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Hashimoto’s disease (by Japanese surgeon; Hashimoto, Hakaru 1881-1934) is a chronic thyroiditis. It is characterized by the production of autoantibodies that attack the thyroid. This will eventually cause a lack of thyroid hormone, thyroid fibrosis, and infiltration of thyroid tissue by lymphoid tissue.
Hashimoto’s disease is also a common cause of a goiter. A goiter is an enlargement of the thyroid gland. It becomes clearly visible as a swelling on the front part of the neck because the thyroids tends to grow 2 to 5 times bigger than normal.
Hashimoto’s disease is also called Hashimoto’s struma, Hashimoto’s thyroiditis, or struma lymphomatosa.
The thyroid gland secretes two hormones controlling the usage of energy and the body temperature. To determine if the thyroid gland is working properly, different hormone levels can be measured in the blood. The pituitary gland secretes a hormone called TSH (thyroid-stimulating hormone). TSH level is clearly elevated when the thyroid gland is not functioning properly. Also an iodine absorption test may be performed to show too low uptake of iodine, which may indicate hypothyroidism.
If you suspect that your thyroid is not active enough, you can do a thyroid self-test in the morning. Stay in bed after you awake and take your temperature from under your arm. Try to stay very still and quiet for fifteen minutes. If your temperature is 97.6F or lower for 5 days, you can ask your professional health care provider if there is a reason to test the condition of your thyroid.
Symptoms of Hashimoto’s disease include fatigue, loss of appetite, weight gain, sensitivity to cold, muscle cramps, depression, fertility problems, painful premenstrual periods, muscle weakness, dry and scaly skin, yellowish coloration in the skin, yellowish bumps on the eyelids, hair loss, constipation, persistent infections, swollen eyes, and milky discharge from breasts.
Hashimoto’s disease is a rare disease and it is more common among women than men. Usually it appears in the age range of 30-50. About 10-30% of people suffering from Hashimoto’s disease will develop hypothyroidism. The treatment is usually replacement of the thyroid hormone for the rest of the patient’s life. In case autoimmune diseases run in your family it doesn’t mean that you will definitely be ill.
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Your support reckons
The medical science has broadly divided the reason contributing to erectile dysfunction into two parts: organic and psychological. The majority of ED patients display organic component but the fact is, in the most common cases of ED caused by organic faults are, to a great extent, influenced by psychological aspects. These psychological aspects could be loss of self-confidence, anxiety, conflict with the partner, depression in the relationship. The same aspects play an important role in psychological erectile dysfunction. The importance of high level of intimacy and love and the wife’s continuous support in treating ED, is undeniable.
The foundation
As you are the other half of a man suffering from ED, let me ask you…have you ever contemplated on the foundation of your conjugal relationship? Is it a good friendship? Mutual understanding and trust? Just a compromise? A family commitment? Or only sexual attraction? All of the above? Or only one of them? How important is sex in your relationship? Understanding your own self and analyzing what actually you want from your partner is very important for a strong foundation of a marital relationship. The more you are confused, the more are the chances of your being dissatisfied, frustrated and depressed with your life and as severely suffering sexual life. Ignoring this will aggravate the situation, while addressing this, can change things for better.
Psychosomatic façade of ED
Let me explain the male erectile response to explain the statement above. The male erection is a complex interplay of vascular and neurological actions initiated by the central nervous system that integrates the psychogenic stimuli. The stimuli is source of the urge are desire to have sex, this can be the desire of the person you love, perception etc. Sensory stimuli from the penis are important in continuing this process and help to maintain erection during sexual activity. Men are very sensitive about the support of the partner, be it social, physical and psychological, a slightest hint of disapproval can affect his performance. He may withdraw because of the fear that an unsatisfactory sexual session may ruin your overall relationship. So while undergoing a treatment for ED, the improvement depends upon how supportive and peaceful the relationship is.
Let’s talk
It’s important to have a clear communication between you two, let each other know what makes you happy, mentally, physically and spiritually. If you do not know what makes your partner happy, one of you may end up with the feeling “I give more than I receive”. This mental dissatisfaction in anyone in the couple affects mental and social relationship within the couple and hence the man may face erectile dysfunction while the woman feels she is no more attractive to her husband. The confidence, that you two know each other, love each other, strengthens the relationship from all the dimensions. The process of knowing each other is like wandering in an unexplored, deep forest. Both of you need to be confident, the confidence will flow from the urge to understand each other and experiencing and embracing your own sexual forte and desires along with your partner’s. Tell your partner what makes you happy sexually and try to understand his fantasies related to sex. This way, you both gain the confidence about each other, that you know what will make the other happy.
Love and be loved
The prism of love has many colours; empathy, patience, perseverance, compromise that can fight any social, physical and psychological challenges in a relationship. Love is the main spice of life that can take your sexual pleasure to a height where there is no need of Viagra or other temporary measures of fighting ED. You communicate openly and honestly to your partner and let him know that you love him. This understanding will be enough for him to fight all the physical hindrances and he will take you to a never-ending love ride.
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Most love stories begin with once upon a time there was a charming boy and a beautiful girl. They start dating and they fall in love. So, they decided to marry; marriage held and the consummation of marriage also happened. The first encounter of sex was great, both achieved euphoria. The boy was strong and his enthusiasm was great; he took the girl at the peak of pleasure thrice on the first night. But, after few years the boy lost his libido, not because of he doesn’t like the girl anymore, but because of Erectile Dysfunction (ED). The girl became depressed and unsatisfied lady.
This is a small story, which unfortunately is repeated with many of us. During the earlier phase of sexual life, men are highly energetic because in this phase all sex related organs work in a glib manner. But in later phases, ageing degenerates sexual organs, particularly muscles of penis and a man tries to avoid sexual relations. Embarrassment is the feeling which restricts him to be in sexual contact even with his beloved one. Non-arousal of penis is definitely embarrassing when your sexual counterpart is desperate to take you in. How would she feel then; it is a matter of serious concern for a man who loves her by the core of heart. A woman is on the peak sensuality in the later phases of the marriage. Unfortunately, ED dysfunction also occurs when she is willing to play open and rigorously.
Erectile dysfunction (ED) doesn’t come suddenly; when it starts, man loses his natural capability of love making gradually. Even if he is frequented with love making twice or thrice a week, ED can reduce it upto twice or thrice in a month. This is definitely inappropriate for a woman who has high libido.
The good news is that now there is a solution for this problem. Levitra is the name of a beneficial medication, which can help in erection of penis when erectile dysfunction is there. Levitra’s active ingredient Vardenafil HCl increases the flow of blood in the capillaries of penis by stimulating the secretion of GMP. Secretion of GMP is a natural phenomenon for erection of penis but release of GMP comes down to a lower level with ageing and Levitra brings it back at normal level. Phosphodiesterase-5 is a GMP inhibitor whose secretion generally takes place after achieving orgasm. Whenever erectile dysfunction is there, secretion of PDE-5 takes place much earlier then orgasm. Even if penis is inside the vagina, its release can take place and penis falls back during intercourse. Levitra blocks action of PDE-5, so that erection of penis remains for a long duration, which is generally 4 hours.
Levitra is an oral prescription medication, which should be taken only on doctor’s prescription. Levitra might have some mild side effects like chest pain, nausea, dizziness and painful erection. The side-effects are short lived and generally disappear after the use of medication for few days.
Levitra pills come in volume of 10mg and 20mg. Generally, doctor prescribes 10mg of Levitra pill swallowed with a glassful of plain water half an hour before having sex. Levitra is easily available through online order and through online purchase, the delivery of Levitra is made at your doorstep.
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Alan Pease, author of a book titled "Why Men Don't Listen and Women Can't Read Maps", believes that women are spatially-challenged compared to men. The British firm, Admiral Insurance, conducted a study of half a million claims. They found that "women were almost twice as likely as men to have a collision in a car park, 23 percent more likely to hit a stationary car, and 15 percent more likely to reverse into another vehicle" (Reuters).
Yet gender "differences" are often the outcomes of bad scholarship. Consider Admiral insurance's data. As Britain's Automobile Association (AA) correctly pointed out - women drivers tend to make more short journeys around towns and shopping centers and these involve frequent parking. Hence their ubiquity in certain kinds of claims. Regarding women's alleged spatial deficiency, in Britain, girls have been outperforming boys in scholastic aptitude tests - including geometry and maths - since 1988.
On the other wing of the divide, Anthony Clare, a British psychiatrist and author of "On Men" wrote:
"At the beginning of the 21st century it is difficult to avoid the conclusion that men are in serious trouble. Throughout the world, developed and developing, antisocial behavior is essentially male. Violence, sexual abuse of children, illicit drug use, alcohol misuse, gambling, all are overwhelmingly male activities. The courts and prisons bulge with men. When it comes to aggression, delinquent behavior, risk taking and social mayhem, men win gold."
Men also mature later, die earlier, are more susceptible to infections and most types of cancer, are more likely to be dyslexic, to suffer from a host of mental health disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), and to commit suicide.
In her book, "Stiffed: The Betrayal of the American Man", Susan Faludi describes a crisis of masculinity following the breakdown of manhood models and work and family structures in the last five decades. In the film "Boys don't Cry", a teenage girl binds her breasts and acts the male in a caricatural relish of stereotypes of virility. Being a man is merely a state of mind, the movie implies.
But what does it really mean to be a "male" or a "female"? Are gender identity and sexual preferences genetically determined? Can they be reduced to one's sex? Or are they amalgams of biological, social, and psychological factors in constant interaction? Are they immutable lifelong features or dynamically evolving frames of self-reference?
Certain traits attributed to one's sex are surely better accounted for by cultural factors, the process of socialization, gender roles, and what George Devereux called "ethnopsychiatry" in "Basic Problems of Ethnopsychiatry" (University of Chicago Press, 1980). He suggested to divide the unconscious into the id (the part that was always instinctual and unconscious) and the "ethnic unconscious" (repressed material that was once conscious). The latter is mostly molded by prevailing cultural mores and includes all our defense mechanisms and most of the superego.
So, how can we tell whether our sexual role is mostly in our blood or in our brains?
The scrutiny of borderline cases of human sexuality - notably the transgendered or intersexed - can yield clues as to the distribution and relative weights of biological, social, and psychological determinants of gender identity formation.
The results of a study conducted by Uwe Hartmann, Hinnerk Becker, and Claudia Rueffer-Hesse in 1997 and titled "Self and Gender: Narcissistic Pathology and Personality Factors in Gender Dysphoric Patients", published in the "International Journal of Transgenderism", "indicate significant psychopathological aspects and narcissistic dysregulation in a substantial proportion of patients." Are these "psychopathological aspects" merely reactions to underlying physiological realities and changes? Could social ostracism and labeling have induced them in the "patients"?
The authors conclude:
"The cumulative evidence of our study ... is consistent with the view that gender dysphoria is a disorder of the sense of self as has been proposed by Beitel (1985) or Pfäfflin (1993). The central problem in our patients is about identity and the self in general and the transsexual wish seems to be an attempt at reassuring and stabilizing the self-coherence which in turn can lead to a further destabilization if the self is already too fragile. In this view the body is instrumentalized to create a sense of identity and the splitting symbolized in the hiatus between the rejected body-self and other parts of the self is more between good and bad objects than between masculine and feminine."
Freud, Kraft-Ebbing, and Fliess suggested that we are all bisexual to a certain degree. As early as 1910, Dr. Magnus Hirschfeld argued, in Berlin, that absolute genders are "abstractions, invented extremes". The consensus today is that one's sexuality is, mostly, a psychological construct which reflects gender role orientation.
Joanne Meyerowitz, a professor of history at Indiana University and the editor of The Journal of American History observes, in her recently published tome, "How Sex Changed: A History of Transsexuality in the United States", that the very meaning of masculinity and femininity is in constant flux.
Transgender activists, says Meyerowitz, insist that gender and sexuality represent "distinct analytical categories". The New York Times wrote in its review of the book: "Some male-to-female transsexuals have sex with men and call themselves homosexuals. Some female-to-male transsexuals have sex with women and call themselves lesbians. Some transsexuals call themselves asexual."
So, it is all in the mind, you see.
This would be taking it too far. A large body of scientific evidence points to the genetic and biological underpinnings of sexual behavior and preferences.
The German science magazine, "Geo", reported recently that the males of the fruit fly "drosophila melanogaster" switched from heterosexuality to homosexuality as the temperature in the lab was increased from 19 to 30 degrees Celsius. They reverted to chasing females as it was lowered.
The brain structures of homosexual sheep are different to those of straight sheep, a study conducted recently by the Oregon Health & Science University and the U.S. Department of Agriculture Sheep Experiment Station in Dubois, Idaho, revealed. Similar differences were found between gay men and straight ones in 1995 in Holland and elsewhere. The preoptic area of the hypothalamus was larger in heterosexual men than in both homosexual men and straight women.
According an article, titled "When Sexual Development Goes Awry", by Suzanne Miller, published in the September 2000 issue of the "World and I", various medical conditions give rise to sexual ambiguity. Congenital adrenal hyperplasia (CAH), involving excessive androgen production by the adrenal cortex, results in mixed genitalia. A person with the complete androgen insensitivity syndrome (AIS) has a vagina, external female genitalia and functioning, androgen-producing, testes - but no uterus or fallopian tubes.
People with the rare 5-alpha reductase deficiency syndrome are born with ambiguous genitalia. They appear at first to be girls. At puberty, such a person develops testicles and his clitoris swells and becomes a penis. Hermaphrodites possess both ovaries and testicles (both, in most cases, rather undeveloped). Sometimes the ovaries and testicles are combined into a chimera called ovotestis.
Most of these individuals have the chromosomal composition of a woman together with traces of the Y, male, chromosome. All hermaphrodites have a sizable penis, though rarely generate sperm. Some hermaphrodites develop breasts during puberty and menstruate. Very few even get pregnant and give birth.
Anne Fausto-Sterling, a developmental geneticist, professor of medical science at Brown University, and author of "Sexing the Body", postulated, in 1993, a continuum of 5 sexes to supplant the current dimorphism: males, merms (male pseudohermaphrodites), herms (true hermaphrodites), ferms (female pseudohermaphrodites), and females.
Intersexuality (hermpahroditism) is a natural human state. We are all conceived with the potential to develop into either sex. The embryonic developmental default is female. A series of triggers during the first weeks of pregnancy places the fetus on the path to maleness.
In rare cases, some women have a male's genetic makeup (XY chromosomes) and vice versa. But, in the vast majority of cases, one of the sexes is clearly selected. Relics of the stifled sex remain, though. Women have the clitoris as a kind of symbolic penis. Men have breasts (mammary glands) and nipples.
The Encyclopedia Britannica 2003 edition describes the formation of ovaries and testes thus:
"In the young embryo a pair of gonads develop that are indifferent or neutral, showing no indication whether they are destined to develop into testes or ovaries. There are also two different duct systems, one of which can develop into the female system of oviducts and related apparatus and the other into the male sperm duct system. As development of the embryo proceeds, either the male or the female reproductive tissue differentiates in the originally neutral gonad of the mammal."
Yet, sexual preferences, genitalia and even secondary sex characteristics, such as facial and pubic hair are first order phenomena. Can genetics and biology account for male and female behavior patterns and social interactions ("gender identity")? Can the multi-tiered complexity and richness of human masculinity and femininity arise from simpler, deterministic, building blocks?
Sociobiologists would have us think so.
For instance: the fact that we are mammals is astonishingly often overlooked. Most mammalian families are composed of mother and offspring. Males are peripatetic absentees. Arguably, high rates of divorce and birth out of wedlock coupled with rising promiscuity merely reinstate this natural "default mode", observes Lionel Tiger, a professor of anthropology at Rutgers University in New Jersey. That three quarters of all divorces are initiated by women tends to support this view.
Furthermore, gender identity is determined during gestation, claim some scholars.
Milton Diamond of the University of Hawaii and Dr. Keith Sigmundson, a practicing psychiatrist, studied the much-celebrated John/Joan case. An accidentally castrated normal male was surgically modified to look female, and raised as a girl but to no avail. He reverted to being a male at puberty.
His gender identity seems to have been inborn (assuming he was not subjected to conflicting cues from his human environment). The case is extensively described in John Colapinto's tome "As Nature Made Him: The Boy Who Was Raised as a Girl".
HealthScoutNews cited a study published in the November 2002 issue of "Child Development". The researchers, from City University of London, found that the level of maternal testosterone during pregnancy affects the behavior of neonatal girls and renders it more masculine. "High testosterone" girls "enjoy activities typically considered male behavior, like playing with trucks or guns". Boys' behavior remains unaltered, according to the study.
Yet, other scholars, like John Money, insist that newborns are a "blank slate" as far as their gender identity is concerned. This is also the prevailing view. Gender and sex-role identities, we are taught, are fully formed in a process of socialization which ends by the third year of life. The Encyclopedia Britannica 2003 edition sums it up thus:
"Like an individual's concept of his or her sex role, gender identity develops by means of parental example, social reinforcement, and language. Parents teach sex-appropriate behavior to their children from an early age, and this behavior is reinforced as the child grows older and enters a wider social world. As the child acquires language, he also learns very early the distinction between "he" and "she" and understands which pertains to him- or herself."
So, which is it - nature or nurture? There is no disputing the fact that our sexual physiology and, in all probability, our sexual preferences are determined in the womb. Men and women are different - physiologically and, as a result, also psychologically.
Society, through its agents - foremost amongst which are family, peers, and teachers - represses or encourages these genetic propensities. It does so by propagating "gender roles" - gender-specific lists of alleged traits, permissible behavior patterns, and prescriptive morals and norms. Our "gender identity" or "sex role" is shorthand for the way we make use of our natural genotypic-phenotypic endowments in conformity with social-cultural "gender roles".
Inevitably as the composition and bias of these lists change, so does the meaning of being "male" or "female". Gender roles are constantly redefined by tectonic shifts in the definition and functioning of basic social units, such as the nuclear family and the workplace. The cross-fertilization of gender-related cultural memes renders "masculinity" and "femininity" fluid concepts.
One's sex equals one's bodily equipment, an objective, finite, and, usually, immutable inventory. But our endowments can be put to many uses, in different cognitive and affective contexts, and subject to varying exegetic frameworks. As opposed to "sex" - "gender" is, therefore, a socio-cultural narrative. Both heterosexual and homosexual men ejaculate. Both straight and lesbian women climax. What distinguishes them from each other are subjective introjects of socio-cultural conventions, not objective, immutable "facts".
In "The New Gender Wars", published in the November/December 2000 issue of "Psychology Today", Sarah Blustain sums up the "bio-social" model proposed by Mice Eagly, a professor of psychology at Northwestern University and a former student of his, Wendy Wood, now a professor at the Texas A&M University:
"Like (the evolutionary psychologists), Eagly and Wood reject social constructionist notions that all gender differences are created by culture. But to the question of where they come from, they answer differently: not our genes but our roles in society. This narrative focuses on how societies respond to the basic biological differences - men's strength and women's reproductive capabilities - and how they encourage men and women to follow certain patterns.
'If you're spending a lot of time nursing your kid', explains Wood, 'then you don't have the opportunity to devote large amounts of time to developing specialized skills and engaging tasks outside of the home'. And, adds Eagly, 'if women are charged with caring for infants, what happens is that women are more nurturing. Societies have to make the adult system work [so] socialization of girls is arranged to give them experience in nurturing'.
According to this interpretation, as the environment changes, so will the range and texture of gender differences. At a time in Western countries when female reproduction is extremely low, nursing is totally optional, childcare alternatives are many, and mechanization lessens the importance of male size and strength, women are no longer restricted as much by their smaller size and by child-bearing. That means, argue Eagly and Wood, that role structures for men and women will change and, not surprisingly, the way we socialize people in these new roles will change too. (Indeed, says Wood, 'sex differences seem to be reduced in societies where men and women have similar status,' she says. If you're looking to live in more gender-neutral environment, try Scandinavia.)"
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Penis size does matter! Not to women, but to you!
If you believe that you have a small penis, it may matter very much to you, however unimportant the issue might seem to other men, women, doctors and experts.
Most articles in women's magazines, surveys and studies show that penis size does not really matter to women. Surveys and studies can say what they want about what men and women prefer but if YOU are unhappy about your penis size, then penis size does matter.
This is nicely illustrated by a young university student's view on the size of his penis : "It's not the fact that I am ugly and repulsive- well I don't think I am, at least I've never been told I am. The fact is that I lack serious confidence, now that I have been told before. I lacked faith in myself and in my ability to perform. I am 5'10" tall - which isn't extremely tall or small, just average. But I was never satisfied with my penis size. However I looked at it, I just simply wasn't satisfied with it- I would go as far as to say I was really embarrassed."
Telling men that penis size does not matter, is like telling a woman that feels her breasts are undersized, that her breast size does not matter. The fact that most men do not care about breast size when they get involved with a woman whether emotionally or sexually, has nothing to do with her perception of herself as having small breasts. If she "feels" she has small breasts, then it does matter to her.
The key word here is "feeling". It boils down to self perception. If you "feel" you have a small penis, no reassurance from your partner will convince you otherwise. It is based on your "feelings" which in turn is based upon self perception and self acceptance.
True, that some men may in fact have an under size penis, and may in fact have been ridiculed in the past, but most men thinking about penis enlargement are in fact "normal" or average. They may however "feel" that they have a small penis and for these men it is as real as their hair color. It has very little to do with fact, and for them penis size does really matter.
For most women penis size do not matter because most women can only accommodate the average penis size anyway. The fact is women vary in size, too. Some have longer vaginas, some shorter. So if you pride yourself on your exceptional length, but the women in your life is shorter than average, you might be missing the spot.
We appreciate the fact that women want to save our fragile male ego's because in their eyes penis size really does not matter (their preferences are usually a blend of taste, aesthetics, habit, comfort, pressure and pleasure) but for some men it is important to have a larger penis.
Just as you would keep reassuring your better halve that her breast size does not matter, no amount of "convincing" from your part can make her think otherwise because "breast size" is important to her and the way she perceives herself. If she "feels" she has small breasts, then it really does matter to her.
What is important to note here is that most men will have a penis that falls within the suggested normal size range, but that does not always make them feel normal or better about themselves. Both they, and their doctor, should recognize that this is primarily a psychological problem, connected to physical and sexual self-image, rather than a physical handicap.
This is why I get so upset with people saying that penis size does not matter. It does! It matters to the person who "feels" they have a small penis. And it is as real as anything else in their lives. And it does not help dismissing the topic all together. It does not help asking women about penis size and whether it matters. They do not have penises so of course it will not matter to them! It matter's to the person who "feels" they have a small penis. Penis size does matter!
