The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver. Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.
We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to 'schedule.'

The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver. Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.
We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to 'schedule.'

The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver. Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.
We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to 'schedule.'

The main causes of liver damage are:

The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver.
Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.

We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to 'schedule.'

The main causes of liver damage are:

The main causes of liver damage are:

1. Sleeping too late and waking up too late are main cause.
2. Not urinating in the morning.
3. Too much eating.
4. Skipping breakfast.
5. Consuming too much medication.
6. Consuming too much preservatives, additives, food coloring, and artificial sweetener.
7. Consuming unhealthy cooking oil. As much as possible reduce cooking oil use when frying, which includes even the best cooking oils like olive oil. Do not consume fried foods when you are tired, except if the body is very fit.
8. Consuming raw (overly done) foods also add to the burden of liver.
Veggies should be eaten raw or cooked 3-5 parts. Fried veggies should be finished in one sitting, do not store.

We should prevent this without necessarily spending more. We just have to adopt a good daily lifestyle and eating habits. Maintaining good eating habits and time condition are very important for our bodies to absorb and get rid of unnecessary chemicals according to 'schedule.'

The top five cancer-causing foods are:

1. Hot dogs

Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.

2. Processed meats and bacon

Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.

3. Doughnuts

Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.

4. French fries

Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .

5. Chips, crackers, and cookies

All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.

BRAIN DAMAGING HABITS

1. No Breakfast

People who do not take breakfast are going to have a lower blood sugar level. This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating

It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking

It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption

Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution

The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation

Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping

Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness

Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts

Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely

Intellectual conversations will promote the efficiency of the brain

Sponsored by: CoQ10, jojoba oil, goliath lab ejaculoid, palmetto

The top five cancer-causing foods are:

1. Hot dogs

Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.

2. Processed meats and bacon

Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.

3. Doughnuts

Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.

4. French fries

Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .

5. Chips, crackers, and cookies

All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.

BRAIN DAMAGING HABITS

1. No Breakfast

People who do not take breakfast are going to have a lower blood sugar level. This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating

It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking

It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption

Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution

The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation

Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping

Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness

Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts

Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely

Intellectual conversations will promote the efficiency of the brain

Sponsored by: CoQ10, jojoba oil, goliath lab ejaculoid, palmetto

The top five cancer-causing foods are:

1. Hot dogs

Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.

2. Processed meats and bacon

Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.

3. Doughnuts

Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.

4. French fries

Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .

5. Chips, crackers, and cookies

All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.

BRAIN DAMAGING HABITS

1. No Breakfast

People who do not take breakfast are going to have a lower blood sugar level. This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating

It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking

It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption

Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution

The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation

Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping

Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness

Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts

Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely

Intellectual conversations will promote the efficiency of the brain

Sponsored by: CoQ10, jojoba oil, goliath lab ejaculoid, palmetto

The top five cancer-causing foods are:

The top five cancer-causing foods are:

1. Hot dogs

Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.


2. Processed meats and bacon
Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.




3. Doughnuts
Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.



4. French fries
Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .




5. Chips, crackers, and cookies
All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.


BRAIN DAMAGING HABITS


1. No Breakfast
People who do not take breakfast are going to have a lower blood sugar level.
This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating
It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking
It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption
Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution
The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation
Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.
7. Head covered while sleeping
Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness
Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts
Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely
Intellectual conversations will promote the efficiency of the brain

The top five cancer-causing foods are:

The top five cancer-causing foods are:

1. Hot dogs

Because they are high in nitrates, the Cancer Prevention Coalition advises that children eat no more than 12 hot dogs a month. If you can't live without hot dogs, buy those made without sodium nitrate.


2. Processed meats and bacon
Also high in the same sodium nitrates found in hot dogs, bacon, and other processed meats raise the risk of heart disease. The saturated fat in bacon also contributes to cancer.




3. Doughnuts
Doughnuts are cancer-causing double trouble. First, they are made with white flour, sugar, and hydrogenated oils, then fried at high temperatures. Doughnuts, says Adams , may be the worst food you can possibly eat to raise your risk of cancer.



4. French fries
Like doughnuts, French fries are made with hydrogenated oils and then fried at high temperatures. They also contain cancer- causing acryl amides which occur during the frying process. They should be called cancer fries, not French fries, said Adams .




5. Chips, crackers, and cookies
All are usually made with white flour and sugar. Even the ones whose labels claim to be free of trans-fats generally contain small amounts of trans-fats.


BRAIN DAMAGING HABITS


1. No Breakfast
People who do not take breakfast are going to have a lower blood sugar level.
This leads to an insufficient supply of nutrients to the brain causing brain degeneration.

2. Overeating
It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking
It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption
Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution
The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation
Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.
7. Head covered while sleeping
Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness
Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts
Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage.

10. Talking Rarely
Intellectual conversations will promote the efficiency of the brain

Your Guide to Masturbation

Your Guide to Masturbation

Masturbation is the self-stimulation of the genitals to achieve sexual arousal and pleasure, usually to the point of orgasm (sexual climax). It is commonly done by touching, stroking or massaging the penis or clitoris until an orgasm is achieved. Some women also use stimulation of the vagina to masturbate or use "sex toys," such as a vibrator.

Who Masturbates?

Just about everybody. Masturbation is a very common behavior, even among people who have sexual relations with a partner. In one national study, 95% of males and 89% of females reported that they have masturbated. Masturbation is the first sexual act experienced by most males and females. In young children, masturbation is a normal part of the growing child's exploration of his or her body. Most people continue to masturbate in adulthood, and many do so throughout their lives.

Why Do People Masturbate?

In addition to feeling good, masturbation is a good way of relieving the sexual tension that can build up over time, especially for people without partners or whose partners are not willing or available for sex. Masturbation also is a safe sexual alternative for people who wish to avoid pregnancy and the dangers of sexually transmitted diseases. It also is necessary when a man must give a semen sample for infertility testing or for sperm donation. When sexual dysfunction is present in an adult, masturbation may be prescribed by a sex therapist to allow a person to experience an orgasm (often in women) or to delay its arrival (often in men).

How do people masturbate?

Most guys masturbate by rubbing their penis with their hand or hands, or by rubbing the penis against something, such as a pillow. Girls masturbate by rubbing the outside of their vagina, or by inserting something (such as a vibrator) into the vagina. However, there are a lot of variations on these methods. JackinWorld contains dozens of techniques for guys to try.

Why masturbate?

First and foremost, because it feels good, and second, because ejaculating semen reduces the sexual tension that builds up in adult men and especially teenagers. However, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Normal?

While it once was regarded as a perversion and a sign of a mental problem, masturbation now is regarded as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable and safe. It is a good way to experience sexual pleasure and can be done throughout life. Masturbation is only considered a problem when it inhibits sexual activity with a partner, is done in public, or causes significant distress to the person. It may cause distress if it is done compulsively and/or interferes with daily life and activities.

Is masturbation healthy?

Masturbation is a healthy and normal practice, like daydreaming or napping. Even masturbating several times each day is completely harmless. You may encounter people, books, or websites that say masturbation is bad or harmful; this is just plain incorrect. As any reputable medical doctor will tell you, old myths about masturbation affecting the eyesight, causing permanent fatigue or insanity, etc., have long been disproved. In fact, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Harmful?

In general, the medical community considers masturbation to be a natural and harmless expression of sexuality for both men and women. It does not cause any physical injury or harm to the body, and can be performed in moderation throughout a person's lifetime as a part of normal sexual behavior. Some cultures and religions oppose the use of masturbation or even label it as sinful. This can lead to guilt or shame about the behavior. Some experts suggest that masturbation can actually improve sexual health and relationships. By exploring your own body through masturbation, you can determine what is erotically pleasing to you and can share this with your partner. Some partners use mutual masturbation to discover techniques for a more satisfying sexual relationship and to add to their mutual intimacy.

Can I masturbate too much?

Unless you're rubbing yourself raw (try lubrication) or you're doing it so much that it's interfering with other aspects of your life, no, it is not possible to masturbate too much. Some Web sites claim that there is such a thing as "overmasturbation," but they're only doing this to scare people into buying phony pills that do nothing. Masturbation does not cause hair loss, chronic fatigue, etc. Don't let one bad Web site ruin your enjoyment of this healthy activity.

Is my penis normal?

If you're asking this question, there's probably about a 98% chance that your penis is normal. Perfectly good penises come in a wide variety of shapes and sizes, and teenagers' penises grow at very different rates. They are often curved somewhat, and the skin often has bumps and various colorations (which have nothing to do with STDs). Try not to obsess so much about your penis, and stop looking for things that might be wrong. It's there to create pleasure, not trouble and worry.

Can I make my penis bigger?

If you pay a plastic surgeon several thousand dollars, your penis can become fatter, but not really longer. And you know what? That's really the only method of penis enlargement that works. Everything else — particularly pills sold through magazines and the Internet — is a scam, aimed at malekind's #1 biggest insecurity. Some devices involving suction or vacuum can actually injure your penis. Instead of trying to change it, learn to accept your penis exactly the way it is. It's amazing how much incredible pleasure it can provide.

I can't reach orgasm! What can I do about this?

Some guys do have a lot of trouble reaching orgasm. Several possible reasons: (1) You may be giving up too soon. (2) You may have ejaculated too recently. Wait a day or two (or longer) and try again. (3) You may be too young still. Some guys don't develop the ability to reach orgasm and ejaculate until well into puberty. If you're an adult and have never been able to reach orgasm or ejaculate, seek an opinion from a professional such as a urologist.

When I reach orgasm, urine comes out instead of semen. What's happening?

This is actually a common experience in boys still going through the early stages of puberty. There is an internal mechanism that prevents urine from being expelled during ejaculation — but many guys are able to ejaculate before this mechanism fully matures. When this happens, a small amount of urine (rather than semen) may be expelled with orgasm. The condition will go away as you get older. If it's still happening by the time puberty is near completion, consult a physician.

My semen comes out clear, not thick and whitish. Am I sterile?

No, that's unlikely. Semen varies in color and texture, not only from person to person, but it can also vary over time. Particularly if you're still in the early stages of puberty, semen can be clear or watery, but it may still contain lots of viable sperm. Semen, whether clear or not, contains many other ingredients besides sperm cells.

What are these bumps or spots on my penis?

It's totally normal, and very common in teenagers, for there to be bumps, pimples, or different-colored spots on the penis. They might look a little gross, but there's nothing to be ashamed of and you can't really do anything about them. Bumps on the penis may be a form of acne or may occur where new hairs are starting to grow. We recommend not focusing so much on what may be wrong with your penis — most likely, everything about it is just fine. Instead, try to accept your penis as it is: an amazing part of your body that can provide you with huge amounts of pleasure for a lifetime.

What position do most guys masturbate in?

The most common is lying on the back. Other favorites are lying face down, standing up (such as in the shower), or kneeling.

I masturbate by lying on my stomach and rubbing against the bed — is that okay?
It's fine. that's just as valid as any other position.

I'd like to try to orally stimulate my own penis, but I can't quite reach it. How can I do that, and is it normal to want to try?

It's very common to want to do this. (There's an old joke that goes, "Why do dogs lick themselves? Because they can.") Actually doing it, though, is another question. Your penis has to be especially long (like over 8"), or you have to be especially limber, to succeed. Some guys are able to reach their penis by doing a backwards somersault and stopping in mid-roll. However, we must caution you to be careful when doing this. We heard from one fellow who wanted so badly to suck his own penis, he strained his back and had to be taken to the hospital — extremely embarrassing! Never perform any technique that makes you contort your body in an uncomfortable manner — you might be very sorry you did.

I'm unable to ejaculate by masturbating with my hand — I have to be rubbing against something. Should I worry about that?

No. It wouldn't hurt, though, to eventually learn to do it — that will open up options for sexual play with other people. We don't have any suggestions for this; just keep working at it (both literally and figuratively!).

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia

Your Guide to Masturbation

Your Guide to Masturbation

Masturbation is the self-stimulation of the genitals to achieve sexual arousal and pleasure, usually to the point of orgasm (sexual climax). It is commonly done by touching, stroking or massaging the penis or clitoris until an orgasm is achieved. Some women also use stimulation of the vagina to masturbate or use "sex toys," such as a vibrator.

Who Masturbates?

Just about everybody. Masturbation is a very common behavior, even among people who have sexual relations with a partner. In one national study, 95% of males and 89% of females reported that they have masturbated. Masturbation is the first sexual act experienced by most males and females. In young children, masturbation is a normal part of the growing child's exploration of his or her body. Most people continue to masturbate in adulthood, and many do so throughout their lives.

Why Do People Masturbate?

In addition to feeling good, masturbation is a good way of relieving the sexual tension that can build up over time, especially for people without partners or whose partners are not willing or available for sex. Masturbation also is a safe sexual alternative for people who wish to avoid pregnancy and the dangers of sexually transmitted diseases. It also is necessary when a man must give a semen sample for infertility testing or for sperm donation. When sexual dysfunction is present in an adult, masturbation may be prescribed by a sex therapist to allow a person to experience an orgasm (often in women) or to delay its arrival (often in men).

How do people masturbate?

Most guys masturbate by rubbing their penis with their hand or hands, or by rubbing the penis against something, such as a pillow. Girls masturbate by rubbing the outside of their vagina, or by inserting something (such as a vibrator) into the vagina. However, there are a lot of variations on these methods. JackinWorld contains dozens of techniques for guys to try.

Why masturbate?

First and foremost, because it feels good, and second, because ejaculating semen reduces the sexual tension that builds up in adult men and especially teenagers. However, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Normal?

While it once was regarded as a perversion and a sign of a mental problem, masturbation now is regarded as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable and safe. It is a good way to experience sexual pleasure and can be done throughout life. Masturbation is only considered a problem when it inhibits sexual activity with a partner, is done in public, or causes significant distress to the person. It may cause distress if it is done compulsively and/or interferes with daily life and activities.

Is masturbation healthy?

Masturbation is a healthy and normal practice, like daydreaming or napping. Even masturbating several times each day is completely harmless. You may encounter people, books, or websites that say masturbation is bad or harmful; this is just plain incorrect. As any reputable medical doctor will tell you, old myths about masturbation affecting the eyesight, causing permanent fatigue or insanity, etc., have long been disproved. In fact, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Harmful?

In general, the medical community considers masturbation to be a natural and harmless expression of sexuality for both men and women. It does not cause any physical injury or harm to the body, and can be performed in moderation throughout a person's lifetime as a part of normal sexual behavior. Some cultures and religions oppose the use of masturbation or even label it as sinful. This can lead to guilt or shame about the behavior. Some experts suggest that masturbation can actually improve sexual health and relationships. By exploring your own body through masturbation, you can determine what is erotically pleasing to you and can share this with your partner. Some partners use mutual masturbation to discover techniques for a more satisfying sexual relationship and to add to their mutual intimacy.

Can I masturbate too much?

Unless you're rubbing yourself raw (try lubrication) or you're doing it so much that it's interfering with other aspects of your life, no, it is not possible to masturbate too much. Some Web sites claim that there is such a thing as "overmasturbation," but they're only doing this to scare people into buying phony pills that do nothing. Masturbation does not cause hair loss, chronic fatigue, etc. Don't let one bad Web site ruin your enjoyment of this healthy activity.

Is my penis normal?

If you're asking this question, there's probably about a 98% chance that your penis is normal. Perfectly good penises come in a wide variety of shapes and sizes, and teenagers' penises grow at very different rates. They are often curved somewhat, and the skin often has bumps and various colorations (which have nothing to do with STDs). Try not to obsess so much about your penis, and stop looking for things that might be wrong. It's there to create pleasure, not trouble and worry.

Can I make my penis bigger?

If you pay a plastic surgeon several thousand dollars, your penis can become fatter, but not really longer. And you know what? That's really the only method of penis enlargement that works. Everything else — particularly pills sold through magazines and the Internet — is a scam, aimed at malekind's #1 biggest insecurity. Some devices involving suction or vacuum can actually injure your penis. Instead of trying to change it, learn to accept your penis exactly the way it is. It's amazing how much incredible pleasure it can provide.

I can't reach orgasm! What can I do about this?

Some guys do have a lot of trouble reaching orgasm. Several possible reasons: (1) You may be giving up too soon. (2) You may have ejaculated too recently. Wait a day or two (or longer) and try again. (3) You may be too young still. Some guys don't develop the ability to reach orgasm and ejaculate until well into puberty. If you're an adult and have never been able to reach orgasm or ejaculate, seek an opinion from a professional such as a urologist.

When I reach orgasm, urine comes out instead of semen. What's happening?

This is actually a common experience in boys still going through the early stages of puberty. There is an internal mechanism that prevents urine from being expelled during ejaculation — but many guys are able to ejaculate before this mechanism fully matures. When this happens, a small amount of urine (rather than semen) may be expelled with orgasm. The condition will go away as you get older. If it's still happening by the time puberty is near completion, consult a physician.

My semen comes out clear, not thick and whitish. Am I sterile?

No, that's unlikely. Semen varies in color and texture, not only from person to person, but it can also vary over time. Particularly if you're still in the early stages of puberty, semen can be clear or watery, but it may still contain lots of viable sperm. Semen, whether clear or not, contains many other ingredients besides sperm cells.

What are these bumps or spots on my penis?

It's totally normal, and very common in teenagers, for there to be bumps, pimples, or different-colored spots on the penis. They might look a little gross, but there's nothing to be ashamed of and you can't really do anything about them. Bumps on the penis may be a form of acne or may occur where new hairs are starting to grow. We recommend not focusing so much on what may be wrong with your penis — most likely, everything about it is just fine. Instead, try to accept your penis as it is: an amazing part of your body that can provide you with huge amounts of pleasure for a lifetime.

What position do most guys masturbate in?

The most common is lying on the back. Other favorites are lying face down, standing up (such as in the shower), or kneeling.

I masturbate by lying on my stomach and rubbing against the bed — is that okay?
It's fine. that's just as valid as any other position.

I'd like to try to orally stimulate my own penis, but I can't quite reach it. How can I do that, and is it normal to want to try?

It's very common to want to do this. (There's an old joke that goes, "Why do dogs lick themselves? Because they can.") Actually doing it, though, is another question. Your penis has to be especially long (like over 8"), or you have to be especially limber, to succeed. Some guys are able to reach their penis by doing a backwards somersault and stopping in mid-roll. However, we must caution you to be careful when doing this. We heard from one fellow who wanted so badly to suck his own penis, he strained his back and had to be taken to the hospital — extremely embarrassing! Never perform any technique that makes you contort your body in an uncomfortable manner — you might be very sorry you did.

I'm unable to ejaculate by masturbating with my hand — I have to be rubbing against something. Should I worry about that?

No. It wouldn't hurt, though, to eventually learn to do it — that will open up options for sexual play with other people. We don't have any suggestions for this; just keep working at it (both literally and figuratively!).

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia

Your Guide to Masturbation

Your Guide to Masturbation

Masturbation is the self-stimulation of the genitals to achieve sexual arousal and pleasure, usually to the point of orgasm (sexual climax). It is commonly done by touching, stroking or massaging the penis or clitoris until an orgasm is achieved. Some women also use stimulation of the vagina to masturbate or use "sex toys," such as a vibrator.

Who Masturbates?

Just about everybody. Masturbation is a very common behavior, even among people who have sexual relations with a partner. In one national study, 95% of males and 89% of females reported that they have masturbated. Masturbation is the first sexual act experienced by most males and females. In young children, masturbation is a normal part of the growing child's exploration of his or her body. Most people continue to masturbate in adulthood, and many do so throughout their lives.

Why Do People Masturbate?

In addition to feeling good, masturbation is a good way of relieving the sexual tension that can build up over time, especially for people without partners or whose partners are not willing or available for sex. Masturbation also is a safe sexual alternative for people who wish to avoid pregnancy and the dangers of sexually transmitted diseases. It also is necessary when a man must give a semen sample for infertility testing or for sperm donation. When sexual dysfunction is present in an adult, masturbation may be prescribed by a sex therapist to allow a person to experience an orgasm (often in women) or to delay its arrival (often in men).

How do people masturbate?

Most guys masturbate by rubbing their penis with their hand or hands, or by rubbing the penis against something, such as a pillow. Girls masturbate by rubbing the outside of their vagina, or by inserting something (such as a vibrator) into the vagina. However, there are a lot of variations on these methods. JackinWorld contains dozens of techniques for guys to try.

Why masturbate?

First and foremost, because it feels good, and second, because ejaculating semen reduces the sexual tension that builds up in adult men and especially teenagers. However, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Normal?

While it once was regarded as a perversion and a sign of a mental problem, masturbation now is regarded as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable and safe. It is a good way to experience sexual pleasure and can be done throughout life. Masturbation is only considered a problem when it inhibits sexual activity with a partner, is done in public, or causes significant distress to the person. It may cause distress if it is done compulsively and/or interferes with daily life and activities.

Is masturbation healthy?

Masturbation is a healthy and normal practice, like daydreaming or napping. Even masturbating several times each day is completely harmless. You may encounter people, books, or websites that say masturbation is bad or harmful; this is just plain incorrect. As any reputable medical doctor will tell you, old myths about masturbation affecting the eyesight, causing permanent fatigue or insanity, etc., have long been disproved. In fact, recent studies suggest that ejaculating regularly isn't just fun, it can actually help prevent a certain kind of cancer later in life.

Is Masturbation Harmful?

In general, the medical community considers masturbation to be a natural and harmless expression of sexuality for both men and women. It does not cause any physical injury or harm to the body, and can be performed in moderation throughout a person's lifetime as a part of normal sexual behavior. Some cultures and religions oppose the use of masturbation or even label it as sinful. This can lead to guilt or shame about the behavior. Some experts suggest that masturbation can actually improve sexual health and relationships. By exploring your own body through masturbation, you can determine what is erotically pleasing to you and can share this with your partner. Some partners use mutual masturbation to discover techniques for a more satisfying sexual relationship and to add to their mutual intimacy.

Can I masturbate too much?

Unless you're rubbing yourself raw (try lubrication) or you're doing it so much that it's interfering with other aspects of your life, no, it is not possible to masturbate too much. Some Web sites claim that there is such a thing as "overmasturbation," but they're only doing this to scare people into buying phony pills that do nothing. Masturbation does not cause hair loss, chronic fatigue, etc. Don't let one bad Web site ruin your enjoyment of this healthy activity.

Is my penis normal?

If you're asking this question, there's probably about a 98% chance that your penis is normal. Perfectly good penises come in a wide variety of shapes and sizes, and teenagers' penises grow at very different rates. They are often curved somewhat, and the skin often has bumps and various colorations (which have nothing to do with STDs). Try not to obsess so much about your penis, and stop looking for things that might be wrong. It's there to create pleasure, not trouble and worry.

Can I make my penis bigger?

If you pay a plastic surgeon several thousand dollars, your penis can become fatter, but not really longer. And you know what? That's really the only method of penis enlargement that works. Everything else — particularly pills sold through magazines and the Internet — is a scam, aimed at malekind's #1 biggest insecurity. Some devices involving suction or vacuum can actually injure your penis. Instead of trying to change it, learn to accept your penis exactly the way it is. It's amazing how much incredible pleasure it can provide.

I can't reach orgasm! What can I do about this?

Some guys do have a lot of trouble reaching orgasm. Several possible reasons: (1) You may be giving up too soon. (2) You may have ejaculated too recently. Wait a day or two (or longer) and try again. (3) You may be too young still. Some guys don't develop the ability to reach orgasm and ejaculate until well into puberty. If you're an adult and have never been able to reach orgasm or ejaculate, seek an opinion from a professional such as a urologist.

When I reach orgasm, urine comes out instead of semen. What's happening?

This is actually a common experience in boys still going through the early stages of puberty. There is an internal mechanism that prevents urine from being expelled during ejaculation — but many guys are able to ejaculate before this mechanism fully matures. When this happens, a small amount of urine (rather than semen) may be expelled with orgasm. The condition will go away as you get older. If it's still happening by the time puberty is near completion, consult a physician.

My semen comes out clear, not thick and whitish. Am I sterile?

No, that's unlikely. Semen varies in color and texture, not only from person to person, but it can also vary over time. Particularly if you're still in the early stages of puberty, semen can be clear or watery, but it may still contain lots of viable sperm. Semen, whether clear or not, contains many other ingredients besides sperm cells.

What are these bumps or spots on my penis?

It's totally normal, and very common in teenagers, for there to be bumps, pimples, or different-colored spots on the penis. They might look a little gross, but there's nothing to be ashamed of and you can't really do anything about them. Bumps on the penis may be a form of acne or may occur where new hairs are starting to grow. We recommend not focusing so much on what may be wrong with your penis — most likely, everything about it is just fine. Instead, try to accept your penis as it is: an amazing part of your body that can provide you with huge amounts of pleasure for a lifetime.

What position do most guys masturbate in?

The most common is lying on the back. Other favorites are lying face down, standing up (such as in the shower), or kneeling.

I masturbate by lying on my stomach and rubbing against the bed — is that okay?
It's fine. that's just as valid as any other position.

I'd like to try to orally stimulate my own penis, but I can't quite reach it. How can I do that, and is it normal to want to try?

It's very common to want to do this. (There's an old joke that goes, "Why do dogs lick themselves? Because they can.") Actually doing it, though, is another question. Your penis has to be especially long (like over 8"), or you have to be especially limber, to succeed. Some guys are able to reach their penis by doing a backwards somersault and stopping in mid-roll. However, we must caution you to be careful when doing this. We heard from one fellow who wanted so badly to suck his own penis, he strained his back and had to be taken to the hospital — extremely embarrassing! Never perform any technique that makes you contort your body in an uncomfortable manner — you might be very sorry you did.

I'm unable to ejaculate by masturbating with my hand — I have to be rubbing against something. Should I worry about that?

No. It wouldn't hurt, though, to eventually learn to do it — that will open up options for sexual play with other people. We don't have any suggestions for this; just keep working at it (both literally and figuratively!).

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia

Masturbation techniques?

Masturbation is the physical stimulation of the sexual organs to produce feelings of pleasure. If you're a male and your body has matured to a certain point, masturbating will eventually result in semen (fluid containing sperm cells, among other things) being expelled from the penis, usually accompanied by a very good whole-body feeling known as orgasm.

Positions or techniques?

Just about every successful masturbation session begins with getting an erection (ee-RECK-shun), commonly called a "hard-on," "boner," or "woody." An erection occurs when your penis fills with blood to the point that it becomes quite a bit larger and firm to the touch, usually sticking straight out from your body or angled upward as you stand. (If you're lying on your back, your erect penis might rest against your abdomen.) Getting an erection is usually as easy as thinking sexy thoughts and rubbing your penis. If you're going through puberty, or if you haven't ejaculated in a while, you may not have to do anything to get an erection — they can happen spontaneously, or without provocation. This is normal and just one of those puberty things everyone has to deal with.Once your penis has reached its full length and hardness, take a hold of it and rub it lengthwise at a consistent rate. This will mimic what it feels like to move your penis in and out of a woman's vagina, which is what happens during sexual intercourse.
Here are four basic "grips" you can try. They're really just starting points; it's important for you to try little variations on them, as this will allow you to choose techniques that feel best to you.

THE FIST
In this common technique, you simply wrap your fingers around the shaft of your penis like a baseball bat and rub it up and down. It provides lots of contact between your hand and penis — and more contact means more pleasure. This technique is especially good if you have a big penis; if it isn't much longer than your fist is wide, you won't be able to stroke it very far, so another grip might be more effective.

THE FIVE-FINGER
In this technique, your hand and arm form an angle with your penis, with four fingers on top of the shaft at a diagonal and your thumb below. This allows you to get more control over the hand-to-penis contact, and it lets you move your hand along the entire length of the shaft, even if your penis isn't very large.

THE THREE-FINGER

This one is good if you have a smaller penis. Simply hold the penis as you would a pen or a pencil. This grip allows maximum control and maximum distance of motion (from the base of the penis all the way to the head), but the hand-to-penis contact is less than with the other grips.

THE BACKHAND
This one — kind of a backwards version of the "fist" — is a little funny, but it feels very good. This time, grab your penis from the left side rather than the right (if you're right-handed). To do this, rotate your wrist so your thumb is pointing down; you may have to pull your penis slightly to the side. It's a little awkward at first, but it's an excellent grip to use when you just want to try something other than the "Fist" for a few minutes.

IS MASTURBATION ADDICTIVE?

Okay, so you've discovered this really nifty thing to do with the equipment between your legs, and it gives you some of the most intense feelings of pleasure you've ever felt. In fact, it's been so pleasurable you have begun to do it a lot — a whole lot. And now you might be wondering what you've gotten yourself into. You might have read somebody's comment about how addictive masturbation is. Or, you might have noticed how similar the desire to masturbate is to what you understand addiction to be. In short, you want to know if this practice is going to take control of your life and hurt you. Honestly, I think the answer is, "It depends" — one of those wishy-washy, yes-and-no, weasel answers. But it really does depend on a number of factors in your life, on how you experience masturbation, and what kinds of consequences masturbation has for you. To answer the question well, we need to review some knowledge about addiction.
First, consider the dictionary definition of the word. Webster's Collegiate Dictionary, 10th Edition, gives two:1. The quality or state of being addicted [to an activity or thing] (such as, being "addicted to reading")2. Compulsive need for and use of a habit-forming substance (such as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal.Broadly — persistent, compulsive use of a substance known by the user to be harmful.In the second definition the phrase, "characterized by tolerance," means that over time the body builds a resistance to a substance such as alcohol, so that increased amounts are needed to get what feels like the same effect. Let's see how these definitions apply to what you and I know about masturbation.The first definition seems to be a lighter, more general use of the word "addiction" — much as we might say, "I just love to read (or masturbate)." The second definition is heavier and gets more to the heart of the concern that masturbation could be addictive. My experience has been that masturbation feels so good it can feel quite compelling. Since I discovered it, my desire to masturbate persisted, even in the face of strong discouragement from my mother when I was a boy. During adolescence, I think I was obsessed with it. As I grew older, the practice took its place among other very satisfying interests in my life. From what I have read at JackinWorld, I think my growth into adulthood is similar to that of many other men.When I have masturbated frequently, it has taken longer to achieve subsequent orgasms, and their intensity has seemed to diminish. This seems like it might be "tolerance," except for the fact that when my masturbation frequency decreases, the old intensity returns. I have never believed masturbation to be harmful to me. At times, for one reason or another, I have gone a long time without masturbating; I don't remember having any strong physical signs of withdrawal during these times — but when I resumed, the intensity of the orgasm was both astonishing and highly satisfying.So, when I try to fit my experience of masturbation to the definition of addiction, it seems to fit only slightly. Yes, masturbation is compelling. However, I don't get strong physical reactions if I abstain, even though it feels really great when I resume. The intensity of feeling seems to lessen the more frequently I masturbate, but it comes right back if I decrease the frequency. This doesn't sound as though my body is building a tolerance to masturbation the way it might to alcohol, nicotine, or heroin. By now I'm ready to say I don't think I can become addicted to masturbation — but I can become obsessed with it, just as I could become obsessed with many other kinds of behavior. Obsessive behavior is characterized by excessive repetition of some act. [Editor's Note: The repeated up-and-down movement of the hand isn't necessarily the "repetition of some act"!]Next, let's look at some other ideas that seem to apply both to obsession and addiction. Substances and behaviors can be addictive/obsessive to some people and not to others. And there are degrees of addiction/obsession.Take alcohol as an example. You may know people who drink responsibly. They can control their drinking so they always drink at appropriate times and places, and moderately so they don't become drunk and lose control of themselves inappropriately. You might know others who occasionally get drunk and lose control, even though most of the time they drink responsibly. And you might know a few unfortunate people who are addicted to alcohol. They are drunk more than they are sober, can't drive or hold a job, and have alienated their families because they cannot control their alcohol consumption. Alcohol is also destroying their bodies, and they are likely to die young because it attacks the liver and other organs.The physical and psychological dynamics of addiction are at least partially understood, but we still don't understand completely why some people can control their use of a substance such as alcohol, where others have no control at all. There is much obsessive-compulsive behavior connected with addiction. You might have heard of Alcoholics Anonymous, the highly successful program that helps people deal with their alcohol addiction. Much of that program deals with controlling obsessive-compulsive behavior. So it is possible that if you have the genetic predisposition, and if early childhood experiences contributed to it, you could become obsessed with masturbation to the extent that it harms you. But I think the chance is slight.Some people ask counselors or newspaper advice columnists if they are "addicted" to alcohol, drugs, sex, or whatever concerns them because they do a lot of it. And some people have written to JackinWorld to say they are worried about being addicted to masturbation because they do it so much. I think often they are referring to an obsession rather than addiction.Whether obsession or addiction, one way you can answer questions like these is to see if you can stop for a while without suffering major physical symptoms, such as getting the shakes or becoming ill. (Humping the davenport, doorknob, or barbecue grill does not count! Nor does running around going berserk. Yes, it's stressful, but we're talking major physical symptoms here.)Another way to answer questions such as these is to ask yourself to assess negative consequences. If you have been fired from your last three jobs because you missed work too much due to being hung over, you were arrested last week for drunk driving, and your wife just filed for divorce because last night you fell asleep on the front sidewalk and the neighbors complained, these are all strong suggestions that you are addicted to alcohol. If you were suspended from school yesterday for excessive tardiness (because you stayed home masturbating in the morning before going to school), or your parents had to come to the police station to pick you up because you were caught masturbating in a downtown park at noon, or you spurn sex with your partner because you prefer to masturbate exclusively, you are probably obsessed with masturbation.Most of us, however, can control our behavior so that it is appropriate. We masturbate in private — in bed at night, when we are home alone, or in a toilet stall or bathroom behind a locked door. In such cases, I can't see masturbation as an addiction or obsession — compelling, perhaps, but not an immobilizing addiction or obsession. Even if you do it a lot — a whole lot — it still is not an addiction or obsession unless you find it having some major, harmful consequences in your life.If you do find that masturbation is hurting you and you want to stop (or just cut down), you need to seek professional help near where you live. One way to find this kind of help is to call a local crisis hotline. These community services are listed in the blue pages of your telephone directory, along with government agencies and offices. They can refer you to an agency that can help you.Masturbation plays a big role in a normal sex life. Some of us discover it as children because it starts to feel so good between our legs. Others are shown by our friends. We continue to masturbate because it feels so good. It gets us ready for mature sexual relationships when we reach adulthood, and it helps us take care of those raging hormonal urges and surges when we are teenagers. Masturbation can enhance mature sexual relationships where two partners use it either as a prelude to other sexual activity, or as the main fare. And it keeps us going when relationships falter, such as when a partner is ill or away. It is a great equalizer in a relationship where one partner needs more sexual activity than the other. All of these uses of masturbation were reported by mature JackinWorld readers in response to the Adult Masturbation Survey undertaken last year. So stroke on in the comfort and joy of knowing that you probably are not addicted to or obsessed with masturbation, no matter how compelling it may be to you or how often you do it. And now you have some guidelines to help assess whether you are developing an obsession, and if so, what you can do about it.

Sponsored by: cildenafil citrate, viagra, cialis, provigra, prozac, tramadol, levitra, propecia

Masturbation techniques?

Masturbation is the physical stimulation of the sexual organs to produce feelings of pleasure. If you're a male and your body has matured to a certain point, masturbating will eventually result in semen (fluid containing sperm cells, among other things) being expelled from the penis, usually accompanied by a very good whole-body feeling known as orgasm.

Positions or techniques?

Just about every successful masturbation session begins with getting an erection (ee-RECK-shun), commonly called a "hard-on," "boner," or "woody." An erection occurs when your penis fills with blood to the point that it becomes quite a bit larger and firm to the touch, usually sticking straight out from your body or angled upward as you stand. (If you're lying on your back, your erect penis might rest against your abdomen.) Getting an erection is usually as easy as thinking sexy thoughts and rubbing your penis. If you're going through puberty, or if you haven't ejaculated in a while, you may not have to do anything to get an erection — they can happen spontaneously, or without provocation. This is normal and just one of those puberty things everyone has to deal with.Once your penis has reached its full length and hardness, take a hold of it and rub it lengthwise at a consistent rate. This will mimic what it feels like to move your penis in and out of a woman's vagina, which is what happens during sexual intercourse.
Here are four basic "grips" you can try. They're really just starting points; it's important for you to try little variations on them, as this will allow you to choose techniques that feel best to you.

THE FIST
In this common technique, you simply wrap your fingers around the shaft of your penis like a baseball bat and rub it up and down. It provides lots of contact between your hand and penis — and more contact means more pleasure. This technique is especially good if you have a big penis; if it isn't much longer than your fist is wide, you won't be able to stroke it very far, so another grip might be more effective.

THE FIVE-FINGER
In this technique, your hand and arm form an angle with your penis, with four fingers on top of the shaft at a diagonal and your thumb below. This allows you to get more control over the hand-to-penis contact, and it lets you move your hand along the entire length of the shaft, even if your penis isn't very large.

THE THREE-FINGER

This one is good if you have a smaller penis. Simply hold the penis as you would a pen or a pencil. This grip allows maximum control and maximum distance of motion (from the base of the penis all the way to the head), but the hand-to-penis contact is less than with the other grips.

THE BACKHAND
This one — kind of a backwards version of the "fist" — is a little funny, but it feels very good. This time, grab your penis from the left side rather than the right (if you're right-handed). To do this, rotate your wrist so your thumb is pointing down; you may have to pull your penis slightly to the side. It's a little awkward at first, but it's an excellent grip to use when you just want to try something other than the "Fist" for a few minutes.

IS MASTURBATION ADDICTIVE?

Okay, so you've discovered this really nifty thing to do with the equipment between your legs, and it gives you some of the most intense feelings of pleasure you've ever felt. In fact, it's been so pleasurable you have begun to do it a lot — a whole lot. And now you might be wondering what you've gotten yourself into. You might have read somebody's comment about how addictive masturbation is. Or, you might have noticed how similar the desire to masturbate is to what you understand addiction to be. In short, you want to know if this practice is going to take control of your life and hurt you. Honestly, I think the answer is, "It depends" — one of those wishy-washy, yes-and-no, weasel answers. But it really does depend on a number of factors in your life, on how you experience masturbation, and what kinds of consequences masturbation has for you. To answer the question well, we need to review some knowledge about addiction.
First, consider the dictionary definition of the word. Webster's Collegiate Dictionary, 10th Edition, gives two:1. The quality or state of being addicted [to an activity or thing] (such as, being "addicted to reading")2. Compulsive need for and use of a habit-forming substance (such as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal.Broadly — persistent, compulsive use of a substance known by the user to be harmful.In the second definition the phrase, "characterized by tolerance," means that over time the body builds a resistance to a substance such as alcohol, so that increased amounts are needed to get what feels like the same effect. Let's see how these definitions apply to what you and I know about masturbation.The first definition seems to be a lighter, more general use of the word "addiction" — much as we might say, "I just love to read (or masturbate)." The second definition is heavier and gets more to the heart of the concern that masturbation could be addictive. My experience has been that masturbation feels so good it can feel quite compelling. Since I discovered it, my desire to masturbate persisted, even in the face of strong discouragement from my mother when I was a boy. During adolescence, I think I was obsessed with it. As I grew older, the practice took its place among other very satisfying interests in my life. From what I have read at JackinWorld, I think my growth into adulthood is similar to that of many other men.When I have masturbated frequently, it has taken longer to achieve subsequent orgasms, and their intensity has seemed to diminish. This seems like it might be "tolerance," except for the fact that when my masturbation frequency decreases, the old intensity returns. I have never believed masturbation to be harmful to me. At times, for one reason or another, I have gone a long time without masturbating; I don't remember having any strong physical signs of withdrawal during these times — but when I resumed, the intensity of the orgasm was both astonishing and highly satisfying.So, when I try to fit my experience of masturbation to the definition of addiction, it seems to fit only slightly. Yes, masturbation is compelling. However, I don't get strong physical reactions if I abstain, even though it feels really great when I resume. The intensity of feeling seems to lessen the more frequently I masturbate, but it comes right back if I decrease the frequency. This doesn't sound as though my body is building a tolerance to masturbation the way it might to alcohol, nicotine, or heroin. By now I'm ready to say I don't think I can become addicted to masturbation — but I can become obsessed with it, just as I could become obsessed with many other kinds of behavior. Obsessive behavior is characterized by excessive repetition of some act. [Editor's Note: The repeated up-and-down movement of the hand isn't necessarily the "repetition of some act"!]Next, let's look at some other ideas that seem to apply both to obsession and addiction. Substances and behaviors can be addictive/obsessive to some people and not to others. And there are degrees of addiction/obsession.Take alcohol as an example. You may know people who drink responsibly. They can control their drinking so they always drink at appropriate times and places, and moderately so they don't become drunk and lose control of themselves inappropriately. You might know others who occasionally get drunk and lose control, even though most of the time they drink responsibly. And you might know a few unfortunate people who are addicted to alcohol. They are drunk more than they are sober, can't drive or hold a job, and have alienated their families because they cannot control their alcohol consumption. Alcohol is also destroying their bodies, and they are likely to die young because it attacks the liver and other organs.The physical and psychological dynamics of addiction are at least partially understood, but we still don't understand completely why some people can control their use of a substance such as alcohol, where others have no control at all. There is much obsessive-compulsive behavior connected with addiction. You might have heard of Alcoholics Anonymous, the highly successful program that helps people deal with their alcohol addiction. Much of that program deals with controlling obsessive-compulsive behavior. So it is possible that if you have the genetic predisposition, and if early childhood experiences contributed to it, you could become obsessed with masturbation to the extent that it harms you. But I think the chance is slight.Some people ask counselors or newspaper advice columnists if they are "addicted" to alcohol, drugs, sex, or whatever concerns them because they do a lot of it. And some people have written to JackinWorld to say they are worried about being addicted to masturbation because they do it so much. I think often they are referring to an obsession rather than addiction.Whether obsession or addiction, one way you can answer questions like these is to see if you can stop for a while without suffering major physical symptoms, such as getting the shakes or becoming ill. (Humping the davenport, doorknob, or barbecue grill does not count! Nor does running around going berserk. Yes, it's stressful, but we're talking major physical symptoms here.)Another way to answer questions such as these is to ask yourself to assess negative consequences. If you have been fired from your last three jobs because you missed work too much due to being hung over, you were arrested last week for drunk driving, and your wife just filed for divorce because last night you fell asleep on the front sidewalk and the neighbors complained, these are all strong suggestions that you are addicted to alcohol. If you were suspended from school yesterday for excessive tardiness (because you stayed home masturbating in the morning before going to school), or your parents had to come to the police station to pick you up because you were caught masturbating in a downtown park at noon, or you spurn sex with your partner because you prefer to masturbate exclusively, you are probably obsessed with masturbation.Most of us, however, can control our behavior so that it is appropriate. We masturbate in private — in bed at night, when we are home alone, or in a toilet stall or bathroom behind a locked door. In such cases, I can't see masturbation as an addiction or obsession — compelling, perhaps, but not an immobilizing addiction or obsession. Even if you do it a lot — a whole lot — it still is not an addiction or obsession unless you find it having some major, harmful consequences in your life.If you do find that masturbation is hurting you and you want to stop (or just cut down), you need to seek professional help near where you live. One way to find this kind of help is to call a local crisis hotline. These community services are listed in the blue pages of your telephone directory, along with government agencies and offices. They can refer you to an agency that can help you.Masturbation plays a big role in a normal sex life. Some of us discover it as children because it starts to feel so good between our legs. Others are shown by our friends. We continue to masturbate because it feels so good. It gets us ready for mature sexual relationships when we reach adulthood, and it helps us take care of those raging hormonal urges and surges when we are teenagers. Masturbation can enhance mature sexual relationships where two partners use it either as a prelude to other sexual activity, or as the main fare. And it keeps us going when relationships falter, such as when a partner is ill or away. It is a great equalizer in a relationship where one partner needs more sexual activity than the other. All of these uses of masturbation were reported by mature JackinWorld readers in response to the Adult Masturbation Survey undertaken last year. So stroke on in the comfort and joy of knowing that you probably are not addicted to or obsessed with masturbation, no matter how compelling it may be to you or how often you do it. And now you have some guidelines to help assess whether you are developing an obsession, and if so, what you can do about it.

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Masturbation techniques?

Masturbation is the physical stimulation of the sexual organs to produce feelings of pleasure. If you're a male and your body has matured to a certain point, masturbating will eventually result in semen (fluid containing sperm cells, among other things) being expelled from the penis, usually accompanied by a very good whole-body feeling known as orgasm.

Positions or techniques?

Just about every successful masturbation session begins with getting an erection (ee-RECK-shun), commonly called a "hard-on," "boner," or "woody." An erection occurs when your penis fills with blood to the point that it becomes quite a bit larger and firm to the touch, usually sticking straight out from your body or angled upward as you stand. (If you're lying on your back, your erect penis might rest against your abdomen.) Getting an erection is usually as easy as thinking sexy thoughts and rubbing your penis. If you're going through puberty, or if you haven't ejaculated in a while, you may not have to do anything to get an erection — they can happen spontaneously, or without provocation. This is normal and just one of those puberty things everyone has to deal with.Once your penis has reached its full length and hardness, take a hold of it and rub it lengthwise at a consistent rate. This will mimic what it feels like to move your penis in and out of a woman's vagina, which is what happens during sexual intercourse.
Here are four basic "grips" you can try. They're really just starting points; it's important for you to try little variations on them, as this will allow you to choose techniques that feel best to you.

THE FIST
In this common technique, you simply wrap your fingers around the shaft of your penis like a baseball bat and rub it up and down. It provides lots of contact between your hand and penis — and more contact means more pleasure. This technique is especially good if you have a big penis; if it isn't much longer than your fist is wide, you won't be able to stroke it very far, so another grip might be more effective.

THE FIVE-FINGER
In this technique, your hand and arm form an angle with your penis, with four fingers on top of the shaft at a diagonal and your thumb below. This allows you to get more control over the hand-to-penis contact, and it lets you move your hand along the entire length of the shaft, even if your penis isn't very large.

THE THREE-FINGER

This one is good if you have a smaller penis. Simply hold the penis as you would a pen or a pencil. This grip allows maximum control and maximum distance of motion (from the base of the penis all the way to the head), but the hand-to-penis contact is less than with the other grips.

THE BACKHAND
This one — kind of a backwards version of the "fist" — is a little funny, but it feels very good. This time, grab your penis from the left side rather than the right (if you're right-handed). To do this, rotate your wrist so your thumb is pointing down; you may have to pull your penis slightly to the side. It's a little awkward at first, but it's an excellent grip to use when you just want to try something other than the "Fist" for a few minutes.

IS MASTURBATION ADDICTIVE?

Okay, so you've discovered this really nifty thing to do with the equipment between your legs, and it gives you some of the most intense feelings of pleasure you've ever felt. In fact, it's been so pleasurable you have begun to do it a lot — a whole lot. And now you might be wondering what you've gotten yourself into. You might have read somebody's comment about how addictive masturbation is. Or, you might have noticed how similar the desire to masturbate is to what you understand addiction to be. In short, you want to know if this practice is going to take control of your life and hurt you. Honestly, I think the answer is, "It depends" — one of those wishy-washy, yes-and-no, weasel answers. But it really does depend on a number of factors in your life, on how you experience masturbation, and what kinds of consequences masturbation has for you. To answer the question well, we need to review some knowledge about addiction.
First, consider the dictionary definition of the word. Webster's Collegiate Dictionary, 10th Edition, gives two:1. The quality or state of being addicted [to an activity or thing] (such as, being "addicted to reading")2. Compulsive need for and use of a habit-forming substance (such as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal.Broadly — persistent, compulsive use of a substance known by the user to be harmful.In the second definition the phrase, "characterized by tolerance," means that over time the body builds a resistance to a substance such as alcohol, so that increased amounts are needed to get what feels like the same effect. Let's see how these definitions apply to what you and I know about masturbation.The first definition seems to be a lighter, more general use of the word "addiction" — much as we might say, "I just love to read (or masturbate)." The second definition is heavier and gets more to the heart of the concern that masturbation could be addictive. My experience has been that masturbation feels so good it can feel quite compelling. Since I discovered it, my desire to masturbate persisted, even in the face of strong discouragement from my mother when I was a boy. During adolescence, I think I was obsessed with it. As I grew older, the practice took its place among other very satisfying interests in my life. From what I have read at JackinWorld, I think my growth into adulthood is similar to that of many other men.When I have masturbated frequently, it has taken longer to achieve subsequent orgasms, and their intensity has seemed to diminish. This seems like it might be "tolerance," except for the fact that when my masturbation frequency decreases, the old intensity returns. I have never believed masturbation to be harmful to me. At times, for one reason or another, I have gone a long time without masturbating; I don't remember having any strong physical signs of withdrawal during these times — but when I resumed, the intensity of the orgasm was both astonishing and highly satisfying.So, when I try to fit my experience of masturbation to the definition of addiction, it seems to fit only slightly. Yes, masturbation is compelling. However, I don't get strong physical reactions if I abstain, even though it feels really great when I resume. The intensity of feeling seems to lessen the more frequently I masturbate, but it comes right back if I decrease the frequency. This doesn't sound as though my body is building a tolerance to masturbation the way it might to alcohol, nicotine, or heroin. By now I'm ready to say I don't think I can become addicted to masturbation — but I can become obsessed with it, just as I could become obsessed with many other kinds of behavior. Obsessive behavior is characterized by excessive repetition of some act. [Editor's Note: The repeated up-and-down movement of the hand isn't necessarily the "repetition of some act"!]Next, let's look at some other ideas that seem to apply both to obsession and addiction. Substances and behaviors can be addictive/obsessive to some people and not to others. And there are degrees of addiction/obsession.Take alcohol as an example. You may know people who drink responsibly. They can control their drinking so they always drink at appropriate times and places, and moderately so they don't become drunk and lose control of themselves inappropriately. You might know others who occasionally get drunk and lose control, even though most of the time they drink responsibly. And you might know a few unfortunate people who are addicted to alcohol. They are drunk more than they are sober, can't drive or hold a job, and have alienated their families because they cannot control their alcohol consumption. Alcohol is also destroying their bodies, and they are likely to die young because it attacks the liver and other organs.The physical and psychological dynamics of addiction are at least partially understood, but we still don't understand completely why some people can control their use of a substance such as alcohol, where others have no control at all. There is much obsessive-compulsive behavior connected with addiction. You might have heard of Alcoholics Anonymous, the highly successful program that helps people deal with their alcohol addiction. Much of that program deals with controlling obsessive-compulsive behavior. So it is possible that if you have the genetic predisposition, and if early childhood experiences contributed to it, you could become obsessed with masturbation to the extent that it harms you. But I think the chance is slight.Some people ask counselors or newspaper advice columnists if they are "addicted" to alcohol, drugs, sex, or whatever concerns them because they do a lot of it. And some people have written to JackinWorld to say they are worried about being addicted to masturbation because they do it so much. I think often they are referring to an obsession rather than addiction.Whether obsession or addiction, one way you can answer questions like these is to see if you can stop for a while without suffering major physical symptoms, such as getting the shakes or becoming ill. (Humping the davenport, doorknob, or barbecue grill does not count! Nor does running around going berserk. Yes, it's stressful, but we're talking major physical symptoms here.)Another way to answer questions such as these is to ask yourself to assess negative consequences. If you have been fired from your last three jobs because you missed work too much due to being hung over, you were arrested last week for drunk driving, and your wife just filed for divorce because last night you fell asleep on the front sidewalk and the neighbors complained, these are all strong suggestions that you are addicted to alcohol. If you were suspended from school yesterday for excessive tardiness (because you stayed home masturbating in the morning before going to school), or your parents had to come to the police station to pick you up because you were caught masturbating in a downtown park at noon, or you spurn sex with your partner because you prefer to masturbate exclusively, you are probably obsessed with masturbation.Most of us, however, can control our behavior so that it is appropriate. We masturbate in private — in bed at night, when we are home alone, or in a toilet stall or bathroom behind a locked door. In such cases, I can't see masturbation as an addiction or obsession — compelling, perhaps, but not an immobilizing addiction or obsession. Even if you do it a lot — a whole lot — it still is not an addiction or obsession unless you find it having some major, harmful consequences in your life.If you do find that masturbation is hurting you and you want to stop (or just cut down), you need to seek professional help near where you live. One way to find this kind of help is to call a local crisis hotline. These community services are listed in the blue pages of your telephone directory, along with government agencies and offices. They can refer you to an agency that can help you.Masturbation plays a big role in a normal sex life. Some of us discover it as children because it starts to feel so good between our legs. Others are shown by our friends. We continue to masturbate because it feels so good. It gets us ready for mature sexual relationships when we reach adulthood, and it helps us take care of those raging hormonal urges and surges when we are teenagers. Masturbation can enhance mature sexual relationships where two partners use it either as a prelude to other sexual activity, or as the main fare. And it keeps us going when relationships falter, such as when a partner is ill or away. It is a great equalizer in a relationship where one partner needs more sexual activity than the other. All of these uses of masturbation were reported by mature JackinWorld readers in response to the Adult Masturbation Survey undertaken last year. So stroke on in the comfort and joy of knowing that you probably are not addicted to or obsessed with masturbation, no matter how compelling it may be to you or how often you do it. And now you have some guidelines to help assess whether you are developing an obsession, and if so, what you can do about it.

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What is hyperthyroidism?

Hyperthyroidism is a condition in which an overactive thyroid gland is producing an excessive amount of thyroid hormones that circulate in the blood. ("Hyper" means "over" in Greek). Thyrotoxicosis is a toxic condition that is caused by an excess of thyroid hormones from any cause. Thyrotoxicosis can be caused by an excessive intake of thyroid hormone or by overproduction of thyroid hormones by the thyroid gland.

What are thyroid hormones?

Thyroid hormones stimulate the metabolism of cells. They are produced by the thyroid gland. The thyroid gland is located in the lower part of the neck, below the Adam's apple. The gland wraps around the windpipe (trachea) and has a shape that is similar to a butterfly formed by two wings (lobes) and attached by a middle part (isthmus).
The thyroid gland removes iodine from the blood (which comes mostly from a diet of foods such as seafood, bread, and salt) and uses it to produce thyroid hormones. The two most important thyroid hormones are thyroxine (T4) and triiodothyronine (T3) representing 99.9% and 0.1% of thyroid hormones respectively. The hormone with the most biological activity (for example, the greatest effect on the body) is actually T3. Once released from the thyroid gland into the blood, a large amount of T4 is converted to T3 - the more active hormone that affects the metabolism of cells.

What causes hyperthyroidism?

Some common causes of hyperthyroidism include:
Graves' Disease
Functioning adenoma ("hot nodule") and Toxic Multinodular Goiter (TMNG)
Excessive intake of thyroid hormones
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake

Graves' Disease

Graves' disease, which is caused by a generalized overactivity of the thyroid gland, is the most common cause of hyperthyroidism. In this condition, the thyroid gland usually is renegade, which means it has lost the ability to respond to the normal control by the pituitary gland via TSH. Graves' disease is hereditary and is up to five times more common among women than men. Graves' disease is thought to be an autoimmune disease, and antibodies that are characteristic of the illness may be found in the blood. These antibodies include thyroid stimulating immunoglobulin (TSI antibodies), thyroid peroxidase antibodies (TPO), and TSH receptor antibodies. The triggers for Grave's disease include:
stress, smoking, radiation to the neck, medications, and infectious organisms such as viruses.

Graves' disease can be diagnosed by a standard, nuclear medicine thyroid scan which shows diffusely increased uptake of a radioactively-labeled iodine. In addition, a blood test may reveal elevated TSI levels.

Grave's disease may be associated with eye disease (Graves' ophthalmopathy) and skin lesions (dermopathy ). Ophthalmopathy can occur before, after, or at the same time as the hyperthyroidism. Early on, it may cause sensitivity to light and a feeling of "sand in the eyes." The eyes may protrude and double vision can occur. The degree of ophthalmopathy is worsened in those who smoke. The course of the eye disease is often independent of the thyroid disease, and steroid therapy may be necessary to control the inflammation that causes the ophthalmopathy. In addition, surgical intervention may be required. The skin condition (dermopathy) is rare and causes a painless, red , lumpy skin rash that appears on the front of the legs.

Functioning Adenoma and Toxic Multinodular Goiter

The thyroid gland (like many other areas of the body) becomes lumpier as we get older. In the majority of cases, these lumps do not produce thyroid hormones and require no treatment. Occasionally, a nodule may become "autonomous," which means that it does not respond to pituitary regulation via TSH and produces thyroid hormones independently. This becomes more likely if the nodule is larger that 3 cm. When there is a single nodule that is independently producing thyroid hormones, it is called a functioning nodule. If there is more than one functioning nodule, the term toxic, multinodular goiter is used. Functioning nodules may be readily detected with a thyroid scan.
Excessive intake of thyroid hormones
Taking too much thyroid hormone medication is actually quite common. Excessive doses of thyroid hormones frequently go undetected due to the lack of follow-up of patients taking their thyroid medicine. Other persons may be abusing the drug in an attempt to achieve other goals such as weight loss. These patients can be identified by having a low uptake of radioactively-labelled iodine (radioiodine) on a thyroid scan.

Abnormal secretion of TSH

A tumor in the pituitary gland may produce an abnormally high secretion of TSH (the thyroid stimulating hormone). This leads to excessive signaling to the thyroid gland to produce thyroid hormones. This condition is very rare and can be associated with other abnormalities of the pituitary gland. To identify this disorder, an endocrinologist performs elaborate tests to assess the release of TSH.

Thyroiditis (inflammation of the thyroid)

Inflammation of the thyroid gland may occur after a viral illness (subacute thyroiditis). This condition is association with a fever and a sore throat that is often painful on swallowing. The thyroid gland is also tender to touch. There may be generalized neck aches and pains. Inflammation of the gland with an accumulation of white blood cells known as lymphocytes (lymphocytic thyroiditis) may also occur. In both of these conditions, the inflammation leaves the thyroid gland "leaky," so that the amount of thyroid hormone entering the blood is increased. Lymphocytic thyroiditis is most common after a pregnancy and can actually occur in up to 8% of women after delivery. In these cases, the hyperthyroid phase can last from 4 to 12 weeks and is often followed by a hypothyroid (low thyroid output) phase that can last for up to 6 months. The majority of affected women return to a state of normal thyroid function. Thyroiditis can be diagnosed by a thyroid scan.

Excessive iodine intake

The thyroid gland uses iodine to make thyroid hormones. An excess of iodine may cause hyperthyroidism. Iodine-induced hyperthyroidism is usually seen in patients who already have an underlying abnormal thyroid gland. Certain medications, such as amiodarone (Cordarone), which is used in the treatment of heart problems, contain a large amount of iodine and may be associated with thyroid function abnormalities.

What are the symptoms of hyperthyroidism?

Hyperthyroidism is suggested by several signs and symptoms; however, patients with mild disease usually experience no symptoms. In patients older than 70 years, the typical signs and symptoms also may be absent. In general, the symptoms become more obvious as the degree of hyperthyroidism increases. The symptoms usually are related to an increase in the metabolic rate of the body.

Common symptoms include:
Excessive sweating
Heat intolerance
Increased bowel movements
Tremor (usually fine shaking)
Nervousness; agitation
Rapid heart rate
Weight loss
Fatigue
Decreased concentration
Irregular and scant menstrual flow
In older patients, irregular heart rhythms and heart failure can occur. In its most severe form, untreated hyperthyroidism may result in "thyroid storm," a condition involving high blood pressure, fever, and heart failure. Mental changes, such as confusion and delirium, also may occur.

How is hyperthyroidism diagnosed?

Hyperthyroidism can be suspected in patients with:

tremors,
excessive sweating,
smooth velvety skin,
fine hair,
a rapid heart rate, and
an enlarged thyroid gland.

There may be puffiness around the eyes and a characteristic stare due to the elevation of the upper eyelids. Advanced symptoms are easily detected, but early symptoms, especially in the elderly, may be quite inconspicuous. In all cases, a blood test is needed to confirm the diagnosis.
The blood levels of thyroid hormones can be measured directly and usually are elevated with hyperthyroidism. However, the main tool for detection of hyperthyroidism is measurement of the blood TSH level. As mentioned earlier, TSH is secreted by the pituitary gland. If an excess amount of thyroid hormone is present, TSH is "down-regulated" and the level of TSH falls in an attempt to reduce production of thyroid hormone. Thus, the measurement of TSH should result in low or undetectable levels in cases of hyperthyroidism. However, there is one exception. If the excessive amount of thyroid hormone is due to a TSH-secreting pituitary tumor, then the levels of TSH will be abnormally high. This uncommon disease is known as "secondary hyperthyroidism."

Although the blood tests mentioned previously can confirm the presence of excessive thyroid hormone, they do not point to a specific cause. If there is obvious involvement of the eyes, a diagnosis of Graves' disease is almost certain. A combination of antibody screening (for Graves' disease) and a thyroid scan using radioactively-labelled iodine (which concentrates in the thyroid gland) can help diagnose the underlying thyroid disease. These investigations are chosen on a case-by-case basis.

How is hyperthyroidism treated?
The options for treating hyperthyroidism include:
Treating the symptoms
Antithyroid drugs
Radioactive iodine

Surgery treating symptoms

Treating the symptoms

There are medications available to immediately treat the symptoms caused by excessive thyroid hormones, such as a rapid heart rate. One of the main classes of drugs used to treat these symptoms is the beta-blockers [for example, propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor)]. These medications counteract the effect of thyroid hormone to increase metabolism, but they do not alter the levels of thyroid hormones in the blood. A doctor determines which patients to treat based on a number of variables including the underlying cause of hyperthyroidism, the age of the patient, the size of the thyroid gland, and the presence of coexisting medical illnesses.

Antithyroid Drugs

There are two main antithyroid drugs available for use in the United States, methimazole (Tapazole) and propylthiouracil ( PTU). These drugs accumulate in the thyroid tissue and block production of thyroid hormones. PTU also blocks the conversion of T4 hormone to the more metabolically active T3 hormone. The major risk of these medications is occasional suppression of production of white blood cells by the bone marrow (agranulocytosis). (White cells are needed to fight infection.) It is impossible to tell if and when this side effect is going to occur, so regular determination of white blood cells in the blood are not useful.
It is important for patients to know that if they develop a fever, a sore throat, or any signs of infection while taking methimazole or propylthiouracil, they should see a doctor immediately. While a concern, the actual risk of developing agranulocytosis is less than 1%. In general, patients should be seen by the doctor at monthly intervals while taking antithyroid medication. The dose is adjusted to maintain the patient in as close to a normal thyroid state as possible (euthyroid). Once the dosing is stable, patients can be seen at three month intervals if long-term therapy is planned.

Usually, long-term antithyroid therapy is only used for patients with Graves' disease, since this disease may actually go into remission under treatment without requiring treatment with thyroid radiation or surgery. If treated from one to two years, the data shows remission rates of 40%-70%. When the disease is in remission, the gland is no longer overactive, and antithyroid medication is not needed.

Recent studies also have shown that adding a pill of thyroid hormone to the antithyroid medication actually results in higher remission rates. The rationale for this may be that by providing an external source for thyroid hormone, higher doses of antithyroid medications can be given, which may suppress the overactive immune system in persons with Graves' disease. This type of therapy remains controversial, however. When long-term therapy is withdrawn, patients should continue to be seen by the doctor every three months for the first year, since a relapse of Graves' disease is most likely in this time period. If a patient does relapse, antithyroid drug therapy can be restarted, or radioactive iodine or surgery may be considered.

Radioactive Iodine

Radioactive iodine is given orally (either by pill or liquid) on a one-time basis to ablate a hyperactive gland. The iodine given for ablative treatment is different from the iodine used in a scan. (For treatment, the isotope iodine 131 is used, while for a routine scan, iodine 123 is used.) Radioactive iodine is given after a routine iodine scan, and uptake of the iodine is determined to confirm hyperthyroidism. The radioactive iodine is picked up by the active cells in the thyroid and destroys them. Since iodine is only picked up by thyroid cells, the destruction is local, and there are no widespread side effects with this therapy.

Radioactive iodine ablation has been safely used for over 50 years, and the only major reasons for not using it are pregnancy and breast-feeding. This form of therapy is the treatment of choice for recurring Graves' disease, patients with severe cardiac involvement, those with multinodular goiter or toxic adenomas, and patients who cannot tolerate antithyroid drugs. Radioactive iodine must be used with caution in patients with Graves' related eye disease since recent studies have shown that the eye disease may worsen after therapy. If a woman chooses to become pregnant after ablation, it is recommended she wait 8-12 months after treatment before conceiving.

In general, more than 80% of patients are cured with a single dose of radioactive iodine. It takes between 8 to 12 weeks for the thyroid to become normal after therapy. Permanent hypothyroidism is the major complication of this form of treatment. While a temporary hypothyroid state may be seen up to six months after treatment with radioactive iodine, if it persists longer than six months, thyroid replacement therapy (with T4 or T3) usually is begun.

Surgery

Surgery to partially remove the thyroid gland (partial thyroidectomy) was once a common form of treatment for hyperthyroidism. The goal is to remove the thyroid tissue that was producing the excessive thyroid hormone. However, if too much tissue is removed, an inadequate production of thyroid hormone (hypothyroidism) may result. In this case, thyroid replacement therapy is begun. The major complication of surgery is disruption of the surrounding tissue, including the nerves supplying the vocal cords and the four tiny glands in the neck that regulate calcium levels in the body (the parathyroid glands). Accidental removal of these glands may result in low calcium levels and require calcium replacement therapy.
With the introduction of radioactive iodine therapy and antithyroid drugs, surgery for hyperthyroidism is not as common as it used to be. Surgery is appropriate for:
pregnant patients and children who have major adverse reactions to antithyroid medications.
patients with very large thyroid glands and in those who have symptoms stemming from compression of tissues adjacent to the thyroid, such as difficulty swallowing, hoarseness, and shortness of breath.

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