The Young and Invincible.

The Young and Invincible. Sounds like the title to a soap opera, but actually it’s the attitude that many young adults have about getting sick or injured. Young people think they are invincible and as a result neglect the most important thing that they possess: there health! Listed below are ten medical issues in young adults that I see in my Family Practice that I want to discus with you.

HIV/AIDS
The human immunodeficiency virus (HIV) has become one of the most devastating sexually transmitted diseases ever known to man. Once infected with HIV, the body’s immune system can become weakened and the infected individual will develop the acquired immune deficiency syndrome (AIDS). According to statistics reported by the Centers for Disease Control (CDC): an estimated 38,500 young people (age 13-24) in the United States received a diagnosis of AIDS; African American youth were the largest group of young people affected by HIV, accounting for 56% of all infections; young women, especially of African American and Hispanic decent are at increasing risk. Risk factors for infection with HIV include unprotected sex, multiple sex partners, use of IV drugs, the presence of an undiagnosed sexually transmitted disease, lack of awareness, and poverty. The key is to get tested if you don’t know your status, and if you decide to have sex, Rap It Up!

Obesity
In the past 20 years, there has been a significant increase in over weight and obese individuals in the United States. The Food and Drug Administration (FDA) estimates that almost two-thirds (64%) of all Americans are overweight; almost one third are obese. Childhood obesity is on the rise and we are now seeing shocking increases in diabetes, heart disease, and hypertension in this previously active and healthy population. Today, approximately 17 percent of young people are seriously overweight. One main problem that I see is the decrease in mandatory physical education classes for school aged children. Lack of exercise, poor diets high in fat and calories, and the fast food epidemic are the main reasons for this epidemic. Young people are stuck on computers and hove video games and don’t bike and or play outside as much studies have shown. So get moving! Exercise at least 20-30 minutes most days of the week and eat foods low in calories and fat.

Cervical Cancer
Cervical cancer, a disease of the female reproductive system, is more common in young women. It accounts for 6% of all cancers in women and is caused by the human papilloma virus (HPV) in 90-95% of the cases. The virus is passed from person to person usually by unprotected sex and in most cases the woman has no symptoms. Risk factors for HPV include multiple sex partners, cigarette smoking, and unprotected sex. The key point is that all women who are sexually active need to have a pap smear at least once a year whether you wear condoms or not. Even if you are not sexually active, annual pap smears are still recommended by the age of 18. Cervical cancer can be detected and treated if diagnosed early by pap smears. Talk to your doctor about the vaccine currently in use that may reduce your risk of cervical cancer.

Anabolic Steroids
Barry Bonds is not the first person accused of using steroids and won’t be the last. His situation, however, has brought much needed attention to the topic of steroids. The desire to be competitive and to gain an edge on one’s competitor is natural, however the facts still remain: steroids are illegal and are associated with short and long term effects which can be very damaging to the body. Don’t get it twisted; they do help to build muscle mass, however, with side effects like elevated cholesterol, high blood pressure, balding in men, breast development in men, facial hair in women, and mood swings just to name a few, there is no way I would recommend to anyone using them. The National Institutes of Drug Abuse (NIDA) reported an increase in steroid use among 8th and 10th grade boys in 2000. The primary reasons for using steroids among these young men where to enhance athletic performance and physical appearance. If you want to be the best, work hard and don’t use a substance that is illegal and might permanently damage your body. Also remember, never take or rub a substance on your body if you don’t know what’s in the solution.

Cigarette Smoking
Cigarette smoking is the single most preventable cause of death in the United States. Twenty three percent of high school students and 8% of middle school students in this country are regular smokers. There are more deaths each year from tobacco use than by HIV, drug abuse, alcohol abuse, motor vehicle injuries, suicides, and murders all together. The active ingredient in cigarettes and smokeless tobacco is the very addictive substance called nicotine. Cigarette smoking is associated with cancers of the lung, bladder, and cervix; heart disease; low birth weight babies; sudden infant death syndrome, and chronic obstructive lung disease (COPD). Smoke free facilities are becoming the norm as society is becoming more aware of the harmful side effects of second hand smoke. If you plan on living longer, then you need to stop smoking.

Mental Disorders
Mental health is just as important as physical health and everyone should be comfortable discussing these topics with their doctor. The most common mental health issues seen in my practice are anxiety and depression. Approximately 25% of young adults experience depression by the time they are 24 years old, but very few seek help. This is alarming and depression, if left untreated, can lead to suicide. Anxiety, the most common form of mental disturbance in the U.S., affects approximately 28 million Americans each year. Both anxiety and depression are major problems for society as they can interfere with work, school and family life. They contribute to high rates of substance abuse and alcohol abuse. If you or a loved one has been diagnosed with anxiety or depression, it is important to take your medicines as prescribed and see your doctor and/or therapist on a regular basis.

Suicide
Suicide is the end result of severe depression that is untreated or under-treated. Suicide is common in young adults and the elderly. In general women attempt more suicide than men; men are more “successful” in suicide attempts. Signs of depression include disturbances in sleep, loss of interest in things the person normally does, guilty feelings about a situation or situations, decreased energy, decreased concentration, decreased or increased appetite, abnormal and unintentional weight loss or weight gain, decrease sex drive, and suicidal or homicidal thoughts. These symptoms have to be present for more than two weeks for the diagnosis to be made. The challenge is to recognize these signs and symptoms and to get help for the affected person before a suicide attempt (s) occurs. Suicide is the permanent answer to a temporary problem. If you are someone you love is talking about suicide, get him or her help immediately!

Substance Abuse
Despite what some might try to convince you, drugs of abuse are mind altering and can put you at risk for STD’s, accidents, and time in jail. The trends of abuse have shifted in young adults somewhat from the gateway drugs marijuana and cocaine, to designer drugs such as ecstasy and the date rape drug, GHB. There are more potent forms of marijuana, which make them more addictive, and crystal meth is slowly becoming a drug of choice for many young Americans. The results of substance abuse are quite evident: mental disorders such as depression and anxiety, incarceration, STD’s including HIV, destruction of families, and untimely deaths due to accidental overdose, suicide, or crimes as a result of the drug’s influence. While under the influence of these mind-altering substances, an individual often makes poor decisions and will participate in behaviors that he or she would normally avoid. Education and awareness about the different drugs available and how they affect the body is one of the major ways to decrease abuse.

“Staph” Infections
Community acquired methicillin resistant staphylococcus aureus (CA-MRSA) infections are on the rise! What the hell is that you ask? Well if you have ever had a boil that was hard to treat and it came back to visit you on several occasions requiring multiple doctor visits, drainage by a physician, and sometimes hospitalization and antibiotics through an IV, chances are you had a staph (staff) infection. MRSA was at one time primarily seen in hospital patients with wounds and in individuals with weak immune systems. As a result of antibiotic overuse by physicians to treat simple skin infections and patient noncompliance with medications (not taking them like they are suppose to), these very intelligent bacteria have become resistant to the very basic and inexpensive antibiotics that we have available in our local pharmacies. Staph infections can be very dangerous and are now being associated with pneumonias in healthy individuals. MRSA can kill! If you develop a painful to the touch, red and swollen area on your body that produces pus (drainage), you could have a staph infection. See your doctor right away so that this can be treated quickly and effectively.

Sexual Transmitted Diseases/Sexually Transmitted Infections (STDs/STIs)
Chlamydia, gonorrhea, herpes, HPV, syphilis, and HIV are on the rise again. One out of every 2 Americans will have an STD/STI by the there 25th birthday. The reasons are many and include lack of education and awareness, having unprotected sex, and substance abuse. If a person is infected with one STD/STI, then he or she is at risk of getting another. The concept that oral sex is safe sex or not sex at all is garbage. Herpes, HPV, and gonorrhea can be spread via oral sex. The likely hood of being infected with HIV is very low in someone receiving oral sex compared to the “giver”. However, there is still some risk. Abstinence is still the best way to prevent the spread of sexually transmitted diseases, however, this method is not always practiced. If you choose to have sex protect yourself. Know your HIV status, practice monogamy, wear condoms, and if you perform oral sex learn how to use dental dams. They come in tasty flavors and colors.

This by no means is a comprehensive list of all the potential problems young people encounter, but it’s a great start. Hopefully this will give you a good foundation and help guide your own research regarding the medical issues that I commonly see in my practice.

(c) 2007 Rani Whitfield. This article was published November 2007 by Ozone Magazine.

Sexual Enhancement

In the pursuit of sexual success and fertility, the moon, and everything under it, has been touted as an aphrodisiac by some person or culture. Love potion peddlers stop at nothing to sell their sexual wares. "I'll make you the same promise that my wife made to me," says Theodore Maximillian in the provocative brochure for his "Maxim" product. "I'm going to cure your impotence immediately!" Maxim "acts as a potent aphrodisiac," according to the advertisement.
An aphrodisiac is a food, drink, drug, scent, or device that, promoters claim, can arouse or increase sexual desire, or libido. A broader definition includes products that improve sexual performance. Named after Aphrodite, the Greek goddess of sexual love and beauty, the list of supposed sexual stimulants includes anchovies and adrenaline, licorice and lard, scallops and Spanish fly, and hundreds of other items.

According to the Food and Drug Administration, the reputed sexual effects of so-called aphrodisiacs are based in folklore, not fact. In 1989, the agency declared that there is no scientific proof that any over-the-counter aphrodisiacs work to treat sexual dysfunction.
Countering Cultural Views

FDA's findings clash with a 5,000-year tradition of pursuing sexual betterment through use of plants, drugs and magic. Despite FDA's determination that OTC aphrodisiacs are ineffective--and sometimes even dangerous--people continue the optimistic quest for drug-induced sexual success.

Several principles help demystify some cultural views about aphrodisiacs. Sometimes the reason for an item's legendary reputation is obvious. It's easy to imagine how the sex organs of animals such as goats and rabbits, known for their procreativeness, have achieved their esteemed status as love aids in some cultures.

Chilies, curries, and other spicy foods have been viewed as aphrodisiacs because their physiological effects--a raised heart rate and sometimes sweating--are similar to the physical reactions experienced during sex. And some foods were glorified as aphrodisiacs based on their rarity and mystery. While chocolate was once considered the ultimate aphrodisiac, the reputation wore off as it became commonly available.

Many ancient peoples believed in the so-called "law of similarity," reasoning that an object resembling genitalia may possess sexual powers. Ginseng, rhinoceros horn, and oysters are three classical examples.

The word ginseng means "man root," and the plant's reputation as an aphrodisiac probably arises from its marked similarity to the human body. Ginseng has been looked on as an invigorating and rejuvenating agent for centuries in China, Tibet, Korea, Indochina, and India. The root may have a mild stimulant action, like coffee. There have been some experiments reporting a sexual response in animals treated with ginseng, but there is no evidence that ginseng has an effect on human sexuality.

The similarity of the shape of the rhinoceros horn to the penis is credited for its worldwide reputation as a libido enhancer. The horn contains significant amounts of calcium and phosphorus. The addition of the food to a deficient diet could improve general physical vigor and possibly lead to an increased sexual interest. But in most Americans' diets, which are usually not lacking calcium or phosphorus, the small quantities usually consumed would not affect physical performance.

Because Aphrodite was said to be born from the sea, many types of seafood have reputations as aphrodisiacs. Oysters are particularly esteemed as sex aids, possibly gaining their reputation at a time when their contribution of zinc to the nutritionally deficient diets of the day could improve overall health and so lead to an increased sex drive.

Shortage of Studies
There is no proof that ginseng, rhinoceros horn, or oysters have an effect on human sexual reaction. But might some foods and OTC drugs eventually be proven to affect sexual appetite? Some big obstacles exist to answering this question. The placebo effect is one scientific stumbling block.

"The mind is the most potent aphrodisiac there is," says John Renner, founder of the Consumer Health Information Research Institute (CHIRI). "It's very difficult to evaluate something someone is taking because if you tell them it's an aphrodisiac, the hope of a certain response might actually lead to an additional sexual reaction."

Because the psychological complications are absent in animals, some studies have been done on the effect of certain drugs on animals' sexual activity. One substance that was tested extensively in animals is yohimbine. Obtained from the bark of an African tree, yohimbine has been used for centuries in Africa and West India for its supposed aphrodisiac properties. It supposedly works by stimulating the nerve centers in the spine that control erection. FDA called the res ults of preliminary animal studies "encouraging," but animal studies cannot be relied on to show the effectiveness of the drug in humans.

In people, the only available evidence is anecdotal and subjective. To scientifically measure sexual stimulation, a valid human study would have to be performed in the laboratory, comparing a placebo (an inert pill with no active ingredients) to the test aphrodisiac. Preferably, neither the researchers nor the patients would know who was getting the test substance. Because of cultural taboos, few such studies have been undertaken.

A second obstacle to obtaining proof of aphrodisiac effects is that some drugs may not actually have specific sexual effects, but may change a person's mood and therefore seem to be an aphrodisiac. For example, alcohol has been called a "social lubricant." People drink for many reasons, including to relax, reduce anxiety, gain self-confidence, and overcome depression. Because sexual problems can be caused or worsened by psychological stress, moderate drinking might seem like a sexual enhancer. In fact, it merely lessens inhibitions.

Alcohol is actually a depressant, and so, as the porter in Shakespeare's Macbeth observed, it "provokes the desire, but it takes away the performance." And drinking too much actually decreases desire.

No Quick Fix
Despite the lack of scientific evidence of safety and effectiveness, the fraudulent OTC love potion industry thrives to this day. Marketers use a "blatant snake-oil approach," according to CHIRI's Renner. He estimates that the aphrodisiac sellers, who do much of their business by mail-order, take in revenues in the hundreds of millions of dollars a year.

The FDA sends warning letters to companies that make aphrodisiac claims, stating that the agency may take further regulatory action if the violations continue. "In the health fraud area, when they get a warning letter, most people take their profits and run," says Joel Aronson, director of FDA's division of nontraditional drugs. "They don't want to get into a legal battle with the agency becau se it could involve protracted, expensive litigation."

Aphrodisiac experimentation isn't just a rip-off--it can be deadly. Spanish fly, or cantharides, is probably the most legendary aphrodisiac--and the most dangerous. Made from dried beetle remains, the reported sexual excitement from Spanish fly comes from the irritation to the urogenital tract and a resultant rush of blood to the sex organs. But Spanish fly is a poison that burns the mouth and throat and can lead to genitourinary infections, scarring of the urethra, and even death.

To avoid being taken for their money or their lives, individuals with sexual problems should seek a physician's advice. A lack of sexual energy or ability in men or women could be caused by something as simple as stress or a medication one is taking, or as serious as an underlying condition like diabetes or high blood pressure.

A doctor can diagnose a sexual problem and recommend treatment. If necessary, a doctor can prescribe a drug to treat sexual dysfunction. Testosterone replacement therapy is one prescription option for men whose natural testosterone level is not within the normal range, but its serious potential side effects cal l for a physician's supervision. For those with an impotence problem that isn't caused by low testosterone levels, the new "Caverject" injection may be the answer.

"People will continue to have false hopes of finding easy ways of resolving their problems," says Aronson. And so the hunt for the elusive love drug persists. A universal aphrodisiac may never be found, but experts agree that what's good for your overall health is probably good for your sex life too.

A good diet and a regular exercise program are a more dependable path to better sex than are goats' eyes, deer sperm, and frogs' legs. A good mental state is equally important.
Maybe the wishful search for a cure-all drug should be abandoned in favor of an easier, more reliable mechanism: the erotic stimulation of one's own imagination. To quote renowned sex expert "Dr. Ruth" Westheimer, Ed.D.: "The most important sex organ lies between the ears."
Tamar Nordenberg is a lawyer with the Office of the Director in FDA's Center for Drug Evaluation and Research.

First Impotence Drug
For the 10 million to 20 million American men who suffer from impotence, the Food and Drug Administration's July 6, 1995, approval of Upjohn Company's prescription drug Caverject (alprostadil) may prove to be life-altering. Caverject is the first prescription drug approved for impotence, and is expected to successfully treat 70 to 80 percent of patients.
The drug provides an alternative to devices previously approved by FDA. A vacuum device involves placing a cylinder-like device and attached pump over the penis. By using the pump, blood is drawn into the penis, creating an erection. A constriction band is then placed at the base of the penis to maintain erection. A second treatment option, the penile implant, involves the surgical placement of cylinders in the penis and is available in a variety of designs. (See "Inflatable Penile Implants Under Scrutiny" in the January-February 1994 FDA Consumer.)
FDA approved Caverject to treat impotence caused by neurological, vascular or psychological dysfunction. While psychological factors such as anxiety and depression can lead to sexual dysfunction, more than 85 percent of impotence cases have a physical cause, according to the Impotence Institute of America. A complete physical examination is important so that any underlying condition can be diagnosed and treated. Some common causes of impotence are diabetes, arteriosclerosis (hardening of the arteries), and high blood pressure. Also, impotence has reportedly been caused by 16 of the 200 most commonly prescribed drugs, including drugs for high blood pressure, heart disease, and depression.

Caverject is self-injected into the penis shortly before sexual intercourse. The drug creates an erection by relaxing the smooth muscle tissue and dilating the major artery in the penis, which enhances the blood flow to the penis.

The drug's most common side effect is penile pain. Other side effects include bleeding at the injection site and an unhealthy, prolonged erection of four to six hours. (c) 2007 Rani Whitfield. This article was published October 2007 at http://allhiphop.com/