Friends today I am discussing about a problem In males is known as Phimosis. Phimosis is a condition in which the foreskin can’t be retracted (pulled back) from around the tip of the penis. A tight foreskin is common in baby boys who aren’t circumcised, but it usually stops being a problem by the age of 3. Phimosis can occur naturally or be the result of scarring. Young boys may not need treatment for phimosis unless it makes urinating difficult or causes other symptoms. As these boys grow up, the need for treatment may increase. Symptoms of phimosis The main symptom of phimosis is the inability to retract the foreskin by the age of 3. The foreskin usually loosens over time, but this process can take longer in some boys. By around the age of 17, a boy should be able to easily retract his foreskin. Another common symptom of phimosis is a swelling of the foreskin while urinating. Causes of this condition Phimosis can occur naturally. It’s unclear why it occurs in some boys but not others. The condition can also occur if the foreskin is forcibly retracted before it’s ready. This can harm the skin and cause scarring, making it more difficult to retract the foreskin later on. Inflammation or an infection of the foreskin or the head of the penis (glans) may cause phimosis in boys or men. Balanitis is an inflammation of the glans. It’s sometimes the result of poor hygiene or an infection of the foreskin. One of the infections that can lead to balanitis is called lichen sclerosus. It’s a skin condition that may be triggered by an abnormal immune response or a hormone imbalance. Symptoms can include white spots or patches on the foreskin. The skin may become itchy and easily torn. Recurrent infections of the glans or foreskin should also be evaluated by a doctor. Signs of an infection may include: changes in the color of the glans or foreskin the presence of spots or a rash pain itching swelling Treatment for phimosis A physical exam and a review of your son’s symptoms are usually enough to diagnose phimosis or an underlying condition, such as balanitis. Treating balanitis or another type of infection usually starts with a swab of the foreskin to be studied in a lab. A bacterial infection will require antibiotics, while a fungal infection may require antifungal ointments. If there is no infection or other disease causing phimosis, and it appears that the tight foreskin is simply a naturally occurring development, there may be several treatment options available. Depending on the severity of the condition, daily gentle retraction may be enough to treat the problem. A topical steroid ointment can be used to help soften the foreskin and make retraction easier. The ointment is massaged into the area around the glans and foreskin twice a day for several weeks. In more serious cases, circumcision or a similar surgical procedure may be necessary. Circumcision is the removal of the entire foreskin. Surgical removal of part of the foreskin is also possible. While circumcision is usually done in infancy, the surgery can be performed on a male of any age. Circumcision may also be necessary if your son experiences recurrent balanitis, urinary tract infections, or other infections. Phimosis versus paraphimosis A condition called paraphimosis can also result when the foreskin is retracted, but can’t be moved back into its normal position. This may require emergency medical attention. One complication of paraphimosis is a reduction in blood flow to the end of the penis. The treatment options for paraphimosis are similar to those for phimosis. Lubricating the glans and the foreskin may help slide the foreskin back up. Before trying this at-home treatment, you should discuss it with a doctor. Have the doctor recommend brands and types of ointments or lotions that are safe. If the paraphimosis continues for several hours, color changes occur, or there is pain, you need to get a medical evaluation immediately. Circumcision or partial circumcision can eliminate the concerns of foreskin retraction. Be sure to discuss the risks and benefits of this procedure with a doctor. Being uncircumcised places a man at a higher risk of HIV and other infections. If daily retraction is enough to loosen the foreskin, then pulling it back gently when bathing or urinating should be enough to keep the penis from any hygiene-related complications. Phimosis can be a serious and painful condition. However, it’s treatable, and outcomes are usually very good. The key is to seek medical attention when symptoms become obvious. HOMEOPATHIC MEDICINES Balanitis APIS, AUR, CALC, Cor r, Dig, KALI M, Kali s, Nat c, Rhod, Sars Balanoposthitis jac c, Cor r, MERC C, Merc Pain & Burning while urinating Apis, ARS, Can s, CANTH, Calc, Cinnb, dig, kali i, Lyc, MERC C, Nit ac, Rhod, Rhus t, Sars, SULPH Discharge of pus Hep, sulph, cinnb Blood in urine bell, CANTH, can s, kali i, lyc, Merc c, Merc, Nit ac Retention of urine APIS, ARN, ARS, BELL, Calc, Can s, CANTH, Coloc, cinnb, Dig, Hep, kali i, LYC, merc c, Nit ac, Rhus t, sulph Painful Erection CAN S, CANTH, Dig, hep, kali i, lyc, merc c, Nit ac

12 years female depigmentation on vulvar area since 2 years. patient complaining of itching on that area and burning micturition since 2 months. what is the diagnosis? treatment?

Friends today I am discussing about Dyspareunia In Women. Pain during intercourse. What is dyspareunia? The word dyspareunia is derived from the Greek language, and the meanings include "difficulty in mating" or "badly mated." Dyspareunia or pain during sexual intercourse can occur both in men and women but is more common among women. The pain can range from moderate to severe and occurs in a woman's labial or vulvar areas, during or immediately after sex. The pain may also be experienced as a pelvic pain or vaginal pain and is often accompanied by a burning or throbbing sensation. What are the causes of dyspareunia? There are a variety of causes that can lead to dyspareunia: Depression, fear, and anxiety which can affect sexual arousal and lead to conditions such as vaginismus, or vaginal dryness A history of sexual abuse or trauma Stress Domestic violence The medical factors that can lead to dyspareunia include: Atrophic vaginitis or vaginal atrophy which is a common condition that causes thinning, drying or inflammation of the vaginal lining in postmenopausal women Urinary tract infections, vaginal yeast infections, or sexually transmitted diseases like candida, herpes simplex or genital warts Skin disease, such as psoriasis or lichen sclerosus. Cystitis or inflammation of the bladder wall caused by a bacterial infection Endometriosis a painful gynaecological condition, which occurs in women when the tissue that makes up the uterus lining develops elsewhere in the body. Fibroids which are often benign tumours that grow on the wall of the uterus Interstitial cystitis which is a chronic painful bladder condition Irritable bowel syndrome (IBS) which is a functional disorder of the digestive tract Ovarian cysts a condition where a build-up of fluid within an ovary occurs Pelvic inflammatory disease (PID) which causes inflammation of the female reproductive organs, usually caused by infection Uterine prolapse a condition in which one or more pelvic organs extend into the vagina The other causes that can lead to dyspareunia include: Side effects of some drugs Allergic reaction to clothing, or spermicides What are the symptoms of dyspareunia? How is dyspareunia diagnosed? The symptoms of dyspareunia include: Lack of sexual desire Inability to get aroused Pain that occurs only during sexual penetration Repeatedly experiencing pain while the partner thrusts Burning sensation along with the pain Inability to experience orgasm Pain while inserting a tampon Throbbing or burning sensation which occurs with the pain and lasts for a long time after the intercourse Diagnosis A medical evaluation for dyspareunia includes: The doctor asking in detail about your sexual history, medical and surgical history, when did your pain begin, whether it occurs in certain sexual positions. In case of multiple sex partners, the patient needs to mention if the pain occurs only with certain partners. A pelvic exam by the doctor to check for any form of infections. During the pelvic exam, the doctor may apply gentle pressure on the genital muscles with a cotton swab to identify the location of the pain. Based on the physical exam the doctor may recommend a pelvic ultrasound a visual exam of the vagina, using an instrument called a speculum What are the complications of dyspareunia? Dyspareunia does not usually cause any form of severe health complications. However, it can affect the sexual life of the person. With the right intervention and treatment, dyspareunia can be managed and even cured. What is the treatment for dyspareunia? Medical Treatment for Dyspareunia The treatment of dyspareunia varies according to the cause: In case of dyspareunia which is caused by vaginal dryness, the doctor prescribes vaginal lubricants and may also suggest adequate foreplay. In case of infections and sexually transmitted diseases, the doctor will prescribe antibiotics. In case of allergies, the doctor may prescribe topical creams. For women suffering from dyspareunia due to hormonal problems, hormonal therapy may be prescribed. Surgical intervention may be required for women suffering from problems such as abnormal endometrial tissue growth or uterine fibroids. Psychological counselling may be required for women who have suffered from sexual abuse and trauma. Exercising for Managing Dyspareunia Stretch exercises which strengthen the pelvic floor can help immensely in doing away with the symptoms of dyspareunia. Practicing yoga regularly can help in strengthening and removing the tightness of muscles that can cause the pain associated with dyspareunia. Yoga can also decrease stress levels, anxiety, depression and boost your self-image and self-confidence. Doing The Kegel Exercise Doing the Kegel exercise can help with the symptoms of dyspareunia. The Kegel exercise was named after Dr. Arnold Kegel, who has popularized them in the ‘50s.This exercise initially was meant to cure patients suffering from urinary incontinence (often after childbirth). Gradually the efficacy of Kegel’s exercise was discovered for patients who suffer from conditions like dyspareunia and vaginismus. You can easily identify the vaginal muscles which play an active part during sex with this simple exercise. Go to the bathroom and urinate a little, then stop the flow of your urine. Then start urinating again, retain the flow of urine, and stop again and then start again. Do so until you have emptied your bladder. The muscles which just acted according to your wishes are the same ones involved in dilating and contracting during sex especially during vaginal penetration. Once you identify these muscles it is important to exercise them in order to be able to contract and relax these muscles at will. This will help you gain control over the vaginal muscles keeping pain at bay during sexual penetration. This is known as Kegel’s exercise. The exercise of alternatively stopping and letting the urine flow is only for test purposes to identify the muscles which need to be exercised while performing the Kegel's exercises. Warning: Please do not do the Kegel exercise while urinating. When you are still at the stage of practicing the Kegel exercise, do not attempt a sexual intercourse with penetration. The Kegel Exercise Practice the Kegel exercise for a week or two. Find a quiet suitable place to do the exercise. You can do it after waking up in the morning and just before bedtime while lying on your bed. Follow the steps given below: Contract your pelvic muscles. Squeeze and hold for 3 seconds Then relax for another 3 seconds. Repeat the exercise for as many as 10 times each session, until you can do around 15 repetitions. Initially, a certain effort of concentration will be needed to contract the pelvic muscles only, without contracting the abdominal and gluteal muscles. When you get used to it, it will become automatic. Once you become comfortable doing these sessions quietly in bed, you can do the Kegel exercises anytime while doing some other activities for example, watching TV, working on your computer, in your car, etc. Syncing the Kegel Exercises with Breathing Exercises Once you are comfortable doing Kegel’s exercise anywhere, sync it with breathing exercises: Focus on your breathing for a few minutes. Breathe in and out deeply a couple of times to relax yourself. Then inhale deeply and hold your breath for a few seconds while strongly contracting your pelvic floor muscles. Then exhale deeply and relax these muscles. Repeat several series of this exercise. You can do this exercise in front of a mirror in order to visualize your vaginal muscles at work. This can immensely help to improve your mental awareness of this part of your body and help boost your performance when you resume your sex life. This could be due to vaginal infection. Please get examined by gynaecologist and get the vagina seabed for culture and sensitivity. Ask health queries and get free answers from doctors in 24 hrs Did you know? Dyspareunia in Women Dyspareunia affects 8 - 22% of females, making it a very frequent issue in gynecologic practice. Even without this disorder a significant proportion of women – between 6.5% and 15% – experience varying levels of pain in their genital areas particularly during sexual intercourse at some point in their life. Here are a few effective homeopathic treatments that can help get rid of pain during intercourse: Sepia and lycopodium: It is the top homeopathic medicine for vaginal dryness. Sepia and lycopodium are evaluated as the best cures. Sepia is suggested where vaginal dryness occurs along with itching. Pain from vaginal dryness during intercourse also calls for the use of sepia. Bellis perennis: This medicine helps cure the wounded sensation in the vagina, if intercourse is obstructed due to pain and spasms. Cactus grandiflora: This is used when the vagina shuts close during the act of intercourse. Intercourse might be simpler just before periods. Coffea: This may be used when, if the vulva and vagina are oversensitive and you feel heat as well as itchiness. Cuprum: This medicine is prescribed for cramping in the vagina and the legs, during intercourse. Ferrum: When your vagina feels dry and aches, this medicine may be prescribed. Gelsemium: This medicine is used to treat any tension preceding intercourse. These symptoms usually show an inclination towards vaginismus.

32 years, married for two years, presented with this lession for last seven months. Initially the lesion was small, gradual onset without itch. Treated by local doctors without any improvement rather worsen. At present complaints of mild itch and discomfort during intercourse. No other co-morbodities. How will you proceed to arrive : 1. Diagnosis ? 2. Investigations want to perform ? 3. Management ? 4. D/D ? *** Please please write your answer in chronological order. Thank you everyone.

30 years old PT/ known Diabetic , have this kind of lesions..no itching at all plz RX and DX