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What could possibly be worse than struggling with a painful condition and feeling ashamed to discuss the problem because of its intimate nature? Such is the case for many suffering with pudendal neuralgia, a little known disease that affects one of the most sensitive areas of the body. This area is innervated by the pudendal nerve, named after the Latin word for shame. Due to the location of the discomfort combined with inadequate knowledge, some physicians make reference to the pain as psychological. But nothing could be further from the truth. Unfortunately, discussing the condition with gynecologists, urologists and neurologists often proves fruitless since most know nothing about the condition and therefore cannot diagnose it.
Pudendal neuralgia is a chronic and painful condition that occurs in both men and women, although studies reveal that about two-thirds of those with the disease are women. The primary symptom is pain in the genitals or the anal-rectal area and the immense discomfort is usually worse when sitting. The pain tends to move around in the pelvic area and can occur on one or both sides of the body. Sufferers describe the pain as burning, knife-like or aching, stabbing, pinching, twisting and even numbness. These symptoms are usually accompanied by urinary problems, bowel problems and sexual dysfunction. Because the pudendal nerve is responsible for sexual pleasure and is one of the primary nerves related to orgasm, sexual activity is extremely painful, if not impossible for many pudendalites. When this nerve becomes damaged, irritated, or entrapped, and pudendal neuralgia sets in, life loses most of its pleasure.
So, where exactly is the pudendal nerve? It lies deep in the pelvis and follows a path that comes from the sacral area and later separates into three branches, one going to the anal-rectal area, one to the perineum, and one to the penis or clitoris. Since there are slight anatomic variations with each person, a patient’s symptoms can depend on which of the branches are affected, although often all three branches are involved. The fact that the pudendal nerve carries sensory, motor, and autonomic signals adds to the variety of symptoms that can be exhibited.
Because pudendal neuralgia is uncommon and can be similar to other diseases, it is often misdiagnosed, leading some to have inappropriate and unnecessary surgery. Early in the diagnosis process, it is crucially important to undergo an MRI of the lumbar-sacral and pelvic regions to determine that no tumors or cysts are pressing on the nerve. In addition, the patient should be screened for possible infections or immune diseases, as well as having an evaluation by a pelvic floor physical therapist to determine the health of the pelvic floor muscles and to uncover whether skeletal alignment abnormalities exist. An accurate patient history is needed to assess whether there has been a trauma or an injury to the nerve from surgery, childbirth, or exercise. Tests that offer additional diagnostic clues include sensory testing, the pudendal nerve motor latency test, and electromyography. A nerve block that provides several hours of relief is another tool that helps to determine if the pudendal nerve is the source of pain.
One of the most common symptoms that accompanies pudendal neuralgia is severe depression. Some people with the disease have committed suicide due to the intractable pain. For that reason, it is important to consider antidepressants, as they can help lessen the hypersensitivity of the genital area in addition to relieving bladder problems. Certain anti-seizure drugs reportedly help to alleviate neuropathic pain while anti-anxiety drugs provide substantial relief of muscle spasms and assist with sleeping. Uninformed physicians are reluctant to prescribe opiates for an illness that shows no visible abnormality, yet the desperate nature of genital nerve pain requires that opiates be prescribed for these patients. While medications are not always satisfactory, they do help take the edge off of the pain for many people. Until the correct treatment is determined, it is imperative that patients with pudendal neuralgia receive adequate pain management since the pain associated with this illness can be intense.
Treatment depends on the cause of distress to the nerve. When the cause is not obvious patients are advised to try the least invasive and least risky therapies initially.
Physical therapy that includes myofascial release and trigger point therapy internally through the vagina or rectum assists with relaxing of the pelvic floor, especially if pelvic floor dysfunction is the cause of nerve irritation. If no improvement is found after six to twelve sessions, nerve damage or nerve entrapment might be considered.Botox is now used in medical settings to relax muscles and shows promise when injected into pelvic floor muscles; though finding a physician adept at this treatment is difficult.Pudendal nerve blocks using a long-acting analgesic and a steroid can reduce the nerve inflammation and are usually given in a series of three injections four to six weeks apart. If physical therapy, Botox, and nerve injections fail to provide adequate relief, some patients opt for pudendal nerve decompression surgery. There are three published approaches to pudendal nerve decompression surgery but there is debate among members of the pudendal nerve entrapment community as to which approach is the best. Since there are advantages and disadvantages to each approach, patients face considerable confusion when deciding which type of surgery to choose. Because there are only a handful of surgeons in the world who perform these surgeries, most patients have to travel long distances for help. Moreover, the recovery period is often painful and takes anywhere from six months to several years since nerves heal very slowly. Unfortunately, early statistics indicate that only 60 to 80 percent of surgeries are successful in offering at least a 50 percent improvement. Patients whose surgeries are not successful or who do not wish to pursue surgery have the option of trying an intrathecal pain pump which delivers pain medication locally and helps to avoid some of the side effects of oral medications. Others pursue the option of a neurostimulator either to the sacral area or directly to the pudendal nerves. These are relatively new therapies for pudendal neuralgia so it is difficult to predict success rates. Some pudendalites have devised ingenious contraptions for pain relief ranging from u-shaped cushions cut from garden pads all the way to balloons filled with water, frozen, and inserted into the vagina. Most have a favorite cushion for sitting and many have special computer set-ups for home and office use in order to avoid sitting. Generally speaking, jeans are a no-no, so patients revise their wardrobes to include baggy pants and baggy underwear – if they are able to tolerate wearing underwear.
Clearly more research is required to find effective methods to better manage the pain and debilitation of pudendal neuralgia. But in the meantime, friends and family close to those who have this devastating illness play a huge role in helping patients cope, thereby maintaining the best quality of life possible. Support, love and understanding are of primary importance for those suffering with this affliction.
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The case where a man experiences a prolonged and painful erection that lasts for maybe a few hours to a few days is called priapism. This is a condition that is not related to any sexual activity or thought. What happens is that blood flows into the penis, but does not drain as normal. With little room to circulate, the blood becomes stagnant, acidic and loses oxygen where red blood cells become stiff.
Priapism can occur to anyone; even to new born babies. Priapism was named after the Greek god of fertility, Priapus where he was always projected well endowed and perpetually erect in statues and pictures.
Priapism usually occurs with an obvious cause of either some medications or certain medical conditions. There are two types of medications that cause priapism; increasing the recommended number of penile injections to treat some types of impotence or anti-depressants. The medical conditions that start priapism are those that cause the blood to thicken or where red blood cells lose flexibility and mobility like in sickle-cell anemia and leukemia. Even any trauma to the genital area or spinal cord may lead to priapism. Carbon monoxide poisoning, bites of black widow spiders and illicit drug use of marijuana and cocaine usually leads to priapism too.
There are basically two types of priapism; low-flow and high-flow priapism. With low flow priapism, blood gets trapped in erection chambers of men who are otherwise healthy. It also affects men with leukemia, sickle-cell disease and malaria. High flow priapism is a rare condition and is less painful. A ruptured artery from any injury to the penis or perineum may cause this condition as blood in the penis is prevented from circulating as normal.
It is always better to seek treatment for priapism; as soon as possible. This is because if left untreated, the erection can go on for four to six hours where the penis may get scarred if not treated early. This in turn leads to impotence. The treatment for priapism usually involves the draining of the penis by placing a needle in the side of the penis. Sometimes medications that act on blood vessels are injected to shrink blood vessels; which in turn decreases the blood flow to the penis. Those having sickle-cell anemia and priapism are usually treated with blood transfusion.
When meeting the doctor, it is important that you inform him or her of the length of time since having the erection and how long your usual erections last. You should be honest in disclosing legal and illegal medications that have been taken as marijuana and cocaine are linked with priapism. With this information, and a physical examination to determine the cause of priapism, the doctor can advise the necessary medication to treat priapism.
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A few fortunate, and likely quite popular men, have learned to make ejaculation voluntary. This means they can last a long time and come when they want to. Most however ejaculate involuntarily—perhaps prematurely, that is, before they or their partner are ready for it.
Coming too soon may be due to a physical medical condition, but this is not common. Most men who ejaculate prematurely do so because of learned behavior and sexual beliefs, or because they haven’t discovered the simple techniques that can help them last.
In order to make ejaculation completely voluntary, a man must learn to do two things. First he must learn to keep his entire body relaxed regardless of how sexually aroused he becomes. Second he must learn to move the sexual charge that builds up during lovemaking away from his genitals and circulate that energy throughout his entire body.
RELAXATION
Men usually tense their bodies as ejaculation approaches. This is a natural involuntary reflex, but by deliberately applying some of the following relaxation techniques you can become skilled at letting go and staying loose even at intense levels of sexual arousal.
Massage
Few things enable a man to be as profoundly relaxed as a loving erotic full-body massage. Women can help men get out of their heads and into their bodies by giving them a massage as a prelude to intercourse. Most men will notice a significant improvement in their ability to delay ejaculation after receiving a massage. Not only does massage help relax your body, it also opens up your flow of energy so that the sexual charge does not get stuck in your genitals.
Stop And Become Still Or Slow Down
Before you get to the point of no return, try slowing or stopping all movement. This usually works every time. Wait for the energy and excitement to subside and then you can resume active lovemaking.
Breathe Slowly And Deeply
As you come close to climax, switch your attention away from your genitals onto your breath. Take slow deep breaths that fill your entire lungs. Make your exhalation last about as long as your inhalation. Let your body go loose. Open your eyes and make eye contact with your partner. Try to breathe in rhythm together. Continue breathing in this deliberate way until your sexual energy has calmed down.
Avoid Stimulating The Frenulum
The frenulum is the bulge of loose skin just below the glans head on the underside of your penis. This spot is very easily excitable and can build the man too quickly to climax. Stay away from this spot to avoid involuntary ejaculation.
Squeezing The Glans
The glans of the penis is the big smooth head at the top of the penis shaft. When ejaculation is imminent you or your partner can squeeze the glans firmly and hold on tight. With the other hand use your thumb and index finger to press firmly on both sides of your penis at the base where the penis rises from the pubic bone. This effectively cuts off the neurological ejaculatory response from your brain to your prostate and will stop the ejaculation. This technique is easiest to use when your are being stimulated orally or manually. It also requires split second timing. Do not do it if ejaculation has already begun, it can be quite painful!
Three Finger Perineum Press
When you reach a point of high arousal and you know ejaculation is close, you or your partner can press on the perineum, the stretch of skin between your anus and scrotum. In preparation for using the technique during active intercourse, try touching this spot when an ejaculation starts and you will feel the vibrations of climax in your prostate gland. This is how you will know where to press. Notice where the vibrations are strongest - usually at about the midpoint on the perineum. To delay ejaculation, when you are at the point of no return but before the ejaculation has started, press firmly on this area of the perineum with the first three fingers of either hand. You can do this yourself or your partner can do it for you. Hold until the urge to ejaculate subsides.
MOVING YOUR SEXUAL ENERGY
Learning to circulate hot sexual energy is not really difficult, but it takes discipline and practice. Within a few days of trying some of the techniques mentioned below you’ll likely notice an improvement in your ability to delay ejaculation. Real sexual energy mastery, however, may take several months or even years. But unlike childhood piano lessons this is practice you’ll look forward to!
The PC Pump
PC stands for pubococcygeus muscle. Actually the PC muscle is a group of muscles that together make up the pelvic diaphragm which stretches from your pubic bone around to your tailbone. It includes muscles used in urination and bowel movements, muscles around your anus, testicles, penis, and perineum. Pumping the PC muscle is one of the easiest, simplest and fastest ways to learn to move energy and delay ejaculation. Pumping the PC muscle means squeezing or contracting the muscle and then allowing it to relax repeatedly. Alternately you can squeeze and then push out. You can do rapid pumps or long slow ones.
When you squeeze the PC muscle you pump the hot sexual energy up from your genitals and into the upper part of your body. This prevents the sexual energy from building up to involuntary ejaculation. If you can stay relaxed and move energy away from your prostate as fast as it builds up, you can delay ejaculation as long as you want. This is how Tantric lovers are able to extend active lovemaking for 6 or 8 hours or more. By the way, strengthening your PC muscle usually results in longer and stronger ejaculations when you do have them.
Add PC pumping to your fitness routine. Build up to several hundred squeezes per day over a two week period and eventually (if you are really keen) increase to 1000 or more per day. This might sound like a lot but you can do 100 PC squeezes in a few minutes. You don’t even need to find new time to do PC pumps—try them when you are standing in line, driving your car, hoisting a few at the bar.
Make Sound
As you get more and more excited make lots of sounds. You can moan, groan, yell, scream, chant, sing, growl and make animal noises. The louder and stronger the sounds you make the more that sound will carry your sexual energy with it, up and away from your genitals. A wonderful technique is to harmonize your chanting sounds with your lover. When you do this at the peak of sexual arousal the sounds you make together can be exquisitely beautiful.
Hand Movements
Moving your hands up your body, or having your partner move her hands up your body from your genitals to the top of your head, either on the front or back of your body, is an amazingly simple but effective way to move energy. You and your partner can do this repeatedly throughout the length of your lovemaking.
The Big Draw
You can alternate relaxing your body with a conscious full-body contraction—the Big Draw. Breathe very deeply and rapidly for about a minute when you are almost ready to come. Then hold your breath and clench every muscle in your body. Tighten you fists. Curl your toes. Grit your teeth. Tighten your buttocks, abdomen, arms, legs, chest, etc. If you are lying on your back (recommended for doing the Big Draw), push off from the surface with your buttocks and neck, while arching your back. This forces the hot sexual energy up and often leads to an explosive orgasm without any ejaculation. You may also experience altered states of consciousness with this very powerful technique.
LEARNING THROUGH MASTURBATION
Masturbation is an excellent way to become skilled at lasting a long time. Select a private, comfortable, safe place for your practice where you will not be interrupted. A wonderful variation is to have your partner watch you masturbate. In this way you can teach her exactly how you like to be touched and stimulated. But try it a few times alone before you put on a show for your lover.
Build your arousal to approximately 75% of the way to the point of no return. As you get better at it, you can go closer to 90% or more. The point of no return is that point at which ejaculation will become involuntary, when you’re likely to ejaculate within seconds, most certainly within minutes. Stop what you are doing. Use some of the techniques above for relaxation and energy movement and allow your excitement to subside. Your erection should also subside before you start again. This allows the old blood to move out of the penis taking with it waste products. When you start to re-build your arousal, fresh blood will engorge the penis giving you a new erection. This new blood carries with it a fresh supply of oxygen and hormones bringing strength, vitality and virility. Many men ejaculate simply because they do not allow their erection to diminish every 30-45 minutes—the penis becomes exhausted and involuntary ejaculation follows quickly.
Repeat this masturbation process of building to approximately 75% of your point of no return, then stop, rest, and build again, for any number of times. As you do this pay very careful attention to what is happening in your body. Notice how your body feels as you get closer and closer to orgasm. Notice that your body gives you signals about how close to ejaculation you are: heat and hardness of your erection, rapid breathing, muscular tension, and so on. In particular look for sensations in your genital area at the prostate gland. As your sexual energy builds in the prostate it is like a pressure cooker. When the pressure gets too high, smooth muscles go into involuntary spasm, forcing the ejaculation. If you pay attention you will certainly feel something in the prostate as you approach this point of involuntary ejaculation. As soon as you feel this sensation, instead of going on to complete the ejaculation, you are going to stop stimulating yourself and rest. Notice how your body feels as you relax and let the energy (and erection) subside. Once you become adept at recognizing this feeling in your prostate during self-pleasuring, you can also be alert to this feeling during lovemaking, including active intercourse with a partner.
OTHER TECHNIQUES FOR MASTERING EJACULATION
Positions
Change intercourse positions frequently. Experiment with various positions to find out if you can more easily delay ejaculation in some of them. There are an infinite variety of positions in the following categories: face to face, front to back, lying down, standing up, sitting, rear entry, and sideways. Some men report that it is easier for them to last longer during intercourse if the woman is on top. Also, face to face positions tend to be calmer, making it easier for the man to delay ejaculation, while rear entry positions tend to increase arousal very rapidly.
Communicate With Your Lover
You must communicate your state of arousal to your lover. If your arousal is cresting too rapidly ask her to change what she is doing, to stop what she is doing or to slow down. Give her very specific feedback on what you want and what you can stand. Be sure to do this in a loving, respectful and playful way! Some women believe that men aren’t happy with the lovemaking until they come. Let her know that you’re having a great time and want to keep on sharing your pleasure together.
Examine Your Beliefs And Assumptions About Sex And Women.
Generally the more you like, respect and admire women the easier it will be to learn voluntary ejaculation. On the other hand, the more you dislike women the more difficult it will be. The simple reason for this is that you will be in a hurry when you have sex if you dislike women. Sex will tend to be a maintenance chore necessary for tension release.
With a subtle shift in the way you think, perhaps you can begin to make love instead of just having sex. Open yourself to giving and receiving pleasure rather than trying to perform. Open your heart. Allow yourself to love your partner and be loved by her. Allow yourself to feel emotions as well as physical pleasure. Quick ejaculation is one of the ways men use to deny themselves pleasure and to avoid intimacy. Extended, ecstatic lovemaking requires surrendering and being vulnerable to your partner. Many men find that when they can let go of the need to keep everything under control, including lovemaking, their ejaculation response becomes much more manageable. It is ironic that less repressive control of feelings means more “control” or mastery of ejaculation response.
SORE PROSTATE
If after practicing techniques for delaying ejaculation you experience a sore prostate or “blue balls”, this only means that the sexual energy is building up in your genitals faster than you can move it out. This is not dangerous, simply uncomfortable. You can relieve this discomfort immediately by ejaculating, which releases all the pressure. If the discomfort does not go away, this may mean you have a medical disorder, such as a urinary tract infection, and you should see your doctor.
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Most men have been there at one time or another. That moment when total sexual exhilaration turns to pure panic and fear...fear that the "little astronaut" out on his moon walk has lost his space suit. Fear that the knight is no longer wearing his shining armor.
The number one reason that condoms break or slip off during the horizontal mambo is that the Johnson in question was not properly suited. Like shoes or bras, careful consideration must be given to condom size.
Yes, all men are created equal — but in very different shapes and sizes when it comes to the trouser department.
And while it may not be the size of the wave that floats your boat, when it comes to choosing a condom, your size does matter.
RESEARCHERS AGREE
A recent survey by Durex Condoms revealed that the length of an erect penis can range from four to nine inches, while penis widths can vary from just over one inch to more than two inches.
The Durex study also found that 50% of the almost 3,000 survey respondents felt that the condoms they regularly used did not fit properly; 25% said the condoms were "too tight," 10% said they were "much too tight," and 15% responded that the condoms were "too loose" or "much too loose."
Not surprisingly, 42% of those surveyed indicated that condoms should be "better shaped."
A whopping 44% of those surveyed reported they had experienced condom slippage or breakage problems in the past.
The Durex study concluded, "Given the wide range of penis sizes and the relatively narrow range of condoms designed to fit them, it is perhaps unsurprising to find that 50% of respondents felt that the condoms they use did not fit them properly”.
The answers provided also indicate that condoms which don't fit properly are more likely to break during use..."
Another study performed by La Trobe University in Australia examined the effect of penis dimension on the probability of complete condom slippage and/or condom breakage in actual use.
A total over the course of the study, 16% of the men experienced at least one instance of breakage and 19% experienced complete slippage.
The study concluded that condom breakage was strongly associated with penis circumference, particularly for men with above-average girth.
In fact, each additional centimeter of penis circumference beyond the average 13.19 cm increased the risk of breakage by 50-100%.
Like the Durex study, the researchers concluded, "This finding suggests a need to increase either the range of condom sizes currently available or the [girth] of currently available condoms.” of 3,658 condoms were used by 184 men.
ERECTION REJECTION
It is no secret that many men dislike wearing condoms. Some Men say that condoms interfere with sex, "get in way," or "kill the mood."
Most of the time however, these problems arise because the man has difficulty putting on the condom, or is concerned that the darn thing may slip off.
If a condom is difficult to put on due to size issues, the little soldier may suddenly be unable to stand at attention.
A survey conducted by the University of Sydney, Australia found that two-thirds of the men surveyed reported they "sometimes" or "often" lost their erection while trying to put on a condom.
Of course without an erection, a condom is impossible to put on at all.
While many men struggle to put on ill-fitting condoms that are too small, many others experience anxiety that the condom may slip off their slimmer girth.
This anxiety can also interfere with the ability to keep the flag at full mast. Condoms that are too loose increase the odds of slippage or leakage.
Paradoxically, one of the most common reasons condoms slip off is because they are too tight or too long — if not fully rolled down, the ring at the base can enter the man's partner and be dragged off.
Condoms that are too short also increase the risk of exposure to STDs.
When condoms are too tight, breakage and slippage is more likely to occur, and sensitivity can be significantly diminished.
The reality is that condom size is very important. Unfortunately, unlike penises, most condoms around the world today are made in a very narrow range of sizes.
In fact, the overwhelming majority of condoms does not refer to size at all, and simply are marketed as a "one size fits all" product.
While a few companies like Trojan have shown some sensitivity to the size issue by producing some larger sized models, very few such products exist, and even fewer are available for those needing a snugger fit.
Millions of men continue to struggle with the "one size fits all" mentality that the condom manufacturers apply to condom size, often leading to very unfortunate results.
Given the inherent difficulties in measuring customers to ensure a more tailored condom fit, condom producers simply continue to force round pegs into square holes.
That’s why to fit a condom effectively and snugly, you have to up your size.
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Lately have you noticed that you are not able to achieve the quality erection that was never a problem earlier? Further, the staying power is also diminishing and your partner has started complaining about it. You could be on the threshold of a serious medical crisis termed as Impotence or Erectile Dysfunction (ED).
This problem can affect both young and old men. The causes range from injury, illness, stress, physical or mental trauma or simply old age. If left untreated impotence can ruin your family life and reduce your confidence levels such that you feel like ending it all. But don’t be disheartened as now there is a treatment for this sexual problem and you can regain all that is lost.
Medical researchers have found that a chemical compound called tadafil has certain properties that can be used in treating impotence. This compound is available in the market under the brand name Cialis.
In men suffering from impotence, the penile region does not receive sufficient amount of blood necessary to provide a full erection. The result is a partial or no erection at all. Cialis reverses this condition by relaxing the penile region facilitating the arteries to carry extra blood to the penile tissue. This causes the penis to become fully erect and hard. The erection lasts longer and sexual intercourse is achieved with satisfaction for both partners.
Cialis is FDA approved and a very safe drug. It can be used in combination with a number of other medicines. It is light on the pocket as well. It is even better if you purchase it from an online pharmacy where you can cheaper prices for your orders and refills. As Cialis is a prescription medication, you can obtain an online prescription before placing your order. Delivery is discreet and you don’t have to leave the comfort zone of your home.
Before beginning on a course of Cialis consult your doctor and discuss your medical state as this will determine the dosage and may require monitoring in early stages. Cialis may cause some mild side effects, which will diminish as you continue the usage. If you are bothered by any symptom, seek medical opinion.
Cialis is not for women and children. It should be stored in safe place away from heat, light and moisture. Overdose can cause complications and in the event of such a condition immediate medical attention is required.
Clinical studies on volunteers indicate that Cialis can show its effect in as less as 30 minutes and you can continue to enjoy it upto 36 hours. This means that once you have taken a dose you are ready for the special moment whenever it arises. You and your partner can be at easy as there is no pressure of rushing as is the case with some other medications in the same category. Sexual stimulation adds to the benefit and your partner assumes an active role in order for both of you to reach the desired climax.
Some men, not suffering from ED, have submitted independent claims that using Cialis gave them an increased firmness and girth and left there partners wanting more. We would like you to share your experience in this regard.
Cialis has captured a large market share and is a trusted companion for millions worldwide. If you want to be a part of this satisfied group then you must try it.
Always practice safe sex.
