NETGURUMALI

Hair loss is surprisingly common in women, affecting more than 30 million in the U.S., according to the American Academy of Dermatology. It can start as early as puberty or much later in life. In fact, 38 percent of women 70 and older experience hair loss, in part because hair thickness decreases with age, especially after menopause. The condition often leads to low self-esteem, social anxiety, and self-imposed isolation.

Female pattern hair loss (FPHL) is characterized by thinning over the top of the scalp and sometimes the sides. In men, a male hormone known as an androgen is primarily responsible for hair loss, but the main cause of FPHL appears to be less clear-cut. Women normally produce male hormones too, and in some cases the condition is associated with excessive androgen levels. Other types of hair shedding in women may be related to estrogen loss or significant changes in estrogen levels, as in the postpartum period or in menopause. Hair loss can also result from breakage during hair treatments and styling, certain medication—including hormones—and conditions like iron deficiency, severe dieting, thyroid disease, lupus, and even stress.

Finasteride (Propecia) is approved by the Food and Drug Administration to treat male pattern hair loss (also called androgenetic alopecia). At higher doses, it's also approved to reduce the symptoms of enlarged prostate in men. It works by blocking the enzyme that is responsible for the conversion of testosterone to dihydrotestosterone, the androgen that causes the prostate to enlarge. It also reduces dihydrotestosterone levels in the scalp, which slows hair loss and even increases hair growth. Because finasteride has been effective in controlling male pattern hair loss, it has been used to treat female pattern hair loss, although it has not gained FDA approval for that purpose. Medication prescribed to treat a condition that does not have FDA approval for that use is known as "off-label." Doctors can legally prescribe any medication they deem appropriate for treatment.

"If a woman has female pattern hair loss and elevated androgen levels that we can document, then she is likely to respond to treatments that block or decrease androgens, and finasteride is an option," says Elise A. Olsen, M.D
., a professor of dermatology and oncology and director of the Hair Disorders Research and Treatment Center at Duke University Medical Center. "But often we will try it even in women who don't have elevated androgen levels because other treatment options are very limited, and these women may have sensitivity to androgens at the cellular level of the hair follicle that we can't document."
What is the evidence?

The only randomized, double-blind, placebo-controlled trial on this subject involved 137 postmenopausal women with low androgen levels and hair thinning at the front of their scalp. After 12 months, there were no significant differences in hair count between the patients receiving finasteride or a placebo, and both groups continued to lose hair. The authors concluded that finasteride was well-tolerated but did not reduce hair loss in these women.

Another group of researchers studied 48 premenopausal women with FPHL and elevated androgen levels: 36 subjects were randomized to treatment with one of three drugs with anti-androgen effects, including finasteride, and 12 subjects declined treatment but were observed. The study wasn't blinded, meaning that patients and researchers knew which medication was received. After a year, those taking finasteride continued to lose hair.

In contrast, two studies reported some success with finasteride, but neither was randomized, blinded or placebo-controlled. In one, 37 premenopausal women with FPHL but without androgen excess received finasteride along with an oral contraceptive. After 12 months, most of them showed improved hair density, although the contraceptive contained drospirenone, which has anti-androgen actions and may have contributed to that effect. And in a 2010 study, 86 pre- and postmenopausal Asian women with FPHL and normal androgen levels were treated with finasteride for 12 months, resulting in slight increases in hair density for 57 women, moderate increases in 10 women, and more substantial increases for four women. Anecdotal reports and small, uncontrolled trials have also noted beneficial results with hair loss in pre- and postmenopausal women with or without increased androgen levels.

With the exception of herpes simplex and varicella-zoster encephalitis, the viral forms of encephalitis are not treatable. The primary objective is to diagnose the patient as soon as possible so they receive the right medicines to treat the symptoms. It is very important to lower fever and ease the pressure caused by swelling of the brain.

Patients with very severe encephalitis are at risk for body-wide (systemic) complications including shock, low oxygen, low blood pressure, and low sodium levels. Any potentially life-threatening complication should be addressed immediately with the appropriate treatments.
Treating Probable Causes of Encephalitis

Since it is difficult to determine the cause of encephalitis, and rapid treatment is essential, clinical guidelines recommend immediately administering intravenously the antiviral drug acyclovir without waiting to determine the cause of the illness.

Once the doctor receives results from diagnostic tests, drug treatment depends on the cause of the encephalitis. Antiviral drug treatments for specific causes of encephalitis include:

    Herpes Simplex Virus . Acyclovir is recommended.
    Varicella-Zoster Virus . Acyclovir is recommended. Ganciclovir or adjunctive corticosteroids may also be considered.
    Cytomegalovirus . Combination of ganciclovir plus foscarnet.
    Epstein-Barr Virus . Corticosteroids may be used, although risks may outweigh benefits. (Acyclovir is not recommended.)
    Human Herpesvirus 6. Ganciclovir or foscarnet are recommended for immunocompromised patients.
    Measles. Ribavirin may be considered.
    ADEM. High-dose intravenous corticosteroids.
    St. Louis Encephalitis . Interferon alfa-2a may be considered.

For bacterial meningitis, antibiotics (not antiviral drugs) are used.
Additional Treatments

Other encephalitis treatments are aimed at reducing symptoms.

    Seizures may be prevented by using oral anticonvulsant drugs.or intravenous lorazepam (Ativan).
    Sedatives may be prescribed for irritability or restlessness.
    Simple pain relievers may be used for fever and headache.
    In patients who are otherwise stable, the only other treatment measures are to keep the head elevated and monitor the patient's status.

Investigational Treatments

No specific drugs have been effective for treating arboviruses, including West Nile virus, although a number of drugs used to treat other virus infections are being investigated. They include interferon alfa 2a (Roferon-A) and other interferons.

There are 78 organs in the human body.It is difficult to give the right answer. There are 13 major organ systems in human body. The organs work together systematically to keep you alive and active and each plays a specific role related to your health and development. By definition, an organ is a structure that comprises at least two kinds of tissue that function together for a common purpose. Some of the most important organs in the human body are the skin, liver, heart and lungs.
Regional groups

    Head and neck – includes everything above the thoracic inlet.
    Upper limb – includes the hand, wrist, forearm, elbow, arm, and shoulder.
    Thorax – the region of the chest from the thoracic inlet to the thoracic diaphragm.
    Human abdomen to the pelvic brim or to the pelvic inlet.
    The back – the spine and its components, the vertebrae, sacrum, coccyx, and intervertebral disks.
    Pelvis and Perineum – the pelvis consists of everything from the pelvic inlet to the pelvic diaphragm. The perineum is the region between the sex organs and the anus.
    Lower limb – everything below the inguinal ligament, including the hip, the thigh, the knee, the leg, the ankle, and the foot.

Internal organs (by region)

Head and neck

    Brain
        Amygdala
        Basal ganglia
        Brain stem
            medulla
            midbrain
            pons
        Cerebellum
        Cerebral cortex
        Hypothalamus
        Limbic system

    Eye
    Pituitary
    Thyroid and Parathyroids

Thorax

    Heart
    Lung
    Esophagus
    Thymus
    Pleura

Abdomen and pelvis (both sexes)

    Adrenals
    Appendix
    Bladder
    Gallbladder
    Large intestine
    Small intestine
    Kidney
    Liver
    Pancreas
    Spleen
    Stomach

Male pelvis

    Prostate
    Testes

Female pelvis

    Ovaries
    Uterus

Human organs

 Most have no symptoms
Most people infected with the West Nile virus have no signs or symptoms.

Mild infection signs and symptoms
About 20 percent of people develop a mild infection called West Nile fever. Common signs and symptoms of West Nile fever include:

    Fever
    Headache
    Body aches
    Fatigue
    Skin rash (occasionally)
    Swollen lymph glands (occasionally)
    Eye pain (occasionally)

Serious infection signs and symptoms
In less than 1 percent of infected people, the virus causes a serious neurological infection. Such infection may include inflammation of the brain (encephalitis) or of the brain and surrounding membranes (meningoencephalitis). Serious infection may also include infection and inflammation of the membranes surrounding the brain and spinal cord (meningitis), inflammation of the spinal cord (West Nile poliomyelitis) and acute flaccid paralysis — a sudden weakness in your arms, legs or breathing muscles. Signs and symptoms of these diseases include:

    High fever
    Severe headache
    Stiff neck
    Disorientation or confusion
    Stupor or coma
    Tremors or muscle jerking
    Lack of coordination
    Convulsions
    Pain
    Partial paralysis or sudden weakness

Signs and symptoms of West Nile fever usually last a few days, but sign and symptoms of encephalitis or meningitis can linger for weeks, and certain neurological effects, such as muscle weakness, may be permanent.

When to see a doctor
Mild symptoms of West Nile fever usually resolve on their own. If you experience signs or symptoms of serious infection, such as severe headaches, a stiff neck or an altered mental state, seek medical attention right away. A serious West Nile virus infection generally requires hospitalization.

Many times those who are close desire change in something about others so their lives can be made a little bit easier.

While even close friends may see the need for someone to change, the person in need of the change may not agree and may even resist any expectations that they should change.

In most relationship therapy not everyone involved sees the need for change, many would think that therapy may not be effective unless both parties can agree change is needed. However, in my experience rarely do couples come into therapy with the clear understanding of where changes, growth and development needs to occur. The use of Emotional Focused Therapy enables change to occur as a part of the ongoing sessions. The changes will likely be gradual but recognizable for all of the parties involved.

Through their experiences in the sessions couples will begin to learn and understand how to make the needed individual changes, and they will also discover how these changes will benefit their relationship and personal development. This will allow them to see for themselves how the personal development they experience will improve their problems with communications and maintaining intimate relationships. As these experiences that take hold couples will experience more opportunity for connection to happen which can mean even better experiences in the future of the relationship.

Talk therapy will help people grow as individuals which will ultimately lead to stronger, healthier and more intimate relationships.

Seborrheic dermatitis is a common, chronic condition of skin which affects millions of people worldwide. It is a troublesome inflammatory skin condition which is not  fatal. Seborrheic dermatitis can affect different body areas such as the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the outer ear, and middle of the chest. It tends to affect places where the skin is oily or greasy. In most cases the scalp is affected. [Read: What is Seborrheic Dermatitis?]

Common symptoms of seborrheic dermatitis are:
Yellowish-white scales and flakes on the scalp. The flakes may fall and are seen on shoulders of dark clothing—this is often the first symptom of dandruff. The scales and flakes may be waxy or greasy.
Dry itchy scalp, itch in the ear canal
Dry skin on face usually without any rash. It does not improve on application of lotions and creams. In fact it may become worse.
Yellowish-white, dry-looking, or thick, greasy scales on the eyebrows, sides of the nose, and behind the ears
Itch in ear canal and recurrent ear eczema.
Rash on eyebrows, nose, and ears. It may appear to be because of dry skin but application of moisturising creams and lotion may worsen it.
Oily scalp and facial skin with dry flakes.
Mild redness in the affected areas beneath the scales.
Dandruff on eyebrows or beard.
Rash on chest with dry flakes and red spots.

Cradle cap

It is the term used to indicate seborrheic dermatitis on scalp of infants. It is a harmless, temporary condition which improves in few weeks to months. Cradle cap is not contagious disease and it is not caused because of poor hygiene or allergy.

Signs and symptoms of cradle cap are:
Yellow, greasy scale on the scalp. It may be sparse and thin or a thick layer of scale can be present over the entire scalp. Scale may be yellow to brownish in colour. The scale becomes flaky and fall off in a few weeks to months (with or without treatment). Rarely cradle cap may be present till the age of 3. Other areas that can be affected by seborrheic dermatitis in infants are the face, usually on a baby’s eyelids, around the nose, or ears. In some infants it may appear on diaper area and rarely seborrheic dermatitis may cover most of the body of an infant.

Monsoon is the time for occurrence of vata dosha, according to Ayurveda. It is the season when you feel like gorging on oily foods, but your digestive system is most vulnerable to various ailments. By following certain dos and don’ts, you can make sure that your body is guarded from increased microbial activity of the season, as well as the adverse effects of a slowed down digestion.

Dos for Monsoon in Ayurveda

Have simple and easily digestible food in monsoon. They should be dry in nature like chickpea, corn, gram flour and oats. Having moong dal is advisable.
To ensure removal of germs, drink only boiled water. Water should be consumed within 24 hours of boiling.
Wash green vegetables thoroughly before eating, especially if you want to have them raw.
One of the foremost rules for monsoon in Ayurveda is to eat according to the ability of your digestion.
Know the capability of your jatharagni, i.e. digestive fire, when having food. Use spices such as pepper, ginger, asafoetida (hing), garlic, jeera powder, coriander and turmeric for enhancing your digestive capability. These help to improve your immunity too.
The vegetables recommended in the season include yam (suran), snake gourd (turi), pointed gourd (parwal), gourd (dudhi), bitter gourd (karela), cluster beans (gavaar), and apple gourd (tinda).
Stick to seasonal fruits during monsoons as the unseasonal ones can easily get infected with microbes. These include mangoes, pomegranates, apples, bananas, lychees and cherries.
In case you catch a cold, freshly prepared radish juice, along with a pinch of pipli and rock salt in warm water would help to lessen the trouble of mucous formation.
Fasting is especially recommended in the monsoon season, particularly for people fond of socialising and erratic eating. You can gain a lot of health benefits simply by observing a weekly or fortnightly fast during monsoon. It helps to improve your digestive fire.

Don’ts for Monsoon in Ayurveda

Avoid fermented foods which include idli, dosa, uttapam, and the like.
Avoid sprouts, raw vegetables, refrigerated and sour foods. Foods that are sour include tamarind, various pickles and chutneys.
Heavy grains such as bajra and ragi should be avoided. Limit the intake of foods with high water content such as rice, muskmelon, watermelon and lassi. These can lead to swelling.
Foods that strain your digestive system such as buttermilk, yoghurt, curd should be avoided.
Avoid non-vegetarian foods in monsoon. The possibility of germ content is highest in non-vegetarian foods.
Do not sleep during the day.
Do not tire yourself with work.
Avoid eating late at night. It is particularly important in this season.
Perform only moderate exercises in monsoon such as light walks and simple yogasanas.

By following these dos and don’ts, you would be able to revel in monsoon without fearing its adverse impact.

Read more articles on Ayurveda

Yoga can relieve arthritis pain by creating more mobility in the joints and increasing flexibility while stretching and strengthening the muscles around the joints. Yoga may also help to prevent or minimize the erosion of cartilage that causes joint pain and swelling in arthrits.

I have a number of yoga students with varying degrees of arthritis, and they've all experienced that their joints are more mobile and hurt less when they take yoga classes regularly. They also feel better overall.

If you're interested in practicing yoga as a way to ease your own arthritis symptoms, a good teacher can help you modify poses as necessary, to bring your body into better alignment and with more ease. If you can't find a teacher, I've listed some good Yoga for Arthritis DVDs and Yoga for Arthritis Books later on this page to safely get you started.

Also you may be interested in reading these excellent online articles from Suza Francina, certified Iyengar Yoga Teacher: Yoga, the Antidote for Arthritis, and Yoga for Arthritis: Guidelines and Cautions.

The `Aphorisms on Love' by Vatsyayana contain about one thousand two hundred and fifty slokas or verses, and are divided into parts, parts into chapters, and chapters into paragraphs. The whole consists of seven parts, thirty-six chapters, and sixty-four paragraphs. Hardly anything is known about the author. His real name is supposed to be Mallinaga or Mrillana, Vatsyayana being his family name. At the close of the work this is what he writes about himself:
`After reading and considering the works of Babhravya and other ancient authors, and thinking over the meaning of the rules given by them, this treatise was composed, according to the precepts of the Holy Writ, for the benefit of the world, by Vatsyayana, while leading the life of a religious student at Benares, and wholly engaged in the contemplation of the Deity. This work is not to be used merely as an instrument for satisfying our desires. A person acquainted with the true principles of this science, who preserves his Dharma (virtue or religious merit), his Artha (worldly wealth) and his Kama (pleasure or sensual gratification), and who has regard to the customs of the people, is sure to obtain the mastery over his senses. In short, an intelligent and knowing person attending to Dharma and Artha and also to Kama, without becoming the slave of his passions, will obtain success in everything that he may do.'
The Kama Sutra contains a total of 64 sexual positions and depicts positions as arts. Vatsyayana believed there were eight ways of making love, multiplied by eight positions within each of these. In the book, they are known as the 64 Arts. The chapter listing sexual positions is the best-known, and a translation (different from Burton's) is in wide circulation on the Internet. This chapter was pirated from the 1980 translation of Indra Sinha and first appeared on the internet server wiretap.spies in the late eighties. It is commonly mistaken to be the entirety of the Sutra.

However, only about 20 percent of the book is devoted to sexual positions. The remainder gives guidance on how to be a good citizen and insights into men and women in relationships. The Kama Sutra describes making love as "divine union". Vatsyayana believed that sex itself was not wrong, but doing it frivolously was sinful. The Kama Sutra has helped people enjoy the art of sex at a deeper level and can be considered a technical guide to sexual enjoyment, as well as providing insight into the sexual mores and practices of India in those times

Kamasutram, generally known to the Western world as Kama Sutra, is an ancient Indian text on human sexual behavior, widely considered to be the standard work on love in Sanskrit literature. The text was composed by Vatsyayana, as a brief summary of various earlier works belonging to a tradition known generically as Kama Shastra, the science of love. Kama is literally desire. Sutra signifies a thread, or discourse threaded on a series of aphorisms. Sutra was a standard term for a technical text, thus also the Yogasutram of Patanjali. The text is originally known as Vatsyayana Kamasutram ("Vatsyayana's Aphorisms on Love"). Tradition holds that the author was a celibate scholar. He is believed to have lived sometime between the 1st to 6th centuries AD, probably during the great cultural flowering of the Gupta period.

The earliest text of the Kama Shastra tradition, said to have contained a vast amount of information, is attributed to Nandi the sacred bull, Shiva's doorkeeper, who was moved to sacred utterance by overhearing the lovemaking of the god and his wife Parvati.
During the 8th century BC, Shvetaketu, son of Uddalaka, produced a summary of Nandi's work. However this "summary" was still too vast to be accessible.
Modern translated version of the original Sanskrit.A scholar called Babhravya, together with a group of his disciples, produced a summary of Shvetaketu's summary. This remained a huge and encyclopaedic tome.
Between the 3rd and 1st centuries BC, several authors reproduced different parts of the Babhravya group's work in various specialist treatises. Among the authors, those whose names are known are Charayana, Ghotakamukha, Gonardiya, Gonikaputra, Suvarnanabha, and Dattaka:
— Dattaka composed a work on courtesans which Vatsyayana reproduces almost entirely in Kama Sutra.
— Suvarnanabha's text mentions Shatakarni Shatavahana, a king of the 1st century BC who killed his own wife accidentally during sadistic practices, thus giving a hint on the time period it was written.
Yashodhara, in his commentary of Kama Sutra, attributes the origin of erotic science to Mallanaga, the "prophet of the Asuras", meaning it originated in prehistoric times. Nandi is then said to have transcribed it for mankind. The attribution of the name "Mallanaga" to Vatsyayana is due to the confusion of his role as editor of the Kama Sutra with that of the mythical creator of erotic science.

The Kamasutra is an ancient Indian text renowned more for its one portion which consists of practical advice on sexual intercourse. The words “kama” and “sutra” have definite meanings. Kama means desire in the general sense but particularly sexual desire. Sutra literally means thread but it is implied in the sense of a thread to hold a line going in a direction. In Sanskrit it refers to a set of aphorisms or verses that form a manual.

The Kamasutra is not exclusively on sex as popularly believed. It is a guide book or art of leading a virtuously which touches upon many aspects of social and individual life such as nature of love, family life and pleasure oriented activities with much needed restraint.

With 1250 verses divided in 36 chapters organized into 7 parts, it offers an excellent commentary on various aspects of a householder’s life in providing better sex life and may helps in solving sexual problems.

Part 1

The first part deals with goals and priorities of life, how to acquire knowledge, dealings of well-bred citizen, suggestions for the intermediaries who hep in lover’s enterprises.

Part 2

Deals with stimulation of desire, kinds of embraces, kissing and caressing, amorous marking with nails, amorous biting acts and making a mark with teeth, positions of copulation, slapping followed by moaning, virile behaviour in women, better coition, precursors and conclusions of the art of love making. 64 types of sexual acts are described in it. Kamasutra has become notorious for this part of the book.

Part 3

Deals with types of marriage, making the girl feel relaxed, getting the girl, surviving alone, union by marriage.

Part 4

Deals with conduct of the only wife and in case there are more than one, the conduct of chief wife and other wives.

Part 5

Deals with behaviour of women and men, how to get to know each other, evaluation of sentiments, the task of go-between, the king's pleasures, behavior in the women's quarters (6 chapters).

Part 6

Deals with advice of the amorous assistants on making a choice of lovers, finding a steady lover, how to earn money, making up with a former lover and renewing friendship, occasional profits, profits and losses.

Part 7

Deals with improvement of physical attractions and stirring up a damaged sexual power.

Lower back painis very common in women and there are several reasons for it apart from kidney problems and strain on the tissues and ligaments of the back. An imbalance in nutrition plays an important role in causing this pain as does the change in lifestyle and stress at work and at home. This lower back pain has become such a common occurrence that most women simply take painkiller and pretend like as though it’s not even there. This simply causes the pain to worsen and increase and in some cases become chronic which may lead to serious conditions. In these cases all you want is lower back pain relief.

The human spine is the main nerve structure which connects the brain to the rest of the body. Hence it is also considered the most important part of the body. This structure is quite flexible. However, the muscles of the back are just the opposite. They are quite weak and may be further weakened by bad nutrition and other factors. Due to these weak muscles, the spine will then be unable to remain in place which causes this lower back pain.

There are both primary and secondary causes of lower back pain in women. Primary pain is generally caused due to spine injuries or other issues such as microscopic tears in the tendons and ligaments or muscles. Secondary back pain, on the other hand may be caused due to different injuries such as problems related to internal organs, tumors and even osteoporosis, which is the deterioration of the human bones. Tumors that cause lower back pain are usually malignant or benign which means they are not cancerous. One is advised to do a CT scan to accurately determine the cause of this pain.


Other causes of this pain in women could be improper posture while sitting, standing or sleeping. The amount of time spent in sitting in front of a computer or driving could also determine the cause of your pain. Long hours of physical labor or bad workouts are other causes of this pain. Obesity too, often leads to lower back pain, due to one’s extra body weight. Other causes of back pain in women may be pregnancy and menopause. Menopause often leads to the development of osteoporosis which is another cause of severe lower back pain.

Women by nature are quite dainty and gentle. Hence, if the back muscles are not strengthened from the beginning, the risk of being a victim of lower back pain is present even if the other various symptoms are not.

The goal of treating impotence is to enable a man to achieve and maintain an erection so that he can have sexual intercourse. Depending upon the cause of impotence, treatment may include one or more of the following.

Phosphodiesterase-5 inhibitors — Phosphodiesterase-5 (PDE-5) inhibitors work by increasing chemicals that allow the penis to become and remain erect. They help a man to achieve an erection after sexual stimulation, but the medication does not increase sexual desire.

PDE-5 inhibitors are effective in restoring potency in about 70 percent of men. They work best in men with psychogenic impotence, though can be used in men with other types of impotence as well. In men with conditions that affect the blood vessels (such as diabetes), PDE-5 inhibitors are effective in about 55 to 60 percent of cases. The success rate in men who have undergone prostate cancer surgery is between 25 and 30 percent.

Sildenafil — Sildenafil (Viagra®) should be taken one hour before planned sexual intercourse. Its effect lasts for about four hours; this refers to the time frame that erection is possible if sexual stimulation occurs, not the duration of the erection. The recommended dose is 50 mg for most men; men over the age of 65 should start with 25 mg. The dose may be increased up to 100 mg if the erection was unsatisfactory or decreased to 25 mg if there are bothersome side effects. Only one dose should be taken per 24 hours.

Vardenafil and tadalafil — Vardenafil (Levitra®) and tadalafil (Cialis®) are also PDE-5 inhibitors used to treat ED. Like sildenafil, men who take vardenafil may have an erection (in response to sexual stimulation) as soon as 30 minutes and for up to four hours after taking a vardenafil tablet (this refers to the time frame that erection is possible if sexual stimulation occurs, not the duration of erection). The recommended dose is 10 mg for most men; men over 65 years should start with 5 mg. The dose may be increased to 20 mg or decreased to 2.5 mg as needed. No more than one dose should be taken per 24 hours.

Men who take tadalafil may have an erection within 16 minutes (in response to sexual stimulation) and may be able to experience an erection (in response to sexual stimulation) up to 36 hours after each dose (this refers to the time frame that erection is possible, not the duration of erection). The recommended starting dose is 10 mg for most men. The dose may be increased to 20 mg or decreased to 5 mg as needed. No more than one dose should be taken every 24 hours. Tadalafil can also be taken every day as a low dose pill.

Use of PDE-5 inhibitors

Side effects — Side effects of PDE-5 inhibitors include headache, flushed (red) skin, indigestion, and dizziness. Sildenafil may cause distorted (blue-tinged) vision. Side effects are generally short-lived and resolve spontaneously.
Drug interactions — Men who use nitrates (nitroglycerin) in any form, either on a regular basis or only as needed for chest pain, should never use PDE-5 inhibitors. Taking PDE-5 inhibitors and nitrates can lead to dangerously low blood pressure. PDE-5 inhibitors do not cause heart attacks.
A man who has used a PDE-5 inhibitor and then develops cardiac problems and requires nitrate medications should NOT use the PDE-5 inhibitor in the future. Men who develop chest pain should contact their healthcare provider or go to an emergency department immediately.

Certain medications (including erythromycin, ketoconazole, protease inhibitors, rifampin, phenytoin, and grapefruit juice) can alter the duration of time that sildenafil, vardenafil, and tadalafil remain in the blood stream, which can cause additional side effects. A healthcare provider or pharmacist can provide specific information.

Medications such as doxazosin (Cardura®) and terazosin (Hytrin®), used to treat frequent urination and other urinary symptoms caused by an enlarged prostate (called benign prostatic hyperplasia or BPH), should not be taken with any of the PDE-5 inhibitors; the combination of drugs can cause very low blood pressure. However, tamsulosin (Flomax®), also prescribed for bothersome urinary symptoms caused by BPH, is safe to take with tadalafil as it does not cause a dangerous decline in blood pressure. It is not known if tamsulosin is safe to take with sildenafil or vardenafil. (See "Patient information: Benign prostatic hyperplasia (BPH) (Beyond the Basics)".)

Safety — It is not yet proven that sildenafil is safe for these groups:

Men who have had a heart attack, stroke, or life-threatening irregular heartbeats (called arrhythmia) within the last six months
Men with untreated low or high blood pressure
Men with retinitis pigmentosa, a progressive eye disorder that can lead to blindness
Resuming sexual activity after a prolonged period of inactivity is similar to beginning a new exercise routine. Men considering a PDE-5 medication should be able to participate in an activity that is approximately equal to the energy required for sex (eg, walking two to four miles per hour on a flat surface). The healthcare provider may recommend exercise treadmill testing to ensure that sexual activity will be safe.

Nonarteritic ischemic optic neuropathy or NAION, a condition associated with loss of vision, has been reported in a few men who have taken sildenafil and tadalafil. Most of these cases occurred in men with underlying nerve or blood vessel disease.

Purchasing medications for erectile dysfunction — A number of sources claim to sell medications such as Viagra®, Cialis®, Levitra®, or herbal supplements for erectile dysfunction through the internet or by mail for a reduced cost, often without a prescription. These sources are not known to be safe or reliable, and it is not possible to know whether the pills from these sources contain the actual drug or are counterfeit. Consumers are strongly cautioned to avoid potentially unreliable sources for any medication. Community pharmacies or reputable web-based pharmacies are the most reliable source for all types of medications.

Penile self-injection — With penile self-injection, the patient injects a medication (alprostadil or papaverine) into the corpora cavernosa (the two chambers of the penis that are filled with spongy tissue). This causes an erection by allowing the blood vessels within the penis to expand so that the penis first swells and then stiffens to create a fully rigid erection (figure 1). The erection created by penile injection occurs without sexual stimulation (different from the erection that occurs after sildenafil, vardenafil or tadalafil).

It takes a lot of training for men to feel comfortable with this type of therapy. Under the guidance of urologists, men are shown how to make the skin on the penis sterile and how to inject the medication properly (figure 2). Although this treatment works well for erections, many men eventually stop using it because of discomfort from the injections.

Side effects — Pain is the most common side effect. Men often say that this is the reason they discontinue this type of treatment.
There is also a small risk that the penis will remain erect after intercourse. This occurs in 6 percent of men who use alprostadil and about 11 percent of those who use papaverine. Prolonged erection, called priapism, that lasts longer than four to six hours is a medical emergency. A healthcare provider should be contacted immediately. An emergency procedure must be done as soon as possible to empty the blood that is trapped in the penis. An erection that lasts longer than 48 hours often results in scarring of the tissue inside the penis.

Intraurethral alprostadil (MUSE) — This treatment uses the same medication (alprostadil) as penile self-injection. Instead of injecting it, the man inserts a device with an alprostadil pellet into the urethra. The urethra is the opening in the center of the penis from which urine flows. The alprostadil is then absorbed into the erectile bodies (corpus cavernosum) to create an erection.

Side effects — Side effects include pain as the blood vessels in the penis widen and swell to create the erection. Problems like prolonged erection and scarring on the outside of the penis are less common than with self-injection therapy.
Vacuum-assisted erection devices — There are several products on the market that use vacuum pressure to draw blood into the penis. A rigid ring is placed at the base of the penis (near the body) to hold the blood inside the penis, allowing it to remain erect. Vacuum devices successfully create erections in as many as 67 percent of patients. Satisfaction with vacuum-assisted erections varies between 25 and 49 percent.

Vacuum-assisted devices require that a man be able to hold and pump the unit. It may take a week or more for the device to work effectively. After a man is accustomed to using the device, he can usually create an erection that is rigid enough for penetration and sexual intercourse. He will not be able to ejaculate because the ring that holds blood in the penis also compresses the urethra, preventing semen from exiting. The ability to have an orgasm is not affected by the ring.

Penile prostheses — A penile prosthesis is a device that is surgically implanted and inflates to allow the penis to become erect (figure 3). Penile prostheses are used less frequently because of the popularity of PDE-5 inhibitors and penile injection therapies. For men who do not respond to these therapies or who find vacuum erection therapy distasteful, penile prostheses are an option.

Side effects — Side effects of prosthetic devices include the possibility of infection, pain, and mechanical failure. Mechanical failure may require surgically removing the prosthesis and implanting a new one.
Testosterone replacement therapy — Testosterone therapy is prescribed if a man's testes do not make enough of the hormone testosterone. It is of no benefit in improving sexual function in men whose bodies make normal amounts of testosterone. Testosterone levels are determined with blood tests.

Men with low blood testosterone levels may have diminished libido (sex drive), erectile dysfunction (impotence), decreased muscle mass, increased fat, and are at increased risk for thinning of the bones (osteoporosis). Treatment is designed to increase a man's testosterone level, libido, erectile function, fat and muscle levels; bone density usually improve as testosterone levels return to normal.

Treatment options for testosterone deficient men include:

Testosterone injections — Testosterone injections of either testosterone cypionate (Depo-Testosterone®) or testosterone enanthate (Dela-Testryl®) increase the blood level of testosterone promptly. However, testosterone levels decline quickly; to sustain normal testosterone levels, injections must be given every one to two weeks. Pain at the injection site is the most common side effect.
Testosterone gels — Testosterone gel is applied daily to the skin surface, which allows the testosterone within the gel to be absorbed from the skin into the blood. One gel (Androgel®) is supplied as a foil packet; another (Testim ®) is in a small toothpaste-like tube. The gel is applied to the upper arms, near the shoulder, every morning. The gel dries quickly; blood testosterone levels increase within two hours and are stable for 24 hours.

Because testosterone gel applied to a man's skin surface can be transferred to a female partner's skin, men are cautioned to wear a shirt if sex is planned immediately after applying the gel. The gel is fully absorbed after two hours and the shirt precaution is not necessary after this time.
Testosterone skin patch — The testosterone patch (Androderm®) contains testosterone as well as a chemical enhancer that allows the testosterone to be absorbed through the skin into the blood. The patch is applied in the morning, usually after a shower, to the arm, or back, preferably in an area that has little to no hair (to enhance adhesion); the area where the patch is applied should be rotated. The patch must be changed every day. Side effects include skin irritation and a local rash.
Testosterone lozenge — A testosterone lozenge (Striant®) is placed in the mouth between the cheek and upper gums. It softens and forms a gel that adheres to the gums and remains in place for 12 hours; the testosterone is absorbed through the gums and into the bloodstream. It should be used twice daily and should not be chewed or swallowed. Any remaining gel should be removed before placing the next lozenge. Gum irritation and gingivitis (inflammation of the gums) occurs in a small percentage of men using this treatment.
Psychotherapy and psychoactive medications — Depression, anxiety, and distractions can cause erectile dysfunction. Often these problems can be treated using psychological counseling, antidepressant drugs, or both. Sexual therapy is sometimes needed as well.

Medications are used to treat both depression and anxiety. They are very effective, though some (especially those of the serotonin reuptake inhibitor (SSRI) class) can cause decreased sex drive and erectile dysfunction. On the other hand, some antidepressant drugs can cause delayed ejaculation, which can be helpful for men with premature ejaculation. (See "Patient information: Depression treatment options for adults (Beyond the Basics)".)

Psychological counseling or psychotherapy involves the patient talking to a therapist about his thoughts and concerns. Psychotherapy may be helpful for:

Couples, when one or both partners have a serious medical condition. Anxiety over the safety of sexual activity may be present in people who are ill and his or her partner.
Men who suddenly experience one or more erectile failures during attempted intercourse. This is called performance anxiety.
Men who are depressed. In this case, psychotherapy may be combined with an antianxiety or antidepressant medication. Almost all antidepressant medications are effective for improving symptoms of depression, but may cause sexual side effects (eg, erectile dysfunction).
Sex therapy — This type of therapy is often helpful for men who lack focus or become distracted during sex. Treatment focuses on encouraging both sexual partners to work together and uses structured home exercises to improve concentration.

Yohimbine — Yohimbine was once the only pill available to treat erectile dysfunction. It has been replaced with PDE-5 inhibitors, described above (see 'Phosphodiesterase-5 inhibitors' above).

Impotence, also referred to as an erectile dysfunction (ED), is the term used to describe men who cannot acquire or maintain an erection during 75 percent of attempts to have sexual intercourse. Men who experience an occasional inability to have an erection and then have no problems later do not have ED.

Limited blood flow — Anything that limits blood flow to the penis can cause impotence. The most common conditions that limit blood flow include cigarette smoking, diabetes, high blood pressure, alcoholism, drug abuse, normal aging, and depression. In addition, many commonly prescribed medications can interfere with male sexual function.

Psychologic causes — Depression, performance anxiety, and lack of focus are common causes of psychogenic impotence.

Depression — Loss of libido and lack of interest in sexual activity are common symptoms of depression. Impotence is, in itself, a depressing experience for any man. Many men choose to accept a decline in sexual function as a natural consequence of aging. Because of shame or embarrassment, they do not discuss this problem with their healthcare provider. This is unfortunate because it is possible to determine the cause(s) of sexual problems, and many options are available to treat erectile dysfunction.
Performance anxiety — Performance anxiety may develop in men who suddenly experience one or more erectile failures during intercourse. The focus of the sexual act shifts from a sensual experience to one filled with anxiety. During later attempts to have sex, the inability to acquire and maintain an erection becomes the focus of the sexual experience.
Lack of sensate focus — Lack of sensate focus refers to the decline in the importance of sex. As a man matures, his interests and concerns expand. If, in the midst of sexual intimacy, he finds himself preoccupied with concerns about money or business matters, his mind will drift and he will lose his sexual focus as well as his ability to concentrate on the sensual experience, both of which are needed to maintain an erection.
DIAGNOSIS OF SEXUAL PROBLEMS IN MEN

In order to determine the cause of the dysfunction, a healthcare provider will take a sexual history, perform a physical examination, and order blood tests to determine if conditions such as diabetes or low testosterone levels are contributing to the sexual problems. Sometimes more specialized tests, such as nocturnal penile tumescence, are done (see 'Testing' below).

Sexual history — The clinician will ask the patient personal questions about his sex life to help determine the cause of the condition. It is important that the patient answer the questions honestly and provide as much detail as possible.

The clinician will want to know if:

Impotence developed slowly or happened suddenly
There are erections during the night or in the morning when he first wakes up
There are personal problems with a spouse, girlfriend, or sexual partner
There are any risk factors for impotence, such as a history of smoking, diabetes, high blood pressure, alcohol or drug abuse, or depression
Physical examination — In addition to doing a basic physical examination, the clinician may:

Listen to the pulse in the groin blood vessels
Perform an eye examination
Check the breasts for abnormal swelling, a condition called gynecomastia
Examine the penis
Check the testicles' size and for any abnormal testicular masses
Check a nerve reflex that causes the scrotum to contract when the inner thigh is stroked
Testing — The clinician may order tests to measure levels of testosterone, prolactin, and thyroid hormones in the blood. Abnormally low testosterone, elevated prolactin, and either low or elevated levels of thyroid hormones can cause sexual problems. All men with sexual problems should have blood tests.

If a hormonal problem is present, these tests may help to diagnose a more serious problem, such as growth in the pituitary gland or malfunction of the gonads. Even the most experienced clinicians cannot determine hormone levels by asking about the history and performing a physical examination; blood testing is necessary.

Nocturnal penile tumescence — Home nocturnal penile tumescence (NPT) may be recommended. NPT testing measures how many erections a man has during the night, and the quality of the erection (how rigid the penis becomes). Impotent men impaired NPT are considered to have "organic" impotence (usually due to blood vessel or nerve disease). Men with normal NPT are considered to have psychogenic impotence. Depending on the results of the NPT test, the clinician may order specialized tests, such as Doppler ultrasonography or angiography, to observe the deep arteries in the penis.

Early pregnancy symptoms can sometimes happen before a missed period and before apositive pregnancy test. Especially the 3, 4, 5, and 6 weeks pregnant signs.  Early pregnancy symptoms and signs are usually related to thepregnancy hormone hCG or "Human Chorionic Gonadotropin" which is responsible for pregnancy signs. Even though hCG is usually not detectable in large number until after a missed menstrual period, there are many women who report having typical pregnancy symptoms even before they miss their period. There are early detection pregnancy tests available than can confirm pregnancy as early as 6 - 8 days after conception has occured (well before a missed period).

If you're like everyone else then you're trying to figure out what the signs of pregnancy or pregnancy symptoms are and how likely they are to mean that you are pregnant. Read more about a day-by-day appearanceof pregnancy signs on the Pregnancy Symptoms Timeline Page. You can ask other people, you can worry in silence, but the best thing is to read through the categories and add up the signs. The more typical early pregnancy signs you have, the more likely you are to be pregnant.

Early pregnancy symptoms and signs differ from one woman to the other and from one pregnancy to the other. The most significant early pregnancy sign is a late or missed menstrual period. However, the only definite diagnosis even with the best pregnancy sign is to have a positive pregnancy test.

Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. Some women experience early pregnancy signs within a week after ovulation/fertilization and conception.

In other women, early pregnancy symptoms and signs may develop much later, well after a missed period and after a positive pregnancy test. Other women may not have early pregnancy signs at all.
The first pregnancy symptoms and the time of their appearanceare listed here:  

Pregnancy Symptoms	Timing of Pregnancy Symptom
Temperature drop (dip)	Implantation day
Implantation bleeding or spotting:(a slight staining of a pink or brown color)	8-10 days after ovulation
Lower abdominal cramps /Implantation cramps / hot flashes	8-10 days after ovulation
A positive blood hCG pregnancy test	10 days after fertilization/ovulation
A positive urine home pregnancy test (HPT)	10-14 days after ovulation/fertilization
An elevated BBT	15+ days without a menstrual period
No period. A missed menstrual period (amenorrhea)	Your period is supposed to come 14-16 days after ovulation
Nausea	2-4 weeks after ovulation
Nipple or breast tenderness	3-4 weeks after conception
Fatigue and tiredness	3-10 weeks after conception
Vomiting	3-10 weeks after conception
Food cravings	1-2 months after conception
Frequent urination	Usually after 1-2 months
Softening of cervix	6+ weeks after LMP
Constipation	Later
Lower-back pain	Later
Darkening of areola (area around breast nipple)	After 14 weeks
Fetal heartbeat on sonogram	8-9 weeks after conception
Fetal movements	18-20+ weeks

Women can experience signs of a baby on the way within even their first few weeks. Every sign experienced is significant because they may be indications of other problems too. Early signs may include headaches, tiredness that may even lead to drowsiness, nausea and aches in the lower back.

These all indicate a ruffling up of the hormones which takes place when an embryo is beginning to develop. Many women lose hope when they experience light bleeding. However, this can be an indication of a developing embryo. In fact, this is often an extremely common first sign, which can be experienced as early as six days following conception.

The bleeding is usually a result of the embryo planting into the uterine wall. However, where there is no embryo, it could be a sign of infection, irritation from intercourse or hormonal upheaval caused by going off the pill. It might even be an early menstruation.

Missed periods are the signs that have many women bouncing with excitement.
It is an extremely common sign and the most recognized of symptoms. Little known to some is that some women experience bleeding while they’re pregnant. Their bleeding will most likely be lighter and cycles may be shorter and for more information about getting pregnant tips, Click Here.

Missed periods could also be the result of sudden weight changes, whether it’s a loss or gain. Exhaustion and tension, commonly felt by women highly stressed about falling pregnant, can also cause missed menses. Illness and breastfeeding are other causes.

Within the first two weeks of conception, women often have sore or sensitive breasts. These can also be caused by an upcoming period, contraceptive pills, and hormonal imbalance. Breasts may also become slightly swollen.

Tiredness after conception can be felt within the first week.
It can be quite a dramatic exhaustion and some women might find themselves becoming far more forgetful than they usually are. Of course, tiredness could also be caused by many illnesses such as flu or the common cold. People under a lot of stress often feel it too.

Morning sickness is the bane of some, while others never experience it at all. It usually shows up within two to eight weeks and could be experienced as nausea alone or heavy vomiting. Morning sickness is a misnomer as it can be experienced at any time of day. Certain foods might even trigger it, and it can help to make alterations to diet to try and ease it.

Crackers and other dry foods are often helpful, while pungent, spicy foods sometimes make it worse. Food poisoning, stress, hormonal changes due to birth control pills and other illnesses can all cause it in cases where conception hasn’t taken place. Some women are unfortunate enough to experience morning sickness throughout their entire nine months.

Tip # 1. To get pregnant faster have sex three times a week.
Having regular sex is the best way to get pregnant right away. Couples often try to time everything perfectly for ovulation but do not have sex when they think they are not ovulating. It is true that sex that is not within the time of ovulation will not result in pregnancy. However, because women do not always ovulate when they think they will, having sex three times a week will help a woman to cover her bases, so to speak, and not miss an opportunity to get pregnant.

Tip # 2. To get pregnant faster use an ovulation prediction kit or fertility monitor.
Using an ovulation kit (or opk) to predict when you are ovulating will improve your chances of getting pregnant. For many women charting or other methods of ovulation prediction are too confusing. Ovulation prediction kits work by reading LH surges prior to ovulation. They are relatively easy to use and are generally accurate for predicting ovulation. Fertility monitors, such as the Clear Blue Easy monitor, are also a worthwhile investment if you would like to get pregnant faster. Fertility monitors are similar to ovulation prediction kits in that they read changes in LH but they also read changes in other hormones and don’t require any guesswork for couples. They are easy to use and will tell you when the best time to get pregnant is.

*Use JustMommies' Ovulation Calendar to help you determine when to start testing with an opk.

Tip # 3. To get pregnant faster have sex before ovulation (not after).
Sometimes couples get confused about the best time to have sex in relationship to ovulation. You have a small window of time each month to get pregnant. After a woman ovulates the egg will survive approximately 24 hours. Sperm, on the other hand, will live for up to three to five days. This is why having sex two to three days before ovulation will increase your chances of getting pregnant. Don’t wait until the day you ovulate to have sex. Your partner’s sperm will last longer than your egg and you don’t want to miss an opportunity by waiting.

Tip # 4. Don’t rely on the Calendar method for predicting ovulation.
A lot of couples have heard to have sex around day fourteen of your cycle. This is based on the calendar method and assumes that you have a regular 28-day cycle and ovulate mid-cycle. Although this is better than just picking an arbitrary day to have sex, it is not a very accurate way to predict when you ovulate. Many women do not ovulate on day fourteen and knowing precisely when you ovulate will help you time intercourse better. Ovulation prediction kits, looking at previous months bbt charts, or watching for signs of ovulation will help you to determine when you ovulate.

Tip # 5. If you want to get pregnant faster, don't rely on fertility charting alone to predict ovulation.
Fertility Charting is great for tracking your cycle but it does have disadvantages. By the time you can see ovulation on a bbt chart, you have already ovulated. It is good to chart so you can track your cycles, see if you ovulate the same time each month, and also so you can look back on your cycle and see if you timed things right. But if this is your first cycle trying to get pregnant or if you are not ovulating at the same time each month, an ovulation prediction kit would be more helpful.

Tip # 6. Before you start trying to get pregnant see your doctor.
Make sure you are in good health and have had a regular check up from your OBGYN or medical provider. Untreated infections, sexually transmitted diseases, or poor health can affect your chances of getting pregnant. Its good to see a doctor as well as start taking prenatal vitamins prior to trying to conceive.