in delivering quality-counselling services in the coming years.
Take Erectile Dysfunction as a model for online consultation if you will. Here I can immediately see that there are some distinct advantages to this way of doing business over the more conservative traditional head-to-head model. Chief among these I would list:
(a) Men do not like talking live to another about their erectile dysfunction. So, if they can't get help through the internet they may never get it elsewhere.
(b) Completing a detailed medical questionnaire online allows the client, maybe for the very first time in their life, to focus in on their problem. This of itself can be therapeutic.
(c) Research has shown that people are more likely to be truthful and accurate when alone and away from head to head encounters.
(d) In receiving a diagnosis and advice online, the client has a better chance of absorbing all the details of the consultation than he would if it were being delivered to him verbally.
No doubt, this topic will remain a controversial one for some time yet. I agree that the Internet can often be a den or rouges and thieves. Nevertheless, equally it can be an extremely useful and powerful tool. It is up to all of us to make it an honest and safe place to do business. One area that has hardly been touched yet is in the realms of psychotherapy. Watch this space.
Please visit http://www.doctorrynne.com/ for more information
Wednesday, February 23, 2011
Treatment for Vaginismus
Vaginismus or vaginal muscle spasm on penetration makes sex impossible. You may have noticed that I have not used the term "fidget" to describe any female sexual dysfunction. I have not because I consider such a term to be a judgemental pejorative belonging to an earlier era of sexual repression. It may have been applied however to, among other things, muscular spasm to the vaginal entrance preventing intercourse. Today this is called 'vaginismus' and it can put a real strain on your daily life, as well as your sex life. Indeed it can spiral into a major problem you feel you'll never find a cure for. It can make a woman feel utterly inadequate and miserable. Her sex partner also will often incorrectly blame himself and this can make matters even worse.
If that happens to you, it is very easy to feel that no one fully understands what you are going through, or is prepared to take your vaginismus seriously. Searching for a quick fix for your problem, it is likely you will consider the many pills, exercises and vaginal dilators available both online, and in some cases, as a prescription via your GP.
Vaginismus is defined as the involuntary contractions or spasm of the muscles surrounding the vaginal opening causing pain and preventing penetration. In its more severe forms, the tensing may also extend to muscles of the inner thigh and abdomen.
Vaginismus may be either primary or secondary. Primary vaginismus is where the woman has had the problem from the very first attempt at intercourse. In this case there is often a background of strict religious orthodoxy where sex is depicted as 'dirty' or sinful or simply as painful and as something that has to be endured to please men.
Secondary vaginismus on the other hand is the situation where the woman once enjoyed sex to the full but, because of some traumatic experience like a rape or very difficult childbirth, developed vaginismus as a result of that assault.
Treatment consists of (a) relaxing the muscles of the pelvic floor and vaginal opening through specific relaxation exercised and (b) gentle and graded dilatation of the vagina using finger(s) and specially graded vaginal dilators known as boogies. Remember that practically all vaginismus is curable but it does take time and some effort. There is no quick fix.
Attending a skilled sex councilor is often the best way forwards.
If that happens to you, it is very easy to feel that no one fully understands what you are going through, or is prepared to take your vaginismus seriously. Searching for a quick fix for your problem, it is likely you will consider the many pills, exercises and vaginal dilators available both online, and in some cases, as a prescription via your GP.
Vaginismus is defined as the involuntary contractions or spasm of the muscles surrounding the vaginal opening causing pain and preventing penetration. In its more severe forms, the tensing may also extend to muscles of the inner thigh and abdomen.
Vaginismus may be either primary or secondary. Primary vaginismus is where the woman has had the problem from the very first attempt at intercourse. In this case there is often a background of strict religious orthodoxy where sex is depicted as 'dirty' or sinful or simply as painful and as something that has to be endured to please men.
Secondary vaginismus on the other hand is the situation where the woman once enjoyed sex to the full but, because of some traumatic experience like a rape or very difficult childbirth, developed vaginismus as a result of that assault.
Treatment consists of (a) relaxing the muscles of the pelvic floor and vaginal opening through specific relaxation exercised and (b) gentle and graded dilatation of the vagina using finger(s) and specially graded vaginal dilators known as boogies. Remember that practically all vaginismus is curable but it does take time and some effort. There is no quick fix.
Attending a skilled sex councilor is often the best way forwards.
Dr Andrew Rynne.
http://www.doctorrynne.com
Dr Andrew Rynne is a medical practitioner and writer. He has thirty years experience in treating Sexual Dysfunction in men and women
Female Anorgasmia - Understanding and Treatment
Female Anorgasmia - Can not Orgasm through intercourse.
It is estimated that as many as one in four women suffer from this sexual difficulty. Not being able to orgasm during intercourse can put a real strain on your daily life, as well as your sex life. Before too long your inability can spiral into a major problem that you feel you'll never find a cure for. It can make a woman feel utterly inadequate and miserable. Her sex partner also will often incorrectly blame himself and this can make matters even worse.
Like so many sexual dysfunctions, Anorgasmia often elicits very little understanding and even less sympathy. So what if you can't have an orgasm during intercourse? Therefore it must it is very easy to feel that no one fully understands what you are going through, or is prepared to take your problem seriously. Searching for a quick fix it is likely that you will have considered the many pills, exercises and devices available both online, and in some cases, as a prescription via your GP.
Anorgasmia is defined as the sustained inability to reach orgasm through sexual intercourse while not having any trouble when alone through masturbation. It is a complex multifaceted problem involving all aspects of a relationship both physical and emotional. In may be caused by something as simple as depression or stress or a lack of physical fitness. Or it can be caused by something more complex like premature ejaculation in the man, distrust, anger or inadequate sexual stimulation.
Lack of communication and faking orgasms are other major issues often found in conjunction with Anorgasmia. Women may find it easier to lie and to pretend to have had an orgasm rather than run the risk of hurting his fragile ego or of having him, perhaps unfairly, blame himself. A history of sexual abuse or exploitation or one of a repressive upbringing are other areas that need enquiring into.
Finding that solution, tailor-made to address your specific needs, can be a challenge. Too many people think that by just throwing tablets at it, female Anorgasmia can be cured. If you are already taking SSRI antidepressants then these need to be discontinued before any progress can be made.
Dr Andrew Rynne.
Dr Andrew Rynne is a medical practitioner and writer. He has thirty years experience in treating Sexual Dysfunction in men and women.
Subscribe to:
Posts (Atom)