Masturbation is the sexual stimulation of one's own genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. The stimulation may involve hands, fingers, everyday objects, sex toys such as vibrators, or combinations of these. Manual stimulation of a partner, such as fingering, a handjob or mutual masturbation, is a common sexual act and can be a substitute for penetration. Studies have found that masturbation is frequent in humans of both sexes and all ages, although there is variation. Various medical and psychological benefits have been attributed to a healthy attitude toward sexual activity in general and to masturbation in particular. No causal relationship is known between masturbation and any form of mental or physical disorder. 
Masturbation has been depicted in art since prehistoric times and is mentioned and discussed in very early writings. In the 18th and 19th centuries, some European theologians and physicians described it as "heinous", "deplorable", and "hideous", but during the 20th century these taboos generally declined. There has been an increase in discussion and portrayal of masturbation in art, popular music, television, films, and literature. Today, religions vary in their views of masturbation; some view it as a spiritually detrimental practice, some see it as not spiritually detrimental, and others take a situational view. The legal status of masturbation has also varied through history and masturbation in public is illegal in most countries. 
In the Western world, masturbation in private or with a partner is generally considered a normal and healthy part of sexual enjoyment. Animal masturbation has been observed in many species, both in the wild and in captivity.

Health effects
The medical consensus is that masturbation is a medically healthy and psychologically normal habit. According to the Merck Manual of Diagnosis and Therapy, "It is considered abnormal only when it inhibits partner-oriented behavior, is done in public, or is sufficiently compulsive to cause distress." 
In the US, masturbation was a diagnosable psychological condition until DSM II (1968). The American Medical Association declared masturbation as normal by consensus in 1972. 
Masturbation does not deplete one's body of energy or produce premature ejaculation. 

Erectile dysfunction

A healthy sex life is an indicator of well-being. For men, erectile dysfunction is not just a physiological problem but it can also be an emotional challenge that affects their lives.
Well in this article we will discuss the depth of What is erectile dysfunction & how is it Treatable.

ED Is A terror That Every 3 men out of 5 men Face-
Erectile Dysfunction is the inability to achieve or maintain an erection sufficient for successful sexualintercourse. The general term for erectile dysfunction is impotence.

Erectile Insufficiency –
It is generally found in older men, though a significant number of men below 40 years of age may also experience it. Erectile dysfunction not only hampers the man’s sexual pleasure but also affects his relationships like fights, divorces, misunderstandings etc.
Ed can have simple visible symptoms that will help you find if you are suffering from it.

Symptoms of Erectile Dysfunction
● Trouble getting an erection
● Lack of required penile rigidity
● Inability to maintain an erection till sexual satisfaction is achieved.
● Reduced sexual desires
● Fears regarding sexual performance
After not being aware of the symptoms people tend to go through a huge change in life.
ED actually can ruin your life with the sad & horrible effects that it has. Many marriages even break up due to this. The reason is that many are not aware for that they are actually facing a sexual problem.
So there are many and much more effects of only ED alone.
Check it out before its late…

Effects of Erectile Dysfunction
● Unsatisfactory sex life not just for the man, but also for his partner.
● Undue stress and anxiety about the perceived failure of sexual prowess.
● Low self-esteem
● Relationship issues may arise if the couple is not able to talk about this and
resolve it.
● If the woman is trying to conceive, this could be a problem in getting pregnant.
After all the research & hard work in dealing ED, researchers believe that there can be a much various reason that leads to the problem.
From the brain to the physical stance the cause can be any. You need to know what and where is affecting you. You need to know what causes ED & how can you save your Life from it.
Causes of Erectile Dysfunction

1. Vascular disease –
The main cause of erectile dysfunction in older men is any vascular disease like diabetes or atherosclerosis. This results in decreased blood flow to the penis and hence an erection can’t be maintained.
Men who suffer from diabetes have high glucose levels in their blood which can damage blood vessels. So the blood vessels that supply oxygen to the penile tissues tend to get damaged.
This is also seen in men with high blood pressure and hardened arteries. Circulation is a problem here and this is a cause of erectile dysfunction.

2. Hormonal Imbalance –
Sometimes, hormones in men can get imbalanced and this can cause erectile dysfunction. Abnormally high or low levels of thyroxine and increased production of prolactin in men can lead to problems getting and sustaining an erection.

3. Psychological causes –
The main cause of erectile dysfunction amongst young men is psychological in nature. The brain and one’s mental state play an important role in triggering the erection and producing feelings of sexual excitement.
Anxiety and depression are two mental states that can actually hamper an erection. A feature of both problems is withdrawal from sex. Stress is another major killer of the sex drive.
This is seen a lot in men who work in an environment which is very stressful and cannot cope well with it. Stress causes the release of stress hormones or corticosteroids in the blood which negatively impact the sex drive.
Apart from this, performance anxiety about sexual performance and communication issues between partners can cause the man to have negative thoughts about his performance during a sexual encounter and this can lead to an inability to sustain the erection.

4. Medication –
Certain prescription drugs taken by men for various other reasons like cancer, high blood pressure, depression and gum disease can interfere with nerve signals that produce the erection and affect physiological arousal.
These drugs include antihistamines, diuretics, sedatives and stimulants which reduce the amount of dihydrotestosterone which is the main component of a man’s sex drive.

5. Nicotine, alcohol and drug abuse –
Excessive tobacco use restricts blood flow to the penile tissues as it leads to tar deposits that clog the arteries.
Alcohol and drug abuse are also factors that adversely affect physiological arousal during sex. After all the sad facts & information about ED I would like to keep your hopes very much in place. ED can be treated.
After going through the causes of ED you would be sad to know what a miserable problem can actually take so much of your life.
Well, you don’t need to be disheartened, there are cures.

Premature ejaculation

Premature Ejaculation / शीघ्रपतन का इलाज
Premature ejaculation (PE) means ‘coming too quickly’ is also known as early discharge or quick discharge , early fall, Shighra-patan, rapid ejaculation, rapid climax, premature climax, or early ejaculation) affects 25%-40% of the men. 

Premature ejaculation is also defined as the occurrence of ejaculation prior to the wishes of both sexual partners. 

Premature ejaculation is one of the most frequent, of sexual disorders in the male and is characterized by sudden ejaculation of the semen, just prior to or immediately after vaginal penetration during intercourse (before one wishes or before he could satisfy the female partner).
It’s one of the commonest of all sexual problems. Recently, a survey done of several thousand males, shows that 50 per cent of them ‘often’ or ‘sometimes’ had this trouble. 

It’s commoner in younger men. Men generally get better control as they grow older. 

However, various surveys showed that many middle-aged men still have this problem. 

This problem makes people unhappy and frustrated and in severe cases PE can threaten or even ruin a marriage – simply because it spoils the sex lives of both partners. Sometimes, the condition is so bad that the man cannot even manage to have intercourse because he invariably ejaculates before he can get into the vagina. 

This can be devastating for a man’s self-confidence. And it can be hugely frustrating and annoying for his partner, too especially if she wants to get pregnant. One of the major contributor towards this problem is wrong or misadventerous sex practices during early days. 

Anxiety too plays a part in many cases of PE. If you’re nervous, you’re likely to come too quickly. That’s why many males have discovered for themselves that a small amount of alcohol eases their nerves and makes them less likely to climax prematurely. But alcohol is not recommend as a treatment ! 

An estimated 30%-70% of males experience premature ejaculation. The National Health and Social Life Survey (NHSLS) indicates Dr.S. K. Singh edit PE 2 approximately 10% to 30% people of all age group suffer with quick semen discharge. 

However, various surveys have shown that many men do not report premature ejaculation to their physician, possibly because of embarrassment or a feeling that no treatment is available for the problem. 

Premature ejaculation may alter self-esteem, may cause marital dysfunction/divorce, and may be a factor in depression, with its obvious consequences. 

This is a very frustrating disorders of male sexual function in which man feels totally helpless. This leads to bitterness in husbands & wife relationships. His pleasure is often decreased by the abrupt early discharge. 

When a man is, ejaculating fast, the woman will probably be left unsatisfied. Her frustration will only increase the negative pattern. 

As he concentrates on controlling his ejaculation, this concentration may begin to get in the way of maintaining the erection. This then can bring about the loss of erection. After some time this may even completely inhibit the erection from occurring. Often a problem that might begin with premature ejaculation gets joined to a problem of impotence, and then both issue have to be dealt with. 

After a time the couple will begin to withdraw from each other, not wanting to enter an experience that is going to end up frustrating them. The man doubts his masculinity, and the wife later experiences a lessening of confidence in her, along with anger toward her partner. 

To clarify, a male may reach climax after 8 / 10 minutes of sexual intercourse, but this is not premature ejaculation if his partner regularly climaxes in 5 minutes and both are satisfied with the timing. 

Another male might delay his ejaculation for a maximum of 15 minutes, yet he may consider this premature if his partner, even with foreplay, requires 20 minutes of stimulation before reaching climax. 

The organ systems directly affected by premature ejaculation include the male reproductive tract (i.e., penis, prostate, seminal vesicles, testicles, and their appendages), the portions of the central and peripheral nervous system controlling the male reproductive tract. 

If the premature ejaculation occurs so early that it happens before commencement of sexual intercourse and the couple is attempting pregnancy, then pregnancy is impossible to achieve unless artificial insemination is used. 

The genes of a male who ejaculates rapidly (but not so rapidly that ejaculation occurs before intromission) would be more likely to be passed on to succeeding generations. 

Premature ejaculation is of two types:

Primary premature ejaculation :- Primary premature ejaculation applies to individuals who have had the condition since they became capable of functioning sexually. Secondary premature ejaculation means that the condition began in an individual who previously experienced an acceptable level of ejaculatory control, and, for unknown reasons, he began experiencing premature ejaculation later in life. If the patient has ED that began after the premature ejaculation, then treatment of both conditions may be required. 

With regard to premature ejaculation, some type of performance anxiety is often a major factor. Performance pressure (ie, fear of failure to satisfy the partner) can arise from various events. ED is a common precipitating event. If the male is afraid his erection will not last, because of either actual instances of previous ED or imagined failure of his erection, this may precipitate premature ejaculation. The patient may have used the phrase, “Honey, you excited me so much I just could not hold back.” 

Science of mechanism of ejaculation:
The physical process of ejaculation requires two sequential actions: emission and expulsion. 

The emission phase is the first phase. It involves deposition of seminal fluid from the ampullary vas deferens, seminal vesicles, and prostate gland into the posterior urethra. The second phase is the expulsion phase. It involves closure of bladder neck, followed by the rhythmic contractions of the urethra by pelvic-perineal and bulbospongiosus muscle, and intermittent relaxation of external urethral sphincters. 

Sympathetic motor neurons control the emission phase of ejaculation reflex, and expulsion phase is executed by somatic and autonomic motor neurons. These motor neurons are located in the thoracolumbar and lumbosacral spinal cord. 

Causes of Premature Ejaculation:
Premature ejaculation can be caused by physical or psychological factors. Sometimes, if a man becomes depressed he may experience this issue. Stopping premature ejaculation depends largely on determining why it is happening in the first place. 

Thus premature ejaculation causes a man to focus more and more on his own sexual response pattern, thus getting away from the freedom and naturalness of allowing the response to occur by itself. As he concentrates on controlling his ejaculation, this concentration may begin to get in the way of maintaining the erection. This then can bring about the loss of erection. After some time this may even completely inhibit the erection from occurring. Often a problem that might begin with premature ejaculation gets joined to a problem of impotence, and then both issue have to be dealt with. 

After a time the couple will begin to withdraw from each other, not wanting to enter an experience that is going to end up frustrating them. The man doubts his masculinity, and the wife later experiences a lessening of confidence in her, along with anger toward her partner. 

Possible psychological and environmental factors:
There are number of possible causes of premature ejaculation.
(These causes are diagnosed by detailed history and a thorough physical check-up). 

In addition to a general medical history, the history should include details about prior relationships in which premature ejaculation was not a problem. Does he have an impotence problem? If he has erectile dysfunction (ED), did is begin after the premature ejaculation or before? Is the patient experiencing premature ejaculation with self-stimulation or just with coitus? 

What is the time required for the female partner to reach climax? Can she reach climax with intercourse, or does she require direct clitoral stimulation (oral or manual) to be able to climax? Was premature ejaculation always a problem or did it start after an initial time frame when coitus was satisfactory to both partners? 

1. Hormone disorder.
2. Urogenital Infections.
3. Neurogenic causes.
4. Increased penile sensitivity to touch.
5. Sex Centre disorder i.e. hyper excitability of sex centre.
6. Psychogenic i.e. psychiatric illness.

In following section we’ll discuss these causes in detail:

1. Hormone disorder:
In recent studies it have been seen that many hormone disorder directly causes premature ejaculation. Additionally hormone disorder may cause other sexual dysfunction, which may secondarily cause early discharge. These hormones are important for normal control on your ejaculation. Testosterone is thought to play a role in the ejaculatory reflex. Higher testosterone (free and total) levels have been demonstrated in men with premature ejaculation than in men without premature ejaculation. Many men with premature ejaculation have been shown to have low serum levels of prolactin. 

2. Urogenital Infections:
Any infection of urethra, prostate, epidididymis, seminal vesicle, Orchitis, epididimo-orchitis etc. Leads to irritability of sacro-coccigeal nerves, which govern the function of all these sex organs. This irritability leads to lowers threshold for ejaculation. Thus infections are one of the significant causes of early orgasm. 

3. Neurogenic causes:
Among nervous system disorder, any disorder involving sex centre area in brain as multiple sclerosis, hyper-excitable focus or any organic lesion will lead to very fast semen discharge. Any lesion of conus medullaris of spinal cord leads to premature ejaculation. 

4. Increased penile sensitivity to touch:
There is excess of certain neurotransmitters in the penile skin which makes it highly erogenous at time of sexual excitation leading to reaching peak of excitation & climax fast. In various studies it has been found that bulbo-cvernous reflex is hyperactive. 

5. Sex Centre disorder:
There are certain conditions in which sex centre, which is situated in brain, becomes hyper excitable so that peak of orgasmic threshold reaches very quickly, which occurs due to various reasons. Sex centre is a part of brain, which is situated in hippocampal part of forebrain. It controls the time taken for orgasm i.e. ejaculatory discharge during sexual activity. 

In early orgasm disorders the sex centre is extremely sensitive to sexual stimulation so that sex centre reaches peak of excitation within few moments after penetration in vagina so that the orgasmic threshold reaches within seconds of sexual intercourse or even before coitus. 

Sex centre also controls the other component of sex cycle namely desire & erection. Thus beside premature ejaculation, patient may also suffer with low desire or erectile dysfunction. 

6. Psychogenic:
Psychological factors commonly contribute to premature ejaculation. While men sometimes underestimate the relationship between sexual performance and emotional well-being, premature ejaculation can be caused by temporary depression, stress over financial matters, unrealistic expectations about performance, a history of sexual repression, or an overall lack of confidence, many psychiatric illnesses as anxiety, anxiety neurosis, schizophrenia, Performance Anxity leads to early climax. 

Deficiency of neuro-transmitters as serotonin & others have been found to be one of the significant causes of early semen fall. 

Research published in an andrology journal showed that semen from men with premature ejaculation contained significantly less acid phosphatase and alpha-glucosidase than did the semen of controls. These researchers concluded that these may reflect dysfunction of the prostate and epididymis, possibly contributing to premature ejaculation. 

According to Dr. S.K. Singh – who heads the Dr. Singh Clinic, Noida, India — 

I have found from my 23 years of experience that those males who have less sperm counts in their semen (like oligospernia & Azoospermia) suffers from premature ejaculation. 

Diagnosis of Cause:

We take detail history: 

Detailed general & systemic examination.
Investigation & Diagnostic tests.
Complete Male Hormone Profile tests.
Biochemistry tests.
Urine is tested for pus cells.
Scrotum, epididydmus, prostate is examined for infection.
Semen is examined for pus & semen culture sensitivity.
Ultrasonography of scrotum & prostate may be required.


Treatment may involve the clinician simply explaining why premature ejaculation occurs, assuring the person or couple that it is a normal part of the male sexual response, and providing techniques that may assist the man in learning to delay ejaculation. 

Such techniques (Sex Therapy) may include : 

1. The “stop and start” method:
This involves sexual stimulation until the man recognizes that he is about to ejaculate, the stimulation is then stopped for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. 

2. The “squeeze” method popularized by Masters & Johnson:
This involves sexual stimulation until the man recognizes that he is about to ejaculate, at that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds whilst withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. 

Stopping premature ejaculation is a major goal of any man who suffers from it. It can be one of the most embarrassing and frustrating sexual problems that a man can deal with, and there is a lot of advice out there about how to put it to an end. Men who find themselves grappling with this issue are likely to try practically anything to make it stop. Men may try many different techniques in order to stop premature ejaculation; they range from medication to therapy to specific methods in bed. Trying many different things is the best idea, though. 

There are dozens of different hints and tips for stopping premature ejaculation; in some cases, sexual therapy is the best method. Other men find that the best way to stop premature ejaculation is by trying medication. 

3. Kegel exercise:
First published in 1948 by Dr. Arnold Kegel, a pelvic floor exercise, more commonly called a Kegel exercise, consists of repeatedly contracting and relaxing the muscles that form part of the pelvic floor. Exercises are usually done to reduce premature ejaculatory occurrences in men, as well as to increase the size and intensity of erections. 

The aim of Kegel exercises is to improve muscle tone by strengthening the pubococcygeus (PC) muscles of the pelvic floor. 

Kegel exercises can help men achieve stronger erections, maintain healthy hips, and gain greater control over ejaculation. 

PC muscles control the flow of semen and urine, the firmness of your penis during erection and the shooting power of your ejaculation. The great thing about Kegel exercises for men is that you can do them anywhere, anytime — and nobody will know the difference. 

You will be able to have better sex by being able to better control your orgasms and ejaculations, and last for longer. 

4. Delay Creams And Gels:
One of the most common treatments for stopping premature ejaculation are topical creams, gels and other ointments. These products usually work to numb up a man’s penis, making it less sensitive and prolonging sexual encounters and some men claim that they are the most effective means of stopping premature ejaculation. However, other men have little success with them. As mentioned previously, stopping premature ejaculation differs from man to man; trying out different kinds of creams and gels is just another way of trying to achieve success against this embarrassing problem. 

5. Some men try to distract themselves by thinking non-sexual thoughts (such as naming baseball players and records) to avoid getting excited too fast.

In Korea and other areas of the Far East, SS cream (a combination of 9 ingredients, mainly herbal; SS stands for Super Secret) has been shown to desensitize the penis, decrease the vibratory threshold, and help men with premature ejaculation to significantly delay their ejaculatory response. 

Unfortunately, SS Cream is not yet approved by the US Food and Drug Administration (FDA). 

6. Using of Condoms:
Using one or two condom during intercourse also delay the ejaculation time, as the condom reduces the touch sensation. 

Some therapists advise young men to masturbate (or have their partner stimulate them rapidly to climax) 1-2 hours before sexual relations are planned. 

7. Oral Medicines:
After the finding out the cause of premature ejaculation. Various drugs to treat sex centre & other causes are prescribed along with sex therapy. 

Hormone pills are given when hormone disorder are found.
Medicines to cure the urogenital infections when infection as the cause is confirmed.
In recent years, Doctors are trying to treat premature ejaculation with antidepressant drugs. That may seem a little odd, but the reason is that certain antidepressants are well known for the side-effect of delaying male climax. For most men, that side effect is unwanted. But for guys with premature ejaculation, it’s quite desirable. 

8. Surgical Care:
No recommended surgical treatment exists for premature ejaculation. 

Night fall 

Sleep is meant to be a period of rest and relaxation. We dream, we rejuvenate and we wake up refreshed.
But for some, especially if you are a man, you may experience this phenomenon called nightfall. You may wake up from a wet dream in the morning wondering what that wet patch on your bed sheet is.
What exactly happened?
Nightfall is also known as nocturnal emissions or night discharges. Your body has experienced a spontaneous orgasm during your sleep. This is a natural process which usually does not involve a physical stimulus but does involve an involuntary ejaculation during the night sleep.
Nightfall is mostly experienced amongst teenagers who have just reached sexual maturation. However, it occurs in some adult men as well. Studies report that over 83% of men have experienced at least one nocturnal emission at some point in their lifetime.
The frequency of emission varies from man to man. Sometimes, a functional erection may still be there when you wake up. It is also possible for you to sleep through the entire process or wake up just after you’ve had the orgasm.
Nightfall during teenage years
If you are an adolescent reading this, you don’t have much to worry about. Regular emissions are common and nothing for you to worry about. When you hit puberty, your testosterone levels increase. This stimulates your sex drive, helps in the production of sperm and in the process of ejaculation.
As a teen, you are going to have a lot of questions. There is a lot of curiosity about sex, especially if adults do not discuss it and sex becomes a topic of taboo. This is also a time when masturbation and sex dreams become frequent activities. There is also exposure to various erotic materials which can also stimulate the teenage mind and it is common to replay this through sexual dreams. Nightfall is commonly experienced this way and may or may not be accompanied by a wet dream.
Nightfall can cause confusion and anxiety during this period as you may not be familiar with your body and its sexual functioning.

Myths about nightfall
There are many misconceptions about nocturnal emission. They are:
•    Nightfall is a rare phenomenon.
•    It afflicts only people who are unnaturally preoccupied with sex.
•    It happens only to non vegetarians.
•    It can cause erectile dysfunction.
•    It reduces your sperm count and affects sexual performance.
When does nightfall become a problem?
Nightfall is regular amongst adolescents but as an adult, if it happens too often, it is always better to speak to your physician about it. If you feel it is affecting your quality of life, and if you are experiencing other symptoms like a burning sensation during or after urination, leg or back cramps or an inability to concentrate due to fatigue, then discuss these symptoms with your doctor.
Causes of Nightfall
Nocturnal emissions can have multiple causes and it is difficult to pinpoint one specific cause for it. Some of the reasons are:
1.    Increase in testosterone – This is usually the main cause for teenage boys. The spike in testosterone levels increases the chances of having nocturnal emissions.
2.    Rubbing of genital against bed sheet – While sleeping, if your penis shaft rubs against a pillow or bed sheet, it can trigger an erection. This will automatically result in an ejaculation. You may not even wake up during this entire scene.
3.    Sensual dreams – During sleep, there is intense brain activity. More blood flow happens and the nervous system gets excited through physiological arousal and you have a wet dream followed by an ejaculation.
4.    Sexual inactivity – If you are sexually inactive, it is possible that the excess semen may come out during sleep. This is also a natural way for your body to relieve itself of the buildup of sexual energy.
5.    Weakness of nerves – Your genitals and reproductive system are connected to your brain and they work in tandem for all sexual activity. When nerves get weakened, this connectivity can get disturbed. This can cause excessive nightfall as you may experience some difficulty in ejaculating during climax. The stored semen then comes out during sleep.
6.    Certain medications taken for health reasons such as tranquilizers or sedatives may cause nightfall for adult men.
1.    Watching erotic content excessively can cause the nervous system to get stimulated really fast, especially if this happens before bedtime. This could result in sexual dreams and consequent ejaculations during sleep.
If you are experiencing nightfall, do not be embarrassed. There are different treatment options available for you to get your sound sleep back.
Treatment for Nightfall
The main treatment for excessive nightfall involves taking medication or using home remedies. Nightfall is not a major medical ailment and is often taken care of with lifestyle modifications and relaxation.
1.    If you are on any medications that are increasing your testosterone levels, then ask your doctor to reduce the dosage or change the medication if you are experiencing excessive nightfall.
2.    Cut down on watching or reading erotic content before sleeping.
3.    Certain home remedies have proven to be beneficial in regulating this problem. Consuming a mixture of fenugreek and honey, yoghurt, gourd juice, garlic, sage tea and gooseberry can be tried.
4.    If alternate medicine is something you want to consider, homeopathy and Ayurveda offer some excellent medications as well.
5.    Relaxation is very important. Take a warm bath with essential oils before sleeping.
6.    Do not be embarrassed to discuss about this with your partner or loved ones. If you are experiencing any anxiety related to this, you can talk to a sex therapist if needed.
7.    Make lifestyle modifications such as avoiding spicy food and coffee, exercising and urinating before bedtime.
Nightfall is normal and only needs to be checked if it happens excessively. Getting the right treatment gets you back that refreshing sleep without any worries.

Sexual transmitted disease 

Sexually Transmitted Diseases (STD)
Sexually Transmitted Diseases (STDs) or Sexually Transmitted Infection (STI) or Venereal Disease (VD) are diseases that are mainly passed from one person to another (that is transmitted) during sex. There are at least 25 different sexually transmitted diseases (Like 1) Syphilis, 2) Gonorrhea, 3) Chancroid, 4) Genital Herpes, 5) HIV/AIDS, 6) Human Papillomavirus (HPV), 7) Lymphogranuloma Venereum (LGV), 8) Bacterial Vaginosis, 9) Chlamydia, 10) Trichomoniasis, 11) Hepatitis B & 12) Hepatitis C) with a range of different symptoms. These diseases may be spread through vaginal, anal and oral sex.

Most sexually transmitted diseases will only affect you if you have sexual contact with someone who has an STD. However there are some infections, for example scabies, which are referred to as STDs because they are most commonly transmitted sexually, but which can also be passed on in other ways. 

With STDs And viruses spreading like wildfire across the world we must all take steps to protect ourselves. The estimated total number of people living in the US with STD is over 65 million. There are literally millions of new STD cases each year creating an extremely dangerous environment for all of us. 

Most at risk of contracting an STD or STI are people from ages 16 to 26 Young people tend to be more promiscuous and by having more partners increase their risk in contracting an STD or virus. There has also been a steady STD increase in college students because of drug and alcohol use. 

There are many types of sexually transmitted diseases and viruses out there which can be easily treated or can be become terminal (deadly). But all of them are dangerous. We all have unanswered questions about STD’s and viruses, and being properly informed is without a doubt our best defense to preventing, contracting, and/or spreading these harmful disease’s and bacteria’s. 

Many sexually transmitted diseases can be easily cured, but if left untreated, they may cause unpleasant symptoms and could lead to long-term damage such as infertility. Some STDs can be transmitted from a pregnant woman to her unborn child. It is important that anyone diagnosed with an STD informs everyone they have had sex with within the past year (or everyone following the partner they believe may have infected them). 

Common signs / symptoms of STD / STI / VD:
STD symptoms vary, but the most common are:
•    Itching around the vagina and/or discharge from the vagina for women.
•    Discharge from the penis for men.
•    Pain during sex or when urinating.
•    Pain in the pelvic area.
•    Sore throats in people who have oral sex.
•    Pain in or around the anus for people who have anal sex.
•    Chancre sores (painless red sores) on the genital area, anus, tongue and/or throat.
•    A scaly rash on the palms of your hands and the soles of your feet.
•    Dark urine with bad smell, loose, light-colored stools, and yellow eyes and skin.
•    Small blisters that turn into scabs on the genital area.
•    Swollen glands, fever and body aches.
•    Unusual infections, unexplained fatigue, night sweats and weight loss.
•    Soft, flesh-colored warts around the genital area.

If you are experiencing any of these STD symptoms you should see a medical professional immediately. Some STD’s and STI’s can be cleared up quickly if treated early so time is a factor. 

Others may be quite dangerous and must be treated immediately before it becomes worse. 

Many STDs are (more easily) transmitted through the mucous membranes of the penis, vulva, rectum, urinary tract and (less often—depending on type of infection)[citation needed] the mouth, throat, respiratory tract. The visible membrane covering the head of the penis is a mucous membrane, though it produces no mucus (similar to the lips of the mouth). Pathogens are also able to pass through breaks or abrasions of the skin, even minute ones. The shaft of the penis is particularly susceptible due to the friction caused during penetrative sex. 

This is one reason that the probability of transmitting many infections is far higher from sex than by more casual means of transmission, such as non-sexual contact—touching, hugging, shaking hands. 

Although mucous membranes exist in the mouth as in the genitals, many STIs seem to be easier to transmit through oral sex than through deep kissing. According to a safe sex chart, many infections that are easily transmitted from the mouth to the genitals or from the genitals to the mouth, are much harder to transmit from one mouth to another. 

Depending on the STD, a person may still be able to spread the infection if no signs of disease are present. For example, a person is much more likely to spread herpes infection when blisters are present (STD) than when they are absent (STI). However, a person can spread HIV infection (STI) at any time, even if he/she has not developed symptoms of AIDS (STD). 

All sexual behaviors that involve contact with the bodily fluids of another person should be considered to contain some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling HIV, which causes AIDS, but each STD presents a different situation. 

It is not possible to catch any sexually transmitted disease from a sexual activity with a person who is not carrying a disease. Some STDs such as HIV can be transmitted from mother to child either during pregnancy or breastfeeding. 

Prevention of STD / STI / VD:
The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer with an infected partner. 

Proper use of condoms reduces contact and risk. 

Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. 

Ideally, both partners should get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. 

Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. 

Taking safety precautions is essential to not catching an STD. The best method of protecting yourself from catching an STD is through abstinence and not having any contact with your partners genitals. 

It’s also important to have an STD tests done regularly, particularly if you are sexually active. 

Condoms only provide protection when used properly as a barrier, and only to and from the area that it covers. Uncovered areas are still susceptible to many STDs. 

Proper usage entails: 

•    Wearing a condom too loose can defeat the barrier.
•    Avoiding condoms made of substances other than latex or polyurethane, as they don’t protect against HIV.

However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD. 

In order to achieve the protective effect of condoms, they must be used correctly and consistently. Incorrect use can lead to condom slippage or breakage, thus diminishing their protective effect. 

Inconsistent use, e.g., failure to use condoms with every act of intercourse, can lead to STD transmission because transmission can occur with a single act of intercourse. 

In order to best protect oneself and the partner from STIs, the old condom and its contents should be assumed to be still infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier.


Male infertility

In our Indian society, the objective of marriage is propagation, having children to carry forward the family name. The name & achievements of a childless person are forgotten with his or her Death. Childless couples do not get due respect in the society. They are considered to be handicapped. They have to bear the taunts from people. Sometimes the taunts become so unbearable that the women commit suicide or have extra marital affairs to have children because it is the woman who is held responsible for having no children. Some times, pressurized by the family members, the husbands give divorce to the wives.

Q – Dr. V agrawal, please tell us the real meaning of infertility.
A – If you are married and you want a child. You are having intercourse regularly, without using any contraceptives (condom, copper T or contraceptive pills). After doing all this, if the wife does not conceive for A YEAR, it is called infertility. 

Q – The woman is held responsible for having no Children, is it a fact?
A – No. Not at all. The fact is, in 30 % cases, the man is at fault for having no children. In 30 % cases, the woman is at fault. In 30 % cases, both the man and woman are at fault and in remaining 10 % cases, the reason is unknown. For having a healthy baby, the outer and inner sex organs of the man and woman need to be normal. Any disease or abnormality in these organs will make it difficult to conceive. 

Q – What are the reasons of male infertility?
A – When the man is at fault for not having a baby, there is some problem in his semen. Normally, when the sperms in the semen are not normal, the man cannot have a baby. There may be no sperms at all (Azoospermia) or the number of sperms may be very small (Oligospermia) or the sperms may be less mobile (Nil Motility -Asthenospermia). In some cases, the Quantity of semen is very small because sufficient semen is not produced in the testes. In some cases, Antisperm antibodies are found in the semen. 

In some cases, The Laboratory reports show that the sperm count and sperm mobility is Normal. But still there is problem in conceiving. In such cases, the sperms are very weak. They die before reaching the egg or cannot break the outer layer (cover) of the egg. This condition is also deterrent for conceiving.

Apart from semen related problems, surgery around penis, vericocele, (painful and swollen testicles), hydrocele (increased size of and hanging testicles), some diseases like Syphilis, Gonorrhea, Mumps, T.B. etc.. 

Apart from these reasons, there are other reasons too, responsible for male infertility. These are Low sex power, Erectile Dysfunction, Premature Ejaculation etc. Sometimes, the man cannot have sexual intercourse. These are the main reasons of male infertility. When proper intercourse is not possible, conception is also not possible. 

The reasons for female infertility are obstructions or swelling in the fallopian tubes, problems in the uterus, acidic discharge from the vagina, surgery around vagina, STD, inconsistent periods, underdeveloped uterus, ovulation problems etc. 

Q – What would you like to tell the Childless couples?
A – Most of the couples resort to the means like worshipping gods, pooja-paath, mantra-tantra, black magic etc. This is nothing but waste of time, energy and money. Many years after the marriage, they come to the doctor. I would like to urge them that they should not waste time and money in these things and visit good sexologist / Gyaenecologist / Infertility Specialist in time so they can find the exact reason of male or female infertility and treat it accordingly. Sometimes wasting time may make the disease Incurable. 


Varicocele का इलाज सर्वश्रेष्ठ परिणाम
A varicocele often produces no signs or symptoms. Rarely, it may cause pain, Atrophy (Shrinking) of the Testicles. The pain may : Vary from dull discomfort or light or dual pain or a feeling of heaviness or to sharp pain. 

•    Pain Increase with sitting, standing or physical exertion, especially over long periods.
•    Pain Increase over the course of a day or during long weeks or running.
•    Be relieved when you lie on your back.
•    Low Testosterone level in blood.

Because a varicocele usually causes no symptoms, it often requires no treatment. Varicoceles may be discovered during a fertility evaluation or a routine physical exam. However, if you experience pain or swelling in your scrotum or you discover a mass on your scrotum, contact your doctor. A number of conditions can cause a scrotal mass or testicular pain, some of which require immediate treatment. 

Male reproductive system
Your spermatic cord carries blood to and from the testicles. It’s not certain what causes varicoceles, but many experts believe a varicocele forms when the valves inside the veins in the cord prevent your blood from flowing properly. The resulting backup causes the veins to widen (dilate). 

Varicoceles often form during puberty. They are most frequently diagnosed when a patient is 15-30 years of age, and rarely develop after the age of 40. They occur in 15–20% of all males, and it is the main cause of male infertility. 

98% of idiopathic varicoceles occur on the left side, apparently because the left testicular vein connects to the renal vein (and does so at a 90-degree angle). However, a varicocele in one testicle can affect sperm production in both testicles. 

There don’t appear to be any significant risk factors for developing a varicocele. However, some research suggests that being overweight may increase your risk. 

A varicocele may cause: 

•    Shrinkage of the affected testicle (atrophy). The bulk of the testicle comprises sperm-producing tubules. When damaged, as from varicocele, the testicle shrinks and softens. It’s not clear what causes the testicle to shrink, but the malfunctioning valves allow blood to pool in the veins, which can result in increased pressure in the veins and exposure to toxins in the blood that may cause testicular damage.
•    Infertility. It’s not clear how varicoceles affect fertility. The testicular veins cool blood in the testicular artery, helping to maintain the proper temperature for optimal sperm production. By blocking blood flow, a varicocele may keep the local temperature too high, affecting sperm formation and movement (motility).

If the pain is sharp & you are not able to see your Doctor then u can use over-the-counter pain reliever and wear an athletic supporter to relieve pressure. 

Tests and diagnosis
Your doctor will conduct a physical exam, which may reveal a twisted, nontender mass above your testicle that may feel like what’s been described as a bag of worms. If it’s large enough, your doctor will be able to feel it. If you have a smaller varicocele, your doctor may ask you to stand, take a deep breath and hold it while you bear down (Valsalva maneuver). This helps your doctor detect abnormal enlargement of the veins. 

If the physical exam is inconclusive, your doctor may order a scrotal ultrasound. To ensure there isn’t another reason for your symptoms. One such condition is a tumor that compresses the spermatic vein. 

Treatments and Drugs
Varicocele treatment may not be necessary. However, if your varicocele causes pain, testicular atrophy or infertility, you may want to undergo varicocele repair. The purpose of surgery is to seal off the affected vein to redirect the blood flow into normal veins. However, the effect of varicocele repair on fertility is unclear. 

Although varicoceles typically develop in adolescence, it’s less clear whether you should have varicocele repair at that time. Indications for repairing a varicocele in adolescence include progressive testicular atrophy, pain or abnormal semen analysis results. 

Varicocele repair presents relatively few risks, which may include: 

•    Buildup of fluid around the testicles (hydrocele)
•    Recurrence of varicoceles
•    Damage to an artery

Repair methods include:
•    Open surgery. This treatment usually is done on an outpatient basis, using general anesthetic or local anesthetic. Commonly, your surgeon will approach the vein through your groin (transinguinal), but it’s also possible to make an incision in your abdomen or below your groin. 

Advances in varicocele repair have led to a reduction of post-surgical complications. One advance is the use of the surgical microscope, which enables the surgeon to see the treatment area better during surgery. Another is the use of Doppler ultrasound, which helps guide the procedure. 

You may be able to return to normal, nonstrenous activities after two days. As long as you’re not uncomfortable, you may return to more strenuous activity, such as exercising, after two weeks. 

Pain from this surgery generally is mild. Doctor may prescribe pain medication for the first two days after surgery. After that, your doctor may advise you to take over-the-counter (OTC) painkillers, to relieve discomfort or pain. 

Doctor may advise you not to have sex for one to two weeks. You’ll have to wait three or four months after surgery to get a semen analysis to determine whether the varicocele repair was successful in restoring your fertility.

•    Laparoscopic surgery. Your surgeon makes a small incision in your abdomen and passes a tiny instrument through the incision to see and to repair the varicocele. This procedure requires general anesthesia.
•    Percutaneous embolization. A radiologist inserts a tube into a vein in your groin or neck through which instruments can be passed. Viewing your enlarged veins on a monitor, the doctor releases coils or a solution that causes scarring to create a blockage in the testicular veins, which interrupts the blood flow and repairs the varicocele. This procedure is done with local anesthesia on an outpatient basis. This procedure isn’t as widely used as surgery.

Lifestyle and home remedies 

If you have a varicocele that causes you minor discomfort but doesn’t affect your fertility, you might try the following for pain relief: 

•    Take over-the-counter painkillers, such as Paracetamol etc.
•    Wear an athletic supporter or Langot to relieve pressure.
Penile enlargement 



HIV/AIDS Treatment, Symptoms, Causes and Diagnosis
Human Immunodeficiency Virus (HIV) is a lentivirus (a member of the retrovirus family) that causes acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. 

Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids. 

The four major routes of transmission are unsafe sex, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (vertical transmission). 

HIV infection in humans is considered pandemic by the World Health Organization (WHO).

From its discovery in 1981 to 2006, AIDS killed more than 25 million people. A third of these deaths are occurring in Sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. 

HIV infects primarily vital cells in the human immune system such as helper T cells (to be specific, CD4+ T cells. 

HIV infection leads to low levels of CD4+ T cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. 

Most untreated people infected with HIV-1 eventually develop AIDS. These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. 

HIV progresses to AIDS at a variable rate affected by viral, host, and environmental factors; most will progress to AIDS within 10 years of HIV infection: some will have progressed much sooner, and some will take much longer.Treatment with anti-retrovirals increases the life expectancy of people infected with HIV. 

Three main transmission routes for HIV have been identified. HIV-2 is transmitted much less frequently by the mother-to-child and sexual route than HIV-1. 

UNAIDS and the WHO estimate that AIDS has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive pandemics in recorded history. . 

Sub-Saharan Africa remains by far the worst-affected region, with an estimated 21.6 to 27.4 million people currently living with HIV. 

South & South East Asia are second-worst affected with 15% of the total. AIDS accounts for the deaths of 500,000 children in this region. South Africa has the largest number of HIV patients in the world followed by Nigeria. 

Countries such as Uganda are attempting to curb the epidemic by offering VCT (voluntary counselling and testing), PMTCT (prevention of mother-to-child transmission) and ANC (ante-natal care) services, which include the distribution of antiretroviral therapy. 

There are two species of HIV known to exist: HIV-1 and HIV-2. HIV-1 is the virus that was initially discovered. It is more virulent, more infective, and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2 relatively poor capacity for transmission, HIV-2 is largely confined to West Africa. 

Comparison Of HIV Species

Species    Virulence    Infectivity    Prevalence    Inferred Origin
HIV – 1    High    High    Global    Common Chimpanzee
HIV – 2    Lower    Low    West Africa    Sooty Mangabey

Signs & Symptoms
Infection with HIV-1 is associated with a progressive decrease of the CD4+ T cell count and an increase in viral load. The stage of infection can be determined by measuring the patient’s CD4+ T cell count, and the level of HIV in the blood. 

HIV infection has basically four stages :
1) Incubation period, 
2) Acute infection, 
3) Latency stage and 
4) AIDS. 

The initial incubation period upon infection is asymptomatic and usually lasts between two and four weeks. The second stage, acute infection, lasts an average of 28 days and can include symptoms such as fever, lymphadenopathy (swollen lymph nodes), pharyngitis (sore throat), rash, myalgia (muscle pain), malaise, and mouth and esophageal sores. 

The Latency stage, which occurs third, shows few or no symptoms and can last anywhere from two weeks to twenty years and beyond. AIDS, the fourth and final stage of HIV infection shows as symptoms of various opportunistic infections. 

Main symptoms of acute HIV infection.
The initial infection with HIV generally occurs after transfer of body fluids from an infected person to an uninfected one. The first stage of infection, the primary, or acute infection, is a period of rapid viral replication that immediately follows the individual’s exposure to HIV leading to an abundance of virus in the peripheral blood with levels of HIV commonly approaching several million viruses per mL. 

This response is accompanied by a marked drop in the numbers of circulating CD4+ T cells. This acute viremia is associated in virtually all patients with the activation of CD8+ T cells, which kill HIV-infected cells. 

The CD8+ T cell response is thought to be important in controlling virus levels, which peak and then decline, as the CD4+ T cell counts rebound. A good CD8+ T cell response has been linked to slower disease progression and a better prognosis, though it does not eliminate the virus. 

During this period (usually 2–4 weeks post-exposure) most individuals (80 to 90%) develop an influenza, the most common symptoms of which may include fever, lymphadenopathy, pharyngitis, rash, myalgia, malaise, mouth and esophageal sores, and may also include, but less commonly, headache, nausea and vomiting, enlarged liver/spleen, weight loss, thrush, and neurological symptoms. Infected individuals may experience all, some, or none of these symptoms. The duration of symptoms varies, averaging 28 days and usually lasting at least a week. 

Because of the nonspecific nature of these symptoms, they are often not recognized as signs of HIV infection. Even if patients go to their doctors or a hospital, they will often be misdiagnosed as having one of the more common infectious diseases with the same symptoms. As a consequence, these primary symptoms are not used to diagnose HIV infection, as they do not develop in all cases and because many are caused by other more common diseases. However, recognizing the syndrome can be important because the patient is much more infectious during this period. 

Latency stage
A strong immune defense reduces the number of viral particles in the blood stream, marking the start of the infection’s clinical latency stage. Clinical latency can vary between two weeks and 20 years. During this early phase of infection, HIV is active within lymphoid organs, where large amounts of virus become trapped in the follicular dendritic cells (FDC) network. 

The surrounding tissues that are rich in CD4+ T cells may also become infected, and viral particles accumulate both in infected cells and as free virus. Individuals who are in this phase are still infectious. During this time, CD4+ CD45RO+ T cells carry most of the proviral load. 

When CD4+ T cell numbers decline below a critical level of 200 cells per µL, cell-mediated immunity is lost, and infections with a variety of opportunistic microbes appear. 

The first symptoms often include moderate and unexplained weight loss, recurring respiratory tract infections (such as sinusitis, bronchitis, otitis media, pharyngitis), prostatitis, skin rashes, and oral ulcerations. 

Common opportunistic infections and tumors, most of which are normally controlled by robust CD4+ T cell-mediated immunity then start to affect the patient. Typically, resistance is lost early on to oral Candida species and to Mycobacterium tuberculosis, which leads to an increased susceptibility to oral candidiasis (thrush) and tuberculosis. 

Later, reactivation of latent herpes viruses may cause worsening recurrences of herpes simplex eruptions. 

Pneumonia caused by the fungus Pneumocystis jirovecii is common and often fatal. In the final stages of AIDS, infection with cytomegalovirus (another herpes virus) or Mycobacterium avium complex is more prominent. Not all patients with AIDS get all these infections or tumors, and there are other tumors and infections that are less prominent but still significant. 

The majority of HIV infections are acquired through unprotected sexual relations. Sexual transmission can occur when infected sexual secretions of one partner come into contact with the genital, oral, or rectal mucous membranes of another. 

The correct and consistent use of latex condoms reduces the risk of sexual transmission of HIV by about 85%. 

In general, if infected blood comes into contact with any open wound, HIV may be transmitted. This transmission route can account for infections in intravenous drug users. 

Since transmission of HIV by blood became known medical personnel are required to protect themselves from contact with blood by the use of universal precautions. People who give and receive tattoos, piercings, and scarification procedures can also be at risk of infection. 

HIV has been found at low concentrations in the saliva, tears and urine of infected individuals, but there are no recorded cases of infection by these secretions and the potential risk of transmission is negligible..It is not possible for mosquitoes to transmit HIV. 

The transmission of the virus from the mother to the child can occur in utero (during pregnancy), intrapartum (at childbirth), or via breast feeding. In the absence of treatment, the transmission rate up to birth between the mother and child is around 25%.[31] However, where combination antiretroviral drug treatment and Cesarian section are available, this risk can be reduced to as low as one percent. 

Postnatal mother-to-child transmission may be largely prevented by complete avoidance of breast feeding. 

Many HIV-positive people are unaware that they are infected with the virus. 

HIV-1 testing consists of initial screening with an enzyme-linked immunosorbent assay (ELISA) to detect antibodies to HIV-1. 

Specimens with a reactive ELISA result are retested. If retest is reactive, the specimen is reported as repeatedly reactive and undergoes confirmatory testing with a more specific supplemental test (e.g., Western blot. Specimens that are repeatedly reactive by ELISA and reactive by Western blot are considered HIV-positive and indicative of HIV infection. 

Modern HIV testing is extremely accurate. 

There is currently no publicly available vaccine or cure for HIV or AIDS. However, a vaccine that is a combination of two previously unsuccessful vaccine candidates was reported in September 2009 to have resulted in a 30% reduction in infections in a trial conducted in Thailand. Additionally, a course of antiretroviral treatment administered immediately after exposure, referred to as post-exposure prophylaxis, is believed to reduce the risk of infection if begun as quickly as possible. 

Current treatment for HIV infection consists of highly active antiretroviral therapy, or HAART. This has been highly beneficial to many HIV-infected individuals since its introduction in 1996, when the protease inhibitor-based HAART initially became available. 

Current HAART options are combinations (or “cocktails”) consisting of at least three drugs belonging to at least two types, or “classes,” of antiretroviral agents. 

In developed countries where HAART is available, doctors assess their patients thoroughly: measuring the viral load, how fast CD4 declines, and patient readiness. They then decide when to recommend starting treatment. 

HAART neither cures the patient nor does it uniformly remove all symptoms; high levels of HIV-1, often HAART resistant, return if treatment is stopped. Moreover, it would take more than a lifetime for HIV infection to be cleared using HAART. 

Despite this, many HIV-infected individuals have experienced remarkable improvements in their general health and quality of life. 

The development of HAART as effective therapy for HIV infection has substantially reduced the death rate from this disease in those areas where these drugs are widely available. 

Without treatment, the net median survival time after infection with HIV is estimated to be 9 to 11 years. 

In areas where it is widely available, the development of HAART as effective therapy for HIV infection and AIDS reduced the death rate from this disease by 80%, and raised the life expectancy for a newly diagnosed HIV-infected person to 20–50 years. 


Syphilis is a sexually transmitted disease caused by the bacteria Treponema pallidum. 

Primary syphilis 
Secondary syphilis 

Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing. 

Syphilis is a bacterial infection usually spread by sexual contact. The disease starts as a painless sore on your genitals, mouth or another part of your body. If untreated, syphilis can damage your heart and brain. 

Syphilis progresses in stages and can lead to serious complications or death. Having syphilis also makes you more vulnerable to HIV. When caught early, syphilis can be cured with antibiotics.

Syphilis develops in four stages, and symptoms vary with each stage. But the stages may overlap, and symptoms don’t always occur in the same order. You may be infected with syphilis and not notice any symptoms for years. 

Primary syphilis
These signs may occur from 10 days to three months after exposure: 

A small, firm, painless sore (chancre).
The sore will heal without treatment, but the syphilis infection remains. In some people, syphilis then moves to the secondary stage. 

Secondary syphilis
The signs and symptoms of secondary syphilis begin two to 10 weeks after the chancre appears and may include: 

Skin rash, often appearing as rough, red or reddish-brown, penny-sized sores, over any area of your body, including your palms and soles
Fatigue and a vague feeling of discomfort
Soreness and aching
Swollen lymph glands
Sore throat
Wart-like sores in the mouth or genital area

These signs and symptoms may disappear within a few weeks or repeatedly come and go for as long as a year. 

Latent syphilis
If you aren’t treated for syphilis, the disease moves from the secondary to the latent (hidden) stage, when you have no symptoms. The latent stage can last for years. Signs and symptoms may never return, or the disease may progress to the tertiary (third) stage. 

Tertiary or late syphilis
About 15 to 30 percent of people infected with syphilis who don’t get treatment will develop complications known as tertiary, or late, syphilis. In the late stages, the disease may damage your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. These problems may occur many years after the original infection. 

Some of the signs and symptoms of late syphilis include: 

Jerky or uncoordinated muscle movements
Gradual blindness

Congenital syphilis
If you’re pregnant, you may pass syphilis to your unborn baby. Blood containing the bacteria reaches the fetus through the placenta, the organ that nourishes the developing baby. This is known as congenital syphilis. 

Most infants born with syphilis have no symptoms of the disease. Almost all develop symptoms by 3 months of age, though some children with congenital syphilis show no signs of the disease until after age 2. 

Early signs and symptoms, which occur before the age of two, may include: 

“Snuffles” (runny nose)
Skin sores
Jaundice — yellow skin
Infection of the umbilical cord
Swollen liver and spleen

If not treated right away, the baby may experience serious problems, including: 

Tooth abnormalities
Developmental delays

What is the treatment for syphilis?
Syphilis is treated with various Antibiotics. The amount of reatment depends on the stage of syphilis the patient is in. Pregnant women with a history of allergic reaction to penicillin should undergo penicillin desensitization followed by appropriate penicillin therapy. A baby born with the disease needs daily penicillin treatment for 10 days. 

What can be done to prevent the spread of syphilis?
There are number of ways to prevent the spread of syphilis:

•    Limit your number of sex partners;
•    Use a male or female condom;
•    If you think you are infected, avoid sexual contact and visit your local STD clinic, a hospital or your doctor;
•    Notify all sexual contacts immediately so they can obtain examination and treatment;
•    All pregnant women should receive at least one prenatal blood test for syphilis

Genital warts

Genital Wart
Genital warts (known as condylomata acuminata or venereal warts) may be small, flat, flesh-colored bumps or tiny, cauliflower-like bumps. In men, genital warts can grow on the penis, near the anus, or between the penis and the scrotum. In women, genital warts may grow on the vulva and perineal area, in the vagina and on the cervix (the opening to the uterus or womb). Genital warts vary in size. 

Genital warts are caused by the human papillomavirus (HPV). There are many kinds of HPV. Not all of them cause genital warts. HPV is associated with cancer of the vulva, anus and penis. However, it’s important to note that HPV infection doesn’t always lead to cancer.

HPV is a sexually transmitted infection (STI). The most common way to get HPV is by having oral, vaginal or anal sex with someone who is infected with HPV. The only sure way to prevent genital warts is to have sex. Sex only with a partner who is not infected with HPV. 

Just because you can’t see warts on your partner doesn’t mean he or she doesn’t have HPV. The infection can have a long incubation period. This means that months can pass between the time a person is infected with the virus and the time a person notices genital warts. Sometimes, the warts can take years to develop. In women, the warts may be where you can’t see them–inside the body, on the surface of the cervix. 

Using condoms may prevent you from catching HPV from someone who has it. However, condoms can’t always cover all of the affected skin. 

In many cases genital warts do not cause any symptoms, but they are sometimes associated with itching, burning, or tenderness. They may result in localized irritation. Women who have genital warts inside the vagina may experience bleeding following sexual intercourse or an abnormal vaginal discharge. Rarely, bleeding or urinary obstruction may occur if the wart involves the urethral opening. 

Depending on the sizes and locations of warts (as well as other factors), a doctor will offer one of several ways to treat them. Podofilox is the first-line treatment due to its low cost. 

Podofilox solution in a gel or cream can be applied by the patient to the affected area and is not washed off. Podofilox is safer and more effective than podophyllin. 

Podophyllin and podofilox should not be used during pregnancy, as they are absorbed by the skin and could cause birth defects in the fetus. 

Cryotherapy: This technique freezes the wart using liquid nitrogen or a “cryoprobe.” It is an excellent first-line treatment because response rates are high with few side effects. 

Laser treatment: This treatment is used for extensive or recurrent genital warts. It may require local, regional, or general anesthesia. Disadvantages include high cost, increased healing time, scarring. 

Electrodesiccation: This technique uses an electric current to destroy the warts. It can be done in the office with local anesthesia. Of note, the resulting smoke plume may be infectious. 

Surgical excision is best for large warts, and has a greater risk of scarring.