Saturday, February 26, 2011

Why God Allows Pain

A man went to a barbershop to have his hair cut and his beard trimmed.
As the barber began to work, they began to have a good conversation.
They talked about so many things and various subjects.
When they eventually touched on the subject of God, the barber said:
"I don't believe that God exists."

"Why do you say that?" asked the customer. "Well, you just have to go out in
the street to realize that God doesn't exist.
Tell me, if God exists, would there be so many sick people?
Would there be abandoned children?

If God existed, there would be neither suffering nor pain.
I can't imagine a loving God who would allow all of these things."
The customer thought for a moment, but didn't respond because he didn't want to start an argument.
The barber finished his job and the customer left the shop.

Just after he left the barbershop, he saw a man in the street with long, stringy, dirty hair and an untrimmed beard.
He looked dirty and unkempt. The customer turned back and entered the barber shop again and he said to the barber:
"You know what? Barbers do not exist."
"How can you say that?" asked the surprised barber.
"I am here, and I am a barber. And I just worked on you!"
"No!" the customer exclaimed. "Barbers don't exist because
if they did, there would be no people with dirty long hair and untrimmed
beards, like that man outside."

"Ah, but barbers DO exist! That's what happens when people do not come to me."
"Exactly!" affirmed the customer. "That's the point! God, too, DOES exist!
That's what happens when people do not go to Him and don't look to Him for help.
That's why there's so much pain and suffering in the world."

Thursday, February 3, 2011

25 Things about God

I love this! Let's keep it going! No catches. Just the peace in knowing that you were able to share God's love and
wisdom to all those you have contact with and even bless someone you don't know.

1. Give God what's right -- not what's left.
2. Man's way leads to a hopeless end! - God's way leads to an endless hope.
3. A lot of kneeling will keep you in good standing.
4. He who kneels before God can stand before anyone.
5. In the sentence of life, the devil may be a comma--but never let him be the period.
6. Don't put a question mark where God puts a period.
7. Are you wrinkled with burden? Come to the church for a face-lift.
8. When praying, don't give God instructions - just report for duty.
9. Don't wait for six strong men to take you to church.
10. We don't change God's message -- His message changes us.
11. The church is prayer-conditioned.
12. When God ordains, He sustains.
13. WARNING: Exposure to the Son may prevent burning.
14. Plan ahead -- It wasn't raining when Noah built the ark.
15. Most people want to serve God, but only in an advisory position.
16. Suffering from truth decay? Brush up on your Bible.
17. Exercise daily -- walk with the Lord.
18. Never give the devil a ride -- he will always want to drive.
19. Nothing else ruins the truth like stretching it.
20. Compassion is difficult to give away because it keeps coming back.
21. He who angers you controls you.
22. Worry is the darkroom in which negatives can develop.
23. Give Satan an inch & he'll be a ruler.
24. Be ye fishers of men -- you catch them & He'll clean them..
25. God doesn't call the qualified, He qualifies the called.

LORD God, bless the person reading this in whatever it
is that You know he or she may be needing
this day....) 
Live LIFE to the fullest, for we only live once...

Wednesday, February 2, 2011

Sexual Dysfunction

Describe what happens during the four phases of sexual response described by stimuli Masters and Johnson
1.    Excitement: internal or external
activation of the central nervous system (CNS) deep breathing, increase in heart rate,blood pressure, and sexualtension; generalized vasocongestion skin flush, breast engorgement, nipple
        erection, engorgement of labia and clitoris, vaginal transudation, and uterine tenting
2.    Plateau: marked degree of vasocongestion throughout the body _ further engorgement of the labia,  lower third of vagina, breast, and areolae. Secretion from the Bartholin glands, retraction of the clitoris, vagina lengthens with dilation of the upper two-thirds, muscle tension begins to build up
3.    Orgasm: release of sexual tension, generalized myotonic contractions, perivaginal muscles and   
Anal sphincter contract at precise intervals, vaginal and uterine contractions
4.    Resolution: a gradual diminution of sexual tension and response

What is the biopsychosocial model of female sexual response?
The biopsychosocial nature of female sexual response is influenced by the dynamic interaction of four components: biologic, psychologic,sociocultural influences, and interpersonal relationships. All of these components must be addressed in order to achieve sexual satisfaction

What are the possible etiologies of sexual dysfunction?
1. Change in vascularity (atherosclerosis, pudendal artery insufficiency affecting vaginal
2. Neurogenic causes (spinal cord dysfunction or injuries)
3. Depression or anxiety disorders
4. Medications (selective serotonin reuptake inhibitor [SSRI], tricyclic antidepressants, H2 blocker, and some antihypertensive medication)
5. Psychosocial factors (prior history of sexual abuse, religious or cultural expectation, fear of rejection or intimacy, and distorted body image)
6. Hormonal changes (premature ovarian failure and menopause)

What is the prevalence of sexual dysfunction?
Studies show a range of 10–60%; the average is 43%

What are the types of female sexual dysfunction and what is the main symptom of each?
1. Sexual desire disorders:decreased sexual fantasy and/or desire, sexual aversion
2. Sexual arousal disorders: decreased genital vasocongestion and lubrication
3. Orgasmic disorders: anorgasmia
4. Sexual pain disorders: vaginismus, dyspareunia, noncoital sexual pain

How should the question of sexual dysfunction be addressed?
The evaluation should involve an interview of the couple and each partner separately. A complete assessment should include past medical, psychological, sexual history and physical examination including gynecologic examination. Each patient should be asked if she has any
questions or concerns about her sexual activity. The most important aspect of taking a sexual history is to make the patient feel comfortable

What hormones influence vaginal blood flow?
Estrogen and testosterone increase vaginal blood flow; Progesterone diminishes vaginal blood flow

What types of therapies are available for the treatment of sexual dysfunction?
1. Nonpharmacologic therapy: Patient education, lifestyle and behavioral changesshould be tried first
2. Pharmacologic therapy: Hormones: estrogenincreases genital blood flow and enhanced lubrication Testosteronemay improve libido, data nonconclusive Herbal therapy: (e.g., St. Johns wort, ginseng, yohimbine) generally ineffective L-Arginine: increases nitric oxide
(NO) leading to genital vasocongestion; needs further study Tibolone: used for osteoporosis; has
androgenic activity that may improve sexual function Sildenafil: a vasodilator; datainconclusive on its benefit for women, not FDA approved

Describe what changes occur with aging that affect sexual function
1. Decreased libido
2. Hormonal changesestrogen levels gradually drop leading to vaginal atrophy and dryness.
Testosterone levels decrease leading to a decrease in arousal andintensity and frequency of orgasm
3. Medical issuesincrease in medical problems and use of medications that may affect sexual
4. Past experiencesfor example, recurrent dyspareunia can lead to introital spasm, which can further impede sexual function
5. Relationship issues
6. Self-esteem changes

What types of medication or substances can lead to sexual dysfunction?
Alcohol; antihypertensives; illicit drugs; SSRIs Psychotropic Antihistaminic
What are the adverse effects of SSRI use on sexual function?
SSRIs have been reported to reduce libido in women and men, to cause anorgasmia in women, and to
increase ejaculation latency in men

What types of changes occur under the following circumstances that may affect female sexual function?
            During pregnancy: breast tenderness, mild cervical bleeding during intercourse, and uterine
contractions with orgasm
Postpartum: fatigue, vaginal dryness, bleeding, vaginal discomfort

What is hypoactive sexual desire disorder (HSDD)?
Recurrent and persistent lack of sexual fantasies or desires or receptivity to sexual activity that
causes personal distress

How should HSDD be evaluated?
Take a careful history including medications, medical illness, depression, substance abuse, and
stress. Thyroid test and prolactin levels may be indicated if there is any suggestion of hyperprolactinemia. Androgen levels are not useful in the majority of cases

How should HSDD be treated?
Physiologic causes should be assessed and managed. Further treatment may require individual therapy or relationship therapy

What is sexual aversion disorder?
It is characterized by a phobia with avoidance of sexual contact and severe anxiety associated with contemplation of sexual activity

What are sexual arousal disorders and how are they treated?
When women experience desire and orgasm, but lack signs of sexual stimulation, such as lubrication and genital vasocongestion. Treatment includes masturbation, vaginal lubricants, vibrator to increase stimulation, foreplay, distraction technique to alleviate anxiety, and/or
estrogen replacement therapy for postmenopausal women

What is orgasmic dysfunction and how is it treated?
A persistent delay in or absence of orgasm after sufficient stimulation and arousal resulting in distress or interpersonal difficulty. Treatment involves orgasm goal directed sexual

What types of orgasmic dysfunction exists?
Primary anorgasmia is found in 510% of women and is lifelong
Secondary anorgasmia is often related to relationship problems, medications, medical illness,
depression, substance abuse, and self-monitoring/anxiety during arousal

What types of sexual pain disorders exist and what are they?
Vaginismus (recurrent involuntary contraction of the vaginal musculature during vaginal penetration)
Dyspareunia (general pain that occurs before, during, or after intercourse)

What organic disorders must be ruled out when vaginismus is diagnosed?
Endometriosis; PID; partial imperforate hymen; vaginal stenosis

How is vaginismus treated?
Education; relaxation techniques; kegel exercises; progressive vaginal dilatation

What organic disorders must be ruled out when dyspareunia is diagnosed?
Bartholin cysts; vulvitis; vestibulitis;vaginitis; clitoral irritation/ hypersensitivity; rigid hymenal ring/introital scar tissue; vaginal atrophy and dryness; pelvic adhesion; fibroid; endometriosis
How is dyspareunia treated?
The treatment depends on the etiology

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