"Not yet!" - When the UTIs will not be closed in middle age

This week, the patient has unveiled two terrible urinary infections that have taken this summer during the holidays. She is in her 50s, after menopause and healthy. Having sex with your partner, she woke up with burning and painful urination. She was treated for a urinary tract infection with antibiotics and felt better within a few days.  

She did very well for two weeks, until they have sex again, when the same symptoms again. Although antibiotics have worked yet, and rapidly, at this point, it was consumed by the whole thing. He was unable to enjoy their holiday, and she was afraid to have sex. It took weeks before she feels normal "there".

If this sounds familiar, then maybe you suffer from recurrent urinary tract infection (UTI). Recurrent UTI was defined as one of three episodes of infection in the previous 12 months or two episodes in the last 6 months.

Recurrent urinary tract infections are common in young healthy men and middle-aged women in good health. Here's why. There are many types of bacteria that normally live in the vagina and happily coexist. And they hold each other in check, like a mini-ecosystem. The hormone estrogen helps "good" bacteria called Lactobacillus flourish. These bacteria produce acid, which lowers the pH in the vagina, which helps keep the "bad" bacteria in check.

For young women, the frequent sex is one of the greatest risk factors for a urinary tract infection. Sex can cause bacteria in the vagina and the rectum to enter the urinary tract because they are neighbors. But in middle age, the main culprits of recurrent urinary tract infections are physical changes, including thinning of the vaginal mucosa, pelvic organ prolapse, incontinence and problems with bladder emptying. Lower levels of estrogen after menopause are also a factor.

There are effective prevention strategies for healthy women in their forties who are struggling with recurrent urinary tract infections. A good place to start is with urination habits. When sitting on the toilet, make you as comfortable as possible in a relaxed sitting position (not squat). Start urine flow by relaxing the pelvic floor muscles, instead of difficulty urinating. Allow enough time to completely empty the bladder time. Also empty the bladder after intercourse.  

This can help eliminate bacteria that may have been introduced into the urinary tract during sex. Some studies suggest that blueberry extract can help prevent urinary tract infections by reducing the "stickiness" of bacteria. I prefer supplements cranberry juice cranberry, which tends to be very high in sugar and calories.

Estrogen creams or vaginal rings can help restore the normal bacterial balance of the vagina. Ask your doctor before taking preventive antibiotics or after sex, or regularly at a low dose. Your doctor may also check to see if you have pelvic organ prolapse, which may be associated with an inability to empty the bladder completely.

Support your bladder health, and not let recurrent urinary tract infections in the way of your active life. If you are struggling with recurrent urinary tract infection, see your doctor for a thorough examination - and I know that this condition is entirely preventable and easily treatable once.

By: Hope Ricciotti, MD.

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Following cancer of the prostate with low risk before starting treatment increasingly common

Men with prostate cancer at low risk slow growth may not live long enough to die of their disease. And since there is no conclusive evidence that the management of cancer at low risk prostate prolongs survival, doctors may recommend cancer surveillance and treatment only when it begins to spread.

This is called active surveillance. It is usually reserved for men with small, slow-growing tumors and normal life expectancy of less than 10 to 15 years after diagnosis. Older men in particular are much more likely to die of heart disease and other causes prostate cancer at low risk. Which fueled concern that low risk cases are dealt with too many men who experience side effects without mounting advantages.

The doctors examined the men on active surveillance in three ways:

     *  periodically measuring the amount of PSA in the blood
     *  tumor growth check with rectal examination
     *  giving repeated biopsies at varying intervals.

Active surveillance takes off 
Although it has a long history, active surveillance has recently expanded its scope from academic cancer centers in the community. Now, a new study shows adoption accelerates. "The trend is real and what is a step in the right direction," said Matthew Cooperberg, associate professor of urology, epidemiology and biostatistics at the University of California, San Francisco Medical Center, and lead author of the study.

Cooperberg and his co-author Peter Carroll, chair of Urology at UCSF, examined data from 10,000 men with cancer of low risk prostate cancer treated at 45 urology practices throughout the United States. From 1990 to 2009, the rate of use of active surveillance in men who averaged 66 years of age at diagnosis was hovering at just under 15%. But between 2010 and 2013, the rates suddenly jumped to over 40%. Active surveillance rate increased from 54% to 76% in the same period of time - a similar trend for men to 75 years or more at diagnosis was observed.

"During the treatment of cancer low-risk prostate is a major problem, and these results suggest that the decline," said Cooperberg.

With studies from Sweden, Australia, Michigan, and elsewhere that show similar increases, active surveillance "seems to be gaining ground as a standard business practice," said Stacy Loeb, a urologist and researcher at the Faculty of the University of New York of Medicine in New York.

The future of prostate cancer surveillance 
The long-term data demonstrating the safety of active surveillance for low-risk disease. For example, a Canadian study published this year showed that only 1.5% of 993 men enrolled in an active surveillance protocol in 1995 had died of prostate cancer two decades later. The men were 69 years old on average at diagnosis. "But the active surveillance is not just for older men," Cooperberg said. "Our data show that can be effective in young men too."

Scientists are also looking for less invasive ways to monitor the progress of the tumor - for example, imaging tests or more precise in the blood and urine markers. These alternative approaches could make a much lighter active surveillance in time.

"Active surveillance is used as a middle-ground option," said Dr. Marc Garnick, Gorman Brothers professor of medicine at Harvard Medical School and Beth Israel Deaconess Medical Center and editor of HarvardProstateKnowledge.org. "For example, men who are not sure to consider the PSA test in the first place and who are concerned about over-treatment if they are diagnosed with prostate cancer can find the option of active surveillance attractive. 

This is especially true being Given the lack of evidence that the management of prostate cancer at an early stage extends life. Fortunately, a day mark to provide a means of predicting whether a given processing task based on the genetic makeup of a tumor man. "
By: Charlie Schmidt

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It is not a "pink Viagra"

Many of my patients, colleagues, friends and even neighbors ask me about the new drug flibanserin (brand name Addyi). Just last Tuesday, the FDA approved the drug for the treatment of hypoactive sexual desire in women.

Flibanserin generated more questions, comments and questions from the media for me that I have never experienced in my 20 year career as an obstetrician / gynecologist. Although there are several drugs that enhance sexual function in men (including Viagra, the most famous), flibanserin is the first drug approved by the FDA to improve sexual function in women. Here are what I consider the relevant facts and data on flibanserin and the advice I give to my patients.

First, it is not a "pink Viagra." Viagra (sildenafil) for erectile dysfunction in men, improving blood flow to the penis by inhibiting nitric oxide synthase enzyme. However, it is estimated that the acts of FLIBANSERIN by increasing the release of dopamine and norepinephrine hormones neurotransmitters, while decreasing the release of serotonin in the brain area regulating sexuality. Viagra is taken just before sex, while flibanserin must be taken every day. Flibanserin is approved for pre-menopausal women. It has been shown that slightly improved sexual satisfaction in some women (some more than others).

Possible side effects include low blood pressure, nausea and fainting. Women should not drink alcohol or birth control use while taking as it may aggravate side effects. Of course, some women may decide these requirements and side effects are not worth it, because it can be pretty big inconvenience for a drug intended to improve the sex lives of premenopausal women.

In my practice, women of all ages have questions and concerns about sex and sexuality. Most women who see an obstetrician / gynecologist do. These questions often come right after a woman has a baby, during perimenopause, and later in life too. Women's sexuality is very complex and is affected by brain chemistry, mood, relationships, drugs and health status (torque).  

As a doctor, if a woman comes to my attention their concerns to sexuality, I begin by assessing their physical and mental health (depression is a common cause of loss of interest in sex), and then check to see if she takes medication that may influence the interest in sex. Guilty of common drugs are birth control pills, pills for high blood pressure and antidepressants. I then asked about their relationship. If all this seems to be going well, so I looked in your stress level and your schedule.

I often find that couples who are struggling with sexuality have not neglected any time and energy to your relationship. I ask, "If you and your partner were alone on a tropical island, and he had no concerns or schedules, would you be interested in sex?" If the answer is yes, we are working on strategies to prioritize and time to build the relationship. If the answer is no, then I prefer disorder diagnosis of hypoactive sexual desire disorder (also known as DSH).  

I often try to send these couples to sex therapists, but these experts are rare, and are often expensive. In addition, many couples are too embarrassed to go ahead. This subgroup of women with hypoactive sexual desire was confusing to me mostly because I have not been able to help. They are generally in a healthy relationship, and not have the desire, sexual desire, or the answer to sexuality. I try to explore all options with these women; However, to date there has not been a medical option. Flibanserin is to this group of women.

The approval of flibanserin took many years, and after two previous rejections by the FDA because he thought that the side effects were stronger than the modest profit in sexual function. In the latest revision of the FDA, the sponsor of the drug provides additional safety data that showed the absence of impaired driving following day, a comparison of side effects of flibanserin, and other products that have already approved by the FDA, and the analysis confirms that the side effects were more pronounced when flibanserin is taken with alcohol. The controversy arose because only two of the 25 volunteers for the study of alcohol were women. To add to the controversy, an advocacy group that wanted flibanserin approved, called "equalize" he suggested was sexism in the process of FDA review.

A major concern that many people, including myself, is the potential of flibanserin to be used off-label, which means it could be used in a larger population of women for whom it was not approved. For example, this population could include older women, people with medical problems, and combining the use of birth control pills or alcohol.  

The use of flibanserin for women in any of these categories can increase the risk and severity of side effects. Another concern is whether the modest improvement in sexual function worth the potential risk of side effects. I plan to discuss with women who might benefit, and let them decide. Who am I to be the final arbiter of what is important to the quality of life of a woman? A doctor-patient relationship in good health should allow this type of discussion and joint decision making.

I welcome these discussions and controversy. Female sexual dysfunction is a significant unmet medical need and deserve research and treatment options. The problem of hypoactive sexual desire and excitement, particularly for women, is real. Either flibanserin help the subset of women for whom it is appropriate, and the extent to which improves sexual function, remains to be seen.  

I suspect that the effect is low, and the group that can be safely applied is limited, but at least it is a step in the right direction. My advice is to proceed with caution and follow the FDA's advice to the letter in this case. Explore all non-pharmacological options that can help create a fulfilling sex life - reduce stress, take care of your health, talk to your doctor about medications and health status, and to give priority in their relationship.
By: Hope Ricciotti

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Tips to get pregnant fast.

Get a baby is an honor in itself for each pair of a family, the family will feel more complete with the presence of the baby.  
Various festive event to welcome the presence of children in the future.

However, problems began to arise when the baby is not as present in the family, the woman is not pregnant, even disturbed family harmony.  

So many questions, wife Why not get pregnant?Several attempts were made to get a baby, from supplements, consult a physician to perform certain rituals to become pregnant. In fact, children are a gift from God, can not try to make our desires.Here are some steps you can do to get pregnant fast.

First.
Consult your doctor with health expertise. Health Check is important to know the level of physical health and fertility, as it will impact on the health of the fetus and the child in later life.

In second place. 
Adopting a healthy lifestyle. Healthy habits is important to do this as it will impact you, the environment and the fetus or child at a later date. Exercise regularly for at least 15-20 minutes a day is enough to just stretch and would be better if added with a morning run with friends to keep in shape.

Eating fruits and vegetables is important for you to meet the body's nutrients. If you are a lover of cigarettes, then you should avoid this practice, affecting the uterus and the fetus also stop drinking alcohol for men will kill sperm and the female or very influential in egg egg. 

Third. 
Know your fertile period.Fertile period is characterized by an increase in luteinizing hormone just before ovulation (release of an egg from the ovary) for palopii tube is in place between the egg for fertilization by sperm. That in this period called the fertile period, the egg is usually in the fallopian palopii for 3-4 days, but only two days just for the design, then it will die.

Fourth.
Learn the basics about pregnancy.Knowing the basis of pregnancy is important to make a husband and wife to have a picture later in pregnancy. What should be taken into account in order to have a healthy pregnancy.

Five. 
The consumption of vitamins and supplements.The consumption of vitamins and supplements will help keep your fitness and fertility. Such as vitamin C can improve sperm quality. Consumption of 1000 mg and 10 mcg of vitamin D or vitamin E can increase fertility in men and women.

Women who take folic acid has a higher pregnancy risk than those who do not consume. Folic acid also plays an important role in tube formation fetal brain later in life.

Sixth. 
Healthy relationships. Take an intimate relationship with a relaxed and pleasant atmosphere to use the position for you environment. The position of older men are more likely than men in the bottom of pregnancy, women who could use a booster cushion is placed on the hip so that the cervix can accommodate many sperm.

Avoid stress during intercourse guard so as not to stress conditions, serileks date as possible, shower before sex will be more energetic and fresh, empty the first thoughts on work in the office and enjoys doing.

Seventh. 
Always pray to God.As I mentioned earlier that we can only try and God disposes, resigned to what happens when we always strive corrections to what we have done, we hope to soon get what you expect.

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Tips on taking care of the female sex organs healthy.

For a woman, maintaining the health of sexual organs is very important to do so because in addition to what is healthy, comfortable, clean, non-white, new pair will continue with you.

Female sexual organs are highly susceptible to various diseases apparent, moisture around, so be aware that germs and bacteria do not settle. Requires diligence and patience with this body, but it will give you a positive impact on your life.

Ok guys, here you can do to take care of their sexual organs.

1. not customary to use a loose clothing that binds directly to their sexual organs because it will allow a rapid wetter and wetter.

2. Urinate familiarize After washing again with clean water and dry with a soft cloth or tissue paper.

3. Currently used sanitary napkins that do not use deodorant fragrance substances that cause allergies in some skin types.

4. The currently menstrual change the bandage around 5-8 hours each day and adjusting the amount of menstrual blood sheets.

5. Be sure to wear soft cotton clothes because cotton feature readily absorbs perspiration and water to maintain moisture in the skin, the air flow was smooth and healthy.

6. intimate body has its own properties clean the feminine area, but not the obligation for you not diligent in cleaning or drugs are not allowed to use water spray, as it will affect the pH or acidity of the vagina.

7. If you are in the tropics, betel leaves can be used to clean the feminine area. Betel leaf is known to be powerful enough to kill bacteria and germs health of their sexual organs are well preserved. The use of water betel leaves slurry for washing the woman area once a week.

Familiarize yourself healthy lifestyle and provide personal health also to strengthen the marital relationship, the family harmony was maintained.

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5 Tips To Keep A Marriage Exciting

Marriage is very interesting, make arrangements, plan for your future life together. But after the honeymoon is over, real life begins.  

And while you may have the most beautiful wedding, even the most loyal partner that is sure to find a style of married life is at times, well let's say, less attractive. 

I mean let's face it, you have to love someone, but spend the whole day with the same people make to many routine activities, that if you are not careful can draw on your relationship and make you both feel satisfied with what is otherwise a relationship both very loving.

Consequently, it is very important that couples do not just sit back in the belief that marriage will remain attractive only on its own momentum. Instead, it is important that couples take some basic steps to infuse their relationship with a little excitement.

The First. Have independent interest.

You can not have something interesting to say if you spend every waking moment doing and experiencing the same thing. Have independent interests is not a sign of a weak marriage, as some newlyweds believe, but rather a sign of strength. Have independent interests means that you have something unique to bring the conversation, make sure that you both always have something interesting, and yes interesting, to say to each other. 

Second. Spontaneous event.

While you're on a date, event planning spontaneous seemed rather innate. But, as we grow comfortable in our relationship with obligations and more hectic lives, we have a tendency to rely on the strength of our relationship and thus failed to keep things spontaneous. So to mix things; plan an afternoon or evening event that is completely new. Try that show your partner have been dying to see, or visit that new restaurant that just opened. 

Third. Never threaten separation.

It is less a rule to keep things interesting, and more one to keep them healthy. A relationship can only grow and remain attractive if both parties are confident in their commitment to one another. As a result, make rules between you and your partner that you never threaten separation or divorce. Build an understanding that if you threaten separation, you should head out the door to go back to the top. It is a hard rule, but one that needs imposition if your relationship is to survive the ups and downs that are part of every wedding. 

Fourth. Weekend trip.

One powerful way to inject some romance in your marriage is to take a vacation with just the two of you. But with the rigors of life and cost of travel, full-blown vacation can be difficult to justify. So, instead opting for one night in a local. Plan a dinner and an evening out, and cap it off with a night in a hotel. This burden is not much considering the excitement that trip, no matter how small, can bring to the relationship. 

Fifth. Spice up your bedroom.

The final tip to bring excitement into any relationship to spice things up in the bedroom. Your sex life has a strong correlation with the strength of your relationship and satisfaction. So try exploring a new position or even a sexual fantasy or adult toy with your spouse, and thus share something intimate and bring some excitement in your marriage. 

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Sexual education

Sexual education is actually very important to us all, especially for teenagers. Primary purpose of providing sexual education to children or teenagers is that they can understand the meaning, function and purpose of sex to them so that they can dispense with the good, true and valid.  

Sex is not only limited to the meaning of sexual relations with the opposite sex alone, but more than that.

In terms of sexual education no sex instruction is explained about reproduction, breeding process through sexual intercourse opposite sex. And education in sexuality is a lesson about ethics, morality and knowledge economy for the teens themselves to realize that he is a sexual individual.

So the notion of sexual education in general is something that is related to the genitals or anything related to those cases of genital intercourse with men and women. While the specification of the sexual character of each person is different.

Indeed, some people will find it taboo to provide sex education to the sons and daughters, but we must realize that sex is a biological necessity which is owned by everyone. So debriefing sex education to their importance to be given.

Another purpose of sex education to children or adolescents, among others.

1. For the teens can find a variety of information about sex as early as possible.

2. Have an awareness of the importance of sexual subjects.

3. Understand the positive and negative effects of sex for teens.

4. Understand the problems that caused the sex for teens.

5. Knowing healthy sex for a better life.  

If there is no knowledge of the teens about sex education in fear that one day they abuse the sex which ultimately affect the lives of their own in the future.

Various sexual behavior of young people who have not the time they do naturally, are as follows.

1. Masturbation or masturbation is manipulating events to the genitals in order to channel the sexual desire to fulfill the desire for pleasure which often lead to personal and emotional shock.

2. Dating with mild sexual conduct such as touching hands, breasts touch to kissing, which is basically just to satisfy sexual desire.

3. All activities that lead to the satisfaction of the sexual impulse which basically shows no success or failure of a person to control the urge to switch to another activity that is still workable.

Basically sexual education is also intended that the teens can avoid free sex practices, which in turn actually plunged themselves in a more complicated situation and endanger the lives of their own. Of course, the role of parents in this case is in need, oversight of the development of youth while outside the home is a top priority when they do not fully understand the importance of sexual education.

Thank may be useful

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