WNHO SEXOLOGY INSTITUTE OF PUNE, INDIA
Indian Society of Sex Medicine with collaboration of Institute of Complementary Medicine & IBCM PG Diploma & Certificate course, Pune. India.This Course is run under Govt Certified Startup DIPP NO3274 WNHO Health Care PVT.Ltd, Pune.
Dear Member,
On behalf of our President, and the Educational Committee of the IBCM International Board of complementary Medicine we invite you to apply for the ISSM School of Sexual Medicine programed. Only for qualified doctors & counselors.
1day/3day/10 days therapy training course.
Three day – Practical training PG certificate training in Sexology therapy……….. Rs.50.000/ For Doctors
Three day – Practical training PG certificate training in Sexology counselling … Rs. 50,000/ For Counselors.
Three Days- PG Diploma Course certificate training in Sexual Medicine therapy. Rs. 50,000/ for doctors Three Days-
Ten days Detail Fellowship Certificate Course in Sexual Medicine……………..Rs..50,000/ equivalence to PHD. Only for Doctors only and registered medical practitioners. + 18% GST
The application is available here: www.wnhohealthcare.com
Government Certified Startup Wnho Health Care Pvt.Ltd
For further information, please e-mail the Programme Directors drrameshm2@gmail.com/ wnhohealthcarepvt.ltd@gmail.com.
Background
The ISSM School of Sexual Medicine was a joint venture established by the IBCM – Intentional Board of Complementary Medicine & Institute of Complementary Medicine, Pune.
Our programmed is intended for clinicians seeking to acquire the knowledge and skills essential for practice in Sexual Medicine and Clinical Sexology.
Medically-qualified participants should find the programmer helpful when preparing for the Fellowship of the Sexual Medicine.
Psychologists will also find the program helpful for qualification as Psycho sexologist.
Programmed & Requirements
The Programmed is intended for persons with post-graduate experience in any relevant clinical specialism. Interest in and enthusiasm for Sexual Medicine are the essential qualifications; whilst previous experience in the clinical practice of Sexual Medicine is an advantage, the programmed is also suitable for those starting out in this fascinating and rapidly developing area of medicine.
All sessions during the programmed will be conducted in the English language; participative learning techniques for skill development will be used, as well as interactive teaching.
There will be practical training in Sexual Medicine consultation techniques and history-taking, and in the basic use of sex therapy techniques in Clinical Sexology.
The academic programmed will include
•sexual development
•psychology and physiology of sexual desire, arousal and response
•impact of gender on sexuality
•ageing and sexuality
•sexual dysfunctions in men and women
•problematic sexual behavior
•gender identity disorders
•impact of medical treatments and other health problems on sexuality
•clinical skills in Sexual Medicine
•clinical management of sexual disorders
•genital anatomy.
•ethical and legal aspects of Sexual Medicine
•standards of care in Sexual Medicine.
Hands on Training for PRP Growth Hormone for Penile Enlargement & Shock wave therapy
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Squeeze Technique In Premature Ejaculation
II PHARMACOLOGICALThe first choice as mentioned before is behavioral but pharmacotherapy can be concurrently used for better results.1. ANAESTHETIC AGENTSExcessive sensitivity of the penis especially the glans has been thought to be one of the causes of premature ejaculation. Local anesthetics have been used with the intention of reducing sensory input from the penis thereby delaying ejaculation. RETARDED EJACULATIONRetarded ejaculation is defined as the man being able to ejaculate only after what seems to him to be an ‘excessive’ period of time. It is usually reported when the man requires ½ an hour or more of vigorous coital thrusting. It is interesting to note that most of these men do not seem to have any difficulties with erection but sometimes seems to hold them back and they are unable to trigger the ejaculatory reflex at the proper time. This is a very common symptom in men who are regular abusers of recreational drugs or alcohol. The usual story from the couple is that the woman becomes weary and uninterested ones she has had her orgasm and the man becomes tried, exhausted and fatigue which is frustrating for the couple.TREATMENTA three steps process is useful in treating delayed ejaculation.-Teaching masturbating to the point of ejaculation as a solo activity.-Masturbation to the point of ejaculation with a partner.-Finally, coital connection with ejaculation to be established.This is easier said than done and the following aspects have to be considered.-Allay fears, anxieties and myths about masturbating in both partners.-Liberal use of lubricating jelly during masturbation.-Mechanical means of stimulation with vibrators is useful stimulation which should initially be used for short periods.-Encouragement of the partner to stimulate the penis with sufficient force and speed as many men use vigorous stimulation which the female may not understand. -Use of fantasy to evoke psychological stimulus as many men ‘use’ only mechanical arousal methods.-Those who cannot fantasies, could be advised to use erotic videos.-Drugs like midodrine may help.
Sexual problems in illness and after surgery
Angina after myocardial infarction:
Sexual activity can be resumed as part of general programed of increasing or graded physical activity. Although the timing of resumption will depend upon the severity of damage, 3-4 weeks after an uncomplicated attack is generally considered appropriate.
In the initial stages female superior position may be advisable. In any case too vigorous activity must be avoided.
Sex should be avoided after heavy indulgence in alcohol or food.
The room should be warm.
If angina occurs with moderate physical activity or stress, prophylactic pre-sexual nitrates may be helpful.
Note: For some patients it may be necessary to have objective method of measuring cardiac parameter during the sex act.
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PREMATURE EJACULATION
Definition:
Presistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.
It has been difficult to define ‘Premature ejaculation ‘ since there is a great variation in physiology of ejaculation. International Society for Sexual Medicine (ISSM) has defined (PE) as “Ejaculation in less than 60 seconds from start of intercourse.
PE is seen in young men from their first attempt at intercourse. Later they acquire ability to delay the orgasm after a adequate function. PE can create tension in relationship. Wife’s estimate of duration of time from the beginning of intercourse until ejaculation , as well as her judgment of whether PE is a problem, can be quite misleading. PE can create tension in relationship.
Patients may misinterpret secretion from bulbo-urethral glands as semen and label himself suffering from P.E. Some may see prolonged period of intercourse in blue flims and feel it as standard. Some may think that anything short of ability to prolong till wife’s orgasm is PE. Some think duration mentioned by friend is normal. Patient try their own way to prolong the period by diverting attention, pinching self, using a condom during the intercourse, drinking alcohol or masturbating prior to intercourse. All these are found to be unproductive techniques. In attempting to control orgasm, man is distracting himself from stimulation of touch and arousal, and he fails to enjoy his sexual feelings and may lose erection. Therefore emphasis should be on increasing penile stimulation and not avoiding it.
Causes:
Anxiety. Hurried sexual experience.Excessive sensitivity of glans.Rapid ejaculatory reflex. Fear of losing erection. Prolonged abstinence. Fear of detection.
Treatment:
Counseling:
Counseling of Couple is done. It is emphasized that problem is not in genitals, problem is in the brain.
Sex Therapy:
It is based on systemic desensitization to bring about behavioral modification.
Posted by Dr. Ramesh Maheshwari, Wnho Clinic, 2014 sadashiv peth, Tilak road, Pune. Free to call for further information.
FELLOWSHIP COURSE IN SEXOLOGY BY WNHO PUNE INDIA. CALL 08048890517/ 9822006427.
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WHAT MAN / WOMAN WANTS?
“The ignorance of women physiology which prevails among most men is boundless and incredible’’
“Honesty is probably the sexiest thing a man cans give to woman”
Debra Messing
An individual lives as a man or as a woman. It is difficult for a man to understand the sexuality of women and vice versa. A man feels that her sexual pleasure is as his. In reality is a lot of difference between the two. Her anatomy hormones and conditioning are responsible for the difference. Till recent times (1976)women never talked about their sexual pleasure. Therefore myths continued to exist.
What Man feels?
“A woman has ten times sex desire than that of a man’’
“To satisfy her,he should have frequent sex with her’’
“She needs a long duration of sex for her sexual satisfaction’’
“If not fully satisfied, she may seek extra marital relationship.’’
“She gets orgasm in her vagina by friction of penis’’
“Man needs to have a thick and long penis for her satisfaction”
“The first experience of sex is very sensational for both.”
“Women is dependent upon man or her orgasm”
“During masturbation the woman puts a long object in her vagina”
“Sex with a virgin woman gives extra a sexual pleasure.”
The facts are:
In man there is no homologous organ like vagina. The biggest misconception is that the women gets erotic vagina. If man were to have vagina, its opening would be 1 inch in front of the anus on the median scrotal raphe. Though the touch sensation is present, it is not as erotic as the touch of glands. This touch can be felt up to one inch deep in the vagina. Beyond that the vagina is insensitive, since it is developed from Endoderm. A woman does not put any long object in her vagina. During masturbating, she stimulates her clitoris and inner side of labia minora.
In man the organ of pleasure and of intercourse is one and the same i.e. penis. In woman, the organ of pleasure is clitoris and the organ of intercourse is vagina. She can have erotic pleasure by stimulating clitoris and without indulging in intercourse. During the intercourse the penis does not touch the clitoris and therefore she does not get the orgasm by vaginal stimulation. A woman, unlike man , self – sufficient for erotic pleasure. Secondly she is devoid of testosterone, a sex-desire stimulating hormone. The hormones present in her are for menstruation, pregnancy, delivery and lactation. For these reasons, woman does not seek sexual pleasure from extra-marital relationship.
Nymphomaniacs, Gigolos and male sex workers are rare to find. A virgin woman is ignorant and inexperienced in the matter of sexual activities. Such woman generally has fear of pain during vaginal penetration.
Frist night after the wedding is also disappointing since both husband and wife are novice, ignorant and inexperienced about sexual act. In general, the woman is not interested in intercourse as much as he is. For her, intercourse is one way of pleasing the person whom she loves. For man it is something ‘taking’ and for woman it is something ‘giving’. For man, it is final goal for woman it is means of achieving the goal. Unlike man, a woman can survive without sexual stimulation for years.
What woman feels?(woman’s sexual needs)
Woman complains that :
“He makes a lot of haste during the sexual act”
“He does not indulge in sufficient foreplay”
“The foreplay is routine and mechanical”
“He is not romantic”
“As soon as he reaches climax, he turns his face and goes to sleep”
“He leaves me half way”
“He is very selfish in the matter of sex”
“He uses me like a sleeping pill”
“He is interested in nothing else but intercourse”
“He is very rough. I expect him to be slow, soft, honest, and faithfuland spend more time in loving each other.”
“He feels that I should be ready for sex as and when he desires. He never cares for my mood.”
“It is he who decides when, how long how often and in what way to perform sex.”
“I wonder why he goes after other women in spite of providing him everything he desires”
What the Researchers say?Shere Hite:
“Lying on the back and stimulating the clitoral area with hand gives satisfaction physically, but not psychologically. The difference between this and sex with a partner is that the intense heat of another body is missing, plus the stimulation of the other parts of the body. But, Masturbation you can do alone, quickly and you are sure of an orgasm”.
“Majority of woman do not experience orgasm as a result of intercourse”.
“Intercourse is not a reliable way to orgasm”
“Intercourse with or without orgasm is more fulfilling than orgasm without intercourse”
“Affections and closeness were the basic reasons for liking the intercourse, rarely mentioning the orgasm”
“Women have a different arousal system than men. Their arousal is a total body response, rather thana genital one “
“The sequence foreplay, penetration and intercourse followed by male orgasm and end of sequence, is always under the control of man, gives no chance for female orgasm, but teases the women inhumanly”
“Sex is an Activity engaged in by two for the satisfaction of one.”
What Indian women say?
“It is true that woman has more desire for sex. Unlike men, women do not seek extramarital relationship. She will sacrifice everything only for being loved by her husband”
“For sexual pleasure women is not dependent upon man. Her concept of sexual pleasure can be different than that of man”
“Women do not have sex desire as much as men have; otherwise there would have been dens of male sex workers.”
“Intercourse is necessary for fertility but not for woman’s sexual pleasure”
It seems Mother Nature has dissociated the instinct for propagation of life into two components. Majority of pleasure component is given to the male and majority of fertility component is given to the female.
Posted by Dr. Ramesh Maheshwari, Wnho Clinic, 2014 sadashiv peth, Tilak road, Pune. Free to call for further information.
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MYTHS & MISCONCEPTIONS
MYTHS & MISCONCEPTIONS
Causes
Sexuality is related to obscenity or vulgarity. Therefore there is secrecy. Nobody talks about it openly though there is tremendous curiosity, especially during the adolescence and youth. Secrecy leads to ignorance. They turn to their friends for information, who are equally ignorant and may provide misinformation. Since they cannot dare to ask their parents or teachers, they try it through pornographic literature. They expect quacks to solve their problems. Myths and misconceptions gathered are propagated from generations to generations.
Effects
Many myths are responsible for
Fear, Anxiety, depression
Guilt feeling, Poor self esteem
Over expectations
Sexual dysfunctions
Marital disharmony, conflict, divorce
Suicide
Victimization by quacks
Some of the common myths are mentioned below in italics, followed by their scientific explanations:
Penis
Men can will an erection
No. Erection is controlled by parasympathetic part of autonomic nervous system. Like salivation and perspiration, erection is a situational reflex. Therefore sensate focus is the most important factor for getting erection.
To satisfy a woman, the man needs a long, thick and straight penis.
No. Like the shape of the nose, each penis is different. As a long and big nose does not improve the smell of a rose, A long and thick penis is not required for the pleasure of the self or of the woman. Penis is never straight like the railway signal. In some, it has a shape of banana. Vagina accommodates any shape of penis. Since the length of the vagina is 3.5 inches and only outer one inch is sensitive to touch, any erect penis over 1 inch in length is sufficient.
Testes
Both the testes should be at the same level. Using tight underwear (Langot) prevents hydrocele and hernia.
No, the left testis is usually at a lower level, for some anatomical reasons. If the testes are brought near the body by using tight underwear, their temperature rises and adversely affects the formation of sperms.
Semen
Semen is a precious fluid.
No, semen is like any other secretion to be thrown out of body. Semen is a mixture of secretions from prostate, seminal vesicles and bulbuo-urethral glands plus sperms. Semen provides nutrition, helps motility and acts as a vehicle for the transport of sperms.
Losing Dhaat in sleep or passing it in urine is a disease.
Passing semen Dhaat in sleep is known as wet dreams or nocturnal emission. This is a normal event and a sign of puberty, the beginning of adolescence. It also proves that the reproductive system has started functioning. When the reproductive glands are full with secretions and person gets a sensuous dream, like escape of steam from the cooker,he ejaculates in sleep. This does not cause weakness or loss of vitality.
The sphincter of urinary bladder closes during ejaculation. Therefore, semen cannot be mixed with urine. If prostration secretion accumulates in the urethra at night the individual will see milky white secretion of prostate while passing urine next morning. This is physiological. Passing phosphates in the urine is sometimes mistaken for semen.
Losing semen through masturbation does not cause not any harm. Masturbation is not a bad habit. It cannot be overdone, since it is controlled by autonomic nervous system. The frequency of masturbation depends upon the hormone, testosterone and the secretions of reproductive glands. Those who have never masturbated since puberty, the ejaculatory reflex do not work after the marriage and hence the man cannot father a child.
Masturbation does not cause pimples, weakness, impotence or any other disease. It does not bend the penis. Masturbation or nocturnal emissions are inversely proportional to each other.
Not only young people but married persons, old people and the females also masturbate.
It is not the loss of semen, masturbation or wet dreams that harm a person, but the anxiety and fear about it harm him.
VAGINA.
Presence of hymen is the surest test for virginity.
No. There is no surest test for proving virginity. A woman may or may not bleed from her vagina at the first intercourse after marriage; even then she could be a virgin. Sports, cycling, horse riding or exercise can be responsible for the tear of the hymen. Hymen, if lax, can remain intact even after the child birth.
Hymen is a vestigial structure formed at the junction of external and internal genitals during the embryonic life. It may or may not be present at birth. Character is in the mind and not in the genitals. Secondly, there is a double standard for virginity. Man takes pride in mentioning about the number of women with whom he had sex. Such man deserves no right to ask his wife about premarital sex.
Vagina is a sensuous organ. Woman gets orgasm by stimulation of vagina.
No. Like esophagus, vagina is developed from endoderm and therefore there is no sensation in vaginal barrel. Vaginal orgasm is a myth. Orgasm in a woman is always clitoral in origin. Clitoris is the homologous organ of penis. The area of vestibule and the outer inch of vagina is developed from ectoderm and hence it is erotically sensitive to touch; only next to clitoris.
There is no homologous organ like vagina in man. If men were to have vagina the site of opening would be on the median scrotal raphe, one inch in front of the anus. Vagina is considered as the organ of honor and character. However, physiologically, vagina is a passage for the menstrual flow and baby to outside it is the side of sensuous pleasure for male, where gets maximum erection that terminates in ejaculation for fertility.
MENSTRUATION
Bad blood is passed out menstruation. Woman becomes impure during menstruation.
Menarche (beginning of menstruation) is the first indication that girl has been promoted to become a woman, Every month the inner lining of the wall of the uterus becomes thickened and engorged with blood vessels and mucus glands, ready to nourish the fertilized egg. If the egg is not fertilized, this lining breaks down and is discharged with little blood and mucus through the vagina. This is menstruation. Neither the blood is bad, nor does the woman become impure. A woman can lead a normal and usual life during menstruation.
Breasts
Small breasts produce less of milk. Their size can be augmented by hormones/ massage.
The size of breast has no relation to the production of milk in it.. Even a small breast can produce enough of milk breast- feeding. The size of the breast depends upon the amount of fatty tissue in it.
Massage or hormones do not help in increasing the size. For aesthetic reasons, silicon gel implant or fatty tissues injection can help in augmentation of the size of breast. The simplest way is to use a padded bra.
Having unequal size of the breast is a normal variation and does not need any treatment.
INTERCOURSE
The first wedding night is the most sensuous and the most memorable experience. Sex with a virgin woman gives maximum pleasure.
No.A virgin woman being a novice may not be able to enjoy sex herself. In fact, love, caring and sharing with the partner is needed. She inhibitions, feel relaxed,establish a loving relationship with partner, engage in foreplay, and then only she will be able to enjoy herself and herself and give the pleasure of sex to him. On the first wedding night,though the expectations are high, both being ignorant about the genitals, having pressure of performance and fear of failure, the intercourse may be unsuccessful and both may disappointed.
My friend says that he performs three times every night and each times he lasts for half an hour.
He is exaggerating his performance. Researchers have proved that the duration of intercourse from the time of penetration to the time of ejaculation is 1 to 3 minutes. The frequency becomes less and less. However, frequency and duration varies from person to person. For fertility it should be daily or on alternate days especially during the sexual performance is controlled by autonomic nervous system. Man cannot will an erection. If he tries to imitate his friend, nature does not cooperate and he may not be able to get an erection as he desires.
Simultaneous orgasm of the two is necessary for pregnancy.
No, It is not possible, since every individual has /her own speed. However, women should have orgasm prior to man’s, either by manual stimulation of clitoris or by ‘woman-on-top position. Simultaneous orgasm is not necessary for the pregnancy to occur. A woman is capable of becoming pregnant even without having an orgasm.
Sex during menstruation and oral-genital sex are harmful
There is no medical evidence to prove that sex during menstruation or oral genitals sex is harmful, provided:
1. The mouth and the genitals are cleaned before the act
He/she has no dislike or objection to it.
Intercourse causes weakness or objection to it.
Intercourse causes weakness. Sex tonic improves theperformance
During the intercourse, the tension in the muscles rises. This is followed by fatigue which recovers in a day. There is nothing like ‘sex tonic’. Masters and Johnson used to say “Sound health, interested and interesting partner is the best sex tonic.
Hysterectomy/ menopause is the end of sex life.
No. individuals can indulge in sex till the end of life. ‘Use it, or lose it’ is the rule applicable to it. Those who have regular sexual outlet do not find any discomfort or pain during sex.
Homosexuality
Homosexuality is abnormal. A Homosexual can be identified.
A homosexual is normal in every respect except that his sexual orientation is different. There are 4% of male and 2 to 3% of female homosexuals in any society. No definite cause has been found. A homosexual cannot be identified by his look or behavior.
Infertility
Woman is always responsible for infertility in the couple.
In 40 to 50 percent of the couples, man is responsible for infertility.
The female is responsible for giving birth to male or female child
Male is responsible. It depends on the sex chromosome that fertilizes the egg,
If the sperm containing Y sex chromosome fertilize the egg, it will be a boy, and if X sex chromosome fertilizes. It will be a girl.
However, this too is not under his control, Whatever the outcome is one has to accept and love the child.
Family Planning
Pill causes cancer, Coper T leads to profuse menstruation, Papaya causes abortion, and vasectomy leads to impotence.
All these are myths. Pill contains minimum amount of hormones. Numerous studies done on the usage of pill show that it does not causes cancer. Coper T may cause little excessive menstrual flow in some cases that too initially only. Papaya or any other food stuff or hormone injection does not cause abortion. Manual vacuum aspiration is the only way (up to 6 weeks) for the termination of pregnancy. Vasectomy does not interfere with person sexual desire, erection or sexual performance. The quantity of semen also remains as before only that it does not contain sperms.
STI/ HIV/ AIDS
A Person using public toilet, using cloths of the patient or touching him, is liable to get STI or HIV infection
NO. These diseases are transmitted through sexual contact. The germs of these diseases do not thrive in open. Using the public toilet, using the clothes or utensils used by the patient cannot transmit these diseases.
Miscellaneous
A female has ten times the sex desire than that in the male
No. the hormone responsible for the sex desire testosterone is more abundant in the male than in the female. She is interest in love, caring and sharing than in intercourse. For that reason there are no male sex workers to service the females.
Hysteria is the female is due to sex starvation. Marriage is the solution
Hysteria is a psychological disorder sex starvation does not cause any disease. Marriage in such a mental state complicates the problem.
Blood group of both should be matched before marriage.
Blood groups need not be matched, but the compatibility of Rh factor in blood of both should be examined. If the female is Rh negative and male is Rh negative, then the second child of this couple may get jaundice and may not survive. To avoid this Rh negative female is given Anti D immunoglobulin injection immediately after first delivery (or after abortion).
Posted by Dr. Ramesh Maheshwari, Wnho Clinic, 2014 sadashiv peth, Tilak road, Pune. Free to call for further information.
Medico Legal Aspects of Sex Therapy
POINTS TO BEAR IN MIND· All forms of sex therapy which violate the local laws should be handled with care recommending oral sex as a part of therapy is violative of section 377 of the indian penal code which deal with unnatural sexual offences.· The Hippocratic oath forbids the physician to take advantage of the therapeutic context in order to engage in either homosexual or heterosexual relationship.· It is a universal rule that whenever dealing with reproductive functions is involved, express consent of both the spouses should be obtained. · Proof of competence is the ability to provide objective and responsible services to the clients.· There does exist a potential liability under the laws of the land prohibiting consensual conduct such as prostitution, fornication, lewd and lascivious behaviour and adultery which might arise from therapeutic or non- therapeutic sex research activities.· Sex between therapist and client is always unethical. No matter how therapeutic the rationale might appear, there is no justification for a therapist having sex with a client. The purpose of sex therapy is to improve function, not to change values or beliefs of the client.
(Mutual Pleasuring by touching)
Basis
Touch is a vital of personal human communication.
Tenderness, affection, solace, understanding, desire, warmth, comfort, any feeling can be conveyed to the partner by touching. Thus a fullness of sexual expression can be achieved.
No goal orientation
Elimination of pressure of performance and hence fear of failure.
Procedure: Both the partners are equally involved. The entire act should be slow, steady and full of love and understanding. There should be no time limit.
Step1
Both the partners take off their clothes
One partner (either one)gives experience of pleasurable touching to the other; massages or fondles the other
A soothing lotion is used for application
The Getting partner gives verbal/nonverbal directions about preferences for the location and the intensity of touching
The giving partner provides pleasure accordingly to the getting partner
The getting partner should inform the giving partner if anything is unpleasant, irritating or distracting
Both should think and feel sensuously
Avoid touching the breasts and genitals at this stage
The couple should Not proceed to intercourse
The entire procedure is reciprocated by the other partner
The procedure is repeated daily for 3-4 days.
Step 2
The previous procedure is repeated by both the partner
They proceed to the touching the breasts and genital
The couple should Not proceed to intercourse
Touching is reciprocated by the other partner
This is repeated daily for next 3- 4 days.
Step 3
Touching is done to each other by both in a simultaneous and mutual way.
Note: In Indian situation, Sensate Focus Exercise can be done by taking bath together and using oil for massage, provided there is availability of enough of water and privacy.
Posted by Dr. Ramesh Maheshwari, Wnho Clinic, 2014 sadashiv peth, Tilak road, Pune. Free to call for further information.
