Mens Health Blog. Medical Blog

In a sense this fragmentary approach is inevitable because love is indefinable, means different things to different people (and even to the same people at different times of their lives) and subtly affects many of the areas of life we have covered.

Mother and child love-Clearly there is a bond of vital importance between a young mammal and its mother, especially in the earliest days and weeks. This is true of human infants, though research into the subject is very difficult to carry out in an ethically acceptable way. But enough work has been done with babies who have been separated from their mothers in

non-experimental situations for us to gauge the effects.

A baby must be cared for in order to survive and, like certain other animals, human mothers are genetically programmed to respond to their new-born offspring’s behaviour. A baby continually tries to attract the mother’s (and later the father’s) attention to make sure that she is aware of his or her needs. As she cares for him or her in response to these needs, she’ll talk to him or her, smile, cuddle and play. In return the baby will stop crying, listen intently, gaze at her face (and eyes in particular), keep quite still or sometimes kick in a certain way, and smile or coo at her.

At around three months, it is clear that the baby recognises his mother. He or she has an extra special smile for her and within a few months will cry when she leaves him or her, or if a stranger approaches. The baby is said at this stage to be ‘attached’ to his mother and treats her in a special way, clearly liking her more than anyone else. He is now in love with her and responds very badly to losing her as his love object. If his mother does not look after him or her, the baby becomes attached to whoever does. Whoever brings them up, babies form an attachment to one person in particular (if given the opportunity to) by between six and twelve months. Babies brought up in institutions by many caretakers can become confused and even emotionally deprived. This is why it is always best for one particular person to be responsible for a baby for much of the time.

It is well known that a baby can become attached to people other than his mother. Babies can, in fact, form multiple attachments. This is obvious, but can be forgotten when one talks in psychological jargon. However many people a baby is attached to, there is always a favourite (usually the mother). If she is not there, someone else will do and the baby will turn to the person next on the list of his own personal hierarchy – it may be his father, sister, granny or nanny, for example. Although they are ‘second best’ in his or her attachment league they are still very important to him or her.

When babies or young children are with several people to whom they are attached, they automatically choose to be with the one they are most attached to. For instance, if a baby is tired or falls over and both his or her mother and nanny are there, he or she will want to be comforted by the mother if he or she is most attached to her. One thing is certain and that is that a stranger will not do. A baby does not become instantly attached to someone new but takes time to get to know them.

It is the emotional aspects of the baby’s attachment experience that are most important and this is true of all love-bonds. One person may take physical care of him or her – feeding, washing and keeping him or her warm, for example – but if another person is the one who mainly reacts in a loving way (even if only for a short time each day), the baby will become attached to that person. Active and responsive interaction with a baby is what counts and sensitive responsiveness to the quality most likely to further attachment. Usually of course, the person who gives a baby this also meets his or her physical needs, besides comforting him through anxiety, fear, illness and tiredness.

It is through a baby’s first love with the person to whom he or she is attached that he or she learns to love other people. The more adequately the emotional needs are met, the better able he or she will be to respond lovingly to others in turn.

A child can become attached (or remain attached) to someone even though he or she may treat him or her very inconsistently or even harshly. This explains why a baby or young child who is sometimes physically or emotionally hurt by the mother will still cling to her when in the company of others. It seems that it is better for children to have someone to be attached to, however he or she treats them, than to have no one special to call their own.

Almost all of this attachment form of love arises because young babies rely totally on their mothers (or other close people) to answer their needs and cravings. This makes it very important, in our view, that such needs are met lovingly, unconditionally and promptly by the attached adult figure, so that the baby thinks well of the world from day one of life. Although it is extremely difficult to prove what the effects of poor mother-baby love are in later life, and there is little doubt that even quite severe harm in this area can be repaired in later childhood, we feel safe in stating that a really responsive, loving relationship must be the best way of starting off life.

It is fairly obvious that babies can either grow up knowing they are loved and loving someone else or they can grow up with feelings of anger, resentment, frustration and sadness because they have not experienced such love. This is a totally dependent form of love and one which most people can easily understand. It also raises another important concept when discussing love and that is caring.

One way in which we can recognise love (even if we cannot define it) is to watch people’s behaviour. This shows that whatever they love, they care for. It matters to them what happens to it. They are prepared to make sacrifices for it. They jealously guard it in the face of threats and they want the best for it. So it is with mother-love. A mother knows all these feelings and recognises them as a part of the complex emotion, we call love. The baby cannot, of course, realise such things but knows, even before he can express himself, what love means to him.

Every love experience in life to some extent takes us back to our first childhood experience. Indeed, it is the very aspect of love that many people find so difficult. In every adult loving relationship there are seeds of child-like love, yet many adults fight them, thinking that adult love, linked as it so often is to genitality, is something apart.

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Prolapse-The womb can also fall down into the vagina and in some cases can appear at the opening of the vagina. There are several reasons for a prolapse. A few women have weak supports to the womb from their birth. Others have their natural support mechanisms severely weakened by childbirth, lifting heavy weights, or by repeated straining to pass hard bowel motions. There is a swelling and a sense of fullness in the vagina and the womb feels as though something is coming down inside. There are often urinary symptoms, backache, heavy periods or a discharge. If you have any of these in combination see your doctor at once.

Smoking-In addition to the well known risks of lung cancer and diseases of the blood vessels women smokers are said to be more hairy and more prone to cystic ovaries, infertility and ectopic pregnancy. Also, if pregnant, smoking and alcohol are known to endanger the child.

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When asked if AIDS has altered their sexual behaviour people in the UK tend to say ‘no’ but the evidence says otherwise. According to Virgin Healthcare, condom sales had been increasing by 4-5 per cent a year but in 1986 increased by 20 per cent. Hepatitis B virus is transmitted in very similar ways to HIV and in 1987 only 800 cases were notified – the lowest figure since statistics were first collected in 1974. Methods used to make sex safer also reduce the chances of getting syphilis or gonorrhoea. Expressed as a percentage of all new cases these two diseases have fallen from 16 per cent in 1976 to 7 per cent in 1986

Further sources of information

• Local health education department

• Local sexually transmitted disease clinic

• Special AIDS line 0800-555777

• Healthline telephone service: 01-981-2717, 01-980-7222, 0345-581-151

• Health Education Authority, 78 New Oxford Street, London wcia iah, 01-631-0930

• The Terrence Higgins Trust, BM/AIDS, London wcin 3XX Helpline 01-833-2971 (7 pm-10 pm everyday)

• The Haemophilia Society, PO Box 9, 16 Trinity Street, London SEI TDEOI-407-IOIO

• SCODA (Standing Conference on Drug Abuse), 1-4 Hatton Place, London ecin 8nd

• Welsh AIDS Campaign, 0222-464121

• Scottish Aids Monitor 031-558-1167

• Northern Ireland AIDS Line, Belfast 0232-226117

• Foundation of AIDS Counselling, Treatment and Support (FACTS)

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Let us now look at the sexually transmitted diseases in turn. But before doing so let us consider vaginal discharges because they can cause such confusion and worry.

Vaginal discharge-The normal, healthy vagina produces a whitish secretion with a characteristic odour. The amount of this fluid produced varies considerably from day to day and with the stage of the menstrual cycle. This discharge is different from the lubrication which occurs during sexual arousal, when all healthy women produce clear fluid. Normal vaginal secretions have a very characteristic smell which turns many men on sexually. Unfortunately, the advertising industry has done its best to portray the vagina as needing frequent cleaning and many women believe they should wash out their vagina with a douche, on a bidet, or mask their natural odour with deodorants. None of these is necessary. Simply wash the outside regularly and leave the inside to take care of itself. If you think you have too much of the normal secretions, or if the secretion smells unpleasant or makes you itch.

Two common diseases produce a vaginal discharge. One is thrush (moniliasis or candidiasis) and the other trichomoniasis.

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What should we do if the children burst in when we’re making love?

This depends on the age of the child. Babies and toddlers cannot be expected to look after themselves safely so you cannot make love when they are awake anyway. Pre-school children may have to have some attention paid to them before you ask them to go and play while you cuddle, but older children can be handled more firmly and kindly. Very young children can mistake a man on top of a woman as an act of brutality, especially if she is noisy when having orgasms. Older children who know that you are having sex can be quietly and firmly asked to go because you are making love.

Most parents are embarrassed, shocked or angry but this is not the child’s fault. If you are likely to react in this way lock the door beforehand so that you don’t take your feelings out on the child. Explain as soon as you can afterwards why you were cross and don’t make him or her feel bad about it.

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Test results can show no antibodies to HIV (a negative result) or enough antibodies to indicate a positive result for HIV. However, there may also be some reactivity on this test but not enough to indicate infection. There are two possible explanations: a person may be newly infected but not yet have formed a full panel of antibody, or a person may not be infected. These partially reactive Western blot results are referred to as indeterminate. A repeat test a few months after the first test will help distinguish between the two scenarios. If a person is newly infected and shows an indeterminate Western blot result, then eventually he or she should show a true positive result on the test. If the test is reactive for some other reason, then it may show indeterminate pattern indefinitely or swing back and forth between a negative result and an indeterminate result. These results are sometimes confusing, even to health care providers, so make sure you receive an explanation of any test results. Clinics that perform many HIV tests (either STD clinics or health department STD clinics or health department STD enough to you.

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If a person has been exposed to someone who has been infected with hepatitis A and may have been infected but has not yet shown symptoms, there is something that can be done. This person can receive the hepatitis A vaccine for future protection and also receive an immune globulin shot, which will provide shorter-term protection against infection about 80-90 percent of the time. (Immune globulin is composed of antibodies to the hepatitis A virus as well as to other infections, which can help to fight off the infection before the person’s own immune system kicks in to combat it.) To be effective, an immune globulin injection must be given within two weeks following the exposure.

The immune globulin injection can also be given to persons traveling to areas where hepatitis A is common and who have not received the vaccine, or in whom the vaccine has not had sufficient time to work. Since the vaccine takes more than two weeks to be effective, immune globulin would be the choice for a person who within two weeks would be traveling to a country with a high risk for infection. Immune globulin has limited effectiveness, however, probably losing its ability to offer protection within three months of the injection.

There is a low risk of problems, such as allergic reactions, from the immune globulin injection. It is usually more painful than the hepatitis A vaccine. Immune globulin is pooled from donated blood; it is screened for hepatitis B and C and human immunodeficiency vims (HIV) infection and routinely treated with chemicals to kill these viruses. It presents a very low risk of transmission of these infections: no cases of transmission of hepatitis B or C or HIV have been reported to date from the immune globulin shot.

It is as safe for pregnant and nursing women, children, and immunosuppressed individuals as for the rest of the population.

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As many as half of the women with BV have no noticeable symptoms, and the diagnosis is often made when a woman has a routine gynecological examination or an examination for other reasons. If BV does produce symptoms, they are often subtle and include a thin white to gray discharge from the vagina and a “fishy” odor. The odor is stronger after sexual intercourse and during a period. BV does not cause inflammation of the vagina or labia but frequently.

Despite its mild symptoms, BV can cause serious complications when a woman who has the infection undergoes an invasive procedure such as an abortion, a biopsy of the endometrium (the lining of the uterus), placement of an IUD, or hysterosalpingography (a procedure in which dye is inserted into the uterus and Fallopian tubes to help visualize abnormalities). Although BV usually does not cause infection above the vagina, under these circumstances it can cause infection higher up, in the cervix or uterus, which can result in pelvic inflammatory disease (PID). (See the section on pelvic inflammatory disease.) Any woman who has BV whether or not it is symptomatic, should be treated for the infection before having an abortion.

BV has also recently been associated with several complications of pregnancy, including preterm delivery, delivery of a low-birth-weight may cause mild itching. These symptoms may cause more psychological than physical stress, especially if the infection recurs infant, premature rupture of membranes, premature labor, and infection of the uterus and amniotic fluid. Between 12 and 22 percent of pregnant women have By so many women and infants are potentially at risk. Many specialists recommend treating the infection in pregnant women, particularly those who are in the high-risk category and have delivered a premature infant in the past.

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The anal area and buttocks will be examined for any rashes, bumps, or sores. If there are symptoms in the anal area, or if the woman has diarrhea or evidence of infection on examination, then the area may be wiped with a swab to collect a sample for testing. If a woman has received anal intercourse, then swabs may be taken to rule out gonorrhea and chlamydia, whether or not she has symptoms. If a woman has diarrhea, a stool sample may be obtained to test for evidence of intestinal infections.

An anal examination is an important part of the check-up. Even if a woman has never received anal intercourse, certain STDs, such as warts and herpes, can reveal signs of infection in the anal area. If a woman has a gonorrhea infection in the cervix, for example, the anal area can become infected from secretions, even if she has not received anal sex.

If the woman has diarrhea or anal symptoms, a procedure called an anoscopy may be performed. This involves inserting a small plastic speculum into the anal area to look for changes in the lining of the rectum or for skin lesions such as warts. This is not a routine part of the examination if a woman is without symptoms in this area.

A rectal examination may be performed. In this procedure, the health care provider inserts a gloved, lubricated finger into the anal area to feel for masses or bumps.

6. A bimanual examination will be performed. In this procedure, the health care provider inserts one or two gloved, lubricated fingers into the vagina to feel the cervix, and then gently presses on the pelvic area with the other hand to feel the shape and contour of the uterus and ovaries. In this way, any swelling or tenderness of these organs can be detected. This part of the examination is important in detecting pelvic inflammatory disease.

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The easy answer is that semen is the ejaculate. It consists of sperm plus the secretions from the sex accessory tissues (these include the prostate and seminal vesicles), and is composed of prostaglandins, spermine, fructose, glucose, citric acid, zinc, proteins, and enzymes such as immunoglobulins, proteases, esterases, and phosphatase. Less than i percent of semen comes from other reproductive organs such as the testes and epididymis, which produce sperm.

Semen is not merely sperm; sperm is just a tiny fraction of the seminal fluid. So why the other secretions? In some mammals, sperm removed from the epididymis—having never made contact with secretions from the prostate and seminal vesicles—has proved capable of fertilizing an egg. Many scientists believe the varied secretions that make up semen are there as a buffer, to help sperm survive and remain active, to encourage sperm’s passage in the male and female reproductive tracts, and to minimize environmental shock during intercourse. The presence of sugars such as fructose and glucose may be there to nourish the sperm, to provide energy for sperm’s metabolism on its journey.

And still other secretory products—the zinc, for example, and proteases and immunoglobulins—may exist as disease fighters that cleanse the urethra, repulsing attack by harmful substances in the body that enter the urinary tract.

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