Number of vasectomies plunges amid fears relationships won’t last

2017-10-06

The number of vasectomies carried out by NHS hospitals and clinics has dropped by nearly two thirds in a decade, official figures show.

Experts said the trend could reflect social shifts, with greater awareness that relationships might not last, and a reluctance to take steps seen as irreversible.

It could also be a symptom of deepening NHS rationing, they said, or changes in practices with the surgery increasingly offered by GP practices.

The new data from NHS Digital shows 29,344 vasectomies took place in hospitals and sexual health clinics in 2005/6, falling to 10,880 in 2015/16.

Over 2015/16, the number of procedures dropped by two per cent, the statistics show.

Sexual health experts said men were increasingly waiting until they are older to start families, or avoiding the procedure in case relationships failed and they wanted to have more children later in life.

NHS funding for vasectomies has been  restricted in some areas, as part of efforts to reduce spending.

A spokeswoman for the British Pregnancy Advisory Service (BPASA) said: “The fall in vasectomies may reflect the fact that there are more GP practices offering men this service which are not captured in the statistics.

“However, some men may be finding it harder to access the procedure – and we know women sometimes feel under pressure to accept a long-acting reversible contraceptive like a coil or an implant when their partner requests a vasectomy.

“This is not acceptable as vasectomy offers couples a way for a man to take the burden of contraception that his partner may have long shouldered.

“But the decline may also reflect social shifts – couples are waiting longer to start and complete their families, and there may also be greater awareness that relationships can fail and that vasectomy is generally an irreversible choice.”

Natika Halil, chief executive of the Family Planning Association (FPA), said: “Being able to choose the right contraceptive method for you is incredibly important, and given the lack of choices currently available for men, this makes access to vasectomies even more vital.

“Some commissioners in England, in areas including Essex, are now no longer offering vasectomies on the NHS, which means men may have to pay up around £500 for a private procedure.

“Unfortunately evidence shows that cuts to services, a fractured commissioning system, a lack of accountability, and a lack of training for healthcare professionals have all led directly to a reduction in access to contraception.”

She said “dramatic” cuts in public health budgets had exacerbated the problem, with £800m reduction in six years.

The figures show that overall, 1.19 million people had contact with sexual reproductive health services in hospitals and clinics in 2015/16, compared with 2.48 million a decade before. However, some of the change may be because increasing numbers of GPs surgeries are offering the service.

Seven per cent of women aged between 13 and 54 had contact with such services – compared with just one per cent of men of the same age, the statistics show

Vasectomies are more than 99 per cent effective, according to the NHS, and the procedure – which involves cutting, blocking or sealing the tubes that carry sperm from a man’s testicles to the penis – takes around 15 minutes. It is usually carried out while the man is under local anaesthetic, and the NHS warns that it can lead to painful swelling of the scrotum as well as “ongoing pain” in the testicles.

•  Laura Donnelly, health editor 

When you and your partner have mismatched libidos

2017-09-25

Why we must talk to children about sex

In recent days, incidents involving the assault and rape of young adolescents—girls and also boys—have come to attention. On the one hand, two girls, aged 10 and 13, were raped by supposedly “trusted” adults in Chandigarh and Mumbai. They silently bore the abuse until they fell pregnant and could no longer hide their condition.

In Mumbai, two boys swallowed insecticide and committed suicide after being abused and raped by older boys. They couldn’t stand the shame and prospect of further abuse. One boy died before he could tell his parents; the other sought his parents’ help only after he had consumed the fatal potion, but disclosed the names of his abusers before he lost his life.

These incidents should force adults to confront some hard realities. Today, growing up is fraught with physical insecurity, and yet adolescents know little about their bodies— how does one become pregnant, or protect oneself from unwanted pregnancies and infections? How does one confront a sexual predator or distinguish between good and bad touch? Too few girls and boys know these things and fewer still have access to a trusted mentor with whom they can share their experiences and who can take protective action. Most are never told that, if abused, it’s not their fault.

A study conducted by the Population Council on unmarried girls in Bihar and Jharkhand who underwent abortions showed that pregnancy took place after a forced sexual encounter for several of them. The study also sheds light on the reasons why the girls waited till they were well into the fourth or fifth month of pregnancy to seek termination. Several did not know the links between menstruation and pregnancy. Komal and Najma, both of whom were 18 and had experienced a forced sexual encounter, explained: “When I did not have my periods, I did not even think that I could have conceived. I did not feel anything. But one day my employer asked me why my stomach was looking so big… I started having a vomiting sensation. I had no idea that your periods stop when you conceive a child. Then my mother asked me when I had my last period.”

Many girls also described feelings of fear and anxiety about disappointing their family; they were worried about breaking the trust of their parents and losing their reputation. Others feared that their parents would beat them, abuse them or impose restrictions on their freedom of movement. Binita, a 20-year old, said, “My parents’ view towards me would have been shattered. They have full faith in me but had they come to know about this, they would have lost trust in me.”

While research on boys is sparse, it is likely that all four of the adolescents in the news recently, and thousands like them, react similarly to incidents of forced sex.

To prevent such incidents, we must shed the misconception that talking to adolescents about sex will encourage them to experiment with sex. Nothing could be further from the truth, as study after study in every part of the world has shown. Yet in India, teachers and parents shy away from sex education. They refuse to engage adolescents even on topics like pregnancy and menstruation, body changes, and good and bad touch. They believe that there is no need to provide this information, or that talking about these matters will encourage sexual activity. These perceptions are short-sighted, irrelevant in today’s times, and damaging for the adolescents. Informing adolescents about these matters does not lead them “astray”; rather, it empowers them and helps them make healthy choices.

School-based comprehensive sex education and open parent-child communication are urgently needed. Comprehensive sex education informs adolescents in an age-appropriate way about sexual and reproductive health, and unwanted sexual advances. At the same time, it also encourages them to develop notions of gender equality, and an ability to communicate and negotiate.

Parents, likewise, must be persuaded to discard their misconceptions and communicate openly with their children. They must teach their children that, if violated in any way, they must confide in their parents, and promise them unconditional support.

Elsewhere, parenting programmes have succeeded in breaking communication and trust barriers between parents and children, and there is scope for such programmes in India as well.

There are success stories in India too. A police outreach programme in Mumbai schools teaches children about good and bad touch. This month, a six-year-old girl in Mumbai, who had attended this programme, recognized that what a man was doing to her constituted bad touch, and was empowered enough to shout and raise an alarm as she had been taught, and succeeded not only in preventing him from perpetrating rape but also in ensuring his arrest. The little girl acted courageously, and the Mumbai police must be commended for delivering such an effective programme.

Parents and teachers must learn from this example. A three-pronged approach that includes comprehensive sex education, close parent-child interaction, and age-appropriate public awareness campaigns such as the police outreach programme will go a long way in fighting sex abuse.

Shireen Jejeebhoy is a social scientist and demographer.

This fruit boosts your libido

When you think of dates—the fruit, not going for dinner—you probably think of digestive issues and constipation. That’s because they are known to help you in such cases. But dates can also be enjoyed to improve another area of health—sexual function in men.

Experts suggest that men should include dates in their diet as a means of improving their sexual function and boosting libido. Dr. Aminu Kazeem, a sexual health therapist who works at Energy for Sex Clinic in Lagos, Nigeria, explained, “Eating dates will promote sperm quality and quantity as it is one of the best natural fruits used for male fertility. It also increases the size of testes in men and the size of breast in women. Consuming the fruit can help to treat sexual disorders because it is a natural aphrodisiac.”

What makes dates such a potentially potent natural Viagra? It’s because they are packed with flavonoids and estradiol, which could work to improve sperm mobility and counts.

Dates are also known to boost sexual hormone levels and provide essential nutrients to improve sexual function in both men and women.

Generally speaking, anyone can consume dates regularly, but if you are diabetic, you may want to consult your doctor prior due to dates sugar content.

Nutritionist Toyin Adeola explained how you could consume dates as a means of boosting sexual performance. She said, “It is advisable to remove the seed and grind seven or eight pieces of dates and soak in water for about two to three hours. Add one glass of milk and one teaspoon of honey and drink at least once a day to boost sexual power.”

Other foods that boost libido naturally

Aside from dates, there are other foods that you can incorporate into your daily diet that could put your sex drive into overdrive.

Garlic

While the root is synonymous with smelly breath—not exactly sexy—it also contains a compound that increases blood flow and circulation to the genitals. So be sure to enjoy some with your dinner. Just make sure you brush your teeth before taking it to the bedroom.

Almonds

These high-protein snacks can do more than just keep you satiated between meals. Men who snack on almonds regularly could also benefit from increased production of male hormones that help regulate the sex drive.

Figs

Figs have been referred to as the “food of the Gods” and the “food of love,” and for good reason! These sweet fruits are loaded with natural aphrodisiacs that could ignite your sex drive and increase your stamina.

Asparagus

Some experts have asserted that eating three stalks of asparagus daily could boost your sex drive, thanks to its high levels of certain libido-enhancing vitamins.

Bananas

These yellow fruits are full of enzymes, vitamins, and minerals that have all been associated with increasing the production of sex hormones.

Avocados

One of the latest health food trends, avocados have more benefits than you may have realized. While they’re a fantastic source of healthy fats, they also contain vitamins and minerals that increase energy, regulate sex hormones, and boost libido for men and women.

Chilies

Hot chili peppers contain a chemical that triggers the production and release of endorphins. In addition to making you feel good, endorphins could also stimulate nerve endings and raise your heart rate.

So, the next time you feel your libido is lagging, try reaching for one of these foods to help kick-start your sex drive and better your bedroom performance.

Conversations about sex

2017-08-29

In a survey carried out on youngsters on sexual and reproductive health, 35% of the respondents did not believe pregnancy could occur in the first sexual encounter, while 19% believed using two condoms at the same time offered better protection.

The Malaysian Youth Sexual And Reproductive Health Survey 2016 certainly shed some light on the poor levels of sexual and reproductive health (SRH) knowledge among our youngsters.

Why are we so embarrassed to talk about this topic? Parents tend to avoid talking about the birds and the bees, schoolteachers whiz through the boy-girl anatomy sections, and youngsters discuss the subject in hushed whispers.

Because it is widely considered a taboo topic in Asia, our youngsters are ill-equipped with SRH knowledge, which leads them to make rash or bad decisions.

But this culture can be changed.

It begins at home and starts with a conversation about intimacy. Instead of skirting the issue, leaving it to schools or turning a blind eye, parents should talk about sex with their children.

“When we start talking about it, we will be able to address the deep-rooted perception that SRH education encourages sexual activity and promiscuous behaviour.

“Additionally, talking equips one with an in-depth understanding and respect of the physical, mental and social aspects on all matters relating to SRH.

“When parents speak to their children about their private parts, it is best to avoid using nicknames to ensure children treat their genitals the same as with other body parts. By addressing the private parts with their biological terms, it will help children not to feel ashamed of those parts, but appreciate and respect them.

“If parents continue addressing the private parts with nicknames, their children will build a perception that it is not right to talk about such things, and they carry this culture into adulthood,” says obstetrics and gynaecology consultant Prof Dr Harlina Halizah Siraj.

She was commenting on the ongoing #TalkNowProtectAlways campaign by Durex Malaysia, which seeks to encourage Malaysian youth and parents to talk about the subject in an effort to correct misconceptions.

According to certified parenting coach Zaid Mohamad, parents should treat it like a normal conversation at home, like how they would talk about school, games, and even programmes they watch together.

“Though it may be tough at first, I strongly urge parents to take note of the benefits their children will have by having such knowledge.

“Parents should also remember that it is okay to not have all the answers to the questions their child may have. Be honest with your child. If you do not know how to respond to them, let them know you will go find out and you will get back to them,” says Zaid, who is also the author of Smart Parents, Brighter Kids and Smart Parents, Richer Kids.

Every day, we read stories of rape and teenage pregnancy, with both victims and perpetrators getting younger. Just last month, a seven-year-old boy was alleged to have raped a six-year-old kindergarten pupil in Melaka.

Teaching children about SRH and sex crimes should be the priority for every parent as primary caregivers, as soon as the child is able to understand things.

Prof Dr Harlina says, “First, parents need to educate themselves on what SRH knowledge is truly about. They need to be made aware that it covers a wide range of areas that are fundamental to one’s growth and in keeping children safe and protected.

“These include a basic understanding of the bodily parts and their correct terminologies, puberty and respect of others, healthy relationships to staying protected and using contraception.”

While there is no ideal age for parents to start educating their children on SRH, Zaid feels these conversations should begin as early as possible.

“Opportunities may arise when parents are spending time with their children at home or when they are out doing activities together.

“For instance, when watching TV together and a pregnant teenager appears on screen, parents can educate their younger children on what pregnancy is all about. Or, if they have teenage children, ask them about the kind of feelings and emotions that the pregnant teenager might be going through,” he advises.

The conversation should not be treated as a one-off and has to progress in tandem with the child as he or she grows older and develops physically, mentally and emotionally.

Zaid adds, “A parent who has a two-year-old can start talking about body parts, private behaviours, as well as the difference between boys and girls.

“As the child grows older, say, when they are five years old, the conversation can evolve to include topics about understanding and respecting their bodies, appropriate touch, as well as when to say no.

“As the child reaches the pre-teen or teenage years, then it progresses into topics on dealing with puberty, body changes, relationships and much more.”

Prof Dr Harlina says, “When you talk, connect it back to your family values so that those are communicated as well. Though it may seem like a tall order at first, rest assured, that over time the conversations will get better, smoother and easier for both the parent and the child.

“In fact, a key message that I would like to tell parents is to be an ‘ask-able’ parent, rather than a lecturer. Listening is key to understanding what your child is going through, so do not be quick to judge nor brush aside their thoughts as it may deter them from coming to you again.”

Asians are accustomed to the practice of saying “no” to their children and expecting them to follow suit.

However, in today’s world where information is easily accessible, parents need to realise that they no longer stand as the sole source of information to which their children can go to for guidance.

In the digital age, false information is also widely available – and it is this type of inaccurate information that tends to go viral.

“As parents, we all know that constantly saying ‘no’ may even fan the fire of curiosity, and in turn, make them more rebellious. Knowledge is power. Help them understand the potential repercussions of their actions rather than just telling them ‘no’.

“This is particularly important when it revolves around your child’s SRH whereby one mistake is all it takes to have a permanent effect on your child’s life. Keep a lookout for signals that your child may be contemplating doing something behind your back,” says Zaid.

By instilling in the child an understanding of unprotected sex and its repercussions, it will help the child appreciate their body and the process of reproduction, which in turn will help them make informed decisions.

And contrary to what critics fear, such awareness does not encourage youth to start “experimenting”. Young people need age-appropriate and culturally-sensitive sex education to empower them.

“It is important to educate boys to learn to respect girls and their decisions. It is not enough to only teach girls about pregnancy and how to stay protected; boys need to learn to take responsibility, too. We need to educate them on the female’s reproductive system, how it works, as well as how to be respectful and responsible.

“This will in turn cultivate a culture whereby boys are responsible, considerate and protective. These are all part of a healthy understanding of SRH that we hope to grow and develop among Malaysians,” stresses Zaid.

Read more at http://www.star2.com/health/wellness/2017/08/28/conversations-about-sex/#ym7Bk7xthC08fm7p.99