Dr Tahira Rubab Hafeez

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infertility in male

MALE INFERTILITY: BASIC REVIEW

  In this post, you will learn about male infertility issues. Healthy fertile men continue to make sperm throughout their lives. Fresh sperm is made daily in a large quantities to the extent that fresh sperm have been made with every heartbeat. For an infertile man, this might be due to an underlying medical condition, for example, heart disease, diabetes, high cholesterol, thyroid disease, etc. As a male, your fertility depends on the quality and quantity of your sperm. If the number of sperm in your ejaculate is low or if the sperm is of poor quality, it will be difficult and, in some cases, impossible to get pregnant.  It is important to look for any underlying condition. There may also be featured in the man’s past medical or surgical history indicating a cause for Infertility. For example, a man has undergone an operation to bring down an undescended testicle. A man who is got a varicocele, a varicose vein around the testicle, may also be the reason for his male Infertility.  Causes: Infertility can be caused by low sperm production or sperm that simply doesn’t work as it should. Infertility can also be caused by physical problems, such as blockage in the tubes that lead from the testicles to the penis. Other less common causes of Infertility include sexual problems that affect whether the semen is able to enter the vagina or low levels of hormones made in the pituitary gland that affect the testicles and sperm antibodies.  Simply male infertility cause is simply genetic. The most common genetic cause is chromosomal conditions that affect the way that the sperm is produced, such as Klinefelter syndrome, Y chromosome deletions, and other genetic problems like down syndrome.  If there is a history of infections, particularly repeated infections, this can also affect fertility. With regards to the investigation, a key step is a detailed semen analysis, and this is done by a fully trained reproductive doctor or sex therapist according to criteria set down by the world health organization.  The man might also need to have a series of blood tests carried out, including measuring testosterone and, for men with very low sperm counts, genetic testing, chromosome analysis or testicular ultrasound. How is Infertility diagnosed? Infertility is diagnosed after a couple has been trying to achieve pregnancy for a year with regular, unprotected intercourse. In up to 50% of cases, Infertility is due to male factors, the causes of which range from physical obstruction of sperm passage to genetic defects that affect sperm production. It is treatable in many men, and understanding the causes and approach to this condition will help the physician diagnose and treat the infertile male. Can old age cause male fertility problems? Healthy men in their 70’s and beyond can still father children, although if you are middle-aged or older, it usually takes longer for your partner to become pregnant, and this might be because of less sexual activity or lower semen volume, changes in sperm movement, or a lower number of properly working sperm or possibly lower sperm function and DNA quality. The common symptoms of Infertility in men In most cases, there are no obvious signs of Infertility, but sometimes, the common symptoms are as follows:  Erectile Dysfunction Changes in sexual desire Premature Ejaculation Testicle pain or swelling Small, firm testicles Treatment of Male Infertility Most Common: Blood tests Semen analysis Physical Exam Other Tests: Genetic testing Ultrasound Testicular Biopsy Laboratory testing in the setting of male Infertility consists of semen analysis and hormone evaluation. Ultrasound imaging can assess ejaculatory duct obstruction via the determination of seminal vesicle size and ejaculation for prostatic cysts and can help confirm varicocele. Treatment includes both medical and surgical therapy. Medical therapy can mitigate hormonal imbalance and potentially improve sperm production, whereas surgical approaches can be used to bypass structural abnormalities or obtain sperm for use with assisted reproductive technologies.  Medication that may be used to treat abnormal hormone levels  men with low sperm counts includes chronic human gonadotropin, selective estrogen receptor modulators, and aromatase inhibitors.  Busting Myths about Male Factor Infertility 30% of infertility cases are caused by male Infertility, Male fertility declines with age. The health of sperm also declines with age. Smart Strategies for Resolving Male Infertility Maintain a healthy weight. Quit smoking. Avoid drugs. Take Vitamins because sperm may clump with low Vitamin C and Zinc levels. Exercise regularly. Reduce exposure to chemicals. Reduce stress. Adequate sleep. Avoid caffeine. Important Nutrition Elements for Man ZINC: Improve sperm quality. OMEGA 3: Enhance sperm mobility. VITAMIN E: Antioxidant. SELENIUM: Important for sperm development. GREEN TEA EXTRACT: Anti-inflammation. L-CARNITINE: Enhance sperm energy  

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Do Not Be Worried About Being Good in Bed

Ask Tahira: I’m worried I’m not good in bed Problem: I am not good in bed and I am very much worried about this issue. Please help me to get out of this. Tahirs Rubab Says… The fear that you might not be very good in bed is something that many people experience at some point in their lives. One of the most common issues that affects relationships is sex insecurity. Every year, we see thousands of people with similar concerns in Relationship Counselling and Sex Therapy sessions. So, first and foremost, if this is something on your mind, know that you are not alone. But, before we address the issue, it’s worth considering what we might mean when we say we’re not ‘good in bed.’ Understanding your relationship: When we say we’re not excellent at something, we’re usually referring to our relationship with it rather than our ability level. We may believe we aren’t good at sketching because we don’t consider ourselves to be particularly ‘artistic.’ We may also claim that we aren’t adept at public speaking because we don’t consider ourselves to be confident. When someone says they’re “not good in bed,” they’re almost always referring to their relationship. Sex is frequently used as a metaphor for deeper concerns in a relationship. We frequently have couples who come in claiming that sex is the biggest issue, but who only discuss it a few times during counselling — instead, they focus on their relationship as a whole and how they’re feeling about it. It’s not about being ‘excellent at’ having a wonderful sex life with someone; it’s about doing things in a way that is mutually gratifying for both of you. Getting to that stage usually entails discussing any concerns that may present in the relationship and determining how to address them. How do we do that? It depends entirely on your individual relationship. Problems with sex can come from a wide variety of places. It might be worth thinking about any of the following: Have you recently had a lot of disagreements? Do you notice that minor arguments can quickly escalate into major squabbles? Or that seemingly insignificant things can easily set you and your partner off? Do you have any other sources of stress in your life, such as family or work? Anxiety from other sources can have a significant impact on our sexual lives. Are you a good communicator? Are you able to express your needs and feelings while also empathizing with what the other is saying? Do you spend much time with each other? Or are other demands on your time making it hard to properly prioritize your relationship? Have you been through a big life change recently? Things like moving, starting a new job, or having children can provide problems that you weren’t expecting. While different relationship issues may necessitate varying levels of attention, a lack of good communication is frequently the common denominator. It’s far more difficult to cope with problems and sustain your relationship when we don’t communicate to our partner freely and constructively – and they don’t talk to us. Communication is a big topic, but you might like to start by checking out our article about communication tips to try with your partner. These tips will help you think about how you’re communicating together, and using them can help to make tricky conversations easier. However, if you think you might need a little help, then you may find it useful to find out a bit more about Relationship Counseling and how it works. Counseling is a great way of beginning to explore any issues in your relationship in a safe space where you’re both able to express openly how you’re feeling.   Talking about sex and learning together: Another possibility is that you believe you are unable to satisfy your spouse because you lack experience or have never acquired a sufficient number of skills.’ In this case, it’s important to take a step back and look at things from a different perspective. We have a tendency to exaggerate these concerns in our imaginations. People often stress about things like being ‘excellent’ in bed, their attractiveness, or the size of specific organs when, in reality, their partner isn’t bothered nearly as much as they think they are. It’s also a good idea to address the idea of you not being a good bed partner. We don’t have sex with our partner by ourselves; it’s something we do together. If you and your spouse don’t feel like you’re getting things ‘right,’ it’s something you and your partner should work on together. Much of this, once again, may be solved through improved communication. Although discussing sex might be difficult, it is an important aspect of having a successful sex life. Remember: the goal isn’t to be ‘excellent’ on your own; it’s to be good together. The ultimate goal is to talk about it and understand each other’s requirements in order to figure out what works best for both of you. Getting help: If you and your partner think you could benefit from getting some professional help when it comes to sex, there’s no shame in asking. People who come to Sex Therapy are so often surprised by how effective they find it – and how quickly they begin to see changes. You can come in for an initial consultation to find out whether it would be useful for you and your partner. Watch this video to know more tips About the Author  Tahira Rubab a Relationship Counsellor and Sex Therapist .If you’ve got a relationship worry you’d like some help with, please call us at 0311 4482787

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Why Does a Wife Avoids to Be Intimate With Her Husband

My wife doesn’t want to have sex with me? Problem: I separated from my wife a while ago. I’ve agreed to go back and try and save things, but I’m not sure I can. I was severely depressed last year and this made me intensely lonely. Despite not having shared any intimacy for over 8 years, I felt the need for sex in our relationship. We discussed this, along with the fact I felt the lack of intimacy had caused me to no longer be ‘in love with’ my wife. But it didn’t change anything. There have also been some difficult dynamics between us because I was abused as a child. Last week she got nasty about the counseling session and objected to it ‘taking her weekend up’. This upset me and things escalated, so I ended up leaving. We’ve barely spoken since. I still insist on the intimacy returning pretty quickly, otherwise I don’t want to stay in this marriage. I want to be in a loving, sexual relationship. But my wife doesn’t seem bothered. Am I being unreasonable? Tahira Rubab says … No, you’re not being at all unreasonable in craving intimacy from your relationship – but neither can you insist on it. Insisting will get you nowhere, because intimacy is a two-way street: both partners need to want it. But clearly there’s nothing wrong with wanting to be  in a loving, sexually intimate relationship. Many people feel that being loved and cared for in this way enhances both their mental and emotional wellbeing. It will undoubtedly be soul destroying; being with someone who can’t (or won’t) acknowledge this important side of you will only add to the loneliness you feel. You describe a really sad and difficult situation and one that you’ve both been facing for many years. More lately, the depression you’ve experienced has reminded you how lonely  and isolated you feel. This, along with the legacy of abuse you suffered as a child, must be a painful thing to bear and I’m not at all surprised that you’re feeling this way. The very interesting thing about sex though, is that it means different things to different people. Often people think about ‘sex’ in terms of some sort of penetration. For some couples, this is the only outcome of any sort of foreplay and anything less than intercourse (of whatever description) is a disappointment.  Often in sex therapy clinics, we see couples with very mismatched expectations of what they want from this part of their relationship. For some, intercourse makes them feel alive and connected – for others, just the touch of a hand, a gentle massage and kind words have the same effect, with no need to progress on to anything else. I’m wondering what has caused the lack of intimacy or sex between you and your wife over the years? What might your wife say from her perspective? I’m wondering if you’ve been able to discuss this problem openly and honestly as a couple and really understand what you’re asking of each other? Sometimes, although the obvious answer might seem to be ‘let’s just have sex –  we’ll both feel good about it and it will solve everything’ it just doesn’t wash, because one or other of the partners feels unheard. So it’s probably not surprising to hear that when we feel unheard, we can often switch off. But what to do right now? If ever a situation called out for couple counseling, it’s this one. The risk at the moment is that you might both be making assumptions about how and why the other feels the way they do. Harsh, destructive things are being said and as you’re now finding, the only thing achieved is more pain, misery and the awful loneliness you describe so eloquently.  Couple counseling might help you find the ‘space’ to explore what’s gone wrong and see if there’s a way back to finding a place where you can both get some of your needs met some of the time. From what you tell me, it sounds like you and your wife have reached that classic, insoluble position which can be loosely described as “I’m not talking to you – well, that’s fine because I’m not listening”. Clearly, if you both keep taking the same approach, I strongly suspect that you’ll keep getting the same responses from each other. Couple counseling could provide a holistic space to unravel everything without destroying each other. It could help you both to make sense of your respective concerns and give you plenty of opportunity to potentially reclaim something that could become important to both of you. But regardless of whether it helps you both find your sexual mojos again, hopefully you would emerge with a much clearer idea of what’s possible. Of course, it could equally signpost that the relationship has nowhere left to go, which I guess would be very painful. However, the question you might ask yourself is whether it would be more painful than having a constant expectation of your wife that for whatever reason she feels unable or unwilling to meet. I hope you find what you’re looking for with or without this current relationship. Watch this video to know more tips About the Author  Tahira Rubab a Relationship Counsellor and Sex Therapist .If you’ve got a relationship worry you’d like some help with, please call us at 0311 4482787

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