Headaches

Headaches are a common problem and can sometimes indicate other conditions. We look at the causes and treatments to help you.

What is a headache?

Headaches involve mild to severe pain in one or more parts of the head as well as the back of the neck.

There are many different types of headache, with different patterns of pain and other related symptoms, and a variety of causes.

While painful and annoying, the majority of headaches are not a sign of a serious disorder and, if they are not a persistent problem, may be relieved by simple medicines and/or changes in lifestyle.

What causes headaches?

There is no single cause of headaches. A number of causes have been identified which fall into two general categories.

Tension headache

This type of headache results from contraction of head and neck muscles.

It is the most common form of headache and accounts for 70 per cent of headaches.

It can occur in people of either sex and at any age, but it's most common in adults and adolescents.

Tension headache usually occurs in isolated incidents but can become chronic for some people.

Possible causes of muscle contraction associated with tension headaches include:

• stress
• fatigue
• poor posture
• eye strain
• sensory overstimulation – loud noise, bright sunshine etc
• tobacco and alcohol use
• in women, hormonal changes occurring before and after a menstrual period.

Migraine headache

Migraine is the cause of 20 per cent of all headaches.
The underlying problem that leads to migraines is still not clear but several theories exist.
They are probably the result of a series of complex changes in the nerves, blood vessels and chemical signalling within the brain.
Migraine is usually experienced as a throbbing pain on one side of the head with an associated feeling of sickness and sensitivity to light and sound. However there are various types of migraine. The main ones are the following.

• Migraine with aura: an aura is a warning symptom or sign that develops before the headache itself. Auras include flashing lights and visual changes, and neck stiffness. One in three people with migraine have auras.
• Migraine without aura.
• Migraine without headache. Although migraines are a type of headache, some people find they get all the other symptoms, especially an aura but no headache develops.

Migraines are known to affect more women than men and are often chronic. In extreme cases they may totally disrupt a person's daily life.
Below are some of the factors that have been identified as being associated with migraines:

• family history of migraine
• prolonged muscle tension and stress
• alcohol use
• smoking or exposure to tobacco smoke
• lack of sleep
• for women, menstrual periods and the use of oral contraceptives
• certain foods such as chocolate, nuts and fermented or pickled condiments, as well as foods containing the amino acid tyramine (aged cheese, red wine, smoked fish) and foods containing preservatives and artificial sweeteners are linked to migraine. It was thought they might contain chemicals that could trigger a migraine, but other research suggests that one of the early symptoms of a migraine might be a craving for foods such as these.

What are the symptoms of tension and migraine headaches?

Tension headache

• Pain is often felt in the generalised area of the head and neck as opposed to on one side.
• Pain may also be situated in the back of the head and neck and feel like a 'tight band'.
• Sometimes accompanied by muscle tightness in back of neck.
• Of relatively short duration if treated in time.

Migraine headache

Migraines tend to follow five stages.

• A prodromal stage: this comes before the headache (often hours or even days before) and varies from person to person. Prodromal symptoms include generally feeling unwell, low mood, extremely tired, changes in appetite, craving certain foods, yawning and temperature changes in the extremities (such as hot ears or a cold nose). Many people with long standing migraine can recognise their prodromal stage even if they can't fully describe what they feel is wrong.
• Aura: about one in three people get an aura – a warning symptom just before the headache starts which lasts 10 to 15 minutes. These aura often include visual symptoms such as flashing lights.
• Headache.
• Resolution: symptoms gradually fade. Sleep can help this.
• Postdromal or recovery: many people recognise certain symptoms once the headache has gone, especially exhaustion but sometimes hunger too.

When should you consult a doctor?

Most people with isolated tension headaches usually manage to control their symptoms with over-the-counter pain relievers and anti-inflammatories, such as paracetamol or ibuprofen, or simple self-treatment such as relaxation and sleep.
However, those with chronic headaches should be checked out by their GP to consider possible causes and prevention.
If any of the below symptoms are present your GP should be contacted immediately.

• A sudden, severe headache accompanied by nausea and vomiting.
• Persistent and recurring headaches accompanied by memory problems, difficulty concentrating and tiredness.
• A high fever with neck stiffness (unable to bend the chin down to the chest).
• Convulsions (fits).
• Persistent vision disturbances (light flashes).
• Trouble controlling arms and legs.
• Loss of feeling in the arms and legs.
• Tiredness and apathy with difficulty communicating.

How does the doctor make a diagnosis?

An accurate history of any previous illnesses, family background, diet and lifestyle is crucial to help the doctor decide whether to perform further tests and to advise on treatment.
The doctor will ask for information about the headache, its length, duration, location, associated features, quality and causative factors.
Bear in mind that the vast majority of headaches, even persistent ones, are not sinister.
However, when symptoms suggest that the headaches may be related to a chronic or more serious disorder, the following diagnostic procedures might be performed, usually following assessment by a specialist.

• Head CT (computerised tomography) scan.
• Head MRI (magnetic resonance imaging).
• Sinus X-rays.
• Temporal artery biopsy.
• Lumbar puncture.

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How to Reduce Breast Size Naturally

Breasts develop from embryological tissues, and the high estrogen level in females during puberty causes breasts to start growing bigger.

Breasts are mammary glands composed of layers of different types of tissue, including adipose, glandular and connective tissues. As these tissues have hormone receptors, there is often fluctuation in breast sizes and volumes based on hormonal changes in the body.

As breasts are considered a sign of femininity and beauty, women want their breasts to be perfectly shaped and sized. However, at times the breasts become larger in size, which can be due to several factors including
Extremely large breasts can cause physical and emotional problems. Health problems may include rashes under the breasts, tenderness, back pain, neck pain, and shortness of breath.

It can even affect your posture, confidence level and your attractiveness. Moreover, women who have large breasts can have a difficult time exercising and finding clothes that fit well.

To reduce breast size, choose simple lifestyle changes, dietary changes and home remedies. Bear in mind that these remedies do not specifically target the fatty tissue of the breast. You must lower your overall body fat, which will lead to a reduction in breast size.

1. Cardio and Strength-Training Exercises

A regular exercise regimen will help you lose fat throughout your body, including your breasts. Certain cardiovascular and strength-training exercises target fat in the chest and upper body.

• Focus on low-impact cardio workouts since most women who have very large breasts simply cannot do high-impact exercises like jogging or running. Do low-impact cardio exercises on equipment like a stationary bike, treadmill or elliptical trainer for 45 minutes, at least 5 days a week.
• Also, perform specific strength-training exercises to help tighten up the chest muscles and reduce breast size. Examples of these exercises include classic pushup and dumbbell bench press. Do these exercises with high repetitions between 8 to 12 reps in 2 or 3 sets, a few times a week.

Note: When exercising, always wear a well-fitted sports bra to prevent sagging breasts.

2. Aerobic Exercises

Aerobic exercises speed up your metabolism rate, which in turn reduces overall body fat. Once you start losing weight, your breasts will automatically reduce in size.

• Stair climbing is a simple aerobic exercise that you can do daily.
• Cycling is another great form of aerobic exercise.
• Brisk walking also helps burn fat all over your body.

Make sure to do aerobic exercises for 30 minutes, at least 4 or 5 times a week.

3. Massage

Massage is an age-old remedy to reduce overall body fat as well as breast size. When massaging your breasts, give equal time to each breast.

1. Apply warm olive or coconut oil on your breasts.
2. Using your middle finger and ring finger, massage each of the breasts in circular motions and upward direction for 10 minutes.
3. Repeat the massage twice daily for at least 3 months to notice size reduction.

You can also massage using a breast-reduction cream or lotion.

4. Ginger

In many traditional medicines, ginger is used to reduce breast size. It increases the body’s metabolic rate to help burn more fat. This also affects the breast size since they are mostly made of fatty tissues.

1. Boil 1 teaspoon of grated ginger in 1 cup of water for 10 minutes.
2. Strain, add a little honey and sip it slowly.
3. Drink 2 to 3 cups of ginger tea daily.

5. Green Tea

Green tea is also effective in aiding weight loss and reducing breast size. Catechins found in green tea promote weight loss by stimulating the body to burn calories and decreasing body fat. This helps reduce breast size. In addition, green tea reduces the risk of breast cancer.

1. Add 1 teaspoon of green tea leaves to a cup of hot water.
2. Cover and steep for a few minutes.
3. Strain, then add a little honey.
4. Drink 3 to 4 cups of green tea daily for at least a few months.

6. Flaxseed

Flaxseeds contain omega-3 fatty acids that help reduce estrogen levels in the body. A high estrogen level is one of the reasons behind enlarged breasts. In addition, flaxseeds aid in removing harmful toxins from the body.

• Add 1 tablespoon of ground flaxseeds to a glass of hot water. Drink it once daily.
• Another option is to take 1 to 2 tablespoons of flaxseed oil daily.

Follow either of these remedies until you get the desired result.

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Gaining Weight The Healthy Way!

It's easy to gain weight, but it's not eat to gain muscle mass without a lot of fat gain. Plan your diet and training for weight gain without too much fat!

There are many reasons why a person may require weight gain due to being underweight. Genetics may play a major part in keeping a person lean. Some medical conditions may alter the way food is digested or have an effect on a person’s food intake. So the first port of call for any underweight individual would be to visit their doctor to rule out any hormonal imbalances and also medical conditions that may lead to inadequate absorption of nutrients.

Other problems like social pressures may contribute to being underweight, an example would be females who desire to be thin. A working environment which is very physical, yet has no time for meal breaks. Students, who might be constantly studying for exams may have a problem with constantly missing their meal times. Emotional problems may cause difficulties with food intake in that during periods of emotional crisis appetite may be increased due to comfort eating and in some people the opposite may occur with appetite being depressed, often for long periods. Another problem may be economic in which an individual may not be able to spend much money on foods due to having to make money available to meet other financial commitments.

Having a purpose for gaining weight.

Having an important reason for gaining bodyweight may give the drive required for weight gain.
One reason may be for an increased physical appearance for attracting partners. Self esteem may be another reason. The athlete who may want to increase power, strength, speed or muscle mass may also benefit for weight gain.
Whatever the reason that a person may have for gaining weight remember that weight gain may compromise speed if that is a main goal from weight gain.

Calorific Intake

This subject is a very important factor in weight gain and depends on a number of factors, age, bodyweight, sex, resting energy expenditure (REE), the thermic effect of feeding (TEF) and also a persons physical activity levels (PA).
REE is the amount of calories required by the body for a day at rest to stay alive (also known as BMR or basal metabolic rate). Most of the body's energy, about 60-70%, goes to supporting the ongoing metabolic work of the body's cells. This includes such activities as heart beat, respiration and maintaining body temperature. There are many formulas used in calculating REE or BMR depending on medical conditions, age, obesity and other factors. One of the most frequently used formulas for predicted energy expenditure is the Harris Benedict formula.

Harris-Benedict Equations (calories/day):
Male: (66.5 + 13.8 X weight) + (5.0 X height) - (6.8 X age)
Female: (665.1 + 9.6 X weight) + (1.8 X height) - (4.7 X age)
(weight in kilograms, height in centimetres, age in years)

TEF or Thermic effect of feeding; represents the increase of energy expenditure associated with digesting, absorbing and storing food. In most individuals it accounts for approx 10% of daily energy expenditure.
TEA or Thermic effect of activity; is the amount of energy expended in all non resting daily activities be they occupational, recreational or domestic, and contributes 20-30% to the body’s total energy output.
An easy way to calculate your calories required to maintain your bodyweight is to use Muscle&Strength's BMR Calculator.
We now know by use of the calculator above what calorie s we require per day to maintain our bodyweight. Our goal though is to “increase” our bodyweight, not maintaining it, but without the common gaining of large increases of bodyfat. The only way we can do this is by increasing bodyweight through resistance training, which in turn increases our muscle tissue. But to do this we have to increase our calorie intake.
Our muscle tissue consists of approx 70% water, 22% protein, and the remainder is fat, carbohydrates and minerals. By taking away the water content of the muscle which has no calorific value, the total caloric value of one pound of muscle tissue is only approx 700-800 cal. We already know that to add muscle tissue we have to add more calories than our body burns off to synthesise new muscle tissue.
Studies have shown that between 5 to 8 calories are required to support an additional 1 gram of new tissue during growth. With the recommended amount of weight gain per week of 1 lb (1 lb = 454 grams). This gives us an approximate requirement of 2300 – 3500 extra calories would be required per week. Which would give us a requirement of an extra 400 – 500 extra calories per day, above our normal calorific maintenance level.
Ok; we now know that we require extra calories, but where do we get them from? We can have extra fast food that would increase calories. This would also increase body fat; we have to increase the foods that the body requires if we are going to embark on a resistance training program to increase our lean body mass and also our total bodyweight. The foods that are required are proteins, carbohydrates and essential fats but how much?

Protein:

Protein Foods: Lean meats, Fish, Poultry, Eggs, Milk, Cheese, Yogurt, Peanut Butter, Beans, Tofu, Lentils, and other Legumes, Grains, including bread and pastas, Nuts, and Seeds
Protein Functions: Proteins that we eat are digested into amino acids and these are joined along side other amino acids produced by the body to constitute the amino acid pool. Tissues take the amino acids from the pool to synthesise specific proteins the body needs for muscle, hair, nails, hormones, enzymes etc. Proteins maintain fluid balance and buffer both acid and alkaline environments to maintain blood pH, transporter of vitamins and minerals, oxygen. Provide a source of carbon for energy yielding reactions by amino acid conversion to glucose and metabolised to provide ATP, while others can be stored as fat.

Carbohydrates:

Carbohydrate Foods: Rice, Pasta, Bread, Potatoes, Cereals, Fruits, Vegetables, Beans, Pulses, Yogurt, Milk.
Carbohydrate Functions: To provide energy and muscular fuel for body strength and building muscle. Carbohydrates are converted to stored energy as liver and muscle glycogen, sugars and starch acts as the perfect fuel to enable you to carry out your physical activities efficiently and effectively. Fiber is important in keeping bowel function going smooth. Carbohydrates aid in regulating blood glucose.

Fats:

Fat Foods: Nuts, Nut oils, flaxseeds, avocados, sunflower, rapeseed and olive oil and olive oil spreads, fish and fish oils.
Fat Functions: Essential fats (EFAs) are necessary fats that us as humans cannot synthesise and must be obtained though our diet. EFAs are long chain polyunsaturated fatty acids derived from linolenic, linoleic, and oleic acids. EFAs support the cardiovascular, reproductive, immune, and nervous systems.
The human body needs EFAs to manufacture and repair cell membranes, enabling the cells to obtain optimum nutrition and expel harmful waste products. An important function of EFAs is the production of prostaglandins, which regulate body functions such as heart rate, blood pressure, blood clotting, fertility, conception and play a large role of immune function by regulating inflammation and encouraging the body to fight infection.

Dietary Supplementation

For some people dietary supplementation is necessary to increase calorie intakes due to some restraints with regard to obtaining nutrient dense solid foods. Protein powders, carbohydrate powders like Maltodextrins or Dextrose, and essential fats, are all available to supplement a nutrition plan, but may be costly.

Creatine Supplementation.

Using creatine can increase bodyweight and can improve strength with high intensity resistance exercises with short term recovery. Weight gain at the start of using the supplement will be water weight, but an increased resistance training capacity may lead to muscle gains over time.

Weight Gain With Resistance Training

Resistance training places a heavy load on a muscle cell and creates an increase in protein synthesis in the muscle cells and the cells increasing in size by incorporating more protein. Secondly the myofibrils in each cell may multiply, which will increase the size of the muscle fiber. Thirdly the amount of connective tissue surrounding the muscle fiber and around each bundle of muscle may increase and thicken, again increasing the size of the muscle. Fourth, the cell may increase its content of enzymes and energy storage, particularly ATP (muscle energy) and muscle glycogen levels.
The increased muscle glycogen along with the increased muscle protein binds additional water which contributes to an increased bodyweight. Studies have also shown that resistance training exercises may increase bone mineral content, with the possible increase in muscle tension effects on the bone and which may also increase bodyweight slightly.
Resistance training may be effective in increasing muscle size and mass and as such help improve muscular strength and endurance and both are important in weight control programs. Females who perform resistance training normally do not experience the same amount of hypertrophy (muscle size) that males experience with the same amount of resistance training although they do experience gains in muscular strength and endurance.

Types of Resistance Training for Increasing Bodyweight.

There are many methods of resistance training. Isometric training involves a muscle contraction against an immovable object like trying to trying to pull a fence post out of a hole. If you managed to pull the fence post out of the ground then you would be performing isotonic type movement. Isotonic training involves two types of movement.
Firstly the concentric movement means shortening the muscle as you would experience when performing a bicep curl. The second movement is the eccentric phase which means the muscle is lengthening even though the muscle is still contracting, as in the down phase of the bicep curl, the muscle is contracting eccentrically as it slows the decent of the weight even though gravity is trying to pull the arm down to the start position.
Another form is Isokinetic type training which involves resistance machines that regulate the resistance as you are trying to perform the exercise, as happens with Nautilus type machines. Studies have shown that resistance training with free weights is the most effective method of increasing the size and weight of muscles provided that the basic principle of overload is followed.

The Basic Principles of Resistance Training.

The principle of overload is the most important principle in all resistance training programs. The use of weights places a greater stress on the muscle cell. This overload stress stimulates the muscle to grow and become even stronger to overcome the increase resistance imposed by the weights. So to continually overload the muscle you must increase the volume of training that the muscle must do, another way is to increase the number of repetitions and sets that you perform. Although there is no single best combination of sets and repetitions, usually two or three sets with 8-12 RM (repetition maximum) provide an adequate training stimulus for muscle growth. If you know your 1RM (Maximum weight that can be used for 1 repetition with strict form) you should be able to do 8-12 RM if you use 60-80 percent of your 1RM value. As the muscle continues to get stronger during the training program, you must increase the amount of resistance training overload to continue to get the proper stimulus for sustained muscle growth. This is known as principle of progressive resistance exercise (PRE), another basic principle of resistance training. After a learning period the normal recommended program for beginners is three to five sets with 8RM in each set, the first step is to find out the maximum amount of weight that you can lift for eight repetitions. If you can do more than eight repetitions, the weight is too light and you will need to increase weight. As you get stronger during the weeks you will be able to lift the initial weight more easily, when you can perform 12 repetitions, add more weight to force you to go back to the eight repetitions, this is the progressive resistance principle. Over the next several months you will probably need to increase the weight several times as you get stronger.
The principle of specificity is a broad training principle with many implications for resistance training, including specificity for various sports movements, strength gains, endurance gains, and body weight gains. An example would be a swimmer who wants to gain strength and endurance for a specific swimming stroke should find a resistance program that exercises the specific muscles in a way as close as possible to the form used in that particular stroke. If you want to gain muscle mass in a certain part of the body, those muscles must be exercised.

The exercise routine should be based on the principle of exercise sequence. This means that if you have ten exercises in your training routine then they should be arranged in an order so that muscle fatigue does not limit your ability to lift. For example the first exercise in the routine might stress the biceps and second the abdominals, the third the quadriceps etc. After you perform one full set of all the exercises you then do a complete second set, followed by a third set depending on how long you have been lifting. This training approach is best for beginners to training. Another popular method is to do three sets of the same exercise with a small rest in between the exercises and then perform three sets of the second exercise and so on. This type of training is very effective but may be fatiguing for the beginner at the outset. Beginners should start on an all over body routine as stated above to allow an adaptation by the body to weight training before moving onto a split type routine (splitting the body into different muscle groups to be trained on different days)
The Principle of exercise recovery states that resistance training if done correctly achieves the greatest gains and also imposes a severe stress on the muscles, requiring a period of recovery both during the workout and between workouts. For beginners resistance training should generally be performed about three days per week, with a rest day in between sessions. This rest day allows time for the muscles to repair and to synthesise new protein as it continues to grow.

Bulk-Up Method of Resistance Training.

If your goal is to increase a large amount of muscle mass then you may wish to use the bulk-up method of resistance training. This method involves the use of exercises to stress the major muscle groups of the body. About three to five sets of each exercise is performed.
The use of 8-12 repetitions is recommended for beginners and using the principle of progressive resistance exercise you start with a resistance that you can perform eight repetitions and progressively increasing the repetitions to twelve. After you reach the twelve you must increase the weight until you again achieve the lower of the repetition being used, in this case 8.
The bulk-up method should be used for several months to increase the body weight. Once you have achieved the weight that you want to be at, you may then wish to shape the bulk or known as “cutting up.” Again once you have achieved the reduction of bodyfat in the cutting phase that you want, you again hit a bulking up phase, this technique is used to both maintain weight and shape.

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Premature Ejaculation: Causes, Symptoms and Treatments

In recent years, the medical world has improved its recognition and understanding of male sexual dysfunction, including the problems men can experience when engaging in sexual intercourse. Premature ejaculation is one form of sexual dysfunction that can adversely affect the quality of a man's sex life.
Reaching climax and ejaculating semen during penetrative sex is the typical route by which babies are conceived, but premature ejaculation does not just complicate reproduction, it can also adversely affect sexual satisfaction, both for men and their partners. The information here aims to demystify premature ejaculation and outline active treatment options for those cases where it is desired.

Fast facts about premature ejaculation
Here are some key points about premature ejaculation. More detail and supporting information is in the body of this article.

• In medical terms, premature ejaculation is a form of sexual dysfunction where a man has always, or consistently climaxes and ejaculates before or very soon after sexual penetration, causing distress. Under strict criteria, premature ejaculation is relatively rare.
• Cases of premature ejaculation that do not meet the strict medical criteria for the sexual disorder are more common and are defined simply as a man climaxing and ejaculating sooner than he or his partner desire. Often, a man's partner is less concerned than the man himself.
• In the majority of cases, an inability to control ejaculation is rarely due to a medical condition, although doctors will need to rule this out, including checking for erectile dysfunction
• Most cases of premature ejaculation have psychological causes - ranging from common anxieties about sex and relationships resulting in a temporary problem, to more serious psychological factors contributing to a persistent problem.
• Premature ejaculation can lead to secondary symptoms such as distress, embarrassment, relationship stress, anxiety and depression.
• Treatment options range from reassurance from a doctor that the problem can go away in time, through home methods of "training" the timing of ejaculation (alone or with the help of a trusted partner), to talking therapies and couples counselling.
• Drug options are available, there are currently no medicines approved for use in treating premature ejaculation.
• Doctors may consider offering "off-label" prescription of a certain type of antidepressant to help with premature ejaculation, but such medication can have side-effects. Additionally, some men find it helpful to apply a local anaesthetic cream to their penis to delay ejaculation by decreasing sensation.

What is premature ejaculation?

Premature ejaculation is a form of male sexual dysfunction. From the point of view of the man and his sexual partner, premature ejaculation means the man having an orgasm or "climaxing" sooner than wanted.¹
Estimates of the number of men affected by premature ejaculation vary depending on how the problem is defined. A high proportion of men report being affected by premature ejaculation, whereas a very small proportion of men actually meet the medical criteria for the most persistent form.²

Medically, the most persistent form of premature ejaculation (primary or lifelong premature ejaculation) is defined by the presence of the following three problems from the point at which a man becomes sexually active:^2-4

• Ejaculation always, or nearly always, happening before sexual penetration has been achieved, or within about a minute of penetration
• The man finding an inability to delay his ejaculation every time, or nearly every time, he does achieve penetration
• Negative personal consequences, such as distress and frustration, or avoidance of sexual intimacy.

Premature ejaculation was once known, in Latin as ejaculatio praecox (the translation being "precocious ejaculation").² It is also called rapid or early ejaculation.
An internet search will also reveal a lot of slang or colloquial phrases for premature ejaculation, although these often have little bearing on the reality of lived experience and may instead reinforce false ideas that are harmful to men's mental health. For example, such slang terms can lead men to feel they are to blame, have failed, are alone in their problem, or cannot be treated, while the opposite is usually the case. Premature ejaculation can cause a lot of embarrassment in boys and men, with a significant degree of stigma often attached to male sexual performance.⁵

How many men experience premature ejaculation?

Information obtained through surveys puts the "self-reported" prevalence of premature ejaculation in men as somewhere between 15% and 30%.^2,6
However, the prevalence of medically diagnosed and diagnosable premature ejaculation is much lower.^2,6 This statistical disparity does not in any way diminish the suffering experienced by men who do not meet the strict criteria for diagnosis.^2,6
In one analysis of nearly 5000 men in nine Asia-Pacific countries, 16% of men met the criteria for a diagnosis of premature ejaculation (PE) on the five-question Premature Ejaculation Diagnostic Tool (PEDT).¹⁹ Probably PE was found in 15% of respondents, while 13% of men self-reported PE.

Interestingly, less than half (just 40%) of the men with PEDT-diagnosed PE self-reported the condition, and just 19% of those with probable PE self-reported having the condition. A large number of men (some 6% of respondents) had a negative PE diagnosis on the PEDT but reported PE.¹⁹
Primary or lifelong PE is the most persistent problem in men and describes a condition where men have rarely experienced sex without prematurely ejaculating. This is the least common form of the condition and is thought to affect around 2% of men.⁷
However, more loosely defined premature ejaculation remains the most common form of male sexual dysfunction - more common than erectile dysfunction.^6,7

Causes of premature ejaculation

Let's discuss the causes of premature ejaculation, from psychological factors to medical causes and erectile dysfunction.

Psychological factors

Most cases of premature ejaculation are not related to any disease and are instead due to psychological factors.
Examples of psychological causes of premature ejaculation include:^8,9

• Sexual inexperience
• Novelty of a relationship
• Overexcitement or too much stimulation
• Relationship stress
• Anxiety
• Guilty feelings
• Depression
• Issues related to control and intimacy.

These common psychological factors can affect men who have previously had normal ejaculation; such cases are often referred to as secondary or acquired premature ejaculation.⁷
Most cases of the rarer, more persistent form - primary or lifelong premature ejaculation - are also believed to be caused by psychological problems. The cause(s) of primary or lifelong PE can often be traced back to early trauma, such as:⁷

• Strict sexual teaching and upbringing - affecting young men who have been brought up under strict ideas that sex should be prohibited until marriage, for example, making enjoyment of sex more difficult because of a feeling that it is wrong or a sin
• Traumatic experiences of sex - anxiety and premature ejaculation can result from problems ranging from a loss of privacy when masturbating ("being caught" masturbating), to sexual abuse
• Conditioning - it is thought that early sexual behaviors can feed into later experiences of sex. One example is a teenager learning to ejaculate quickly to avoid being found masturbating. 

Medical causes of premature ejaculation

Biological causes of premature ejaculation are much less common than psychological ones. In rare cases, the cause can be more serious, such as nervous system damage as a result of surgery or physical trauma.¹⁰
The following are also possible medical causes of PE⁷ (doctors will focus on diagnosis and management of the underlying condition first and monitor for improvement in sexual function⁸):

Erectile dysfunction

Erectile dysfunction is a condition that doctors will want to rule out or treat first when working with a patient concerned about premature ejaculation.^6,7
Some men may confuse erectile dysfunction and premature ejaculation, believing themselves to have the former when they actually have the latter. This is because the penis normally loses its firmness after ejaculation.⁶
In some cases of erectile dysfunction, heightened sensitivity caused by changes to the normal pattern of nerve signals means that much less stimulation is needed to cause ejaculation.⁷
Finally, some studies have found an association between levels of serotonin - a natural neurotransmitter chemical involved in mood and depression - and ejaculation problems. Men with low brain levels of serotonin may have problems with premature ejaculation.¹⁰ However, the role of such factors remains largely theoretical, especially given that scientists still have a fairly poor understanding of the normal physiological processes that produce ejaculation.²

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5 Natural Impotence Remedies

Straightforward steps to stimulate your sagging love life 

"Impotence - that's what it must be!" He had a gentle Irish brogue and had well and truly labelled himself as "sexually dysfunctional". Philip had tried Viagra, but all it had done was produce a headache "like Nagasaki!"
"The thing is," he told me, "I need a natural remedy for impotence. Can you help me?"
What did I do to help Philip with impotence? Well, you can read about some of the approaches in my article "Male Sexual Enhancement Techniques" - such as how to maximize your psychological attitude to sex, as well as some exercises you can do to strengthen erections (here's a hint: they don't involve gym membership). But here are some other tips and techniques to help rectify the 'collapse of stout party' and get you relaxed and hard during lovemaking.

Impotence - the natural 'curse'

Failing to achieve an erection that is strong enough or sustained enough to allow for normal lovemaking is known as impotence. It can happen once or many times and the majority of men (regardless of what they may tell one another) experience it at some time. As I pointed out to Philip, actually all men are meant to be impotent for much of the time. When we are in meetings at work, doing sports, reading a weather report, or wearing Speedos on the beach, not having an erection is a good thing.
When we're under attack or feel threatened, sexual arousal is meant to switch off fast. It's a myth that men are - and always should be - capable of instant sexual arousal (regardless of, say, problems in a relationship). But repeated failure to achieve erection during foreplay can start to feel like a real problem for many men; especially if it's a problem that spans different relationships.
So what causes impotence? Well, impotence can be caused by physical or psychological factors or, of course, a combination of both. It's good to know what's been causing it.

1) Check whether there are physical causes for the impotence

Do you regularly wake up with an erection? If so, then it's unlikely the cause of impotence is physical, as all seems to be working from a 'mechanical' point of view. Illnesses such as diabetes or conditions such as high blood pressure can cause impotence, as can injury or rapidly declining hormone levels. The blood needs to circulate well in order for erections to occur, so any condition which restricts circulation, such as smoking, may prevent erections. Additionally, overindulgence in alcohol may cause 'brewers droop' by interfering with testosterone levels.
Impotence can also result as a side effect from some medications, such as antidepressants, so if you suspect there may be some medical cause for impotence, consult your doctor. Also take a look at your lifestyle. Are you drinking too much? Not exercising? Getting too little rest? Smoking like a steam train? Sexual health is a by-product of living well.

2) Don't think yourself into impotence

Robin Williams once reputedly said: "God gave men both a penis and a brain, but unfortunately not enough blood supply to run both at the same time."
After laughing at this quote, I thought about it. (Don't you just hate it when people think about something before laughing at it?) On the face of it, this remark seems disparaging toward men. And it's often said that men give pet names to their penises because they "like to know who's dictating their behaviour". But actually women are led by their sex drives just as much as men sometimes and can also make "mistakes", ending up in bed with "the wrong man". We are all, to some extent, led by our desires.
I reckon the usefulness of Williams's remark (apart from the humour : ) ) is to highlight that over-analysis of sex can spoil it completely. "Will I/won't I achieve an erection?" is just too much pressure. The fact is that when enjoying sex, we really don't need to be thinking too much. When you focus on physical closeness and the enjoyment of being together naked, an erection becomes a by-product of the experience, not the end in itself. Stop trying to get an erection and focus on physical closeness - if an erection happens, it happens. But this is easier said than done, so...

3) Use self-hypnosis to relax about your sexual performance

It's easy for me to say: "Don't worry about whether you get hard or not!" But, of course, much impotence is caused by worrying, and stress switches desire off pretty rapidly. Self-hypnosis is a wonderful way to help you change your mindset and help you experience sex beyond concern with penile mechanics. In ancient China, the eunuchs reputedly made the best lovers because (without the use of a penis) they used much more imagination during lovemaking. To get a feel for self–hypnosis, listen to this short and free hypnosis audio.

4) Remember: impotence happens in context

If you've been experiencing impotence, it may be that you are bored in your relationship or with your lover and need to spice things up a bit. As the old joke has it: "Please don't come to bed yet; I haven't had a chance to think of anyone!"
Perhaps there are resentments in your relationship or your lover pressures you. Lovemaking isn't something you do to your partner, but with them. Give yourself a break sometimes - it would be amazing if a man didn't experience impotence in some contexts. It's not a reflection on you as a man, but perhaps rather your relationship or lifestyle.

5) Improve your circulation

Smoking is a very effective way of spoiling efficient blood circulation, which is why heavy smokers experience fewer erections than non-smokers. Any way you can improve blood circulation will strengthen your erections (as well as providing you with other obvious overall health benefits). Exercise, diet, and relaxation will all improve the flow of blood around your body. As will certain foods. For example, taking Ginkgo biloba for several months seems to have a hugely beneficial effect for many men (1). Eating garlic regularly may well have a similar effect (although taking it in tablet form may enable you to actually get close enough to use your erection!).
Take a look at my male sexual enhancement article for more tips on how to naturally overcome impotence and keep positive - because you can get your mojo back.

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Asthma Symptoms, Treatment and More

Asthma is a disease affecting your lungs. Asthma causes wheezing, shortness of breath, chest pain and coughing. In many instances, these symptoms appear mostly at night or early morning. Some people with asthma have these symptoms daily. People with asthma often have asthma attacks. An asthma attack occurs when something bothers your lungs. Airways become swollen and inflamed, which makes it hard to breathe. These attacks can be mild, moderate or severe. Even though you may feel fine, an asthma attack can occur anytime.

Asthma affects 25 million people in the United States, including 7 million children. Many children outgrow their asthma. For others, it becomes a lifelong condition. Most children develop symptoms before the age of 5. More boys have asthma than girls. In adults, there is no difference between men and women.

What Causes Asthma?

We don't know the exact cause of asthma. Researchers believe it results from several factors. Genes appear to be involved. For example, children of parents who have asthma are more likely to have asthma than children of parents who don't have asthma. Environmental factors also play a role. These factors are called "triggers." An asthma attack occurs when you come in contact with these triggers. Most people with asthma have allergies, which are also triggers.

Not all people have the same triggers. To help you identify your triggers, you should keep a diary and write down what you were doing before your symptoms got worse. If your asthma gets worse when you come in contact with a particular agent, then that agent is a trigger. According to the U.S. Centers for Disease Control and Prevention, common asthma triggers include: tobacco smoke, dust mites, cockroaches, pets, outdoor air pollution, mold, smoke from burning wood or grass and infections. Many other things can make asthma worse, including exercise, food additives, food preservatives, fragrances, medicines and emotions. Knowing and avoiding your triggers will help keep your asthma under control.

How Is Asthma Treated?

Asthma is treated with two types of medicines—a long-term medication and a quick relief medication. The quick relief medicine is also called a "rescue" medication. The long-term medication helps reduce airway inflammation. This medication reduces or even eliminates asthma symptoms. Most patients are given inhaled corticosteroids for long-term use. Quick relief medication is used when an asthma attack occurs or when symptoms suddenly get worse. You need to carry your quick relief medication with you at all times because an asthma attack can occur without warning.
Your treatment depends on the severity of your symptoms. Once you begin taking medication, your doctor will ask about your symptoms. He will also ask about any side effects that you may be experiencing. If symptoms are not under control, your doctor will adjust your dose or try another medication. The goal is to achieve maximum control with the least amount of medication.

What Is an Asthma Action Plan?

You and your doctor will create an asthma action plan. This plan describes your daily treatments and the time you should take your medication. It will also tell you which triggers to avoid. Your asthma action plan helps you identify if your asthma is getting worse. The plan gives you instructions as to when you should call the doctor or 911.

Your asthma action plan also tells you how to measure and record your peak air flow. You will be given a small handheld device along with instructions on how to use it. The device will measure how well air is coming out of your lungs. If your peak air flow measures at 80 percent or higher, your asthma is considered to be under control. If your peak air flow is between 50 percent and 79 percent, it means your asthma is not under control. If your peak air flow is less than 50 percent, you need to call your doctor or an ambulance.

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How to Reduce Breast Size Naturally Fast Without Surgery

To reduce breast size naturally fast without surgery might be one of the best decision you can make. You will agree with me that…
Big breasts are assets!!!
They turn heads around whenever you are passing by causing you to receive both deserved and undeserved attention.
Irrespective of how good that might seems, only the carrier of the big boobs understands the burden, stress and sometimes the pain she is going through.
There are two major ways to decrease breast size so as to get the perfect breast shape. It is either through surgery or through natural procedure.
While surgical procedures for breast reduction are costly and often come with various kind of risks and after-problems, Natural procedures are cheaper, with minimal risk and also fast acting.
This article takes a comprehensive look at the best and fastest home remedies for breast reduction.

How to Reduce Breast Size Naturally

It is important we discuss the composition of breast, causes of big breast and problems associated with large breast size before talking about the natural process of reducing big bust.

Breast Anatomy

The breast lies directly above the chest (pectoralis) muscle.
It is made up of fatty tissues (adipose tissues) and milk producing tissues (glandular tissues) and the ratio of fatty tissues to glandular tissues varies with individual. For example, at the beginning menopause, the fatty tissues in the breast increases while the glandular tissues diminishes.
It is however important to understand that the amount of fat determines the size and shape of the breast.

Problems Of Large Breast Size

While small breasts may cause aesthetic discomfort due to perceived failure to achieve certain beauty standards, large breasts have been associated with various forms of complaints and serious health problems.
Common problems of large breast include

• Back ache
• Neck pain
• Shoulder pain
• Numbness in the fingers and hand: often as a result of weight on the shoulders pulling on nerves behind the collar bone
• Migraine (headache)
• Short breath
• Chafing(a skin condition caused by skin rubbing)
• Heat rash
• Permanent indentation on the shoulders as a result of bra strap
• Limited physical activities: Aerobic activities such as jogging or running may be uncomfortable or impossible and lack of physical activity itself causes weight gain, bad physical condition and health problems
• Yeast infection
• Bad emotional condition: Apart from difficulty in finding fitting clothes, teenagers with large breasts are especially vulnerable to teasing which may lead to poor emotional condition and make them unhappy with their appearance

Causes of Large Breast Size

Increase in breast size is a normal development in the female. It often starts at puberty and may reoccur again throughout life time as a result of several reasons.
Breast size is essentially determined by a combination of genetic and environmental factors. While genes are beyond our control, lifestyle modifications may be effective in reducing bust size.
Knowing the factors responsible for your big breast will help to resolve the problem and reduce breast size faster.
Here are some common causes of big boobs.

• Genetic factor
• Weight gain
• Hormonal fluctuation
• Lactation
• Drugs side effect

Home Remedies to Reduce Breast Size

Best Type of Exercises to Reduce Breast Size

Since breast tissue are mainly composed of adipose (fat) tissues, therefore the best exercises to reduce breast size will be those which stimulate your metabolism to lose body fat. These exercises can also help make breast firm and get rid of saggy breasts

Cardiovascular training to reduce breast size

Doing daily cardio exercise for 30-60 minutes will help to burn fat from all over your body, enhance flat stomach naturally and gradually reduce the size of your breasts.
It is essential to focus on low impact cardio exercises since most women who have very large breasts simply can’t do high impact exercises like jogging or running.

Other cardio exercise to reduce breast size includes

• Walking
• Riding a bike
• Using elliptical machine
• Pilates

Furthermore, If you’re looking for something even more active and allows you to socialize then sports are also on the list of the best exercises, as they count as cardio as well
Good examples sports exercise for breast reduction includes;

• Swimming
• Boxing
• Hiking
• Kayaking
• Rebounding
• Water aerobics

Strength training exercise for breast reduction

In addition to cardiovascular training, you should also incorporate specific strength training exercises to your fitness routine, as this will help build and tone your pectoral muscles, which lies directly below your breasts.
Strength training such as bench press and pushups are among the best exercises to tighten up the chest muscles and help reduce breast size.
Good examples include;

• Pushups
• Barbell Bench Press
• Dips
• Pec Deck Butterflys
• Decline Dumbbell Flyes

However, to achieve the aim of breast reduction, it is important to keep the weight light and the repetitions high or else you’ll end up building up your pectoral muscles instead of tightening them

Diet Changes to Reduce Breast Size Naturally

Coupled with growth hormone, the main hormone that determines breast size is oestrogen. The more oestrogen you have in your system, the bigger your breasts tends to be
If you are serious about reducing the size of your boobs, it is important to do without birth control pills cos the major constituent of most of these combined pills is oestrogen. Apart from that, the pills tend to mess with your hormonal levels thereby causing hormonal fluctuations.

In addition, estrogen-like compounds (otherwise called ‘xeno-oestrogens’) from plastic packaging (which include plastic bottles) and industrial residues are also known to contaminate food and drinks.
As a result, It is recommended to drink mineral water from glass bottles whenever possible, and avoid processed foods packaged in plastic.
Meat and possibly some dairy products tend to contain oestrogen and should also be taken moderately.
Oestrogen is broken down in the liver, so anything you do to improve liver function might help.
Eating a diet based on whole-foods, fruits and vegetables (preferably organic) with plenty of water and very little alcohol should help to maximise your liver function and minimise the impact of oestrogen in your body.
Since the breast is composed of fatty tissue, it is important to maintain healthy weight and get rid of excess fat from the body by eating healthy and balanced diet.
Here are some healthy eating tips to lose weight and reduce breast size.

• Eat less fat and few calories
• Eat more vegetables especially cruciferous vegetables e.g, kale, broccoli etc..
• Take lot of fruits
• Get your proteins from seafood.e.g cod, tuna, salmon
• Take more nuts.e.g, walnut, almond

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