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 Blue Pill

Blue Pill is one of the most widely-known prescription drug names on the U.S. market. Often dubbed “the little blue pill”, Blue Pill (sildenafil) was the first phosphodiesterase 5 (PDE5) inhibitor approved to treat erectile dysfunction (ED). ED is a common sexual problem for men and its frequency increases with age.

It is estimated roughly 30 million men in the U.S. and over 100 million men worldwide suffer from ED. A large U.S. survey determined about 50 percent of men 40 to 70 years of age experience some degree of ED.

The Unexpected Discovery of Viagra


The discovery that sildenafil could lead to an erection was an unplanned event. The sildenafil compound was originally developed by Pfizer for the treatment of hypertension (high blood pressure) and angina pectoris (chest pain due to heart disease). During the heart clinical trials, researchers discovered that the drug was more effective at inducing erections than treating angina. Pfizer realized ED was an unmet medical need and a major opportunity for financial gain.

In 1998, the FDA approved Blue Pill, the first oral treatment for erectile dysfunction, under a priority review.

Quick Success: The FDA-Approval of Blue Pill

At the time of its approval, Blue Pill had the fastest initial sales growth following its launch of any prescription product, reaching 2008 sales of close to $2 billion. Pfizer promoted Blue Pill and ED awareness via direct-to-consumer (DTC) advertising, which prompted men to seek medical advice and a prescription from their doctors.

For many men, the stigma and embarrassment of talking to their doctor about ED has declined since the introduction of Blue Pill and other PDE5 inhibitors.

The Impact of Erectile Dysfunction (ED)


Erectile dysfunction (ED), or the inability to achieve and maintain an erect penis for sexual function, can lead to performance anxiety, a negative impact on self-esteem and personal relationships, and even clinical depression.

In a survey published in BMJ, 62 percent of men reported a decline in self esteem, 29 percent reported a negative effect on a relationship, and 21 percent reported that their relationship had ceased due to ED.

For many men, the inability to perform adequately during sex directly affects their feelings of masculinity.

What Causes ED?


Risk factors for ED include underlying health issues such as diabetes, high blood pressure, obesity, high cholesterol, chronic alcohol or drug abuse, certain medications, and injuries, all of which can also contribute to erectile dysfunction (ED). Any condition that may restrict blood flow to veins over time, like smoking and normal aging, can lead to ED.

Medical conditions like Parkinson’s disease or Peyronie’s disease (scar tissue build-up in the penis) may also cause ED.

Mental health issues can take their toll, too — depression or stress can result in loss of libido. Erection failures may occur repeatedly in men who experience performance anxiety due to ED.

Which Medications Cause ED?


Many medications have impotence or sexual dysfunction listed as a side effect. A medication review should be performed by a health care provider to determine if any prescription drug treatment may be contributing to symptoms.

Medications that may lead to erectile dysfunction include:

  • antidepressants (commonly the selective serotonin reuptake inhibitors)
  • blood pressure drugs
  • certain antihistamines
  • antipsychotics
  • drugs used for benign prostatic hypertrophy (BPH)
  • anti-HIV drugs

If you regularly experience sexual function or ED problems, contact your doctor for evaluation and treatment.

Just the Basic Facts: How Blue Pill Works


Blue Pill works in response to sexual stimulation to increase the blood flow to the penis leading to an erection. Viagra does not result in an erection without sexual stimulation.

When a man is aroused, muscles in the penis relax to allow this greater blood flow. Blue Pill helps to elevate the levels of a substance (cyclic guanosine monophosphate, or cGMP) that causes the tissues to relax, leads to an inflow of blood, and causes an erection with sexual stimulation.

Blue Pill and other PDE5 inhibitors like Cialis, Levitra, Stendra and Staxyn treat erectile dysfunction (ED), but do not directly increase a man’s sexual desire. However, knowing that one can perform better in bed may indirectly boost libido. Several of these agents are now available generically, too, which can help in the wallet.

What’s the Safest Way to Take Blue Pill?

Blue Pill (sildenafil) is taken by mouth usually as a 25 or 50 milligram (mg) tablet one hour before sexual activity. However, Blue Pill may be taken within a range of one-half hour to four hours before sex.

The dose may be adjusted based on doctor recommendations, but it should not exceed 100 mg per dose and should not be taken more than once per day. A physician will prescribe your specific dose.

Have your pharmacist check for drug interactions, too.  Men who use nitrates (such as nitroglycerin or isosorbide) should never use Blue Pill or other PDE5 inhibitors (Cialis, Levitra, Stenda, or Staxyn) due to severe, possibly fatal hypotension (low blood pressure).

Does Viagra Have Side Effects?


In general, the most common side effects  with PDE5 inhibitors like Blue Pill are mild and short-lived. Side effects may include:

  • Headache
  • Flushing
  • Heartburn
  • Vision problems
  • Nausea
  • Dizziness

Report a sudden hearing or vision loss to your healthcare provider immediately. An erection lasting more then 4 hours (priapism) is a rare event, but if it occurs get emergency treatment.

Be sure to review Blue Pill drug interactions and precautions with your healthcare provider prior to use. Your dose of Blue Pill may need to be adjusted based on other drugs you may be taking.

Other Options for Erectile Dysfunction


The simplicity of taking an oral tablet for erectile dysfunction has revolutionized treatment. However, PDE5 inhibitors may not work in about 30 percent of men. It is important for men to know that there are other options available for ED. These solutions were used prior to Blue Pill, and are still available today:

  • Penile self-injection (Caverject)
  • Transurethral suppositories (MUSE)
  • Vacuum-assisted erection devices
  • Surgical penile prostheses

These options may be useful for some; however, for many men they can be complicated, painful, and more expensive. Be sure to talk to your doctor about all options.

What is Low T?


Media advertising has dramatically, and sometimes sensationally, increased the awareness of “Low-T” or low blood testosterone (also called androgen deficiency). Typically, a man’s testosterone level is considered low if it’s below 300 nanograms/deciliter. Men with low blood testosterone levels may suffer from a lower sex drive, erectile dysfunction (ED), brittle bones (osteoporosis), low muscle mass and higher fat accumulation.

However, a report from the Testosterone Trials noted that testosterone therapy can raise the risk of heart disease and stroke, and may not be safe is men with low-but-normal testosterone levels and no outward symptoms related to low T.

  • These trials were a set of seven year-long clinical trials conducted at 12 sites across the United States.
  • Overall, the Testosterone Trials showed that the volume of arterial plaque increased more in the testosterone-treated group compared to the untreated “control” group, which could increase the risk over time for heart attack or stroke.
  • The trials showed a positive benefit for bone health and anemia, but experts stated that it’s unlikley testosterone will be considered a first-line treatment for those conditions, as other more effective and well-established options are available.

Testosterone therapy is available by injection, gel, skin patch, spray or lozenge to raise testosterone levels. However, in addition to heart risks, older men who take testosterone replacements may need to have regular prostate cancer screening tests. Plus, testosterone therapy currently carries a boxed warning of potential heart risks, mandated by the FDA.

One more important point: adding testosterone to sildenafil (Blue Pill) treatment has no added benefit in men with erectile dysfunction and low testosterone levels, as noted in one well-designed clinical study.

Blue Pill: But at What Cost?


Erectile dysfunction drugs have finally become affordable due to generic availability. However, some men still prefer the brand names.

But beware. Much of the advertised Blue Pill on the Internet is counterfeit, and may even contain dangerous and toxic drugs.



Another option is to talk to your doctor about using the generic form of Revatio  (sildenafil), approved for pulmonary hypertension. It’s the same drug that’s in Blue Pill, just at a slight lower dose. Just like Blue Pill, you’ll need a prescription, but the cost savings are significant, too.

Counterfeit Blue Pill: A Dangerous Practice


Blue Pill has become the victim of Internet fraud due to its rapid success and famous name. According to Pfizer, 80 percent of the top 22 Internet sites that came up in search results for the phrase “buy Viagra” were selling counterfeit pills.

Products sold as “natural” or “herbal” Blue Pill claim to enhance performance; however, these illegal products have not undergone FDA review or approval. Fraudulent Viagra products contain unknown chemical ingredients that may pose a serious health risk.

Will Blue Pill Be Approved For Women?


More than 50 million women experience some type of sexual dysfunction. Studies looking at Blue Pill in women have theorized that sildenafil could increase genital blood flow and boost arousal. However, most studies have found a limited beneficial effect of Blue Pill for women. Lack of sex drive in a woman is a complicated process, often magnified by stress, hormonal changes, or lack of intimacy.

However, medications to help boost libido in women are becoming available. Addyi(flibanserin) was approved in August 2015 to treat low sex drive — generalized hypoactive sexual desire disorder (HSDD) in pre-menopausal women.

Osphena (ospemifene), as well as Intrarosa (prasterone) are available for vaginal dryness and dyspareunia (painful intercourse) that can interfere with sex in menopausal women. In May 2018, Imvexxy (estradiol vaginal insert) was also approved for females who experience painful sexual intercourse.

The Surprising Health Benefits of Sex

Once upon a time, there was a little blue pill. Its inventors were trying to treat heart disease and prevent heart attacks and found that the little blue pill could dilate blood vessels. The theory was that angina or chest pain could be decreased when more red blood cells carrying oxygen were delivered to heart muscle cells through the dilated coronary vessels. Though good in theory, since it works for nitroglycerin, clinically, the little blue pill wasn’t very effective.

The little blue pill wasn’t very specific as to where it dilated blood vessels. Not only were heart vessels dilated, but so were blood vessels in other places, and this side effect became its claim to fame. Blue Pill hit the market as the first treatment for erectile dysfunction and was a superstar.

It was also becoming a superstar in the athletic world. Studies with cyclists and mountain climbers found that at high altitude, the little blue pill dilated blood vessels in the lung and allowed more oxygen to be extracted from the air, increasing the oxygen concentration in the bloodstream. This translated into faster and stronger training. All of a sudden, the little blue pill moved from the bedroom to the playing field…please insert your own performance-enhancing joke here.

And so we have the latest revelation that baseball players are loading up on Viagra. No big surprise, since Viagra has been a hit on the pro cycling tour for a while, and baseball usually lags behind by a couple of years. History reminds us of anabolic steroids and growth hormone.

The theory is simple. Aerobic metabolism  needs oxygen and glucose to occur. During training and competition, if more oxygen can be delivered to a muscle, then it can maintain a higher level of activity before switching over to anaerobic metabolism (when the oxygen supply runs out). Lactic acid, the byproduct of anaerobic metabolism, is a death sentence for performance. The acid-base balance within the muscle cells is upset, and muscle contraction stops. Recovery time is needed to flush   the acid and restore normalcy to the cell and to the muscle as a whole.

There are a variety of ways of increasing oxygen delivery to cells, and most have to do with increasing the number of red blood cells in the body. The more red cells, the more oxygen molecules that can be delivered to a muscle with each heartbeat. But one should be wary of too many red cells, since they can cause sludging in the blood vessels and lead to bad things like stroke and heart attack.

The legal way to increase the number of red blood cells in the bloodstream is to move to a high altitude. The body recognizes the lower oxygen concentration in the air and stimulates the bone marrow to produce more red cells. Instead of moving, you could sleep in a tent with lower oxygen levels. (Nike has a built a whole house for some of their athletes.)

Less than legal ways to increase red blood cell numbers include blood doping, in which blood transfusions are used to increase the blood count or injecting erythropoietin, the hormone in the body that stimulates the bone marrow.

When winning is dependent on a tenth of a second, or a fraction of an inch, the athlete will look for an extra edge. Sometimes that extra edge is needed to remain on the roster instead of being cut or demoted to the minor leagues. Some athletes look for that little extra within themselves by working harder or training longer. Others look for that edge with performance-enhancing drugs.

Blue Pill has more than a few side effects, but those who choose to go the route of drug enhancement have already made their own deal with their conscience; a few minor or major side effects won’t deter them. Even death is an acceptable risk. Ask a potential Olympian whether they would trade years of their life for a gold medal. Researchers have asked, and the answer, of course, is yes. The only question left was…how many years?


Erectile Dysfunction (ED) Causes and Treatment

What Is Erectile Dysfunction (ED)?


Erectile dysfunction (ED) is when a man has persistent problems achieving and/or sustaining an erection. Erectile dysfunction can make sexual intercourse impossible without treatment. Erectile dysfunction can first emerge in a man as early as 40 according to the Massachusetts Male Aging Study on sexual dysfunction. They also found that an estimated 18 to 30 million men are affected by erectile dysfunction.

Does Erectile Dysfunction Mean Poor Libido?


Erectile dysfunction refers specifically to problems achieving or maintaining an erection. Other forms of male sexual dysfunction include poor libido and problems with ejaculation. Men with erectile dysfunction often have a healthy libido, but their bodies fail to respond in the sexual encounter by producing an erection. Usually there is a physical basis for the problem.

Can Low Testosterone (Low T) Cause Erectile Dysfunction?

While low T isn’t the only cause of erectile dysfunction, the two do seem to be connected. However, the connection between low testosterone and erectile dysfunction is complicated. Researchers believe two are connected because they both seem to coincide as a man ages. However, some men with low testosterone continue to produce healthy erections.

Erectile Dysfunction Symptoms


Symptoms of erectile dysfunction include erections that are too soft for sexual intercourse, erections that last only briefly, and an inability to achieve erections. Men who cannot have or maintain an erection at least 75% of the time that they attempt sex are considered to have erectile dysfunction.

Who Gets Erectile Dysfunction?


Sexual dysfunction is more common as men age. According to the Massachusetts Male Aging Study, about 40% of men experience some degree of inability to have or maintain an erection at age 40 compared with 70% of men at age 70. And the percentage of men with erectile dysfunction increases from 5% to 15% as age increases from 40 to 70 years. erectile dysfunction can be treated at any age.

The Mechanics Behind Erectile Dysfunction


When blood fills two chambers in the penis (known as the corpora cavernosa) an erection occurs. This causes the penis to expand and stiffen, much like a balloon as it is filled with water. The process is triggered by nerve impulses from the brain and genital area. Anything that interferes with these impulses or restricts blood flow to the penis can result in erectile dysfunction.

Diseases That Can Lead to Erectile Dysfunction


The link between underlying chronic disease and erectile dysfunction is most striking with diabetes. Approximately half of the men with diabetes experience erectile dysfunction. Nevertheless, good blood sugar control can minimize this risk.

In addition, the following four diseases can lead to erectile dysfunction by interfering with blood flow or nerve impulses throughout the body.

  • Cardiovascular disease
  • Atherosclerosis (hardening of the arteries)
  • Kidney disease
  • Multiple sclerosis

Lifestyle Choices Can Cause Erectile Dysfunction


Lifestyle choices, such as smoking, alcohol abuse, and obesity can impair blood circulation and lead to erectile dysfunction. Smoking, excessive drinking, and drug abuse may damage the blood vessels and reduce blood flow to the penis. Smoking makes men with atherosclerosis even more vulnerable to erectile dysfunction. Smokers have almost twice the risk of erectile dysfunction compared with nonsmokers. Being overweight and getting too little exercise also contribute to erectile dysfunction. Men who exercise regularly have a lower risk of erectile dysfunction.

Surgery Can Cause Erectile Dysfunction


Surgical or radiation treatments for prostate cancer, bladder cancer, or prostate enlargement (BPH) can sometimes damage nerves and blood vessels near the penis. Occasionally, the nerve damage is permanent and the patient requires treatment to achieve an erection. Sometimes, surgery causes temporary erectile dysfunction that improves on its own after 6 to 18 months.

Medications That Cause Erectile Dysfunction


Many medications can cause or contribute to erectile dysfunction, including certain blood pressure drugs, antidepressants, and tranquilizers. Men with erectile dysfunction should talk with their doctor if they suspect a prescription or over-the-counter drug may be causing erectile problems.

Born This Way? Physiology and Erectile Dysfunction


It is common for men with erectile dysfunction to have an underlying physical basis for it, particularly in older men. However, psychological factors may be present in 10% to 20% of men with erectile dysfunction. Experts say stress, depression, poor self-esteem, and performance anxiety can impair the ability to have an erection. These factors can also make erectile dysfunction worse in men whose sexual dysfunction stems from something physical.

Cyclists and Erectile Dysfunction


Avid cyclists suffer more erectile dysfunction than other athletes because the shape of some bicycle seats causes pressure on the nerves that are vital to sexual arousal. Cyclists who ride for many hours each week may benefit from seats designed to protect the perineum.

Erectile Dysfunction Diagnosis: Physical Exam


To diagnose erectile dysfunction, the doctor will ask questions about the symptoms and medical history. A complete physical exam is done to detect poor circulation or nerve trouble. The physician will look for abnormalities of the genital area that could cause problems with erections.

Erectile Dysfunction Diagnosis: Lab Tests


Many lab tests can be helpful in diagnosing male sexual problems. Measuring testosterone levels can determine whether there is a hormonal imbalance, which is often linked to decreased desire.

These tests may reveal underlying medical causes of ED:

  • Blood cell counts
  • Cholesterol levels
  • Blood sugar levels
  • Liver function tests

Is Erectile Dysfunction a Sign of Heart Disease?


Erectile dysfunction can be a warning sign of serious underlying disease. Research has found that erectile dysfunction is a strong predictor of heart attack, stroke, and even death from cardiovascular disease. All men with erectile dysfunction should be evaluated for cardiovascular disease. Notably, this does not mean every man with erectile dysfunction will develop heart disease, or that every man with heart disease has erectile dysfunction; however, erectile dysfunction patients should be aware of the link.

Erectile Dysfunction Treatment: Lifestyle Changes


Often men with erectile dysfunction are able to improve sexual function by making a few lifestyle changes. Stopping smoking, losing weight, and exercising regularly can help by improving blood flow. If you suspect a medication could be contributing to erectile dysfunction, talk to your doctor about it.

Erectile Dysfunction Treatment: Oral Drugs


While popularized in the media, Viagra is not the only erectile dysfunction drug. Other erectile dysfunction drugs include:

  • Cialis
  • Levitra
  • Staxyn
  • Stendra

These drugs work by improving blood flow to the penis during arousal and are taken 30 to 60 minutes before sexual activity. They should not be used more than once a day. Cialis can be taken up to 36 hours before sexual activity and also comes in a lower, daily dose. Staxyn dissolves in the mouth. All require a doctor’s prescription for safety.

Erectile Dysfunction Treatment: Injections


There are also injectable drugs for erectile dysfunction. Some men sustain stronger erections by injecting these medications directly into the penis. These drugs work by widening the blood vessels, causing the penis to become engorged with blood. Another option is a medicated pellet that is inserted into the urethra and can trigger an erection within 10 minutes. Patients should discuss the use of these injections in detail with their doctor before use.

Erectile Dysfunction Treatment: Vacuum Devices (Pumps)


Vacuum devices for erectile dysfunction, also called pumps, offer an alternative to medication. To use a pump, the penis is placed inside a cylinder. Then the pump draws air out of the cylinder to create a partial vacuum around the penis causing it to fill with blood, leading to an erection. An elastic band worn around the base of the penis is used to maintain the erection during intercourse. Individuals should discuss the use of this device, and especially the elastic band use to avoid potential penile damage.

Erectile Dysfunction Treatment: Surgery


If erectile dysfunction is caused by a blockage in an artery leading to the penis, surgery can be used to restore blood flow. Optimal candidates are typically younger men whose blockage stems from an injury to the crotch or pelvis. The surgery is not recommended for older men with widespread narrowing of the arteries throughout their bodies.

Erectile Dysfunction Treatment: Implants


For those men with persistent erectile dysfunction, a penile implant can restore sexual function. An inflatable implant uses two cylinders that are surgically placed inside the penis. When an erection is desired, the man uses a pump to fill the cylinders with pressurized fluid. Alternatively, a malleable implant with surgically implanted rods can be used to bolster erections.

Erectile Dysfunction Treatment: Psychotherapy


Psychotherapy can be beneficial for men with erectile dysfunction even when erectile dysfunction has a known physical cause. The therapist can instruct the man and his partner in techniques to reduce performance anxiety and improve intimacy. Therapy can also help couples adjust to the use of vacuum devices and implants.

Erectile Dysfunction Treatment: Alternative Therapies


Men with erectile dysfunction should talk with their doctors before trying supplements for erectile dysfunction. They can contain 10 or more ingredients and may complicate other health conditions. Asian ginseng and ginkgo biloba (seen here) are popular, but there isn’t a lot of good research on their effectiveness. Some men find that taking a DHEA supplement improves their ability to have an erection. Unfortunately, the long-term safety of DHEA supplements is unknown. Most doctors do not recommend using it.

Erectile Dysfunction Treatment: Buyer Beware


There are dozens of “dietary supplements” that claim to treat erectile dysfunction, but the FDA warns that many of these are not what they seem. One investigation discovered that supplements for erectile dysfunction can often contain prescription drugs not listed on the label, including the active ingredient in Viagra. These can put the man at risk for dangerous drug interactions.

Reducing Your Risk of Erectile Dysfunction


To reduce your risk of erectile dysfunction, exercise and maintain a healthy weight, stop smoking, avoid alcohol and substance abuse, and keep your diabetes under control, if you have it.

Discussing Erectile Dysfunction With Your Partner


It’s natural to feel angry or embarrassed when confronted with erectile dysfunction. Remember too that your partner is also affected. Talking openly about erectile dysfunction with your partner will help them understand the diagnosis and treatment options (and will reassure your partner that you haven’t lost interest).

Men’s Health: Natural Ways to Boost Testosterone

Add Zing to Your Meals


Onions and garlic are your allies in the kitchen and in the bedroom. They help you make more and better sperm. Both raise levels of a hormone that triggers your body to make testosterone. And both have high levels of natural plant chemical called flavonoids, which safeguard your li’l swimmers against damage.

Pile on the Protein


Lean beef, chicken, fish, and eggs are some of your options. Tofu, nuts, and seeds have protein, too. Try to get about 5 to 6 ounces per day, although the ideal amount for you depends on your age, sex, and how active you are. When you don’t eat enough of these foods, your body makes more of a substance that binds with testosterone, leaving you with less T available to do its job.

Go Fish


Fatty kinds like salmon, tuna, and mackerel are rich with vitamin D. It’s a natural testosterone booster because it plays a crucial role in hormone production.

More Magnesium


This mineral blocks a protein from binding with testosterone. The result? More of the usable man-stuff floating around in your blood. Spinach is packed with magnesium. Almonds, cashews, and peanuts are good sources, too.

Order Oysters


There’s a reason why these mollusks are known for being great for fertility. They have almost five times your recommended daily dose of zinc. This mineral helps your body make testosterone. You can also get it in beef and beans. And it’s often added to breakfast cereal.

Bonus: Zinc boosts your immune system.

Pick Pomegranate


Start your day with a glass of this ancient seedy fruit’s juice instead of OJ. It lowers levels of stress hormones, such as cortisol, which helps raise levels of sex hormones including testosterone. And it can lower your blood pressure and put you in a better mood!

Diet Down


A Mediterranean-style diet can help keep your weight in check and protect you from insulin resistance, which is related to lower T levels. And when your testosterone is low, your fat levels go up, which can lead to your body not using insulin well. You can break this cycle.

Trade saturated fats for healthier ones such as olive oil, avocado, and nuts. Choose lean meats and whole grains. Eat lots of veggies and fruits.

Back Off the Beer


It takes only 5 days of regular drinking for your testosterone level to drop. Alcohol may throw off many parts of your body’s hormone system. Heavy drinkers can have shrunken testes, thin chest and beard hair, and higher levels of the female hormone estrogen.

Use Glass, Not Plastic


Be careful about what you store your leftovers in. Bisphenol-A (BPA) is a chemical found in some plastics, cans, and other food packaging. It can mess with your hormone-making process. After 6 months, men who worked around BPA every day had lower testosterone levels than men who didn’t.

Build Your Strength


Focus your workouts on your muscles. Hit the weight room at the gym, or get a trainer to help you with a routine on the exercise machines. Cardio has its benefits, but it doesn’t boost your testosterone like strength training can.

Be careful to not overdo it. Too much exercise can take your T level in the other direction.

Get Enough ZZZs


Your body turns up the testosterone when you fall asleep. The levels peak when you start dreaming and stay there until you wake up. But daytime testosterone levels can drop up to 15% when you get only 5 hours of sleep. Aim for 7 or 8 hours every night, even if it means a shift in your schedule or a limit to your late-night plans.

Low Testosterone (Low T) Treatments

What Is Testosterone?


Testosterone is a hormone that is necessary for proper muscular development and masculinity. Testosterone is made in the testes (testicles). Women also have testosterone, but in much smaller amounts than in men. If testosterone levels are below normal, a doctor may prescribe one of several types of treatments. However, there is debate about who needs to be treated.

What Does Testosterone Do?

  • Fuels the sex drive
  • Adds muscle mass
  • Regulates mood
  • Regulates bone strength

Testosterone and Aging


Testosterone levels decrease as men age. Sometimes this lower level of testosterone is termed “andropause” or “male menopause.” Symptoms of male menopause may not be caused by low testosterone, but additional research is needed. Many men do not show any symptoms of decreasing levels of testosterone.

Symptoms of Male Menopause

  • Irritable moods
  • Decreased interest in sex
  • Hot flashes
  • Fatigue
  • Weakness
  • Depression

Body Changes Caused by Low Testosterone


How Low Testosterone Can Change the Male Body

  • Less muscle mass (atrophy of muscles)
  • Obesity
  • Loss of body hair
  • Smaller testicles
  • Softer testicles
  • Larger breasts

Low Testosterone Affects Bones


Although osteoporosis (brittle bone disease) is usually thought of as occurring mainly in women, the disease in men is commonly caused by low testosterone. Low testosterone levels can cause bones to thin, weaken, and become more likely to fracture.

Low Testosterone and Sex

Low testosterone doesn’t always interfere with sex, but it is possible. Some men with low testosterone may experience a drop in libido while others lose interest in sex completely. Low testosterone levels can make sex more difficult because it may be tougher to get or keep an erection. Low testosterone might not be the sole cause of low libido; stress, sleep deprivation, depression, and chronic medical illnesses can also alter a man’s sex drive.

Testosterone, Mood, and Thinking


Some of the changes that may occur with low testosterone are nonspecific symptoms such as easy irritability, mood changes, poor concentration, and feeling fatigued or having less energy. However, these symptoms may be caused by a condition other than low testosterone.

Other Health Problems That Mirror Low T Symptoms

  • Anemia
  • Sleep apnea
  • Depression
  • Other chronic illnesses

Low Testosterone and Infertility


One of the many functions of testosterone is to help produce sperm. When testosterone levels are low, the “sperm count” can also be low. If the sperm count is very low, the man may not be able to father a child.

What Causes Low Testosterone?


Although increased age is the most common cause of decreased testosterone levels in men, there can be other causes. Other common causes include:

  • Diabetes
  • Kidney disease
  • Liver disease
  • Chronic obstructive pulmonary disease (COPD)
  • Testicular injuries
  • Pituitary gland problems
  • Radiation therapy
  • Chemotherapy
  • Steroid medications

Should You Be Tested For Low Testosterone?


You might need to be tested for low testosterone if you have erectile dysfunction (ED), a very low sex drive, low sperm count, loss of body hair, decrease of muscle mass, and osteoporosis. Conditions other than low testosterone could be the underlying cause of one’s symptoms. A doctor will want to rule out other conditions before diagnosing and treating low testosterone.

Low Testosterone Testing


Tests for testosterone levels are done by sampling the blood early in the morning when levels of testosterone are highest. Your doctor may want to run a second test a few days later to check for consistency in testosterone levels measured. Normal testosterone levels range from about 300 to 1000 nanograms per deciliter (ng/dL), although some labs consider 200 ng/dL the cutoff for low testosterone. Your doctor will help interpret the tests for you.

Low Testosterone Treatment


If you are diagnosed with low testosterone, your primary care doctor may suggest you see a specialist such as an urologist or an endocrinologist. Not everyone with low testosterone will need or qualify for treatment. These specialists will help guide your treatment and design an approach to your low testosterone problem that is best for you.

Low Testosterone Treatment: Testosterone Replacement Therapy

Low testosterone treatment is designed to boost testosterone levels. Studies suggest this increase in testosterone can strengthen muscles, protect bones, and improve sex drive. Testosterone replacement therapy is only recommended for men who have blood levels that show low testosterone. Such treatments can have different effects from one man to another so it is difficult to predict the treatment outcomes for any one individual.

Methods of Testosterone Delivery

  • Intramuscular shots
  • Topical gels and patches
  • Buccal patches
  • Implanted pellets

Low Testosterone Treatment: Testosterone Injections


Testosterone injections are the least expensive form of testosterone treatment, but they can be painful. The shots are given about every 7 to 22 days and the body slowly absorbs the testosterone into the bloodstream. Injections can be given into the muscles or implanted as pellets. Testosterone levels can increase and then fall between shots.

Low Testosterone Treatment: Testosterone Gels or Patches


Gel or patch treatments for low testosterone are placed directly on the skin. The hormone seeps out of the patch or gel and goes through the skin, and is slowly absorbed into the blood. Gels and patches are applied every day, and as a result, the level of testosterone remains fairly steady. A drawback to these treatments is they sometimes can cause itching, skin irritation, and blisters. In addition, women or children should not come in contact with skin that has been treated with a gel for 2 hours to avoid absorbing any testosterone.

Low Testosterone Treatment: Buccal Patches


Buccal patches are placed on the gums above the incisors (teeth) about every 12 hours and slowly release testosterone. They are not effective if swallowed. Buccal patches may cause a bitter taste, irritation to mouth tissues and gums, and may cause headaches. Fortunately, these side effects lessen over time. The patient can eat, drink, and kiss others while using buccal patches because they are not directly exposed to testosterone.

Low Testosterone Treatment: Risks of Testosterone Therapy


Although testosterone therapy has been tried in many individuals, the risks and benefits of this treatment over many years is still not known because such studies are still underway. Testosterone should not be given to men with untreated prostate cancer, untreated sleep apnea, or untreated breast cancer. In some men, testosterone therapy may need to be stopped if the risks outweigh the benefits.

Side Effects of Testosterone Treatment

  • Enlarged prostate
  • Acne
  • Too many red blood cells
  • Swelling of the feet or ankles
  • Infertility
  • Smaller testicles
  • Breast swelling or soreness

Genital Herpes: Causes, Treatment, and Prevention

Genital Herpes Symptoms


You may feel itchy or tingly around your genitals. This is usually followed by painful, small blisters that pop and leave sores that ooze or bleed. Most people notice symptoms within a few weeks after they catch the virus from someone else. The first time it happens, you may also have a fever, headache, or other flu-like feelings. Some people have few or no symptoms.

How You Do — and Don’t — Get Herpes


You get herpes by having any kind of sex — vaginal, oral, or anal — with someone who’s infected. It’s so common in the U.S. that 1 in every 5 adults has it. Herpes can be spread during oral sex if you or your partner has a cold sore. Because the virus can’t live long outside your body, you can’t catch it from something like a toilet seat or towel.

Worried It’s Herpes?


Sometimes people mistake a pimple or ingrown hair for herpes. Your doctor can take a small sample from sores by using a swab test. If you don’t have symptoms but think you might have herpes, your doctor can do a blood test. It may take a few days to get your results.

What Causes It?


Genital herpes usually comes from the virus called herpes simplex-2 (HSV-2). Its cousin, HSV-1, is what gives you cold sores. You can get HSV-2 from someone whether they have symptoms or not.

How Is Herpes Treated?


Your doctor will prescribe an antiviral medicine. These pills can help you feel better and shorten an outbreak. In the meantime, don’t kiss or have any kind of sex with other people. Even if you don’t have symptoms, you can still spread the disease.

How to Prevent an Outbreak


Some people only take their medications if they feel the itching and tingling that means an outbreak is coming on — or when sores show up — to stop it from getting worse. Your doctor may suggest you take an antiviral every day if you:

  • Have lots of outbreaks
  • Want to prevent more outbreaks
  • Want to lower the risk of spreading it to your partner

Is There a Cure?

You can treat herpes, but once you get it, you’ll always have it. When symptoms show up, it’s called having an outbreak. The first is usually the worst. Most people have them on and off for several years, but they get milder and happen less often over time.

How to Avoid Herpes


As long as you’re sexually active, there’s a chance you could get herpes. You’ll make it a lot less likely if you use a latex or polyurethane condom or dental dam every time, for every activity. The dam or condom only protects the area it covers. If you don’t have herpes, you and your partner should get tested for STDs before sex. If you’re both disease-free and aren’t having sex with other people, you should be safe.

How to Feel Better During an Outbreak


  • Wear loose-fitting clothes and cotton underwear.
  • Avoid sun or heat that could cause more blisters.
  • Take a warm, soothing bath.
  • Don’t use perfumed soaps or douches near your blisters.

What Triggers an Outbreak?


The herpes virus stays in your body forever, even if you have no symptoms. You may have an outbreak when you’re sick, after you’ve been out in the sun, or when you’re stressed out or tired. If you’re a woman, you could get one when you start your period.

Sex and Herpes


You still can have sex if you have genital herpes, but you must tell your partner you have the virus. They need to know so they can get tested. Wear a condom any time you have sex. Never have sex during an outbreak.

Problems With Herpes


People often don’t have serious problems from herpes, but there’s a chance of them. Wash your hands often, especially during an outbreak. If you touch a blister and rub your eyes, the infection can spread to your eyes. If your eyes are red, swollen, hurt, or are sensitive to light, see your doctor. Treating it can help prevent serious vision problems.

Herpes and Pregnancy


If you’re pregnant and have herpes, your doctor may suggest that you have your baby by C-section. Why? During vaginal birth, the herpes virus could spread to your baby, especially if your first outbreak happens around the delivery time. The virus could give your baby rashes, eye problems, or more serious issues. A C-section makes that less likely. Your doctor may also have you take anti-viral medicine as your due date gets closer.

Tips for “‘The Talk'”


Getting ready to talk to your partner about herpes? These tips can help you prepare for the conversation. The American Sexual Health Association recommends you pick a time when you won’t be interrupted, plan what you want to say ahead of time, and practice what you’ll say so you feel confident.

12 Preventable STDs: Pictures, Symptoms, Diagnosis, Treatment

Preventing Sexually Transmitted Diseases and Infections


Are you prepared to protect your health from sexually transmitted diseases and infections? Some of these infections are more familiar—you’ve probably heard of chlamydia, gonorrhea, genital herpes, and HIV. But many more are less talked about. You can protect yourself and your loved ones from future health problems by understanding these common STDs.

In this article we answer some of your tricky and sometimes uncomfortable questions about STD symptoms and diseases. You will learn why herpes is sometimes considered a sexually transmitted disease, what sexual disease is nicknamed “the clap,” and which kinds can lie dormant for a long time. You will also find information on the best treatments for herpes, HIV, chlamydia and various other sexually-transmitted diseases.


Some experts prefer the term “STI” (sexually transmitted infection). STIs include all infections that can be transmitted sexually.

Genital Warts (HPV)


It’s not necessary to have sexual intercourse for a sexually-transmitted disease (STD) to harm your health. The human papillomavirus (HPV), the disease that causes genital warts, can be transmitted by close skin-to-skin contact. Some types of HPV cause cervical or anal cancer, and vaccines are available to protect against the most dangerous types. Other HPV types cause genital warts, which can be raised, flat, or cauliflower-shaped. HPV can be transmitted even by people who have no visible warts or other symptoms.

HPV Symptoms

Genital warts can be big or small, flat or raised. They generally appear as a small bump or group of bumps in the genital region, and may be shaped like a cauliflower.

HPV Vaccine

A vaccine to prevent HPV is given in three shots. The second shot is given a month or two after the first shot. The third shot comes six months after the first shot.

The Centers for Disease Control recommends boys and girls be vaccinated at ages 11 or 12.

If they did not get the HPV vaccine as children, women can get the HPV vaccine through age 26. Men can get it through age 21. The CDC recommends HPV vaccination for men through age 26 for men who have sex with men or men with compromised immune systems, including HIV.

Pubic Lice (Crabs STD)


Pubic lice are colloquially known as “crabs.” This name refers to the shape of these parasites, which is different from that of body lice. Pubic lice live in pubic hair and are spread among people during close contact. Pubic lice can be treated with over-the-counter lice-killing medications.

Pubic Lice (Crabs) Symptoms

  • Severe itching
  • Visible crawling lice or eggs attached to pubic hair



Like pubic lice, scabies is another parasitic STI. This parasite is not necessarily sexually transmitted, since it can affect any area of the skin. However, scabies is often spread during sexual contact.

Scabies Symptoms

  • Extreme itching that is worse at night.
  • The skin appears to have a pimple-like rash, as shown in the above photo.
  • Both the itching and rash may be across the body or limited to the wrist, elbow, armpit, webbing between fingers, nipple, penis, waist, belt-line or buttocks.
  • Tiny blisters (vesicles) and scales may appear.
  • Tiny burrows left by the tunneling of female scabies mites may be visible on the skin. They appear as tiny raised and crooked grayish-white or skin-colored lines.

The only way to prevent this STI is to avoid touching people, as any skin-to-skin contact can spread this highly contagious mite. Condoms, while good at preventing many diseases, will not prevent scabies.

Fortunately, this STI is treatable. Prescription creams can cure a scabies infestation. Protect your health by visiting a doctor if you believe you may have this STI.

Gonorrhea (The Clap)


Gonorrhea is an easily transmitted disease that affects both men and women. It can harm your health by causing infertility in men and women if it is left untreated. There may be no early symptoms of this common STD.

Gonorrhea Symptoms

  • Burning during urination
  • Vaginal or urethral discharge
  • Pelvic pain in women
  • Men may experience swelling of the testes and discharge from the penis

In some cases, the symptoms are mild and the condition is mistaken for a UTI or yeast infection. Visit your health care provider if this sounds like you.



Syphilis can be cured with antibiotics, but many people don’t notice its early STD symptoms. It can play havoc with your health, leading to nerve damage, blindness, paralysis, and even death over time if not treated.

Syphilis Symptoms

  • A round, firm, painless sore on the genitals or anal area (often the first sign)
  • A rash can develop later on the soles of the feet, palms, or other parts of the body
  • Enlarged lymph nodes
  • Fever
  • Fatigue
  • Hair loss
  • Late-stage syphilis can cause damage to many different organ systems. That’s why early detection is so critical to your health.



Chlamydia is a very common STD. It can cause infertility if not treated. The symptoms may not be noticed, or they may be vague and nonspecific. Some people experience no health effects at all.

Chlamydia Symptoms

  • Burning or itching of the genitals
  • Discharge
  • Painful urination

Chlamydia infections can also develop in the rectum and throat.

Oral Herpes (Herpes Simplex 1 Virus)


Cold sores or “fever blisters” on the lips are a sign of herpes virus infection, usually caused by the type of herpes virus known as human herpes virus 1, also known as oral herpes.

Oral herpes is usually not considered a sexually transmitted disease. It can be transmitted through kissing or household contact. However, it can also spread to the genitals. (While this type of herpes can be contracted on the genitals, it is different from the disease known as genital herpes). There is no cure for herpes infection, but medications can reduce the severity and duration of outbreaks.

Oral Herpes

  • Itching of the lips or skin around the mouth
  • Burning near the lips or mouth area
  • Tingling near the lips or mouth area
  • Sore throat
  • Swollen glands
  • Painful swallowing
  • A rash may form on your gums, lips, mouth or throat

Symptoms of oral herpes usually appear 1-3 weeks after first infection. When symptoms return, they are typically milder than the initial herpes outbreak.

Genital Herpes (Herpes Simplex 2 Virus)


In contrast to oral herpes, genital herpes infections are caused by a different virus known as HSV-2 HHV-2. The genital herpes virus spreads through direct genital contact and is considered an STD. More than 87% of those infected with genital herpes are unaware of their infection due to very mild or nonexistent symptoms.

Genital Herpes Symptoms

  • Painful, fluid-filled blisters and crusted sores on the genital area, buttocks, thighs, or anus.
  • Mild tingling or shooting pain in the legs, hips, or buttocks may occur hours to days before a genital herpes outbreak.

After the first infection, less severe outbreaks are common in the first year. Outbreaks tend to decrease over time, though the infection may stay in the body indefinitely.

A genital herpes infection can spread to the lips through oral contact. As with oral herpes, medications can reduce the severity of genital herpes, but there is no cure.

Hepatitis B


Hepatitis B is a virus that spreads through contact with body fluids and blood, so it can be transmitted through sexual intercourse. Hepatitis B infection is also possible through sharing of needles, razors, and toothbrushes. Babies can become infected at birth from an infected mother. It’s possible to go for years without symptoms of this STI.

Hepatitis B Symptoms

  • Nausea
  • Abdominal pain
  • Jaundice (yellowing of the skin and whites of the eyes)
  • Over time, scarring of the liver (cirrhosis) and liver cancer can develop.

Although there is no cure, there is a vaccine to prevent hepatitis B infection.



The HIV virus (AIDS virus) weakens the body’s immune system. It is spread through sexual contact, needle sharing, or from an infected mother to baby. There may be no symptoms for years, but a blood test can tell if you have been infected. With appropriate treatment, many serious illnesses can be prevented.

HIV Symptoms

    • Flu-like symptoms 1 to 2 months after first infection, including like swollen lymph nodes, fever, and headaches
    • Chills
    • Rash
    • Night sweats

Muscle Aches

  • Sore throat
  • Swollen lymph nodes
  • Mouth ulcers

AIDS Symptoms

  • Rapid weight loss
  • Recurring fever or profuse night sweats
  • Extreme and unexplained tiredness
  • Prolonged swelling of the lymph glands in the armpits, groin, or neck
  • Diarrhea that lasts for more than a week
  • Sores of the mouth, anus, or genitals
  • Pneumonia
  • Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
  • Memory loss, depression, and other neurologic disorders

HIV Testing


There are accurate tests to identify whether or not you have been infected with the HIV virus. These can be done in the clinic or at home with the FDA-approved Home Access test kit. The test can be performed anonymously, with only a number to identify you. However, sometimes people may not test positive in the initial 3-4 weeks to 6 months after infection. This time period is referred to as the “window period” in which antibodies may not have developed enough for a positive test. You can still transmit the virus to others during this time.

HIV/AIDS Treatment Options


While there is no cure for HIV, there are medications that can suppress the amount of virus multiplying inside the body. People take a combination of antiviral drugs in hopes of preventing the infection from advancing to AIDS. Additional treatments can help prevent or fight off serious infections, if the immune system has weakened.

Trichomoniasis (“Trich”)


Trichomoniasis is a parasitic infection (caused by Trichomonas vaginalis) that is spread during sexual contact. It affects both men and women and can be cured with medications. Most affected men have no specific symptoms.

Trichomoniasis Symptoms

  • Men: minor discharge or burning with urination
  • Women: yellowish-green vaginal discharge with a prominent odor, itching of the vaginal area, or painful sex or urination

Symptoms can develop anywhere from 5 to 28 days after contracting the infection.



Chancroid is an STD that is rarely seen in the U.S. It is more common in Africa and Asia. It causes painful lumps in the genital area that can progress to open sores. Antibiotics can cure the infection; chancroid is caused by bacterial infection with Haemophilus ducreyi.

Chancroid Symptoms

  • One or more sores or raised bumps on the genitals. A narrow, red border surrounds the sores. The sores become filled with pus and eventually rupture into a painful open sore.
  • About half the time when untreated, the chancroid bacterial infection spreads to the groin’s lymph glands, causing the groin to enlarge and become hard and painful.

Lymphogranuloma venereum (LGV)


Lymphogranuloma venereum (LGV) is a type of chlamydial infection, but it is caused by a different type of chlamydia (Chlamydia trachomatis) than the usual chlamydial disease. Like other chlamydial infections, it can be cured by antibiotic treatment.

Early Lymphogranuloma venereum Symptoms (3-12 Days After Exposure)

  • Soft red, painless sores on or near the genitals or anus
  • Similar sores in the throat or mouth following oral sex

Later Lymphogranuloma venereum Symptoms (2-6 Weeks After Exposure)

  • Open sores in the genitals
  • Swollen lymph nodes in the groin
  • Headache
  • Anal sores and rectal discharge or bleeding if the infection was acquired through anal sex
  • Painful urination
  • Constipation
  • Rectal bleeding
  • Pain in lower back/abdomen
  • Pus-filled or bloody diarrhea
  • Fever, chills, joint pain, decreased appetite and fatigue

Pelvic Inflammatory Disease


Pelvic inflammatory disease (PID) is not a specific STD. Rather, it is a complication that can develop from various diseases, particularly gonorrhea and chlamydia. In PID, bacteria spread to the uterus and female reproductive tract. Infertility may result if the condition is not treated right away.

Pelvic Inflammatory Disease Symptoms

  • Fever
  • Pelvic or low abdominal pain
  • Painful urination
  • Discharge
  • Painful intercourse
  • Light bleeding

Who’s at Risk of Sexually Transmitted Diseases?


It’s estimated that half of sexually active young adults acquire at least one of these STIs by age 25. In fact, sexual diseases are the most commonly reported type of infection in America. Though more common in teens and young adults, anyone who is sexually active is potentially at risk. The risk is raised by having multiple sex partners. The incidence of some sexually transmitted diseases, including LGV and syphilis, is increasing in men who have sex with men.

Can Virgins Get Sexually Transmitted Diseases?


Many of these diseases can spread through any type of sexual activity. This can include skin-to-skin contact and oral sex. This means that people who have not yet had sexual intercourse can still get infected.

Preventing Infection


Abstinence from any sexual contact (or skin-to-skin contact) is the only absolute way to prevent STIs. Being in a long-term, monogamous relationship also is a good way to avoid them.

There are also steps you can take to decrease the chance of getting an STD if you are sexually active, including:

  • Asking partners if they have ever been infected.
  • Using condoms.
  • Avoiding sexual activity with a partner who shows STD symptoms.
  • Asking partners to be tested before having sex.
  • Being aware of symptoms and signs of these conditions.

The Limits of Condoms


Condoms can prevent the spread of some STDs, but they aren’t 100% effective. They are less effective at protecting against herpes, syphilis, and genital warts, since these STDs can be transmitted by contact with skin lesions that are not covered by a condom. Condoms also do not protect against crabs and scabies infestations.

How to Tell Your Partner You Are Infected


It may be difficult, but it is important to tell your partner as soon as possible if you believe you may be infected. Even if you are being treated, you may still be able to spread the infection. For some diseases, both partners should be treated at the same time.

It can be difficult to share this information, so some people find that preparing a script in advance can be helpful. Here are some facts that can help the conversation go more smoothly:

  • Discovering a sexually transmitted disease is not necessarily evidence of cheating. It may very well have come from either your past relationship or that of your partner.
  • An estimated one in two sexually active people will contract such a condition by the time they reach age 25. Most of these don’t know they have an infection. Many STD symptoms are subtle or don’t even show up when first contracted and may be discovered much later.

It’s normal to be nervous about this topic. But by being bold and taking action, you can actively promote better health for you and your partner.

STDs and Pregnancy


Some STDs can cause premature labor in pregnant women, and many STDs can be passed to the baby either during pregnancy or childbirth. So all pregnant women should be checked for STDs. STDs can cause numerous problems in babies, like low birth weight, stillbirth, nerve problems, blindness, serious infections, and liver problems. Treatment during pregnancy can reduce the risks of these complications and can cure many types of infections.

Can STDs Come Back?


In most cases, new exposures to STDs that you have already acquired in the past can cause you to get the infection again. Most treatments don’t protect you from developing the STD at a future time. If your partner has not been treated, you may pass the infection back and forth. Without the right precautions, you could acquire a second STD or a recurrence of the same infection. In addition, genital herpes virus infections can be recurrent after a single exposure.

Female Sexual Dysfunction: Treatment for Women’s Sexual Disorders

Sexual Dysfunction is Common


Sexual dysfunction is a common concern shared by many women. Problems may occur during any phase of the sexual response cycle (excitement, plateau, orgasm, and resolution) that prevent a woman from experiencing sexual satisfaction. Many women are reluctant or embarrassed to discuss their sexual problems, but it’s important to tell your doctor what you are experiencing since most cases of female sexual dysfunction can be treated. Female sexual dysfunction may encompass problems with desire, arousal, orgasm, hormones, or pain.

What Causes Female Sexual Problems?

Female sexual dysfunction can have physical or psychological causes. Physical causes include diabetes, heart disease, neurological diseases, hormonal imbalances, menopause, chronic diseases such as kidney disease or liver failure, urinary tract infection, alcoholism, drug abuse, and side effects of medications, including antidepressant drugs. Hormone fluctuations that occur during pregnancy, after childbirth, and menopause may play a role, too. Psychological causes of sexual dysfunction can include stress, anxiety, concerns about sexual performance, relationship problems, depression, feelings of guilt, and effects of a past sexual trauma.

Who Is Affected by Sexual Problems?


Both men and women can suffer from sexual dysfunction. Seniors may be affected more often, possibly due to health-related declines associated with aging. Males may experience premature ejaculation or delayed ejaculation, problems getting or maintaining an erection, or problems due to low testosterone. Like women, men may also experience problems with desire.

How Do Sexual Problems Affect Women?


Common types of sexual dysfunction in women include:

  • Inhibited sexual desire
  • Inability to become aroused
  • Lack of orgasm (anorgasmia)
  • Painful intercourse

Hormone fluctuations may play a role in female sexual dysfunction. These will be discussed on the following slides.

Inhibited Sexual Desire


Lack of sexual desire or lack of interest in sex is inhibited sexual desire. This can have many causes, including hormonal changes, certain medical conditions and treatments, depression, pregnancy, stress, fatigue, lifestyle influences such as work stress or child care, and even boredom with regular sexual routines. Speak with your doctor if you believe medication side effects are contributing to your lack of desire. Changing your routine may help if lack of desire is a problem. Having sex in new places, at different times of the day, or trying different sexual positions may help reignite desire.

Inability to Become Aroused

Insufficient vaginal lubrication in women may trigger the inability to become physically aroused during sexual activity. Problems with blood flow to the vagina and clitoris may also affect lubrication and arousal. Lubricants may help women become aroused more easily. If a woman is postmenopausal, estrogen cream may help as well.

Lack of Orgasm (Anorgasmia)


The absence of sexual climax (orgasm) is called anorgasmia. Many factors can contribute to anorgasmia, including sexual inhibition, inexperience, or lack of knowledge. Psychological contributors to anorgasmia may include guilt, anxiety, or a past sexual trauma or abuse. Insufficient stimulation, drugs or medications, and chronic diseases can also result in lack of orgasm. Kegel exercises are one potential treatment for lack of orgasm.

Painful Intercourse


Painful intercourse can be a result of a number of conditions such as endometriosis, a pelvic mass, ovarian cysts, vaginitis, poor lubrication, vaginal dryness, the presence of scar tissue from surgery, or a sexually transmitted disease. A painful, involuntary spasm of the muscles that surround the vaginal entrance is a condition called vaginismus that may occur in women who fear penetration will be painful, have sexual phobias, or previous traumatic or painful sexual experiences. Dyspareunia is pain during intercourse or other sexual activity involving penetration or attempted penetration. Pain may be superficial or deep.

How Is a Female Sexual Problem Diagnosed?


Sexual dysfunction in women is diagnosed by a physical exam and symptom history. The doctor will probably perform a pelvic exam with a Pap smear to check for cancer or precancerous changes in the cervix. Other tests may be ordered to rule out medical conditions that may cause sexual dysfunction. You may also be asked about attitudes toward sex, past sexual trauma or abuse, problems in your relationship, or alcohol and drug abuse to help determine if these psychological factors contribute to the dysfunction. A woman’s age will factor into the possible diagnosis of female sexual dysfunction. The doctor may order lab tests to look for potential physical issues contributing to sexual dysfunction.

How Are Female Sexual Problems Treated?


Many types of sexual problems can be treated by addressing the underlying physical or psychological problems. Usually it involves cooperation between the woman, her doctors, and therapists. Treatment strategies are discussed on the following slides. Involvement of a woman’s sexual partner may be part of the treatment process.

Providing Education


Patient education is important to help women overcome anxiety about sexual function and performance. Learning about sexual behaviors and normal responses may ease anxiety. Knowing about normal anatomy, sexual function, changes that occur during aging, and changes that occur in pregnancy and menopause may help ease a woman’s fears. Women should know they have permission to enjoy sex and sexual experimentation.

Enhancing Sexual Stimulation


It may be necessary to enhance sexual stimulation to help a woman overcome some sexual dysfunction. Masturbation, changing your sexual routine, or use of erotic videos or books may help. Get to know your body and what feels good to you. Tell your partner. Try different sexual positions, have sex at different times of the day, and have sex in new places. Schedule sex and make time and energy for the date so you won’t feel rushed or tired.

Providing Distraction Techniques


Anxiety may be alleviated with distraction. Erotic or non-erotic fantasies can be useful. Music, videos, or television can also distract and help women relax. Contracting and relaxing pelvic muscles, similar to the movements one makes during Kegel exercises, can also be a distraction technique.

Encouraging Non-Coital Behaviors


Other behaviors that do not involve intercourse such as sensual massage may help a woman feel more comfortable with her sexuality and with intercourse, and feel less pressure and anxiety surrounding sexual activity. Sensual massage can help a woman feel more comfortable and communicate better with her partner.

Minimizing Pain


If sexual dysfunction is due to pain, sometimes changing sexual positions may help minimize or eliminate the pain. Vaginal lubricants may relieve pain caused by friction, and relaxation before intercourse (warm bath, meditation) may decrease pain responses. Avoiding deep thrusting may help. A doctor may recommend that a woman takes nonsteroidal anti-inflammatory drugs (NSAIDs) prior to having intercourse to minimize pain.

Can Sexual Problems Be Cured?


The prognosis for treating sexual dysfunction in women depends on whether the underlying cause can be treated. If sexual dysfunction is related to a treatable physical condition, the outcome is often positive. When dysfunction is due to psychological causes, it can often be treated successfully with counseling, education, and improved communication between partners. If a combination of factors contributes to female sexual dysfunction, all of them need to be addressed to improve the chance of a good outcome.

How Do Hormones Affect Sexual Function?

Hormones play a large role in sexual function in women. As women age, the hormone estrogen decreases, which can lead to poor vaginal lubrication and decreased genital sensation. Low levels of the male hormone testosterone in women may also contribute to reduced sexual arousal, genital sensation, and orgasm. As long as it is not contraindicated, hormone replacement therapy may help women enjoy improved sexual function. Estrogen combats urogenital atrophy, menopausal mood disorders, and vasomotor symptoms, like flushing, which can negatively impact female sexual function.

What Effect Does a Hysterectomy Have on Sexual Function?


A hysterectomy (surgical removal of the uterus) may cause sexual dysfunction in many women. Women who have their uterus removed for a benign condition may experience a decrease in sexual responsiveness of up to 30 percent. Hormonal changes associated with removal of the ovaries may result in loss of desire, decreased vaginal lubrication, and genital sensation. Nerves and blood vessels integral to sexual functioning may also be damaged during the surgery. Finally, some women may become depressed or feel a loss of self-esteem from their uterus being removed that may make it hard for them to engage sexually following the procedure.

How Does Menopause Affect a Woman’s Sexual Function?


Menopause and the associated loss of estrogen can affect women’s sexual function such as a loss of vaginal lubrication and genital sensation. Other emotional aspects of menopause may contribute to a loss of interest in sex or an inability to become aroused. Loss of estrogen causes thinning and loss of elasticity of the vagina. Estrogen suppositories may help this problem.

However, many postmenopausal women have increased sexual satisfaction. This is thought to be due to less anxiety about getting pregnant, or having the time to relax and enjoy being intimate with their partners.

When Should I Call my Doctor About Sexual Problems?


Sexual problems in women are common, and nearly every woman will experience them on occasion. If the problems persist, they can be very upsetting for a woman and can affect her relationship with her partner. If you experience any sexual problems on a regular basis, talk to your doctor. Help is available! You don’t have to suffer in silence and forgo the pleasure of sex.

Sex Tips for Men: How to Have a Better Sex Life

Was It Good For You?


In the movies, sex always looks great. But if you’re like a lot of men, sex may not be as good as you think it could be. You might feel anxiety, concerns about your performance, or even self-consciousness about your body. No matter what the scenario, it just feels like you’re not having sex as often as everyone else.

How’s Your Sex Life?


An Ohio State University study found young men think about sex about 19 times per day (as compared to young women who think about it 10 times daily). Despite it being on men’s minds much of the time, men still remain confused about what great sex is, and how to have it. Men face both mental barriers and physical barriers to great sex. They may be plagued with self-doubt, and cling to myths and misperceptions about sex. Physically, many men could use some work on the mechanics of lovemaking.

What Is Great Sex?


“Great sex is in the eye of the beholder, or the be-hander,” says Patti Britton, a clinical sexologist and author of The Art of Sex Coaching. “For some men, it might be the ability to produce fantabulous multiple orgasms in their partner. For other men, it might mean being able to last three minutes. Being a great lover means becoming a great lover to your particular partner, and that requires doing something very difficult: opening your mouth.”

Men may talk a good game when it comes to sex, but most don’t think the sex they have is as good as it could be. The following slides are a guide to great sex, with six tips for more sexual pleasure.

Great Sex Tip 1: Take Up Pillow Talk

Pillow talk is important. Aside from kissing and other sexual activities, men can use their mouths for talking to their partner about what they want, and what their partner likes. It’s about being open and trusting.

“If you get to know yourself and your partner, you’ll have a much more erotic and explosive sexual relationship,” says Joy Davidson, a New York-based psychologist and sexologist, and the author of Fearless Sex.

Great Sex Tip 2: Don’t Believe Locker Room Talk


Men may brag to friends and exaggerate the frequency of their sexual activity, but unlike women, men are less likely to talk about insecurities they have surrounding sex. The result is that men create distorted pictures of sexual frequency and prowess for themselves and one another.

According to Michael Castleman, a San Francisco-based sex expert and author of Great Sex: A Man’s Guide to the Secret Principles of Total-Body Sex, the average frequency of sex in committed long-term relationships is roughly once every 10 days.

“A lot of men wind up thinking that their sex life is missing something, that other men are having wilder sex or more frequent sex,” Davidson says. “They have a sense that the pleasure ship has sailed and left them behind.”

Great Sex Tip 3: Don’t Compare Your Sex Life With Porn


Unfortunately, men may learn a lot of what they know about sex from pornography. The problem with that is women and men who appear in porn are often in great physical shape. Both women and men are well-endowed, which can create unrealistic expectations.

“One of the most destructive myths of porn is that it convinces so many guys that they’re too small,” Castleman says. “They forget that pornography is self-selecting… These are not average men. They’re the extreme end of the scale.”

Other myths men may learn from pornography include the ideas that women are always ready for sex, that the same moves work on every partner all the time, and that sex always ends in orgasm.

Porn isn’t all bad. It can give men ideas for sexual exporation and fun scenarios to enjoy withtheir partners, with a caveat: “As long as you’re aware that it’s not reality,” Castleman says. “It’s like watching a car chase in an action movie. It’s exciting. It’s entertaining. But everyone knows it’s not the way to drive.”

Great Sex Tip 4: Focus on Pleasurable Sensations


Stress, anxiety, and distractions can lead to less satisfying sex. Leave the stress of the job at work, and minimize your anxiety about your performance. “If we can quiet our monkey-minds, put a stop to that ceaseless inner-chatter, we can open ourselves up to better sex,” Britton says.

She recommends that men adopt a mantra: FOPS, or Focus on Pleasurable Sensations. “There are techniques ranging from eye-gazing to massage and synchronized breathing that help keep you in the moment,” Britton says. “Great sex happens in the present. It doesn’t happen in the future, like worrying about how quickly you’re going to come.”

Great Sex Tip 5: Focus Less on Size and More on Other Matters


When it comes to penis size, men always hear that size doesn’t matter to women. While this may be the case for most, it’s not so much about having the biggest penis as it is fitting with your partner. “I’m not going to pretend it doesn’t matter,” Davidson says. “There are plenty of women for whom it absolutely does. But I prefer to focus on the idea of the right fit.”

People come in all shapes and sizes and some fit better with each other. For many women, average sized men are the best fit. This is usually a matter of personal preference. However, it’s not something to get caught up in and worry about. Focus on foreplay – kissing, caressing, and other ways of giving pleasure – can lead to satisfying sex for men and women of all shapes and sizes.

Don’t forget to talk to your partner, too. “A lot of women are very responsive to a man’s voice during lovemaking,” Davidson says. “If a man has verbal facility and can entice a woman through his voice that can become a powerful part of his repertoire.”

Great Sex Tip 6: Schedule Sex…Really!


It may sound mundane to schedule sex, but it can actually make it more relaxing with both partners having more realistic expectations. “There’s this powerful mythology that says you should fall into each other’s arms spontaneously, with string music playing and the sun setting in the West, and if that doesn’t happen there’s something wrong with you,” Castleman says. “Nonsense. Real life doesn’t work that way.”

Scheduling sex can also eliminate conflict over desire differences and remove the pressure to perform. “People say, ‘What if I’m not in the mood?’ Well, one of the things about relationships is that you sometimes make compromises. But what astonishes people once they start scheduling sex is that they can actually enjoy it,” says Castleman.

Sex-Drive Killers: The Causes of Low Libido

Sex-Drive Killer: Stress


The body does not react well to stress. Emotional stress may affect physical function, including sexual desire and performance. Realizing what underlying stressors may exist is the first step in treatment. Self-help may work but some people may need to visit a counselor or doctor.

Sex-Drive Killer: Partner


Sexual desire requires two to tango. Both partners need to feel connected and women especially need the feeling of being close. Poor communications, a sense of betrayal, lack of trust, and repeated fighting and criticism may create a relationship that lacks closeness and intimacy. Counseling may be the answer if couples find that the issues are too tough to resolve on their own.

Sex-Drive Killer: Alcohol


Alcohol is usually not the answer to any problem. While alcohol may decrease inhibitions, it also decreases sexual performance and libido. Your partner may not appreciate a drunken advance and may be turned off by it. Alcohol is an addictive drug and you may need help to quit.

Sex-Drive Killer: Too Little Sleep


As with any physical activity, a rested body increases performance. Lack of sleep, including lack of proper sleep, may be the culprit that decreases sex drive. Sleep apnea is a potential cause for lack of good sleep and lack of libido. Medical help may be needed if you or your partner suspect it.

Sex-Drive Killer: Having Kids


Being a parent is a full-time job and you need to carve out time without a child or baby around. Planning quiet time for intimacy and sexual desire may require some creative thinking, like having sex when the baby naps, or hiring a babysitter so mom and dad can have a play date.

Sex-Drive Killer: Medication


Side effects of many prescription medications include loss of libido and sex drive. Some examples include:

  • High blood pressure medications including water pills and beta blockers
  • Cold medications that contain antihistamines and decongestants
  • Antidepressants
  • Birth control pills
  • Narcotic pain pills
  • Chemotherapy drugs

If this is the cause, your doctor may be able to suggest a medication alternative that might have fewer side effects.

Sex Drive Killer: Poor Body Image


Sexy is as sexy feels. Many people have low self-esteem when it comes to their body shape and this can affect their sex drive and desire. Being happy with yourself is an important first step. A supportive partner always helps.

Sex-Drive Killer: Obesity


Obesity affects one-third of all Americans and being overweight can limit desire because of decreased sexual enjoyment, lack of performance, and poor self-esteem. How you feel about yourself goes a long way in affecting how you enjoy sex. Counseling may be helpful.

Sex-Drive Killer: Erection Problems


Erectile dysfunction (ED) can not only affect the ability to have intercourse but also how a man feels about his ability to perform. There are many options available to treat ED and your doctor can help find the option that is best for you and your partner.

Sex-Drive Killer: Low T


While a man’s testosterone level gradually falls with aging, there is not necessarily any relationship between hormone levels and the desire for sex. It is just one potential cause for decreased libido and your doctor may want to look for other causes in addition to just low testosterone (“low T”).

Sex-Drive Killer: Depression


Depression affects all facets of life including sex drive. Losing pleasure in daily activities often requires treatment including counseling and perhaps medication. Unfortunately, some antidepressants also depress libido. Your doctor and therapist need to know if low sex drive is one of your symptoms of depression.

Sex-Drive Killer: Menopause


Menopause may cause physical changes that affect intercourse, including vaginal dryness and pain with intercourse (dyspareunia). Treatments are available to enhance sexual desire and function after menopause.

Sex-Drive Killer: Lack of Closeness


Making love is more than just sex. Intimacy and closeness are important part of a healthy love life. If sexual desire is waning, it may be time to inject romance back into the relationship. Snuggling, giving each other massages, and spending casual time together may help ignite that spark.

Men, Love, and Sex: 18 Secrets Guys Wish You Knew in Pictures

Men Will Talk About Feelings


Was your guy raised as a traditional, stoic, man’s man? If so, let WebMD walk you through 18 relationship secrets, gathered from psychologists who study gender roles. Secret No. 1: It may be easier for your man to talk about feelings indirectly. Ask what he’d do during a romantic weekend. Or what he thought the first time he met you. His answers will reveal how he feels and bring you closer.

Men Say “I Love You” With Actions


Some men prefer to show their feelings through actions rather than words. Your guy may say “I love you” by fixing things around the house, tidying up the yard, or even taking out the trash — anything that makes your world a better place.

Men Take Commitment Seriously


Men have a reputation for being afraid to commit. But the evidence suggests men take marriage seriously. They may take longer to commit because they want to make sure they are onboard for good. In a survey of currently married men, 90% say they would marry the same woman again.

He Really Is Listening


When you’re listening to someone talk, you probably chime in with a “yes” or “I see” every now and then. It’s your way of saying, “I’m listening.” But some guys don’t do this. Just because a man isn’t saying anything doesn’t mean he’s not listening. He may prefer to listen quietly and think about what you’re saying.

Shared Activities Form Bonds


Men strengthen their relationships with their partners through doing things together, more than by sharing thoughts or feelings. For many men, activities like sports and sex make them feel closer to their partner.

Men Need Time for Themselves


While shared activities are important, men also need time for themselves. Whether your guy enjoys golf, gardening, or working out at the gym, encourage him to pursue his hobbies, while you make time for your own. When both partners have space to nurture their individuality, they have more to give to each other.

Men Learn From Their Fathers


If you want to know how a man will act in a relationship, get to know his dad. How they are with each other and how the father relates to his own partner can predict how a man will relate to his wife.

Men Let Go Faster Than Women


Women tend to remember negative experiences longer and may have lingering feelings of stress, anxiety, or sadness. In contrast, men are less likely to dwell on unpleasant events and tend to move on more quickly. So while you may still want to talk about last night’s argument, your guy may have already forgotten about it.

Men Don’t Pick Up on Subtle Cues

Men are more likely to miss subtle signals like tone of voice or facial expressions. And they are especially likely to miss sadness on a woman’s face. If you want to make sure your guy gets the message, be direct.

Men Respond to Appreciation


Showing appreciation for your guy can make a big difference in the way he acts. Take parenting: Studies show that fathers are more involved in care-giving when their wives value their involvement and see them as competent.

Men Think About Sex … A Lot


OK, so maybe this one is no secret. Most men under age 60 think about sex at least once a day, compared with only a quarter of women. And that’s not all. Men fantasize about sex nearly twice as often as women do, and their fantasies are much more varied. They also think more about casual sex than women do. But thinking is not the same as doing.

Men Find Sex Significant


It’s a myth that most men think sex is just sex. For many, sex is a very important act between two committed people. And just like most women, men find sexual intimacy to be most satisfying within a committed relationship. One reason is that long-term partners know how to please one another better than strangers do.

He Likes It When You Initiate Sex

Most guys feel as though they’re the ones who always initiate sex. But they also like to be pursued and wish their partner would take the lead more often. Don’t be shy about letting your guy know you’re in the mood. Initiating sex some of the time may lead to a higher level of satisfaction for both of you.

Guys Aren’t Always Up for Sex


Men, much to many women’s surprise, aren’t always in the mood for sex. Just like women, men are often stressed by the demands of work, family, and paying the bills. And stress is a big libido crusher. When a guy says, “not tonight,” it doesn’t mean he’s lost interest in you. He just means he doesn’t want to have sex right then.

Men Like Pleasing Their Partner


Your pleasure is important to your man. But he won’t know what you want unless you tell him. Too many women feel uncomfortable talking about what they like and don’t like. If you can tell him clearly in a way that doesn’t bruise his ego, he’ll listen. Because he knows he’ll feel good if you feel good.

Guys Get Performance Anxiety


Most men get performance anxiety on occasion, especially as they age. Your guy may worry about his body, technique, and stamina. If you can help him learn to relax and stay focused on the pleasures of the moment, sex will become less stressful.

Men May Stray When Needs Aren’t Met


If a man doesn’t feel loved and appreciated in his relationship, he may turn elsewhere for satisfaction. For one man, that may mean burying himself in work. Another may develop a fixation on sports or video games. And some men cheat. To avoid this, partners need to work together to meet each other’s needs.

He’s Vested in You

Most men realize there’s a lot to lose if a long-term relationship goes sour — not just each other’s company, but the entire life you’ve built together. If you’re willing to work to strengthen your marriage, chances are your man will be, too.

19 Secrets Women Wish You Knew With Pictures

A Caring Guy Is a Hot Guy


What do women want? For those who’ve ever pondered this question, here are 19 relationship secrets. They’re based on the study of healthy, happy couples and our changing gender roles. Secret No. 1: Women appreciate a guy with a sensitive side, especially when they’re upset. Put your arm around her and hand her a tissue. Nurturing is a powerful way to connect.

Chivalry Still Has a Place


When it comes to romance, many women do like men to take a traditional masculine role. This is especially true in the wooing stage of a relationship, according to psychologist Diana Kirschner, PhD, who’s written several books about love. She’s perfectly capable of pulling out her own chair or opening a door, but if you see her hesitate, she might just be waiting for you to be the gentleman.

Dress to Impress


Styles come and go, but a man’s attention to his grooming and clothing should be long lasting. It’s important to women from the first flirtation through the honeymoon and beyond. “You’ve got to figure out if there’s a certain look that she likes,” says Kirschner. “If she likes a guy in tight jeans, you wear tight jeans.”

Guy Wears Red, Guy Gets Girl


OK, this tip doesn’t come from women, but from clever testing by psychologists of women’s subconscious preferences. One intriguing study found that the color red made men seem more powerful, attractive, and sexually desirable to women. There’s a caveat, though. Red doesn’t make guys appear nicer or kinder. That part is up to you.

Don’t Hide Your Flaws

Nothing captures a woman’s heart quite like a good man who wants to be a better man, according to love guru Kirschner. “Women love personal growth, they love a man who is thoughtful and sensitive.” She likes it when her man recognizes a flaw — a short temper, for example, or a regularly sullen mood after work — and loves it when he makes an effort to address it.

Don’t Try to Fix Her World


When something’s bothering her, she wants your ear, not your advice. “Men feel the need to fix things because they are solution-oriented,” says Kirschner. “But to a woman, really listening is a wonderful, wonderful thing that deepens the relationship.”

Nodding Is Not Enough


Listening is important, but she also wants to know that she is being heard. Nodding along won’t cut it. When she pauses, she’s giving you a cue to respond in a compassionate, caring way, says Kirschner. If she tells you that she is upset because her boss gave her a tough time, she wants to hear you say, “I’m sorry that work was such a drag for you today.” And remember: Resist the urge to offer solutions.

Date No. 3 Is Not a Bedroom Key


The three dates before sex rule is an urban legend. Women don’t set a timeline on when they’ll invite a potential partner into the bedroom. Some women will want to have many dates before sex. A good rule of thumb is to give the relationship at least two months to grow before entering the sexual arena.

Women Like the Slow Lane


Guys often want to take the quickest path to sex. But many women prefer the scenic route. “Women want sex but they get to it in a different way,” says psychologist Kirschner, who has helped hundreds of couples achieve a more rewarding relationship. “They want to feel connected and understood, they want to be romanced.” That means time and talking and touching — in other words, foreplay.

Safe Sex Is a Turn-On


This is something both of you need to focus on, but Kirschner says that women appreciate it and feel more protected when the guy makes it clear that it’s a concern to him — and then shows her that he practices what he preaches.

Learn What She Wants in Bed


Women do like to talk to about what’s going on in the sack, and they want to please their man — and a tactful approach is often best. Ask her what she likes. Be sure to ask for what you want in a positive and validating way. Kirschner advises saying something along the lines of, “I would really love if you [fill in the blanks].”

Performance Anxiety Is Shared


When you have an off night and can’t perform, she feels bad, too. She might worry that she no longer turns you on and she will want assurance that that is not true. She will want to talk about what’s going on and what you are doing about it, especially if it’s a recurring problem. “It’s a touchy thing for both of you,” says Kirschner, “but talking about it is a plus.”

Mirroring Is a Barometer of Love


Remember the saying “imitation is the highest form of flattery”? A woman often conveys how she feels about you by mirroring your moods and moves. She may order a meal that pairs with yours, wear your favorite color, or smile or cross her arms when you do. Mimicking is her way of putting you at ease and letting you know she is charmed.

Your Shirt May Be a Love Magnet


Does your partner curl up in your sweater or sneak into your work shirt? Some researchers have found that the scent of a man’s perspiration has a relaxing effect on women.c

Say It, Again and Again


Women like to be told they look nice, and they like a man who notices without being told. When she’s wearing a sexy new dress, for example, she’ll give you major points for saying how hot she looks, especially if you mention the dress before she does. If she’s looking particularly attractive, if she has a new haircut, if she’s looking more fit — let her hear about it.

Don’t Fear the Relationship Talk


When your woman wants to talk about the relationship, it doesn’t mean you did something wrong (well, not necessarily). Kirschner says that many women like to talk about the “state of the union” — what’s going right, what’s going wrong, or simply what’s going on. This is a good thing. An honest, wide-ranging talk can bring the two of you closer.

Look Your Partner in the Eye


You may feel more comfortable sitting side by side, but many women prefer face time — and we don’t mean the latest mobile video chat technology. Kirschner says that women prefer their men to make eye contact with them as they’re talking. And looking her in the eye during sex will deepen the relationship outside the bedroom.

Don’t Miss the Moment


How do you know if she is ready to commit? She’ll say so. This is something that women are often quite up front about. But they don’t want to have “the talk” too often. If she’s ready and she’s given you time, the next time the subject comes up, be prepared to step up or step off.

Romance Is Simple; Keep It Coming


Romance is something she will always want, whether you’ve been together two months or 20 years. Flowers, an intimate dinner, a few lines of love poetry — don’t worry, they don’t have to be your own — might sound cliché, but Kirschner insists that most women appreciate such simple romantic gestures and often show their appreciation after the lights go down.

Your Sex Life After Pregnancy



Getting busy after your baby is born can be a challenge! “Babies are sex killers,” says psychiatrist Gail Saltz, MD, at New York-Presbyterian Hospital/Weill Cornell Medical Center. Caring for a newborn takes a lot of time, and can sap you of energy you used to devote to your partner. Reclaiming your sex life after you have a child is a challenge most couples face. “It’s difficult, but doable,” says Saltz, who specializes in sex therapy and is author of The Ripple Effect: How Better Sex Can Lead to a Better Life. Have reasonable expectations of yourself and your body and you will get back into the sexual swing of things.

Getting the Green Light to Have Sex After Baby


Before you start having sex post-delivery, make sure you don’t have any postpartum vaginal discharge (lochia). Most women can resume intercourse from four to six weeks following delivery, regardless of whether you had a vaginal birth or C-section. Having sex before the discharge stops can put you at risk for infection. Some women need a lot of stitches during childbirth and this can also put sex on hold for a longer time period.

Lack of Sleep Smothers Your Sex Drive – Moms


One of the biggest obstacles to resuming sexual activity is the overwhelming fatigue that accompanies the care for a newborn. For several months, most new babies require feeding every two to three hours around the clock. The National Sleep Foundation estimates up to 30% of babies still don’t sleep through the night at 9 months. This lack of sleep can cause moms to lose sexual desire and sensation.

Lack of Sleep Smothers Your Sex Drive – Dads


Dads are usually more interested in sex, even if they are tired as well. Men crave sex to help them feel emotionally close to their partners, and also to relax, according to Saltz. Most men can have sex on a whim, while women need foreplay to become aroused.



Talk to your partner if you are so tired it’s affecting your sexual desire, says Saltz. There may be ways you can get more rest, so you can get in the mood. Start by asking your partner to watch the baby so you can nap, or try to have sex in the morning, after both of you are rested. Keep in mind that the baby may still wake up just when you’re trying to get down! To get some true alone time, family and friends, or babysitters can take over so you and your partner can be intimate without worrying about the baby.

Post-pregnancy Hormones and Sex


After giving birth, estrogen levels decrease. This can cause a lack of vaginal lubrication, which may make sex less pleasurable or even painful. “Lubrication issues usually go away after you stop breastfeeding or after your period resumes,” says Cleveland Clinic OB-GYN Elisa Ross, MD. In the meantime, use a topical lubricant to reduce irritation.

Hormonal changes may also result in postpartum depression, which includes feelings of sadness, anxiety, or irritability after giving birth. These feelings can interfere with sexual desire and may persist for weeks to months. Talk to your doctor if you suffer from any depression or anxiety after childbirth.

Breastfeeding May Get in the Way


Breastfeeding is good for the baby, and good for mom to bond with her newborn, but it may also get in the way of your sex life. Constant nursing or pumping milk can make breasts feel tender and a woman may not want to be touched there. If you’re worried about leakage or tenderness, try keeping your bra on during sex, Ross says. In addition, the amount of energy spent on nursing can make a new mom feel like a baby feeding machine, which can hinder sexual feelings.

Body Changes, Inside and Out


Body changes and how a woman feels about her new post-baby body can have a big impact on her feelings of sexuality. Most women gain 25-35 pounds in a typical pregnancy, and many women get stretch marks. A C-section can leave a scar. All these things may contribute to a woman feeling self-conscious or depressed about her body. In reality, your partner likely still views you as sexy. You can also enlist help to regain your pre-baby body. Ask your partner to watch the baby so you can exercise, or have them help prepare healthy meals. You may also want to try buying some new sexy lingerie that can cover some new problem areas, suggests Saltz.

Body Changes, Inside and Out (cont.)


Vaginal delivery may also stretch the vaginal walls, which can decrease friction and reduce sexual enjoyment. It takes tome for the muscle tone to return to that area. In some women, it never does, according to Ross. To help tone pelvic muscles, try Kegel exercises. These exercises can also help heal the area after vaginal tears or an episiotomy.

Be Honest About What’s Holding You Back


In some cases, lack of interest in sex after having a baby is more than just physical. There may be some things going on in your relationship that need to be examined. “Ask yourself, ‘What is making me uncomfortable enough that I don’t want to express intimacy with my partner through sex?'” Saltz says. A common feeling is resentment at being stuck at home changing diapers and nursing, while spouses get to go outside the house and spend time with other adults.

Communicate With Your Partner


Self-consciousness about your body and your mental fatigue are other emotional issues that may need to be addressed. Talking to your partner can go a long way to reassure you that you are a team and are working together to care for your new family.

If you are having difficulty communicating, couples counseling may help. Ross recommends every couple should proactively seek counseling after having a baby, to help resolve small problems before they get out of control.

Explore the Alternatives


Remember that sex isn’t just about intercourse. “Sex is about pleasuring each other and there are many ways to do that,” Saltz says. Consider oral sex, manual stimulation, or erotic massage for intimacy. Even if you are not feeling sexual, try to connect with your partner by kissing, hugging, holding hands, or cuddling.

Scheduling Sex


The first year with a newborn is very physically and emotionally demanding, and many couples may have to realize their sex lives may not be the same as they were before baby. However, most sexual issues women experience following childbirth improve within the first year. Even so, sexual activity does not always return to what it was pre-baby and couples may find they need to schedule sex. It may not feel as romantic as the spontaneity you used to enjoy, but it may be a necessary way to ensure you don’t miss out on intimacy.

Accepting the New Normal


With a new child your sex life may change from what it was before and you may have sex less frequently than you used to. If you’re both fine with not having sex as much, you’re OK. “But it’s not about how much sex you’re having. It’s about how unhappy you each might be about not having it,” Saltz says, “If one partner feels denied all the time, it creates a vulnerability in the relationship.” These problems have to be addressed before it’s too late.”

Health and Sex: How Sex Drive Changes Through the Years

What Is Sex Drive?

It seems like a simple question, but scientists still can’t agree on exactly what makes up sex drive or how to measure it in men or women. While hormones play a role, it’s not always clear how much of a difference they make. But other factors — psychological, social, and physical — also work together to create your libido.

Men: Your 20s


Testosterone, a hormone men need for sexual arousal, is typically high in your 20s, and so is your sex drive. But it’s also a time when you could be anxious about sex because of inexperience. That might be part of why 8%, and possibly more, of men in their 20s report erectile dysfunction (ED). The condition can happen because of a medical or mental health issue or even be a sign that you’re at risk for heart disease. Talk to your doctor about your symptoms.

Women: Your 20s


You’re likely to be more fertile from your teens to late 20s than you are in the years that follow. This may make you choosier about if and when you have sex, though it’s not clear exactly why. In fact, scientists think that female desire might go up just as fertility starts to decline toward the end of your 20s.

Men: 30s and Early 40s


Many men continue to have a strong sex drive through these years, though testosterone starts to slowly decrease around age 35. It typically goes down by about 1% per year, but it could be faster for some men. This could have some effect on your sex drive. Plus, for many men, the stress of work, family, and other commitments can affect how interested you are in sex.

Women: 30s and Early 40s


This time of life may be when your sex drive is strongest. One study showed that women between 27 and 45 had more frequent and more intense sexual fantasies than younger or older women. They also had more sex and were more likely to have it sooner in a relationship.

Women: Having Kids


At any age, pregnancy and childbirth have a big impact on your sex life, but it’s different for everyone. Your body and hormones change throughout pregnancy. That may mean a boost in libido at times, especially during the second trimester, and a lack of desire at others. You also may be anxious about whether it’s safe to have sex while you’re pregnant. (It usually is, but ask your doctor if you’re unsure.) Breastfeeding, raising kids, and other work can also affect the time, energy, and interest you have in sex.

Men: 50s and Beyond


If you’re in good physical and mental health, there’s no reason you shouldn’t continue to enjoy your sex life as you get older. ED does become more common as you age. Your erections may happen less often and may be less firm. But it’s not age itself that causes the problem as much as health problems that become more common with age, like heart disease, diabetes, high cholesterol, and obesity, and the drugs that treat them. Your doctor can talk to you about your options for treating ED.

Women: 50s and Beyond

Around age 50, an “empty nest” or less worry about getting pregnant might make some women more interested in sex. But as you head toward menopause, estrogen levels drop, which might cool your libido down a bit and lead to vaginal dryness. Hot flashes, anxiety, weight gain, and sleep problems also can make you less in the mood. Ask your doctor about medicines, hormones, lubrication, and other treatment.

Men: It’s Not Just Testosterone


You need some testosterone to get aroused, but it’s not clear how much. It may vary from person to person. And though it’s true your levels decline with age, scientists don’t know exactly how this affects sex drive. Some men with “low” testosterone show normal sex drive, while others with high levels have sexual problems. Other medical issues, physical fitness, and mental health could be more important factors.

Your Doctor Can Help


Talk to your doctor about any issues with your sex drive, as they could be a sign of a medical condition. If your physical response is the problem, your doctor may prescribe hormones that can increase overall sex drive (estrogen for women, testosterone for men), or drugs that boost sexual arousal: sildenafil (Viagra) and tadalafil (Cialis) for men, and flibanserin (Addyi) for women.

Talk About It


Ask your partner about their needs and desires, and talk about yours, too. Don’t be afraid to try new things as your bodies evolve and your stage of life changes. This can help keep you and your partner engaged and interested in sex. Be honest about your physical and emotional satisfaction. It might even be a good idea to set aside certain times to be intimate.

Health and Sex: Exercises for Better Sex



Getting physical can ramp up the pleasure for you and your partner. Any activity that gets your heart beating faster and you breathing harder, from brisk walking to cycling, can boost blood flow — including to your nether regions. That’s a plus for both genders: stronger erections for men, and greater arousal for women according to a University of Texas study.



Harvard researchers found that male and female swimmers in their 60s had sex lives similar to people 20 years younger. Swimming builds endurance, boosts blood flow, improves flexibility and strength, and slashes stress. It also burns some serious calories, a plus for anyone who’s overweight (extra pounds lower libido), especially obese men with erectile dysfunction.

Core and Abs Work


A strong, flexible core underpins most everything you do. That includes performing between the sheets.

Frog Pose


This move will make you more flexible during lovemaking, says NYC-based exercise physiologist Liz Neporent. It’s an intense hip opener that stretches your inner thighs, groin, and hips. It also releases stress, which can be a real buzz-kill in bed.



To help hold yourself in a “favorable position” without your back or legs giving out, Neporent recommends the hinge. Lean back at a 45-degree angle for a few seconds before returning upright, and repeat. The move is subtle but creates a lot of staying power.



Developed to treat urinary incontinence, these strengthen your pelvic floor muscles, and that may mean more intense orgasms. Women may be more familiar with Kegels, but they also help men prevent premature ejaculation. But studies show half of people don’t do them correctly. Ladies, if you put a finger in your vagina, you should feel a pulling up when you squeeze. Men, your penis will lift up.



This is a perfect way to strengthen the deepest layer of your ab muscles (transversus abdominis), along with your upper arms, thighs, and buttocks. These muscles help stabilize you so you can stay close to your partner when and where it counts most. Do it once a day, and build up to 60 seconds or longer. If it’s too challenging on your toes, try balancing on your knees instead.

Cat/Cow Stretch


Think of this yoga pose as another form of foreplay. It limbers your spine, helps get you into an even breathing rhythm, and improves focus — so your mind stays in the moment. Move with a steady flow, so that each rounding up (the cow part) takes a full breath out and each arching downward (the cat part) takes a full breath in.

Pelvic Thrust


Whether your favorite position is missionary or cowgirl, this move is a key part of it. But powerful pushes can be exhausting when you’re out of shape. Work your glutes, calves, and hamstrings to build stamina and flexibility. Pelvic thrusts also sculpt your booty, so you feel good and look good.

Better Together


Couples who sweat together stay together, so make an exercise date with your significant other. Studies show that challenging physical activities spark arousal. You’ll be more attracted to your partner post-workout, too. Coordinate your actions (for example, run at the same pace) to strengthen your emotional connection even more.

Sexual Health: What Happens When You Stop Having Sex?

You Might Feel More Anxious


Maybe sex is the last thing on your mind when you’re stressed out. But it might help lower your anxiety. Sex seems to lessen the amount of hormones your body releases in response to stress. And an active sex life can make you happier and healthier, which might also help keep anxiety at bay.

Your Heart May Not Work as Well


Research says people who have sex once a month or less get heart disease more often than those who have it twice a week or so. Part of the reason could be that you get a bit more exercise and are less likely to be anxious or depressed. But it could also be that if you have more sex, you’re physically and mentally healthier in the first place.

You Might Get Less Exercise

Sex typically burns about 5 calories a minute. That’s about equal to a brisk walk. And you use a bit more oxygen too — about the same as digging in the garden or walking down the stairs.

That may not seem like much, but it starts to add up over the long term. And because sex can improve your mental health, you might be more likely to do other types of exercise like the neighborhood kickball team, hiking, or housework.

You May Lose Your Keys More Often


Well, not so much lose them as forget where you put them. That’s because regular sex seems be linked to improved memory, especially if you’re between ages 50 and 89. It’s not clear why.

Your Immune System May Get Weaker


Weekly sex seems to boost your immune system compared to those who have it less often. Part of the reason may be that it raises levels of a germ-fighting substance called immunoglobulin A, or IgA. But more is not always better here. People who had sex more than twice a week had lower levels of IgA than those who had no sex.

Your Relationship Changes


Sex bathes your brain in a chemical “afterglow” that lasts about 2 days and helps to bond you to your partner over the long term. Without it, you could lose some of the satisfaction of your relationship. A healthy, happy sexual relationship — couples who do it at least once a week seem to be happiest — can help build trust and understanding between you and your partner.

Your Prostate May Be Less Healthy


The reasons aren’t exactly clear, but in at least one study, men who ejaculated less than seven times a month were more likely to get prostate cancer compared to those who did it at least 21 times a month.

But unprotected anonymous sex and multiple partners can also raise your chances for the disease, so when you do have sex, take care.

You Might Sleep Less


Without sex, you’ll miss out on the hormones that promote restful sleep, like prolactin and oxytocin. Women get an estrogen boost that helps even more. The reverse is true, too: If you decide you want to start having sex again, a good night’s sleep is just the thing to keep you feeling frisky.

Aches and Pains Hang Around


Sex can be a good way to take your mind off of any aches and pains you have. But it does more than that. Orgasm causes your body to release endorphins and other hormones that can help ease head, back, and leg aches. They may help arthritis pain and menstrual cramps, too.

You Could Have Sexual Problems Later


It may seem odd, but “use it or lose it” may apply here. For women at menopause, vaginal tissue can get thin, shrink, and dry out without regular intercourse. That can make sex painful and weaken your desire. And some research says men who have sex less than once a week are twice as likely to have erectile dysfunction (ED) as those who have it weekly.

Your Blood Pressure Might Rise


Sex seems to help keep your blood pressure down. That makes sense when you consider what it does: It adds a bit of aerobic and muscle-building exercise, and it can ease anxiety and make you feel better. Both of those can help keep your numbers where they need to be.

The Surprising Health Benefits of Sex

The perks of sex extend well beyond the bedroom…


Sex is not only pleasurable, did you know it’s also good for you? It’s true. The benefits of sex range from slashing stress levels to lowering your risk of cancer and heart attacks. Sex facilitates bonding and feelings of intimacy with your partner. This kind of connectedness does more than make you feel warm and fuzzy, it actually reduces anxiety and boosts your overall health.

How would you like a stronger immune system or better sleep? Action between the sheets can help you get all of this and more.

1. Get Less Colds & Boost Your Immune System


More sex equals fewer sick days. That’s what the results of studies comparing sexually active people to those who are not sexually active say. Sex boosts your body’s ability to make protective antibodies against bacteria, viruses, and other germs that cause common illnesses. Of course, there’s more to cultivating a robust immune system than having a healthy sex life. Eating right, exercising, getting adequate sleep, and keeping up to date with vaccinations all contribute to having strong and healthy defenses against contagious illnesses.

2. Boost Your Libido


Believe it or not, the best antidote for a waning libido is to have sex! Having sex actually boosts desire. And if pain and vaginal dryness make it challenging for some women to have sex, sexual activity can help combat these problems, too. Sex boosts vaginal lubrication, blood flow to the vagina, and elasticity of the tissues, all of which make for better, more pleasurable sex and heightened libido.

3. Improve Women’s Bladder Control


Urinary incontinence affects about 30% of women at some point in life. Having regular orgasms works a woman’s pelvic floor muscles, strengthening and toning them. Orgasms activate the same muscles that women use when doing Kegel exercises. Having stronger pelvic muscles means there’s less risk of accidents and urine leaks.

4. Lower Your Blood Pressure


Are you one of the millions of people who suffer from high blood pressure? Sex can help you lower it. Many studies have documented a link between intercourse specifically (not masturbation) and lower systolic blood pressure, the first number that appears on a blood pressure test. That’s good news for individuals looking for an easy adjunct to lifestyle (diet, exercise, stress reduction) and medication strategies to get blood pressure into a healthy range. Sex sessions cannot replace blood-pressure lowering drugs to control high blood pressure, but they may be a useful addition.

5. Counts as Exercise


Like every other kind of physical activity, sex burns calories, too! Sitting and watching TV burns about 1 calorie per minute. Having sex increases your heart rate and utilizes various muscle groups, burning about 5 calories per minute. Regular sex cannot replace sessions at the gym, but a having an active, healthy sex life is a nice way to get some extra physical activity.

6. Lower Heart Attack Risk


Want a healthier heart? Have more sex. Sexual activity helps keep levels of hormones, like estrogen and testosterone, in check. When these hormones are out of balance, conditions like heart disease and osteoporosis may develop. When it comes to protecting heart health by having sex, more is better. One study in men showed that those who had sex at least 2 times a week were 50% less likely to die of heart disease than their less sexually active peers.

7. Lessen Pain


Sexual stimulation (including masturbation) and orgasm can help keep pain at bay. Both activities can reduce pain sensation and increase your pain threshold. Orgasms result in the release of hormones that can help block pain signals. Some women report that self-stimulation through masturbation can reduce symptoms of menstrual cramps, arthritis, and even headache.

8. May Reduce Prostate Cancer Risk


There are male-specific health benefits of sex, too. One study showed that men who had frequent ejaculations (defined as 21 times a month or more) were less likely to develop prostate cancer than those who had fewer ejaculations. It did not matter if the ejaculations occurred through intercourse, masturbation, or nocturnal emissions. Of course, there’s more to prostate cancer risk than frequency of ejaculations, but this was one interesting finding.

9. Improve Sleep


Sex can help you sleep better. That’s because orgasm simulates the release of a hormone called prolactin, a natural sleep aide. Prolactin promotes feelings of relaxation and sleepiness. This is just one of the reasons you may notice that you have an easier time falling asleep after having sex.

10. Relieve Stress


Sex is a great stress reliever. That’s because touching, hugging, sexual intimacy, and emotional attachment stimulate the release of “feel good” substances that promote bonding and calmness. Sexual arousal also releases substances that stimulate the reward and pleasure system in the brain. Fostering intimacy and closeness can help relieve anxiety and boost overall health.

11. Burn Calories


Add sex to the list of activities that burns calories. One study in young men and women showed that sex burns about 108 calories per half hour! That’s enough to burn off 3, 570 calories – that’s a little more than the number of calories in one pound – in 32 half-hour sessions.

12. Improve Cardiovascular Health


Better cardiovascular health may be as close as the bedroom. While some people may worry that physical exertion from sex may lead to a stroke, science suggests otherwise. In a 20-year-long study of more than 900 men, researchers found that frequency of sex did not increase stroke risk. They found that sex protects against fatal heart attacks, too. Men who had sex at least twice per week reduced their risk of a fatal heart attack by 50% compared to gents who had sex less than once a month.

13. Strengthen Your Well-Being


Humans are wired for social connection. Interaction with friends and family boosts your overall health and well-being. Close connections with others, including your partner, make you happier and healthier compared to those who are less well connected. Studies prove it!

14. Improve Intimacy and Relationships


You can hug and cuddle your way to develop warm, intimate relationships. Sex and orgasms stimulate the release of a hormone called oxytocin that helps people bond. This “love hormone” as it’s commonly known, helps build feelings of love and trust. In a study of premenopausal women, the more time the ladies spent canoodling and hugging their husbands or partners, the higher their oxytocin levels were. The hormone inspires fuzzy feelings and generosity, too.

15. Look Younger


Forget surgery and anti-aging creams, sex keeps you younger looking, too. Regular sex stimulates the release of estrogen and testosterone, hormones that keep you young and vital looking. Estrogen promotes younger-looking skin and lustrous locks. In one study, judges viewed participants through a one-way mirror and guessed their ages. People who had sex at least 4 times per week with a regular partner were perceived to be 7 to 12 years younger than they actually were.

16. Live Longer


What’s the secret to living longer? It may be having more sex. In a decade-long study of over 1,000 middle-aged men, those who had the most orgasms had half the death rate of those who did not ejaculate frequently. Of course many factors contribute to longevity, but having an active sex life may be an easy, pleasurable way to extend your lifespan.

17. Boost Brainpower


The benefits of sex truly extend from head to toe. An active sex life might actually make your brain work better. Researchers found that sex switches the brain into a more analytical mode of and thinking processing. And animal studies suggest that sex enhances areas of the brain involved in memory.

18. Sex Makes Fertilization Easier


When it comes to expanding your family, practice makes perfect. A study performed at a fertility center found that men who had daily ejaculations for a week had higher-quality sperm than those who did not ejaculate daily. Men in the daily ejaculation group had sperm with DNA that was less fragmented than the DNA from sperm of men who ejaculated less frequently. Less fragmented DNA implies healthier DNA. And hearty sperm that have healthy DNA are more likely to fertilize an egg.

Tattoo Pictures: The Scoop on Tattoo Safety, Removal, and More

The Truth about Tattoos


You don’t have to look far in a crowd to see a tattoo today. Among people 18 to 30 years old, one person in four is inked. In the next few years, 40% of this age group likely will be. Once a guy thing, now up to 65% of those with tats are women. Thinking of a tattoo for yourself? Find out why people get them, the health risks involved, and your options if you change your mind.

Types: Amateur Tattoos


Anybody can jab ink, charcoal, or ashes under the skin with a pin. These home-made tats often aren’t as arty as those done by pros. Because such tattoos are often done under unclean conditions, they also have a much higher risk of infection.

Types: Cultural Tattoos


Different cultures have tattoo traditions. These tats may look a certain way or have a special purpose. They might be done for rituals or as a mark of beauty, for example.

Types: Professional Tattoos


These tattoos are applied by registered artists using a tattoo machine. That’s the term many artists prefer to “tattoo gun.”

Types: Cosmetic Tattoos


Tattoos aren’t always designs or messages. Sometimes they’re used as “permanent” make-up. People have tattooed eye and lip liner, lipstick, blush, eyebrows, or even fake hair. Because tattoos fade over time, the inking has to be repeated to keep colors fresh.

Types: Medical Tattoos


Some people get inked for medical reasons. Someone with a chronic disease like diabetes may use a tattoo to alert health care workers in case of an emergency. If you’re getting radiation therapy more than once, the doctors may use a tattoo to mark the site. After surgery to rebuild a breast, a tattoo may be used for the nipple.

Why Get a Tattoo?


Most people get a tattoo for one of two reasons. They want to express themselves and show they’re unique. Or they want to show they belong to a group. Take your time to settle on a design. Also think about where you want it, and who will see it.

Safe Tattooing: Choosing a Studio


Getting a permanent tattoo requires breaking the skin and having contact with blood and body fluids. Above all, make sure the studio is as clean as a doctor’s office. (Hint: Check the bathroom.) Make sure the artist’s business license is up to date. Tattooing should be done in a separate area. It should have a clean, hard surface and no random items that add unwanted germs to the work area.

Safe Tattooing Tips


  • Don’t drink alcohol or take drugs (especially aspirin) the night before or while getting a tattoo.
  • Don’t get a tattoo if you’re sick.
  • Make sure all needles come from sterile, one-use packages.
  • See that the studio has machines to kill the germs on the instruments after each use.
  • Make sure the artist washes his or her hands and puts on sterile gloves. Many have to be trained in how to stop illnesses spread by blood.
  • Be sure the work area is clean.
  • Get details of everything used in your tattoo, including color, sometimes called pigment, maker’s name, and lot number.
  • Closely follow all advice on healing. You may be told to use a germ-fighting ointment, for example.

Tattoo Risks: Infection


Any type of tattoo involves health risks. The worst is a very dangerous infection, like HIV or hepatitis C, from unclean needles. You could also get MRSA or impetigo, which are staph infections, or cellulitis, a deep skin infection. Another danger is impure ink that has mold or bacteria. This can lead to problems with the eyes, lungs, and other organs.

Tattoo Risks: Allergic Reaction


Some people are allergic to tattoo inks. This happens most with reds. The woman in this picture developed an allergic reaction to the red used in her cosmetic lipstick tattoo. A bad reaction to dyes or metals used can injure tissue or cause swelling or a rash.

Tattoo Removal


Tired of your tat? You can have it removed. Results can be good, and look best if the tattoo was done only in black. Don’t expect skin to look the same as before you got inked.

Tattoo Removal Techniques


There are three basic ways to lose a look. The tattoed skin can be cut away, rubbed away (dermabrasion), or removed with lasers. Most doctors prefer to use lasers. That’s how the tattoo shown here was removed. The scar below it was left from dermabrasion removal. Some color inks are harder to remove than others and repeated visits are required. Your tattoo may never be 100% gone. DON’T use a do-it-yourself tattoo removal product. These products contain acids and can cause harmful skin reactions. It’s best to see a doctor, not a tattoo artist, for tattoo removal.

Tattoo Removal: What To Expect


Different lasers are used on different tattoo colors to break down the pigment into small bits that go away. Right after treatment, the skin under the tattoo may whiten. More normal skin color usually appears over time.

Tattoo Removal Risks: Allergic Reactions


As lasers break down tattoo pigments, you could have an allergic reaction. In the heart tattoo shown here, several different laser treatments caused blisters. These blisters got better with routine skin care.

Tattoo Removal Risks: Scarring


Not every tattoo comes off perfectly. This picture shows how a laser tattoo removal left a scar.

Even Temporary Tattoos Have Risks


You can avoid a forever tattoo by using short-term, henna-based ink painted on the skin. Be careful, though. As this picture shows, even these tattoos can cause allergic reactions. Red-brown vegetable henna is approved by the FDA only for hair color, not for skin designs.

Stay away from “black henna” or “blue henna” tattoos. The color may come from coal tar, which often causes severe allergic reactions.

Pet Health Pictures Slideshow: Dangerous Foods That Dogs Should Never Eat

Dangerous Foods for Dogs


Who can resist those big brown eyes and cute doggie grin? Can a little reward from the table or getting into Mom or Dad’s stuff really hurt your dog? Well, that depends on what it is and what’s in it. If it contains the sweetener xylitol, it can cause your dog some real problems. In fact, there’s a lot of people food your dog should never eat. And, it’s not just because of weight. Some foods are downright dangerous for dogs — and some of these common foods may surprise you.



Candy, gum, toothpaste, baked goods, and some diet foods are sweetened with xylitol. It can cause your dog’s blood sugar to drop and can also cause liver failure. Early symptoms include vomiting, lethargy, and coordination problems. Eventually, your dog may have seizures. Liver failure can happen within just a few days.



Is a treat from the table OK for your dog? That depends on what it is. Avocados, for example, have something called persin. It’s fine for people who aren’t allergic to it. But too much might cause vomiting or diarrhea in dogs. If you grow avocados at home, keep your dog away from the plants. Persin is in the leaves, seed, and bark, as well as the fruit. Also, the avocado seed can become stuck in the intestines or stomach, and obstruction could be fatal.



Alcohol has the same effect on a dog’s liver and brain that it has on people. But it takes a lot less to hurt your dog. Just a little beer, liquor, wine, or food with alcohol can be bad. It can cause vomiting, diarrhea, coordination problems, breathing problems, coma, even death. And the smaller your dog, the worse it can be.

Onions and Garlic


Keep onions and garlic — powdered, raw, cooked, or dehydrated — away from your dog. They can kill his red blood cells, causing anemia. That’s even the onion powder in some baby food. A rare small dose is probably OK. But eating a lot just once can cause poisoning. Look for signs like weakness, vomiting, and breathing problems.

Coffee, Tea and Other Caffeine


Give your dog toys if you want him to be perky. Caffeine can be fatal. Watch out for coffee and tea, even the beans and the grounds. Keep your dog away from cocoa, chocolate, colas, and energy drinks. Caffeine is also in some cold medicines and pain killers. Think your dog had caffeine? Get your dog to the vet as soon as possible.

Grapes and Raisins


There are better treats to give your dog. Grapes and raisins can cause kidney failure in dogs. And just a small amount can make a dog sick. Vomiting over and over is an early sign. Within a day, your dog will get sluggish and depressed.

Milk and Other Dairy Products


On a hot day, it may be tempting to share your ice cream with your dog. Instead, give her some cold water. Milk and milk-based products can cause diarrhea and other digestive problems for your pup. They can also trigger food allergies, which can cause her to itch.

Macadamia Nuts


Keep your dog away from macadamia nuts and foods that have macadamia nuts in them. Just six raw or roasted macadamia nuts can make a dog sick. Look for symptoms like muscle shakes, vomiting, high temperature, and weakness in his back legs. Eating chocolate with the nuts will make symptoms worse, maybe even leading to death.



Most people know that chocolate is bad for dogs. The problem in chocolate is theobromine. It’s in all kinds of chocolate, even white chocolate. The most dangerous types are dark chocolate and unsweetened baking chocolate. Chocolate can cause a dog to vomit and have diarrhea. It can also cause heart problems, tremors, seizures, and death.

Fat Trimmings and Bones


Fat trimmed from meat, both cooked and uncooked, can cause pancreatitis in dogs. And, even though it seems natural to give a dog a bone, she can choke on it. Bones can also splinter and block or cause cuts in your dog’s digestive system.

Persimmons, Peaches and Plums


The problem with these fruits is the seeds or pits. Seeds from persimmons can cause problems in a dog’s small intestine. They can also block his intestines. That can also happen if a dog eats the pit from a peach or plum. Peach and plum pits also have cyanide, which is poisonous to people and dogs. People know not to eat them. Dogs don’t.

Raw Eggs


Some people feed their dogs a “raw diet” that includes uncooked eggs. But the major veterinary medical associations don’t think that’s a good idea. There’s the chance of food poisoning from bacteria like salmonella or E. coli. Talk to your vet if you have questions.

Raw Meat and Fish


Like raw eggs, raw meat and fish can have bacteria that causes food poisoning. Some fish such as salmon, trout, shad, or sturgeon can also have a parasite that causes “fish disease” or “salmon poisoning disease.” It’s treatable, but get help right away. The first signs are vomiting, fever, and big lymph nodes. Fully cook the fish to kill the parasite.



It’s not a good idea to share salty foods like chips or pretzels with your dog. Eating too much salt can make your dog seriously thirsty. That means a lot of trips to the fire hydrant and it could lead to sodium ion poisoning. Symptoms of too much salt include vomiting, diarrhea, depression, tremors, high temperature, and seizures. It may even cause death.

Sugary Foods and Drinks


Too much sugar can do the same thing to dogs that it does to people. It can make your dog overweight and cause problems with her teeth. It can even lead to diabetes.

Yeast Dough


Before it’s baked, bread dough needs to rise. And, that’s exactly what it would do in your dog’s stomach if he ate it. As it swells inside, the dough can stretch your dog’s abdomen and cause a lot of pain. Also, when the yeast ferments the dough to make it rise, it makes alcohol that can lead to alcohol poisoning.

Your Medicine


Dogs shouldn’t take people medicine. It’s can make them very sick. Just as you do for your kids, keep all medicines out of your dog’s reach. And, never give your dog any over-the-counter medicine unless your vet tells you to. Ingredients such as acetaminophen or ibuprofen are common in pain relievers and cold medicine. And, they can be deadly for your dog.

Kitchen Pantry: No Dogs Allowed


Many other things often found on kitchen shelves can hurt your dog. Baking powder and baking soda are both highly toxic. So are nutmeg and other spices. Keep food high enough to be out of your dog’s reach and keep pantry doors closed.

If Your Dog Eats What It Shouldn’t


No matter how careful you are, your dog might find and swallow something she shouldn’t. Keep the number of your local vet, the closest emergency clinic, and the ASPCA Animal Poison Control Center — (888) 426-4435 — where you know you can find it. And, if you think your dog has eaten something toxic, call for emergency help right away.

What Dogs Can Eat


You can make sure your dog has a healthy, well-balanced diet by asking your vet to suggest a quality dog food. But that doesn’t mean you can’t sometimes give your dog people food as a special treat. Only give him a little. Be sure the foods are cooked, pure, and not fatty or heavily seasoned. Here are some ideas.

Safe: Lean Meats


You can make sure your dog has a healthy, well-balanced diet by asking your vet to suggest a quality dog food. But that doesn’t mean you can’t sometimes give your dog people food as a special treat. Only give him a little. Be sure the foods are cooked, pure, and not fatty or heavily seasoned. Here are some ideas.

Safe: Some Fresh Fruits


Slices of apples, oranges, bananas, and watermelon make tasty treats for your dog. Take out any seeds first. Seeds, stems, and leaves can cause serious problems.

Safe: Some Vegetables


Your dog can have a healthy snack of carrot sticks, green beans, cucumber slices, or zucchini slices. Even a plain baked potato is OK. Don’t let your dog eat any raw potatoes or any potato plants from your pantry or garden.

Safe: Cooked White Rice and Pasta


Dogs can eat plain white rice or pasta after it’s cooked. And, a serving of plain white rice with some boiled chicken can sometimes make your dog feel better when she’s having stomach problems.

Pet Health and You: 27 Ways Pets Can Improve Your Health

Stay Well With Your Animals


Most pet owners don’t need reminding. Animals make people feel good. But we’re talking about more than feeling glad they’re around. Your favorite animal can make you healthy and help you stay that way. You may be surprised at just how many ways a pet can improve your health.

Pets Are Natural Mood Enhancers


It only takes a few minutes with a dog or cat or watching fish swim to feel less anxious and less stressed. Your body actually goes through physical changes in that time that make a difference in your mood. The level of cortisol, a hormone associated with stress, is lowered. And the production of serotonin, a chemical associated with well-being, is increased. Reducing stress saves your body wear and tear.

Keep Blood Pressure in Check


You still have to watch your weight and exercise. But having a pet can help you manage your blood pressure. In one study of 240 married couples, pet owners had lower blood pressure and lower heart rates during rest than people who did not own a pet. That held true whether they were at rest or undergoing stress tests. Another study showed that children with hypertension lowered their blood pressure while petting their dog.

Help for Lowering Cholesterol


To manage cholesterol, doctors still recommend that you follow guidelines regarding diet, exercise, and medication. But owning a pet has the potential of making it easier to avoid the dangers of cholesterol. Researchers have noted lower levels of cholesterol and triglycerides in people who own pets compared to people who don’t. However, this could be attributed to lifestyle factors of pet owners.

Cats and Dogs Good for the Heart


Research has shown the long-term benefits of owning a cat include protection for your heart. Over the 20 years of one study, people who never owned a cat were 40% more likely to die of a heart attack than those who had. Another study showed that dog owners had a significantly better survival rate one year after a heart attack. Overall, pet owners have a lower risk of dying from any cardiac disease, including heart failure.

Pet an Animal to Fight Depression


Therapists have been known to prescribe a pet as a way of dealing with and recovering from depression. No one loves you more unconditionally than your pet. And a pet will listen to you talk for as long as you want to talk. Petting a cat or dog has a calming effect. And taking care of a pet — walking with it, grooming it, playing with it — takes you out of yourself and helps you feel better about the way you spend your time.

Better Physical Fitness


People who own dogs tend to be more physically active and less obese than people who don’t. Taking your dog for a daily 30-minute walk will keep you moving and ensure that you meet the minimum recommendations for healthy physical activity. Two 15-minute walks, one in the morning and one in the evening, will do the same thing. And after that, just playing fetch in the back yard with your dog will earn you healthful dividends.

Make Your Pet an Exercise Buddy


If you exercise with your pet, you’ll both benefit. Shine a flashlight on the wall or wave a string while you do a step aerobics routine. Your cat will get a healthy workout chasing the light, and you’ll be thoroughly entertained. And nationwide, there are yoga classes for people and their dogs, called doga. Call your local gym or ask your vet if there are similar programs in your area.

Fewer Strokes Among Cat Owners


Researchers aren’t sure why. But cat owners have fewer strokes than people who don’t own cats. It’s partly due to the effects owning a pet can have on a person’s circulation. But researchers speculate that cats may have a more calming effect on their owners than other animals do. It may also have something to do with the personality of a cat owner. Cats often become the focus of their owner’s interest, which diverts them from other stressful worries.

More Interaction, Less Isolation


One key to a healthy mind is staying engaged with others. And pet owners have a tendency to want to talk with other pet owners. A dog is a conversation waiting to happen. People, especially other people with dogs, will stop and talk with you when they see you walking your pet. Visiting a dog park lets you socialize with other owners while your dog socializes with their dogs.

Fewer Allergies, Stronger Immunity


Researchers have found that when children grow up in a home with a dog or cat they are less likely to develop allergies. The same is true for kids who live on a farm with large animals. In addition, children with pets have higher levels of certain immune system chemicals and therefore have a stronger immune system. This will help keep them healthy as they get older.

Cats and Asthma Prevention


It doesn’t seem to make sense. Pet allergies are one of the most common triggers of asthma. But researchers have studied the effects of having cats in the homes of infants at risk for asthma. What they found was that those children were significantly less likely to develop asthma as they got older. There’s one exception. Children whose mothers have a cat allergy are three times more likely to develop asthma after early exposure to cats.

Snack Alarm


For people with diabetes, a sudden drop in the level of blood glucose can be very serious. Some dogs can alert their owner to a dangerous drop before it actually happens. They may be responding to chemical changes in the body that give off a scent. The alarm gives the owner time to eat a snack to avoid the emergency. About one in three dogs living with people with diabetes have this ability. Dogs for Diabetics is training more dogs to help more people.

Working With a Counselor


Some mental health therapists use a dog in therapy. A dog in the office may help someone be more comfortable. But that’s not all. A remark to or about a dog may show what’s really on someone’s mind. One therapist tells about a couple in his office who started arguing. The dog, which usually just slept during the session, got up and wanted out. He used that to help the couple see how their fighting affected others, especially their children.

Partners in Better Cancer Care


Cats and dogs both get cancer, and both benefit from research on human cancer. But more and more the opposite is also true. Humans are benefiting from research on pet cancers. Dogs and cats can get the same kinds of cancers humans do. For example, studies of prostate cancer in dogs have led to a better understanding of how it develops in older men. And preventing cancer in pets may lead to new prevention strategies for their human owners.

Overcoming the Limitations of ADHD


Kids with ADHD can benefit from working with and keeping a pet. Taking charge of the jobs on a pet care schedule helps a child learn to plan and be responsible. Pets need to play, and playing with a pet is a great way to release excess energy. That means an easier time falling asleep at night. And because the bond between a pet and a child is unconditional love, pets help children with ADHD learn about self-esteem.

Autism: Addressing the Senses


Sensory issues are common among children with autism. Sensory integration activities are designed to help them get used to the way something feels against their skin. Or it may be how they react to certain smells or sounds. Dogs and horses have both sometimes been used in these activities. The children usually find it calming to work with animals. And animals easily hold the attention of children with autism.

Want Stronger Bones? Walk the Dog


Strong bones are your best defense against osteoporosis and painful fractures. Walking your dog helps. It’s a weight-bearing exercise that strengthens your bones and the muscles around them. It also lets you spend time in the sun, which provides vitamin D. If you have osteoporosis, be sure you guard against falls. Use a short leash that won’t get tangled. And don’t walk a dog that is liable to jump on you and make you lose your balance.

Stretching With the Cat


If you have arthritis, you know its important to stretch. You also know it can be hard to know when you’re stretching enough. Cat owners may want to learn from their cat. Watch how many times she stretches every day, and when she does, you do it too. If you can, get down on the floor and go through the same motions. If you can’t get on the floor, sit on a chair and follow along by stretching your upper body.

Managing Arthritis Together


If your dog has arthritis, you can use the effort to manage his to help manage yours. When you make an appointment at the vet, also call and make your own doctor’s appointment. Regular exercise is important for both of you, so walk with your dog. Keep your medicine in the same place you keep the dog’s. That way you’ll see it when you get his. And if you can, coordinate taking your medicines at the same time you give him his medicine.

Getting Back in the Saddle


Some rehab programs for stroke patients use horses to help with recovery. Often, people who have had strokes start riding with someone walking alongside them as someone else leads the horse. Horseback riding gives stretching exercise, which is especially good if one side has been made weaker. It also helps the person regain balance and build core strength.

Relief From RA


People with rheumatoid arthritis benefit from movements like walking and throwing a Frisbee with their pet. And pets give you a distraction that can help take your thoughts off of your own condition. But perhaps the best help comes from those dogs or cats that seem to be super sensitive to people who aren’t feeling well. Sometimes just their presence can make you feel better.

Soothing Heat for Chronic Pain


A Mexican hairless dog called a Xolo is known for generating intense body heat. An organization called Paws for Comfort trains Xolos to be service dogs for people with fibromyalgia and other forms of chronic pain that respond to heat. People get relief just by placing their hurting limbs against the dog’s body or lying up next to it. Some dogs have even been trained to ride around wrapped around the neck of a person with chronic neck pain.

Seizure Dogs


A “seizure dog” is one that has been specially trained to live and work with people who have epilepsy. Some are trained to bark and alert the parents when a child is having a seizure outside or in another room. Some lie next to a person having a seizure to prevent injury (as seen in this demonstration). And some work has been done training dogs to warn before a seizure occurs. This gives the person time to lie down or move away from a dangerous place such as a hot stove.

Staying Independent


Specially trained dogs can perform tasks that let people with Parkinson’s disease maintain their independence. They can pick up dropped items or fetch requested ones. They can provide balance support, open and close doors, and turn lights on with their paws. They can also sense when someone with Parkinson’s is “freezing” and touch the foot to let the person keep walking. Groups like Pet Partners can help you find a good service dog.

A Better Quality of Life


Visits from therapy dogs help patients recovering from devastating illness or an event such as a stroke. Some dogs are trained to understand a range of commands which lets them help people with aphasia (a language disorder common in older adults, particularly those who’ve had a stroke) feel good when they see the dog understands them. And, petting or scratching a dog can help a patient rebuild strength while recovering from a stroke or other illness. It also creates a feeling of calm.

A Calming Presence


People with AIDS are less likely to be depressed if they own a pet, especially if they’re strongly attached. And with an animal in the home, people with Alzheimer’s have fewer anxious outbursts. The animal also helps the caregivers feel less burdened. Cats seem to be particularly helpful since they require less care than dogs.

Animal Assisted Therapies


Some studies are being done on bringing specially trained animals into clinical settings, which is happening in more and more hospitals and nursing homes. One of the biggest advantages of letting patients interact with animals in such places appears to be improved mood and reduced anxiety.

Pet Health and You: Exercising With Your Dog

Dogged by Obesity


Man’s best friend is battling one of man’s worst enemies — obesity. Up to 50% of dogs in the U.S. weigh too much. Like people, overweight dogs are at risk for health problems, from arthritis to heart disease. This is one challenge you and your pet can face together. Research suggests people who exercise with their dogs are more likely to stick to a fitness program. The key is finding activities you both enjoy.



Brisk walking is an ideal exercise for human and hound. The benefits include a stronger heart, lower blood pressure, more energy, denser bones, and a lower risk of depression. In dogs, regular walks can also reduce common behavior problems. There’s no set rule for how far or how long a dog should walk. Just work slowly toward a goal and slowly increase your speed and how far you walk. A trip to the vet for your dog and a doctor’s checkup for you is recommended before starting an exercise program.



If long walks don’t entice you, try dancing with your dog. Also called musical freestyle, you choreograph a dance routine to upbeat music. You’ll have your pooch running between your legs and performing other tricks, while both of you get an aerobic workout. The benefits of dance include burning calories and developing greater stamina, better balance, lower blood pressure, and improved muscle tone and bone density.



Not all dogs are built to jog. Greyhounds, for example, are pros at short-distance sprinting, but can become fatigued during long-distance runs. If you want to jog with your dog, choose a breed that is suited to distance-running, such as a Labrador. Wait until your pup is full grown and then gradually build up to a 30-minute excursion. This should include five minutes of warm-up, 20 minutes of jogging, and five minutes of cooldown. Remember that dogs can’t sweat, so avoid the hot times of the day and stop if your dog is lagging behind you.



Swimming is an all-in-one workout that is especially beneficial for people or dogs with arthritis. Because it’s a low-impact sport, swimming is easy on the joints. But that doesn’t mean it’s a wimpy workout. Swimming works various muscle groups, improves endurance, and strengthens the heart and lungs. Not all dogs enjoy swimming, so start slowly. Use toys or treats for encouragement, and if your dog still resists, find another sport.



Frisbee offers a classic canine workout. You can play a relaxed game in your own yard or join a formal “Disc Dog” team. Participating in competitions may give you and your dog greater motivation to practice regularly. Competitions give you a goal to work toward. They give you motivation to keep exercising, while working on your training and your relationship with your pet.



If your area offers hiking opportunities, you’ve got one lucky dog. Most dogs love to go out and find new smells and see other animals while spending time with their owner. Like walking, you’ll need to keep a brisk enough pace to elevate your heart rate. And if you live in an area where ticks carry Lyme disease, make sure you cover up and apply an insect repellent containing DEET — and protect your dog with flea and tick prevention and a Lyme vaccine. After hiking, check your body for ticks and do the same for your dog.

Agility Training


Agility training is another popular goal-oriented sport. Your dog races through an obstacle course with ladders, hurdles and tunnels, while you run alongside offering praise and encouragement. The fast pace provides both of you with an excellent cardiovascular workout, while your dog also develops improved coordination. Participate in organized competitions or look for a park with an agility course you can use on your own time.



Downward-dog takes on a whole new spin when you bring your dog to yoga class. “Doga” incorporates your pet into Hatha yoga poses. For example, you recline in resting pose with your legs bent over your terrier’s torso. Classes are springing up across the country, but this is no fat-burner for Fido. Experts say it’s great for the owner-pet bond, but not much of an exercise experience for your dog.



If you’re a soccer fanatic, why not make your dog a fan, too? Check your pet supply store for soccer-style exercise balls for dogs. These are made of hard plastic and come in different sizes to suit your particular breed. You kick the ball, and your dog tries to pass it back with his nose or paws. You can also use a regular soccer ball made for people — just be careful about kicking the ball directly at your dog’s face or body.



People who like rollerblading may be afraid to bring their pup along. No one wants to be yanked off the sidewalk whenever Sparky spots a squirrel. But experts say rollerblading with your leashed dog can be safe with proper training. The goal is to have your dog run right next to you without pulling on the leash. You may be able to encourage this behavior by giving her treats whenever she runs without yanking you around.



Like rollerblading, cycling safely with your dog requires special training. Teach your dog to run next to the bicycle without pulling. You may want to attach her leash to your bike with a Springer. This is a device that absorbs some of the force of your dog’s tugs, which could help you keep your balance if she pulls suddenly. Keep a close eye on your dog’s condition. It’s easy for her to overdo it if she’s running while you’re on wheels.

Dog Park


To provide a chance for off-leash play, find a local dog park. Off-leash running and playing lets your dog set his own pace, so he can burn energy and rest when he’s tired. Other perks include the chance to socialize and the mental stimulation that comes with unfettered exploration. Dog owners also get a workout trying to keep up with their pets. It’s a good idea to complete some obedience training before allowing your dog off-leash.



Cross-country skiing offers a vigorous workout. Just 20 minutes, three days a week, may deliver as many health benefits as walking 30 minutes, five days a week. If your dog is athletic and weighs at least 30 pounds, he may qualify as your ski buddy. In skijooring, your dog is harnessed to you while you ski. Beginners should consider an introductory course with skijooring safety tips for man and beast.



Fetching a ball or favorite toy over and over can be great exercise for your dog. But it doesn’t do much for you, if you’re just standing there tossing. Instead, make a game of fetch part of your home workout routine. Do lunges or abdominal crunches as you throw the ball. You might build more muscle by throwing a heavy ball, but a soft, lightweight toy is safest for your dog’s mouth.

Getting Started


When making your dog your exercise buddy, step one is a trip to the vet. Your vet can evaluate your dog for any heart, lung, or other health problems. It’s also important to check for signs of arthritis or musculoskeletal disease. A dog with inflamed joints or ligaments may require a low-impact exercise plan.

Establishing a Routine


Develop a workout routine that’s realistic, considering your job schedule and other demands on your time. Also consider your dog’s needs – working breeds and juvenile dogs usually need a lot of exercise. Start with a short-term goal of exercising just five or 10 minutes every day. Gradually work up to 30 minutes on most days of the week. Keep in mind that deep-chested breeds, such as Danes or Doberman pinschers, should not exercise right after meals.

Avoiding Overkill


When exercising with your dog, watch for signs that one of you may be overdoing it. You may be working too hard if you are too breathless to carry on a conversation. Your dog may be overworked if he is breathing fast, panting excessively, staggering, or refusing to follow you. If either of you are stiff, sore, or exhausted for hours after a workout, take it easier next time.

Preventing Heat Exhaustion


Just like people, dogs are susceptible to dehydration and heat exhaustion. On hot days, bring a water bottle and foldable drinking bowl or stick to places with a public water source. Signs of dehydration in dogs include excessive panting, confusion, weakness, and collapse. Brachycephalic or short-faced breeds, such as bulldogs and boxers, are especially vulnerable because they don’t pant efficiently.

Paw Protection


Long walks on rough surfaces can damage a dog’s paws. Start slowly. If you work your way up to longer walks, most dogs will develop thicker pads on their feet and not have problems. On hot days, avoid too much contact with asphalt or sand. On snowy days, check paws for ice build-up. And if you venture onto very rough surfaces, consider buying a set of dog booties.

Gentle Exercises for Older Dogs


Just because your senior dog moves with a slower, stiffer gait than when he was a pup doesn’t mean he should stop exercising. Senior dogs, especially those with arthritis, not only can exercise — in many cases, they should. Exercise helps increase flexibility and endurance, strengthens muscles around the joints, and can help stave off health problems caused by obesity. Exercise also aids bowel function, which is especially important in older dogs. And, since obesity tends to make arthritis worse, any activity that helps your dog lose weight could ease his symptoms in the long run. Try low-impact exercises, such as swimming and moderate walking, with your old fellow.

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