Medicurio

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Penis health is an important part of your health — and it goes beyond your ability to get and keep an erection, ejaculate, and reproduce.

Penis problems can be a sign of an underlying health condition. Ongoing health issues affecting your penis also can impact other areas of your life, causing stress, relationship problems or poor self-confidence. Know the signs and symptoms of penis problems and what you can do to protect your penis health.

What conditions affect penis health and function?

Problems related to sexual function, sexuality activity and penis health include:

• Erectile dysfunction, the inability to get and keep an erection firm enough for sex
• Ejaculation problems, including the inability to ejaculate, premature ejaculation, delayed ejaculation, painful ejaculation, reduced ejaculation or retrograde ejaculation, when semen enters the bladder instead of emerging through the penis
• Anorgasmia, the inability to achieve an orgasm despite adequate stimulation
• Decreased libido, a reduced desire for sex
• Sexually transmitted infections — including genital warts, gonorrhea, chlamydia, syphilis and genital herpes — that can cause painful urination, penis discharge, and sores or blisters on the penis or in the genital area
• Yeast infection, which can cause inflammation of the head of the penis (balanitis), a reddish rash, white patches on the penis, itching or burning, and a white discharge
• Peyronie’s disease, a chronic condition that involves the development of abnormal scar tissue inside the penis, often resulting in bent or painful erections
• Penile fracture, rupture during an erection of the fibrous, tubelike tissue in the penis, usually caused by an erect penis forcefully striking the female pelvis during sex
• Priapism, a persistent and usually painful erection that isn’t caused by sexual stimulation or arousal
• Phimosis, a condition in which the foreskin of an uncircumcised penis can’t be retracted from the penis head, causing painful urination and erections
• Paraphimosis, a condition in which the foreskin can’t be returned to its normal position after being retracted, causing painful swelling of the penis and impaired blood flow
• Penile cancer, which may begin as a blister on the foreskin, head or shaft of the penis and then become a wartlike growth that discharges watery pus

What factors increase the risk of problems?

Various risk factors can affect penis health — some modifiable and some not. For example:

• Heart disease, diabetes and related conditions. Heart disease, diabetes, high blood pressure, high cholesterol and obesity can increase the risk of erectile dysfunction.
• Certain medications. Erectile dysfunction is a possible side effect of a number of common medications, including blood pressure drugs, antidepressants, prescription sleep medicine, ulcer drugs and drugs for prostate cancer.
• Prostate cancer treatment. Surgical removal of the prostate gland (radical prostatectomy) and surrounding tissue as treatment for prostate cancer might cause urinary incontinence and erectile dysfunction.
• Smoking. Along with other health risks, smoking increases your chances of having erectile dysfunction.
• Excessive drinking. Excessive drinking can contribute to reduced libido, erectile dysfunction and poor choices in sexual behaviors.
• Hormone levels. Hormone imbalances, especially testosterone deficiency, have been linked to erectile dysfunction.
• Psychological factors. Depression, severe stress or other mental health impairments, as well as medications for these conditions, may increase the risk of erectile dysfunction. In turn, erectile dysfunction may contribute to anxiety, depression, low self-esteem or stress about sexual performance.
• Neurological conditions. Stroke, spinal cord and back injuries, multiple sclerosis, and dementia can affect the transfer of nerve impulses from the brain to the penis, causing erectile dysfunction.
• Getting older. Aging generally results in a decline in testosterone levels and is associated with an increased risk of erectile dysfunction, decreased intensity of orgasms, decreased force of ejaculation and less penile sensitivity to touch.
• Unsafe sex. Unprotected sex, sex with multiple partners and other risky sexual behaviors increase the risk of sexually transmitted infections.
• Piercings. A penis piercing can cause a skin infection and disrupt urinary flow. Depending where the piercing is placed, it might also worsen your ability to achieve an erection or orgasm.

When to see your doctor?

Consult your doctor as soon as possible if you have any of the following signs or symptoms:

• Changes in the way you ejaculate
• Abrupt changes in sexual desire
• Bleeding during urination or ejaculation
• Warts, bumps, lesions or a rash on your penis or in your genital area
• A severely bent penis or curvature that causes pain or interferes with sexual activity
• A burning sensation when you urinate
• Discharge from your penis
• Severe pain after trauma to your penis

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What can I do to keep my penis healthy?

You can take steps to protect your penis health and overall health. For example:

• Be sexually responsible. Use condoms or maintain a mutually monogamous relationship with a partner who’s been tested and is free of sexually transmitted infections.
• Get vaccinated. If you’re age 26 or younger, consider the human papillomavirus (HPV) vaccine to help prevent cancers associated with the virus.
• Stay physically active. Moderate physical activity can significantly reduce your risk of erectile dysfunction.
• Make healthy choices. Maintaining a healthy weight can help reduce the risk of developing high cholesterol, high blood pressure, type 2 diabetes and other risk factors for erectile dysfunction.
• Practice good hygiene. If you’re not circumcised, regularly clean beneath your foreskin with soap and water. Be sure to return your foreskin to its normal position after sex.
• Know your medications. Discuss medication use and possible side effects with your doctor.
• Pay attention to your mental health. Seek treatment for depression, anxiety or other mental health conditions.
• Stop smoking and limit the amount of alcohol you drink. If you smoke, quit. If you need help quitting, talk to your doctor. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

Not all penis problems can be prevented. However, routinely examining your penis can give you greater awareness of the condition of your penis and help you detect changes. Regular checkups also can help ensure that problems affecting your penis are diagnosed as soon as possible.

While you might find it difficult to discuss problems affecting your penis with your doctor, don’t let embarrassment prevent you from taking charge of your health.

General tips

Penis health needs a holistic approach. In other words, taking care of all aspects of your general health is important for the health of your penis. This is especially important since a range of different health conditions can affect your fertility and penile health.

Stay hydrated

Hydration is important for your overall health, as well as the health of your penis. There might be a link between dehydration and ED, so try to get about two liters of water a day.

Eat a balanced diet

A balanced diet is key in helping you reduce your chances of developing diabetes and heart disease, both of which can cause ED.

One 2016 studyconducted among 25,096 subjects looked at the relationship between ED and flavonoids, which are mostly found in vegetables and fruit.

Researchers found that the subjects who regularly consumed flavonoids were less likely to develop ED.

Certain foods may also boost your testosterone levels and improve your fertility. This includes:

• spinach
• spicy foods with capsaicin
• avocado

Get regular exercise

Moderate physical activity can reduce your chances of ED.

One 2015 study looked at people with ED and a recent myocardial infarction, commonly referred to as a heart attack. It found that a home-based walking program can reduce ED.

Try exercising at least a few times a week — even a brisk walk every so often can improve your penile health.

Practice pelvic floor exercises

Pelvic floor exercises are often associated with vaginal health, but they can be helpful for everyone.

These exercises can improve your ability to get and maintain an erection, as well as prevent dribble after urination.

A small 2005 study on 55 people with ED found that pelvic exercises helped 40 percent of participants regain normal erectile function.

An additional 35.5 percent reported that, although they hadn’t completely regained normal function, their overall erectile function did improve.

You can do basic Kegel exercises by squeezing the muscles you use to urinate. Squeeze for five seconds, relax, and repeat for 10 rounds. Eventually, work your way up to 20 reps. Do this two or three times per day.

Maintain a healthy weight

Maintaining a healthy weight can reduce your chances of diabetes, high cholesterol, and heart disease, all of which affect your penile health.

Practice stress management

Practicing stress management is great for your overall health and the health of your penis.

Stress and anxiety can affect your sexual performance and fertility. Stress also increases your chances of developing cardiovascular disease, which can lead to ED.

Stress management techniques include:

• deep breathing
• spending time with loved ones
• journaling
• meditation

Practice sleep hygiene

Sleep is important for your vascular health, which affects your ability to become erect.

There seems to be a link between obstructive sleep apnea and ED, possibly because sleep deprivation can lead to low testosterone and other hormonal imbalances.

Avoid tobacco

Smoking cigarettes is strongly associated with ED.

A 2013 study showed that this possibly is because smoking disrupts your heart’s autonomic function, which in turn leads to ED.

Smoking can also decrease your fertility.

Drink alcohol in moderation, if at all

As with tobacco, excessive drinking can cause a number of health problems, which can in turn affect your penis health.

To help you manage your health, we’ll send you sharp coverage of fitness, nutrition, and other wellness topics just for men.

How to wash your penis

You can wash your pubic area using warm water and unscented, mild soap. Don’t use harsh soaps or scrub the area too hard, as the sensitive skin in the area can be irritated.

Make sure you:

1. Wash your pubic mound and the skin around the base of the penis, as well as the skin between your thighs and your pubic mound. Sweat can collect here.
2. Wash the shaft of your penis.
3. If you have a foreskin, gently pull it back and wash it. This helps to prevent smegma build-up, which can lead to conditions like balanitis.
4. Wash your scrotum and the skin around it.
5. Wash your perineum (the piece of skin between your scrotum and anus).
6. Wash near your anus and between your butt cheeks.

It’s best to wash your penis every time you bathe.

As you wash yourself, examine the skin around your groin for STI symptoms. This includes:

• unusual discharge
• rashes
• blisters
• warts

How to groom your pubic hair

Some people like grooming their pubic hair, while others don’t. Whether you groom your pubic hair or not is your decision.

If you’d like to remove or trim your pubic hair, keep your skin type in mind. This will help you avoid razor burn and other discomfort.

Shaving

Shaving is a painless way to remove hair. It’s important to take certain precautions to avoid getting a rash.

Shave in the same direction that your hair grows. Use shaving cream while shaving and apply cortisone cream after to reduce irritation.

Never share razors with anybody else, and disinfect yours before use. If you use disposable razors, replace them every so often.

Waxing or threading

Waxing involves applying warm wax to the skin and pulling the hair out from their follicles.

Threading involves twisting thread around the hairs and pulling them out by the root.

Waxing and threading can be uncomfortable — it all depends on your individual pain tolerance.

If done incorrectly, these removal methods can cause swelling and rash.

You can reduce your risk for discomfort by visiting a professional waxer or threader.

Chemical hair removal

Hair removal cream breaks down the proteins in hair so that it can be washed away and removed.

While it can be an effective way to remove hair, some people find that hair removal creams irritate their skin.

You shouldn’t use these creams if you have sensitive skin or chemical allergies.

If you do use hair removal cream, don’t apply it directly to your penis.

Trimming

If you don’t want to remove the hair entirely, you can trim it with a pair of scissors or electric trimmer.

Be sure to disinfect scissors before and after use. You should only use these scissors for grooming — using them for other tasks can spread germs.

How to prevent STIs

There are a number of ways to prevent STIs.

Get vaccinated

The Centers for Disease Control and Prevention (CDC)Trusted Source recommend that everyone gets vaccinated for human papillomavirus (HPV) around age 11 or 12.

Doing so at a young age — before you’re sexually active — ensures that you’re protected against HPV before you’re exposed to the virus.

But if you weren’t vaccinated as a child, you may still benefit from getting vaccinated as an adult. Talk to a doctor or other healthcare provider to learn more.

Get tested after every new partner

Many STIs are asymptomatic, which means that you won’t have any noticeable symptoms.

For this reason, it’s important to get tested before having sex with a new partner. Both you and your partners should get tested.

If you or a partner has an infection, you might be able to take certain precautions to prevent it from spreading between you.

For example, if you have HIV, your partner can take Truvada (pre-exposure prophylaxis, also known as PrEP) to help prevent them from contracting it.

Use a condom every time you have sex

Using a condom every time you have sex — oral, vaginal, or anal — is the best way to help prevent the spread of certain STIs.

If you don’t want to use a condom, ensure that both you and your partners don’t have any STIs.

If you suspect you’ve contracted an STI, try not to panic. Most are treatable, and it’s nothing to be ashamed of. Talk to a healthcare provider. They’ll help you find the cause of your symptoms and advise you on any next steps.

Common questions

At this point, you might have more questions about penis health. Here are some common concerns that many people have.

Does it matter if you’re circumcised?

Circumcision has its pros and cons. Whether you’re circumcised or not, it’s important to wash regularly.

If you have a foreskin, pull it back gently and clean it to avoid a smegma build-up. Circumcised penises are more likely to get chafed or irritated, so use loose-fitting, cotton underwear always.

Circumcision doesn’t affect fertility, but uncircumcised penises are more susceptible to STIs, as well as conditions like balanitis.

Practicing good hygiene and safe sex can reduce your chances of getting these conditions.

Does it matter if you’re a “grower” or a “shower”?

So far, there isn’t any scientific information that shows whether being a “grower” or a “shower” is better or healthier. Both are totally okay — so embrace whatever category your penis may fall into!

Is it normal for your penis to have a bend or a curve?

It’s normal for your penis to curve slightly, but if you have a significant bend and pain in your penis when it’s erect, you could have Peyronie’s disease.

This condition can cause some discomfort. It’s often caused by a traumatic injury.

If you’re concerned that you may have Peyronie’s, see a doctor or other healthcare provider.

Is “use it or lose it” true?

Many people believe that sex is a “use it or lose it” thing — that if you stop having sex, you’ll end up struggling to have sex.

While it’s true that frequent sex has many health benefits and can boost your sex drive, there’s no evidence that chastity can permanently or seriously damage your penis.

Is there such a thing as too much or too little ejaculate?

If you’re noticing that you are ejaculating a lower volume of semen than usual, it’s called perceived ejaculate volume reduction (PEVR).

This could be caused by a number of things, including depression, diabetes, and certain testicular conditions. It could also be a side effect of medication.

How can you maintain penis sensitivity as you age?

The tissue on your penis might lose sensitivity as you age. This could be caused by friction, so wear loose cotton underwear instead of tight, rough underwear.

How can you maintain your ability to get an erection?

Taking steps to reduce your risk of heart disease and diabetes — both of which can cause ED — can help you maintain your ability to get an erection.

What can you do to promote fertility?

Certain foods can promote fertility. For example, spinach contains magnesium, which can boost your testosterone levels.

Tomatoes and carrots can increase your sperm count and motility.

Other than that, healthy lifestyle choices help maintain fertility.

As outlined above, avoiding tobacco smoking and alcohol, eating a balanced diet, and exercising are all important for penis health.

Is it OK if your pee changes colors?

Your urine could change colors depending on how hydrated you are:

• Clear urine could mean you’re overhydrated.
• Yellow to amber urine is considered normal.
• Orange or brown urine could mean you’re dehydrated.

Some colors might also be a cause for concern.

For example, bloody, cloudy, blue, or green urine could indicate that you have an infection or another health condition.

See a doctor if you’re experiencing unusual changes in color or consistency.

What if you start peeing more than usual?

Frequent urination could be a sign of:

• urinary tract infection (UTI)
• diabetes
• interstitial cystitis

If you’re peeing a lot more than usual and you think something is wrong, contact a doctor. This is especially important if you’re experiencing a burning sensation during urination.

Is it normal for your penis to smell?

Your groin might naturally smell a little like sweat, as it’s common to sweat in that area. This smell can be reduced through daily washing.

However, the smell shouldn’t be pungent. An unpleasant-smelling penis could indicate that you have a condition such as:

• UTI
• yeast infection
• balanitis
• gonorrhea
• chlamydia

If the smell doesn’t clear with careful washing, see a doctor for diagnosis.

What if your penis is sore or inflamed?

If your penis is sore or inflamed, it could be a sign of certain penis conditions. This includes:

• balanitis
• phimosis, a condition where the foreskin can’t be pulled back over the head of the penis
• penile cancer, which is rare but serious

No matter the cause, pain and inflammation can be uncomfortable, so see a healthcare provider. They can help you find relief.

Is it possible to break or fracture you penis?

Although the penis doesn’t have bones in it, the term “penis fracture” is often used to refer to a penis injury where the lining inside becomes torn. This is often caused by rough sex.

If you fracture your penis, it will turn black and blue, flatten, and it may make a popping noise. This is considered a medical emergency and requires immediate attention.

When to see a doctor or other healthcare provider

Ideally, you should see a doctor once a year for a penile check-up.

Otherwise, you should seek medical attention if you experience:

• bruises on the penis
• yellow, green, or otherwise unusual penile discharge
• swelling or inflammation of the penis
• blisters, rashes, warts, or sores on or near your penis
• burning, pain, or bleeding when you urinate or ejaculate
• pain during sex
• pain during an erection
• difficulty getting or maintaining an erection

Check your groin for signs of infections and other conditions regularly.

If you have any concerns, don’t hesitate to speak to a healthcare provider. They can help set your mind at ease and advise you on any next steps.

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The phrase “feminine hygiene” belongs in the trash alongside your last soiled dental dam or tampon.

But that doesn’t mean vagina owners shouldn’t prioritize the health of their genitals — they should!

Read on to learn why the language used to describe vulvar health is garbage. Plus, what vulvar health and hygiene really entails.

What does ‘feminine hygiene’ actually mean?

As it’s primarily used, “feminine hygiene” doesn’t really mean anything.

It’s nothing more than a marketing ploy. One that’s based in transphobic, misogynistic values designed to make cisgender women feel ashamed of their genitals, and therefore buy so-called feminine hygiene products.

The (false) message: Using these products makes you (and your genitals) clean, while not using them makes you dirty.

Why is it referred to as ‘feminine’ and not ‘vulvar’?

“While the phrase ‘feminine hygiene’ is often used to make people with vaginas feel dirty, the goal of the phrase is recognizing the unique qualities of the parts that make up the vulva and the vaginal canal,” explains Felice Gersh, MD, author of “PCOS SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness.”

So, actually, a better, more accurate phrase would be vulvar/vaginal hygiene.

If you’re wondering why the phrase “vulvar hygiene” would *not* suffice, here’s a quick anatomy lesson:

• The vagina = the internal part of the genitals. It’s the canal where things like tampons and dildos can go.
• The vulva = the external parts of the genitals, which include the pubic mount, inner and outer labia, clitoris, and the vestibule.

And as Gersh notes, here we want to be talking about both parts.

At what age should you start developing your routine? 

As young as possible, actually.

“Just as parents explain to their children that they need to clean between their toes and brush their teeth, they need to explain to their child that they should tend to their genitals,” Gersh says.

What does a typical routine consist of?

Just as oral hygiene entails more than just one thing, vulvar/vaginal hygiene does too!

Feeding

It really does all start with food!

“Our entire body needs a wide range of nutrients in order to function optimally,” Gersh says. “So, what we eat and drink affects our vulva and vagina in the same way that what we eat and drink affect all parts of our body.”

To maintain the most optimal vulvar and vaginal health, she recommends a diet rich in:

• antioxidants
• vitamin E
• vitamin C
• omega-3 fatty acids
• omega-6 fatty acids
• protein
• probiotics

Cleaning

Likely, cleaning your bits is a far less ~involved~ process than you might have guessed.

In the shower

The vagina is a self-cleaning machine.

If you’ve ever seen discharge in your undies — assuming it doesn’t have a new odor or tinge — that’s evidence that your vagina is functioning just right.

The vulva, on the other hand, isn’t self-cleaning.

“The vulva is skin, and it’s skin that needs to be washed just like any other skin on the body,” explains Lauren F. Streicher, MD, clinical professor of obstetrics and gynecology and author of “Sex Rx: Hormones, Health, and Your Best Sex Ever.”

“A mild, fragrance-free soap with water and your fingers in the shower are more than adequate enough,” she says.

After going to the bathroom

“The most important thing to keep in mind when wiping [after pooping and peeing] is that you want to wipe your anus and vagina separately,” Streicher says.

Meaning, wipe one area, discard the used paper. Then wipe the other area.

The reason? “You don’t want to contaminate the urethra with anything from the rectum, because it increases the risk of a urinary tract infection,” she says.

And if you wipe each area separately, that’s a nonissue.

Just peeing? Be sure to wipe front to back, always.

After sex

Simple: pee!

Peeing cleans out any bacteria that may have migrated into the urethra during play, which may help reduce the risk of a UTI, explains Gersh.

“You can also do one little swish of water on your vulva with your finger, but don’t do any internal washing or scrubbing,” she says.

Grooming

Pubic hair has many important biological purposes, says Streicher.

This includes protecting the delicate vulvar skin from friction during intercourse and other activities.

“But there has been no research that shows that the pubic hair has any function as far as hygiene goes,” she says.

That said, if you choose to remove some or all of your pubic hair, the way you do it matters.

“You want to use a fresh blade every time,” Streicher says. If that sounds too pricey, at the very least designate a vulva-only blade. That way you’re not using a blade that’s been dulled by shaving shag elsewhere on your body.

When you’re done, dry the razor and store it away in your cabinet as opposed to on a shower ledge. This can help keep the razor from growing mold and rust.

Even if you follow all these above steps perfectly, ingrown hair and irritation are still a risk. And for folks with uber-sensitive skin, they’re practically inevitable.

“A warm compress on the ingrown hair can help open the pore and pull the follicle from underneath the skin,” Streicher says.

But if the bump you think is an ingrown hair is accompanied by symptoms like funky discharge, a foul odor, or pain, reach out to a healthcare provider.

“They’ll be able to tell you if it’s actually an ingrown, and do any culture swaps they seem fit,” she says.

Soothing

“You really don’t need to be worrying about soothing your vulva skin unless it’s irritated,” Streicher says.

If it is irritated, she recommends backing off any fragrant products and switching to a soap bar with mild, hydrating aloe vera.

If the irritation doesn’t go away, reach out to a healthcare provider.

Monitoring

“The best way to tell if something is awry with your vagina and vulva is to become familiar with it,” says Aleece Fosnight, a board certified physician assistant and medical adviser at Aeroflow Urology.

Her suggestion? Spend time learning the way your genitals typically:

• look
• smell
• feel

How? By slowing down in the shower, sniffing the crotch of your panties, looking at your genitals with a hand mirror, touching or fingering yourself, and regularly going to the doctor.

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Should your routine change over time?

“The biggest indication that something needs to change is if you’re experiencing unpleasant side effects or pain,” Streicher says.

That said, there are some ~major life events~ that may necessitate an update to your routine. Including:

If you have (or continue to have!) sex

If you become a sexually active person, prioritizing your genital health means knowing your current STI status.

Sex isn’t just penis-in-vagina penetrative intercourse. It’s also:

• oral sex
• hand play
• bumping and grinding
• anal sex

And the only way to know your current STI status? Get STI screened after every new sexual partner.

If you’re pregnant

“When you’re pregnant the last thing you want is [foreign] bacteria to take over, so my opinion is that less [cleansing] is more,” Gersh says.

If you’re going through menopause

“After menopause the vulva skin may need more moisture because the skin and area will become more dry,” Gersh says.

She also recommends additional supplements to keep the skin moisturized from the inside out and outside in:

• vitamin E
• vitamin C
• multivitamin
• collagen protein

What about douching, steaming, and other trends?

Two words: Please don’t!

“Trends like douching and steaming may be fun to read about,” Streicher says, but they’re less than fun for your genitals.

“Not only are there absolutely no benefits to these trends, but doing them can actively cause harm,” she says.

Douching — the act of washing the vaginal canal with a water-soap or water-vinegar mixture — can alter the vagina’s natural microbiome.

And when that happens? “You take away the vagina’s natural defense against infections,” she says.

Vaginal steaming can also mess with these defenses. But even more painful and unsavory is the risk that it can literally burn your vaginal tissues and vulvar skin. Ouch!

Is there anything else you should avoid doing or using?

To be very clear: Anything marketed as “feminine hygiene” is a no-go.

Ditto goes for anything that claims to be “pH balancing.” “The vulva doesn’t need to be pH balanced, and the vagina is able to manage its own pH,” Streicher says.

Is there ever a time when you should see a doctor?

Yep! See a healthcare provider if you’ve noticed a change in look, feel, or smell, says Fosnight.

(Not sure how to notice a change? Scroll back up, darling!)

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Retinal vascular occlusion affects the eye, specifically the retina. The retina is the light-sensitive layer of tissue that lines the back of your eye. It’s covered with special cells called rods and cones that convert light into neural signals and send these signals on to the brain so you can see. The retina is vital for vision.

The vascular system includes blood vessels called arteries and veins, which transport blood throughout your body, including your eyes. Your retina requires a constant supply of blood to make sure your cells get enough nutrients and oxygen. Blood also removes the waste your retina produces. However, it’s possible for one of the vessels carrying blood to or from the retina to become blocked or to have a blood clot. This is called an occlusion.

The occlusion can cause blood or other fluids to build up and prevent the retina from properly filtering light. When light is blocked or fluids are present, a sudden loss of vision can occur. The severity of vision loss may depend on where the blockage or clot occurred.

Retinal vascular occlusion is a potentially serious condition, especially if hardening of the arteries, or atherosclerosis, already exists. It most often occurs in middle-aged and older people.

What are the different types of retinal vascular occlusion?

There are two types of retinal vascular occlusion. The type depends on which blood vessel is affected:

Retinal artery occlusion

Retinal artery occlusion is a blockage of one of the retinal arteries, which are blood vessels that carry oxygenated blood from the heart to your retina. A blockage in the main artery of your retina is called a central retinal artery occlusion. A branch retinal artery occlusion happens when the blockage occurs further along in the smaller branches of your artery.

Retinal vein occlusion

Retinal vein occlusion is blockage of one of your retinal veins, which are blood vessels that carry deoxygenated blood back to your heart. Retinal vein occlusion is also divided into two types:

• Central retinal vein occlusion (CRVO) is a blockage in the main vein of your retina, which is called the central retinal vein.
• Branch retinal vein occlusion (BRVO) occurs when the blockage is in a smaller branch of veins throughout the retina.

Blockages in your main vein or artery are often more serious than blockages in your branch veins or arteries.

Causes of retinal vascular occlusion

The specific cause of vascular blockage or blood clots in the retina is unknown. It may occur when the veins of the eye are too narrow. However, other factors that affect blood flow can put you at a higher risk of having retinal vascular occlusion. These risk factors include:

• atherosclerosis, or hardening of the arteries
• blood clots, which often travel from elsewhere in the body to the eye
• a blockage or narrowing in the carotid arteries of the neck
• heart problems, including irregular rhythm or valve issues
• diabetes
• high blood pressure
• high cholesterol
• being overweight
• intravenous (IV) drug use
• being over the age of 60
• glaucoma, which is a condition that damages your optic nerve
• smoking
• rare blood disorders
• macular edema, which is fluid buildup, swelling, and thickening of the central part of the retina
• inflammatory disorders such as giant cell arteritis

Symptoms of retinal vascular occlusion

The primary symptom of retinal vascular occlusion is a sudden change in vision. This could include blurry vision, or a partial or complete loss of vision.

The vision symptoms usually only occur in one eye. Physical pain is not a symptom of retinal vascular occlusion.

The changes in eyesight could be short term or permanent, depending on how quickly you seek treatment and if you have other health conditions. You should make an appointment with your ophthalmologist, or eye doctor, right away if you experience any changes in your vision. Definitely go to the emergency room immediately if you suddenly lose your vision in one eye.

Complications of retinal vascular occlusion

The condition can occasionally lead to complications and more serious symptoms. Vision may be severely and permanently affected if any of the following complications occur:

Macular edema is a swelling in the macula, or the central part of your retina, due to a buildup of blood.

Neovascularization is an abnormal growth of blood vessels caused by poor blood flow and a lack of oxygen to your retina.

Neovascular glaucoma involves fluid buildup and high pressure in your eye. This is a serious complication. It’s associated with severe vision loss and possibly loss of the eye.

Retinal detachment is rare. It’s a separation of your retina from your eye tissue.

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Diagnosing retinal vascular occlusion

Your ophthalmologist will perform a comprehensive exam to diagnose retinal vascular occlusion. They’ll check your vision, pressure within your eyes, and the physical appearance of your eyes. Your doctor will assess your eye function and the look of the pupil. They may also measure your blood pressure and suggest a blood test to check for blood clotting conditions.

The following eye tests may also be done:

• Optical coherence tomography (OCT) can be used to take a high definition image of your retina.
• An instrument called an ophthalmoscope can be used to examine your retina.
• In fluorescein angiography, a dye is injected into a certain vein in your arm. This vein is the one that travels to the blood vessels of the retina. Your doctor can use this to see what happens to the dye once it’s in your eye.

Your doctor may suggest other heart tests if they suspect blood clots are coming from somewhere else in your body. These tests may include an echocardiogram, electrocardiogram, and a heart monitor to check your heart’s rhythm. These tests will assess your heart and vascular.

Preventing retinal vascular occlusion

The best way to prevent retinal vascular occlusion is to identify and treat the risk factors. Since retinal vascular occlusion stems from vascular issues, it’s important to make lifestyle and dietary changes to protect your blood vessels and keep your heart healthy. These changes include:

• exercising
• losing weight or maintaining a healthy weight
• eating a healthy diet low in saturated fat
• not smoking or quitting smoking
• controlling diabetes by keeping your blood sugar at a healthy level
• taking aspirin or other blood thinners after consulting with your doctor first

Routine checkups with your doctor can help you learn whether or not you have any of the risk factors of retinal vascular occlusion. For example, if your doctor discovers you have high blood pressure or diabetes, you can start preventive treatment right away.

Treating retinal vascular occlusion

There’s no medication available that’s specific for retinal artery occlusions. Most people with this condition will have permanent changes to their vision.

To treat retinal vascular occlusion, your doctor may recommend medication such as blood thinners or injections into the eye.

Medications used to treat retinal vein occlusion include:

• antivascular endothelial growth factor (anti-VEGF) drugs such as aflibercept (Eylea) and ranibizumab (Lucentis), which are injected into the eye
• corticosteroid drugs that are injected into your eye to control the swelling

In some cases, laser therapy can be used to break down the blockage in the blood vessels and to keep more damage from occurring.

It’s possible to develop a blockage in your other eye. Your doctor will develop a prevention plan for you if they’re concerned that your other eye is at risk.

Outlook for people with retinal vascular occlusion

The outlook depends on the severity of your condition. Many people will recover and regain most of their vision capabilities, but not all. It’s possible that your vision will not return. Since retinal vascular occlusion typically only affects one eye, your brain may adjust to the change in vision after a few months. Once the eye adjusts, the loss of vision may become less of a problem for you.

If you have other eye conditions or complications from retinal vascular occlusion, such as complete vision loss or glaucoma, you may not fully recover your vision. You’ll need to work with your doctor to ensure that your eye conditions are managed properly.

The treatment of risk factors like diabetes and atherosclerosis dramatically reduces your risk of the occlusion recurring or causing further damage. In rare cases, a blood clot that continues to move throughout your bloodstream could cause a stroke.

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The aim of the rehabilitation is to aid the amputee to gain independence at the highest level they can, with the most efficient gait possible. The assessment must take into account the physical capabilities, level of amputation, psychological status, pre-amputation function, existing medical conditions and the patient’s expectations. Rehabilitation should begin 5 days post-surgery .  A crucial element of constructing a rehabilitation programme is sound gait analysis. This will largely be observational. Validated outcome measures are available to aid goal setting and measure function.

Gait analysis consists of observation of the gait, which should occur from all angles. Knowledge of normal gait patterns for the prosthetic and non-prosthetic user is required to help analysis of movement. On observation of the gait, the assessor compares the function of the amputee to expected patterns of gait and look for deviations. Analysis of the gait pattern will help determine why these deviations are occurring. This will then help to formulate the rehabilitation programme, which includes the correction of the deviations. Outcomes measures can be used to monitor progress.

Amputees should perform pre-prosthetic exercises to help maintain ROM and improve muscle strength in the lower limb and residual limb in preparation for using the prosthetic limb. Abdominal and back exercises should also be considered to help trunk control and reduce back pain. Pre-prosthetic limb exercises can help prevent the occurrence of prosthetic gait deviations.

Due to the loss of the limb, the amputee will automatically shift their centre of gravity over the foot of the non-prosthetic side. After an amputation, there will be a period of time where the amputee is without a prosthesis. This is due to the timeframe of the assessments required to decide if the provision of a limb is appropriate. During this period the amputee will become familiar with the shifted centre which will increase the difficulty of reorientation of the centre of gravity once they receive a prosthetic limb.

The authors of a systematic review study reviewed 18 manuscripts to evaluate the evidence on gait training interventions in patients with lower limb amputations, in order to guide both research and practice. They found that gait training is needed due to improve asymmetry, change in biomechanics, and related secondary consequences after an amputation. Both overground and treadmill-based rehabilitation was included for review. Their results showed that the following interventions are effective in improving gait: overground training (with verbal, manual, or psychological awareness interventions), treadmill-based training both as a supplement to overground, as a home exercise, or on its own with visual feedback or with body weight support.

The following exercises can be used for patients with either transtibial or transfemoral amputations and should be adapted as necessary, depending on the component. The prosthetic knee function could influence the exercises. If possible start with a locked knee or teach the patient to keep their centre of gravity on the prosthesis to keep it from bending when weight-bearing. Different prosthetic knees have different functions and specific ways to teach the patient. This page will give you the basics that can be used with every patient, with links at the bottom of the page to more specific rehab. You can also search on Google or YouTube for the specific company or prosthetic components information.

The Orientation of Centre of Gravity and Weight Bearing on the Prosthesis

Prosthetic training should include orientation of the centre of gravity and improve proprioception and weight bearing on the prosthetic side. There are a number of technique/exercises which can be employed to facilitate the rehabilitation of this:

Lateral weight shifting

Stand between parallel bars with two-handed support. The amputee practices shifting the weight from the non-prosthetic limb to the prosthetic side. This can be performed with pelvis only initially and progress to full-body movement when the amputee becomes more confident. This exercise will help the patient to contract his/her gluteal muscles and contract the muscles of their residual limb to stabilize. Make sure that the patient is actively engaging the muscles especially when the amputation is above the knee where the patient might lean into the socket (Trendelenburg stance) instead of using gluteus medius. A pair of scales under the feet can help to determine the weight transference. Two-handed support can be reduced to one-handed (alternating hands to the contralateral side of the weight shift) and fingertip support, for progression.

All the exercises below can be done with a gait belt and it is important that the therapist focuses on the patient’s safety and that all exercises are tailored to the patient’s ability and fall risk.

Forward and back weight shifting

Weight transference can be practised forwards and backwards to help balance and orientation. The exercise is performed as for lateral weight shifting but the body weight is moved forwards and back. This can begin with pelvic movements only to build confidence and progress to entire body weight. Reduced hand support will be a progression of this exercise. The patient should stand upright, with the feet hip-width apart and start by distributing their weight evenly between the two feet.

Stair/Stool stepping

Single leg stance on the prosthetic side can be improved by high stepping with the non-prosthetic side. With 2 handed support, the amputee steps the non-prosthetic limb onto a stool of approx. 4-8 inches. This exercise can be progressed by increasing the height of the step and/or reducing the hand support required, doing the movement slower, giving a bigger step on the sound side, and swinging the arms. The patient needs to actively engage the gluteals on the standing leg and avoid trunk side flexion. As the amputee becomes more confident and weight bearing improves the step of the non-prosthetic limb will be slower and more controlled.

Balance board

A balance board can be used to help weight bearing and balance where they shift body weight forward and back and laterally between the prosthetic and non-prosthetic side. This can be performed between parallel bars with 2 handed support and then progressed to 1 hand, no hands, movement of the arms, looking up and down, left and right, and catching and throwing a ball.

Throwing and catching

Stood between parallel bars or with supervision, as required the amputee performs throwing and catching with the therapist. This encourages the amputee to adjust their weight bearing as they reach outside their base of support over the prosthetic and non-prosthetic limb. This exercise can be progressed by the non-prosthetic limb being placed on a step or balance cushion. Make sure that the patient is safe. If the patient has a risk of falling make sure that they have a gait belt on and that someone is standing behind them.

Ball rolling

This exercise improves standing posture and balance. Start in the parallel bars and progress from there. The ball is placed under the sound limb, to work on muscle activation and weight bearing on the prosthetic side. Move forwards, backwards, sideways, and make circles. Progress by not holding on, increase the size of the ball, move faster, and change direction.

Single leg standing

Practice balancing on the prosthetic limb will help improve balance on that side. This can be performed with varying levels of hand support.

Kicking a ball

With or without hand support, standing on the prosthetic side, the amputee kicks a ball with the non-prosthetic leg to promote weight shift onto the prosthesis.

Single limb stand with Theraband

This exercise is done by tying the Theraband end around something sturdy and then around the prosthetic foot. Shift the weight to the sound foot and move the prosthetic side against the resistance of the band. Do it slow and controlled and in a straight line.

Gait Re-education

Specific gait re-education and facilitation is important during rehabilitation in order to ensure the correct biomechanics of gait are achieved. Recommendations are that gait re-education commences between parallel bars.

Walking aids

Rehabilitation should begin between parallel bars. However, once the amputee becomes confident and a good gait pattern is achieved walking aids should be introduced to aid the progression of mobility and to encourage mobility in the amputee home environment. Aids should be provided to promote the maximum level of independence and encourage the amputee to be as full weight bearing as possible. The patient’s pre-amputation level of function, current abilities, level of progression, overall health and medical status should be considered when selecting and progressing walking aids.

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Specific gait re-education

The gait cycle can be broken down and each segment practised with the amputee. With 2 handed support begin with heel strike of the non-prosthetic limb while weight bearing on the prosthetic side, encouraging correct foot placement. This is then practised with the opposite leg. Step by step progression of the gait should commence once heel strike is achieved. Forward weight transference onto and off the prosthetic limb to allow floor contact of the prosthetic foot and weight acceptance, without the swing through of the opposite leg, is the next step. This again is practised with both sides. Once this is satisfactory, swing through of the opposite leg can be practised when the leading foot/prosthesis is in stance. This process is followed with each step to help encourage a rhythmical, reciprocal gait pattern with appropriate weight shift. Regular proprioceptive facilitation to aid correct pelvic and trunk movements and help facilitate weight transference along with verbal feedback is used to reinforce correct movement.

Things to address during gait re-training.

1. Symmetrical width of walking base with weight transfer equal on sound and prosthetic limb
2. Stride length – usually patients will take a shorter faster step with the sound limb
3. Loading the prosthetic toe – dynamic weight bearing over the toe
4. Transverse pelvic rotation on the prosthetic side – resistance can be applied the ASIS to give feedback to the patient on what is required.
5. Prosthetic knee flexion
6. Trunk rotation and arm swing

Progressing from parallel bars to free walking

Sidestepping

This can be performed at any stage in the rehabilitation programme. The aim is to encourage lateral weight shifting and strengthen the abductors, The exercise can be performed with 2 hand support in the parallel bars and progress by the amputee moving around furniture/obstacles as a patient would in their own environment.

Backward walking

This activity is more difficult for transfemoral amputees than transtibial due to the lack of knee flexion of the prosthesis. However with practise the transfemoral amputee can perform this action with confidence. They will commonly need to plantarflex the ankle, come onto the toes, of on the non-prosthetic limb as they bring the prosthetic limb back.

Multidirectional changes

This will help improve prosthetic control and balance. Often changes in direction will prove difficult for amputees and practice will help improve mobility in more challenging environments such as crowded public places.

Tandem walking

This can help improve co-ordination, foot placement and weight bearing. A strip is placed on the floor. The exercise can be progressed through 3 stages

1. Foot placement on each side of the line
2. Foot placement heel toe along the line
3. Foot placement crossing over onto opposite sides of the line- for the more advanced amputee.

Braiding

The amputee stands with 2 handed support and swings one leg across the front of the body and then behind. This is performed with both the prosthetic and non-prosthetic side. To advance this exercise the amputee performs this action with more speed meaning they must adjust their weight bearing and balance to compensate for the speed of the movement.

Obstacle stepping

Between parallel bars or with supervision, the action of stepping over obstacles leading with the non-prosthetic limb can help encourage weight bearing on the prosthesis.

Functional Tasks

In addition to specific weight bearing and gait training, prosthetic rehabilitation should also include practice of more functional tasks of daily living. These should be centred on the patient’s individual goals.

Standing up from the floor

Stairs

The technique for performing stairs is the same for above and below knee amputees. Leading with the non-prosthetic limb ascending the stairs and descending with the prosthetic limb first. This can be progressed from 2 handed to non handed support, dependent on the ability of the amputee. Walking aids can also be used to help amputees manage stairs. Some prosthetic knees (hydraulic and microprocessor) allows step over step descending stairs by giving resistance during flexion,

Slopes/hills

Walking up and down slopes can be difficult for amputee patients. Often forward trunk flexion is required and shorted stride lengths. Some amputees will find it easiest ascending and descending slopes through side stepping. Aids and rails can aid with slopes. The same techniques in terms of stepping are applied to slopes as it is for stairs. Some prosthetic knees (hydraulic and microprocessor) allows a smooth step over step ramp descend by giving resistance during flexion.

Curb

The limb sequence applied to walking up and down stairs can be adopted for curbs. Walking aids are useful for assisting with curbs, however more advanced amputee will manage without. Balance and good single limb support is necessary for this. For the more advanced transtibial amputee the prosthetic limb can also be used to ascend curb and control descent.

Weight carrying

Practise walking with a weight on the prosthetic side or with objects in the hand. This may require a walking aid dependent on the patient’s ability.

Uneven surfaces

Walking over various terrains helps improve awareness and proprioception. It encourages the amputee to make use of their vision to compensate for the reduced proprioception on the prosthetic side.

Running

For advanced amputee running can be incorporated into the rehabilitation programme and can help amputees to increase participation in recreational activities.

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The aim of orthotics are to increase the efficiency of function during acute or long-term injury. This includes soft-tissue and boney injury, as well as changes as a result of neurological changes. They can be an effective adjunct alongside physiotherapy techniques such as muscle strengthening and stretches, gait and balance retraining and reach and grasp strategies.

A number of considerations need to be made before deciding on the type of orthotic needed:

• What are the patient’s goals?
• What are the specific impairments impacting on their function (thinking of head-to-toe and gait analysis).
• Are impairments the result of soft-tissue changes? Can they be changed with therapy input?
• Is a walking aid needed?
• Does the injury need to be protected from particular movements?
• Can an orthotic improve the efficiency of an activity?
• Can the patient cope with any adjuncts given?

Orthotics can be pre-made or customised, depending on the patient’s needs. 

“Off the shelf” Orthotics

Many patient’s can utilise ready made orthotics, which can often be adjusted to fit their size. These may come in small, medium and large sizes and can often be sized to the patient, e.g. with velcro straps. These are often lighter materials. They can also be good for an assessment, to confirm or deny a theory before a custom orthotic is made.

Custom Orthotics

Some individuals have more complex injuries / changes to one of multiple joint structures, and therefore require a customised orthosis. This may be particularly true in neurological conditions, such as Cerebral Palsy (CP), Parkinson’s Disease (PD) or after brain injury, such as traumatic brain jury (TBI) or stroke. In these cases, spasticity of muscles may have an impact on the patient’s function. Orthotics can be used both in resting and during mobility to improve affects of spasticity or reduce risk of contractures. In which case the orthotic will be specifically measured to the individual, and likely to be redone as the individual grows (in paediatrics) or as changes are made to joint structures.

Advantages

Lower limb: Influence both swing and stance phase of gait

• Prevent or correct deformity and reduce pain during weight bearing
• Improve efficiency of gait and maintain balance
• Improve base of support / lateral support
• Reduce need for compensation of ipsilateral and contralateral limbs and secondary pain
• To facilitate training in skills

Upper limbs: Can be used after an injury to prevent further injury, or reduced pain by supporting an injured limb.

• Prevent or correct deformity reducing pain and maximising function in reach and grasp tasks.
• In prove efficiency of reach and grasp tasks
• Off load an injured limb to allow healing
• Reduce need for compensation of ipsilateral and contralateral limbs and secondary pain
• Improve role of upper limb in maintaining balance

Spine: Stabalise spinal fractures to allow the patient to return to some normal activies (although they may be restricted) and protect the spinal cord.

Possible Complications

• Loss of sensation (check skin regularly- risk of pressure areas)
• Compensations in ipsilateral or contralateral limbs.
• Impact on spasticity (is the patient utilising spasticity to allow some function in absence of muscle strength?)
• Complications of casting at incorrect angle: Foot deformities, increased knee flexion in stance, muscle contractors
• Loss of sensory feedback and proprioception loss
• Ristricted range of motion
• Loss of natural shock absorption and long term joint damage
• Spinal orthotics must be put on and taken off within the guidelines of a spinal professional. Patients may be able to moblise within set restrictions, depending on the severity of their injury. Non-adherence to guidance may result in spinal cord injury.

Also, success depends on patient’s acceptance. Consider:

• Cosmesis
• Footwear
• Weight/rigidity
• Ability to Don Doff
• Compensations preferred
• Compensations required

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Types of Orthotics

Upper Limb

Healing

• Hinge-elbow brace: May be used to restrict elbow movement post fracture or surgery. Allows early mobilisation without damage to the healing tissue.

Hinge elbow brace: To restrict movement beyond a set degrees into flexion or extension to protect a healing injury / surgical site.

• Slings: Can be used after upper limb injury or surgery to protect the injury site. They can be used to restrict movements in particular directions to prevent further disruption to the injury (for example displacement of a fracture/ fixated bone). 

• Splints: Hand or wrist splints are often customised for individuals based on their specific impairment. This often achieved using thermoplastics. These can be both resting and functional.

Resting hand splint: Often customised to fit a patient to maintain range of movement in the hand for skin care and function.

Functional

• Wrist splint (e.g. fuctural splint)
• Elbow clasp: May be used, alongside exercises, especially if function is affected
• Neuromuscular Electrical stimulation (NMES):

Lower Limb

Orthotics can be used to optimise the alignment of the lower limb. This can be used to stabilise a joint to allow it to heal, or to facilitate ease of function. It can also be used to prevent or correct deformity in the lower limb, increasing efficiency.

Healing

• Wedge boot: Often used as conservative treatment or after surgery for Achilles tendon rupture to allow gradual stretching of the tendon as it heals. A heel wedge may also be used in patient’s with fixed platar flexion deformity to increased base of support and improve balance.

• Aircast boot: Often used after fracture injuries to support and reduce forces through the bone while healing. The air cells can be inflated around the foot and ankle, compressing the injury.

• Hinge-knee brace: Often used to protect knee surgery, such as meniscal repair.

• Splints; Patients with increased tone may require a resting splint to maintain optimal positioning of their lower limb and maintain a functional range in affected joints. Positioning and seated and supine positions are very important for these patients

Functional

• Ankle- Foot Orthosis (AFO): Correct alignment of the lower foot and ankle, which translates to the alignment of the shin, upper leg and pelvis. AFOs have an influence on both the swing and stance phase of gait. Can also be used to reduce risk of trips and falls as a result of foot drop.

• Lateral support ankle brace: In patient’s after ankle injuries, particularly to lateral ligaments, or neuromuscular disorders, a lateral ankle support may be needed. This brace has stiff lateral supports which will prevent excessive pronation or supination at the foot. This reduces the risk of further injury to lower limb structures, or injuries secondary to a fall.

Aircast lateral ankle support. To protect against lateral ankle strain and support lower limb in stance phase.

• Functional Electrical Stimulation (FES): In patient’s with central nervous system disorders / leisions, it may be possible, and safe, to use FES as a dynamic orthosis.Can be used on a number of muscle groups to simulate electrical impulses in peripheral nerves. It is often used to reduced impact of foot drop or knee hyperextension as a result of muscle weakness. There is also some evidence that it may contribute to strengthening of muscles. In this way, FES may reduce the patient’s risk of falls and has been shown to improve quality of life scores  

Functional Electrical Stimulation for lower limb function [illustration from wikimedia]

• Foot Orthotics: Custom orthotics can improve foot alignment by affecting muscle activity. Therefore, they improve efficieny in gait and balance, and minimise shock absorption through the lower limb, pelvis and spine. These corrective devices are placed in an individual’s footwear similar to insoles.

A trained health practitioner will complete a detailed assessment of an individual’s gait and foot position in both a static and a dynamic state to identify asymmetries. This information will be combined with a precise imprint of the feet on a foam cast. This will be sent off to a lab where the orthotics will be fabricated and created. Some facilities will also use a gait scan machine in order to analyse where the majority of your weight is dispersed while you heel strike and push off during the gait cycle. The foot specialist may request that the lab add special features to the orthotics based on the patient’s area of pain, the wear patterns in the patient’s shoes and the skin changes on their feet.

Consideration: It seems logical to think that pain in the foot region links directly to dysfunction in the foot region and that orthotics are the intervention of choice. Unfortunately, it is not always that straightforward. For example, could hip weakness or lower back pain be causing disruption to the gait cycle and compensatory strategies that place increased load on foot stuctures? It is important to determine what is “driving” the pain in the foot and to direct treatment to these structures to see if insoles are needed. Also, can the intrinsic muscle of the foot be trained either alongside, or instead of the use of insole orthotics?

Conditions that may require a foot orthosis as an adjunct include:
• Plantar fasciitis
• Morton’s Neuroma
• Flat feet or high arches
• Knee, hip or low back pain and SIJ dysfunction
• Degenerative Disc Disease and scoliosis
• Osteoarthritis
• Patellofemoral pain syndrome
• Femoral acetabular impingment
• Iliotibial band friction syndrome
• Bursitis
• Chronic ankle sprains
• Piriformis syndrome
• Achilles, Patellar, hamstring or gluteal tendinopathy and Snapping Psoas
• Recurrent Calf Strains

Spinal  Orthotics

Spinal orthotics can be used to give support to a spinal fracture. It is important to have clear instructions about the position that the patient should be in to put the brace on and off. This will be based on spinal scans and an multidisciplinary discussion of the stability of the spinal fracture.

A neck collar may be used for some patients where the fracture is stable, to provide comfort by supporting neck muscles and reducing pain. However, the benefits of a collar need to be weighed up against possible impact on the patient’s skin, their swallow and ability to feed themselves.

If a patient is discharged with a neck collar they will require a suitable collar care plan in the community to ensure their neck is cleaned and skin checked regularly. The soft pads of the neck collar will also need to be cleaned regularly. Therefore, spare pads should be provided to the patient.

Outcome Measures

Use of outcome measures will determine the effectiveness of orthotics. This will be based on the patient’s initial impairments, but may include:

• Neutral-0
• Passive range
• Active range
• Berg Balance Scale
• Tinetti
• Gait speed
• Timed up and go (TUG)
• Timed Unsupported Stand (TUSS)
• Functional gait assessment
• ARM A, B
• Action Reach Arm Test (ARAT)
• Reach and grasp
• Modified Ashworth Scale
• Patient perceived outcome measures

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The phrase “psychological well-being” is used to describe an individual’s emotional health and overall functioning. The author of a study published in Applied Psychology: Health and Well‒Being describes psychological well-being as “the combination of feeling good and functioning effectively.”

Researchers also have found that the absence of distress doesn’t necessarily indicate a person has high psychological well-being. High psychological well-being is about feeling happy and doing well. People with high psychological well-being report feeling capable, happy, well-supported, and satisfied with life.

Why It Matters

Studies have discovered that people with higher psychological well-being are more likely to live healthier and longer lives. They are also more likely to enjoy a better quality of life. Better psychological well-being also is associated with fewer social problems.

For instance, research has found that people with high psychological well-being are less likely to engage in criminal activity or abuse drugs and alcohol. In addition, positive psychological well-being tends to predict higher earnings and more prosocial behavior, such as volunteering.

People also are more likely to enjoy positive psychological well-being when they have their basic needs met. Living in a safe area, having enough food, and having adequate shelter are all important factors for emotional health.

If you’re looking to improve your psychological well-being, there are several things you can do to feel and function better. Here’s an overview of four things you an do to improve your overall sense of well-being.

Creating Purpose

Living a life with meaning and purpose is key to improving your psychological well-being. Your purpose doesn’t necessarily have to involve changing the world or finding a career devoted to helping others though.

Instead, you might make it your purpose to be kind every day. Or, your purpose might involve making the world better by encouraging others to take care of the environment or adopt pets from the shelter. Maybe your purpose is being an advocate for those who are hurting like bullied students, the homeless, or victims of abuse.

If you feel like your life lacks purpose, don’t worry. There are many ways you can find purpose in life and build a life that has more meaning. Begin by thinking about the legacy you would like to leave behind. Write down how you’d like to be remembered at the end of your life, or think about the impact you want to leave on the planet. Then, establish some objectives that can help you reach those goals.

Working toward your goals will give you a reason to get out of bed every day, beyond earning money.

Positive Thinking

Thinking positively also improves your psychological well-being. In turn, as your psychological well-being improves, it becomes easier to think positively and feel good overall. Fortunately, you can begin creating that positive cycle with a few simple strategies. Here’s an overview of the ways you can increase the positivity in your life.

Write About a Better Future

Take a few minutes and write down all the good things that could happen to you in the future. Imagine how you could be spending your time and who you would be spending it with if you were living your best life.

You also may want to devise a plan on how you can make that happen. Make small, measurable goals that will help you achieve that better future. Then, put a plan into place. When you’re working toward a better future—even if the steps are really small—it gives you a sense of purpose and something to look forward to.

Recall Positive Life Events

Spend time thinking about some of the best memories of your life. Whether it’s a family vacation you went on 10 years ago or an award you won at work two years ago, recalling the happiest times in your life can bring more positivity to your mindset.

Recognizing the good things that have happened to you over time—the people you have built memories with or the good times that you have experienced—is an important part of improving your well-being. They serve as reminders of the fullness life has to offer, especially when circumstances may be pulling you down.

Perform Acts of Kindness

Doing nice things for other people reminds you that you have the power to make a difference in the world. Giving to others also helps you think more positively and feel happier. Helping a neighbor in need, volunteering for a community activity, or raising money for a charity are just a few simple ways to improve your psychological well-being.

Also, look for ways to be kind to others in your everyday life. Doing so benefits you in a number of ways. In fact, researchers indicate that individual acts of kindness releases both endorphins and oxytocin—the feel good hormones—as well as creates new neural connections.

Consequently, kindness can become a self-reinforcing habit that takes less and less effort to perform. There’s also some evidence linking kindness and healing. So, look for ways to be kind to others and your body and mind will thank you.

Practice Mindfulness

Mindfulness, which means staying in the moment, has been linked to a multitude of benefits, ranging from increased happiness to better resilience.1 Although mindfulness is a skill that takes practice and dedication, over time you can get better at learning how to be present and in the moment. Doing so has a number of benefits too.

For instance, studies suggest that mindfulness helps people manage stress, cope with serious illnesses, and reduce anxiety and depression. In fact, people who practice mindfulness are better able to relax, have improved self-esteem, and possess more enthusiasm over life.

What’s more studies have found a link between mindfulness meditation and changes in the parts of the brain responsible for memory, learning, and emotion. This discovery is not surprising because mindfulness requires you to pay attention to your thoughts, your actions, and your body.

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Express Gratitude

Whether you send letters to people telling them how much you appreciate them or you write about the things you feel thankful for in a journal, expressing your gratitude will keep you focused on all the good things in life. You can even express gratitude on social media.

Learning to be grateful in everything you do will become a way of life. You’ll discover you can be thankful for little things like the beauty of sunset as well as the big things like a new job or a visit from friend. Finding things to be thankful for everyday is a simple but effective way to boost your psychological well-being.

Identify Your Strengths

Feeling capable and confident is important. One of the best ways to accomplish this task is to remind yourself of the things you’re good at or the character strengths you possess. Try reflecting on your past achievements and the qualities that helped you succeed.

Write down these things as a reminder of what you have to offer the world. And, if there’s an area that you feel needs improvement, don’t be afraid to list that too. Working on improving yourself is a great way to impact your overall well-being.

Practice Forgiveness

Letting go of past hurt and anger is key to good psychological well-being. Forgiving someone doesn’t mean you have to allow that person to hurt you again. Instead, forgiveness is about releasing yourself of the anger that’s holding you back and keeping you bound to that person.

Forgiving another person frees you to put your energy into more positive things rather than ruminating on past hurts and offenses. If the person who wounded you is still a threat to your overall well-being, it also may help to erect some boundaries to safeguard yourself from further unnecessary pain.

Fostering Relationships

Studies show that loneliness takes a serious toll on your emotional and physical health. In fact, one study found that being lonely was as lethal as smoking 15 cigarettes per day. Just being around people, however, isn’t the solution. Instead, it’s important to form deep connections with other people.

The quality of relationships matters more than the quantity when it comes to improving your psychological well-being.

While contact over social media can be a good way to keep in touch when you can’t visit a friend in person, there’s no real substitute for the benefits of face-to-face contact. Have coffee with a friend, eat dinner with your family, and call a loved one just to chat.

Strong social support also is important to staying psychologically healthy. If you lack a support system, take steps to meet more people. Join community activities, get acquainted with your neighbors, or reach out to old friends.

Types of Wellbeing

Psychological wellbeing includes a number of different aspects:

• Autonomy: the freedom to make your own decisions
• Self-acceptance: satisfaction or happiness with oneself. This includes an awareness of one’s strengths and weaknesses. It results in an individual feeling that they are of “unique worth”.
• Mastery: the ability to manage everyday situations.
• Positive relationships with family, friends or others.
• A sense of purpose or meaning in life.
• Personal growth: facing challenges that are manageable and lead to developing new skills or becoming a better person.

Benefits from Wellbeing

Hundreds of research studies have proven, wellbeing doesn’t just feel good – it’s important for happier, healthier living:

• Optimism and positive emotions can reduce the risk of a heart attack by up to 50%. Optimism can be learnt!
• Experiencing three times more positive emotions compared to negative ones leads to a tipping point beyond which we become more resilient to adversity and better able to achieve things.
• Happier people live longer – potentially adding 7½ years to their lifespan.
• Our expression of positive emotions, such as happiness and optimism, influences the people we know, and studies show our positivity can be passed on to others.
• Having high levels of wellbeing has been shown to increase our immunity to infection, lower our risk of some mental health problems, reduce mental decline as we get older, and increase our resilience.
• A high level of wellbeing is as good for heart health and provides as much protection from coronary heart disease as quitting smoking does.

Research also shows that people who report higher levels of wellbeing tend to be:

• More involved in social activities and community groups
• Environmentally responsible
• Experiencing better family and social relationships at home
• More productive at work
• More likely to be working or studying full-time
• more likely to recover quicker from a range of chronic diseases (e.g. diabetes), and
• In young people, higher levels of wellbeing significantly influence alcohol, tobacco and cannabis use.

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• causes,
• consequences and coping with stress, pain and illness.

The term psychosomatic refers to real physical symptoms that arise from or are influenced by the mind and emotions rather than a specific organic cause in the body (such as an injury or infection). 

A psychosomatic illness originates from or is aggravated by emotional stress and manifests in the body as physical pain and other symptoms. Depression can also contribute to psychosomatic illness, especially when the body’s immune system has been weakened by severe and/or chronic stress. 

A common misconception is that psychosomatic conditions are imaginary or “all in the head.” In reality, physical symptoms of psychosomatic conditions are real and require treatment just as any other illness would. Unfortunately, effective treatment doesn’t always come in a timely or effective manner.

The pervasive social stigma attached to psychosomatic illness may prevent someone from seeking treatment.1 Even when someone does seek treatment, stigma is also present in research and medical communities, at least in part because the mechanisms that drive the stress-illness relationship are not yet fully understood. 

Psychosomatic Symptoms

You may not have thought much about the unique ways stress manifests physically, but it can be helpful to learn how to recognize when you are under extreme stress. Once you identify the signs, you can work on reducing the effect stress has on your health.3 

While it sounds like a complicated undertaking, there are actually some simple ways you can determine if you are overly stressed. 

Common physical signs of stress include:

• “Butterflies” in the stomach
• Racing heart
• Sweaty palms
• Tense muscles

Bodily signs of stress may be different depending on if you are biologically male or female. For example, women often report symptoms such as fatigue despite getting enough sleep, irritability, abdominal bloating, and changes to their menstrual periods. Signs and symptoms of stress in men, on the other hand, are more likely to include chest pain, increased blood pressure, and changes in sex drive. 

Symptoms of stress also vary by age. Children often display stress through their bodies because they haven’t yet developed the language they need to communicate how they feel. For example, a child who is having a hard time at school may have frequent stomachaches and may be sent home or ask to stay home. 

Stress in the teen years can be especially intense, particularly during periods of major social adjustment and hormonal shifts. Sometimes, signs of stress in people in this age group may be missed or attributed to “teen angst” when it is really a sign of adolescent depression. 

The elderly are also prone to depression, as they are often contending with several compounding factors, such as isolation, loss and grief, and chronic or serious health problems. If you are caring for an aging loved one, make sure you know the signs of depression in older adults.  How Stress Impacts Your Health

Causes of Psychosomatic Illness

There are actually different kinds of stress, some of which can be positive. Eustress is what makes life invigorating and interesting. It’s a feeling that makes you want to get up in the morning and keeps you motivated.

If you’ve ever enjoyed the thrill of a roller coaster ride or felt a sense of excitement and fulfillment when completing a project, you’ve experienced “good” stress. On the other hand, if you’ve ever experienced a major loss, gone through a big life change, or endured other stressors, you also know what “bad” stress feels like.6

Just like you can feel the giddiness and uplifting feelings of good stress all over, the negative effects of bad stress can be felt in your mind andyour body. While the exact mechanisms are not completely understood, researchers know that stress and depression can be expressed as physical pain and illness.6 It’s a complex process, but here’s an analogy that might help.

Compare your body to a pressure cooker. If it’s allowed to vent its steam, it works efficiently. If it can’t vent steam, the pressure continues to build until the lid blows off. Now, imagine that the cooker is under pressure already and you apply more pressure to keep the lid on. When the container can no longer hold in all the pressure, it will break at its weakest point.

Like the pressure cooker giving way at the weakest point of its structure, stress-related illness is most likely to develop where your body is already weakened. 

Someone who is under stress and not able to “vent” their emotions or who tries to “keep it all in” will eventually reach an emotional breaking point. It may manifest as physical symptoms or trigger an episode of major depression.

In retrospect, you may realize there were some warning signs or “clues” that such a break was coming—especially in terms of the physical symptoms you experience. For example, if your neck has always been your physical weakness, you may find your pain increases when you are stressed. Back pain, stomach trouble, and headaches are other common ways stress may take up residence in your body.  How Stress Can Make You Sick

Stress can also compromise your immunity. Some people find that when they are stressed, they’re more likely to catch a cold or the flu. They may also get more infections or take longer to get better. 

These chemicals are an important part of the body’s “fight or flight” response to stress and can be very useful. However, if the body has high amounts or they are released continuously over an extended period of time, these chemicals may do more harm than good. 

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Psychosomatic Illness Diagnosis

When you go to your doctor with physical symptoms, they will generally look first for a physical explanation for your pain. If there is no obvious physical cause that they can easily test for, coming up with a diagnosis and plan of treatment may be tricky. 

When this happens, people might feel like their doctor is not taking their symptoms seriously, thinks the person is making it up, or that it’s “all in their head.” When your doctor can’t find a clear physical cause for your pain (such as an injury or an infection), they may ask you about how you feel emotionally.

The hope is that if a source of stress can be identified, it can be treated (just as you would get treated for an injury or illness). When they ask about stress in your life, a doctor doesn’t mean to imply that your pain is not real. Symptoms caused by stress that you feel in your body are very real, they are just caused by a different mechanism that, say, if you broke a bone.

Treatment for Psychosomatic Illness

Your doctor may want you to talk to a mental health professional, but that’s not to say that your physical symptoms only need psychological treatment.9 It is important to learn how to effectively manage stress, but that is often a process and can take time. In the meantime, you need to treat your physical pain and other symptoms.

For example, if you have pain in your neck, learning to cope with stressful triggers can certainly help prevent from happening—but the pain is not only in your mind.

While it might start in your brain, stress can cause a cascade of chemicals in your body that produces inflammation in the muscles of your neck, which in turn causes you pain.9 You may need anti-inflammatory medications or another type of treatment, such as massage and physical therapy to manage your pain.

Another helpful analogy is to think of psychosomatic illness as a flooded river that happens after a dam breaks. The most important step for preventing more flooding is to fix the dam. However, it’s also necessary to handle the flooding that’s already happened while the dam is being repaired. 

Coping with Stress

Once you know how to recognize when you are stressed and have identified sources of stress in your life, the next step is to learn coping mechanisms. One of the first (and most important) is to avoid holding in your feelings.

Like a pressure cooker, stress that is pent up in your body will come out one way or another. The healthiest thing you can do is to develop a controlled way to “vent” instead of letting stress find a weak point and explode. 

As you’re working on developing coping mechanisms for combating stress, check to see if you have been using any unhealthy coping mechanisms, such as overusing alcohol.Stress Relievers That Are Totally Free

There are innumerable methods for healthy coping, it’s just a matter of finding what works best for you. Here are a few ideas to get you started. 

• Be honest with others (and yourself).
• Confide in a friend.
• Do something nice for someone else (and be sure to do nice things for yourself, too).
• Eat a balanced diet, get regular exercise, and create a calming sleep space.
• Explore fun new ways to deal with stress.
• Join a support group.
• Learn relaxation techniques.
• Let go of grudges, patterns of thinking, or relationships that are not healthy or helpful for you.
• Make time for leisure activities you enjoy.
• Take a break if you’re in a stressful situation.

Remember that everyone handles stress in their own way. Two people in the same stressful situation will react very differently. Once you understand the unique way stress affects you both emotionally and physically, you can work on developing healthy and effective ways to manage it.

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Counseling Psychology is a specialty within professional psychology that maintains a focus on facilitating personal and interpersonal functioning across the life span.  The specialty  pays particular attention to emotional, social, vocational, educational, health-related, developmental, and organizational concerns.

The practice of Counseling Psychology encompasses a broad range of culturally-sensitive practices that help people improve their well-being, alleviate distress and maladjustment, resolve crises, and increase their ability to function better in their lives. With its  attention to both to normal developmental issues and problems associated with physical, emotional, and mental disorders, the specialization holds a unique perspective in the broader practice-based areas of psychology.

Counseling Psychologists serve persons of all ages and cultural backgrounds in both individual and group settings. They also consult regularly with organizations seeking to enhance their effectiveness or the well-being of their members.

Interventions used by Counseling Psychologists may be either brief or long-term; they are often problem-specific and goal-directed. These activities are guided by a philosophy that values individual differences and diversity and a focus on prevention, development, and adjustment across the life-span.

Counseling psychologists help people of all ages deal with emotional, social, developmental, and other life concerns. These professionals use a variety of strategies to help people manage behavioral issues, cope with stress, alleviate anxiety and distress, and deal with the issues associated with psychological disorders.

Counseling psychology focuses on providing therapeutic treatments to clients who experience a wide variety of symptoms. It is also one of the largest specialty areas within psychology.

The Society of Counseling Psychology describes the field as “a specialty within professional psychology that maintains a focus on facilitating personal and interpersonal functioning across the life span. The specialty pays particular attention to emotional, social, vocational, educational, health-related, developmental and organizational concerns.”

What Do Counseling Psychologists Do?

Many counseling psychologists provide psychotherapy services, but other career paths are also available. Research, teaching, and vocational counseling are just a few of the possible alternatives to psychotherapy.

Whether they are working with clients in a hospital setting or counseling students in an academic environment, these psychologists rely on a broad range of psychological theories and therapeutic approaches to help people overcome problems and realize their full potential.

Where Do Counseling Psychologists Work?

Counseling psychologists work in a variety of locations, including private businesses, the military, government agencies, consulting practices, and more.

• Some professionals work in academic settings as professors, psychotherapy providers, and researchers.
• Others work in hospitals and mental health clinics, often alongside physicians and other mental health professionals including clinical psychologists, social workers, and psychiatric nurses.
• Still, other counseling psychologists are self-employed in independent practice and offer psychotherapy services to individuals, families, and groups.

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Required Education and Training

A Ph.D., Psy.D., or Ed.D. degree is required to become a counseling psychologist. Some students start by earning a bachelor’s degree in a subject such as psychology or social work and then receive a master’s degree in counseling or psychology before entering a doctorate program. In other cases, students can bypass the master’s program and go straight from their undergraduate degree into a five- or six-year doctoral degree program.2

A Doctor of Philosophy or Doctor of Psychology degree will typically be offered through a university’s psychology department, while the Doctor of Education in counseling psychology can be found at a school’s college of education. Most of these programs receive accreditation through the American Psychological Association (APA).

If you are looking for a program in counseling psychology, start by checking out the list of accredited programs in professional psychology maintained by the APA.

Counseling Psychology vs. Clinical Psychology

Out of all the graduate psychology degrees awarded each year, 56% are in the health service provision subfields: counseling, clinical, and school psychology.3 Counseling psychology shares many commonalities with clinical psychology, but it is also different in several different ways.

Some of the key similarities between counseling and clinical psychology are:4

• Both are trained to provide psychotherapy
• Both often work in hospitals, mental health clinics, academic settings, and independent practice
• Both can be licensed in all 50 states as licensed psychologists and can practice independently

Some of the key differences between the two professions include:4

• There are differences in training and education between the professions
• Clinical psychologists tend to focus on psychopathology
• Counseling psychologists tend to concentrate on overall well-being through the lifespan

While both clinical and counseling psychologists perform psychotherapy, those working as clinicians typically deal with clients experiencing more severe mental illnesses. Counseling psychologists often work with people who are experiencing less severe symptoms. The treatment outlook can also differ between clinical and counseling psychology.

Clinicians often approach mental illness from a medical perspective, while counseling psychologists often take a more general approach that encompasses a range of psychotherapeutic techniques. Of course, the individual approach a therapist takes depends on a variety of factors, including their educational background, training, and theoretical.

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Masturbation is a common activity. It’s a natural and safe way to explore your body, feel pleasure, and release built-up sexual tension. It occurs among people of all backgrounds, genders, and races.

Despite the myths, there are actually no physically harmful side effects of masturbation.

However, excessive masturbation can harm your relationships and everyday life. Other than that, masturbation is a fun, normal, and healthy act.

Keep reading to learn more about the side effects and potential health benefits of masturbation.

Side effects of masturbation

Masturbation doesn’t have any harmful side effects. However, some people may feel guilty about masturbating or have issues with chronic masturbation.

Masturbation and guilt

Some people may feel guilty about masturbating because of cultural, spiritual, or religious beliefs.

Masturbation is neither wrong nor immoral, but you may still hear messages that self-pleasure is “dirty” and “shameful.”

If you feel guilty over masturbating, speak with someone you trust about why you feel this way and how you can move past that guilt. Therapists that specialize in sexual health may be a good resource.

Addiction to masturbation

Some people can and do develop an addiction to masturbation. You may be spending too much time masturbating if masturbation causes you to:

• skip your chores or daily activities
• miss work or school
• cancel plans with friends or family
• miss important social events

Addiction to masturbation can harm your relationships and other parts of your life. Masturbating too much may interrupt your work or studies, which can lower productivity.

It may also hurt your romantic relationships and friendships, because you don’t spend as much time with your loved ones as you used to, or don’t pay attention to their needs.

If you’re worried you may have an addiction to masturbation, speak with your doctor or a counselor about ways to cut down on masturbating.

Talk therapy can help you manage your addiction. You could also cut down by replacing masturbation with other activities. Next time you have an urge to masturbate, try:

• going for a run
• writing in a journal
• spending time with friends
• going for a walk

Does masturbation cause a decrease in sexual sensitivity?

For women who have sexual dysfunction, enhanced stimulation — including masturbation — can help increase sexual desire and sensitivity.

In fact, two 2009 studies found that vibrator use among women and men has been linked to an increase in desire, arousal, and overall sexual function. Women also reported an increase in lubrication, while men reported better erectile function, according to the studies.

Masturbation can affect sensitivity during sex for men because of their technique. Research has shown that too tight of a grip on a penis during masturbation can decrease sensation.

Sexual health experts recommend changing your technique during masturbation to restore sensitivity levels during sex.

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Benefits of masturbation

Masturbation is a healthy sexual activity. It has many benefits for your physical and mental health.

There are limited studies on the benefits of masturbation, but there are studies on sexual intercourse and stimulation.

Research and anecdotal reports suggest that sexual stimulation, including stimulation through masturbation, may help you:

• relieve built-up stress
• sleep better
• boost your mood
• relax
• feel pleasure
• relieve cramps
• release sexual tension
• have better sex
• better understand your wants and needs

Couples may also mutually masturbate to explore different desires, as well as avoid pregnancy. Self-pleasuring also helps you prevent sexually transmitted infections (STIs).

Masturbation and prostate cancer

Some research suggests that regular ejaculation may lower the risk of prostate cancer, though doctors aren’t exactly sure why.

A 2016 study found the risk of prostate cancer decreased by about 20 percent in men who ejaculated at least 21 times a month. A 2003 study also discovered a similar link between frequent ejaculation and lower prostate cancer risk.

There’s no evidence, though, that ejaculating regularly protects against advanced prostate cancer.

Masturbation during pregnancy

Hormone changes during pregnancy cause some pregnant women to feel heightened sexual desire. Masturbation is a safe way to release sexual tension during pregnancy.

Self-pleasure may also help ease pregnancy symptoms, such as lower back pain. You may feel mild, irregular cramping, or Braxton-Hicks contractions, during and after orgasm.

They should fade away. If the contractions don’t disappear and become more painful and frequent, contact your doctor right away.

Masturbation may not be safe for women with high-risk pregnancies. This is because orgasm can increase your chances of labor.

Masturbation doesn’t have the health benefits that sex does.

“It appears that not all orgasms are created equally,” says Tobias S. Köhler, MD, MPH, an associate professor at Southern Illinois University School of Medicine in Springfield.

Study after study shows that intercourse has all sorts of benefits for men — for your blood pressure, heart and prostate health, pain, and more. You’d think that masturbation would, too. But it doesn’t.

Why would it make a difference whether you ejaculate during sex or on your own? No one’s sure. But your body seems to respond differently. Even the makeup of semen is different if you masturbate instead of having sex.

Still, does it really matter? Have you honestly been masturbating all these years only because you wanted to boost your prostate health? Didn’t think so. But one study, Harvard’s Health Professional Followup, showed that Masturbation may help lower risk of prostate cancer. 

Takeaway

Masturbation is a healthy, natural, and safe way to practice self-care and improve your health.

Masturbating may have many benefits for your mind and body. Despite the possibility of addiction, there are no harmful side effects.

Feel free to enjoy self-pleasure without guilt or shame. Speak with a therapist or someone you trust about any negative feelings you have.

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Sex is an important factor in your life

Sex and sexuality are a part of life. Aside from reproduction, sex can be about intimacy and pleasure. Sexual activity, penile-vaginal intercourse (PVI), or masturbation, can offer many surprising benefits to all facets of your life:

• physical
• intellectual
• emotional
• psychological
• social

Sexual health is more than avoiding diseases and unplanned pregnancies. It’s also about recognizing that sex can be an important part of your life, according to the American Sexual Health Association.

Sex may give a boost to certain aspects of people’s well-being and physical health, some research suggests. However, several studies on the subject are now outdated, and not all potential benefits apply to everyone.

Scientific research has highlighted several possible benefits besides procreation that come with sexual intercourse. These pluses include preserving heart health in some people, reducing blood pressure, and boosting immunity.

Sex can also improve mood, relationships, and mental well-being.

In this article, we look at the possible health benefits of sex and highlight relevant research, focusing on the physical rather than emotional aspects.

Helping heart health

Partnered sex may be benefical for cardiovascular health.

Partnered sex appears to have some protective effect on cardiovascular health, especially in women.

A 2016 study looked at the potential health benefits of sexual activity with a regular partner.

This research found that sexually active women have a lower risk of cardiac events later in life.

However, the study also concluded that high levels of sexual activity might increase the risk of cardiovascular events in men. This conclusion contradicts most earlier research, and further studies are necessary to verify this risk.

Males and females with heart problems should ask a doctor about how much sex is safe for them. They should also be specific about the regularity and intensity with which they have sex, as this may affect the potential strain on the heart.

Reducing blood pressure

The same 2016 study also measured blood pressure as one of the markers of heart health. The researchers found that older women who expressed satisfaction with their sex lives were less likely to have high blood pressure.

However, the study authors did not find the same results in older men.

According to the American Heart Association (AHA), high blood pressure can affect both libido and a man’s ability to achieve and maintain an erection.

Medication for high blood pressure can also reduce libido and cause erectile dysfunction.

While this does not confirm a benefit, it may show a link between blood pressure and sexual health.

Many people with high blood pressure, or hypertension, have safety concerns when it comes to sexual intercourse.

While it is always important to speak with a doctor, it is usually safe for people with high blood pressure to have sex.

If hypertension medication is causing sexual difficulties, a person can talk to their doctor who may be able to prescribe a different medication or dosage to relieve the adverse effects.

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Boosting the immune system

Research is inconclusive about whether regular sex can boost the immune system.

Some early research found that regular sex increased the effectiveness of the immune system.

Researchers found that people who had frequent sex, which they defined as one to two times per week, had more immunoglobin A (IgA) in their system than others. IgA is an antibody that lives in the mucosal tissue, such as the salivary glands, nose, and vaginal tissue.

However, it is important to recognize that this study appeared in 2004, and researchers have not repeated it since. A new study might yield different results.

A more recent study looked at a small group of women to see if there were differences between the immune activity of those who were sexually active and those who are not.

The study examined their immune system’s ability to kill different infectious pathogens at various points in the menstrual cycle.

While the results suggest that there might be some differences between the groups, the authors say more research is necessary before drawing any conclusions.

Reducing prostate cancer risk

An early study, again from 2004, found that high frequency of ejaculation may reduce the risk of prostate cancer.

The study investigated almost 30,000 males, looking at how often they ejaculated at different points in their life.

They concluded that those who ejaculated more than 21 times per month had a lower risk of prostate cancer than men who only ejaculated 4–7 times per month.

In 2016, the researchers extended this study for an additional 10 years to continue their research on the participants’ risk for developing prostate cancer.

This follow-up confirmed the initial findings. The males who ejaculated most frequently had a lower risk for prostate cancer those who ejaculated less often

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Relieving stress

Sex can serve as a natural way to relieve stress. A 2019 study looked at the effect that intimacy with a partner had on cortisol levels. Cortisol is a steroid hormone that circulates the body in response to stress.

The researchers found that expressions of intimacy, whether sexual or not, helped to bring cortisol levels in both males and female back within normal range.

Sex triggers the release of oxytocin, endorphins, and other “feel-good” hormones, which may be responsible for this stress reducing effect.

Improving sleep

Hormones released during sex may improve sleep.

The National Sleep Foundation suggest that sexual activity has hormonal benefits for sleep.

The same hormones that reduce stress and anxiety are also responsible for inducing sleepiness. Sex leads to the release of oxytocin, dopamine, and endorphins throughout the body.

After a person has an orgasm, another hormone called prolactin starts to circulate. Prolactin induces feelings of satisfaction and relaxation.

Improves Women’s Bladder Control

A strong pelvic floor is important for avoiding incontinence, something that will affect about 30% of women at some point in their lives.

Good sex is like a workout for your pelvic floor muscles. When you have an orgasm, it causes contractions in those muscles, which strengthens them.

Counts as Exercise

“Sex is a really great form of exercise,” Pinzone says. It won’t replace the treadmill, but it counts for something.

Sex uses about five calories per minute, four more calories than watching TV. It gives you a one-two punch: It bumps up your heart rate and uses various muscles.

So get busy! You may even want to clear your schedule to make time for it on a regular basis. “Like with exercise, consistency helps maximize the benefits,” Pinzone says.

Lowers Heart Attack Risk

A good sex life is good for your heart. Besides being a great way to raise your heart rate, sex helps keep your estrogen and testosterone levels in balance.

“When either one of those is low you begin to get lots of problems, like osteoporosis and even heart disease,” Pinzone says.

Having sex more often may help. During one study, men who had sex at least twice a week were half as likely to die of heart disease as men who had sex rarely.

Lessens Pain

Before you reach for an aspirin, try for an orgasm.

“Orgasm can block pain,” says Barry R. Komisaruk, PhD, a distinguished service professor at Rutgers, the State University of New Jersey. It releases a hormone that helps raise your pain threshold.

Stimulation without orgasm can also do the trick. “We’ve found that vaginal stimulation can block chronic back and leg pain, and many women have told us that genital self-stimulation can reduce menstrual cramps, arthritic pain, and in some cases even headache,” Komisaruk says.

Precautions

While sex can be a pleasurable and potentially healthful activity, it is essential to remember that sex without protection can pose a risk to overall health.

People who have sex without using contraceptives have a risk of sexually transmitted infections (STIs) and unplanned pregnancies. Using a condom or other contraceptive method can reduce the risk of these outcomes.

If a person has multiple partners, they can bring down the risk by reducing the number of people with whom they have sexual contact.

If sex becomes painful or causes bleeding, a person should talk to a healthcare professional.

How sex benefits all genders

In men

A recent review found that men who had more frequent penile-vaginal intercourse (PVI) had less risk of developing prostate cancer.

One study found that men who averaged having 4.6 to 7 ejaculations a week were 36 percent less likely to receive a prostate cancer diagnosis before the age of 70. This is in comparison to men who reported ejaculating 2.3 or fewer times a week on average.

For men, sex may even affect your mortality. One study that had a 10 year follow-up reported that men who had frequent orgasms (defined as two or more a week) had a 50 percent lower mortality risk than those who had sex less often.

Although results are conflicting, the quality and health of your sperm may increase with increased sexual activity, as some research suggests.

In women

Having an orgasm increases blood flow and releases natural pain-relieving chemicals.

Sexual activity in women can:

• improve bladder control
• reduce incontinence
• relieve menstrual and premenstrual cramps
• improve fertility
• build stronger pelvic muscles
• help produce more vaginal lubrication
• potentially protect you against endometriosis, or the growing of tissue outside your uterus

The act of sex can help strengthen your pelvic floor. A strengthened pelvic floor can also offer benefits like less pain during sex and reduced chance of a vaginal prolapse. One study shows that PVI can result in reflexive vaginal contractions caused by penile thrusting.

Women who continue to be sexually active after menopause are less likely to have significant vaginal atrophy, or the thinning of vaginal walls. Vaginal atrophy can cause pain during sex and urinary symptoms.

How can sex benefit your mental health?

Sexual activity, with a partner or through masturbation, can provide important psychological and emotional benefits. Like exercise, sex can help reduce stress and anxiety and increase happiness.

Studies suggest that sexual activity (defined as PVI) may correlate with:

• increased satisfaction with your mental health
• increased levels of trust, intimacy, and love in your relationships
• improved ability to perceive, identify, and express emotions
• lessened use of your immature psychological defense mechanism, or the mental processes to reduce distress from emotional conflict

At an older age, sexual activity may affect your well-being and ability to think. Research found that sexually active adults between 50 to 90 years old had better memory. They were also less likely to feel depressed and lonely.

Confidence booster

Frequent sexual activity, whether with a partner or alone, can make you look younger. This is partially due to the release of estrogen during sex.

One study found a correlation between frequent sexual activity and looking significantly younger (between seven to 12 years younger). The majority of these individuals were also comfortable expressing their sexuality and sexual identity.

Social benefits

Sex can help you connect to your partner, thanks to oxytocin. Oxytocin can play a role in developing relationships. You may find that consistent, mutual sexual pleasure helps with bonding within a relationship.

Coupled partners often have increased relationship satisfaction when they fulfill one another’s sexual desires. You may find positive growth in your relationship when you’re able to express yourself and your sexual desires.

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