Antidepressants Blog

Many conditions, such as allergic reactions and viral illnesses, can cause body rashes. In addition certain STDs can cause skin changes in parts of the body other than the genital area. The most common of these are described below.

Gonorrhea. In a small percentage of cases, genital gonorrhea infection spreads throughout the bloodstream and causes skin lesions and joint infection in addition to the more common symptoms of pain with urination and discharge from the penis or the vagina. The skin lesions usually occur on the arms and legs and look like small blood- or pus-filled sores with redness surrounding them.

Human immunodeficiency virus (HIV) infection. Many skin conditions can occur when a person has acquired immunodeficiency syndrome (AIDS), which develops when the immune system begins to decline from HIV infection. Much earlier, however, there may be a sign that HIV infection has occurred. Within two to six weeks after infection with HIV, about a third of people experience a severe flu-like illness with a diffuse rash, sore throat, and lymph node swelling throughout the body. This occurs when the body is mounting an immune response to the virus and is producing proteins called antibodies. These symptoms go away after about a week. After this illness, most people will show a positive blood test for HIV although some may take up to six months to test positive after infection.

Lice. There are three types of lice: head lice, pubic lice, and body lice. The variety that can be sexually transmitted is pubic lice. It usually causes itching and irritation in the genital area where the lice are. As the lice attach to the skin there, there may also be a small amount of bleeding, which can look like rust-colored stains on the underwear. The lice may also infest the eyelashes and the hair under the armpits and on the lower abdomen.

Scabies. This common infection can be sexually transmitted by body contact with an infected person or through infected bedding or clothing. Scabies causes itchy red bumps and lines on the skin (the burrows of the mites that cause the disease), with the itching usually worse at night and after a shower. The rash most commonly develops on the genitals, in the webs between the fingers, at the beltline, under the armpits, behind the knees, and at the ankles.

Syphilis. A person who has second-stage syphilis may develop a rash all over the body, including on the palms and soles. The rash usually does not itch and is not painful. Other symptoms of second-stage syphilis are hair loss, lymph node swelling (not only in the groin but in other areas of the body, such as under the arms and in the neck), fever, and bumps in the genital area that look like warts but are not.

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After the uterus has completely shed the lining and the girl stops bleeding, the lining starts to grow thick and spongy again. While this is happening, the ovaries are getting ready to ovulate again. About ten days or so after a girl finishes her menstrual bleeding, another ovum pops off one of her ovaries. It, too, travels through the Fallopian tube towards the uterus. Unless it is fertilized by a sperm in the tube, it won’t plant in the uterine lining either and will once again disintegrate.

Because the ovum hasn’t been fertilized, the newly grown lining isn’t needed. So it breaks down and dribbles out of the uterus into the vagina, and the process starts again:

• The girl starts bleeding.

• The bleeding lasts for a few days or maybe a week or so, and then it stops.

• The lining of the uterus starts to grow thick and spongy again.

• The ovary releases another ripe ovum.

• The fingerlike ends of the Fallopian tube grasp the ovum and pull it into the tube.

• The hairs inside the tube sweep the ovum towards the uterus.

• Unless the ovum is fertilized, it disintegrates inside the uterus.

• The newly grown lining breaks down and dribbles down the vaginal walls and out through

the vaginal opening.

• The girl starts bleeding and having another menstrual period.

Some girls choose to use sanitary towels or pads to absorb the menstrual blood. The towels are held in place by means of a sanitary belt, or by adhesive strips on the bottom of the pad that make the pad stick to her underwear.

Some girls choose to use tampons. Some types of tampons are inserted by using the fingers to push them into the vagina; others come in special inserter tubes. The tampon is removed by pulling on the string.

The whole process, which is called the menstrual cycle, takes about a month. The cycle repeats itself, month after month, over and over again, year in and year out, throughout most of a woman’s life. When she gets to be about 45 to 55 years old, the cycle stops. The woman stops ovulating and menstruating each month. This stopping of the monthly cycle is called the menopause.

Between puberty, the time when she first starts menstruating, and the menopause, the time when she stops menstruating, a female generally has her period fairly regularly, about once a month. This isn’t a hard and fast rule, though. There are lots of exceptions. For one thing, women stop menstruating when they get pregnant. If a sperm fertilizes an ovum in the Fallopian tube, the fertilized ovum travels to the uterus and plants itself in the uterine lining. The lining provides the blood and nourishment the fertilized ovum needs to grow into a baby. So for the nine months of her pregnancy, while the baby is growing inside her uterus, a woman doesn’t shed her uterine lining. (Here again, there are exceptions to the rule; occasionally, a woman will have one or even two periods after she’s become pregnant. But such periods are shorter than normal periods, and most women don’t have their periods at all once the ovum has been fertilized.) After childbirth, the woman’s periods may start again within a few weeks or a month or two, or it may take several months before they start again.

Also, young girls who’ve just started menstruating don’t always have their periods regularly once a month. It usually takes a while for the body to adjust to menstruating. Many girls have their first period and then don’t have a second one for a number of months. Some have their second period just a couple of weeks after their first. Girls often don’t start having their periods very regularly until they’ve been menstruating for two to three years.

There are certain medical problems that can cause a woman to miss one or more menstrual periods or to stop menstruating altogether. Even healthy women without a single medical problem sometimes miss a period or two. Gaining or losing a lot of weight, moving to a new home, travelling, stress, excitement, nervousness, emotional ups and downs – all these things can cause a woman to miss her period. And there are some perfectly healthy women who menstruate only a few times a year. That’s just the way their particular bodies work.

Most of the time, though, most women have their menstrual periods fairly regularly, about once a month. By ‘fairly regularly’ we don’t mean that it happens once every thirty days exactly. There’s a lot of variation. Some women have periods that come as close together as every twenty-one days; others have periods that come as far apart as every thirty-six days. The average is about twenty-eight days.

No woman’s period is like clockwork. One month the menstrual cycle may last twenty-five days, the next month it may last twenty-eight days and the following month, thirty days. One month the bleeding may last for three days, the next month for five days. Some women’s periods vary quite a bit and others are more regular. In general, though, a woman’s period comes about once a month and lasts for a few days to a week or so.

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As we explained earlier in this chapter, boys sometimes ejaculate while they’re asleep. A common term for this is ‘having a wet dream’. The scientific name for wet dreams is nocturnal emissions. Nocturnal means ‘during the night’ and emissions are things that are ‘emitted’ or ‘sent forth’. So nocturnal emissions are ejaculations (sperm emitted or sent forth) at night.

It’s possible for a grown man to have a wet dream, but they are much more common among boys going through puberty. Not all boys have wet dreams at this time in their lives, but many do. A boy who masturbates regularly is less likely to have a wet dream than one who never or only rarely masturbates. However, even boys who masturbate may have wet dreams fairly often.

Many boys have their first ejaculation during a wet dream. If you don’t know about wet dreams and haven’t been prepared for the fact that it may happen to you, a wet dream can be a confusing experience. Many boys thought they’d wet their beds or were bleeding until they realized that the fluid was milky white, not like blood or urine. As one man we interviewed explained:

I’m what? – 67 years old – so this is over fifty years ago, but I still remember my first wet dream like it was yesterday. Nobody told me anything about anything. So I woke up in the middle of the night. There’s this wet, sticky stuff all over my stomach. I thought I’ve wet my bed – at my age!’ I was 13 or 14 at the time.

So a few days, maybe a week later, it happens again. Only now I pay more attention, and it’s not piss [urine]. It’s white and thick like a lotion or cream, sticky. I think I’ve got some kind of sickness. It keeps happening, so finally I tell my mother. She says if I control myself and don’t think about ‘such things’ it won’t happen. I have no idea what she’s talking about – control myself from what? Don’t think about what things? I wasn’t thinking about anything. I was asleep.

Charlie, age 67

Even if you know about wet dreams beforehand, they can be a surprising experience, as one boy told us after class one day:

My mum and dad had told me all about this sort of thing ever since I was really young. Still, it was a surprise the first time. Everything was hazy, but there was this wetness on my pyjamas and for a while I couldn’t figure things out. I was only half awake. Then as I woke up more, I thought, ‘Oh, yeah, this is what Mum had said about.’ Whether or not you know about wet dreams beforehand, you may feel embarrassed if you have one. One of the films we use in our sex education classes, a film called Am I Normal?, deals with one young boy’s experience as he’s going through puberty. In one scene the boy wakes up after having had a wet dream. He’s so embarrassed that he takes off his pyjamas and the sheets off his bed and sneaks down the hall to the bathroom. He turns the water on in the basin and pours a glass of water over his bedclothes and stuffs them in the laundry basket. His mother hears him and calls out, ‘Is that you, love? Is there anything wrong?’

‘Nothing, Mum… Oh, by the way, Mum, I forgot to tell you … I spilled water all over my bed,’ he nervously explains. ‘I guess I’m going to have to put my sheets in the basket.’

The boys in our classes always get a big laugh out of this scene, probably because many of them have felt the same kind of embarrassment. But wet dreams aren’t anything to be embarrassed about. They’re a natural and normal thing, just another part of growing up.

After the class in which we show this film, there are usually at least a couple of questions about wet dreams in the Everything You Ever Wanted to Know question box. Two questions that come up over and over again are ‘Do wet dreams happen only at night?’ and ‘Do they happen only when you’re asleep?’ The answer is that wet dreams could happen anytime you’re asleep. If you took a nap during the day, it would be possible for you to have a wet dream. But wet dreams happen only when you’re asleep. You don’t spontaneously ejaculate in this way when you’re awake. You might have a spontaneous erection, an erection that happens all by itself, but you won’t have an ejaculation unless you deliberately engage in strong sexual stimulation (such as masturbating or having sexual intercourse).

The children in our classes also want to know why they’re called wet dreams. ‘Do they happen only if you’re having a dream?’ ‘Do you have to be having a sexy dream?’ they ask. The fact is that everyone dreams when he or she is asleep. Even if you don’t remember doing so, you’ve been having dreams (a fact scientists have discovered by studying the electrical patterns in the brains of sleeping people). But the term ‘wet dream’ doesn’t mean that you dream during a nocturnal emission. It just refers to the fact that wet dreams happen when you’re asleep or at least half asleep. You may have been having a ‘sexy dream’ during your nocturnal emission. Many boys who awake to find that they have ejaculated recall that their dream was about something sexual. But you may have a wet dream even if you haven’t been having a sexual dream.

By the way, Charlie’s mother was wrong. A boy can’t stop himself from having wet dreams. They’re just something that happens. In fact, wet dreams, like masturbation, are part of your body’s way of emptying the ampulla and making way for new sperm.

After you’ve read this far in the book, you’ve probably learned just about everything you’ve ever wanted to know about what happens to a boy’s body during puberty. But we haven’t talked very much about what happens to girls’ bodies. So in the next chapter we’ll learn about girls and puberty.

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Semen is very powerful stuff. Just before ejaculation, the seminal vesicles release semen into the ampulla. The sugar-rich semen gives the sperm a big energy boost.

Until the seminal fluid mixes with the sperm, the sperm are fairly sluggish and slow-moving. They hardly move their tails. They don’t even have enough energy to get round by themselves.

Luckily, the walls of the vas deferens have muscles that work rather like the muscles in your throat. These muscles contract and, with the help of tiny little hairs, they sweep the sperm up the tube of the vas deferens into the ampulla. Otherwise, the sluggish sperm would never get themselves out of the scrotum.

Once the sperm get a shot of semen, they start whipping their tails round like mad and moving all over the place. Sperm really need this energy boost. They have quite a long journey to make in order to get to the ovum and fertilize it. After the sperm and semen are ejaculated from the man’s penis into the woman’s vagina, the sperm have to travel to the top of the woman’s vagina and through the narrow opening there that leads to her uterus. Then they have to travel the whole length of the woman’s uterus and half-way up her Fallopian tube in order to meet and fertilize the ovum. And the sperm have to move quickly in order to get to the ovum while it’s still nice and fresh. So the sperm are ‘running’ the whole way.

Altogether the sperm have to travel only about 150 mm (6 in), which doesn’t sound like much. Remember, though, sperm are less than five-tenths of a millimetre (one five hundredth of an inch) long. A distance of 150 mm (6 in) to a sperm would be like 6.4 km (4 miles) to a man. You’d certainly need an energy boost if you were going to run that far at top speed!

The prostate gland-The prostate gland, which lies below the ampulla and seminal vesicles, is ring-shaped. A number of tubes, including the vas deferens, run through the centre of this ring. The prostate gland also adds some fluid to the semen. When a man ejaculates, the prostate contracts and tightens up, squeezing on the vas. This helps push the sperm and the other seminal fluids (that is, the semen) into the tube in the centre of the penis, the urethra.

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In addition to those curly pubic hairs, testosterone also causes hair to grow on other parts of your body. As you’re going through puberty, you may notice that you have more “”hair on your arms, your thighs and your lower legs. This hair probably won’t be as curly as your pubic hair. But there will usually be more hair in these areas of your body than there was during childhood. Hair may also start to grow on your chest. Some boys grow hair on their shoulders and/or their backs. Some grow hair on the backs of their hands. Some boys become really hairy; others have very little body hair.

People often think that the amount of body hair a man has is related to how much testosterone his testicles make. This isn’t true. Testosterone causes your body hair to start to grow, but how much or how little a man has doesn’t have anything to do with how much testosterone his body makes. The amount of body hair you’ll have is determined by two things: your racial or ethnic group and your family. As a group, white men generally have more body hair than Oriental or black men. Within any of these groups, the amount of hair a man has usually depends on his family. Boys who come from families in which the men tend to have lots of body hair usually also have a lot of body hair. Boys who come from families in which the men have little or no hair on their chests, arms, legs, hands and so on usually have very little body hair. Once again, this isn’t a hard and fast rule, but hairiness or lack of it does tend to, as they say, ‘run in families’.

Just as there are a lot of myths about penis size, so there are a lot of myths about body hair. Some people believe that men who have a lot of body hair are more manly or masculine than men who don’t have so much. This is nonsense. Body hair or lack of it doesn’t have anything to do with how much of a man you are. Some people (both men and women) find lots of body hair attractive. For them, body hair is especially sexy. Others feel that smoother, more hairless bodies are more attractive. But for most people it doesn’t matter that much one way or the other. So if you’re worried about the amount of body hair you have, you probably shouldn’t bother. For one thing, worrying won’t make any difference. Besides, anyone who is going to decide whether or not they like you on the basis of how much body hair you have probably isn’t worth knowing anyhow.

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There is no simple answer to this question because each boy is different. But doctors have studied boys going through puberty, so we can tell you about what happens to most boys.

As you may recall from the beginning of this chapter, the earlier starters do not necessarily go through these stages any faster than boys who start puberty later or boys who start at the average age. Boys may take from one year to six years to go from Stage 2, the beginning of puberty, to Stage 5, the fully grown adult stage. The so-called average boy takes about four years. The table you see below shows how long boys take to go through each of the various stages of genital development. The first column shows how long the average boy takes to go through each stage. But, as we’ve said, not all boys are average. The second column shows the range of times it takes most boys to go through these stages.

Let’s say you are 12 years old and have just reached Stage 2. If you are a so-called typical or average boy, you will probably reach Stage 3 in about thirteen more months; that is, in one year and one month. However, you may be quick to develop and may find yourself in Stage 3 in only five months. Or you may be slower to develop and may not find yourself in Stage 3 until

twenty-six months have gone by. This table will not tell you exactly when the various changes that happen during puberty are going to happen to you, but it will give you some idea of what to expect.

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