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premature ejaculation

Questions and Answers About Ejaculation Control


One of the most discussed topics in this men’s health blog is premature ejaculation, and in fact most of the questions from our readers have to do with this topic.

That is why we decided to summarize the information of the different articles that we publish on premature ejaculation and present the most frequently asked questions about it with their corresponding answers.

How could you define premature ejaculation? Is there a normal time of sexual intercourse or intercourse?

The best sexologist in Delhi, Dr. P K Gupta explains that it is necessary to consider the time elapsed from vaginal penetration to ejaculation, the inability to delay ejaculation and the resulting negative personal consequences of the problem. Consequently, sex doctor in Delhi defined lifelong or primary premature ejaculation as a male sexual dysfunction characterized by:

-Ejaculation that always or almost always occurs before or within approximately one minute of vaginal penetration.

-The inability to delay ejaculation in all or almost all vaginal penetrations.

-The negative personal consequences such as anguish, annoyance, frustration and / or the avoidance of sexual intimacy.

Is premature ejaculation frequent?

It is definitely much more prevalent than most people realize. However, we do not have unified figures, and in fact they vary considerably. The highest prevalence rate that has been documented to date is 31% (in men between 18 and 59 years old) and was found in the National Survey of Health and Social Life of the United States of America. However, the prevalence is unlikely to be that high considering the relatively low number of men presenting for consultation with sexologist in Delhi for this symptom.

Are there different degrees of premature ejaculation?

According to the sex specialist doctor in Delhi, three degrees are established:

Grade I or Mild . After penetration and a few coital movements.

Grade II or Moderate . Immediately after penetration, it is also called ante portas .

Grade III or Severe . Before penetration, also recognized as ultra early .

What are the causes of premature ejaculation?

Several causes of premature ejaculation have been established, both from a biological and psychological point of view: generalized anxiety, penile hypersensitivity, performance anxiety, genetic predisposition, poor general health and obesity, inflammation of the prostate, hormone disorders thyroid, diabetes, emotional problems and stress, bad masturbatory habits, traumatic sexual experiences, chronic prostatitis, among others.

Sex specialist in Delhi highlights the particular negative influence of rapid self-stimulation habits, when the man seeks a sexual discharge instead of trying to prolong the pleasure of arousal prior to orgasm. On the other hand, anxiety about sexual performance, understood as the marked (almost obsessive) concern about not ejaculating quickly, generates a physiological acceleration and the lack of awareness of the levels of arousal, perpetuating the problem.

Are there sexual positions that favor or complicate ejaculatory control?

In general, the posture that allows better control is the one in which the couple sits on top of the man, who is lying on his back. In this case, he is physically relaxed and can better perceive the signals of sexual arousal, a fundamental condition for ejaculatory control.

Lateral postures also make it easier to control ejaculation. This is possible because the penetration is not very deep, and the movements in general are not as fast as in other cases.

In general, the missionary position, that is, the man on top, is not favorable for the control of ejaculation since the body is tense, the penis enters the vagina more precisely and in general the position leads to an unstoppable race towards orgasm. In a few cases, men state that it is the best position for them because they better manage the speed and depth of coital movements.

What are the main compensation mechanisms used by men with problems to control ejaculation?

The folkloric methods are many, some really unusual and even counterintuitive. In the consultation during the sex treatment in Delhi we frequently hear the following: mental distraction –thinking of non-sexual or anti-erotic images, drinking alcohol, smoking marijuana, prior masturbation, causing pain by biting or pinching the skin, among others.

How are the treatments for premature ejaculation?

The recommendation of the current protocols is to coordinate medical and psychological treatment (focused on sexual symptoms). According to current scientific evidence, drug therapy is superior in reducing premature ejaculation symptoms compared to psychological treatment alone. However, the pertinent psychological problems and mechanisms should not be overlooked, and it is important to treat, for example, levels of performance anxiety and modify dysfunctional sexual habits for a definitive solution to the problem.

Behavior therapy methods include the stop-start technique and the squeeze technique. Another possible therapy, increasingly recommended by sexologist doctor in Delhi, is pelvic floor rehabilitation exercises. All of these behavioral therapy approaches have the potential to be beneficial when combined with drug treatment.

The topical methods are a simple local treatment modality, wherein the lidocaine-prilocaine cream studied most. The results of research on these types of therapies indicated that the duration of vaginal penetration increased 6.3 times.

We definitely have a lot of evidence and therapeutic tools to help our patients with a premature ejaculation diagnosis. Timely consultation is key to short and effective premature ejaculation treatment in Delhi.


What is sleep paralysis?

What is sleep paralysis?

What is sleep paralysis? After the anatomy of dreams video many of you were asking the question “what is sleep paralysis?” and why does it happen? In this video we’re going to cover the neurobiology and neuroscience of sleep paralysis and try to uncover some of the fascinating theory behind why it happens.


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Killar to Kishtwar – The world’s most dangerous road

Killar to Kishtwar – The world’s most dangerous road


Killar to Kishtwar road journey has rightfully been named the most dangerous road in the world. This road has humbled many egos. It’s not for the faint-hearted and most definitely should not be attempted by novice drivers. The road is in dreadful condition and requires strong nerves to negotiate it. With a frightening high mountain trail, the total length of journey is 114 km.


Officially becoming a district in 2007, Kishtwar, is known as the “Land of Sapphire and Saffron”. Virtually cut off from the rest of the world, Kishtwar is stunning and is situated 235 Kms from Jammu. One of the toughest roads in the world leads to this paradise.

This region has pretty much been closed off to mountaineers for political reasons since the early 1990s. However, with the construction of this extremely dangerous road – residents have rejoiced to the opening of their very isolated world to come commercial activity and tourism. A huge salute and shout-out to the Border Roads Organization and J&K PWD, who have done a brilliant job by constructing roads in the middle of nowhere. A record number of people have sacrificed their lives to make this road a reality. Respect the struggle and be grateful for your “adventures” and what all has been staked for you to achieve this!

About the Killar – Kishtwar Road

Part of the National Highway 26, this road runs right along the Chenab river. It’s extremely befuddling to peek over the edge, or even just to see the valleys a couple thousand feet below you. The vertical drop of hundreds of meters is insane – so it might be wise to skip this adventure on a windy day.

In terms of the road itself – it is made of gravel, stones and sand and it’s pretty much kissing the side of a cliff. Also, it is wise to warn you here of the rocks hanging down which end up obstructing your view of oncoming traffic.


This road is located at the eastern extremity of the Kishtwar District of the Jammu region in Jammu and Kashmir. Let me tell you that the road is narrow, windy and has no rails to secure your edging. Also, to add to the complexity – there is a steep gorge of 1000 ft. straight drop! Yes, the views of the valley are from another world – but, let me promise you – you DEFINITELY won’t be looking at them views. Not if you want to survive this epic journey of mammoth presence! This road gives access into Pangi Valley of Himachal Pradesh.

From Dalhousie onwards, you’d be crossing the Sach Pass to reach Killar – this journey in itself is tough and the pass will test your limits. However, after that – the journey keeps upping the ante! You’ll cover the Killar to Kishtwar journey on the toughest road there is!

Tough journeys
Tough journeys

Road Conditions

The road is so narrow that only one vehicle can (barely) pass at a time. Also, there are scores of steep inclines and declines. The road is “constructed” of rocks, loose soil, etc. To add to the difficulty, on one side there is 1000 feet freefall into the river Chandrabhaga and deadly mountain cliff hanging on other. The road condition is never constant; as it sees many landslides. One mistake and it can turn out to be disaster. There is a reason why this road has been titled as “One of the most Dangerous Roads in the World” by many travel forums and gurus!

More details about the route

The 121 KM stretch from Killar to Kishtwar is the main gateway to the basecamp of Kishtwar Kailash, a 6,451m mountain. In order to get to the trail, you can take the journey from the west, i.e. take the road from Manali towards Rohtang Pass, entering the Chenab Valley and following the route towards Darlang Valley.

There is no sugar coating this – the ascend is terrible, exhausting and WILL take a toll on your body! Obviously, you’ll be experiencing extreme lack of oxygen and the high degrees of steepness will be challenging to say the least!

Things to keep in mind when starting Killar – Kishtwar journey

While being alert at all times is necessary, there are a few things to be aware of that will help you in embarking upon this 121 KM journey


The entire journey is tough and will test your nerves. But, I must warn you that the last 50km of road to the start of the ascent will prove to be a herculean task! and words can’t describe the fear you’ll experience. All your senses will be alert to the highest degree; you’ll be evaluating in real time each step you will be taken. Some tourists had dubbed the track the ‘Almost Killer’ Road.

A few of the sections are especially narrow and barely wide enough for two cars. At certain points, if two vehicles have to pass each other, one vehicle will have to reverse for some kilometres. Doing so in winding narrow roads to get to a place wide enough to pass required professional level skills. And, if you are not completely confident in your skills to reverse (while maintaining balance in extremely narrow spaces) – then DO NOT ATTEMPT TO DRIVE here!

The road has also been nicknamed “The Cliffhanger” thanks to the extremely narrow passage. So much so that cars rarely take this route; you can forget about the buses. Some of the turns are crazy with plenty of blind-spots.

Steep cliffs
Steep cliffs


The road can get especially slippery and muddy after rain. During and after a storm the road may be impenetrable, even with a four-wheel-drive vehicle.

Another thing to keep in mind is this journey should only be made in daylight.


If you are prone to vertigo, or if you’re feeling the effects of AMS – avoid embarking on this journey. Also, if there are passengers in your vehicles who get road sick/ have mountain sickness – it will be better to wait it out and only start the journey on the best of health. You won’t be able to stop in the middle of your journey at many places. And, even if you plan on stopping – the scary cliff will make your nausea worse! This is not the journey for people who are scared of heights, are claustrophobic to test their limits! With a vertical drop of thousands of feet straight into the Chenab river, it is definitely for the brave hearts.

Last, but, most important advice is that – there is little room for error on this road. You should plan on sticking to the centre of the “road”. As the edges can sometimes simply crumble away, and there are huge rock formations which can jump out after turns and curves – this is in your best interest.

Views to keep you company - Killar - Kishtwar Journey
Views to keep you company – Killar – Kishtwar Journey


If you’re planning on visiting a paradise – Kishtwar definitely fits the bill. However, in true Himalayan style – the prettier the views, the tougher the journey. Be prepared for AMS, nausea, terrifying roads, true challenging route to get to this paradise. This is a road hacked across a vertical cliff face and driving it is a spine tingling mix of heady exhilaration and sheer fear. Traversing this road call caution, confidence and consideration towards oncoming traffic. Be prepared for the journey of a lifetime and a story to tell like no others!


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drugs addiction

How are sexual problems treated in people addicted to drugs and alcohol?


Using excessive amounts of drugs and alcohol can damage a person’s sex life in several ways. Erectile Dysfunction (ED), low libido and other sexual problems can be related to substance abuse. In addition, recovering addicts often have psychological work to do. For example, they may need to process past trauma (sexual or otherwise) or repair relationships that have been damaged by addiction, says sexologist in Delhi.

However, people who recover from drug and alcohol addiction can still have healthy sex. The following steps can help:

A thorough medical examination. Having a thorough examination with a sexologist doctor in Delhi can identify the causes of some sexual problems. For example, diabetic men often have problems with erections. A menopausal woman may have problems with vaginal lubrication. Drugs and alcohol can have a significant impact on the body in general, which can affect sexual function. A sex specialist in Delhi can offer treatments and strategies to deal with any changes.

A medication review. Along with a medical examination, it is important to review the medications that a person takes. For example, methadone can help people recover from heroin or opioid addictions, but it can also have sexual side effects, such as low testosterone levels in men. Other medications, such as antidepressants, can decrease libido and cause erectile difficulties. Sometimes adjustments need to be made. However, patients should never adjust medications on their own. This should always be done under the care of the best sexologist in Delhi.

Sexual counselling and therapy. For some patients, the use of drugs and alcohol has been a way of dealing with past sexual abuse and other traumatic events. Others may drink or use drugs if they find it difficult to accept homosexuality or feelings about gender identity. Whatever the reason, counselling can help people to process their emotions and beliefs, build their self-confidence and esteem and develop a healthy support system. Patients can also learn about communication, repairing relationships and safe sexual practices.

Lifestyle changes. Following a healthy diet and staying physically fit can improve sexual health and overall health.

A slow pace. Some sexologists in Delhi recommend that patients take too long to initiate new sexual relationships. This approach can give people more time to rebuild their lives during and after treating addiction.


What If You Die?

What If You Die?

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Your time has come! You’ve kicked the bucket, cashed in your chips, you’re pushing up the daisies. In other words, you’ve died. Sorry about your loss. How would you handle dying? What would happen to your body? And what’s on the other side?

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What If is a mini-documentary web series that takes you on an epic journey through hypothetical worlds and possibilities. Join us on an imaginary adventure — grounded in scientific theory — through time, space and chance, as we ask what if some of the most fundamental aspects of our existence were different.


sleep and sex

People who sleep 8 hours have more orgasm


There are many reasons to get a good night’s sleep. Sleeping for at least eight hours can help improve memory, curb inflammation, and sharpen your attention.

But there is another hidden benefit: those who sleep more each night have more orgasms!

Sex specialist in Delhi, Dr. P K Gupta states that sleeping more can lead to a greater increase in sexual desire and increase sex hormones, such as testosterone.

Sexologist in Delhi tells that the two are so closely linked and how not only good sleep can lead to better sex, but good sex can lead to better sleep.


Sexologist doctor in Delhi says that if you have problems with sleep or sex, it can affect others.

“A good night’s sleep can increase interest in sex and a good sexual encounter can lead to better sleep,” sex doctor in Delhi explains.

A 2015 study conducted by the University of Michigan School of Medicine found that women who slept more had more sex drive the next day.

For every additional hour women slept, the chances of having sex with their partner increased by 14%.

The same study found that more sleep also equated to better genital arousal.

“Women are balancing different demands, whether it be work or children. They feel tired and stressed.”

Best sexologist in Delhi says there are two things that can be done to improve a woman’s sexual desire.

First, sex does not have to happen overnight when you are tired. Find a different time of day,” he said.

The second is what the sex therapist calls “just do it”.

Dr. Gupta says the research has shown that most women in long-term relationships no longer feel spontaneously aroused.

They don’t realize that diminished sexual desire is expected and end up feeling that something is wrong with them, ” We think we first need to feel aroused, then have sex. But there is no need to follow this basic format,” top sexologist in Delhi explained.

“Reverse the equation because, after having sex, you will feel excited and all of these hormones will be released, and you will feel good when you are in the moment.”


Lack of chills translates into a lack of sexual desire in both sexes because it increases levels of cortisol, also known as the stress hormone.

Although this can affect women, it has a particularly powerful effect on male libido.

Along with the fact that insufficient sleep also lowers levels of the sex hormone testosterone, the impact is significant.

A University of Chicago study looked at the time and quality of sleep for men and found that men who slept four hours had significantly lower T levels than those who slept eight hours.

The problem is that cortisol and testosterone work against each other, according to several studies.

High levels of testosterone allow men to decrease body fat, build muscle and maintain a high libido.

The cortisol works exactly the opposite and leads to muscle breakdown and gain visceral fat and slow the immune system.

Not getting enough sleep can also decrease men’s sexual functioning, said sexologist in South Delhi.

A study at Donaustauf Hospital in Germany in 2009 found that men who suffer from sleep apnea are more likely to have erectile dysfunction and general sexual dysfunction.


Just as better sleep can lead to better sex, the reverse is also true, both immediate and long term.

The reason is mainly biological. After orgasm, our body releases a hormone called oxytocin, also known as the “cuddle hormone” (others call it the love hormone).

Oxytocin triggers drowsiness immediately because it counteracts the effects of cortisol.

Sexologist in East Delhi explains that physical contact during sex can also help to improve long-term sleep.

“When you are in physical contact, you experience reduced stress, which in turn helps you to relax and therefore falls asleep,” sexologist in Delhi said.

Studies have shown that intimate touch can help lower blood pressure and heart rate, relieve pain, and reaffirm bonds within relationships.

There are also gender-specific benefits to how good sex helps us sleep.

In women, sex increases the levels of the hormone estrogen. Estrogen is a hormone that maintains sleep and high levels have been shown to improve the quality of sleep, reduce the time to fall asleep and increase the amount of REM sleep (deepest sleep phase).

The effect on women is long-term. There is a natural decrease in estrogen levels after women enter menopause, which is why postmenopausal women are more likely to suffer from insomnia.

For men, among the many hormones they release during ejaculation, one is a biochemist known as prolactin.

Prolactin levels are naturally higher during sleep, and research shows that animals injected with the chemical get tired immediately.


Kanamo Peak Trek: the MOST COMPLETE guide

Kanamo Peak Trek: the MOST COMPLETE guide


The Kanamo Peak is situated at a staggering height of 19,600 ft. Imminent behind Kibber and Tashi Gang villages, the peak is hidden away in the depths of Spiti Valley. Extreme isolation, the Kanamo Peak trek is situated in an area which is untouched by modernity and unperturbed by civilization. If you are on the hunt for a trek that will lead you to the most stunning and picturesque views, while challenging you mentally and physically – Kanamo makes for a wonderful comparable alternative to Stok Kangri trek.

Kaza-Langza road
Winding roads around Kaza

About Kanamo Peak Trek

Serial trekkers and nature enthusiasts often speak about climbing unthinkable heights! There is a charm and heroic attached to conquering mountains of that magnitude. Kanamo is a trekkable peak. And, what I mean by that is you don’t require pro-level mountaineering skills to maneuver your way to the top. What you do require is proper acclimatization, sound knowledge of your surroundings and a keen understanding of your own body!

A similar peak that has become highly popular among trekkers for its trekability is Stok Kangri at 20,190 Ft. Kanamo trumps Stok Kangri because of its seclusion. Stok has become somewhat commercialized and if you’re seeking true isolation and one-ness with nature – Kanamo fits the bill!

Fitness Requirements

Now, do note that while this is a trekkable – it is by no means easy. There is a requirement for high endurance and physical fitness. In order to conquer the summit, you’ll traverse through a relentless climb! Combating altitude related problems adds to the difficulty. Also, on the final day – you’ll have to ascend almost 4,500 Ft to reach the peak and descend back to the base camp on the same day!

But, once you reach the top – the views are magnanimous! 360 degree views of equally majestic mountains around you – is no short of looking at mountains as if from a flight! The Shilla Peak, Kanamo’s sister peak is so close, you can almost reach out and feel it.

Beautiful views when moving through the hills
Beautiful views when moving through the hills

How to get to the basecamp: Kaza

The Kanamo trek starts from Kaza, a beautiful town along the Spiti river & a major town of Spiti Valley. The route to reach your basecamp of Kaza is through Delhi/Chandigarh – Manali – Kaza or from Delhi/Chandigarh – Shimla – Kinnaur Valley – Kaza.

Reaching Kaza

While we have discussed this at length covering the Spiti Valley and itineraries related to the area – basically, you’ll need to take an overnight bus from Delhi or Chandigarh to Manali, reaching early in the morning. From here, the journey towards Kaza is 10 hours in total and a private cab can take you anywhere from 10,000 – 13,000 for a SUV. This cost can, of course, be shared with fellow passengers by way of a shared taxi! To know more details and alternative routes, do check out the Spiti guides.

Detailed itinerary for Kanamo Peak Trek

The detailed itinerary will prepare you with what to expect and how to navigate your way through the trek!

Day 0 – Beginning of your journey (14 hours, 550 km)

Start your journey from Delhi/Chandigarh towards Manali. Preferably, leave late at night by an overnight bus.

Day 1 – Manali (6,725 ft.)

Reach early in the morning and rest. Explore Manali and surrounding areas, as per your fancies! There is a lot to do in this beautiful town – lots of lovely cafes and some super delicious food! The views by the river are majestic. Enjoy your day here!

Also, do note that there are all sorts of accommodations available – from luxury to budget – depending on your preferences. Manali has a wide range of hotels that you can choose from, according to your budget and preferences.

Remember to not overdo it, however. You have a long journey tomorrow!

Beauties of Spiti Valley
Beauties of Spiti Valley

Day 2: Drive from Manali to Kaza (10 hours, 204 km, 12,467 ft.)

Today is going to be a long journey for you! Leave as early in the AM as possible. Since you’ll be crossing two major passes of Rohtang and Kunzum, I should tell you that these are known of TERRIBLE traffic jams. Hence, leave before the sun rises, preferably!

You will be taking the route towards Batal, crossing Rohtang Pass on the Manali-Leh Highway. Once you reach Gramphu, you’ll spot a diversion towards Batal-Kaza. This is the route you’ll be taking. Post Batal, you’ll be in the true Spiti Valley with tiny little villages and arid landscapes. You will have the best time gazing out your vehicle at this world so far from what you experience in the day to day life.

You’ll reach Kaza after a long journey. There are plenty of stay options available here. This is your Day 1 of acclimatization.

Day 3: Kaza to Kibber (1 hour, 19 KMs, 14108 ft.)

Today is going to be an easy-breezy day. With a short one-hour drive to Kibber – you’ll be mostly acclimatizing today. Once you’re settled into your homestay – go out and explore the town. One AMAZING place that must be on your to-do list is the Key Monastery. The stunning views combined with the generations of history will leave you mesmerized, to say the lease. The Key Monastery sits atop a hill while the Spiti river trickles past in the desert mountain valley – straight out of a picture book!

You should take full advantage of the visit to Key. Interact with monks who will happily take you across the compound. Here, you must plan on visiting the prayer rooms and browse through some of the old manuscripts. It truly is an experience to be surrounded by so much history and witnessing a time lapse is definitely eye-opening.

Today, you should also plan on squeezing in an acclimatization walk. What this basically entails are climbing up a hill gradually, gaining more elevation as you go on to get your body used to being at higher altitudes. Since you’ll be sleeping in Kibber – your body would have gone to a higher elevation and come back down – getting used to the limited availability of oxygen and how to function on that. Ideally, you should climb for about an hour to an hour and a half. Also, this will provide you an idea on what to expect in days to come!

Post your acclimatization walk – I suggest you explore Kibber and truly indulge yourself into the experience and culture of the place. The village is tiny, with about 80 households and people are generally friendly and extremely wonderful to interact with.

Day 4: Acclimatization day at Kibber

Another day to acclimatize, get your body used to the high altitude. You may even take up another walk to explore the nearby hills and surrounding areas. This is an important day and should not be skipped. Also, it provides you with ample opportunity to actually squeeze in some rest before you have to hit the soil, literally!

Day 5: Kibber to Kanamo Base camp (6.5 hours, 5km, 15,748 ft.)

Your journey begins in its earnest!!! You’ll be fighting exciting, anxious nerves along with a lot of hope of what’s to come next! The day involves a fairly moderate trek, though it will take you all the way up for the entirety of the 6-7 hours. While during the first 3-4 hours, the trek might seem steep and that you’re diving straight into the deep end. But, it will even out and become easier through the day.

Today on the trail you will experience rocky slopes, grass and desert mountain valleys. As you can tell, overall you’ll be climbing 1,640 ft. Right at the beginning of the trek, you’ll cross fields of green peas. Also, throughout the day you will cross 2 lakes. The last two hours are especially picturesque and given that the ascent is moderate, you’ll actually be able to day dream and soak in the views. Lots of flowers and fields of beautiful fauna awaits you. Also, about a KM before reaching the base camp – keep your eyes peeled at the unique rocks you might spot. These are some repositories of fossils of all types.

As with a itinerary I share, I should tell you start your day as early as possible. Also, you should carry sufficient water. Dehydration can be quite painful and you might not be able to complete your journey if it impacts you severely.

For today’s journey – you can refill your water at a lake about an hour before the base . Thus, carry sufficient water with you.

Kibber village spiti valley
Kibber Village

Day 6: Acclimatization day at Kanamo base camp

You get to chill and enjoy the base camp location today. It is stunning and a much needed break for acclimatization. You have to remember one thing – if the climbing mountains is an important part – so is the letting your body get used to the severe and extreme heights! There is no point in skipping any of these acclimatization days – it will do you no good!

Day 7: Kanamo base camp to Kanamo peak and back to base camp (12-13 hours, 19,553 ft.)

I am not going to lie to you. Today is going to be a strenuous and difficult journey. You will be climbing continuously for 3-4 hours to reach the peak on an extremely steep hillside. The descend might seem simpler – but, it isn’t! You have to be extremely careful with every step you take and how you place yourself!

Your day today will start even before the sun wakes up. You should start your attempt on the Summit Day as early as 3 AM! In fact, you should aim to cross the first shoulder in the mountain at dawn. If you do so any later – the journey back becomes challenging. By the time you reach the second shoulder of the mountain – the wind will be picking up and the cold will be excruciating! But, the views are stunning and the ever-changing colours of the sky in the backdrop of the Spiti mountains is indescribable.

Do ensure you’re wearing the right gear and your face, hands and feet are well protected! The wind will be ice-cold and it will be as harsh as it gets. Try making your journey a little more comfortable by packing on the layers. You will be facing this for nearly 4 -5 hours. The last leg of the climb, is a steep ascent of about 80 degrees on the slopes. Now, I should warn you here that is easy to slip down each time you take a step up. A good trick to keep in mind is that small steps would be difficult to maintain, so make sure to take large strides to navigate the slope. This four-hour journey will take you to the Summit!

The Summit – Reaching the Kanamo Peak!

The top is stunning, breathtaking, out of this world. You are greeted with a 360-degree view of the greater Himalayas. Truly, this has to be the best reward for a tough climb. From the top, you’ll be able to feast your eyes on Parang La pass leading to Ladakh on hand, the Pin Parvati pass leading to Kullu valley on the other and multitudes of ranges of Kinnaur, Lahaul and Spiti. From the back, you’ll be greeted by a huge glacier.

A fun fact – Kanamo is actually a twin peak with its sister peak, Shilla, next to it. What’s interesting is that Shilla is generally covered with mountains of snow, but, Kanamo only usually has a small patch.

On a side note, do remember there are no water sources and you should carry at least 3 liters with yourself!

The descent takes about 2.5- 3 hours and will take you back from the same route. You’ll spend the night at the base camp. Much needed rest for the day here! Your body will be aching after the euphoric and adrenaline fueled day you’ve had. Try to eat a healthy meal before the much needed night of rest!

Day 8: Kanamo base camp to Kibber (5 hours, 14,108 ft.)

Today is going to be a descending day. Again, the only water source is the lake one hour after the base camp – so carry sufficient water with you! This trek particularly is picturesque. The inviting Spiti valley ahead and the majestic mountains beckoning from behind make for a truly amazing experience.

Spiti Valley Trip - Dhankar Lake
Spiti Valley Trip – Dhankar Lake

Day 9: Kibber to Manali (6,725 ft.)

Your day today will begin early in the morning. This is so, in case you want to head back to Delhi on the same day. Often, the return days are so nostalgic for the days just spent. You might want to squeeze in a few days at Manali to get used to being in a civilized society again before you head back to the daily hum-drum of life!

Also, you might plan on heading into Spiti and experiencing the valley as well. There is truly too much to do and see here. I highly recommend making the entire journey and experiencing the culture of Spiti, since you’re already here!! Beautiful villages like Rangrik, with a huge Buddha statue atop a mountain, Pagmo etc. come into view. You might even plan on visiting Hikkim, which has the world’s highest post office The exploring options are limitless!

Spiti Valley Sprint | Ki – Kibber, The High Altitude Villages of Spiti Valley
Spiti Valley Sprint | Ki – Kibber, The High Altitude Villages of Spiti Valley


Very few treks are structured like this one. Rarely will you experience a summit day like this! You start off in darkness and hopefully your path is lined by starlight! Day might begin as early as 1 AM – so it is imperative you have sufficient rest on the day prior! Do carry sufficient water. The mountains are slippery and you have to walk with your group in a line – keeping a check on everyone around. You reach the top by early in the morning and the world, as they say, is your oyster (or mountain peak)!


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rheumatoid arthritis

Rheumatoid Arthritis These Days


Among the autoimmune rheumatic diseases, perhaps rheumatoid arthritis is the pathology most known to the population. Or, at least, it is a disease that is heard about quite often. Despite being considered an uncommon disease, it is estimated that there are 7 million people affected by rheumatoid arthritis in India.

Rheumatoid arthritis occurs due to a dysregulation of the immune system, resulting in chronic inflammation in the joints that leads to the destruction of these structures. This inflammation can also occur in other parts of the body, such as in the eyes, lungs, peripheral nerves, and skin.

Historically, when we talk about rheumatoid arthritis, we imagine a person suffering, in pain, in a wheelchair, dependent, with deformed joints. This is how rheumatoid arthritis affected the lives of renowned artists, such as the French painter Renoir and the French singer Édith Piaf, whose weight of the disease is known to have marked their biographies.

However, thanks to advances in early diagnosis and the effectiveness of current arthritis treatment in Delhi, the lives of people with rheumatoid arthritis today are very different from the suffering experienced in the past.

Today, it is known the importance of early diagnosis to institute treatment quickly, following the same reasoning as an early cancer diagnosis. It is known that the sooner we start treating rheumatoid arthritis, the greater the control over the disease. This control means that the complications of the untreated disease will be avoided, especially the joint deformities, which lead to a great loss in the day-to-day functions and loss of quality of life.

Like many other chronic diseases, the onset of rheumatoid arthritis can be very subtle. It is important to pay attention to persistent pain, especially accompanied by swelling, in small joints of the hands, wrists and feet, which are worse in the morning, which alleviate throughout the day. There may be a picture of prolonged sensation, for more than an hour, of morning stiffness, where the joints are very difficult to move. Tiredness and fatigue can occur simultaneously with joint pain. All people with this type of complaint should be evaluated by the best rheumatologist in Delhi. Based on findings from the conversation with the patient, the clinical examination and with the aid of some specific laboratory tests and also suitable imaging methods, the arthritis specialist in Delhi can make the diagnosis of the disease and start the treatment of the patient.

As rheumatoid arthritis is a chronic health problem, it is very important that there is a partnership between the patient and his arthritis specialist in Delhi. Treatment involves the use of medications that act on the immune system and requires regular and frequent monitoring. At each visit, the top rheumatologist in Delhi makes adjustments to the treatment according to the patient’s clinical response. These adjustments must occur in relatively short intervals of time, in order to achieve adequate doses of medications and maximum control of the disease. Keeping the disease under control, the joints are preserved, their function is maintained, there is quality life. The rheumatologist in Delhi is the physician with the knowledge and experience to conduct the follow-up of people with rheumatoid arthritis and even to diagnose this disease among so many others that can also manifest themselves with joint pain. Although there is still no cure for this disease, the progress in this area of ​​medicine allows people to live well, study, play sports, work, take care of their families. The secret is, of course, in early diagnosis and specialized care.


Sexual life of the elderly

Sexual life of the elderly


Sexual life of the elderly: the importance of breaking stereotypes and providing better guidance to patients with dysfunctions

A recent study showed that many men and women with dementia living in their homes are sexually active and, although sexual dysfunction was frequent, they rarely talked about sex with a sexologist in Delhi.

These surveys, as well as older ones, break stereotypes about the sexual life of the elderly and highlight the need for more people to talk to their sexologists in Delhi about sexual issues.

Causes of sexual dysfunction in the elderly

Aging promotes anatomical, physiological (mainly hormonal) and psychological changes that influence sexuality at the end of life. Changes that accompany sexual function include decreased libido, sexual responsiveness, comfort level and frequency of sexual activity.

On the other hand, the sexual dysfunctions of the elderly are influenced by factors that include physical effects of diseases, medications, psychiatric disorders, and psychosocial stress, related to the loss of close people or hospitalizations due to acute illnesses.

A cardiac or cerebral vascular event can raise fears about performance or even death during sex. It is worth mentioning that data have indicated that the probability of sudden death after sex is low.

Main sexual disorders in the elderly

Sexual disorders in elderly men are erectile dysfunction and delayed ejaculation, while in elderly women there is little sexual interest, orgasmic disorder and genital-pelvic pain.

The main predictors of sexual interest and activity at the end of life are: previous level of sexual activity, physical and psychological health, as well as availability, level of interest and integrity of the partner. For men, the main factor for sexual activity seems to be physical health and for women, it seems to be the quality of the relationship.

Residents in long-term environments are significantly less likely to be sexually active, as they face barriers such as difficulty finding partners, lack of privacy and, of course, physical, and mental health problems.

How to assess sexual status and conduct to be adopted in dysfunctions

Examination of sexual status asks about current sexual functioning, past sexual experiences, and attitudes towards sexuality.

The assessment and treatment of sexual dysfunction requires a relationship of trust between the sexologist doctor in Delhi and the patient. The physician’s attitude and language must be appropriate and convey security.

The clinical evaluation must be complete and include mental and psychological status, such as marital stress and grief, for example; urological and/or gynecological function and laboratory tests, especially of the metabolic and hormonal profile, such as testosterone, thyroid and prolactin.

An important point is the detailed knowledge of the medications in use, as several can cause sexual dysfunction.

Anti-hypertensive drugs, especially beta-blockers and diuretics, antiandrogens, used in the control of prostate tumors, and several psychotropic drugs, particularly selective serotonin reuptake inhibitor antidepressants, venlafaxine, and mirtazapine, especially in men, stand out.

Sex doctor in Delhi mentions that sexual dysfunction can be caused by both the antidepressant and the depression that recommends the use of the medication.

Role of education and referral indication

In the management of cases of sexual dysfunction in the elderly, education has an important role. Patients should be informed about factors and causes and possible treatments for dysfunctions. Education about sexually transmitted diseases and safe sexual practices should not be neglected.

Referring patients to specialists, such as urologists, gynecologists, psychiatrists or sex specialist in Delhi, can be useful depending on the problem identified.

Long-term care facilities should train their staff to respect the privacy of residents and assess their ability to avoid possible risks associated with sexual intercourse.

Patients who suffer cardio or cerebrovascular events or interventions should receive advice from doctors or rehabilitation programs on how to gradually resume habitual sexual activity.

The basic psychotherapeutic approach is similar to that of younger individuals, although it must take into account long-standing bad relationships, as well as deficiencies in general and cognitive health.


The specific treatments for sexual disorders are not different from those used for young adults, but some specific recommendations for the elderly should be remembered. Among them, the adoption of measures that minimize pain or discomfort, such as the use of analgesics, oxygen, inhalations, lubricants, and comfortable positions for the sexual act.

Of course, drugs that can cause sexual dysfunction (mentioned above) should be replaced, if possible. Metabolic and hormonal disorders should be investigated and corrected.

Testosterone replacement to treat the decline in serum testosterone concentration, which occurs with advancing age in men in the absence of identifiable pituitary, hypothalamic or testicular disease, is questioned.

For men who show signs or symptoms that could be caused by testosterone deficiency, such as changes in energy, mood and libido, replacement can be considered, but only if the concentration is unambiguously low in three dosages of samples collected in different times, between 8 and 10 am. For replacement, special attention should be paid to the risks of coronary events, prostate and breast cancer, sleep apnea and erythrocytosis.

The use of testosterone to increase libido in women lacks robust evidence and can pose risks.

Phosphodiesterase 5 (PDE, Phosphodiesterase) inhibitors, used to treat erectile dysfunction are effective for older men, although with less response. For some older men with no ideal response to use on demand, daily administration of low doses may be more effective.

Side effects seen in the elderly are headache, flushing of the skin, dizziness, gastrointestinal discomfort, back pain, and blurred vision.

Any changes in visual acuity when taking a phosphodiesterase 5 inhibitor require immediate evaluation, due to reports of cases of non-arteritic anterior ischemic optic neuropathy, characterized by the rapid onset of visual loss

Erectile dysfunction occurs frequently in coronary patients and is even considered a predictor of coronary artery disease. The coronary patient usually gives up sexual activity but can restart it when using phosphodiesterase inhibitors 5.

However, top sexologist in Delhi instructed to avoid the use of these drugs concomitantly with nitrates, as they can suffer severe hypotension, worsening myocardial ischemia, which can even trigger a serious event.


The best sexologist in Delhi should deepen their knowledge of the sexual life of the elderly. It is necessary to know how to approach the topic in an appropriate way, without omission, in order to enable the realization of possible diagnoses, the identification of the causative factors and the correct orientation.


erectile dysfunction medicine

What happens if you take too much medication for erectile dysfunction?


Oral medications provide a convenient way for men to manage their erectile dysfunction (ED). These drugs are called phosphodiesterase type 5 (PDE5) inhibitors. Some of the most prescribed ED drugs are as follows:

  • Sildenafil (Viagra)
  • Vardenafil
  • Tadalafil
  • Avanafil

These drugs work by relaxing the soft muscle tissue in the penis, allowing more blood to flow when a man is sexually stimulated. This blood is essential for a firm erection.

While PDE5 inhibitors are effective for many men with ED, some men wonder if they will see better results if they take more medications than the sexologist in Delhi has prescribed. But doing so can be dangerous.

Therefore, it is important to use these medications exactly as your sexologist doctor in Delhi prescribes and carefully read the accompanying information pack. The top sexologist in Delhi must also know what other medications or supplements a man is currently taking.

One of the risks of an oral overdose of ED drugs is priapism, an erection that lasts several hours. Priapism can happen if too much blood flows into the penis, causing it to swell. Some men with priapism experience discomfort or pain.

Men who have a long-lasting erection are urged to seek emergency medical care. When blood is in the penis for a long time, it is difficult for oxygen to reach the area. This situation can lead to tissue damage, permanent erectile dysfunction, or disfigurement of the penis.

Treatment for priapism may include draining excess blood from the penis, medication, or surgery.

Another risk associated with oral ED drugs is a drop in blood pressure. Men may start to feel weak, dizzy, and nauseous. They may start breathing more quickly, experience blurred vision, and have difficulty concentrating.

In severe cases, low blood pressure can substantially reduce the amount of oxygen that reaches important parts of the body, such as the heart and brain. Eventually, these organs can become damaged.

Men who believe they have taken too much of any drug are advised to see a sex specialist in Delhi as soon as possible. They should also seek immediate medical attention if they experience any of these symptoms after taking an antidepressant medication:

  • Rash
  • Urticaria
  • Swelling of lips, tongue, or throat
  • Breathing or swallowing problems
  • Vision problems
  • Hearing problems

Men who feel that their ED medication is not working should talk to the best sexologist in Delhi. The dose may need to be adjusted, but this should only be done under the care of a sex doctor in Delhi. Men should also remember that these drugs are prescription drugs and are not suitable for all men. For example, men who take drugs that contain nitrates should never take ED drugs.