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Benefits of the vaginal microbiome.. Protection against infections. Maintaining vaginal health. Potential impact on overall health

What is the vaginal microbiome?

The vaginal microbiome is a fascinating and crucial aspect of women's health. It refers to the community of microorganisms, primarily bacteria, that reside in the vagina. These microorganisms play a vital role in maintaining a healthy vaginal environment, protecting against infections, and influencing overall well-being.

Here are some key things to know about the vaginal microbiome:

Composition:

The dominant bacteria in a healthy vaginal microbiome belong to the Lactobacillus genus, particularly Lactobacillus crispatus, Lactobacillus gasseri, and Lactobacillus jensenii. These bacteria produce lactic acid, which creates a slightly acidic environment and inhibits the growth of harmful bacteria that can cause infections.
Other microorganisms, such as Bifidobacterium species, Prevotella species, and Bacteroides species, may also be present in smaller amounts.

Benefits:

- Protection against infections:

The acidic environment created by Lactobacillus helps prevent the growth of harmful bacteria and yeast, such as Gardnerella vaginalis and Candida albicans, which can cause bacterial vaginosis (BV) and thrush, respectively.

- Maintaining vaginal health:

The microbiome helps regulate vaginal pH, lubrication, and cell shedding, contributing to a healthy and functional vaginal environment.

- Potential impact on overall health:

Studies suggest the vaginal microbiome may be linked to reproductive health issues like preterm birth and miscarriage, as well as systemic health conditions like inflammatory bowel disease and allergies.

Factors influencing the vaginal microbiome:

- Hormonal changes:

Estrogen levels, particularly during puberty, pregnancy, and menopause, can influence the composition of the microbiome.

- Sexual activity:

Sexual activity and the type of bacteria introduced through partners can affect the microbiome.

- Douching and hygiene practices:

Douching disrupts the natural balance of the microbiome and can increase the risk of infections. Harsh soaps and hygiene products can also affect the microbiome.

- Antibiotics:

Antibiotics can kill both harmful and beneficial bacteria, disrupting the microbiome and increasing the risk of BV.

Maintaining a healthy vaginal microbiome:

Avoid douching and harsh hygiene products.
Practice good hygiene, but avoid over-washing.
Wear loose-fitting cotton underwear to increase airflow.
Maintain a balanced diet rich in prebiotics and probiotics.
Limit antibiotic use unless medically necessary.
Talk to your doctor about any concerns about your vaginal health or changes in your microbiome.

The vaginal microbiome is a dynamic and complex ecosystem, and research into its role in health continues to evolve. By understanding and supporting a healthy vaginal microbiome, women can protect themselves from infections, promote overall well-being, and contribute to reproductive health.

What is vaginal viscosity?

Vaginal viscosity, or the stickiness of vaginal discharge, is a natural and healthy aspect of female reproductive health. It varies throughout the menstrual cycle and can be influenced by various factors. Here's a breakdown:

Normal Range of Vaginal Viscosity:

- Dry:

During the menstrual cycle's early follicular phase, estrogen levels are low, leading to a drier, less viscous discharge.

- Sticky:

Around ovulation, rising estrogen levels stimulate the production of cervical mucus, resulting in a thicker, stickier discharge with a clear, stretchy consistency – ideal for sperm transport.

- Wet:

Following ovulation, progesterone levels increase, causing the discharge to become thinner and more watery.

- Creamy:

Pre-menstrually, the discharge may thicken and become creamy or cloudy due to hormonal fluctuations.

Factors Affecting Vaginal Viscosity:

- Hormonal changes:

As mentioned, fluctuating estrogen and progesterone levels throughout the cycle significantly impact viscosity.

- Sexual arousal:

Excitement increases blood flow to the vagina, producing more lubricating discharge, which can be thin and watery or thicker and mucus-like.

- Stress and anxiety:

These can affect hormonal balance and lead to changes in vaginal moisture.

- Diet and hydration:

Staying hydrated and consuming a balanced diet can contribute to healthy vaginal health and normal discharge.

- Medications:

Certain medications, like antidepressants and antihistamines, can cause vaginal dryness.

- Underlying medical conditions:

Infections, allergies, and other medical conditions can also affect vaginal discharge and viscosity.

Importance of Vaginal Viscosity:

- Lubrication:

Healthy vaginal discharge helps lubricate the vagina during sexual intercourse and other activities, reducing friction and discomfort.

- Sperm transport:

The sticky, stretchy discharge around ovulation creates a favorable environment for sperm to travel through the cervix and reach the fallopian tubes.

- Barrier function:

Vaginal discharge acts as a natural barrier against bacteria and other pathogens, protecting the reproductive system from infections.

When to Consult a Doctor:

If your vaginal discharge is consistently abnormal in color, odor, or texture, like foul-smelling, green or yellow discharge, excessive bleeding, or severe itching.
If you experience persistent vaginal dryness that interferes with sexual activity or daily life.
If you have any concerns about your vaginal health or discharge.

Remember, vaginal viscosity is a natural and healthy aspect of your body. However, significant changes or persistent abnormalities warrant consultation with a healthcare professional to ensure your reproductive health is optimal.

efinition of frigidity:

The term "frigidity" has been historically used to describe a lack of sexual responsiveness or desire in women. It was often associated with an inability to experience sexual pleasure or difficulty in achieving orgasm. However, it is important to note that the term is outdated and no longer widely used in professional medical or psychological contexts.

Modern understanding acknowledges that sexual desire and functioning can vary greatly among individuals, and it is influenced by a multitude of factors such as physical, psychological, and relational aspects. If someone is experiencing concerns or challenges related to sexual desire or functioning, it is recommended to consult with a healthcare professional or a qualified therapist who specializes in sexual health for a comprehensive evaluation and guidance.

Ways to overcome frigidity:

Here are some tips on how to overcome frigidity in cold and low-temperature areas:

- Wear layers:

This will allow you to trap heat and stay warm. Start with a base layer of long underwear made of a moisture-wicking material, such as wool or synthetic fabric. Add a mid-layer of insulation, such as a fleece jacket or down vest. Finally, top it off with a waterproof and windproof outer layer, such as a shell jacket or parka.

- Cover your head, neck, and hands:

These areas are particularly vulnerable to heat loss, so it's important to keep them covered. Wear a hat, scarf, and gloves to protect them from the cold.

- Stay active:

Moving around helps to generate heat and keep your blood flowing. If you're standing still for long periods of time, try to move your arms and legs or do some light exercises.

- Eat and drink regularly:

Eating and drinking helps to keep your body temperature up. Avoid sugary drinks, as they can dehydrate you. Instead, opt for water, tea, or coffee.

- Take breaks in a warm place:

If you start to feel too cold, take a break in a warm place, such as inside a building or in a car.

- Use a hand warmer or foot warmer:

These devices can provide extra heat to your hands and feet.

additional tips:

Here are some additional tips that may be helpful in cold and low-temperature areas:

- Use a humidifier:

A humidifier can add moisture to the air, which can help to prevent your skin and lips from drying out.

- Take warm baths or showers:

This can help to warm up your body and relax your muscles.

- Avoid alcohol and caffeine:

Alcohol and caffeine can dehydrate you and make you feel colder.

- Get enough sleep:

When you're well-rested, your body is better able to regulate its temperature.

If you are struggling to overcome frigidity, you may want to talk to your doctor. They can rule out any underlying medical conditions and offer additional advice.

Specific tips for women:

In addition to the general tips above, there are a few specific things that women can do to overcome frigidity in cold and low-temperature areas:

- Wear warm underwear:

Thermal underwear can help to keep your core temperature up. Avoid cotton underwear, as it absorbs moisture and can make you feel colder.

- Use a heating pad or hot water bottle:

Place a heating pad or hot water bottle on your lower abdomen or lower back before or during sexual activity to help increase blood flow and arousal.

- Try a lubricant:

A lubricant can help to reduce friction and make sex more comfortable.

- Communicate with your partner:

Let your partner know what feels good and what doesn't. If you're feeling cold, ask them to warm you up with their hands or body heat.

It is important to be patient and understanding with yourself and your partner. Overcoming frigidity takes time and effort.

Child circumcision:

The process of circumcision “purity” for male newborns is one of the most important things that the mother should not be lazy or complacent about after you have given birth to your child, but you must first know how to take care of the circumcision site; So that the wound heals quickly

Simply put, circumcision is the removal of the skin that covers the penis of a male child, the “prepuce of the penis,” in order to protect it from diseases, infections, and infections.

The real benefit of circumcision:

Recent studies have shown that circumcision reduces the incidence of AIDS. The World Health Organization considered male circumcision a means of preventing AIDS. Other studies have also shown that circumcision significantly protects men from penile cancer, in addition to sexual diseases such as syphilis, gonorrhea, and others.

When should the circumcision process take place for a male newborn?

In the first days or weeks immediately after birth, preferably before the newborn is 40 days old, the child is then unconscious, which reduces the pain he may feel if performed at an old age.

How do I take care of my child after circumcision?

Use warm water when washing this area.
Maintaining the cleanliness of this area, as the mother must change the diaper and clean this area for the child periodically so that dirt does not accumulate in it, such as urine and feces.
Applying ointments and creams that keep the area clean and form a buffer layer that prevents friction between the diaper and the circumcision area so as not to cause more inflammation.
Circumcision is not a simple matter, as it is like a surgical operation that takes place for your child, so you must take good care of him during this period, and be sure to communicate with the doctor.

Reasons for circumcision:

People are very willing to circumcise their children, and according to the World Health Organization, 30 percent of males in the world have undergone circumcision, or about 2 billion and 250 million people.

Circumcision is possible for religious reasons, as is the case in the Islamic and Jewish religions, or for medical reasons, with a rate of 30 percent.

And circumcision (purification) is basically a surgical operation, and therefore it must be performed by a surgeon, and it is recommended that he be in the specialty of pediatric surgery, urology, or general surgery.

And it is not an urgent process, so it requires a doctor’s visit before it is performed, in order to conduct a clinical examination, due to the difference in the circumcision process from one person to another.

Clinical examination:

Through the clinical examination, a number of data related to the child are seen, including age, weight, and the quality of the child’s penis, as the circumcision process may encounter some problems, such as the absence of a urination hole in the usual place for some children, and the penis taking opposite forms, such as taking the circular shape or Adhesion to the testicles, in addition to problems in the testicles as well, or many other problems that require a plastic surgery with circumcision.

In addition to other analyzes about the breathing process, allergic diseases, and heart rate rhythm, to take the necessary precautions when anesthetizing the child.

It is desirable that the doctor's office be 3 or 4 days before the circumcision date, and the operation should not be performed if the child is sick.

The relationship between the child and the surgeon:

It is recommended that the child meets the doctor who will perform the circumcision before the day of the operation, in order to avoid the psychological stress and tension that will affect the child as a result of the fear of the circumcision process.

It is necessary for the child to like the doctor and feel reassured that the operation will pass successfully.

family function:

There is a great fear on the part of the family from the circumcision process, especially from the anesthesia process, so there must be psychological preparation for the parents so that their feelings of fear and anxiety do not spread to the child.

circumcision process:

The circumcision process does not deserve medical examinations, but it is necessary to have anemia tests and tests that prove the extent of bleeding control in case of injury, especially in children under walking age.

As for the walking age, the family will be more aware of the matter, due to the child’s exposure to falls and injuries many times

anesthesia:

Parents usually ask about the type of anesthesia that will be given to the child during the circumcision, is it topical or general?

Local anesthesia is acceptable for children up to 6 months. After this age, the anesthesia is supposed to be general, which is light anesthesia in addition to a local anesthetic so that the child does not feel pain when waking up after the circumcision.

G The circumcision process requires that the child be fasting at a rate of approximately 6 hours before the date of circumcision, noting that the operation lasts approximately between 15 and 20 minutes.

After circumcision:

It is recommended to avoid dressings on the child's wound and to wear diapers or undergarments.

treatment:

The most important stage in the treatment is cleaning, using ointments for the purification process, as prescribed by the doctor, and wearing clothes normally.

The doctor also prescribes some anti-inflammatory medications at a rate of 3 times a day, because the circumcision process can cause some swelling, which is normal, and these medications are given starting from the age of 3 months.

The period required for wound healing:

The wound healing process depends on the type of skin of the child and the level of interest in the treatment. The healing period lasts between 3 and 5 days.

The appropriate age for circumcision:

There is no specific age at which circumcision is performed for all children of the same age, as the operation is carried out according to each case and according to the medical examination that is conducted for the child, as it is considered the main determinant of the period in which the circumcision must be performed.

It can be considered that the appropriate age for circumcision is between the age of one year and one and a half years, because a child at this age can be treated when changing diapers, for example, but at an advanced age it becomes difficult.

Circumcision and sea water:

Sea water is medically recommended, but it should be applied to the wound 3 or 4 days after the circumcision, but in the first days it may cause some risks, such as infections and putrefaction, which may result in difficult treatment.

Circumcision and health complications:

Like any surgical operation, the circumcision process may expose the child to some health complications, and to reduce them, the operation must take place in a sanatorium, by a qualified surgeon, and in appropriate conditions that respond to health safety standards (sterile and clean place) and that the anesthesia process be performed by He is a specialist and has experience in dealing with children, which is what makes most circumcisions in Tunisia successful, with a rate of 99.9 percent

Among the health complications, we mention bleeding as a result of non-fusion of one of the veins, as well as putrefaction in the wound, which requires taking some antibiotics.

One of the serious health complications is cutting off the head of the penis, and because the operation is performed, especially at home, by people who are not qualified to perform the circumcision process, so it must be avoided, in addition to anesthesia operations that are carried out by unqualified people, which may sometimes lead to death.

What is circumcision?

Circumcision means removing the skin at the front of the penis, and it is 99 percent successful, but like every surgery, it may result in a set of complications if it is not done in healthy conditions that meet the necessary conditions.

the reasons:

The circumcision process is done because the Islamic religion urges it, and the circumcision process has many health benefits. By removing the front skin covering the penis, the accumulation of germs that cause infections in this area is avoided.

Benefits of circumcision:

Avoid the presence of germs in the urine.
Avoid inflammation of the skin above the penis.
Avoid a urinary tract infection.
And at an advanced age, venereal diseases, especially penile cancer, are avoided.

The appropriate age for circumcision:

Child circumcision is done at any age, but it is recommended to circumcise it at an age between one day and 60 days, where the operation is done using local anesthesia or at the age of more than a year, and thus avoiding complete anesthesia of the body, which harms the respiratory system, especially since the child is in a period growth.

Where should circumcision take place?

The circumcision process must be carried out in appropriate hygienic conditions in the operating room, which must be sterile, and also good equipment must respond to hygienic conditions.

The operation must also be performed by a doctor specializing in pediatric surgery, urology or general surgery

And the operation must be performed after the child is subjected to local anesthesia or full anesthesia.

Post-circumcision tips:

Pain relievers prescribed by the doctor should be taken.
Persistence in cleaning the wound properly for 5 days until it heals.
If the wound becomes infected, the doctor who performed the circumcision should be contacted.

What is sex education?

Sex education is a very important subject, but some people refuse to inform children about it with many pretexts, the most important of which is their belief that sexual behavior is an instinctive behavior that does not require psychological or medical education and knowledge, and that it is not the right time... Why sex education?

Sexual behavior is a physical, psychological and social behavior that requires scientific knowledge to be done in order to be sound in the present and in the future. With the progress of science, especially the science of sex, sexual behavior has transcended instinctive concepts and inherited definitions, so that science is the main reference for this behavior, including medicine and psychology, including the science of emotion, the science of motives, the science of behavior, and others.

The social environment, such as peers and friends, threatens the integrity of the child's sexual behavior due to its lack of scientific reference, as it contains false information that leads to physical, psychological, organic, social and human abuse. Pornographic sites affect the concept of sex and relations between the sexes and lead to deviations and addiction. Social networking sites also threaten children in terms of their physical and psychological inviolability

The concept of sexual behavior:

Sex is a major and essential behavior in human life, as it is a behavior of great pleasure and is the basis of family bonding, love and cohabitation for the individual. As for the family, we are talking about a society that must be coherent, in which an entire generation will be raised. Therefore, we must be aware that sexual behavior is brought up with it from childhood, and not only at the age of marriage. It develops from childhood until it reaches maturity in adolescence, to mature more by the completion of adolescence. The same thing on the physical level, where the body develops during puberty and shows secondary signs of puberty through which a person becomes able to have a full sexual relationship.

Sexual behavior is an upbringing like all kinds of education that are taught such as physical education and civic education... It is through education on principles, morals and values such as preserving the bodies, their eating regimen, the timing of their sleep and waking up, and their practice of recreational activities.

Clarifying the sexual behavior of the child:

The sexual behavior of children must be clarified and not taught to practice sex from a young age. Rather, the child must learn about his body, the names of his organs, the function of these organs, and how to preserve the body and its sanctity (not every human being is able to touch a child’s body, put his hand on his body parts, or practice any behavior as bad as kissing and hugging a child) and understanding the correct behavior that should be practiced towards his body.

Sexual awareness by age:

Educate the child according to his age and starting from (0 to 3 years) by showing the child the names of his body parts (informing him that his body will grow and grow like his parents) so that his sexual identity is stable. And showing him how to clean his body and not raising him on many wrong facts (it is wrong to tell the child that some areas of his body are bad, but rather they are good, but they should not be exposed or touched in any way in front of others).

The child is prepared to show him his body according to age, as he is in the pre-pubescent age, he must know that he will enter the stage of puberty, and he must be prepared for the changes that will occur in his body. And little by little, we talk about the feelings and feelings that should have a lot of respect and appreciation.

The importance of sex education:

It is necessary for there to be sexual education due to the lack of correct answers in society, as these are scientific, physical and psychological issues that must be looked at. There should not be shyness within the family that makes the child search for answers outside the home. When the child searches for information on the Internet, he will not find it to respond to his desire for knowledge, but rather he will understand the information in the wrong way, with a lack of respect, and in an abusive way to the child by exploiting him and with a lot of negativity, especially in countries developing.

While the countries that have sex education have reduced the percentage of sexual harassment, rape, unwanted pregnancy and sexually transmitted diseases. By showing the child his body, the sexual formation and the relationship with the other will be more mature.

Sexual education helps the child to know the behavior that may affect him and to avoid the danger that may threaten him. The child is aware that some acts should not be practiced on him and he has the right to report them and know what they are in order to limit the repeated sexual harassment against him that lasts for years, while the child cannot report it due to his lack of understanding and shyness at the same time. Sex is not exploitation, but rather a relationship of love and respect, and there are many limits that must be stopped.

Child circumcision:

The general public considers circumcision of children a simple and easy process, and it can be performed at home without exposing children to any danger, but the truth is otherwise, as one must beware of the possibility of recording complications that may require urgent intervention with the availability of necessary hospital means that allow saving the child from the danger of life-threatening complications.

Thus, attention must be paid not to be complacent in the decision to perform the circumcision of their child at home or in an unhealthy environment for the simple reason of not meeting the conditions for rapid intervention in it. This necessitates first aid for the child due to the possibility of his exposure to health complications that could endanger his life.

Serious conditions that can occur when circumcised:

Among these cases that need urgent aid is the possibility of the child being exposed to a kind of hypersensitivity to the local anesthetic that is used in most circumcisions. This chemical can cause serious complications in a young child.

A child can suffer from anaphylactique le choc, which is life-threatening and dangerous to the point of death if special aid is not provided to save him.

In addition, the degree of danger is represented in the inability to control the trauma if we do not have the necessary means of intervention, so he stresses the necessity of performing circumcision in public or private hospital institutions in order to avoid such serious tragic accidents that can turn joy into loss, God forbid.

Lab tests are necessary:

It is also necessary to request blood tests to detect that the child does not suffer from the hereditary blood clotting disease known as (hemophilia), especially if the child has not yet reached the age of one or two months and has not previously been subjected to any surgical procedure or blood test.

In this case, his injury, if not previously detected by laboratory tests, may cause severe bleeding in the child during the circumcision process, and knowing this in advance helps in taking the necessary health measures to avoid the child losing a large amount of his blood in the event that he is not expected to bleed as a result. The surgical operation, and because his blood did not clot as a result of not knowing in advance that he had hemophilia. Therefore, it must be emphasized that the operation should not be performed without a blood clotting test first, while making sure that the operation is performed within health frameworks that provide the minimum conditions for intervention to stop the bleeding in the event of its occurrence, to protect the life of the child as well.

Health supervision for circumcision:

The circumcision process must also be health supervised upon the initial examination of the child. Before performing it, it is necessary to ensure that the child does not suffer from congenital deformities.

It is noteworthy that most of them are due to a disease called hypospadias, so he urges the organization of the circumcision process, which is a simple operation within a large operation framed by specialists that aims to treat congenital deformity in the first place after early detection of the child’s condition in order to avoid health damage that accompanies him for life.

That is why parents must be careful to adhere to it so that their happy celebration of their son’s circumcision does not turn into a sad event that accompanies them throughout their lives.

migratory testicle:

The migratory testicle for children is one of the most common operations in pediatric surgery, as this condition affects between 1 and 2% of children, and it usually affects newborns, as one or both testicles remain in the abdominal area instead of settling and descending in its place.

This medical condition has many names such as undescended testicle, undescended testicle, and hidden testicle.

Types of migratory testicles:

We find two types of migratory testicles:

Tangible migratory testicle:

Which represents 70% of the cases, which is represented in the doctor's ability to touch the testicle and trace it clearly in the area in which it settled.

Intangible migratory testicle:

It is a case in which the doctor cannot locate the testicle by clinical examination or by looking.

Causes of migratory testicle:

The reasons that lead to the occurrence of this problem, which include the premature birth of the child, because when the fetus is in his mother’s womb, his testicles are formed in the abdominal area first, then they begin to descend gradually until they settle in place a month or two before the date of birth, and if he was born prematurely The testicle does not settle in its place, and on the other hand, the birth of a child with a low weight can lead to infection of the migratory testicle for children, and other reasons are also the smoking of the pregnant woman during pregnancy and her gestational diabetes, the child’s disease or a hormonal problem, especially the androgen hormone, etc. ..

Diagnosis of migratory testicle:

The clinical examination is sufficient to confirm whether or not surgery is necessary, and sometimes we can use ultrasound, especially if the child is obese.

Complications of migratory testicle:

As for the complications, they are summarized in the possibility of testicular cancer or testicular torsion, which is an urgent condition that requires urgent surgical intervention, and it can also cause weakness in fertility or even infertility. Dr. Chakroun explained that originally the testicles remain outside the body at a temperature lower than the temperature of the human body to ensure that they continue to function properly. Sperm or to lose it completely, especially if the testicle does not develop in size.

However, studies have shown that men who faced the problem of migratory testicles with only one testicle have the same chances of becoming fathers as men who were born with two healthy testicles.

Treatment of migratory testicle:

As for the treatment, Dr. Mohamed Chakroun confirmed that it is mainly surgery, and since the child, if he exceeds the age of six months, the testicle will not be able to descend on its own, so the surgery is performed from the age of nine months, if possible.

It is also possible to perform operations related to the testicle simultaneously with operations related to circumcision or hernia, and he stressed at this point that parents should carry out the necessary examinations and not postpone any surgical intervention as long as it is in the interest of the child.

Male circumcision:

Male circumcision is a surgical procedure that aims to remove excess skin from the head of the penis, and there is no scientific study that determines the age for performing this surgery, but on the other hand, doctors always recommend avoiding circumcision surgery for infants and newborns except in urgent cases, in order to avoid complications of circumcision. Waiting for the completion of the growth of the male organ, because it differs from one person to another in terms of shape and size, and total anesthesia is more dangerous to the health of infants, so it is advisable to wait until the child grows up a little and acquires sufficient immunity to perform this surgery.

Although medical conditions do not stipulate a specific age for circumcision surgery, it is recommended to perform it at the age of two or three years due to several factors that help the child heal quickly, such as during that age he is still wearing diapers and has little movement, and anesthesia is less dangerous to his health at that age.

Medical cases in which circumcision must be expedited:

On the other hand, there are some medical cases in which the specialist is advised to expedite circumcision surgery, considering that it may be a therapeutic solution, in the following cases:

Recurrence of infection with a germ in the urine:

Some children may suffer from repeated infection with a germ in urination, and the specialist advises in this case to do circumcision because it reduces the risk of bacterial infections.

Completely closed penis skin:

In some cases, children may suffer from difficulty in urinating, which is caused by the fact that the skin surrounding the head of the child's penis is closed and covers the urine exit hole, which makes the child suffer from urination difficulties, and circumcision is the best solution in these cases.

Acute inflammation of the skin of the penis head:

Children can get severe inflammation in the skin of the head of their penis because the excess skin surrounding that area is able to store bacteria and germs that lead to the occurrence of these infections. Circumcision and removal of this skin is a solution to get rid of these infections.

Circumcision brings several benefits to the health of the child from childhood to adulthood, as circumcision reduces the transmission of sexual diseases resulting from germs attached to the skin surrounding the head of the male organ. Scientific studies have also shown that males who underwent circumcision surgery are less likely to develop prostate cancer and urinary tract infections.

Psychological and physical preparation of the child for circumcision:

Circumcision surgery, despite its simplicity, deserves a number of psychological and physical preparations to qualify the child to undergo this surgery. The preparations begin with a visit to a specialist who will conduct an examination of the child during the so-called pre-circumcision clinic to identify the child’s penis and reveal its size and shape, which will enable the surgeon to take a comprehensive idea of the child’s penis. The position of the child and thus how to perform the surgery. The specialist during this clinic also detects the child and examines the problems related to his male organ, if any. Some doctors, during this examination, can discover the presence of other problems such as the presence of congenital anomalies, migratory testicles or the presence of water in the testicle and other diseases that are treated before or during the circumcision procedure. In the same period, the child is subjected to a clinic with an anesthesia specialist to examine the child, and the doctor, in case of suspicion of any problem, may request analyzes and pictures.

In addition to health preparation, the psychological aspect must be given great importance during the period of preparing the child for circumcision, as circumcision for children is usually associated with pain and fear due to customs and traditions. Therefore, the specialist’s clinic before performing the circumcision operation is an opportunity during which the specialist conducts a conversation with the child to reduce his fear and even explain what the surgery is. him in a simple way.

After circumcision surgery:

The circumcision process, especially during the first days, may be followed by a number of side effects that appear on children, and they range in severity, some of which require medical intervention, and some that do not deserve, and they are generally represented in:

Bleeding:

Although the medical development that occurred in circumcision surgery and postoperative monitoring reduced the occurrence of bleeding for children, it may occur in some cases as a result of the child falling or hitting that area unintentionally. In this case, it is advised to go to the hospital clinic to treat the bleeding.

swelling of the penis:

Swelling is one of the common side effects that occur after circumcision, and it is caused by an event during the surgery. It is not a serious matter. Parents can take a water bath for the child with the addition of a little salt to reduce swelling.

Secretions:

In the event of secretions, a distinction must always be made between the secretions resulting from an infection and those associated with the cream that is placed on the penis after surgery. Therefore, it is recommended to clean the area well before applying the cream each time.

We mention that the recovery period from circumcision differs from one person to another according to several factors, perhaps the most important of which is the difference in immunity from one child to another, but generally seven days is sufficient for the wound to heal and the child to return to his normal life.

Symptoms of sexual development problems in children:

Child sexual behavior indicates a more serious problem and may require professional intervention if you have the following potential warning signs of a real problem with your child's sexual development:

Developmentally inappropriate sexual behavior:

For example, a 12-year-old wanders around the house naked.

coercive sexual behaviour:

Such as an attempt by a child to persuade another child to engage in sexual activity by threats or use of aggression.

Obsessive sexual behavior:

If the child focuses a lot of time and energy on sexual behaviour, such as being intent on trying to watch their sibling or other person or child in the family take their clothes off.

Behavior not responding to redirect:

If you have adequately addressed your child's risky sexual behavior but it continues, it should be a cause for concern.

Sexual behavior that interferes with the life of the child:

It is a problem if the child's behavior interferes with friendships or the child's relationship with schoolmates. For example, a child is not allowed to go back to a friend's house after repeatedly trying to pull the friend's pants or pulling them out of class.

Sexual behavior that shows mature knowledge of sex:

A problem when children have mature knowledge of sexual behavior and act on that knowledge, for example, a 4-year-old should not imitate adult sexual activity and an 8-year-old should not attempt to access Internet pornography.

Seek professional advice about sexual development problems in children:

If children or teens often behave in the following ways and continue to do these things even when you tell them to stop, it is best to seek professional advice:

1- Young children:

Problematic sexual behavior in young children may include:

Continue to touch their genitals even when someone is trying to get them to do something else.
Invite another child to have sex or touch.
Playing with dolls or other toys in a sexual manner.
Touching the genitals of unprotected adults.
Constantly looking at other children or adults when they are naked or going to the toilet.

2- Pre-school children:

Problematic sexual behavior in a preschooler may include:

Constantly touching or rubbing their genitals in public and not responding to a distraction or trying to get them to do something else.
Insist on using vulgar sexual language, even when asked not to.
Constantly touching the genitals of children or animals, even when someone is trying to get them to do something else.
Trying to insert something into someone else's anus or vagina.

3- Children of school age:

Problematic sexual behavior in school-age children may include:

Constantly rubbing or touching their genitals in public, even when someone is trying to get them to do something else.
Constantly pointing to their genitals to other children.
Insisting on the use of sexual or vulgar language.
Desire to play sexual games with older or younger children.
Forcing or tricking other children into playing sexual games.
Frequent desire to look at or touch the genitals of other children or adults.

How to deal with a deviant child:

In a recent Egyptian study in 2020; It found that children display a wide variety of sexual behaviours, many of which can be explained as developmentally related. Parent demographics and challenging family circumstances certainly influence the frequencies and types of sexual behavior observed, with respect to age range and gender differences.

deviant sexual behaviours:

According to the study sample survey; The least reported deviant sexual behavior was touching the genitals of an animal and attempting to have sex with other children (0.6%). Some elements of sexual behavior were also significantly associated with different age groups and gender differences. A number of demographic and home environmental factors were discussed. causing these behaviors.

How to deal with child sexual perversion:

In light of this study, which is one of the few studies dealing with child sexual behavior in the Arab world; How to deal with a child's deviant sexual behavior certainly starts from the family, where the parents and older siblings are the closest to the child.

When inappropriate sexual behavior occurs, it is important to respond in a manner that is not shameful to the child by parents and adults in the family:

You need to teach him the difference between private and public behavior:

For example, if your 4-year-old takes off his pants while you are at the grocery store, remind him that it is not something he would do in public.

Respond calmly and avoid using words that could shame your child:

Like 'naughty' or 'unkind' or 'dirty'... If your child is feeling shy, they may feel they shouldn't talk to you if they have questions about sex or their own body.

Seek professional help if you are concerned about your child's sexual behavior:

Talk to your pediatrician or mental health professional. They can perform an assessment and make treatment recommendations to help your child.

Sexual development in early childhood:

Many children discover their genitals, and touching the genitals is often one of the first sexual behaviors parents notice.

The important thing is to think about behavior from the children's point of view.. With children's growth, their understanding of what is sexual increases, and we must remember not to use the word abnormality or perversion or to place an unnecessary sexual meaning on the behaviors that we observe in children.

Where the infant who touches his genitals learns that when he moves and touches his body parts, he feels pleasant sensations; This is (normative, exploratory) sexual behavior.

You may see standard sexual behavior referred to as "sex play", due to the quirky and innocent nature of the child.

Examples of normative sexual development and behavior for children:

The following are examples of normative sexual development and behavior of children at different developmental stages:

From birth to 6 years:

Erections can begin in baby boys after birth.
Newborn females may have a menstrual-like vaginal discharge in the days following childbirth.
The child explores and touches the private genitals in public and private places.
May enjoy being naked in public or in private, (shyness).
He talks about the parts of the body and its functions (pigeon talk).
Tries to explore the private parts of familiar people (father and mother).
Blocks himself close to others, has a lack of awareness of personal space.
Engages in imaginative play involving touch (doctor, childcare, husband or wife).
He is curious when family members undress, take a shower, or use the toilet.
Touching the breasts of adults (especially the mother).

From 5 to 8 years:

Sometimes he explores and touches his private parts when he's alone.
Develop awareness of others' physical privacy.
Discuss private intimate organs and bodily functions with children of a similar age.
acts comically or touches the private parts of others; He may ask others to do the same (Show me yours, and I'll show you mine).
Familiar kisses / hugs for adults and children.
Standing too close to others, lack of awareness of personal space.
Participates in imaginative play that includes touch (doctor, child care, partner).
Curious about birth and life cycles and where babies come from.
Curious about bodies and nudity.
Mimics flirtatious or romantic behavior.
Uses vulgar language, makes inappropriate jokes, or makes sexually explicit gestures.

From 6 to 12 years:

Secretly masturbate.
He wants and demands privacy.
Females may start menstruating (average puberty is 12 years).
The child may begin to develop secondary sexual characteristics (pubic hair, enlarged breasts, facial hair, etc.).
The child shows increasing knowledge of physical changes, reproduction, and sex.
Plays games that may be of a sexual nature.
Uses humor to reveal private parts, and may ask others to do the same.
Standing too close to others, lack of awareness of personal space.
Uses vulgar language, makes inappropriate jokes, or makes sexually explicit gestures.
He has expertise in, and interest in, sexual language and media.
Begins to develop sexual attraction to peers.

Malformation of the male urethra:

Hypospadias is a congenital defect defined as a malformation of the male urethra which is abnormally located at the lower end of the glans penis, on the underside of the penis, or at the junction of the penis and scrotum. Therefore, hypospadias can be categorized into anterior, medial, and posterior.

The severity of hypospadias depends on the location of the urethral orifice. In both cases, the man will find it difficult to have intercourse and ejaculate, and pregnancy in a natural way will therefore be complicated.

Definition:

Hypospadias is an anomaly which appears from birth (congenital) and which is characterized by the fact that the opening of the urethra is at a different place than the end of the penis. Hypospadias is also usually associated with a malformation of the foreskin and a curvature of the penis towards the belly. This type of penis is called congenital curved penis.

Due to this curvature of the penis, hypospadias is considered a cause of sexual dysfunction, as it can make sexual intercourse mechanically impossible. In addition, due to the abnormal position of the urethral orifice, ejaculation in the vagina is also hindered.

The frequency of occurrence of hypospadias is between 1 and 8 newborns in 1000.

Hypospadias has both aesthetic and functional consequences. Once the child is older, this malformation can even have psychological consequences.

On the other hand, hypospadias can sometimes be accompanied by other types of malformations that may compromise male fertility, such as cryptorchidism, the presence of hidden testicles and even the diagnosis of sexual ambiguity or pseudo-hermaphroditism must be ruled out. .

Type

There are different types of hypospadias depending on the location of the urethral orifice. The further the urethral orifice is from the glans penis, the more severe the hypospadias. This is how they differ:

- Posterior hypospadias:

is the most severe form. This type of hypospadias appears in 20% of cases and the urethral orifice is very distal to the glans, in the area between the scrotum and the penis or at the base of the penis. Also, posterior hypospadias is accompanied by a very curved penis. This type of hypospadias is also known as penescrotal hypospadias.

- Medium (penile) hypospadias:

constitutes 10% of cases and is of medium severity. The orifice here is located in the central part of the penis, usually on the underside. This causes a certain curvature of the penis towards the belly.

- Anterior hypospadias:

also called glandular hypospadias. This is the most common type, present in 70% of cases. Also, this form of hypospadias is the most benign, since the urinary meatus is close to the glans penis. In addition, the penis has an aesthetically normal appearance and has practically no curvature.

The problems associated with hypospadias will be all the more serious if the urethral orifice is located behind.

Causes of hypospadias:

The exact reason for hypospadias is not known. However, most studies seem to indicate that this abnormality in the position of the opening of the urethra is caused by genetic factors in combination with environmental factors and certain medications. In addition, this malformation is dependent on androgens. Thus, among the causes that can lead to hypospadias, a genetic mutation leading to androgen receptor deficiency may be involved.

This mutation can be inherited in some cases, when a family member already has hypospadias. It is estimated that it is 20% more likely to appear in other members of the same family.

Disruption of embryonic androgen receptors by environmental factors is also thought to be one of the culprits. As well as hormonal treatment in the first month or first trimester of pregnancy or impaired testosterone synthesis.

- Risk factors:

Some factors that seem to increase the risk of hypospadias in children are:

Mothers over the age of 35 with a high body mass index (BMI).
Pregnant women thanks to assisted reproduction techniques.
Administration of certain hormones before and during pregnancy.

However, the presence of these factors does not mean that the baby will have hypospadias. These are only factors that have been studied and appear to increase the risk.

Symptoms:

Symptoms of hypospadias depend on the severity of hypospadias. In any case, the most common clinical manifestations associated with hypospadias are:

Discomfort during erection.
Urine does not come out of the tip of the penis.
Difficulty maintaining direction of urine
Difficulty in sexual relations.
Abnormal appearance of the foreskin.

Due to ejaculation problems, the possibility of having children naturally can be complicated. Additionally, it will also be difficult for sperm to reach the uterus during intercourse.

Diagnosis and treatment:

The way to diagnose hypospadias at birth is by physical examination of the baby. If the pediatrician is unsure of the diagnosis, they may request further evaluation. In general, the treatment of choice for hypospadias is the surgical option. Due to the psychological impact that this anomaly can have on the child, most specialists recommend the operation at an early age, before 3 years of age.

In general, if the problem of hypospadias is corrected when the child is young, it does not need to influence adulthood.

Also, a micropenis can appear due to the curvature of the penis towards the belly. Therefore, during the operation, if necessary, the curvature of the penis can be corrected at the same time as the reconstruction of the urethra and foreskin. Sometimes penis growth can also be stimulated by hormone treatment.

As we have seen, there are different surgical techniques to resolve hypospadias. It is the specialist who will evaluate the case and decide which is the appropriate technique to treat the different aspects to be treated, the orifice, the curvature of the penis and the foreskin.

Hypospadias and fertility:

The concentration of male hormones involved in sperm formation and associated with male fertility may decrease depending on the location of the urethral orifice. Also, hypospadias causes ejaculation problems by preventing sperm from passing through the vagina. For these reasons, the likelihood of having a child with hypospadias is low.

MAP, like any medical treatment, requires that you trust the professionalism of the doctors and the clinic you have chosen. Of course, not all are the same. The Fertility Report selects the most beneficial clinics for you based on our rigorous quality criteria. In addition, the system makes a comparison of prices and conditions offered by different clinics to facilitate your decision-making.

However, if this birth defect of the location of the urethral orifice is treated properly at an early age, it usually does not lead to reproductive health problems in adult men.

Your frequently asked questions:

- How do I know if I have hypospadias?

By José Luis de Pablo (senior clinical embryologist).

Hypospadias is a birth defect in men, where the urinary tract is not on the tip of the penis. This duct may be in an area between the tip of the penis and the scrotum. Some hypospadias are milder or more severe.

- Does hypospadias cause male infertility?

By Dr. Mónica Aura Masip (gynecologist).

Hypospadias is the most common congenital malformation of the penis (1/300 males). It is usually diagnosed at birth during a physical exam and there are varying degrees. It is the ectopic opening of the urethral meatus.

Normally, this opening is located at the tip of the glans penis, but in patients with hypospadias, it is located between the glans and the scrotum, on the underside of the penis.

Hypospadias leads to problems with ejaculation, in some cases preventing the correct exit of spermatozoa, even after surgical correction.

If there is also a hormonal or karyotype alteration, there may be an alteration in the correct production of sperm.

All this means that the chances of having offspring are reduced.

- Is hypospadias hereditary?

By Marta Barranquero Gómez (embryologist).

The exact cause of hypospadias is not precisely known, but there is a link with genetics. For this reason, some studies show that hypospadias runs in families.

More specifically, the genetic cause of hypospadias would be a mutation in a gene, resulting in a lower concentration of androgen receptors. However, it is not possible to say that this congenital malformation of the location of the urethral opening is genetic.

Advice:

Hypospadias can lead to cryptorchidism in humans, which can cause problems in having offspring.

Congenital anomaly that only affects males:

Hypospadias is a birth defect of the penis. Update on the causes, symptoms and management of this anomaly.

Hypospadias is a congenital anomaly that only affects males: this malformation of the penis present from birth is not uncommon since it affects approximately 1 in 300 boys. In medical language, we also speak of hypospadias .

Hypospadias: what are the symptoms?

The word "hypospadias" is made up of the Greek root "hypo-" (which means "below") and "spade" (which means the opening).

In the case of hypospadias, the opening through which urine passes (known as the "urinary meatus") is not located at the end of the penis, but rather at the level of the penis, along the urinary canal. The hypospadias is thus characterized by:

a urinary orifice located on the underside of the penis (we speak of an ectopic meatus). In milder cases, the urinary meatus is near the top of the penis. In more severe hypospadias, the orifice is located in the center or near the base of the penis.
curvature of the penis (hypoplasia of the spongy bodies and skin tissue). When the penis is curved downwards, it is called chordee.
a foreskin open on the back of the penis (dorsal preputial apron).

Hypospadias: what are the causes?

To know. 5% to 10% of cases of hypospadias are familial. Approximately 20 babies out of every 10,000 are born with this birth defect. According to the French Association of Urology (AFU), the frequency of hypospadias has doubled since the 1970s.

The exact causes of hypospadias are not yet fully known. Scientists know, however, that there is talk of poor penile development between the 8th and 14th week of pregnancy. Several hypotheses are put forward today:

Exposure to estrogen-like endocrine disruptors. As the AFU explains, "several substances have been incriminated when they were absorbed during pregnancy, but with a low level of evidence: estrogens, progestins, antiepileptics, certain insecticides, fungicides, pesticides, phthalates, bisphenol A as well as than some phytoestrogen-rich vegetarian diets.”
Exposure to diethylstilbestrol (Distilbene) during pregnancy increases the risk of having a male baby with hypospadias by 20.
Hypospadias is more common in twin pregnancy "and often the smallest of the twins is affected" specifies the AFU.
An endocrine deficiency (androgens) or local growth factors.

Treatment: how to treat hyposdias? When to operate?

To know. Hypospadias is not a congenital malformation dangerous to health. However, it affects the appearance of the penis and its functioning. Some boys with hypospadias may have difficulty urinating while standing up. In adulthood, the location of the urinary meatus and the curvature of the penis can also affect sexual functioning.

The treatment of hypospadias is surgical:

surgery is thus recommended in order to avoid difficulties during urination (this refers to the action of urinating) and aesthetic problems. The aim is also to prevent difficulties during the sexual act and the risk of infertility.

To know. In case of hypospadias, surgery is usually offered when the child is 6 to 24 months old. "Intervening around the age of one means in particular the absence of memory of a gesture which can be painful" underlines the AFU. In 90% of cases, a single surgery is sufficient to correct this malformation. In very severe forms, the risk of re-operation reaches 50%.

Attention! While waiting for this operation, it is very important not to perform circumcision because the foreskin is used during the reconstruction. At the end of the operation, the penis looks circumcised.

The surgical intervention comprises several stages among which the straightening of the penis, the reconstruction of the urethra (urethroplasty) and the reconstruction of the glans. It requires hospitalization (usually a few days) and takes place under general anesthesia.

What are the potential complications?

Among the possible complications, we can point out the fistula (a communication comparable to a "tunnel" between the urethra and the skin) or the stenosis of the urethra (closing of the canal).

The little boy is seen again 4 to 6 weeks after the intervention by the surgeon, then 6 months and 1 year later. Then, a medical follow-up is organized with an appointment every 2 years until puberty to evaluate the functional and aesthetic aspects of the penis: thus, there must be no pain on urination, nor urinary infection. frequent; the stream of urine must be in line with the penis; the penis must be straight during erection.

Hypospadias:

This team of pediatricians and geneticists from Washington State University wondered about the growing prevalence of this congenital anomaly of the penis, hypospadias, characterized by the opening of the urethra on the inside of the penis (instead of its end). The study, published in Scientific Reports, invokes environmental factors, which lead to epigenetic changes, in the developing penis.

genital malformation in male babies:

The research is motivated by the authors' observation, in clinical practice, of an alarming increase in the incidence of this genital malformation in male babies. Epidemiological data show that the prevalence of hypospadias has increased by 11.5% in recent decades, making it the most common genital malformation in newborn boys.

Environmental factors, such as exposure to toxic substances have already been mentioned.

hypospadias causes:

The study of tissue samples of hypospadias finds:

the absence of genetic mutations of DNA sequences correlated with the presence of the disease;
but the presence of specific epigenetic alterations. The authors recall that these epigenetic modifications around the DNA do not modify the DNA but modify their expression;
these same epigenetic alterations are not found in penile tissue samples taken from the foreskin of babies without hypospadias;
finally, tissue samples with mild hypospadias show a greater degree of epigenetic alterations than tissue samples with severe hypospadias: this surprising result can be explained by the fact that cells with very severe epigenetic alterations do not survive.

These observations help to explain this increased incidence and the possible causes of hypospadias: the principal author, Dr. Michael Skinner, professor of biology concludes that "the etiology of the disease is dictated by the environment and epigenetics rather than by mutations or genetic susceptibilities”.

Towards earlier detection?

These data suggest the possibility of this, as well as better clinical management of hypospadias, by targeting a specific epigenetic biomarker that could be collected with a simple buccal swab from a baby's parents to determine the likelihood that the new -born develops the malformation. Such biomarkers have already been identified for other diseases. Their early detection allows for earlier clinical management which means fewer complications for the baby and more peace of mind for the parents.

Behind these epigenetic alterations, what environmental factors?

In other words, what are the toxic substances whose exposure could promote these epigenetic modifications at the origin of hypospadias? One culprit mentioned by researchers may be diethylstilbestrol (Distilbene or DES), a drug used in the late 1950s to ease the later stages of pregnancy in women.

“Because the epigenetic changes caused by drugs like this and other environmental toxicants are epigenetically inherited, they are often passed on from one generation to the next after being contracted. Over time, the adverse effects may linger and spread.”