Although experiencing pain during sexual intercourse is a fairly common problem, 2 out of every 3 women experience it, but pain can actually ruin the very essence of this three letter magic word – SEX.

Causes:

Painful intercourse can be result of a range of conditions – physical or psychological.

Physical causes:

A range of physical causes including infection (yeast or urinary tract), vaginismus (inflammation of the vagina), inadequate lubrication, abdominal or pelvic injury, uterine fibroids (benign tumors of the uterus), a healing episiotomy may result in a painful intercourse.

Psychological causes:

Emotional issues like anxiety, depression, concerns about physical appearance, fear of intimacy, relationship problems or a history of sexual abuse – can all play a spoil sport in sex.

Symptoms:

The classic signs of dyspareunia include a painful penetration, a superficial (entry point) pain or a ‘deep inside’ pain often cited as a lower back pain or abdominal pain. The pain is often associated with a burning, tearing, ripping or aching sensation.

Prevention:

While there are no absolute preventive tips, maintaining a good genital hygiene helps. Avoid using scented bath products especially around the vaginal area as these can irritate the genital area and also zap the natural lubrication. Avoid douching. Drink lots of fluids that help flush out body toxins.

Treatment:

Depending upon the underlying cause of the pain – physical or psychological – the doctor will advice a treatment plan.

While infections, vaginal inflammation or a medical condition require a corresponding drug therapy, emotional issues like anxiety and depression require proper counseling. In addition, a longer foreplay, use of water-based vaginal lubricants such as K-Y jelly or Astroglide can make sex more comfortable.

In postmenopausal women, receding estrogen levels often result in inadequate lubrication. This can be corrected by the use of a prescription cream, tablet or a vaginal ring.

Pain can also a associated with a specific sexual position. Switching positions may help.

The findings, published in the Journal of the American Medical Association, are based on an assessment of 800 patients. The researchers clearly established that an active antidepressant treatment helps combat depression only in people with severe depression.

On the other hand, patients with mild depression who were administered antidepressants ‘do just as well or just about as well with a placebo’, Robert DeRubeis, primary author of the analysis and a psychologist at the University of Pennsylvania remarked.

“Our data should give some pause to doctors who are considering prescribing antidepressants. They should give some consideration to other alternatives,” said Robert DeRubeis added.

According to the estimates of the National Institute of Mental Health, nearly 14.8 million American adults aged 18 and above are affected by depression annually.

The study authors have referred to exercise as well as psychotherapy as an alternative treatment option to combat depression.

The study, which has been published in the Journal of the American Medical Association, assessed 800 patients and established that the efficacy of the antidepressants was markedly better in people with severe depression.

“Our data should give some pause to doctors who are considering prescribing antidepressants. They should give some consideration to other alternatives,” said Robert DeRubeis, primary authors of the analysis and a psychologist at the University of Pennsylvania.

Referring to the patients with mild depression who were administered antidepressants, Robert DeRubeis said, “They would have done just as well or just about as well with a placebo.”

According to the National Institute of Mental Health, depression annually affects roughly 14.8 million American adults, or about 6.7 percent of the U.S. population aged 18 and above.

While antidepressants form the basis of treatment for depression, doctors are progressively prescribing antipyschotics in addition to or on top of antidepressants to treat some patients.

People who had diabetes for years may experience numbness and sometimes pain in their hands, feet and legs. Nerve damage caused by diabetes can also lead to problems with indigestion, diarrhea or constipation, dizziness, bladder infections, and impotence. In some cases, damaged nerves can strike suddenly, causing pain, weakness, and weight loss. Depression may follow.

While some treatments are available, a great deal of research still needs to be done to understand how diabetes affects the nerves and to find better treatments for this complication.

Nerve problems can affect anybody with diabetes, but they are most common in people who have had diabetes for more than 10 years. The majority of patients with neurological impairment due to diabetes do not have symptoms such as pain or numbness.

Scientists do not know how diabetic neuropathy occurs, but it is likely that several factors come into play. High blood glucose causes chemical changes in nerves, impairing their ability to transmit nerve signals. High blood glucose also damages blood vessels that carry oxygen and nutrients to the nerves. Also, inherited factors probably unrelated to diabetes may make some people more susceptible to nerve disease than others.

The study of the chemical changes that happen to nerves exposed to high blood glucose is a very active area of research. A normal substance called aldose reductase converts glucose to a type of sugar alcohol called sorbitol. Scientists have found that when tissues have a high level of glucose, sorbitol builds up and apparently damages the membranes lining body tissues.

Studies have shown that proteins age more quickly when exposed to high glucose. This has the effect of weakening certain connective proteins called collagens, which line and support nerve tissue. While these changes occur with normal aging, high blood glucose speeds up the damage.

The symptoms of diabetic neuropathy vary a great deal. Some people notice no symptoms, while others are disabled by severe problems. Neuropathy may cause both pain and insensitivity to pain the same person. Often, symptoms are slight at first, and since most nerve damage occurs over years, mild cases may go unnoticed for a long time. In some people, though, mainly those afflicted by mononeuropathy, the onset of pain may be sudden and severe.

A doctor diagnoses neuropathy from symptoms and a physical exam. During the exam, the doctor may check muscle strength, reflexes, and sensitivity to position, vibration, temperature, and light touch. Sometimes special tests are used to pinpoint the cause of symptoms and suggest treatment:

* Ultrasound employs sound waves too high to hear, which produce an image showing how well the bladder and other parts of the urinary tract are functioning.

* Nerve condition studies check the flow of electrical current through a nerve. With this test, an image of the nerve impulse is projected on a screen as it transmits an electrical impulse. Impulses that seem slower or weaker than usual indicate possible damage to the nerve.

*Electromyography (EMG) is used to see how well muscles respond to electrical impulses transmitted by the nerves nearby.

*Nerve biopsy involves removing a sample of nerve tissue, which is examined for damage. This test is mot often used in research settings.

Treatment aims at relieving discomfort and preventing further tissue damage. The first step is to bring blood sugar under control by diet and oral drugs or insulin injections, if needed. Although the symptoms can sometimes worsen as blood sugar is brought under control with intensive treatment, careful long-term monitoring of blood sugar helps reverse the pain or loss of sensation that neuropathy can cause. Good control of blood sugar with diet and, if necessary, drug therapy may also help prevent or delay the onset of further problems.

A number of medications are used to relieve the symptoms of diabetic neuropathy: An analgesic such as aspirin or acetaminophen, an anti-inflammatory drug containing ibuprofen, antidepressant medications such as amitriptyline, sometimes used with fluphenazine, or nerve medications such as carbamazepine or phenytoin sodium. Codeine is sometimes prescribed for short-term use to relieve severe pain. Your doctor may prescribe a therapy known as transcultaneous electronic nerve stimulation (TENS). For patients with mild symptoms of slow stomach emptying, doctors suggest eating small, frequent meals and avoiding fats and less fibers.

Another important part of treatment involves special care of the feet, which are especially prone to problems.

Diabetes Insipidus is a disorder that is characterized by intense thirst and a greatly increased output of diluted urine. In diabetes insipidus you are either producing too little of the antidiuretic hormone (ADH) or it is that your kidneys are not responding normally to the output of ADH. Most people develop diabetes insipidus in early childhood or early adulthood. It is commonly found in more males than females. It has a tendency to develop after surgery, illness or a major head injury.

Urination is frequently increased causing you to crave liquids, especially cold water, in great quantities.  If you are unable to keep up with your body’s demand for liquids or if an accident or illness prevents you from drinking sufficient quantities, you may become dehydrated. Patients with diabetes insipidus may need to urinate every 30 minutes to an hour throughout the day and night.

Diabetes insipidus is not related to Diabetes Mellitus (which is the bodies inability to regulate insulin). In Diabetes Mellitus the body has trouble using insulin to turn sugar into energy.

Reasons to suspect diabetes insipidus:

Increased frequency of urination.

Insatiable thirst.

Increased fluid intake.

Diluted urine.

Increased urine output.

Dehydration.

Increased heart rate.

Low blood pressure.

Dry mouth.

Sunken appearance to the eyes.

Lack of tears or inability to sweat.

Poor skin elasticity.

Sudden weight loss.

Unexplained weakness.

Confusion or irritability.

There are two main types of diabetes insipidus: central or neurogenic (related to the nervous system) and nephrogenic (related to the kidneys). With Central diabetes insipidus the hypothalmus (a part of the brain that controls the endocrine system) does not produce enough ADH. This will sometimes cause other conditions, that may include:

Tumors that affect the hypothalmus or pituitary glands.

Tumors that form bumps on the tissues organs.

A rare inherited syndrome called Wolfman syndrome.

Brain injuries due to hypertension.

Uterine bleeding.

Pregancy complications or Sheehans syndrome.

And in some cases acquired immune deficiency syndrome.

Many childhood cases of diabetes insipidus have no underlying causes.

Kidney injury (due to infections of the pelvis and kidney tissues).

Myeloma (a build up of a waxy protein in the organs and tissues).

Sj’grens syndrome (an abnormal dryness of mucus membranes).

Excess calcium or low potassium in the blood.

Cysts in the liver or kidneys.

In some cases those taking lithium for extended periods of time have develope diabetes insipidus also. Nephrogenic diabetes has also been found to be inherited.

Doctors usually suspect diabetes insipidus when the patient complains of increased thirst and frequent urination. The first diagnotic test is a collection of urine for a 24 hour period. In most cases it will be very diluted. You may need other tests to confirm the diagnosis. A doctor may perform a water-deprivation test (to see how your body responds to dehydration) or a vasopressin challenge (to see how your body responds to synthetic ADH). Once diabetes insipidus is diagnosed the cause must be determined. An MRI may also be performed to see if the regions of your brain that pituitary and hypothalmus appear normal.

Medications that are used to treat diabetes insipidus include, pitressin, desmopressin acetate, chlorpropamide, clofibrate and carbamazepine. If you have diabetes insipidus, you may need to take a diuretic and eat a low-sodium diet. Cases of this type of diabetes caused by injury, pregnancy or surgery have sometimes resolved themselves. If this is not the case you may need lifelong treatment.

Besides taking precautions to prevent brain and kidney injury there is no way to actively ward off diabetes insipidus. If you exhibit any of the above symptoms either after pregnancy, injury or surgery tell your doctor immediately. When dealing with children that show these signs make sure that a pediatric internist is consulted.