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If you’ve ever witnessed someone suffer a stroke, you understand the humbling nature of this disease. It can reduce the mightiest human being to an immobile, helpless creature. Impairment of crucial functions like speech, walking, and control of bowel and bladder can wrench control from the body in a moment. Even perpetually youthful TV personality Dick Clark was struck down by stroke at age 75, despite the outward appearance of perfect health. Clark’s stroke resulted in a six-week hospital stay and, judging from fragmented reports, significant disability. Stroke can be like a devastating fire that strikes without warning, leaving only smoldering rubble. Stroke can so ravage basic bodily functions that often all you can hope for is to regain a portion through rehabilitation. The disease process that underlies stroke requires decades—30 or 40 years—to develop. With that much lead time, why aren’t we better able to detect or stop this crippling disease? The truth is that we are able to predict many, if not most, strokes. Advances in imaging technology allow detection of atherosclerotic plaque that cause stroke years before it becomes a threat. Progress in deciphering the causes of stroke has also leapt forward. Unfortunately, your neighborhood physician still focuses on diagnosing the crisis rather than anticipating it. Physicians prefer to deal with catastrophes and are just not that interested in prevention. Most physicians ask: “Is it time to operate or not?” The medical community obsesses over procedures like carotid endarterectomy (surgical removal of plaque) or carotid stents. Even when a person is afforded the warnings of a “mini-stroke”, or transient ischemic attack (TIA), little more is done once it’s determined that surgery is not necessary—even though this person has high risk for future stroke (50% over 10 years). Let’s flip-flop this approach to stroke. Procedures represent a failure of prevention! Where do strokes come from? Stroke develops when some portion of the brain is deprived of blood. This usually results from a tiny bit of debris that dislodges from an atherosclerotic plaque along the walls of an artery (the same sort that accumulates in coronaries causing heart attack). The sources of debris have been a subject of controversy, but new imaging technologies have settled the question. Any blood vessel that leads from the heart to the brain can be a source. The two carotid arteries on both sides of your neck are a frequent source, as these arteries are prone to develop plaque. (Our discussion will be confined to what are called thromboembolic, or ischemic, strokes, i.e, strokes that occur from plaque that fragments, sending debris to the brain, and will not include the far less common hemorrhagic strokes due to rupture of small vessels in the brain, nor will we discuss atrial fibrillation and other heart causes of stroke. The thromboembolic strokes we discuss cause around 88% of all strokes.) Over the last 10 years, the aorta has been recognized as another important source of stroke. The aorta is the main artery of the body whose branches go to the head, arms, and legs. Atherosclerotic plaque is a live tissue that, through poor diet, inactivity, high cholesterol, overweight, etc., grows and becomes progressively more unstable. At some point, plaque fragments. Little bits break away, traveling to the brain. Fractured plaque also exposes its deeper structures to flowing blood, triggering blood clot formation, which in turn can also fragment and go to the brain. Atherosclerotic plaque is a prerequisite for the most common causes of stroke. If the majority of strokes originate from plaque, why not measure plaque to determine if you’re at risk for stroke? How can we easily, safely, and accurately measure plaque in the carotid arteries and aorta? And if plaque can be measured, can it be shrunk or inactivated to reduce or eliminate risk for stroke? How can plaque be measured? Just 20 years ago, the only practical method of identifying plaque in the carotids or aorta was through angiography, requiring catheters inserted into the body to inject x-ray dye. Angiography was impractical as a screening measure. CT scanning and magnetic resonance imaging (MRI) are emerging as exciting methods of imaging both carotids and aorta. Unfortunately, most centers and physicians are much more focused on the diagnostic uses of these technologies for people who have already suffered stroke or other catastrophe, and application of these devices for preventive uses is still evolving. One exception is when aortic calcification or aortic enlargement is incidentally noted on the increasingly popular CT heart scans; this is an important finding that can signal presence of aortic plaque. The one test that is widely available and can be performed in just about any center is carotid ultrasound. It’s simple, painless, and precise. Two basic observations can be made: 1. Plaque detection—Atherosclerotic plaque can be clearly visualized. If plaque blocks more than 70% of the diameter of the vessel, or if there are “soft” (unstable) elements in plaque, then stroke risk may be high enough to justify surgery or stents. However, if there are plaques that are less severe, substantial risk for stroke may still be present that can be reduced with preventive measures. 2. Carotid intimal-medial thickness—This is a measure of the thickness of the lining of the carotid artery in areas not involved by plaque, but often precedes the development of mature plaque. Carotid intimal-medial thickness also provides an index of body-wide potential for atherosclerotic plaque that can place you at risk for stroke. The aorta, for instance, cannot be well imaged by surface ultrasound but can still be a source for stroke. Increased carotid intimal-medial thickness and carotid plaque are closely associated with likelihood of aortic plaque. The Rotterdam Study of 4000 participants demonstrated that if carotid intimal-medial thickness is greater than normal (1.0 mm), then you can be at risk for stroke (and heart attack), even if no carotid plaques are detected. Carotid ultrasound is the one test you should consider that provides the most information with least effort. Ultrasound is harmless, painless, and can be obtained just about anywhere. Even if your doctor disagrees with your request for a carotid ultrasound, an increasing number of mobile services are popping up nationwide that make this test available for around $100. One important point: many scanners and interpreters will only report whether plaque is present or not. While this is important information, you should request that the carotid-intimal medial thickness be made as well. Not all centers can make this simple measure (because of software requirements), but it doesn’t hurt to try. Any amount of carotid plaque is reason to follow a preventive program, even if the plaque is insufficient to justify surgery. Can plaque be reduced? Can we shrink plaque in carotid arteries and aorta and thereby reduce, perhaps eliminate, these sources of stroke? That question is gaining momentum as effective therapies become available that pack real punch for reducing plaque. Study after study has now documented that plaque can be reduced and, with it, risk for stroke. Reduction in plaque of 10–20% is possible within a year or two. Let’s consider the most potent influences on carotid and aortic plaque growth that need to be considered in a plaque-reducing program. (I assume that you are a non-smoker—if you are a smoker, you first need to concentrate on quitting.) Hypertension Considerable experience documents the power of blood pressure-lowering for prevention of stroke. The most recently updated guidelines, the JNC–VII, recommends a blood pressure of 407 mg/dl heightens stroke risk six-fold. C-reactive protein (CRP) This measure of inflammation is proving to be a useful marker for identifying people at risk for stroke, with increased risk beginning at a level of 0.5 mg/l. High CRP also predicts more rapidly growing carotid plaque. Homocysteine Homocysteine is an important marker of increased likelihood of both carotid and aortic plaque, as well as stroke. In 1997, the European Concerted Action Project reported more than a doubling of stroke when homocysteine levels exceeded 12 mol/l. As homocysteine increases to 20 μmol/l, risk for stroke and heart attack increases an amazing 10-fold over that at a level of 9 μmol/l. Asymmetric dimethylarginine (ADMA) ADMA is recently discovered amino acid whose blood levels can skyrocket up to 10-fold in the presence of hypertension, metabolic syndrome, diabetes, high cholesterol and triglycerides, obesity, and high homocysteine levels. ADMA blocks the action of the amino acid, l-arginine. This mimicry reduces the availability of nitric oxide, a powerful dilator and protector of arteries. ADMA levels in the top 10% predict a six-fold heightened risk for future stroke, and ADMA levels in people with strokes are double that in other people. A carotid ultrasound study in 116 subjects showed that higher blood levels of ADMA are associated with more severe carotid plaque. Because of ADMA’s shared role across a variety of abnormal conditions, correction or blocking the action of ADMA has been suggested as a unique therapeutic tool to reduce stroke risk. Cholesterol Data suggest that lowering cholesterol with statin cholesterol-lowering drugs slows carotid plaque growth and reduce stroke risk approximately 22%. An interesting study from the Cardiovascular Institute at Mt. Sinai School of Medicine in New York using the precise measuring ability of MRI of the carotids and thoracic aorta showed an impressive 20% regression of plaque area with simvastatin (Zocor®) taken for two years. Although guidelines for cholesterol treatment recommend reduction of LDL cholesterol to 100 mg/dl in high-risk persons, a report from the Walter Reed Army Medical Center in Washington, DC, showed that carotid plaque was more effectively reduced when LDL cholesterol of 70 mg/dl or lower was achieved with statin cholesterol drugs. Lower LDL cholesterol may, therefore, be better. Treatment Strategies to Reduce Carotid and Aortic Plaque The essential question: How do we reduce carotid and aortic plaque? If we make this the focus of our efforts, many pieces begin to fall into place. If you’ve had any measure of carotid or aortic plaque such as a carotid ultrasound or aortic calcification on a CT heart scan, you know that you’re at increased risk for stroke. You also have a baseline for future comparison to gauge whether your program is working or not. Because most people have not one but several causes of carotid and aortic plaque, there is no one single treatment that effectively eliminates risk for stroke. Instead, most people require a comprehensive program of healthy diet, exercise, supplements, and medication when indicated. Here, we focus on the nutritional supplements that can be critical components of your plaque-reduction program. Fish oil Fish oil is a cornerstone of your stroke prevention program. Epidemiological observations suggest a strong relationship of fish intake and reduction of stroke risk. Carotid ultrasound studies demonstrate less carotid plaque with greater intakes of fish. A cleverly designed University of Southampton study made the fascinating observation that fish oil transforms the structure of carotid plaque. 150 people with severe carotid plaque scheduled for carotid endarterectomy (surgical removal of the plaque) were given fish oil, sunflower oil, or no treatment over several months while waiting for their procedure. (Delays in the British health system permitted this unique design.) Plaque was removed at surgery and examined. Participants taking fish oil had reduced inflammation in plaque and thicker tissue covering the fatty core, markers of more stable plaque. Those taking sunflower oil or no treatment had unstable plaques with greater inflammation and thinner, less sturdy covering tissue. This suggests that fish oil stabilizes carotid plaque, making it less likely to rupture and fragment. A standard capsule of fish oil (containing 300 mg of EPA + DHA) contains the same amount of omega-3s as a 3 oz serving of cod or halibut; three capsules (900 mg DHA + EPA) contain the equivalent of a serving of farm-raised salmon. The dose that seems to provide greatest protection from stroke, lowers triglycerides (that form abnormal lipoproteins; see above), and reduces fibrinogen, is four capsules per day (1200 mg EPA + DHA). Coenzyme Q10 (CoQ10) Although there are no data specifically addressing whether CoQ10 reduces plaque, it is a marvelously effective way to reduce blood pressure, one of the crucial factors causing carotid and aortic plaque growth. A pooled analysis of eight studies showed that, on average, CoQ10 in daily doses of 50–200 mg reduced systolic blood pressure by 16 mm Hg, diastolic pressure by 10 mm Hg. Data suggest that CoQ10 can reverse abnormal heart muscle thickening (hypertrophy), another manifestation of high blood pressure, strongly suggesting that CoQ10 has benefits beyond just reducing pressure. Supplements to correct the metabolic syndrome Weight loss is, without question, the most immediate and direct path to correction of this dangerous pre-diabetic condition. A drop of even 10–20 lbs yields improvements across the board: increased sensitivity to insulin, increased HDL, and reductions in triglycerides, CRP, fibrinogen, small LDL particles, and blood pressure. Diet and exercise are fundamental components of an effort to lose weight; low carbohydrate or reduced glycemic index diets (e.g., South Beach or Mediterranean) rich in fibers are clearly effective. Several supplements can amplify weight-reduction efforts and be useful adjuncts to your lifestyle program. Among them: White bean extract White bean extract blocks intestinal absorption of carbohydrates by 66%. 1500 mg twice a day with meals yields, on average, 3–7 lbs of weight loss in the first month of use. The only side-effect is excessive gas, due to unabsorbed starches. Glucomannan This unique fiber taken prior to meals absorbs many times its weight in water and thereby fills your stomach. You consequently take in less food. Most people lose around four lbs per month using 1500 mg prior to each meal. Interestingly, glucomannan also blunts the rise in blood sugar after meals, an effect that, by itself, may lead to weight loss. Be sure to take with plenty of water. DHEA This adrenal hormone is key to maintaining physical stamina, mood, muscle mass in men, and libido in women. A recent randomized, placebo-controlled study at Washington University in 56 subjects showed a 13% decline in abdominal fat (fat that drives resistance to insulin) measured by MRI with 50 mg of DHEA per day at bedtime, along with improved sugar control and lower insulin levels. Pectin, beta-glucan Pectin is the soluble fiber in citrus rinds, green vegetables, and apples, also available as a supplement. Beta-glucan is the soluble fiber of oats and is also available as a supplement. Both are wonderful fibers that provide feelings of fullness, lower cholesterol, slow release of sugars, and can yield modest weight reduction. A USC study in 573 subjects using carotid ultrasound showed that greater intake of healthy fibers like pectin and beta-glucan is associated with less carotid plaque growth. Folic acid, vitamins B6 and B12 Dr. Daniel Hackam at the Stroke Prevention and Atherosclerosis Research Centre in Ontario conducted a study using carotid ultrasound in 101 participants treated with folic acid 2.5 mg, vitamin B6 25 mg, and B12 250 mcg per day. Treatment resulted in plaque reduction, especially when homocysteine levels exceeded 14μmol/l at the start, compared to untreated participants who experienced substantial plaque growth. An attempt to clarify the role of homocysteine treatment was made through a National Institute of Health-sponsored study of stroke prevention. 3680 participants with a prior history of stroke were enrolled and given either a “low-dose” (20 mcg folic acid, 0.2 mg B6, 6 mcg B12) or a “high-dose” (2.5 mg folic acid, 25 mg B6, 400 mcg B12) regimen. Although starting homocysteine levels showed a graded association with stroke risk (higher homocysteine levels predicted greater stroke risk), the treatment groups experienced, on average, only a 2 μmol drop in homocysteine levels and no reduction in stroke risk over two years. The study investigators as well as critics have suggested that the study failed due to an insufficient treatment period and that the doses were too low. (The doses we use in our plaque reduction program are folic acid 2.5–5.0 mg, B6 50–100 mg, B12 1000–2500 mcg.) L-arginine L-arginine can be used to overpower the adverse effects of ADMA. L-arginine is emerging as an important carotid plaque-reversing tool. Early reports in animals showed that l-arginine completely halted growth of aortic plaque, and did so more effectively than lovastatin (a cholesterol-lowering drug). In humans, L-arginine reduces blood pressure, abnormal constriction of carotid and coronary arteries, blocks entry of inflammatory cells into plaque, increases sensitivity to insulin, and heightens exercise capacity. Following coronary angioplasty or stent placement, l-arginine results in up to 36% reduction in plaque growth. The average American takes in 5400 mg of l-arginine through food every day. Supplementing with doses of 3000–12,000 mg per day has proven useful to correct many of these phenomena. (We use a dose of 6000 mg of l-arginine powder, twice a day on an empty stomach, dissolved in water, for our plaque regression program.) Does this result in a reduction of stroke risk? The emerging data suggest that l-arginine is likely to exert a powerful plaque-reducing and stroke-preventing benefit, but we await more clinical trial data. Conclusion Reducing stroke risk by reversing carotid and aortic plaque is becoming an everyday reality, with better tools becoming available. To know whether you’re at risk, the best and most available imaging tool is carotid ultrasound, aiming to identify intimal-medial thickness >1.0 mm, or carotid plaque. Any degree of calcification of the aorta, such as on a CT heart scan, is another useful measure of risk. Treatment to reduce risk is multi-faceted but is based on examining all your sources of risk, including metabolic syndrome, small LDL, lipoprotein(a), and C-reactive protein. Fish oil is the one absolutely crucial ingredient in any stroke prevention program. Other supplements can be used in a targeted fashion, depending on the causes identified for your carotid or aortic plaque. Ideally, repeat scanning of your carotids should be done sometime after your program has begun to assess whether you’ve successfully achieved reversal of plaque growth. vimax top penis enlargement pills penile enlargment result pennis enlargement surgery cost do penile enlargment pills work penis enhancement pic before and after penile enlargment supplement cheap vigrx pill best enlargment exercise penile

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Sexual dysfunction, in one form or the other and in varying degrees, is common among both men and women. According to recent studies, a large percentage of all men and women encounter some sort of sexual dysfunction at some point in their lives. And as they grow older, such problems become increasingly common. In males, sexual dysfunction may be of different types like lack of desire, failure to obtain and/or maintain an erection, and other problems like premature ejaculation and ejaculatory impotence, or the inability to ejaculate in coitus. Erectile dysfunction, however, is certainly the cause for maximum concern. For the treatment of erectile dysfunction, three oral medications are available: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). They boost the levels of nitric oxide, thereby relaxing the blood vessels and smooth muscle in the penis. As a result, the flow of blood is increased, and erection is achieved and maintained. Whatever may be the cause of erectile dysfunction, sildenafil, vardenafil, and tadalafil have proved themselves extremely helpful. In Europe, another drug under the brand name of Uprima (apomorphine) has hit the market, although it still awaits the approval of the U.S. FDA. Instead of increasing blood flow in the penis, apomorphine acts on the brain to enhance erection. These drugs should not, however, be used by those who have had a heart problem during the past six months, or those with serious liver or kidney ailments, certain eye disorders, and extreme levels of blood pressure. In females, lack of libido, failure to become aroused, lack of orgasm or anorgasmy, and vaginismus are the common sexual dysfunctions. Although no medications have yet been approved specifically for the treatment of female sexual dysfunction, research is continuing on the subject, which includes looking into the possibility of the use of sildenafil in females. A pharmaceutical major is now about to get the go-ahead for a testosterone patch for the treatment of low libido in postmenopausal women. Falls in testosterone levels are believed to be responsible to a large extent for lack of libido in both men and women. The proposed transdermal testosterone patch, to be marketed under the name “Intrinsa,” is worn on the lower abdomen. Further research will determine who should or shouldn’t use the testosterone patch, and its possible side effects as well. magna rx review penis enlarement supplement compare pnis enlargement pills penis enlarement supplement real penile enlargement penis enlargment result pnis enlargement before and after photo best penis enhancement penis enlargement excersizes

There are several types of birth control widely used to prevent pregnancy. Some methods are for men and some for women. If you are having sex with your partner while using any type of birth control, you must remember that all these types of birth control have failure rate, e.g., latex condoms and diaphragms having 15-20% failure rate while in case of birth control pills, injection, sterilization and IUD you have to bear a risk of about 5%. Various types of birth control are described below: Male Condom It is the most common method, easily available and of course is not expensive. It is sold without a doctor’s prescription. You can buy condom from any super Store, medical store or any other related shops. Mostly it is made of latex rubber that should be put on erect penis before having sex. It prevents the partners from pregnancy as well as STD (sexually transmitted disease). Female Condom It is a 17 Cm long pouch that has two rings at both ends. Women wear it before having sex. Open end has a slightly larger ring, which rests outside the vagina. Close end has a smaller ring that keeps the female condom in correct place. It has the similar properties as of male condom that it keeps the vagina away from the skin of the penis or from the secretion from the penis. It also prevents you from pregnancy as well as STD. Birth Control Pills It is based on hormones that keep the sperm from reaching eggs and also keeping ovaries from releasing eggs. It generally comes in 21 or 28 days pack and you must take one pill daily. It does not protect you from STD. Vasectomy It is a permanent method of birth control, which involves surgery, that makes a man sterile or you can say that after having vasectomy operation a man cannot make a woman pregnant. The operation does not take much time, hardly it takes half an hour and during the operation doctor uses local anesthesia. However it does not affect your potency. You must remember that after using this method of birth control you will never become a father in future. Female Sterilization It is also a permanent method of birth control, involving surgery that makes a woman sterile. However this operation takes more time than vasectomy and doctor do the operation under general anesthesia. You must remember that after opting this method of birth control you will never become a mother in future. Spermicides The function of spermicides is to kill the sperms before reaching uterus. It is a chemical product and is available in the form of foam, cream and jelly. You must insert it less than 20 minutes before intercourse and for subsequent sex. You can buy it from any drug store or grocery store. It is alone not effective against STD. It is recommended that you must use condom with spermicides to protect yourself against STD. Apart from above you can also have natural birth control i.e., abstinence. It means you should not have sex in those days when women can become pregnant. You can ask your doctor about these days. pnis enlargement pills penile enlargement photo herbal penis enlarement cheap penis enlargement truth about penis enlagement pills penile enlargement picture free penile enlargment exercise safe penis enlargement penis enlargement excersizes

Pills are one of the staples of the penis enlargement process. Every man interested in this field has heard about at least a half-dozen pills and is familiar with their effects on the body. Many have actually tried them and have a pretty good idea about the limited effectiveness of penis enlargement pills. The Internet is buzzing with the success stories of men who tried combinations of enlargement techniques that include pills. A good number of them used to be very skeptical about anything related to penis enlargement, but have since changed their opinions. It all depends on finding the right mix of techniques and sticking to the program. The basic idea behind all these pills is that the penis can be enlarged by promoting the flow of blood to the pelvic area. And they’re doing a great job of promoting that blood flow. A wide range of ingredients, containing probably all vasodilators known to man plus some of the most potent herbal and artificial libido boosters, are used to give the pills a strong influence over sex life, erect size, flaccid size and the level of pleasure achieved during sex. But is this enough to guarantee the success of a penis enlargement program? Judging by the loud headlines of websites selling these pills and by the forums that deal with penis enlargement, many men have actually put the pills to good use. Tens and hundreds of them have managed to add at least an inch to their penises and are very content with the results. It takes time and it takes patience and persistence, but it can be done. However, one thing that most websites selling pills won’t tell you is that the pills alone are not enough to do the trick. It’s just like taking diet pills: you have to exercise. This is a very common misconception among the biggest part of the penis enlargement community. But the fact remains that pills are a great supplement, a mixture of substances that make enlargement much easier. Simply promoting the flow of blood to the pelvic area can only give the user a slight increase in the erect length as the sponge-like tissue of the penis expands to accommodate a bit more blood than usual. And that’s about all pills can do on their own. However, you can combine the pills with another form of penis enlargement, such as penis exercises or a traction device. Penis exercises and traction devices provide the missing part of the enlargement process. The tissues that make up the penis get the exercise or traction needed to force the body to adapt by tearing the cells apart and making them grow in number. Exercises and traction benefit a lot from the increase in blood flow caused by the pills, although these approaches can do the job on their own. But combining a traction device with penis enlargement exercises is the best way to get those two inches many men are dreaming off. And if you’re really impatient, buy some pills, too. Just don’t rely on them to do the job alone. penis girth enargement natural penis enlargment pills vimax free penis enlargement pills vigrx penis enlargement pill home penis enhancement guide to penis enlarement surgical penis enargement surgical penis enlargement penis enlargement excersizes

Vaginismus is an involuntary contraction of the muscles surrounding the entrance to the vagina, making penetration painful, and or impossible. The muscle group involved is called the pubococcygeal muscles (PC). These are the same muscles used for kegel exercises. Normally, the vaginal sphincter keeps the vagina closed until the need to expand and relax. This relaxation allows for sexual intercourse, medical examination, insertion of tampons and childbirth. Vaginismus occurs when the vagina is unable to relax and permit the penetration of the penis during intercourse however, when vaginismus does occur, the sphincter goes into spasm resulting in the tightening of the vagina. In some women vaginismus prevents all attempts at successful intercourse. Vaginismus may even occur anytime in life, even if a woman has a history of enjoyable and painless intercourse. The severity of vaginismus varies from woman to woman. Some are able to insert a tampon and complete a gynecological exam but are unable to insert a penis. Others are unable to insert anything into their vagina. Vaginismus is not due to a physical abnormality of the genitals. Some women wonder if their vagina is too small to "accomodate" a penis, or perhaps they have no vaginal opening at all. This is understandable especially when the vaginal muscles are in spasm as they can give the appearance that the opening is nonexistent. These concerns, however, are incorrect as the genital area is completely normal. In addition to vaginismus, there are a number of other disorders, such as endometriosis, pelvic inflammatory disease, and Bartholin cysts that can result in painful sexual intercourse or penetration. It's important that a reliable diagnosis is obtained so that the appropriate treatment can be recommended. Nonphysical Causes: The cause of vaginismus is often a result of an aversive stimulus associated with penetration. Some of the more common aversive stimuli are traumatic sexual assaults, painful intercourse, and traumatic pelvic exam. Vaginismus may also result from the patient having strong inhibitions about sex stemming from strict religious beliefs or cultural norms. This disorder does not mean that women suffering from this disorder are frigid. Many are very sexually responsive and may have orgasms through clitoral stimulation. Many women with vaginismus may seek sexual contact and sexual foreplay as long as actual intercourse/vaginal penetration is avoided. Concepts such as penetration, intercourse and even sex can cause fear or trepidation in the mind of may a young inexperienced woman who may hear stories about painful first intercourse, which then reinforce the fear of penetration. This fear can compound and create a pattern of sexual anxiety, causing the vagina to remain dry and unrelaxed before intercourse. Treatment: The treatment of vaginismus is usually a therapy program that includes vaginal dilation exercises using plastic dilators. It's important that the use of dilators proceeds in a systematic progression under the direction of a sex therapist and should actively involve the woman's sexual partner. The treatment include gradually more intimate contact eventually culminating in successful and pain free intercourse. Sex education is also very important to counter sexual naivety and dispel any misinformation which has been identified as a factor in 90% of vaginismus cases. This education should include information about sexual anatomy, physiology, the sexual response cycle, and common myths about sex. Psychotherapy and Counseling See a qualified, licensed professional. Anyone can call themselves a sex therapist, so find a qualified psychologist or psychiatrist; one you trust. Try to get referred by your own physician or health care provider.