Dr Pauline Williams Green on Premature Ejaculation

Problems of ejaculation are common occurrences in the sexual life of men. This week we will discuss premature ejaculation. It occurs when a man ejaculates shortly after intercourse begins.
At least a third of men surveyed in the United States in a 1999 report at least one incidence of premature ejaculation in the previous year. It may well be the most common male sexual problem. It occurs in men who are sexually inexperienced and also among those in sexual partnerships for many years.

Orgasm and ejaculation
Ejaculation is distinct from orgasm in men. While ejaculation describes the release of semen, orgasm is the subjective, pleasurable sensations which occur before ejaculation.
Before a boy reaches puberty, he can experience orgasm but does not ejaculate because the male organs are still immature. After several ejaculations, young men can experience orgasms without ejaculations during intercourse.
So, premature ejaculation becomes a non-issue for men who are concerned only with their own orgasms. In fact, in some cultures, it is considered very masculine to ejaculate very quickly.

Why does premature ejaculation occur?
Men are capable of orgasm within two minutes of initial stimulation while women usually require about eight minutes. It is, therefore, 'normal' for young, inexperienced men to ejaculate before their partners have reached orgasm. To achieve mutual satisfaction, men have to be able to time their ejaculation. Overanxiety will cause premature ejaculation in any relationship. Afterwards, the penis goes down and will not respond immediately to stimulation during the normal refractory period.
Premature ejaculation becomes a problem only when there is the persistent and recurrent absence of reasonable voluntary control of ejaculation. It is generally believed to be caused by psychological factors. Men may have had early sexual experiences where they hurried through intercourse. Sometimes, premature ejaculation presents many years into a relationship and may represent interpersonal problems in the relationship. Premature ejaculation results in disappointment, frustration and ultimately loss of self-esteem.

Medical therapy
Treatment is twofold - medications that delay ejaculation and counselling. Pharmacological agents that may be used to delay ejaculation include antidepressants and benzodiazepine anxiolytics. These are useful in the short term.

Sexual therapy
Open discussion between partners with or without the help of a therapist may resolve the problem. They can be taught simple behavioural techniques to help them manage the problem. First, the frustration of the couple is reduced by teaching them sensate-focus exercises.
These exercises teach the man not to hurry during sexual relations. Then the couple is taught to manually stimulate the penis until the man is close to orgasm. They cease stimulation whenever the man feels ejaculation is imminent. This stop-start technique is repeated several times. In another technique, the man can ask his partner to squeeze his penis firmly behind the glans whenever ejaculation seems close at hand.
Both stop-start and squeeze techniques teach the man to delay ejaculation. Eventually, the man learns to change his thoughts and mental pictures when ejaculation is imminent and thus prolong intercourse.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email yourhealth@gleanerjm.com

Prevention guidelines for BREAST CANCER

Breast cancer awareness takes centre stage in October. Most women are interested in preventing breast cancer.

Rosalee M. Brown

The evidence is not clear, but there are drug trials which have been shown to reduce the risk of recurrent breast cancer in women. The results from the Breast Cancer Prevention Trial have also shown that women at high risk for breast cancer, who take the drug tamoxifen, lowered their risk by 45 per cent.
There are other available prevention measures which include preventative mastectomy and early detection through breast self-examination and routine mammograms.

What of nutrition
There are inconclusive studies and sometimes even conflicting ones regarding the role of nutrition in breast cancer prevention. The Women's Healthy Eating and Living study states that a "diet high in fruits, vegetables and fibre and somewhat lower in fat did not protect early-stage breast cancer survivors from further breast cancer, nor did it help them live longer than women in a comparison group'.
These findings contradict at least one other large study of diet and breast cancer risk. JAMA 2007 Jul 18;298(3): 289-98). Results from the Women's Intervention Nutrition study, a large randomised clinical trial reported in 2005, suggested that a low-fat diet helps prevent breast cancer recurrence in postmenopausal women, especially those whose cancers don't respond to oestrogen.
Another study, Low-fat Diet May Reduce Risk of Recurrence by Chlebowski et al, concluded that a low-fat diet may reduce the risk of breast cancer recurrence in postmenopausal women. However, in the Women's Health Initiative, completed in 2006, researchers found only a slight, statistically insignificant reduction in breast cancer risk among women 50 to 79 who lowered their total fat intake.

Factors at play
It is very difficult to study people's diet because, for example, someone who reduces his or her fat intake may also reduce his or her animal protein intake. The same individual may also increase his or her fruit and vegetable intake. So, there are many factors at play which make it difficult to isolate positive or negative effect.
Although particular foods and nutrients have not been identified as preventative weapons in the fight against breast cancer, there is evidence for the role of diet and a healthy lifestyle in other cancer prevention. The American Cancer Society advises people to reduce cancer risk through exercising, limiting alcohol use, maintaining a healthy weight (as overweight in postmenopausal women has been linked to breast cancer), breastfeeding and avoiding postmenopausal hormone replacement therapy.
Standard nutritional guidelines holds - food has a synergistic effect on health; consume a diet from the six food groups; consume more whole plant-based foods and less processed foods; consume a little animal fat and consume large amounts of fruits and vegetables of all colours.

Rosalee M. Brown is a registered dietitian/nutritionist who operates Integrated Nutrition and Health Services; email yourhealth@gleanerjm.com.

Early Jamaican LGBT History

1976: Meeting point in New Kingston: The Closet

It seems that the first gay club, named The Closet, was established in New Kingston around 1976.

1976: The first Jamaican gay association is founded

Chinese-Jamaican gay man and political organizer, Larry Chang, organized a gay group in Jamaica, called the Gay Freedom Movement (GFM) as early as 1976 in a fiercely hostile climate. He held the position of General Secretary and was Publisher and Editor of its newsletter: Jamaica Gaily News. The newsletter was first named The Toilet Paper. As of issue No.3, Larry decided that the name was no longer relevant and changed it to The Jamaica Gaily News, which was a take-off on the Jamaican daily newspaper The Jamaica Daily News. .

Songs Of Freedom documentary – Interview with Larry Chang

Songs Of Freedom: Compelling Stories of Courage and Hope by Jamaican Gays and LesbiansExcerpt taken from an interview recorded in 2002, available in the documentary Songs Of Freedom.'When I graduated, and it was time for me to think about coming back to Jamaica, I made a conscious decision that I would come back here to contribute to nation building and all of that sort of stuff but on my own terms. /// Having met more and more people, I sort of know my way around gay Kingston, at least what there was at the time. And after I got my own apartment, of course, it became open house for a lot of gay people. If those walls could talk, if my dining room table could talk. These stories it would produce. A lot of people would have come out in my house. There has been all kind of revelations, breakdowns, emotional trauma and everything that you can think of that happen at my house. /// Sometimes after, there happen to be a club called The Closet, which was actually in the heart of New Kingston. I was going on well for quite a while and then we had the eternal problem of gay on gay violence, we had a lot of who we now refer as downtown people who would come there, would pick fights, break bottles, try to stab each other all that kind of wonderful behavior.

And the viability of the club therefore would be threaten by this type of behavior.As a response to this problem of violence, a few of us decided to get together and call a meeting to see if we could develop some sense of community among gay people where by we could turn to each other, just to find out what was on gay people’s mind: why all this violence, why all this self hatred, because that what it was down to: self hatred. What could we, as a population, do to address this. So we called a meeting at The Closet. There was a fairly good turn out and a very good participation. And out of that came a comity of six people, who came together to form the Gay Freedom Movement. At the end of the first meeting, I remember that I pull together (a none page mimeograph - sorry - a one-sheet mimeograph), a one-sheet newsletter, just reporting on what the proceedings were. I irreverently called this The Toilet Paper, because after all, the meeting has taken place in a closet.

It was Toilet Paper No.1 and we went to issue No.2. And by the time the third issue was come out, I said “no, I can’t keep calling this ‘The Toilet Paper’ has it is no longer appropriate”, so I change the name to The Jamaica Gaily News, which was a take-off on the Jamaican daily newspaper The Jamaica Daily News. At about the same time too, a letter had come out in The Daily Gleaner from a Helen Sommers Overcan, on the subject of population control. She was basically giving an historical overview of all the different methods of population control that have been attempted by different people. Among these she listed infanticide, and fracticise all the other things that you can think of.

I found myself to write a letter back to the Gleaner, responding to this letter that it was a very good letter, but she had a gearing ommition that she had not listed homosexuality as a time honored and natural means of population control. I suppose the Gleaner couldn’t believe that anybody would have written a letter like this to them. So they called me to confirmed: “did you really write this letter and signed your named to it and blah, blah, blah”. And I said “yes”. Except that I didn’t just signed my name, but I put under it: Gay Freedom Movement. At that time, the Gay Freedom Movement did not exist, the meeting at The Closet has not yet been held, but I felt that if I put the name of an organization behind my name, that the letter would have a little bit more impact, a little more clout, and that I was not just a voice crying for inunamist. Those two things kind of came together at a point in time, to give us that historical event, which we now referred as the Gay Freedom Movement, which I think happen in the mid to late 70’s.It was at the height of Michael Manley’s area and democratic socialism where the political climate, emphasis durable values, participation, co-operation, sharing, rights and all of these things. It was a very fertile time for ideals, movements, concepts, people-based initiatives. I think the Gay Freedom Movement was born at the right time. There is nothing that happen before its time. It was time for it than. ///The GFM had basically two objectives, one was to educate ourself has who we were. We are talking about consciousness raising, self awareness, that type of thing. An the other objective was to educate others, meaning the public. /// We had connection with almost every gay group right across the world, from Scandinavia to South Africa, to Japan, Australia, New Zealand, Brazil, Israel, you name it.

We had this change arrangement with these groups, we would send them Jamaica Gaily News and they would sent us their publications. Because of the breath of our international connections, when the whole AIDS epidemic broke out, we were able to have up-to-date information on AIDS, long before anybody in Jamaica knew about it. We were fairly well prepared, at least in terms of being armed with information. I think that is one of the things to witch I attribute the fairly low incidence of HIV among the homosexual population in Jamaica. /// 


We started a Pen Pal club because we would have letters from all over Jamaica and all over the world, requesting Pen Pals. That was one of the most popular features that we carried in The Gaily News. I remember in particular one letter from this guy who signed his name and his address was Cornpiece District, Hayes, Clarendon. I was very trilled to know that we were reaching isolated rural people who otherwise would have no kind of contact with anything or anyone gay. And the fact that we were reaching these people, to me it prove that we were doing something worthwhile.

HIV rebounds rapidly without drugs

Zurich University Hospital scientists have discovered that the HIV virus survives antiretroviral medicine and can spread from a single infected cell.
Antiretroviral medication suppressed HIV so well that no traces of it appeared in laboratory tests, researchers said. But scientists Beda Joos and Huldrych Guenthard found that the virus that causes Aids resurfaced with astounding rapidity as soon as patients stopped taking the drugs.

That led them to two debateable theories about the virus's ability to survive medical treatment: either it remained in the blood at extremely low levels of infection, or it built itself into a cell's DNA and waited.

The study looked at 20 patients who had been using anti-HIV medication for a long time. Researchers stopped giving the medicines for two-week periods, followed by two-months of steady treatment.

Numerous variations of the virus rapidly resurfaced between treatments. That meant anti-AIDS medication was so effective because it completely paralysed the virus, researchers said.

Interesting Letter to the Gleaner's Editor - Misreading Human Behaviour

A letter published in your Saturday Gleaner, on October 18, edition signed by S. Richards, took issue with the suggestion by a United Kingdom government minister that discrimination against gays should be halted as part of the efforts to stop the spread of HIV/AIDS.

The writer, I believe, is correct to suggest that a false "health link" argument is being used as the plank to end "discrimi-nation". The writer went off the rails, however, with two other subsequent points.

Higher health risks

First, the health authorities do suggest and have emphasised that anal sexual activity carries higher health risks and so should be avoided or mitigated by the use of condoms.

I don't know if reader S. Richards is so naive as to believe, however, that this kind of activity is exclusively male/male. The influence of pornography has presented this as an acceptable activity for men and women to engage in and anecdotal stories suggest that it does take place among heterosexual couples and may even be increasing as a practice.

Usefulness of the buggery law

Therefore, the second point made in the writer's letter about the usefulness of the buggery law is irrelevant. Does the buggery law apply to a man engaging in anal sex with his female partner? If so, when has this ever been enforced? And if not, then there is discrimination against men and is, therefore, gender-biased. Also, the existence of the law, by itself, has not stopped people from engaging in their 'kinky' activities, whatever the law says.

People often know or suspect their behaviour and, apart from snide comments or the some-times derogatory remarks, for the most part, let them be. And that is how it should be. People should not be excluded from jobs or denied access to health care (if that is happening) because of what they do in the privacy of their homes as consenting adults. Where they are violating moral laws, God will deal with them in His own way, as He does with others who violate His many other strictures.

I am, etc.,

CHAD BARNSWELL

barnswellc@yahoo.co.uk

Kingston

SEE THE ORIGINAL LETTER HERE

Also SEE 'Stop discriminating against gays'

Peace.