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Free dating tips for get laid tonight!

Amy — Mon, 08 Feb 2010 16:00:52 +0000

Your profile is the first thing people get to see about you so creating a great profile is important if you want to succeed in online dating as the number of replies you get basically depends on what you have written on your profile. This is where men get their first impression of you and what you have to offer so make sure you keep them wanting more!

If you have no idea how to write your profile these tips will help you get started:

1 Avoid negativity in your profile because negativity doesn’t get a man’s interest. Instead of putting your dislikes, put your favorites on your profile. A guy is most likely to be turned off if you just whine and complain in your profile.

2 Be original! Think of funny, clever headers. Aside from your photo, your header will be the basis for a guy’s judgment. If you write the same boring header so many other women have used already then a guy isn’t going to notice you either.

3 Your photos must be recent. If you use a photo from years ago a guy isn’t going to recognize you when you meet up and going on a date in real life is the whole point of online dating. This is what you look like now and will when you meet up eventually might as well let him know what you look like from the start.

4 Be honest in your appearance and civil status; however, keep your full name, work and home address, and home phone number confidential. Online dating is fun but you should protect yourself too wait until you really know someone before you give him more information about yourself.

Get some inspiration from other peoples profiles, see what makes them popular and what you could re create for yourself. Just remember when you read your own profile you should want to get to know that person better and not feel like you know all there is to know. Leave them intrigued and if you can make them smile even better that way they will remember you and keep coming back!

Special offer! Sign up for free!

Testosterone For Life- it’s here!

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pimg src=/files/u11/testostlife-abemorg.jpg alt=testbook title=testforlife width=150 style=float: left; /I am delighted to announce the launch of my new book, a href=http://www.amazon.com/TESTOSTERONE-LIFE-Abraham-Morgentaler/dp/0071494804/ref=sr_1_1?ie=UTF8amp;s=booksamp;qid=1217266596amp;sr=1-1 title=testforlifeTestosterone For Life: Recharge Your Vitality, Sex Drive, Muscle Mass, and Overall Health/a (McGraw-Hill). The book is now available online via Amazon.com, and should be in bookstores any day now. /ppbr /This book is written to help men (or their partners) figure out if they have low levels of testosterone (quot;low Tquot;) and how to treat it. Remarkably, as many as one in 5 men over the age of 50 have low T and may benefit from treatment. But most doctors are only beginning to pay attention to low T, and so the vast majority of men with low T are never diagnosed, and so remain untreated. /ppbr /The symptoms of low T include: low sex drive (what we call libido), weak erections, feeling chronically tired and without energy, and depression or a milder version, which I call quot;the blahs.quot; Men with low T also often notice that their athletic performance is reduced, and may lose muscle and gain fat. A big surprise for many people, including physicians, is that men with low T are also at risk for osteoporosis, which can lead to fractures from minor injuries. /ppbr /The treatment of low T has been a big part of my professional career, and I’ve been fortunate to have had the opportunity to contribute to the medical literature on this topic. In particular, my work has uncovered the fact that the historical fear that higher T would increase prostate cancer risk is nothing more than a myth, and without scientific support. On the contrary, emerging data indicates that prostate cancer risk may be greater among men with low T./ppbr /Although the most frequent reason to treat men with T therapy is to help with symptoms, such as reduced sex drive or chronic fatigue, there is also increasing evidence that having a normal testosterone level may be important for overall health. Several studies have shown that low T increases the risk of developing diabetes and the metabolic syndrome (a marker of cardiovascular risk). Even more provocative are data from at least four studies now that showed that men with low T died sooner, on average, than men with normal concentrations of T. Clearly, this is a concept that requires careful study. /ppbr /It’s a fascinating subject, and one that is clearly in flux. However, the important thing is to know that there are many, many men in their 40s, 50’s, and beyond who just don’t feel that great, and who may benefit from T therapy. Testosterone For Life is full of stories from my practice of men who responded well to T therapy. If you’re not feeling as well as you think you should, you might want to take a look at the book to see if you recognize yourself in any of the stories. If so, chances are you could be living a fuller, happier, and more loving life. /p

Is Testosterone Good For Men With Prostate Cancer?

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pUntil very recently, the use of testosterone (T) was prohibited in men with a prior history of prostate cancer, or even in men with just suspicion of prostate cancer. Yet a case I had this week underscores how dramatically ideas can change in medicine over a very short period of time. /ppbr /About 6 months ago I saw Sam (not his real name) in my office, a 57 year old man, accompanied by his wife. He had undergone a radical prostatectomy for prostate cancer in 2004, and the blood test to monitor prostate cancer, called PSA, was undetectable, meaning that there was no evidence of any residual cancer cells in his body. The reason to see me was that he had absolutely no desire to have sex, even though the equipment was working. Also, his wife added, her husband seemed constantly tired, napping at all hours of the day. quot;I’ve never seen him like this,quot; she said, indicating that he had always been a go-go-go kind of guy. He denied being depressed. /ppbr /quot;I just don’t feel like doing anything,quot; he said, quot;sexually or otherwise.quot;br /Blood tests revealed low levels of testosterone. After discussion of the risks and possible benefits, Sam elected to try T therapy. I started him on T gel, applied daily, and subsequent blood tests confirmed good T concentrations in the blood. br /At his visit yesterday, Sam told me he was feeling much better. Specifically, he was more energetic, felt less tired, and he and his wife were now having sex again. Sam’s body composition had changed too. Testing revealed his body fat had decreased from 34% to 30%- still high, but a very impressive improvement. He had gained 2.5 pounds of muscle and lost over 10 pounds of fat! And his PSA was still undetectable, meaning there was still no evidence of cancer recurrence. /ppbr /Until very recently, it was believed that higher T led to more rapid prostate cancer growth, hence the prohibition against T therapy in men with prior prostate cancer. The fear was that any quot;sleepingquot; prostate cancer cells would begin to divide more quickly in the presence of higher T, causing a recurrence of the cancer. Yet in a number of articles I’ve written on this subject, I discovered that the origin of this belief in prostate cancer’s response to T was based on studies in the 1940s and 1960s, and only in men who had been castrated (a common, if unpleasant treatment for metastatic prostate cancer). Modern evidence indicates that in humans and animals, large changes in blood concentrations of T have little if any effect on prostate cancer growth. The one special case is that lowering T to zero (or almost zero), as with castration, does deprive prostate cancer of a needed nutrient, causing it to shrink. br /Clearly, men like Sam can benefit greatly from T therapy, in terms of symptoms as well as overall health (there are important health benefits of having less fat and more muscle beyond the cosmetic ones). /ppAt my lectures over the years, one of my favorite questions of physicians has been how many would treat a man like Sam with T therapy. Five years ago, barely a single hand would be raised in the audience. Two years ago I started seeing a handful. And at a recent debate, I was pleasantly surprised to see that approximately half the urologists in the room indicated they had treated men in Sam’s situation. What an incredible change!/ppbr /We don’t yet have large studies to confirm the safety of the treatment, and so patients like Sam must be informed that treatment entails what I call an quot;unknown degree of riskquot; re cancer recurrence, but so far the data from a number of medical centers around the country appear to be quite reassuring. /ppbr /Are there strongly held beliefs in your own field that have also persisted for many years based on old information that may no longer be correct? I’m curious to hear. /p

Looking for Change? How About Sex in the White House?

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pPresident-elect Barack Obama has promised quot;changequot; as his campaign slogan and for his planned tenure as President of the Unites States. As someone who writes and thinks (too much) about sex, I have to wonder whether this change applies to the idea of sex in the White House. After all, for the first time in my lifetime we have a husband and wife entering the WH who are young, attractive, and actually touch each other affectionately in public. Moreover, the existence of relatively young children provides proof that they had been quot;activequot; in the not-too distant past. /ppbr /How different from each of the last occupants of 1600 Pennsylvania Ave! I mean no disrespect to any of them by commenting on the public presentation of their sexuality, particularly since my professional opinion is that sex is a normal and healthy part of any relationship. Moreover, despite our Puritanical heritage, it is impossible to deny that sex is a near-universal biological activity among animal species (there are a limited number of quot;sexlessquot; species that reproduce without intermingling of bodies and DNA) on this planet. But let’s face it- the idea of a bedroom romp between the US President and his wife is not something that has been easy to imagine. Ever. Perhaps it is the gravity of the position that discourages the public’s imagining of sex in the White House, or the age at which past Presidents entered office, but I would argue it has more to do with the men we’ve elected President. /ppbr /Just try to imagine sex between previous Presidents and their wives- it’s almost impossible. Take the outgoing President. He and his wife are still fairly young, but there is something about his religious fervor and her library-marm presentation that discourage thoughts about freedom of sexual expression. Bill and Hillary? Well, President Clinton had at least one well-exposed sexual escapade in the White House, but it wasn’t with his wife. Amid the forests of pages written speculating on their marriage, nowhere would one find commentary suggesting a warm, physical relationship between them. Bush Sr. and Barbara? Nice ham this year, Grandma. Ronald Reagan and the ever-controlled Nancy? Please. Gerald and Bette Ford? Nope. /ppbr /Going back further in time, we find a few more interesting characters, sexually speaking. Say what you will about Richard Milhous Nixon, but it’s not so difficult to imagine this individual pursuing his urges, so to speak. And Jimmy Carter, devout as he was/is, publicly confessed to having committed quot;adultery in his heart,quot; in Playboy magazine, of all places. Presumably, someone as willing to acknowledge the pull of sexual desire as this would also find no difficulty in acknowledging the beauty of it within a committed, married relationship. Yet President Carter was mocked and demeaned for his openness regarding sexuality. /ppbr /Without a doubt, women would rate John F. Kennedy as the most sexually appealing President of the last half-decade, and many would argue that the quot;sexy genequot; was even passed on to his late son. Yet as the window into JFK’s sexual exploits opened after his death, the stories told were of dalliances outside the marriage, such as with Marilyn Monroe, rather than with his beautiful wife, Jacquelyn./ppbr /And so, the imminent ascension of Barack Obama to the Presidency brings about true change, at least in the sense that it becomes possible to imagine healthy sexuality in the White House, perhaps for the first time. From my perspective, this is nothing but good news. When we look to leaders of other countries who exhibit vitality, energy, and an openness to new ideas, such as Tony Blair of the UK or Nicolas Sarkozy of France, it is easy to imagine them as sexual human beings as well. br /It will be interesting to see what the new changes at the White House will mean to US culture in general, and to attitudes regarding sexuality specifically. Sex in the White House? As Sarah Palin might say with an accompanying wink, You betcha! /ppnbsp;/p

Penis Size: The Measure of a Man?

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pAncient drawings clearly indicate man’s obsession with penis size is nothing new. As an adolescent on family vacation at the ruins of Pompeii, I remember viewing with my father a quot;specialquot; fresco hidden behind a shutter for an extra fee paid to the tour guide. My mother and sister were not invited. Painted on the wall, with only minor decay since the eruption of Mt Vesuvius in the year 79 AD, was the picture of a nobleman with an enormous erect penis, the length and girth larger than a man’s leg, placed on an ancient scale, with sacks of gold balanced on the other side. Some time ago I rediscovered that image on the Internet and have occasionally used it in lectures, with the quip that men have always viewed a large penis as worth its weight in gold. /ppbr /Who knows what primitive neural wiring predisposes men to what I call the Stallion Syndrome, the desire for an ever-larger penis? Yet it appears to be pervasive, and vulnerable to the profit motive, as evidenced by the innumerable ads for pills, supplements, herbs, and devices on the internet and in various magazine that allegedly help men enhance their bedroom quot;footprint.quot; As would be expected, quot;progressquot; has brought us modern versions of this old story. /ppbr /Last week in the office I saw two young men who had experimented with new techniques to expand penis size. The first was a 33 year old married accountant, who used a traction device he obtained online for several months, and now complained of a variety of symptoms, including penile numbness, several areas of chronic discomfort, and a change in urination. This device attaches behind the head of the penis (the glans) and the other end pushes against the pubic bone, with various model-specific methods of stretching the penis away from the body. The user is instructed to wear this device for several hours daily for quot;optimal results.quot; If this device were applied to an al-Qaeda terrorist, is there any question there would be protests in the street against this inhumane practice that violated the Geneva Conventions? Yet men actually purchase this device voluntarily and pay more than $200 for this penile version of The Rack. /ppbr /A second patient I saw was a 19 year old student who feared he had injured himself by practicing jelqing. Jelqing consists of massaging the penis outwards while semi-erect to quot;pushquot; more blood into the glans, thereby (according to jelqing proponents) causing the penis to expand. How this is supposed to enlarge the penis makes no medical sense to me, but a brief internet search leads to dozens of videos and instructional guides. These men aren’t alone. Famed movie ladies’man Austin Powers (quot;Not now, Basil- Twins! Twins!quot;) used a Swedish Penis Pump to keep his mojo in tiptop shape. And back in the reality-based world, an Oklahoma Judge, Donald Thompson, was convicted of indecency due to his apparent habit of using a penis pump behind the bench while presiding over criminal cases. /ppbr /It’s not difficult to understand why a man might want to have a larger penis- on some level every man would like to see himself as a well-hung James Bond. The question is what makes a man actually try to do something about it. For some men, it is a feeling of masculine inadequacy. My first patient, Mr. Traction Device, couldn’t answer my question directly when I asked what he had hoped to gain by using this device, but I later learned his wife had cheated on him. As I’ve described in my book, The Viagra Myth, it is common for men to incorrectly assume that difficulties in a relationship stem directly from their performance in bed. Some men truly believe that by taking Viagra or enlarging one’s penis they may win back the hearts of their partner, even though they may not realize that it is usually non-sexual issues (eg, alcoholism, abusiveness, lack of affection) that lead a partner to stray sexually. /ppbr /My second patient, Mr. Jelqing, seemed interested in enlarging his penis on a purely macho basis. quot;I just thought it would be cool to have a bigger penis,quot; he said. At 19, his sexual experience was limited to two very brief quot;hook-ups,quot; none within the last year. Upon discussion, he hinted that perhaps a larger penis might make him more appealing to women. Were either of these men deficient in terms of penis size? Mr. Traction Device had a perfectly fine penis, quite normal in size. And Mr. Jelqing was definitely on the generous side. But as with individuals with eating disorders, we are not always the most objective judges of our own bodies. /ppbr /Interestingly, the advertising for penis enhancement products is directed at younger men. Life experience tends to balance out (to some extent) the single-minded male focus on the penis within relationships. I’ve always been impressed by the number of men I’ve seen with serious medical conditions that have interfered with their sexual function, such as those in wheelchairs with spinal cord injuries, who are accompanied by attractive women drawn to these men not by some magical penis but because of their kindness, or strength of character. The lesson for creating happiness inside or outside the bedroom is, quot;It’s not about the penis- it’s about the man behind the penis.quot; /ppbr /However this can be a challenging message to appreciate at 19 when just learning the complex rules of sexual engagement, or when dealing with a wife who has gone outside the marriage to find another sexual partner. Far easier to give in to the seductive charms of the Sirens of the Internet, promising incredible virility, instant sex appeal, and eternal happiness ($49.99/mo, credit card required). /ppnbsp;/ppnbsp;/p

Men Who Fake Orgasms

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pThere may not be anything all that unusual about women faking orgasms. But what about men? It turns out some men vie for Oscars in the bedroom too. /ppbr /Why would a man need to fake an orgasm? To understand, it may be helpful to look at the reasons women give for doing so. One of the best discourses on this topic, from the quot;Show mequot; School rather than the dry medical literature, is the scene from the classic movie When Harry Met Sally, in which actors Meg Ryan and Billy Crystal are sitting in a restaurant discussing Crystal’s certainty that no woman has ever faked an orgasm with him. quot;How do you know?quot; asks Meg Ryan. quot;Most women have faked it at one time or another.quot; She then proceeds to mimic an orgasm, complete with moans and shrieks, right at their table. When she is done, a middle-aged woman sitting nearby says to the waiter, quot;I’ll have what she’s having.quot; /ppbr /Why do women fake orgasms? A female colleague suggests quot;it’s just a little white lie.quot; Women, she explains, don’t always experience orgasms with sex, but men may be disappointed if she doesn’t have one. Faking an orgasm makes the guy feel he’s done a good job as a lover, and also allows the activity to come to an end, which can be particularly useful with a partner determined to prove his manly mettle. /ppbr /So, what does this have to do with guys? Aren’t men always able to have an orgasm? After all, the single most common sexual dysfunction among men is that they come too quickly, with anywhere from 10-30% of men reporting premature or rapid ejaculation in various studies. Yet not all men are alike, and some men may actually be unable to reach The Promised Land. Ever. Big problem. /ppbr /A more complicated story was provided by Jim (real names not used), a 33 year old software engineer who had been married for a little more than one year. Jim was happy in his marriage to Gloria, and the sex was fine, but there was a catch- he just couldn’t achieve an orgasm during intercourse. He had no trouble having an orgasm with masturbation, mind you. It was only a problem during sex. /ppbr /Neither Jim nor Gloria had been very active sexually prior to their marriage, leaving them with little to compare this to. At first Gloria considered Jim’s inability to climax quot;A little weird,quot; but soon she began to doubt her own feminine skills and started to ask Jim, quot;Am I doing it wrong?quot; and quot;You don’t find me sexy, do you?quot; The pressure mounted (!), and soon Jim hit upon a solution- he started faking his own orgasm. This seemed to work, as Gloria seemed pleased with their sex life. Yet Jim still didn’t understand what was happening to him. /ppbr /There can be a number of reasons why men may have a difficult time achieving an orgasm during intercourse. Medications, particularly the SSRI antidepressants, are the most common cause. Neurologic conditions and diabetes can contribute, by decreasing genital sensation. And sometimes it’s psychological. I had a patient once who was ambivalent about having children. Although he had nodded assent when his wife asked quot;So, you agree it’s ok if I stop taking my birth control pills?quot; he really didn’t feel prepared to take the giant leap of fatherhood. No wonder he withheld his magic seed. /ppbr /In Jim’s case, it turned out that his technique of achieving orgasm during masturbation was to lie prone and rub his body against the bed, something he’d learned as a twelve-year old. As pointed out by my colleague, Dr. Michael Perelman, some masturbatory practices, such as Jim’s, bear little resemblance to the stimulation achieved during actual intercourse. This seemed to be Jim’s problem. The goal of therapy in these men is a hands-on approach ( of course!) in which the men re-train the penis so that they can learn to have an orgasm with stimulation that is more like sex. Eventually, men like Jim should be able to have an orgasm from sex itself. I’ve referred Jim to an experienced sex therapist, and I hear he’s making good progress. In the meantime, he enjoys sex with his wife, but continues to fake orgasms. /ppIs it OK for Jim to do this? Is it really any different than a woman faking an orgasm, other than the missing quot;evidencequot; (more on that upcoming in Part 2)? Whether it’s right or wrong is hard for me to say, but I do find Jim’s motivations instructive. Jim fakes orgasms to make his wife feel okay about their sex life, and her own lovemaking skills. It really provides a different perspective on men, doesn’t it?/ppWho says guys are just unfeeling louts who care only about themselves?/ppnbsp;/p

Worst Time of the Year for Breakups?

Amy — Tue, 20 Oct 2009 12:27:04 +0000

Uh-oh! It’s post February 14 again, a time of sadness and pain for many couples. In fact, it may be the single worst time of the year for breakups.pFor singles, Valentines’ Day (and evening!) is tough enough, with the ceaseless marketing of romantic gifts, cards, and flowers. And for couples who lack physical intimacy, the sexual not-so-innuendo of Valentine’s Day messages elicits additional feelings of inadequacy./ppA patient of mine with ED once recounted spending a lovely Valentine’s Day weekend with two other couples at a Vermont inn, however at dinner there was considerable banter about sex, quot;and at the end of the evening my wife and I knew the other couples were going to their rooms to have sex, but we were going to turn off the lights and just go to sleep. I felt like such a loser.quot;/ppIn terms of relationships, though, it is the day after Valentine’s Day that can be deadly. Couples who struggle in Sept or October may pull it together for the forced good cheer and family obligations between Thanksgiving, Christmas, and New Year’s. Some regard Valentine’s Day as the final leg of this series of quot;togethernessquot; holidays that applies a temporary bond to cracked relationships, but once Feb 15 rolls around, there’s nothing else on the horizon and it’s time to move on. A patient told me once, quot;I couldn’t break up with my girlfriend until after Valentine’s Day. Her friends all compare notes about what their guys were planning for the day, and it just wouldn’t have been fair if I’d taken that away from her.quot;/ppSo, for those struggling with PVDB (Post-Valentine’s Day Breakup), here are a few thoughts that might help you get through:/pp1) Break-ups are painful, no matter the circumstances, no matter the age. Having teenage daughters reminds me of this, and I don’t think the agony is diminished as we age, although we may (or may not!) learn how to hide it a little better. I guarantee the pain lessens with time. Really./pp2) Real life bears no resemblance to the perfect relationships we see in movies or on TV. Most importantly, the end of a relationship does not mean it was a failure. On the contrary, there is always something to learn. As Roberto noted, quot;My ex-girlfriend Jessica showed me how special it can be to have a regular sit-down dinner at home with my kids. I’d never done that when I was married. What a gift she gave us!quot;/pp3) Acknowledge the magnificence of your former partner, no matter how ugly the circumstances of the breakup. There was a reason, or twenty, that you first were attracted to each other and stayed together. You aren’t an idiot, and he/she isn’t the devil. We live crazy lives, and it’s no small miracle when we can create a special world of two, and allow ourselves to be known to someone else. Even if it only lasted for a moment./ppLast week a patient of mine, a professor in his mid-fifties, shared his concerns about a blossoming new relationship with a former graduate student. He went on for a few minutes listing the issues- she was younger, she lived in another state, he felt weird about the teacher-student thing, and so on. Finally I asked him in a casual way, quot;Why don’t you just enjoy it?quot;/ppHe stopped short as if I’d slapped him, his eyes misted up, and he grabbed my shoulder. quot;That’s so great,quot; he said. quot;I needed to hear that.quot; After a moment, he went on, quot;It’s been fantastic with her so far, and the truth is that I’m very excited. I’m just worried it won’t work out, and I’ll wind up feeling like a fool. Thanks for the encouragement.quot;/ppWe live so much in fear. Fear of hurt, loss, failure. Just the anticipation of failure and pain can prevent us from accepting the most wonderful gifts life has to offer./ppSo, for those dealing with PVDB, or a break-up on any day of the year, remember: Enjoy the miracle, and give thanks, in whatever way you can, to the person with whom you’ve shared this magical time! /p

Obsessed with Octuplets

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pIt’s an epidemic. Everywhere I look I find normally calm, compassionate friends and colleagues foaming at the mouth whenever the word octuplets is mentioned. You have an illness, I say. Own up to it- it’s the first step towards recovery./p
pAlas, if it were only so easy. Anger, Hatred, Moral Outrage! The accusations and recriminations flow one after another, with pressured speech./p
pThat woman is so irresponsible!/p
pHow is she going to take care of all those babies?/p
pWhy should I have to pay for her crazy actions!/p
pShe’s crazy! She’s had plastic surgery to look like Angelina Jolie./p
pThe doctor who did this should go to jail!/p
pDisgusting use of our health care dollars!/p
pFor those of you unaware of this case because you are living in a cave in Afghanistan waiting for Osama bin Laden and his dialysis machine to return to select you for the glory of a suicide mission, here is what you need to know. An unmarried woman in California allegedly underwent in-vitro fertilization (IVF), had six embryos implanted, and somehow delivered eight babies, all of whom have so far survived (A scientific miracle!). She already had six children at home, all conceived via IVF. So, baby (ies) make 14. Everyone involved in the case has been interviewed by People, Dr. Phil, etc, except for the studly tail-wagging sperm that could create eight babies from six embryos (Another miracle)./p
pIt’s hard to know why a particular story captures the imagination the way this one has. My opinion is that the reasons are deeper than those usually expressed./p
pI don’t find the common arguments particularly compelling. To begin, no law was broken; none of my angry friends live in California, and will not be contributing one cent directly or indirectly to care for her children; and I have sympathy for a woman who actually loves and wants her children, even if the numbers are beyond anything I can imagine. As for wanting to look like Angelina Jolie, this seems an indicator of good mental health- I’d be worried if she strove to look like Renee Zellweger./p
pLet’s not forget that there are millions of unwed mothers (often just kids themselves) on welfare with multiple children, unplanned and unwanted, who became pregnant the old-fashioned way. Is that somehow better? And what about the deadbeat dads who flit from woman to woman without taking any financial or parental responsibility for their offspring? Less objectionable? I don’t think so. Not long ago a man in his early 40s came to my office. He proudly told me he had 12 children from seven different mothers. What did he want? A vasectomy(!). I have no idea whether or not he supports any or all of his children, so I’m not criticizing, but just pointing out that Octo-mom may not be so beyond the pale. If only one birth had resulted from the six implanted embryos (as apparently happened with an earlier IVF cycle), leaving her with a final tally of seven children, would her behavior have been any less crazy?/p
pI believe the passion engendered by this case comes from being forced to confront the fact that reproductive science has brought us to a place where traditional notions and experience are inadequate to deal with some of the issues that arise. How do we apply a sense of what is right or wrong when we’ve never even considered the possibility before? Frankly, it is a testament to the integrity of the clinicians and scientists involved in IVF centers in this country that cases like this one are so rare, because the potential for crazy stuff is a daily hazard./p
pThe ethical questions are really challenging. The woman had six of her embryos stored in a frozen state. If some of my froth-addled commentators had their way, she should never have been implanted with any of them. But to whom do they belong, if not the woman? Who is to say what should happen to the embryos, if not her? The doctors? The government? Her church or community?/p
pWho decides how many children are enough- two, four, six? One, as in China? Does the calculus change for a single mom versus a married couple? A rich couple versus one on state assistance? And what if fertility treatment is required? Is having children a right? Does it change if a person pays with their own money for infertility treatment?/p
pIt’s a brave new world, folks. Let’s not be too quick to judge. And if you think these issues are tough to handle, just wait until cloning arrives!/p

Men Who Fake Orgasms- Part II (A.K.A the danger of shear forces)

Amy — Tue, 20 Oct 2009 12:27:04 +0000

pFred was a big, hulking 62 year old contractor with a salty sense of humor who had been my patient for many years. On his most recent visit when I examined him, his penis was black and blue, and there were several small tears of the skin on the shaft. What happened? I asked?/p
pbr /It looks bad, doesn’t it? he said with a grin. This is Nature’s way of demonstrating the laws of physics. We’re talking about shear forces here, doc./p
pnbsp;br /What are you talking about? I asked./p
pbr /Immovable object meets irresistible force, he went on. Except that the coverage of the irresistible force is only a thin layer of delicate skin./p
pbr /Fred has diabetes, and due to poor nerve function, he also has trouble having an orgasm. Diabetes is also a major risk factor for erectile dysfunction (ED), and this had been a problem for Fred for even a longer period of time. The oral medications, such as Viagra, Cialis, and Levitra, often aren’t effective in men with diabetes, and this was the case for Fred. So, for sex Fred used our usual next step in the urologist’s armamentarium for ED, namely injections of medication into the penis itself to create an erection. Not painful (I’m serious!), these injections have a feature which can be very useful for men, namely that the erection often lasts for a very long time, even after a man ejaculates. Which means that a man can keep going for a long time, whether or not he is still excited./p
pbr /So, what happened to Fred with his immovable objects and irresistible forces? Well, three days earlier, Fred’s wife, Selma, took it upon herself to give Fred an orgasm. She was so determined, that she kept working and working at it until Fred was raw, and sore. And bruised and torn a bit, as it turned out./p
pbr /Did her efforts work? I asked./p
pbr /I couldn’t come, but I pretended I did, he said. I couldn’t take it anymore, and I wanted to live for another day. Selma and I used to have a lot of sex, and even though I almost never come anymore, it’s important for Selma. She still loves it, and likes to think she’s the hottest thing going. She would have gotten so down on herself if she knew she hadn’t been able to get me off after all that work she put into it./p
pbr /Although Fred’s penile injections allowed him to keep going like the Energizer Bunny despite diabetes and ED, his reduced sensation made it difficult to have an orgasm. And because Selma was determined to give Fred the satisfaction of a bone-shaking climax, they had just kept going and going until Fred was suffering from his physics experiment. Doc, you’ve got to help me. I can’t go through that again./p
pbr /An easy solution helped Fred and Selma- lubrication. Selma was post-menopausal, and thus had relatively little vaginal lubrication of her own. Some of the over-the-counter lubricants are great at increasing sensation for both men and women, and can avoid the shear forces of too much friction. As the old Brylcreem ads used to say (and if you remember this, you’re showing your age, as I guess I’m showing mine)- A little dab will do ya!/p
pbr /What I like about Fred’s story is how it shows up some of the complex, relational aspects of sex. The tired story line that men are just interested in sex to satisfy their primitive urges is shown the lie by Fred’s behavior. In his case, sex is largely for the pleasure of his wife. And faking his own orgasm, as strange as it may sound, was another example of his concern for her sense of sexual self-worth. And in this case, for self-preservation too!/p
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The Truth About Testosterone Levels

Amy — Tue, 20 Oct 2009 12:27:03 +0000

pAs the national election draws near, observers have commented on every aspect of the candidates’ appearance, including raising questions regarding their testosterone (T) levels. One of the more humorous comments circulating is that Sarah Palin, Republican candidate for Vice-President and Governor of Alaska, has more testosterone than any of the other candidates, based on her self-description as a pit-bull with lipstick, and her attacks on the Democratic ticket. And on Salon.com an article written after the Vice-Presidential debate was titled, Joe Biden is made of testosterone and strong verbs./ppSo what is the story with men and testosterone? And for that matter, women and T? Do virility, strength, or aggressiveness really correlate with T levels? Sexuality and sex appeal? Did the fondness of women for the late Paul Newman have anything to do with his T levels, or could it have been his baby blue eyes? And is there any truth to the notion that Sarah Palin, or Hillary Clinton, or any other powerful woman must have higher than normal T levels in order to achieve their success in a man’s world?/ppAs is often the case, biological aspects of T and its effects on masculinity have been overly simplified in the press and elsewhere in order to try to explain social behavior. Testosterone is a hormone produced by the testicles that is responsible for development of the male genitalia during fetal life, is the major hormone involved in male puberty, and maintains male appearance (eg, shaving, muscularity). Major changes in T certainly produce easily observable results. Centuries ago, domestic farmers figured out that castration (removing the testicles) caused males to be more docile, less apt to engage in mating behaviors, and sterile./ppBut what about males of the human species? Do T levels vary much between normal men, and if so, can this translate into behavioral differences?/ppThe answers are yes, and yes./ppBlood concentrations of T may vary normally from about 300 ng/dl to 1000 ng/dl, meaning that a man at the upper end of normal may have 3 times the T concentration as another normal man with T at the low end of normal. In general, T concentrations decline as we age, with a gentle decline in the total testosterone and a much more rapid decline in bioavailable T. Based on age and population-based statistics alone, Barack Obama at 47 years is likely to have bioavailable T levels that are approximately 33% higher than John McCain at 72 years./ppIn general, though, variations in T levels within the normal range are not associated with behavioral or medical changes. Once an adequate level of T is achieved, additional T acts primarily as an excess. So, for example, if we take a man with normal T and normal sex drive, raising his T further will not transform him into a howling sex addict. An important exception, however, is the response of muscle to T, since there appears to be no upper limit to the ability of ever-greater T levels to stimulate more rapid muscle growth and strength. Hence the doping scandals in sports related to testosterone and testosterone-like substances./ppOn the other hand, there are clear changes that happen to men when T levels drop below normal. Testosterone deficiency becomes increasingly common in men as they age, affecting as many as 10-20% of men over the age of 45 years. Symptoms include reduced energy, vigor, and libido, erectile dysfunction, depressed mood, and irritability, and difficulty concentrating. Men with low T may also sustain fractures and lose height due to osteoporosis, and they are at increased risk of developing diabetes. These are important issues for men, and for this reason I believe it is important for men over 40 years to have a baseline T level obtained, whether or not they have symptoms./ppOf course, I have no idea what are the T levels of John McCain or Barack Obama. And observers of the debates can make their own determination as to who appeared more vigorous or virile. But the fun story has to do with Sarah Palin. Women, after all, lack a key part of the male anatomy that manufactures testosterone in large amounts, but they do make small amounts via the ovaries. As a rule, though, women have only a small fraction of the T levels seen in men, even T-deficient men. Regardless of what one thinks of her politics, one has to be impressed with Governor Palin’s willingness to step into the national spotlight and mix it up with the big boys.nbsp;nbsp;Which leads to this biologically and politically incorrect conclusion- The absence of testosterone does not necessarily indicate the absence ofnbsp;balls./p