АСТМА – ASTHMA

Most couples decide to have a baby because it’s the right time and they have a strong desire for children. Some have clear plans about the number and spacing of the children they want. Others just take their chance, accepting each pregnancy as it happens. Some pregnancies result from forgetting to use or failure of contraception. Not all unplanned pregnancies are unwanted: on the contrary, many are greeted with as much joy as if they’d been carefully planned, though it may take longer to adjust to what’s ahead. In the past men have felt left out of child-bearing and child-care when these things were mostly considered ‘women’s business’. But it takes two to make a baby. One good outcome of the new balance in relationships between sexes has been that men now generally take more part than previously in family planning, pregnancy, childbirth and bringing up children. Many fathers now go along to antenatal checks, preparation-for-birth and parenthood classes, and are present during labour and can even participate (such as by cutting the cord) in delivery of the baby. This was unheard of 30 years ago, and would have been unacceptable to parents-to-be and their attendants. But some men still seem unsure about what’s expected of them. If you and your partner can share all your feelings – plans, joys, woes, hopes and fears – about child-bearing and parenting, it must strengthen and deepen your relationship. There are many facets to having children. Most of them are wonderful, both physically and emotionally. Some are not so good. No matter how carefully it was planned, it may be only when pregnancy is confirmed that you face up to the reality of the next nine months and the rest of your life as a parent. This can bring on mixed feelings, doubts and ‘cold feet’.

Can you cope – physically, emotionally, financially – with the changes and responsibilities ahead? How will a baby affect your relationship, your career, your other plans for the future. Will you be a good parent? Have you realistic expectations of what it means to have a family?

Everyone you know will tell you about their experiences with pregnancy, labour and new babies – all of them are different. Your own experience will be different again. You need to balance all the information and advice you’re given. Books, magazine articles, films and TV programmes produced by experienced professionals provide a reliable background for assessing ‘hearsay’.

Condoms for women

These have been developed during the past decade in response to a perceived need for better protection for women against sexually transmissible diseases, especially AIDS. By partly or completely covering the external genitals, female condoms could offer protection against transfer of genital skin infections such as herpes and warts. When these devices become available, women can take total responsibility for their protection if their partners are reluctant to use penile condoms. And, of course, any barrier that prevents genital transfer of bacteria and viruses will also pork as a contraceptive by preventing sperm from entering the cervix. A device called the Femidom is a transparent plastic pouch with a flexible ring inside the upper, closed end and a larger 5 at the open bottom end. You insert nth your fingers, pushing the upper ring behind the pubic bone. During intercourse, the device is kept in place by the outer ring, which tucks around (and covers) the vulva. The manufacturers report that in four years of testing on 1700 en in the USA, Femidom has proved resistant to slipping, tearing or penetration by bacteria, and its pregnancy-prevention rate is comparable to that of the diaphragm. Some unexpected comments during the North American trials include complaints about noise from the crackling of the plastic during use, and praise for increased sexual pleasure from stimulation of the clitoris by the outer ring. The Femidom isn’t yet available in Australia.

Also being tested is the ‘woman’s choice female condomme’ (a blatant tautology!) – a latex vaginal pouch inserted with an applicator – and what may possibly be the ultimate in contraception and disease prevention, the unisex condom garment’ – latex pants with attached crotch sheath that becomes a vaginal pouch or penis cover, depending on who wears it!

How to use condoms

Most condom packs include a sheet of instructions on ‘How to use’. However, because the instructions are in the outer box and not with the individual condom, and because the time of immediate need may not be ideal for going through a list of instructions, it may be useful to repeat the main points here.

• Remove the wrapping carefully, avoiding contact with sharp fingernails.

• Don’t unroll or test the condom before putting it on.

• Press the air out of the teat (or 1 cm at the tip if there is no teat) to make room for the semen.

• Roll the condom onto the erect penis before any genital contact.

• After intercourse withdraw the penis before it becomes too soft, holding the condom around its base so that it doesn’t slip off and so that the semen doesn’t spill.

• If you need additional lubricant, don’t use petroleum jelly (Vaseline), baby oil or any oil-based substance (which might affect the latex and increase risk of breaking): use a water-based lubricant or spermicidal jelly.

• If the condom breaks or comes off during use, consult a doctor or family planning clinic within 48 hours to see if ‘morning-after’ contraception would be advisable.

• Use condoms once only.

• Keep stored condoms in a cool place and check the expiry date before using.

*125/31/5*

Perhaps the most common sexual worry for women is that they don’t reach orgasm from intercourse: as already mentioned, 5 to 80 per cent of women (depending on whose statistics are quoted) admit to this.

In the past women have been taught to think that the only ‘right’ or ‘good’ orgasm is one that results from penile thrusting in the vagina. Freud is responsible for this notion, which has now been disproved. An orgasm that follows any erotic stimulation, whether from a partner or masturbation, is just as ‘right’ as one resulting only from penile thrusting in the vagina. However, many men have learnt that women ‘should’ reach orgasm purely from penile thrusting, and feel inadequate (or that there’s something wrong with the woman!) if this doesn’t happen. Many women also want or prefer orgasm during intercourse. Why do so many women find it hard to achieve?

To start with, you must be sufficiently aroused before intercourse begins. Some couples neglect to make sure about this. The clitoris is believed to be the most powerful source of arousal. Then if during intercourse you don’t progress to the plateau stage so that the constricted lower vagina grips the penis, there may be insufficient tension on the clitoral hood and thus not enough stimulation from penile thrusting alone. Less commonly, a woman who reaches the plateau phase may not be able to grip the penis tightly enough because her pelvic-floor muscles have been severely damaged during childbirth.

This problem can be overcome by prolonging foreplay to ensure you’re highly aroused before penetration, and, if needed, by you or your partner providing additional stimulation during intercourse to the clitoris or wherever works best for you. Some women can manage just by finding a position that gives them more genital stimulation. Others do the trick by concentrating on erotic fantasies.

Most of us are shy and reticent about asking for what we want in sex, especially if we’ve been taught that it’s ‘bad’. It can be hard to ask your partner to wait before entry or to provide extra stimulation during intercourse, and so many of us (including our partners) feel so guilty about masturbation that we can’t bring ourselves to do it if anyone else is present, even a lover. Others feel bad about asking for a different position (particularly if it’s less satisfactory for the man) or fantasizing during sex with a partner.

You can’t expect your partner to know instinctively what stimulation gives you pleasure. Most men say that they would like some help and feedback from their partner rather than fumbling ‘in the dark’. You needn’t give verbal directions. You can direct your partner’s hand with yours to where, how and how much stimulation excites you best.

Most women can learn to reach orgasm from intercourse. It’s largely a matter of good communication and a sharing of the joys of sex – the problem is rarely physical. If you have no success from your own efforts, see a sexual therapist.

There’s another problem that can result from lack of orgasm. If you become aroused but don’t proceed to orgasm, resolution won’t be triggered and all the congestion and muscle tension won’t be released. This leaves you feeling uncomfortable, unsatisfied and restless – particularly maddening if your partner is snoring blissfully beside you. If this happens over and over, the build-up of congestion can lead to chronic pelvic discomfort or pain. The cure for this problem is for you or your partner to make sure that you go through the full sexual response cycle after arousal.

A small proportion of women say that they’ve never had an orgasm. Is this a danger to their health or relationships? Opinion remains divided. Some experts feel sure that there are women who are quite satisfied sexually without orgasm. Others state equally strongly that missing out on orgasm is harmful. My opinion is that lack of orgasm is only a problem if it worries you.

*95/31/5*

Adolescents are generally under more stress than adults, and they have less experience behind them for coping with pressure. Some young people can take all this in their stride, but many have some pretty rough times.

You read a lot about stress these days, mostly telling you to avoid it. But you can’t avoid it, and not all stress is bad. For example, that nervous tension before an exam or sporting contest can drive you to do better than you would without it. Most of us need pressure to achieve what we want to do.

Bad stress is the constant, prolonged worry or pressure to do things we can’t handle. This builds up to anxiety, which can make you physically and emotionally ill. Anxiety causes the release of too much adrenalin, which can give you a pounding heartbeat, dry mouth, butterflies in the stomach, cold sweats and a panicky feeling that everything is closing in on you. Increased muscle tension can lead to headaches, abdominal pain and backaches. Prolonged anxiety can have more harmful effects when it suppresses the immune system, thus increasing susceptibility to infections and other illnesses, and an increased tendency to accidental injury (because your attention is on your worries and not on taking care).

During adolescence you become aware of the wider world you live in which, compared to the security of childhood, is full of uncertainty, conflict and competition. The media emphasize the bad news. Recession! Crime! Corruption! Disease! War! Riot! Disaster! Everything changes so fast. It’s no comfort that you’re about to enter this chaotic world.

Adolescents are also under pressure from conflicts about what they want and what the rest of the world wants of them. For example, you need to become independent but you also need the support and approval of your parents; the need to express yourself as an individual conflicts with pressure to be one of the gang; the need to compete with your friends may go against your need for them to like you.

Also, you’re getting mixed or confused messages about community values, personal integrity, sex roles and sexuality. Then there’s always the usual hassles with parents, teachers, friends and boyfriends. To top it off, there’s educational pressure and the need to make important decisions about your career. After training you might find your ambition sabotaged by unemployment.

Acupuncture arose from the ancient Chinese philosophy of Taoism. One of it teachings is that healthy life is a balance between two opposing but complementary forces, yin and yang, that influence everything in the world. Yin forces (also called female or negative) are passive am calming, and include moon, earth, darkness, coolness, moisture and stillness Yang forces (male or positive) are aggressive and stimulating, and include sun, sky light, heat, dryness and movement.

Another basic concept of acupuncture is belief in a life force or vital energy, called ch’i, that maintains a healthful balance in living things. Ch’i is believed to circulate in our bodies along precise pathways called meridians. Anything that disturbs the flow, amount or quality of ch’i in the meridians can result in ill health.

In acupuncture, needles are inserted through the skin to stimulate certain points along the meridians so that ch’i energy will be attracted to a deficient area, dispersed from an area of excess and released if the flow is blocked.

Acupuncturists diagnose the imbalances by taking a full health history, making observations (such as skin colour, voice, posture, tongue appearance) and by feeling the pulses.

Acupressure     This is based on the same principles but uses pressure instead of needles over the meridian points.

Shiatsu This Japanese technique uses vigorous massage over the vital points. Shiatsu wasn’t a therapy until the twentieth century: before this it was a home treatment for the relief of pain, muscle tension and fatigue, with the know-how being passed down through generations so that family members could help each other. Japanese children still give their parents Shiatsu to restore energy after a hard day’s work.

The use of plants for healing is as old as history, and herbalism is the parent of modem pharmacology. The majority of today’s drugs were previously used as plant extracts: for example aspirin from willow bark, narcotic analgesics from poppies, digitalis from foxglove. However, now that therapeutic plant chemicals have been isolated and their chemical structure identified, they are often synthesized by pharmaceutical companies because it is cheaper to do so and results in a purer product for more accurate dosage. Plants contain many powerful chemicals that are active in humans and other animals. Some plants contain multiple drugs, and some of these aren’t yet identified – a potential danger when whole plant extracts are used.