Any symptom can result from reaction to things used in connection with sex and contraception, including the classic symptoms of allergy, such as asthma and rhinitis, and the symptoms of chemical sensitivity. Most commonly, however, localised symptoms result, on the genitals, anus and surrounding skin and tissues, plus urinary symptoms and, for women, inflammation or pain in the pelvic region. Dermatitis can also be connected to sexual activity, especially around the mouth, neck, lower face and upper thighs.
There are three main categories of causes. The first, and most common, is chemicals used by you or your partner as toiletries, personal hygiene, or cosmetics; as laundry agents; or on products such as sanitary towels, tampons or incontinence protection. You may be sensitive to things that you use, or that your partner has used. They may be things that you tolerate well unless you have contact in an intimate area. Sweat and friction increase the likelihood of reaction — they make the skin and tissues more permeable and more likely to absorb chemicals. So, for instance, a soap powder or deodorant that normally does not bother you, may make you react where you have intimate contact.
Drugs or ointments that you are taking to treat these symptoms, or some other condition, can also cause genitourinary symptoms. Take medical advice on whether to discontinue these.
Untreated cotton fabrics for upholstery use are available, but they need to be combined with a pure cotton interliner which meets fire safety regulations. It is possible to do this in a combination which minimises exposure to chemicals and meets the fire safety regulations.
One way to use totally untreated materials and meet the fire safety regulations is to re-upholster furniture made before 1950, to which the regulations do not apply. You can legally buy older (pre-1950) or antique furniture in totally untreated materials, or you can re-upholster yourself, or have it re-upholstered in untreated materials of your choice.
Your first problem in doing this is to obtain the materials. Sources of fabrics are given in Fabrics (page 387). John Cotton manufacture cotton wadding and will give names of stockists. Your second problem is to persuade an upholsterer to do the work if you do not do it yourself. Many are reluctant to use untreated materials on old furniture, even though it is legal, because they may be liable in case of accident. It is legal, however, and you can persist in persuading them. Contact the Association of Master Upholsterers for specialists in upholstery who may be able to help.
The principle of a rotation diet is to manage your diet formally, so that you only eat certain foods at given intervals. Its purpose is both to prevent and to cure. It helps prevent you developing new intolerances or allergies by keeping your diet varied and unrepetitive. It can help cure mild allergy or intolerance by reducing the load of a food in your diet, while still allowing you to eat it in moderation.
A rotation diet is usually planned on a four-day basis. You are allowed to eat a particular food on one day in the rotation, and not again until that day comes around once more. The foods that you tolerate are allocated to each of the days of the rotation and you stick to that system. So on Day One you have a list of foods from which you can choose what you will eat that day; on Day Two, you have your Day Two list, and so on.
A four-day basis is chosen because four days gives the body time to clear the food from the system, and most people are able to tolerate foods well at four-day intervals. You usually start out on a four-day rotation, keep to it strictly and then modify it to suit your own system, or way of life.
Allergy and sensitivity to chemicals is a contentious and highly controversial area. Many doctors and scientists would agree that they have an inadequate understanding of many people’s apparent reactions to chemicals in their environment. There is little research data to explain what chemicals cause reactions, what symptoms result, and what the underlying mechanisms in the body actually are.
The areas that are best documented, and where most doctors and scientists agree, are those of allergy to chemicals (where the immune system is involved, and which can be detected by skin and laboratory tests), and irritant and toxic reactions, where exposure to high levels of chemicals, usually at work, causes symptoms and disease.
The area that is most disputed and under-researched is the one which some doctors call ‘chemical sensitivity’. The definition of chemical sensitivity is substantially empirical, based on clinical practice and observation of large numbers of people with a common history of disease and presenting symptoms. In this definition, chemical sensitivity means adverse reactions to tiny or very low levels of chemicals in the environment, in which the immune system is not demonstrably involved.
It may appear to you, if you react to chemicals, that this controversy over allergy versus toxic reactions versus sensitivity has very little relevance for you. However, it is important in that it conditions the response of any doctor who may treat you. You will get very widely differing diagnoses, sympathy and treatment, according to the individual doctor’s own beliefs and attitudes.
Tracking down outerwear or snowsuits that are not of man-made fibre or of polycotton mixes is virtually impossible. It is occasionally possible to find corduroy snowsuits, anoraks and leggings with brushed cotton linings. These still have polyester wadding, but since these are enclosed by 100 per cent cotton, they cause less problems. Heskia produce a range of such outerwear. Their clothes are sold by John Lewis and House of Fraser stores.
Footwear, Socks and Tights
Cotton corduroy boots and padders in 100% cotton are made by many firms and are easy to find. Pex make 100 per cent cotton socks in newborn and baby sizes. These are widely available in children’s shops and large supermarkets. Hundred per cent cotton tights in baby sizes are sold by mail order by Cotton On and by Schmidt Natural Clothing.
Cotton On’s range is specifically designed and chosen for babies with eczema and skin conditions. Their clothes are formaldehyde-free, chlorine bleach-free and do not use other well-known irritants. Cot’n Kids, Fix and Schmidt Natural Clothing also sell formaldehyde-free and chlorine-free clothing. The Green Catalogue sell unbleached cotton underwear. Schmidt Natural Clothing sell silk, silk blend, wool and wool blend clothing.
The large mail-order catalogues companies (such as Littlewoods, Freemans, You and Yours, Grattan) also often sell a selection of cotton jersey sleepsuits and underwear.
The following companies are suppliers of anti-dust mite bedding and covers: Allerayde, Derpi, Green Farm, The Healthy House, Medivac and Slumberland.
The anti-dust mite covers allow ventilation of pillow and mattress, and evaporation of damp without allowing dust mite allergens to pass. They are made of pure synthetic, or synthetic and cotton blend materials. Medivac and Green Farm supply anti-dust mite pillows and duvets which are washable at home at high temperatures. All of these products are sold free of VAT to people who need them on medical grounds. Derpi offers a further discount to people who are members of allergy charities.
Fogarty manufacture Superfil feather and down pillows and duvets in which the filling is treated with a special coating which stops the escape of any fibres which might cause allergy. The outer wrappings are 100 per cent cotton. Fogarty offer a lifetime moneyback guarantee if you react to them. The products have been selling since the early 1980s and none has yet been returned. The prices are similar to ordinary feather and down pillows or duvets.
Pollens are the fine powders produced by plants, trees, shrubs and grasses to fertilise and reproduce their species. Pollens are probably the most common cause of allergic reactions.
The symptoms most closely associated with pollen allergy are those of seasonal rhinitis (also called hay fever) — sneezing, itchy eyes, runny and itchy nose, sore sinuses. Asthma, eczema and any other allergic symptoms such as headaches or joint pain can also be triggered by pollens. You can get late phase reactions — symptoms developing several hours after your exposure to pollens, often at night.
Contact dermatitis can sometimes result when airborne pollens come into contact with exposed skin. These reactions can sometimes be delayed by up to a few days.
If you know that you are allergic to pollens and want advice on how to cope. Spores of fungi and moulds are the subject of a separate section. If you want to know more about pollens, where they are found and how to detect pollen allergy, read on from here.
Exercise can boost potency by increasing your sense of well-being and your ability to handle stress. It also helps keep your arteries functioning well. So it’s important that you exercise regularly. Your doctor can help you plan an exercise program that will be safe and beneficial.
Ask him to focus on aerobic exercise—steady exercise over a prolonged period of time which increases your heart rate and makes your body produce more HDLs. Many activities qualify as aerobic exercise, including jogging, bicycling and walking briskly. To be really helpful, however, most of these exercises need to be done for 20 to 30 minutes at a time, at least three times a week. You don’t need to start out at this pace. Begin slowly and work your way up gradually. Exercise activities with a lot of stops and starts, such as handball, tennis and weight lifting, won’t do your arteries as much good as a less strenuous, but continuous workout. The key is to get your heart rate up to 80 percent of its maximum, and keep it there for 12 to 15 minutes. Ask your doctor what your maximum heart rate should be. Then, when you exercise, stop periodically to check your pulse to see what your rate is.
Faithfully following an exercise program for several months also tends to lower your blood pressure. Doctors know that high blood pressure is a major cause of clogged arteries, so lowering your blood pressure can help your arteries, your heart—and your erections.
Sometimes men who enjoy exercise believe that all they have to do to protect their health and their potency is work Out. Some people believe in the tooth fairy, too. The truth is that all the other elements of the potency program—diet, normal weight, normal blood pressure, no smoking and moderate use of alcohol, if any—are essential, too. If you jog five miles and then reward yourself with a double cheeseburger and fries, followed by a cigarette, your arteries are still susceptible to trouble.
An implant will not change your personality. It will not make you the most popular guy on the block. It can’t be counted on to save a failing marriage.
Having an implant does not, by itself, make you feel aroused. What causes you to feel desire before surgery should have the same effect after the operation. By the same token, if you rarely feel sexual desire before getting an implant, that’s unlikely to change.
Implants are not magic problem-solvers. The prosthesis will not change lifelong sexual patterns. If you rarely had sex before your erection problem developed, the operation will not turn you into a sexual superman. By itself, an implant will not increase your sexual appetite or desire. The prosthesis doesn’t change behavior; it just enables you to have an erection and makes intercourse possible.
Implants produce a simulated erection which, although close in appearance to a natural erection, is not identical. The implants are placed in the corpora cavernosa (those two cylinders which run parallel along the length of the penis, and, in a natural erection, fill up with blood). The head of the penis, which is part of a separate and much more delicate area called the corpus spongiosum, does not become erect with any of the implants. And it’s not likely that a model with such a feature will be developed, because of this area’s small size, irregular shape and closeness to the urethra.
The implant erection usually is not quite as wide or as long as a naturally produced erection. An implant won’t increase the size of a man’s penis.
Sometimes the best way to tell if you’ve found a professional who may be able to help is by what he or she does not do. The following are some warning signs. We suggest that you look elsewhere for your care if your doctor does any of the following things:
• He refuses or is unwilling to have your partner involved in diagnosis and treatment.
• He ignores your sexual problem or tries to change the subject every time you bring it up.
• He tells you to adjust to life without sex, or tells you that sex isn’t important.
• He makes any automatic, unfounded assumptions about the cause of your problem. If your doctor tells you without giving you a thorough evaluation that your erection problems are caused by psychological difficulties or that you have a problem just because you’ve been working too hard, run, don’t walk, out of that office. Generally speaking, no one can assume the cause of your problem without a thorough evaluation specifically focused on your potency problem. Don’t let a well meaning but ignorant professional dissuade you from seeking all the help you need.
• He can’t tell you the success rates and the dangers of various treatments.
• He is quick to tell you, «If this treatment doesn’t work, nothing will!» If you hear this, bolt for the door! No knowledgeable professional will put you under such wholly uncalled-for stress. There are almost always alternative treatments that will help. If you decide on a particular course of action, find out about alternatives if your first attempt at a solution (preferably the least expensive and least complicated treatment) doesn’t work.
Women have many of the same fears as men. And a wife or lover may be afraid that by talking about the problem she’ll find out that she is the problem—that she’s doing something that turns him off. And she may fear finding out that her husband does fine with other women. She also may be afraid that his health is the problem; she may resist talking about the difficulty hoping it will «cure» itself, so she’ll know he is physically okay And some women want to protect their husband’s feelings Sensing their partner’s reluctance to talk, they avoid the topic They don’t want to, as one woman says, «make him feel an^ worse than he already does.»
Our research indicates that women react to erection problems in a wide variety of ways. In many cases we looked at, the way a woman responded appeared to be greatly influence by the way she and her husband normally communicated. The more reassurance and love that was available on both sides and the more both were involved in solving the problem, the more manageable the sexual difficulty was. When there was less communication there was more opportunity for hurt feelings, self-doubt, blame and anger to fester—and erupt.
Jack’s reaction is far from unique. In fact, I’ve seen men, tortured by a long history of erectile dysfunction, suddenly change after taking the medication. With the restoration of a fulfilling sex life, patients have become calmer, happier, and more optimistic about their ability to fully engage in all the aspects of their personal relationships.
One patient described it to me this way: «For the first time in three years, I was able to make love without feeling that I had to totally control the situation from start to finish. We could both relax, take our time, and enjoy being with each other. It’s what sex should be.»
Often, regaining erectile function gives men the confidence to enjoy other sexual activities, including prolonged foreplay, sensate touch, oral gratification, and erotic role playing. It allows them to receive pleasure more readily, and share that excitement with their partner. With the pill there is no longer any need to restrict sexual activity. Men and women can now enjoy the full repertoire of sexual expression. The magic of the medication is that it allows sex to regain its natural rhythm.
Then, too, there are those men who regard their restored function as a second chance. This time, they want to make everything as good as it can be, and share optimally with their partners on every level. To me, they express a deep sense of appreciation and gratitude—especially those who have experienced ED for long periods of time. Such patients take nothing for granted, and particularly not where their relationships are concerned. They are willing, indeed eager, to examine their feelings in ways they couldn’t before because they were preoccupied with their physical states. The result, very often, is two people who are much happier. Having seen the transformative effects of the drug, the partners of these men are delighted with the changes that affect both of them.
Women who are thinking about getting pregnant are constantly advised to give up habits—drinking, smoking, drugs—or alter lifestyles which could put a baby’s health at risk. Recently, researchers have been trying to find out whether the same advice holds true for men as well. Since men contribute half of the genetic material to a baby, researchers have been trying to determine what, if any, effect a man’s health or lifestyle has on pregnancy. As yet, no definite conclusions have been reached. However, new studies are underway and experts may soon have some answers to this very important question.
Recent sperm studies have furnished medical experts with the following information:
1) Babies fathered by men who drink alcohol tend to weigh less and have higher chances of birth defects than do babies of non-drinking fathers.
3) In some cases, men with lower than average levels of vitamin C produce genetically damaged sperm which could cause birth defects if they fertilize a woman’s egg.
4) Men who are exposed to radiation—usually in the workplace—tend to father children with higher-than-normal incidences of leukemia.
Researchers acknowledge that no conclusive evidence exists to date which would lead to recommending that potential or expectant fathers change their habits or lifestyles. However, the circumstantial evidence and additional studies on the long-term genetic consequences of lifestyles and other factors on sperm may very well lead to such a recommendation in the near future.
Osteoporosis is known as the brittle bone disease. It can affect both men and women. Osteoporosis develops slowly over many years. Recent studies show that men over 30 years old begin to lose some bone mass each year. This loss could be as much as 2% a year. This could result in brittle bones.
Here are a few tips that you should take during your younger years. They could help produce stronger bones in your later years.
(1) Get adequate calcium in your daily diet. This can be done by including foods like dairy products, dark-green leafy vegetables, salmon, and tofu.
(2) Get enough vitamin D and the trace mineral manganese.
(3) Exercise regularly. This helps to promote bone growth. It also strengthens the muscle which supports the bones.
(4) Avoid smoking, alcohol, caffeine, and high-protein foods.
Avoid antacids that contain aluminum. Aluminum can reduce the amount of phosphorous in your bones and this could weaken them. You may also want to avoid cooking certain high acid foods in aluminum pots. This can could cause some of the aluminum to dissolve into your food.
A number of studies have shown that caffeine can cause calcium loss. Caffeine leaches calcium from the bones and causes it to be excreted in urine. It can also prevent the digestive system from absorbing enough calcium. Thus, you should limit your intake of caffeine containing beverages. This includes, coffee, tea, and many of the popular soft drinks. You do not need to cut these items out entirely but instead limit yourself to 1 or 2 servings per day.
Too much salt in your diet can have the same effect that caffeine does. It can cause the body to lose calcium in the urine.
Recent studies have showed that Vitamin D is especially important in helping your body to prevent calcium lose.
The New England Journal of Medicine recommends calcium fortified orange juice as a great way to add calcium to your diet. The calcium citrate appears to be helpful in preventing calcium loss from the spine.
1) Location— ideally, you should try to have the garden near enough to the house so that it is almost like a «fresh food cupboard». That way you can get fresh produce any time you need it and put off harvesting vegetables for a meal until the last minute, keeping all their nutrients and flavor intact.
Having your garden close to the house also promotes better care by you and your family. You’ll know what’s going on in the garden nearly all the time and be able to avert many problems before they become serious.
2) Soil— most gardeners aren’t fortunate enough to have perfect garden soil. Instead, they have to make do with whatever soil they have. This means you must usually keep on adding organic matter to your garden because the vast majority of soils require it and plants keep using it up. But you should not get discouraged by poor soil, because you can add natural matter to improve its quality.
3) Water— adequate water is another essential thing your garden will need. It isn’t wise to depend on rain as the sole source of water for your garden— mulching will provide some hel p, but your garden should get, as a general rule, about 1 inch of rain per week.
One way to insure adequate water for your garden is to use a sprinkler system. Depending on the size of your garden, one or two strategically placed sprinklers should give it adequate coverage and water.
You can also try trench irrigation. This is done by digging trenches, about 6 inches deep, on a slight slant in a gridiron pattern between rows. This system doesn’t work especially well in sandy soil and doesn’t provide the freedom to change the pattern °f the garden on s- friort notice if such changes are needed.
4) Tools— for basic organic gardening, you will need very few tools. If you haven’t gardened before, it is a good idea to try getting along with just the essentials to begin. Here are the basic tools you’ll need for starting your organic garden: a spade; a fork; a trowel; a knife; a 3-pronged, hand-held cultivator (can be a short-handle for small gardens or on the end of a long handle for larger gardens); a rake; a hoe; and a file to keep the edges of your tools sharp and effective.
1) All perennial crops, such as strawberries, asparagus and rhubarb, should be located at one side of the garden.
2) To avoid shading, tall-growing crops, such as corn, must not be planted near small crops like carrots or beets.
3) Space for spring crops which are harvested early may be used again for later crops. For example, tomatoes after radishes, and cucumbers after spinach.
4) Crops, such as lettuce, radishes, onions, early cabbage, etc., which are planted early, fast-growing and quick to mature, should all be grouped together.
5) In hilly areas, rows should follow across the slope.
6) If possible, rows should run north and south to keep plants from shading one another.
7) Spacing between rows should be designed for the method of cultivation you plan to use— hand or mechanical.
The latest research on fasting—400 to 800 calorie-per day diets that prohibit eating anything except scientifically devised liquid supplements— shows that it actually may not help you lose weight any faster. The research was conducted by weight-loss experts at Syracuse University and at the University of Pennsylvania over a period of six months. A total of 76 obese women were separated into 3 groups and placed on on 420, 660, and 800 calorie- per-day diets. All of the women lost weight—an average of 45 pounds— but there was very little difference in the amount of weight lost on any of the diets.
It is interesting to note that losing 45 pounds in six months actually averages out o about 2 pounds a week, which is the rate of loss that most doctors recommend. And at type of weight loss can be accomplished by carefully maintaining a low-fat diet, coupled with adequate exercise. No fasting is necessary.
An ongoing study to determine why Hispanic and Black women have lower rates of breast cancer than whites, suggests that diet may play an important role. The study suggests that a diet rich in beans, fruits, and vegetables may be one factor and alcohol may be another. Although all three groups consumed similar amounts of fat and fiber, Hispanics appear to be more likely to eat beans and vegetables containing antitoxidants, substances with anti-cancer properties, and tend to eat the type of monosaturated fat found in olive oil. Whites also consume more alcohol, especially beer, than either Hispanics or blacks,
4 Proven Ways To Lower Nutrient Loss In Foods
1) When shopping for produce, always choose fresh fruits and vegetables with care. Regardless of the price, don’t buy produce that has bruises or cuts or that simply doesn’t look fresh.
2) Don’t soak fresh fruits and vegetables in still water for any length of time or the nutrients may pass into the water. Instead, wash your fruits and vegetables under cold, running water. You can also use a small amount of dishwashing liquid to help remove any residue of fat-soluble pesticides that may remain on the food. And be sure to rinse all of your produce thoroughly.
3) Whenever possible, make salads just before you eat them. Valuable vitamins are lost when fruits and vegetables are cut up in advance and left exposed to air.
4) You should cook food for the shortest time possible. Then, eat it as soon as you can and don’t allow the food to stay hot for prolonged periods. If you thaw frozen vegetables or fish before cooking, cook them immediately.
There is no doubt that most cultures see the breast as a symbol of femininity and the loss of a breast is frequently mourned because of this. Surgeons try to be as conservative as possible but where the priority is longterm survival, and hopefully a cure, the cosmetics take a back seat. Losing a breast can cause a massive psychological reaction, so it is now a relatively common practice for the cancer surgeon to work with a plastic surgeon to reconstruct the breast at the time of the mastectomy. Nonetheless, many women notice a change in their sexual behavior after a mastectomy. This seems to be particularly true of women who rely a lot on breast and nipple stimulation for arousal or orgasm. Sensate focus exercises also come in handy here. The different touching techniques used on other areas of your body stimulate the erotic feelings that build towards orgasm. In the case of mastectomy, it takes the emphasis away from the breasts by discovering other parts of the skin that will give you a similar response.
The loss of a breast can also mean a loss of self-confidence and a reluctance to initiate sex. Rita was forty-two when her breast cancer was diagnosed. ‘I was devastated. I thought they must have put the wrong name on the mammogram. The whole ordeal felt like some terrible nightmare. Matthew and I
had always had a great sex life. We married late and I suppose we were making up for lost time or something. He was always a big breast man and he always said how much he loved the fact that I was well-endowed. When I heard I had to have a mastectomy I thought, «Well that’s it then, he won’t have any interest in me sexually any more. This will turn him right off.» The strange thing was that it was me who had the trouble with sex. I couldn’t bear to let him see me without a shirt on, and I would freeze if his hands went anywhere near my chest. He said it really didn’t matter to him, he was just so glad he still had me. He was so patient and so gentle, I don’t know how I would have coped on my own.’
Being able to express our sexuality is one of those things we take for granted, provided everything is going well. If you have a current partner and your relationship is happy, if you both manage to orgasm most of the time and don’t worry when you don’t, if erections are never a problem, and you have matching libidos, then sexuality is probably not an issue.
As a matter of fact, when you consider the intricate blend of factors that need to combine to make it all happen … personalities, emotions, moods, blood vessels, nerves, hormones and muscles … it’s amazing that it works as often as it does.
But things can go wrong and when they do it can come as a huge surprise. For many people, developing a problem with their sexual function will force them to confront their attitudes and beliefs about sex in a totally new way. It can make you question the way you see yourself, your partner, and your relationship(s). On an even deeper level, a sexual difficulty can suddenly bring up all sorts of memories of the sexual anxieties and insecurities of childhood and adolescence.
It is not possible to talk about sexual problems without also dealing with relationship problems. Difficulties with sex always need to be seen in the context of the whole living situation. It’s a chicken and egg situation. Sexual problems can have an influence on the relationship and, if the relationship is in trouble, one way or another it will show up sexually. All sorts of factors can have an impact. Do you have time alone together? Do you have privacy or are you sharing a house with the in-laws? Are you frightened of getting pregnant? Is sex being used as part of a punishment and reward system? Do you resent your partner controlling the pursestrings and holding back money unless they get their way sexually?
Letting go of a dream can be punishing. ‘It got to the point where I would avoid seeing any of my friends who were pregnant or who had children. It was too painful; they were just a reminder of my deepest insecurity. When my sister told me she was pregnant, I actually found myself feeling angry with her for having it so easy. Even now I still get a little pang when a friend gets pregnant, but I try to hide it. One good thing though … Tom and I came out of it stronger than ever. We learned to talk to each other about what we really wanted out of life, and we have started to readjust our plans for the future.’
Whatever the results of infertility management, it represents a crisis. Both partners are forced to face emotional and sexual issues that may never have arisen otherwise. .The outcome for the relationship depends on the state of the relationship before the infertility is discovered. If things are shaky and the potential pregnancy is seen as the way to patch up their problems, the added stress of IVF/GIFT might be the straw that breaks the camel’s back. As yet, IVF is generally offered only to married heterosexual couples in a stable longterm relationship. This is partly moralizing but it is largely a recognition of the difficulties a couple will face when the going gets tough.
For many years it’s been held to be true that men peak sexually in their late teens and women in their thirties. Are they really so different? Interestingly, these dictums relate more to quantity than quality. Now, at the risk of generalizing, if you count the number of orgasms a man has from wet dreams, masturbation and sex with a partner, combined with the ability to quickly reload and do it again, then the ‘peak’ is around eighteen … but does that make him a better lover? Ask any man in his thirties if he would still like to be making love with the technique he used when he was eighteen and you would surely get a pile of ‘no’ votes. Similarly, women develop a greater ability to orgasm as they get older. It takes time to get it right, and to break down some of the inhibitions that can stand in the way.
In terms of your sexual relationship, there are advantages to a longterm relationship. Getting to really know your partner intimately takes time. The awkwardness and guesswork of the early stages of any sexual relationship develop into a comfortable familiarity that has a passion all its own. The nuances of your partner’s breathing and body movements as they respond to your touch become the unspoken sensual clues in your lovemaking. It is a learning process, and one that evolves. In fact, many people find they can only fully relax sexually when they feel secure in a relationship.
However, longterm relationships have their disadvantages too. While many relationships remain exciting and passionate and fun forever, limited only by the imagination, many people run into problems with sexual boredom.
The issue of permanent contraception is a difficult one. Once a person has decided that they have had all the children they ever want to. have, and their partner agrees that they also don’t want any more children, then it is up to one of them to decide to have the operation of tubal ligation for her, or vasectomy for him. One couple put it quite well when Paula said, ‘Of course I would consider sterilization … for him! I have had to take the Pill for years, I have fiddled around with diaphragms, I had the baby … now it’s his turn.’ Noel agreed. ‘Yes, I’d consider Paula having it done!’ An impasse. Let’s just say they are still locked in negotiations. In Australia you don’t need your partner’s permission for either operation, although most people in a relationship would feel an obligation to include their partner in the decision. If one partner wants more babies or has religious or other objections to sterilization, it can set up a real battleground.
There are benefits in no longer having to worry about contraception. Most people are satisfied with the decision and are relieved that they can have sex without the fear of pregnancy. This may need to be balanced against the sometimes negative feeling that you are no longer fertile. Even though it has no effect on your sex drive, some men equate fertility with masculinity and it would be a particularly difficult decision under those circumstances. As hard as it is to face, marriages aren’t necessarily as lasting as the cut in your tubes, and even though you may not be able to foresee it, things can change. So before you take the plunge, it’s a good idea to go through all the ‘what ifs’: ‘What if my partner dies and I want to have babies with someone else?’; ‘I’m still young; what if I change my mind when our youngest has gone to school?’; ‘What if, God forbid, something happened to one of the kids? Would I still feel the same way?’ What I am saying here is that circumstances can and do change, and if you have any doubts at all, then don’t do it. Not yet anyway.
Tubal ligation needs a general anesthetic. The woman’s Fallopian tubes are located, usually by a laparoscope, and they are clipped, or cut and tied. An Australian study showed that up to six percent of women strongly regretted their decision to be sterilized and that one to two percent actually seek reversal — not an easy operation. Others try for invitro fertilization when they change their minds.
HBV infection is passed on when body fluids or secretions from an infected person get into another person’s body through a break in the skin or a lining membrane. HBV has been found in blood, semen, vaginal secretions, saliva, urine, breast milk, discharges, sweat and even tears.
Hepatitis В is of particular concern for women because a woman who is a chronic carrier (see below) or who develops hepatitis В infection during pregnancy may pass the infection on to her baby, usually during birth. Children infected this way usually become carriers.
HBV is very easy to catch. You can pick it up through sexual contact, blood transfusion, sharing syringes and needles, contaminated instruments (such as those used for tattooing, ear piercing, acupuncture, dental and medical procedures), mouth-to-mouth contact and by contact of any infected fluid with a cut or abrasion on any body surface.
Hepatitis В is not strictly classified as an STD because it is not exclusively passed on by sexual contact, though this is probably the most common means of transmission in Western countries. Homosexual men and men or women with many sexual partners are those most likely to be infected through sex. Catching the virus from blood transfusion, which was once believed to be the most common means of infection, is now rare because of screening of donors. (Blood from transfusion services in Australia and many other countries is now tested for hepatitis В and C, HIV and syphilis). People at most risk of catching hepatitis В non-sexually include health workers who come in contact with blood or secretions from infected people, intravenous drug users and mentally handicapped people living in institutions.
After infection with HBV there is an incubation period during which the virus multiplies in the body. Symptoms usually begin between six and twelve weeks after infection, though the incubation period can range from four weeks to six months. The symptoms often come on gradually: you may feel feverish and unwell for several days before you notice jaundice, which may take several days more to develop its deepest colour.
Of the adults who get hepatitis B, 95 per cent overcome the virus by developing antibodies that eradicate it from the body. Once the antibodies are doing their work, the jaundice begins to fade, usually taking one to two weeks to disappear. Other symptoms of disturbed liver function may subside more slowly: it may be weeks or even months before you feel quite well again. In general, the more severe the attack, the longer it takes to recover. After complete recovery you are immune from hepatitis В infection in the future.
Many women suffer silently and unnecessarily from urinary incontinence, which affects about 5-6 per cent of Australians — over 800 000 of us. Women are eight times more likely to be affected than men. Also, many more people experience occasional ‘accidents’ with involuntary loss of small amounts of urine. A recent survey in Sydney found that 54 per cent of women had experienced loss of bladder control at some time during their adult lives, so if incontinence has ever troubled you, you’re not alone.
Loss of bladder control is a humiliating experience. The possibility of unpredictable, embarrassing accidents can have a profound effect on confidence and self-esteem, and may lead to depression, anxiety, social withdrawal and isolation. Many sufferers are too ashamed and embarrassed to talk about their problem, even to their doctors.
There is good news for all women who suffer from loss of bladder control. In the past two decades there’s been great progress in the understanding of incontinence and in the refinement of tests to identify precisely how and why bladder control becomes disturbed. The new knowledge and understanding have paved the way for more successful treatment. Special incontinence clinics now achieve a success rate of 70 per cent without surgery, and more than 90 per cent with surgery.
The belief that they have too much facial and body hair is a distressing problem for many women. They may fear that they be a hormonal imbalance and become depressed and withdrawn, believing that their appearance is flawed by excessive hair. But how much is too much? This perception depends on your inherited background and where you live.
In our society the image of female beauty promoted by fashion, advertising and the media makes facial or body hair on women a disfiguring blemish. We go to all kinds of trouble to remove it even from sites such as our legs and armpits, where it is normal and inevitable that hair will grow. In other societies, where the majority of women have a genetic tendency to grow more and darker (and thus more noticeable) facial and body hair, moderate female hairiness is quite acceptable.
In the past excessive hair growth has often been considered a cosmetic rather than a medical problem. In recent years the factors that influence hair growth have become more clearly understood; most women with unwanted hair can now be helped by medical as well as cosmetic treatment.
Before discussing the problem of excessive hair, let’s look at a few facts about hair in general.
Types of hair
There are three types of hair. Lanugo hair grows prenatally and is seen mainly on premature infants — fine, darkish hairs that disappear shortly after birth. There are two types of post-natal hair: vellus and terminal. Vellus hair is fine, short and pale, and grows all over the body except on the palms and soles, around the nails and on some parts of the genitals. Terminal hair is thicker, longer, and often strongly coloured. It is seen after birth on the scalp, eyebrows and lashes.
The tiny organs, from which hairs grow, the hair follicles, lie below the surface of the skin. Hair growth is not continuous, but goes through cycles of growth and rest. At the end of the resting phase the hair falls out and a new hair begins to grow. The length of each phase of the cycle varies with the site of the hair. The growing cycle is longest in scalp hair (three years) and shortest in arm and thigh hairs (a few months), which explains why scalp hairs grow to greater length. Each follicle goes through its cycle independently of other follicles, resulting in constant slight hair loss rather than the seasonal moult that occurs in many animals.
We are all (men and women) born with the same number of hair follicles. During life various factors influence some of the vellus hair follicles to produce terminal hairs. The number and situation of follicles normally converted to terminal hairs depend on sex and other inherited factors, both racial and familial. At puberty the production of androgens (male hormones) in both sexes converts vellus hair to terminal hair in the armpits and pubic regions.
As males progress through puberty, androgens cause terminal hair growth to develop further in an orderly sequence on the upper lip, chin and cheeks, lower legs, thighs, forearms, abdomen, buttocks, chest, back, upper arms and shoulders. The amount of this hair growth is enormously variable between men: there are as many men with a sparse beard and little or no body hair as there are men with heavy beards and body hair.
Terminal hair also develops on the lower legs and forearms in the majority of women. Whether this growth is stimulated by sex hormones is uncertain, but as it tends to be proportional to the amount of terminal hair in other sites it seems probable that it occurs more in those women whose hair follicles are more sensitive to androgens.
Excessive hair growth
There are two types of excessive hair growth, hirsutism and the less common hypertrichosis.
Hirsutism refers to the androgen-stimulated growth of coarse terminal hair in women on the ‘man the abdomen and lower back and fronts of the thighs. Note that a few со hairs around the nipples are common a normal.
Hypertrichosis is excessive growth both vellus and terminal hair. It is usually not caused by hormones. The main causes
of hypertrichosis are certain drags, thyroid disorders, after inflammation of the skin and in some metabolic disorders. This sort of excess hair disappears six to twelve months after the cause is corrected. Hypertrichosis may also occur in patches, alone or associated with a mole.
Bleeding between periods
Except for slight spotting at the time of ovulation, all bleeding between periods (and after sex) needs investigation. The most important causes to rule out are cancer of the endometrium or cervix. Other causes include infections and other inflammations of the cervix and uterus, polyps of the uterus and cervix, and hormonal disorders. Ectopic pregnancy and incomplete or missed abortion must be excluded if there is unexpected bleeding and any possibility of pregnancy.
Painful periods (dysmenorrhoea)
There are two types of period pain.
• Primary dysmenorrhea occurs in young women who have normal reproductive organs.
The most common causes are infection of the pelvic organs (PID) and endometriosis. Less common causes include uterine fibroids and polyps, and uterine adenomyosis.
The cause of secondary dysmenorrhoea always needs to be investigated. Periods become painless when the cause is eliminated.
Some women get a particular type of headache with periods. It often starts half a day or so before bleeding and may last for two or three days. This headache is often described as a dull, tight pain around the front and sides of the head. It may be partly relieved by mild painkillers such as aspirin and paracetamol, but it returns after their effect wears off. Menstrual headache can occur both in natural cycles and on the Pill.
This headache is the result of the sudden fall in oestrogen in the blood at the end of the cycle. It can be prevented by taking a very small dose of oestrogen for three or four days starting the day before menstruation is due, or after the last active Pill is taken.
There seems no doubt that mood сchanges around the menopause are influenced by a lack of oestrogen, but your feelings about
getting older and reaching the end of your fertile years also play a part in your emotional response. Physical symptoms can also affect your mood. If your sleep is disturbed by frequent sweats, it’s not surprising that you feel tired, lethargic and irritable during the day, and have trouble concentrating and making decisions.
Physical symptoms may make difficulties for you at home, at work or socially because your family, colleagues and friends don’t understand what’s happening to you. Some women may be embarrassed or unwilling to complain of menopausal symptoms because of the old attitudes (which still prevail in some quarters) that it’s bad form to speak of such things that women should ‘put up with it grow old gracefully’. There’s no graceful about drenching hot flushes,
splitting headaches or depression!
Other women have told me that; are afraid to admit to menopausal toms for fear of being assumed to be ‘over the hill’ or ‘past it’ and thus less competent, rather than being judged fairly on their performance. In a society that values promise and smooth face of youth maturity, older women are often caricatured as unattractive, ill-tempered or doddery figures of derision. Such attitudes don’t do anything for the self-esteem and confidence of middle-aged women. Other things may be causing emotional stress. Middle age can be hectic! You may lie worried about the health of your partner, elderly parents or others. Middle-aged women take on the biggest load of caring for the older generation. This can take a big toll on their physical and emotional energy.
Your own or your partner’s retrenchment may bring financial problems you didn’t expect. Retirement can be hard to adjust to.
Loneliness may follow marriage breakup or death of your partner. Your children maybe growing up and moving away from home, leaving a gap in your life that’s hard to fill, though I think the ‘empty nest’ has been overemphasized as a cause of depression in middle-aged women. Many women are relieved when the children become independent, leaving them extra time (and funds!) to devote to themselves and their partners and friends, careers and other interests. Nevertheless, when the children leave home, it certainly changes the marriage dynamics. It’s a time of life when everything that happens points unswervingly to the fact that we are no longer young: grey hairs! wrinkles! spectacles needed for reading! grandchildren! And then there’s the menopause, a clear signpost that we have arrived at middle age.
Reaching middle age means taking a new look at yourself and your place in your family and community. Be proud of your maturity: don’t deny it! It’s time to review what you want from the rest of your life; time to make some plans so that you can enjoy the years ahead to the full. Let one of these plans be to take steps to ensure the best possible health for the rest of your life.
Night-time cramps in the legs can be a problem. They really hurt and can have you hopping around the bedroom in misery until that agonizing knot relaxes. We don’t know why leg cramps occur more in late pregnancy. It may be a combination of altered amounts of salt and calcium in the blood and reduced blood flow in the legs.
People will tell you different ways to prevent or relieve leg cramps. I found that running warm water over my leg helped to stop the spasm. Some people swear by a knob of camphor in the bed for prevention. This didn’t work for me, but it’s cheap and harmless so worth a try. If friends advise you to take something by mouth to prevent cramps, check with your doctor first.
Skin that is stretching quickly, such as over the abdomen and breasts, can become itchy. A cream containing something to relieve the itch will help; ask your pharmacist. More severe itching can result from an increase in bile salts in the blood, as occasionally happens when the liver is overloaded in pregnancy. The itch affects all skin, including the palms and soles. If you become itchy all over, see your doctor promptly. You may need blood tests to confirm the diagnosis, and treatment to bring the bile salts back to normal.
Wearing a firm support bra and an abdominal support can help reduce the chance of stretch marks forming.
As your baby and your uterus get bigger, your centre of gravity moves forwards. Your upper spine bends further and further back to stop you from toppling over. This puts a strain on the muscles and joints of the spine. Also, the hormones of pregnancy soften and loosen the ligaments of your lower spine and pelvis in readiness for delivery. It all adds up to a high chance of back tiredness and aching in those later weeks.
Your antenatal exercises and advice given on posture will help improve the strength of your back muscles; your physiotherapist will advise you how to move and lift things to reduce back strain. If back problems are really troublesome, speak to your doctor or physiotherapist. A maternity corset or back support may help.
Shortness of breath
As your uterus rises in your belly, there’s less room for your diaphragm to move down when you breathe in; thus your lungs expand less and oxygen intake is decreased. This won’t worry you excel when you’re exerting yourself (such as when walking up stairs and hills), when
shortness of breath and aching muscles may slow you down.
If you get short of breath without or on slight exertion, see your doctor. It may be a sign of anaemia or other disorder.
‘I never feel comfortable’
During the last five to six weeks there may
be discomforts from pressure on your
lower ribs and the weight of your uterus on your pelvic organs and tissues. It’s hard
for some women to find a comfortable position for sitting or lying down. That big belly seems to get in the way, no matter what you do. A straight-backed chair helps for sitting, and you can experiment with extra pillows for more comfort in bed.
Pregnancy hormones also increase the amount of fluid in your body, more so as pregnancy advances. This, plus increased pressure in the veins in your legs, often leads to swollen ankles at the end of the day in the latter weeks. Swelling is aggravated by hot weather and prolonged standing.
When you lie down at night the fluid around your ankles drains back into your blood and is passed as urine. You may find that you have to get up more frequently than in the early weeks! Putting you feet up in the afternoons and evenings may help to make your nights less disturbed.
If ankle swelling extends up over your shins or if your fingers become swollen, see your doctor. If rings start to feel tight, take them off straight away — if they get stuck they may need to be cut off!
The ovum m the past it was thought that the ovum I could be fertilised for up to 24 hours after ovulation, but recent research indicates that its survival time is closer to 12 hours. Thus the most favourable condition for fertilisation would be to have sperm waiting in the tube when the ovum is released. We ovulate on one day only of the cycle, even if more than one ovum is released (as happens in cases of non-identical multiple pregnancy). If an ovum isn’t fertilised, it dies and conception is impossible during the rest of the cycle.
The characteristics of ‘fertile mucus’ — copious in amount, clear, watery, slippery and stretchy — are at a peak just before ovulation. Soon (within 24 hours) after ovulation, progesterone from the corpus luteum changes the mucus, making it thick and sticky. Cervical mucus influenced by progesterone does not allow sperm to pass through the cervical canal.
At the beginning of a cycle the cervix feels firm and its opening into the vagina (external os) feels tightly closed. As ovulation approaches, the cervix feels softer and wider and the os becomes lax enough to admit a fingertip. After ovulation the cervix soon returns to its firm state with a closed os. Some women also notice that their cervix is closer to the vaginal opening at the beginning of the cycle and after ovulation, and further from it during the fertile period before ovulation.
Because changes in the cervix may be hard to compare from day to day, it is recommended that you combine feeling the cervix with observing the cervical mucus and/or keeping a temperature chart.
We have already seen that one of the effects of progesterone from the corpus luteum is to cause a rise of 0.2-0.6°C in basal body temperature.
How does the Pill work?
There are three effects that together make the combined Pill highly effective. First and most important, when taken correctly the hormones in the Pill prevent ovulation. How can hormones taken by mouth do this? You will see that high blood levels of ovarian hormones produced during the natural menstrual cycle stop the pituitary from releasing the hormone (FSH) that triggers the development of ovarian follicles in the next cycle. If you put enough ovarian hormones into your blood by swallowing them, pituitary hormones are suppressed in the same way and ovarian follicles don’t develop: no egg — no pregnancy! Second, the lining of the uterus is altered by the Pill’s progestogen so that it is less suitable for a fertilised egg to implant and develop. Third, progestogen causes the mucus produced in the cervix to become thicker and stickier, making it harder for sperm to get through.
When I was working at Sydney University in the early 1950s and my colleagues and I read that overseas researchers were studying the use of oral hormones to prevent ovulation, we thought it a very cheeky attempt to interfere with nature, and that it would neither work nor ‘catch on’. How wrong we were! But you must admit that hormonal contraception very cleverly uses knowledge of reproductive physiology.
How reliable is the Pill?
If it’s taken according to instructions, the combined Pill is more than 99 per cent effective in preventing pregnancy. Most accidental pregnancies on the Pill are the result of mistakes in use.
How is the Pill used?
All combined Pills are taken for three weeks, followed by a week off. These four weeks are called a Pill ‘cycle’. After the week off, the Pill is taken for another cycle of three weeks on and one week off, and so on. Each pack of the Pill contains enough tablets for one cycle.
Most Pills come in both 21- and 28-day (or ED, standing for Every Day) packs. The 28-day packs contain 7 ‘dummy’ tablets that are taken when women using the 21-day packs would be having their week off. The dummies are a different colour to distinguish them from the hormone tablets. Many women prefer the 28-day packs, finding it easier to remember when to start a new cycle if there is no break in taking the tablets. Whether you are using the 21-day or 28-day pack, you will be taking cycles of 21 hormone tablets followed by 7 days of no hormones.
What is the reason for the ‘week off?
When the Pill was first devised it was intended to be taken continuously. With no fall in hormone levels, the endometrium wouldn’t die and be shed. It was expected (by the men who designed the Pill) that women would be pleased not to have regular vaginal bleeding. However, many women felt ‘wrong’ without periods. What’s more, since missed periods have always been associated with pregnancy, many women couldn’t feel sure that the Pill had ‘worked’. The missed period was particularly confusing with the early higher dose Pills, which often caused side-effects (such as nausea and breast enlargement) that were just like the symptoms of early pregnancy.
Studies showed that contraception was no less effective if a break of no more than 7 days was taken between courses of hormones that lasted no less than 21 days. It was decided that the Pill would be more acceptable if there was a short break between courses. During the break the fall in blood hormones results in some bleeding resembling menstruation (called ‘withdrawal bleeding’), usually starting 24-72 hours after the last hormone tablet is taken. It is usually shorter and lighter, with less bright bleeding than your natural period.
The decision to use the ‘three weeks on, one week off scheme for taking the Pill was quite arbitrary. It fits in with most people’s idea that vaginal bleeding about every four weeks is ‘normal’, provides regular evidence that there’s no pregnancy, and Pills for a four-week cycle could be packaged on a convenient-sized card. However, it could have been 47 days on and three days off, or whatever you like.
A lot of what happens when you’re attracted to someone is the result of instincts and reflexes. Our unconscious nervous systems make sure that sexual attraction does occur (to keep the species going).
When someone takes your fancy, you instinctively move closer to them. Your skin flushes and your pupils dilate, which makes you more attractive to them. Your body starts producing chemicals (pheromones) that attract the opposite sex through smell. Your voice becomes deeper and softer, so that you must move closer still to hear what each other is saying. You then feel the glow of each other’s body from that flushed skin. This brings on a reflex need to touch, and there you go. All this happens outside your conscious control and without you being much aware of it, except that you feel remarkably good with that person! Isn’t biology wonderful!
Who can describe falling in love? All the poems, songs and stories have tried. You’ll recognize what they’re trying to say when it happens to you. It’s something much more than sexual attraction: that feeling that your love is the most wonderful person in history, whom you want to make happy and share your whole life with.
Boyfriends and petting
From the mid-teens on, more girls are likely to have a ‘steady’: someone for whom you feel much more than sexual attraction. Companionship and having fun together are important in going steady, as well as all the delicious cuddling and petting. These relationships might not last long (though they can last for life), but they are good practice for learning about pairing and how to cope with it (and with breaking up).
It’s often said that girls have more romantic feelings and that the boys are only interested in sex. I don’t know about this: many young boyfriends are very committed. But if you have a steady, it’s very likely that sooner or later sex is going to come up. Will you ‘go all the way’?
This is something you must decide for yourself, whether it’s with a steady boyfriend or a casual acquaintance. Let’s hope that if you decide Yes’, you’ll feel sure that you’re ready for it, that it will happen with someone whom you care for and who cares for you, that you’ll know how to avoid possible bad consequences, and that you’ll enjoy the experience.
It seems common for girls to be pushed into having intercourse before they’re ready, usually by boys who want to ‘score’ and are in a state of sexual excitement from anticipating the possibility. They’ll pull lines on you such as the following.
• ‘If you really loved me, you would.’ The obvious answer to this is: ‘If you really loved me, you wouldn’t try to talk me into something I don’t want’.
• ‘I’ll suffer terribly or die if you won’t!’ Well, boys don’t suffer or die from not having an orgasm; they know how to have that by themselves.
• ‘You must be frigid.’ This is a devious, mean tactic, intended to make you feel bad.
Sometimes there’s peer pressure from girlfriends. ‘Haven’t you done it yet? What’s wrong with you? Scared? Hasn’t anyone asked you?’ Take no notice, and find some new friends.
More subtle influences can lead you into sex before the right time. Women’s traditional submissive and subservient role is still pretty strong in most of our minds, making it hard for us to assert our rights and say ‘No’ to men. You mightn’t want to-hurt his feelings. Also, sexual advances can be very flattering — a powerful persuasion.
There are some bad circumstances for first intercourse:
• if you have sex without contraception
• if one or both of you are drunk or doped at the time
• if it’s an act of rebellion against your parents
• if you agree because you think it will make him love you, or that he’ll ‘dump’ you if you refuse (if he did you’d be well rid of him, but you won’t think so at the time)
• if you’re feeling miserable and unloved, and think it will make you feel better. Unfortunately first intercourse for girls rarely lives up to expectations. It’s often so quick that you may wonder if it’s really happened, and you’re unlikely to have an orgasm. It can leave you feeling disappointed, unsatisfied, worried, guilty and embarrassed. Fortunately, for most of us it gets better in the future.
If your first intercourse is through incest or rape, it can have disastrous emotional consequences that can haunt you for years.
Recent surveys show that around halo of all adolescents have had sexual intercourse by the time they’re 17 years old Everyone keeps saying that young people have sex earlier now than in the ‘good old days’. I don’t know how they can know this, because until recently no one asked. There certainly would have been less opportunity in the past, when most social meetings between young people well chaperoned. However, the Australian Вureau of Statistics tells us that between 1910 and 1930 half of all teenaged brides were pregnant (because they had a baby less than nine months after marriage). Maybe things haven’t changed much!
Sex at any age can have some bad outcomes, including unwanted pregnancy, catching STD or making you or anyone else unhappy.
Sore breasts Breasts may become tender while growing or before periods, they’re very uncomfortable it can make you tired and ‘touchy’, and can interfere with your enjoyment and performance during sport or when playing musical instruments.
Uneven breasts Sometimes one breast grows much more quickly than the other. The second breast usually catches up later on. Most of us finish up with more or less evenly matched breasts, though they’re never exactly the same. Rarely one breast remains much smaller than the other, or even more rarely fails to develop at all. This can be an embarrassment and can make it difficult to find clothes that fit properly. In such cases it’s worthwhile considering padding in the bra on the small side, and perhaps discussing the possibility of surgery to make the breasts more even.
Stretch marks These can develop on the skin of the sides and undersides of the breasts when growth is very rapid. Wearing a support bra at this time may help reduce the number and size of marks.
Extra nipples Many mammals (animals that breast-feed their young) that have multiple babies in a litter have more than one breast on each side. Humans are mammals, but as we rarely have more than two babies to feed, we need only one pair of mammary glands. However, like other mammals, before birth we develop a strand of tissue called the milk line that extends in a curve from the armpit to the groin. The cells along this line have the potential to form breast tissue, but our human genes usually ensure that only one pair of breasts develop on the upper chest. Nevertheless, sometimes humans can develop some nipple tissue at other places along the milk line. The most common sites are in the armpit, 8-10 cm below the usual nipple or just below the waist, rarely elsewhere. Extra nipples, which are present from birth, can occur in both males and females.
My textbook says that about one in ten people have extra nipples, but after examining many thousands of men and women, they seem less common to me. But you’ll often see them; take note next time you’re at the beach. Extra nipples are usually smaller and often irregular in shape. They can look like a mole or freckle; many of those who have an extra nipple don’t recognize it.
Sometimes an extra nipple can become sensitive and a bit puffy at puberty. If this worries you, ask your doctor to look at it so that you can be reassured that you are unlikely to have trouble and treatment is unnecessary.
About stretch marks
Stretch marks develop when a part of the body grows more quickly than the skin that covers it. They may appear on the breasts, thighs and abdomen if these parts enlarge very quickly during adolescence and pregnancy. They may develop in both men and women during periods of rapid weight gain.
Stretch marks appear because breaks develop in the fibrous and elastic tissues of the deeper layers of the skin in response to the pressure of expanding tissue beneath.
These breaks can be compared to a deep cut, except that the wound comes from inside rather than from outside the skin. Like a deep cut, the tears in the tissue cannot heal without scarring.
Stretch marks first appear as red or purplish wavy lines. After about six months the colour fades and the lines start to contract. After a year or so the lines become fine white or silvery.
There is, alas, nothing that will take stretch marks away. No diet, cream, oil or other cosmetic has ever worked. Massage may help the colour to fade a little more quickly.
Perhaps the amount of stretch marking of a rapidly enlarging part may be reduced by supporting the part against gravity. This hasn’t been proved but is worth a try, especially by supporting the breasts during times of rapid growth in adolescence and pregnancy.
Now is the time to start looking after уour breasts. Make a habit of doing a breast check after each period finishes. You’ll learn how your breasts normally feel and how to pick up changes that should examined by your doctor. Pamphlets that tell you how to check your breasts can picked up from any doctor, hospital, health centre or family planning clinic.
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