Jumat, 15 Mei 2009

test yourself

Answers are for who you are now...... not who you were in the past.
Have pen or pencil and paper ready.
This is a real test given by the
Human Relations Dept. at many of the major corporations today. It helps them
get better insight concerning their employees and prospective employees.
It's only 10 simple questions, so...... grab a pencil and paper, keep track of your letter

Number your paper 1 to 10 first.
Continue to begin test

1. When do you feel at your best?
a) in the morning
b) during the afternoon and early evening
c) late at night

2. You usually walk.....
a) fairly fast, with long steps
b) fairly fast, with little steps
c) less fast head up, looking the world in the face
d) less fast, head down
e) very slowly

3. When talking to people, you...
a) stand with your arms folded
b ) have your hands clasped
c) have one or both your hands on your hips or in pockets
d) touch or push the person to whom you are talking
e) play with your ear, touch your chin or smooth your hair
4. When relaxing, you sit with...

a) your knees bent with your legs neatly side by side
b) your legs crossed
c) your legs stretched out or straight
d) one leg curled under you

5. When something really amuses you, You react with...
a) a big appreciated laugh
b) a laugh, but not a loud one
c) a quiet chuckle
d) a sheepish smile

6. When you go to a party or social gathering, you...
a) make a loud entrance so everyone notices you
b) make a quiet entrance, looking around for someone you know
c) make the quietest entrance, trying to stay unnoticed

7. When you're working or concentrating very hard, and you're interrupted, you...
a) welcome the break
b) feel extremely irritated
c) vary between these two extremes

8. Which of the following colors do you like most?
a) Red or orange
b) Black
c) yellow or light blue
d) Green
e) dark blue or purple
f) White
g) brown or gray

9. When you are in bed at night, in those last few moments before going to sleep, you
a) stretched out on your back
b) stretched out face down on your stomach
c) on your side, slightly curled
d) with your head on one arm
e) with your head under the covers

10. You often dream that you are...
a) falling
b) fighting or struggling
c) searching for something or somebody
d) flying or floating
e) you usually have dreamless sleep
f) your dreams are always pleasant


1. (a) 2 (b) 4 (c) 6
2. (a) 6 (b) 4 (c) 7 (d) 2 (e) 1
3. (a) 4 (b) 2 (c) 5 (d) 7 (e) 6
4. (a) 4 (b) 6 (c) 2 (d) 1
5. (a) 6 (b) 4 (c) 3 (d) 5 (e) 2
6. (a) 6 (b) 4 (c) 2
7. (a) 6 (b) 2 (c) 4
8. (a) 6 (b) 7 (c) 5 (d)4 (e) 3 (f) 2 (g) 1
9. (a) 7 (b) 6 (c) 4 (d) 2 (e) 1
10. (a) 4 (b) 2 (c) 3 (d) 5 (e) 6 (f) 1

Now add up the total number of points.

Others see you as someone they should 'handle with care.' You're seen as
vain, self-centered and one who is extremely domineering. Others may
admire you, wishing they could be more like you, but don't always trust you,
hesitating to become too deeply involved with you.

Others see you as an exciting, highly volatile, rather impulsive personality; a natural leader, one who's quick to make decisions, though not always the right ones. They see you as bold and adventuresome, someone who will try anything once; someone who takes chances and enjoys an adventure. They enjoy being in your company because of the excitement you radiate.

Others see you as fresh, lively, charming, amusing, practical and always interesting;
someone who's constantly in the center of attention, but sufficiently well-balanced not to let it go to their head. They also see you as kind, considerate, and understanding; someone who'll always cheer them up and help them out.

Others see you as sensible, cautious, careful and practical. They see you as clever, gifted, or talented, but modest. Not a person who makes friends too quickly or easily, but someone who's extremely loyal to friends you do make and who expect the same loyalty in return. Those who really get to know you realize it takes a lot to shake your trust in your friends, but equally that it takes you a long time to get over it if that trust is ever broken.

Your friends see you as painstaking and fussy. They see you as very cautious, extremely careful, a slow and steady plodder. It would really surprise them if you ever did something impulsively or on the spur of the moment, expecting you to examine everything carefully from every angle and then usually decide against it. They think this reaction is caused partly by your careful nature.

People think you are shy, nervous, and indecisive, someone who needs looking
after, who always wants someone else to make the decisions and who doesn't want to get involved with anyone or anything! They see you as a worrier who always sees problems that don't exist. Some people think you're boring. Only those who know you well know that you aren't.

for my children

what the phylosofy of life
remember that

Make new friends
Rediscover old ones
Tell them that you love them
And when you love them feel it deeply

Ignore worries
Forget problems
Pardon enemies
Keep promises

Prize your good ideas
If you get more than one chance, try again
Try not to make mistakes and if you do, learn from them

Be crazy
Appreciate miracles when they happen
Notice where the sun is in the sky
Listen to the rain
Watch for rainbow and fallig stars
Look for the beauty around you

Smile with your heart
Confide in others
Give to others

Hope, desire, grow, hard work and be yourself
Be understanding , when it’s needed
Have confidence in life
Have faith
Comfort a friend
Have confidence in yourself
Enjoy life

life in Al-quran

Al Qur’an itu bukanlah cerita yang dibuat-buat, akan tetapi membenarkan (kitab-kitab) yang sebelumnya dan menjelaskan segala sesuatu, dan sebagai petunjuk dan rahmat bagi kaum yang beriman. (QS Yusuf, 12:111)

… Dan Kami turunkan kepadamu Al Kitab (Al Qur’an) untuk menjelaskan segala sesuatu dan petunjuk serta rahmat dan kabar gembira bagi orang-orang yang berserah diri. (QS An Nahl, 16:89)

Katakanlah: sesungguhnya sembahyangku, ibadatku, hidupku dan matiku hanyalah untuk Allah, Tuhan semesta alam. (QS Al An'am, 6:162)

Barangsiapa yang mengerjakan amal saleh, baik laki-laki maupun perempuan dalam keadaan beriman, maka sesungguhnya akan Kami berikan kepadanya kehidupan yang baik dan sesungguhnya akan Kami beri balasan kepada mereka dengan pahala yang lebih baik dari apa yang telah mereka kerjakan. (QS An Nahl, 16: 97)

Sesungguhnya dalam penciptaan langit dan bumi, dan silih bergantinya malam dan siang terdapat tanda-tanda (ayat-ayat) bagi orang-orang yang berakal. (QS. Al 'Imran, 3:190)
Allah memegang jiwa (orang) ketika matinya dan (memegang) jiwa (orang) yang belum mati di waktu tidurnya; maka Dia tahanlah jiwa (orang) yang telah Dia tetapkan kematiannya dan Dia melepaskan jiwa yang lain sampai waktu yang ditetapkan (QS Az Zumar, 39:42)

Dan Dialah yang menidurkan kamu di malam hari dan Dia mengetahui apa yang kamu kerjakan di siang hari, kemudian Dia membangunkan kamu pada siang hari untuk disempurnakan umur(mu) yang telah ditentukan, kemudian kepada Allah-lah kamu kembali, lalu Dia memberitahukan kepadamu apa yang dahulu kamu kerjakan (QS Al An'am, 6:60)

Karena sesungguhnya sesudah kesulitan itu ada kemudahan; sesungguhnya sesudah kesulitan itu ada kemudahan. (QS Alam-Nasyrah, 94: 5-6)

Dia juga memperingatkan orang yang tidak bersyukur akan pedihnya siksa di Neraka:
Dan (ingatlah juga), tatkala Tuhanmu memaklumkan, "Sesungguhnya jika kamu bersyukur, pasti Kami akan menambah (nikmat) kepadamu, dan jika kamu mengingkari (nikmat-Ku), maka sesungguhnya azab-Ku sangat pedih." (QS Ibrahim, 14:7)

Allah-lah yang menjadikan bumi bagi kamu tempat menetap dan langit sebagai atap, dan membentuk kamu lalu membaguskan rupamu serta memberi kamu rezki dengan sebahagian yang baik-baik. Yang demikian itu adalah Allah Tuhanmu, Maha Agung Allah, Tuhan semesta alam. (QS. Ghafir, 40:64)

Sesungguhnya kamu pada siang hari mempunyai urusan yang panjang (banyak).
(QS Al Muzzammil, 73:7)

… dan Dia menjadikan siang untuk bangun berusaha. (QS. al-Furqan, 25:47)

Orang beriman melihat hari di hadapannya sebagai kesempatan untuk meraih cinta dan ridha Allah serta untuk mendapatkan Surga.

"Ya Tuhanku berilah aku ilham untuk tetap mensyukuri nikmat-Mu yang telah Engkau anugerahkan kepadaku dan kepada dua orang ibu bapakku, dan untuk mengerjakan amal saleh yang Engkau ridhai; dan masukkanlah aku dengan rahmat-Mu ke dalam golongan hamba-hamba-Mu yang saleh." (QS An Naml, 27:19)

Kamis, 14 Mei 2009

33 ways developing Khushoo’ in Salaah

33 ways developing Khushoo’ in Salaah

Book by Sheikh Muhammed Salih Al-Munajjid
Praise be to Allaah, Lord of the Worlds, Who has said in His book (interpretation of the meaning), “…and stand before Allaah with obedience” [al-Baqarah 2:238] and has said concerning the prayer (interpretation of the meaning): “… and truly it is extremely heavy and hard except for al khaashi’oon…’ [al-Baqarah 2:45]; and peace and blessings be upon the leader of the pious, the chief of al-khaashi’oon, Muhammad the Messenger of Allaah, and on all his family and companions.

Salaah is the greatest of the practical pillars of Islam, and khushoo’ in prayer is required by sharee’ah. When Iblees, the enemy of Allaah, vowed to mislead and tempt the sons of Adam and said “Then I will come to them from before them and behind them, from their right and from their left…” [al-A’raaf 7:17, interpretation of the meaning], one of his most significant plots became to divert people from salaah by all possible means and to whisper to them during their prayer so as to deprive them of the joy of this worship and cause them to lose the reward for it. As khushoo’ will be the first thing to disappear from the earth, and we are living in the last times, the words of Hudhayfah (may Allaah be pleased with him) are particularly pertinent to us: “The first thing of your religion that you will lose is khushoo’, the last thing that you will lose of your religion is salaah. There may be a person praying who has no goodness in him, and soon you will enter the mosque and not find anyone whohas khushoo’.” (al-Madaarij, 1/521).
Because of what every person knows about himself, and because of the complaints that one hears from many people about waswaas (insinuating thoughts from Shaytaan) during the salaah and the loss of khushoo’, the need for some discussion of this matter is quite obvious.
The following is a reminder to myself and to my Muslim brothers, and I ask Allaah to make it of benefit.
Allaah says (interpretation of the meaning): “Successful indeed are the believers, those who offer their salaah (prayers) with all solemnity and full submissiveness.” [al-Mu’minoon 23:1-2] – i.e., fearing Allaah and in a calm manner. Khushoo’ means calmness, serenity,tranquillity, dignity and humility. What makes a person have this khushoo’ is fear of Allaah and the sense that He is always watching. (Tafseer Ibn Katheer, Daar al-Sha’b edn., 6/414).

Khushoo’ means that the heart stands before the Lord in humility and submission. (al-Madaarij, 1/520).

It was reported that Mujaahid said: “’…and stand before Allaah with obedience” [al-Baqarah 2:238 – interpretation of the meaning]’ – part of obedience is to bow, to be solemn and submissive, to lower one’s gaze and to humble oneself out of fear of Allaah, may He be glorified.” (Ta’zeem Qadr al- Salaah, 1/188).

The site of khushoo’ is the heart, and its effects are manifested in the physical body. Thevarious faculties follow the heart: if the heart is corrupted by negligence or insinuating whispers from Shaytaan, the worship of the body’s faculties will also be corrupt. The heartis like a king and the faculties are like his troops who follow his orders and go where they
are commanded. If the king is deposed, his followers are lost, which is like what happens when the heart does not worship properly.
Making a show of khushoo’ is condemned. Among the signs of sincerity are

Hudhayfah (may Allaah be pleased with him) used to say: “Beware of the khushoo’ of hypocrisy.” He was asked, “What is the khushoo’ of hypocrisy?” He said, “When the body shows khushoo’ but there is no khushoo’ in the heart.” Fudayl ibn ‘Ayaad said: “It was disliked for a man to show more khushoo’ than he had in his heart.” One of them saw a manshowing khushoo’ in his shoulders and body, and said, “O So and so, khushoo’ is here” –
and he pointed to his chest, “not here” – and he pointed to his shoulders. (al-Madaarij, 1/521)

Ibn al-Qayyim (may Allaah have mercy on him) said, explaining the difference between the khushoo’ of true faith and the khushoo’ of hypocrisy: “The khushoo’ of true faith is when the heart feels aware and humble before the greatness and glory of Allaah, and is filled with awe, fear and shyness, so that the heart is utterly humbled before Allaah and broken, as it were, with fear, shyness, love and the recognition of the blessings of Allaah and its own sins. So no doubt the khushoo’ of the heart is followed by the khushoo’ of the body. As for the khushoo’ of hypocrisy, it is something that is put on with a great show, but there is no khushoo’ in the heart. One of the Sahaabah used to say, ‘I seek refuge with Allaah from the khushoo’ of hypocrisy.” It was said to him, ‘What is the khushoo’ of hypocrisy?’ He said, “When the body appears to have khushoo’ but there is no khushoo’ in the heart.’ The person who truly feels khushoo’ before Allaah is a person who no long feels the flames of physical desire; his heart is pure and is filled with the light of the greatness of Allaah. His own selfish desires have died because of the fear and awe which have filled his heart to overflowing so that his physical faculties have calmed down, his heart has become dignified and feels secure in Allaah the remembrance of Him, and tranquillity descends upon him from his Lord. So he has become humble (mukhbit) before Allaah, and the one who is humble is the
one who is assured. Land that is “mukhbit” is land that is low-lying, in which water settles, so the heart that is “mukhbit” is humble and content, like a low-lying spot of land into which water flows and settles. The sign of this is that a person prostrates to his Lord out of respect and humility, and never raises his head until he meets Him. The arrogant heart, on the other hand, is one that is content with its arrogance and raises itself up like an elevated portion of
land in which water never settles. This is the khushoo’ of true faith.”

Knowing the advantages of khushoo' in salaah
These include:
- The Prophet (peace and blessings of Allaah be upon him) said: “There is no Muslim man who, when the time for a prescribed prayer comes, he does wudoo’ properly, has the proper attitude of khushoo’, and bows properly, but it will be an expiation for all his previous sins, so long as they were not major sins (kabeerah). And this is the case for life” (Reported by Muslim, 1/206, no. 7/4/2)
- The reward recorded is in proportion to the degree of khushoo’, as the Prophet (peace and blessings of Allaah be upon him) said: “A slave may pray and have nothing recorded for it except a tenth of it, or a ninth, or an eighth, or a seventh, or a sixth, or a fifth, or a quarter, or a third, or a half.” (Reported by Imaam Ahmad; Saheeh al-Jaami’, 1626).
- Only the parts of his prayer where he focused and concentrated properly will be of any avail to him. It was reported that Ibn ‘Abbaas (may Allaah be pleased with him) said: “You will only have from your prayer that which you focused on.”
Sins will be forgiven if you concentrate properly and have full khushoo’, as the Prophet (peace and blessings of Allaah be upon him) said: “When a slave stands and prays, all his sins are brought and placed on his head and shoulders. Every time he bows or prostrates, some of them fall from him.” (Reported by al-Bayhaqi in al-Sunan al-Kubraa, 3/10; see also Saheeh al-Jaami’). Al-Manaawi said: “What is meant is that every time a pillar (essential part) of the prayer is completed, part of his sins fall from him, until when he finishes his prayer, all his sins will be removed. This is in a prayer where all the conditions are met and the essential parts are complete. What we understand from the words “slave” and “stands” is that he is
standing before the King of Kings [Allaah] in the position of a humble slave.” (Reported by al-Bayhaqi in al-Sunan al-Kubraa, 3/10; see also Saheeh al-Jaami’).
- The one who prays with khushoo’ will feel lighter when he finishes his prayer, as if his burdens have been lifted from him. He will feel at ease and refreshed, so that he will wish he had not stopped praying, because it is such a source of joy and comfort for him in this world. He will keep feeling that he is in a constricting prison until he starts to pray again; he will
find comfort in prayer instead of wanting just to get it over and done with. Those who love prayer say: we pray and find comfort in our prayer, just as their leader, example and Prophet (peace and blessings of Allaah be upon him) said, “O Bilaal, let us find comfort in prayer.”He did not say “Let us get it over and done with.”

for the rest of this book, must read in the real book......

life is for thanks to God

we must thanks God with all we have now, we thanks to God with all we got, smile and never frustrate because God burdens not a person beyond his scope, he gets reward for that good which he has earned and he is punished for that evil which he has earned.

Al Baqarah 2:286

Allah burdens not a soul beyond its scope, for it is only that which it hath earned, and against it only that which it hath deserved. Our lord, condemn us not if we forget, or miss the mark. Our lord , lay not on us such a burden as thou didst lay in those before us, our lord, impose not on us, that which we have not the strength to bear, pardon us, absolve us and have mercy on us, thou, our protector, and give us victory over the disbelieving folk

life maybe not easy but life is always beautiful when we realize that in the time we thanks god with what we got , that will make our life more haply

Allah tidak membebani seseorang melainkan sesuai dengan kesanggupannya. Ia mendapat pahala (dari kebajikan) yang diusahakannya dan ia mendapat siksa (dari kejahatan) yang dikerjakannya. (Mereka berdoa): "Ya Tuhan kami, janganlah Engkau hukum kami jika kami lupa atau kami tersalah. Ya Tuhan kami, janganlah Engkau bebankan kepada kami beban yang berat sebagaimana Engkau bebankan kepada orang-orang sebelum kami. Ya Tuhan kami, janganlah Engkau pikulkan kepada kami apa yang tak sanggup kami memikulnya. Beri ma'aflah kami; ampunilah kami; dan rahmatilah kami. Engkaulah Penolong kami, maka tolonglah kami terhadap kaum yang kafir."

bersyukur dengan semua yang Allah berikan adalah penyembuh kesedihan dan kegundahan hati.....

pray in early morning why good for health

Shalat tahajud is pray at night in the time when almost people sleep, than we talk with God in pray, the best time between 3.00 am in the early morning.why it's good because pray in early morning will give you strength and good mind, this will make you fresh to begin your day, so why not we do it since now, not easy i know, but we will try to make this day more better than yesterday. will we do it ?

yaa ayyuhaa almuzzammilu

[73:1] Hai orang yang berselimut (Muhammad),

English: O you who have wrapped up in your garments!

qumi allayla illaa qaliilaan

[73:2] bangunlah (untuk sembahyang) di malam hari, kecuali sedikit (daripadanya),

English: Rise to pray in the night except a little,

nishfahu awi unqush minhu qaliilaan

[73:3] (yaitu) seperduanya atau kurangilah dari seperdua itu sedikit.

English: Half of it, or lessen it a little,

aw zid 'alayhi warattili alqur-aana tartiilaan

[73:4] atau lebih dari seperdua itu. Dan bacalah Al Qur'an itu dengan perlahan-lahan.

English: Or add to it, and recite the Quran as it ought to be recited.

innaa sanulqii 'alayka qawlan tsaqiilaan

[73:5] Sesungguhnya Kami akan menurunkan kapadamu perkataan yang berat.

English: Surely We will make to light upon you a weighty Word.

inna naasyi-ata allayli hiya asyaddu wath-an wa-aqwamu qiilaan

[73:6] Sesungguhnya bangun di waktu malam adalah lebih tepat (untuk khusyuk) dan bacaan di waktu itu lebih berkesan.

English: Surely the rising by night is the firmest way to tread and the best corrective of speech.

susah susah mudah sholat tahajud,kadang kita jadi rajin ketika sedang sedih,tapi ketika kita sedang senang lupalah kita akan bermunajat di malam yang penuh keheningan dimana malaikat turun kebumi dan mengaminkan semua munajat kita disaat matahari masih belum tampak dan orang orang pada tidur...alangkah indahnya..ya Allah jadikan aku hambaMu penuh dengan rasa syukur..dan jauhkan kami dari syirik, maupun kesombongan, ataupun riya, lahaula walakuata illa billa alihil ajim

Rabu, 30 Juli 2008

IBU dan Anak

Dorothy Law Nolte mengatakan bahwa begitu besar peran seorang ibu
Kalau seorang anak hidup dalam kritikan , ia akan belajar menghukum
Kalau seorang anak hidup dalam permusuhan, ia akan belajar kekerasan
Kalau seorang anak hidup dalam olokan maka ia akan belajar jadi malu
Kalau seorang anak hidup dalam rasa malu , ia akan belajar merasa bersalah
Kalau seorang anak hidup dengan dorongan , maka ia belajar percaya diri
Kalau seorang anak hidup dengan keadilan, maka ia belajar menjalankan keadilan
Kalau seorang anak hidup dengan ketentraman, maka ia belajar tentang iman
Kalau seorang anak hidup dengan dukungan , ia belajar menyukai diri sendiri
Kalau seorang anak hidup dengan penerimaan serta persahabatan , ia belajar untuk
mencintai dunia

Sabtu, 12 Juli 2008

inspired video

Be yourself and you will be success, love and love with all your heart, never give up. God give you talents and give you brain, heart and mind, be positive thingking and be confident, you are the best , becouse what you are is what you think, what you share and love, just follow your dream never give up . love liza

Rabu, 02 Januari 2008

How to manage my health,....life style management? what is it doc?

General lifestyle management
Written by Dr Dan Rutherford, GP

There are a number of lifestyle factors that are known to impact your overall health and wellbeing.


Alcohol is high in calorie content and low on nutrition. It contributes to weight gain and if you drink too much, too often, it can lead to all sorts of health problems such as high blood pressure and liver damage.

We may all overindulge from time to time, but try not to make this a regular thing. Drinking a lot in one session is never a good thing for your health.

There has been a lot of emphasis on young binge drinkers, but if you are female and have one glass of red wine at home each night, you will exceed the government guidelines for safe drinking.


Most people think of exercise solely in terms of weight loss, but it also builds muscles and bones, lifts mood and is a great way of beating stress. If you don't do 30 minutes of walking most days, plus one or two aerobic sessions a week, you aren't exercising enough.

If you want to make changes to your routine, bear in mind it takes three weeks to adopt a new habit, so you should draw up a plan that carries you beyond this point.


Most adults need six to eight hours of sleep each night. When we sleep, we rest and our body is able to renew its energy. This may be why a good night's sleep seems to improve the immune system, minimising our risk of illness.

Sleep is also important because of dreams. When we dream, we process all the events of daily life. Getting a good night's sleep, therefore, influences our psychological wellbeing.


Smoking causes cell damage, which can lead to illnesses such as cancer and heart disease. It also drains the body of many essential vitamins and minerals, affecting your ability to absorb these vital nutrients. The only way to avoid this damage is to stop smoking.


We all have an instinctive stress response that releases hormones into our bloodstream when we are faced with danger.

These hormones cause instant mental and physical change in us, giving added strength and endurance so we can fight or take flight.

Instead of using our stress hormones in emergencies, we live at such a pace that many of us activate them all the time - like when we are going to miss a train or someone cuts us up on the motorway.

Most tense people don't give themselves sufficient time and space to rest after each stress-filled moment. With no release, your stress hormones keep on working, which is why there are so many people around who lose their tempers at the slightest provocation.

If this sounds like you, make learning how to reduce and cope with stress a priority.

What we drink

Good hydration is essential for mind and body, so make sure you drink plenty of water every day. Not all drinks are equal, so if you need to boost your liquid intake, watch your caffeine (and sugar) levels don't creep up.

Where we get energy from

The food we eat is used to provide energy for every function in the body, from walking and talking to digesting and breathing.

The main types of food - carbohydrate, protein and fats - are important sources of energy.

Current guidelines suggest that we should get:

o about 50 per cent of our energy from carbohydrates (cereals, bread, pasta and potatoes)

o 10-15 per cent from protein (meat, cheese, soya)

o less than 30 per cent of energy from fats (70g per day for women, 100g for men). Many of us eat more than this a day.

The actual amount of energy you require will depend upon the type of lifestyle you lead.

The recommended figures are 2000 calories per day for women and 2500 for men – but you may need less than this if you take little exercise and sit at a desk all day, and more than this if your job involves manual labour.

For further advice on improving your lifestyle, see the factsheets below.

why i get headache easy angry, everytime i have menstruation.. doc?

Premenstrual syndrome (PMS or PMT)
Written by Dr Philip Owen, consultant obstetrician and gynaecologist

What is premenstrual syndrome?

The terms premenstrual syndrome (PMS) and premenstrual tension (PMT) are interchangeable.
Around 90 per cent of menstruating women get advance warning of an approaching period because of physical and/or psychological changes in the days before their period begins.

For most women the symptoms are mild, but a small proportion finds their symptoms so severe they dread this time of the month.

The terms ‘mild’ and ‘severe’ in respect of PMS are arbitrary, but relate to the extent of disruption to your home and work life that's attributable to the monthly cycle.

About a third of women say PMS significantly affects their life, with 5 to 10 per cent classifying their PMS as severe.

Symptoms of PMS

© NetDoctor/Justesen
For some women, the days before the start of their period can be awful.
There are more than 100 recognised symptoms that may be due to PMS. Fortunately, most women experience only a handful of problems. The most common symptoms are listed below.


o Irritability.

o Mood swings.

o Losing your temper easily.

o Loss of confidence.

o Crying for no particular reason.

o Aggression.

o Poor concentration.

o Tiredness.


o Breast tenderness.

o Abdominal swelling or bloating.

o Weight gain.

o Swollen ankles.

o Headaches and possibly migraine.

None of these symptoms is exclusive to PMS. They can be caused by other conditions such as depression, stress, thyroid gland problems (under- or over-activity) and anaemia.

How do I know if I have PMS?

Premenstrual dysphoric disorder (PMDD) is a mood disorder that occurs during the menstrual cycle.
The symptoms are similar to PMS, but are severe enough to impair or prevent quality of life.
PMDD is a depressive disorder.
While blood tests and urine tests are helpful in making sure there isn't another cause for PMS symptoms, there is no test that can diagnose PMS.

Instead, diagnosis is based upon the type of symptoms and when they occur. The symptoms of PMS have a fairly consistent relationship with the start and finish of a period, which is an essential clue to the diagnosis.

However, it is possible to have more than one problem at the same time, so care needs to be taken by doctors not to ‘blame the hormones’ too quickly.

Most women with PMS notice a gradual worsening of their symptoms during the week running up to their period, with a rapid or gradual disappearance of symptoms when their period starts.

But sometimes symptoms can persist during your period or even for a couple of days after it has finished.

To help doctors diagnose PMS, it helps to keep a diary of your symptoms and their severity over a few consecutive months.

A cyclical pattern should be apparent, and a diagnosis of PMS is usually only made if there are 10 consecutive symptom-free days each month.

What causes PMS?

Hormone levels
Measuring hormone levels is of no help in understanding PMS because there are no differences between women who get PMS and those who don't.
It is not exactly known what causes PMS. Common sense indicates it must somehow be linked to the fluctuating levels of female hormones experienced after ovulation. But the subtleties of why some women are more affected than others are not understood.

Normal fluctuations in hormone levels are responsible for some of the symptoms most commonly associated with the monthly cycle, such as bloating, breast tenderness or headaches.

Women who suffer from PMS may possibly have a lower than normal level of a certain chemical in their brain (serotonin), which may explain some of the non-physical symptoms such as irritability, depression and mood swings.

PMS is not caused by any underlying abnormality with the pelvic organs.

When should I seek treatment?

Recognising your symptoms are due to PMS is an important first step.

For the majority of women, the symptoms are a minor inconvenience you can recognise, anticipate and deal with yourself.

Who do I talk to?
A visit to your GP is usually the first step if you are suffering with PMS.
You could ask for a double appointment to give more time for discussion.
Or your GP may prefer to have a quick word at first, then ask you to come back and discuss things in depth.
The Family Planning Clinic and Well-Woman Clinic are other sources of help.
You may seek reassurance from your doctor, but do not necessarily need or want treatment. The value of such a discussion can be high and result in significant improvement in your symptoms.

For a minority of women, PMS is serious enough to affect work, daily life and relationships. If this sounds like you, you should see your GP to discuss your problems, possibly with a view to some treatment.

Women with severe symptoms who have not responded to simple treatments might wish to see a specialist. This usually means a gynaecologist, but a psychiatrist with a particular interest in treating severe PMS can sometimes be more appropriate.

What treatments are available?

The placebo effect
Part of the reason few PMS treatments provide long-term relief is the so-called 'placebo effect'.
A placebo is a treatment that is ineffective (eg a dummy tablet) but has the psychological effect of making you feel better.
To demonstrate a treatment is better than a placebo requires careful scientific study.
Not all PMS treatments have been subjected to evaluation in this way.
There are many treatments for PMS, most of which have some short-term benefit. However, few provide relief for longer than a few months.

Treatment will depend upon the nature of the symptoms and their severity.

For many women, simple changes to diet and lifestyle, reducing alcohol and caffeine intake and cutting down on cigarettes will make the monthly symptoms more bearable. Your GP can give you guidance in this.

A suitable diet sheet is available via the National Association for Premenstrual Syndrome (NAPS) at www.pms.org.uk.

Non-hormonal treatments

Vitamin B6

This is also known as pyridoxine. It is commonly recommended for mood swings and irritability.

There is some scientific support for its use for mild symptoms, but you need to be careful not to take too high a dose. It is advisable to consult your doctor before starting treatment.

Evening primrose oil (EPO)

Capsules of EPO can be helpful in alleviating premenstrual breast pain in some women. However, the evidence in favour of its effect is slight and it has been withdrawn from NHS prescription for this reason.

Bromocriptine and cabergoline

Bromocriptine (eg Parlodel) and cabergoline (Dostinex) reduce the output from the brain of a hormone called prolactin. Prolactin is the hormone that stimulates the breasts to produce milk.

These drugs may be useful if premenstrual breast pain is a major symptom, but their long-term use should be avoided.

Diuretics (water tablets)

Diuretics (water tablets) may give relief from ankle swelling. They will not relieve abdominal bloating, which is not caused by fluid retention but by relaxation and distension of the muscle in the wall of the bowel.

Diuretics need to be prescribed by a doctor and should only be taken for a few days each month in the lowest of doses.


There is much enthusiasm for the use of a class of antidepressants called SSRIs (eg Prozac) in the treatment of severe PMS where the symptoms are mostly depression, mood swings, irritability, etc.

The results of treatment are often dramatic and are supported by scientific studies. Side effects can sometimes be a problem. Discussion with a GP or specialist is essential before starting treatment.

Hormonal preparations


A group of hormones taken for 10 to 14 days before the beginning of the period. Progestogens are widely prescribed and have relatively few side effects.

It was once thought that PMS was due to a lack of progestogen in the bloodstream, but it is now recognised this isn't the case.

Some women do gain short-term relief of mild symptoms with progestogens. Most scientific studies do not support their use.

Combined oral contraceptive (COC) pill

There is no good evidence that the Pill works in PMS, but it is often prescribed, especially if contraception is required. Some women find the COC gives them PMS because of the hormones contained in the pill.

There is some initial evidence to suggest the combined Pill called Yasmin, which contains a novel progestogen, may be of some benefit to women with PMS. However, more data is needed.


Danazol (eg Danol) is a synthetic hormone based on the male hormone testosterone. Its use in PMS is supported by scientific studies.

It has a number of side effects, such as encouraging the growth of body hair and other masculinising effects, which means it is only suitable for use in low doses and will not be tolerated by all women.

Pregnancy must be avoided while taking this medication.

Oestrogen patches and implants

Extra oestrogen (one of the female hormones) via patches or implants can suppress ovulation and reduce the naturally occurring hormone fluctuations.

There is some evidence to support its use in PMS. Usually patches and implants will only be used on the advice of a gynaecologist.

Mirena intra-uterine system (IUS)

Mirena is in fact a contraceptive device, which is placed inside the uterus (womb). It releases a small dose of progestogen hormone into the body.

Most women experience a reduction in the heaviness and duration of their periods and some say it improves their PMS. It may be combined with an oestrogen patch or implant.

Treatments for severe PMS


Drugs known as LHRH analogues or GnRH analogues (such as Zoladex, Prostap and Synarel) are potent medicines used by gynaecologists for a number of conditions.

They temporarily ‘switch off’ a woman's ovaries, which usually gives relief from PMS within two months. They are only suitable for short-term use up to six months.

LHRH analogues may be used to confirm the diagnosis of PMS and to help guide you and your gynaecologist towards considering surgery. They are used only in severe and difficult-to-treat PMS.

One of the potential disadvantages of using these particular drugs is they cause flushings and sweats due to the drop in oestrogen output from the ovaries (like that which occurs in the menopause).

They also accelerate the natural rate of bone loss and can therefore increase your chances of developing osteoporosis (fragile bones).

To counter this, they are usually combined with a drug called tibolone (Livial) that mimics HRT. Doctors call this ‘add-back’ treatment.


Hysterectomy & PMS
Removing the womb only (hysterectomy) may not improve PMS.
This is because you can still get PMS if one or both ovaries are still present and functional.
For a small minority of women, surgical removal of the ovaries is the only measure that will allow them to continue a normal existence, free of PMS.

This is a major and still controversial step to be considered carefully by you, your GP and gynaecologist.

Once the ovaries are removed, you must be prepared to take hormone replacement therapy (HRT) until at least the age of 50.

Because it is such a drastic step, the use of LHRH analogues are usually used first - effectively non-surgical ways of putting the ovaries out of action. If this treatment works well, there is more chance surgery will be effective.

Many gynaecologists will not operate for PMS alone, but will do so if there are additional problems, such as uncontrolled heavy menstrual bleeding, for which surgery is going to help.

Last updated 02.06.2005

Oh i have big breasts doc? can i have operation...?

Large breasts
Written by Dr Erik Fangel Poulsen, specialist

How do breasts change throughout your life?

Breasts develop differently from woman to woman, and their shape and size changes throughout life.

Each month, you may feel a tension and swelling in your breasts before your period is due. This sensation disappears as soon as your period begins.

Pregnancy and birth is a time of breast growth, when the milk glands develop and milk is produced. Once breastfeeding is stopped, your breasts will change shape again.

Later in life the size of the glands decreases whereas the fat content increases. This causes some women's breasts to grow larger, while others experience the opposite effect.

Breasts and body image

A great many women dislike the appearance and size of their breasts. This is, of course, connected to our culture.

Breasts are seen as a crucial part of any woman's sexual appeal. In newspapers, magazines and on TV and films, we are confronted with images of what is regarded as the ideal bosom.

Consciously or unconsciously, some women wish their breasts matched this 'ideal'. Just as those with AA cups can yearn to be larger, so those with E cups can wish for a smaller bust.

Problems associated with large breasts

Even young women who have never been pregnant can feel that their breasts are too large and causing them a significant problem.

You may feel self-conscious wearing certain kinds of clothes or be embarrassed about undressing at the gym or in communal changing rooms when shopping.

A good supportive bra can be a great help, but if your breasts are very heavy, the bra straps may cut deep into your shoulders. Your posture will be affected and you may have aching muscles in your chest and shoulders.

What can be done to help?

If you are unhappy with the size of your breasts, consult your doctor who will be able to assess whether breast-reduction surgery is a suitable option. If so, the doctor will refer you to a hospital or cosmetic surgeon with experience of such operations.

What happens in the operation?

The surgeon will first remove an amount of breast tissue and skin.

The nipples stay connected to the remaining gland and fatty tissue, but are moved upwards on the wall of the breast. A circular piece of skin is removed from a suitable area.

This method is used for both large and pendulous breasts.

The results of these operations are almost always very good, with the surgeon aiming not only to reduce the size of the breast but to make sure you are happy with their new appearance.

Last updated 02.03.2005

Antioxidants for stress....can i get from the fruit doc?

Antioxidants and oxidative stress
Written by Dr Dan Rutherford, GP

What is oxidative stress?

Your body constantly reacts with oxygen as you breathe and your cells produce energy. As a consequence of this activity, highly reactive molecules are produced known as free radicals.

Free radicals interact with other molecules within cells. This can cause oxidative damage to proteins, membranes and genes.

Oxidative damage has been implicated in the cause of many diseases such as cancer and Alzheimer's and has an impact on the body's aging process.

External factors such as pollution, sunlight and smoking also trigger the production of free radicals.


To counteract oxidative stress, the body produces an armoury of antioxidants to defend itself. It's the job of antioxidants to neutralise or 'mop up' free radicals that can harm our cells.

Your body's ability to produce antioxidants (its metabolic process) is controlled by your genetic makeup and influenced by your exposure to environmental factors such as diet and smoking.

Changes in our lifestyles, which include more environmental pollution and less quality in our diets, mean that we are exposed to more free radicals than ever before.

How much do I need?

Your body's internal production of antioxidants is not enough to neutralise all the free radicals.

You can help your body to defend itself by increasing your dietary intake of antioxidants.

Examples of food-based antioxidants

Antioxidant supplements
Studies have shown that antioxidants supplements do not replicate the action of antioxidants from food.
More research is needed before, say, Vitamin C supplements can be advised to prevent cancer.
o Vitamins: vitamin E, vitamin C and beta carotene.

o Trace elements that are components of antioxidant enzymes such as selenium, copper, zinc, and manganese.

o Non-nutrients such as ubiquinone (coenzyme Q) and phenolic compounds such as phytoestrogens, flavonoids, phenolic acids and butylated hydroxytoluene (BHT), which is used as a food preservative.

Foods and antioxidants


Tomatoes contain a pigment called lycopene that is responsible for their red colour but is also a powerful antioxidant.

Tomatoes in all their forms are a major source of lycopene, including tomato products like canned tomatoes, tomato soup, tomato juice and even ketchup.

Lycopene is also highly concentrated in watermelon.

Citrus fruits

Oranges, grapefruit, lemons and limes possess many natural substances that appear to be important in disease protection, such as carotenoids, flavonoids, terpenes, limonoids and coumarins.

Together these phytochemicals act more powerfully than if they were given separately.

It's always better to eat the fruit whole in its natural form, because some of the potency is lost when the juice is extracted.


Black tea, green tea and oolong teas have antioxidant properties. All three varieties come from the plant Camellia sinenis.

Common brands of black tea do contain antioxidants, but by far the most potent source is green tea (jasmine tea) which contains the antioxidant catechin.

o Black tea has only 10 per cent as many antioxidants as green tea.

o Oolong tea has 40 per cent as many antioxidants as green tea.

This because some of the catechins are destroyed when green tea is processed (baked and fermented) to make black tea.


Beta-carotene is an orange pigment that was isolated from carrots 150 years ago.

It is found concentrated in deep orange and green vegetables (the green chlorophyll covers up the orange pigment).

Beta-carotene is an antioxidant that has been much discussed in connection with lung cancer rates. The evidence is conflicting, with one study showing an increase in risk, but further research is being done to see if it has a protective effect.

Will eating antioxidants really protect me from disease?

Studies have shown that people who eat a diet that is rich in fruit and vegetables are less likely to get diseases such as cancer, heart disease and stroke.

It has not yet been proven that antioxidants alone are responsible for this drop in risk.

For example, the research that has been done on the effect of diet on cancer has been difficult to conduct and interpret.

Even so, there is now a good body of evidence to indicate the protective effect of fruit and vegetables on many common cancers, including those of colon, breast and bladder.

Other articles on antioxidants

* Fruit and vegetables

* Antioxidants - tips for healthy living

should i use contraception . doc?..can i still get pregnant....?

Frequently asked questions on contraception
Written by Dr David Delvin, GP and family planning specialist

© NetDoctor/Geir - FAQs on contraception
Only use condoms that carry the European CE mark or the BSI Kitemark BS EN 600.
A lot of the emails we receive about contraception are from people who are too embarrassed to raise their questions with their GPs. Here, I present a sample of the most common queries - beginning with some that arrive regularly from younger people.

My mates say that condoms are dangerous to use, because they break. Are they right?

No. Condoms do break occasionally, but this is unlikely if you handle them gently, and don’t snag them with your fingernails or jewellery.

It’s recently become clear that a lot of females who ask for the morning after pill say the condom broke - because they don’t want to admit that they didn’t use one.

This has helped to give condoms a false reputation for breaking.

Even if one in a thousand condoms breaks, that’s still far, far better than the risks of not using one at all.

Is it true that you can’t get pregnant the first time you do it?

This is a dangerous myth that has been responsible for a lot of unwanted pregnancies.

You can get pregnant the first time you have sex, and it has happened to many, many young women.

You might get away with it, because the chance of getting pregnant from a single act of sex is around one in 20. But it really isn’t worth taking the risk.

If you’re going to do it, use a reliable method of contraception.

A friend has told me that you can’t get pregnant if you do it standing up. Is there any truth in this?

None whatsoever. You can get pregnant in any position.

My boyfriend says we don’t need contraception, because he will pull out at the last minute. Is this a good idea?

Not really. ‘Withdrawal', or coitus interruptus as it’s known, is not a good way to avoid pregnancy – partly because boys leak sperm before they come

I have heard that women can only get pregnant during a certain part of the menstrual cycle. Could my partner and I have unprotected sex if we avoid these ‘dangerous’ times of the month?

I really wouldn’t advise this, particularly if you don’t know much about what you’re doing.

It is true that women are usually at their most fertile during the middle part of their cycle. This is about 12 to 14 days after the start of a period.

Women are generally at their least fertile just before menstruation, during menstruation, and just after menstruation.

But it's still possible to fall pregnant and your monthly cycle can change. Frankly, it’s a gamble.

If you want to use the rhythm method or natural family planning, as it's known, seek advice from an experienced health professional.

I am thinking of trying the Pill, but my mother says it’s dangerous for younger women.

I’m afraid she has this the wrong way round. The risks of the Pill aren’t all that big, but they’re much greater in older women.

In the age group 16 to 30, the danger of serious side-effects from the Pill is very small – unless you are a smoker or have other risk factors such as a history of thrombosis (clots), or a family history of relatives who had heart attacks or strokes at an early age.

You will be asked about these things when you first go to a doc to obtain the Pill. She will also check your blood pressure – because a raised BP does increase the risk of complications from the Pill.

Does the Pill turn women off sex?

No, this is largely a fantasy. Most women become more keen on sex because they know the Pill is giving them excellent protection against unwanted pregnancy.

A very small number of women say the Pill reduces their libido.

If you find this is the case, it’s always worth changing to another of the 22 brands that are available in the UK.

What methods of contraception are reliable?

There are 12 methods of contraception that you can regard as highly dependable.

o The Pill.

o The mini-Pill.

o The patch (Evra).

o The IUD (the coil).

o The IUS (Mirena).

o The injection.

o The implant.

o The condom.

o The diaphragm and the cap.

o Vasectomy (male sterilisation).

o Female sterilisation.

o Natural family planning if taught by a properly qualified professional.

All these methods do carry a small failure rate – nothing is 100 per cent effective. But each of these options is an awful lot better than just crossing your fingers and hoping for the best.

What about spermicides? Are they effective?

Spermicidal creams, foams, pessaries and sponges are no longer considered effective enough on their own.

What is the best method of contraception?

Quite a few couples come into my clinic asking this question, but there isn't a best method of family planning. What matters is what works for you.

Different things suit different people. If it’s any help, the two most popular methods in the UK are the Pill and male condom.

Vasectomy and female sterilisation are popular with people who don’t want any more children, but they have become more difficult to obtain free under the cash-strapped NHS.

A lot of people now get these operations from contraception charities such as Marie Stopes (£990 for female sterilisation, £395 for vasectomy).

What about new forms of contraception? Are they likely?

It is probable that new methods of contraception such as the vaginal ring will soon become available. However, the much hyped ‘male Pill’ is unlikely to be on the market within the next few years.

Further information

If you've more questions, talk to a nurse or doctor who’s been specially trained in contraception – eg at a family planning clinic, Brook Advisory Centre for young people or GP surgery.

masturbation....good or not ? will this make a problem?

Written by Dr David Delvin, GP and family planning specialist and Christine Webber, psychotherapist and lifecoach

Masturbation means producing sexual arousal (and often orgasm as well) by manual stimulation of the genitals.

Generally, the word indicates self-stimulation, but it is worth noting that in 2005 some sexologists use the expression to indicate pleasuring of another person by hand, in phrases such as ‘the husband can masturbate the wife to help her achieve a climax'. However, in this article we shall deal only with self-stimulation.

This is the form of sexual behaviour that most of us learn first – quite instinctively. And, until recently, it was probably the type of sex least talked about. In fact, in the early part of the last century masturbation was widely considered to be a sin - and something to be avoided at all costs. Gradually society became more tolerant of it as an activity, but it still had shameful connotations and was generally seen as a bit sad. Even in 2005, there are loads of bad jokes or disparaging remarks featuring the word 'wanker', which is of course a slang word for masturbator.

Till far into the 20th century, there were many doctors, educators and youth leaders who strongly disapproved of masturbation, and who wrote books which claimed that it had terrible health consequences – like insanity! This was all nonsense.

But until around the 1960s, there were doctors and pundits who advised people to avoid masturbation. They suggested that it was immature or undesirable and that if someone got fixated on it, they might not learn more 'grown up' responses.

Nowadays, experts have a completely different view of masturbation - and a very much more positive one. One of the reasons for this is the big change in people's lifestyles.

In this 21st century, most of us can expect to have a much more changeable and flexible life than our grandparents did. We will live longer and we'll almost certainly have far more sexual and co-habiting relationships.

But between these relationships we will find ourselves returning to single status. During these single periods, we'll most probably continue to have normal sex drives - and the most obvious form of sexual relief and satisfaction available to us at those times will be masturbation.

So masturbation needs to be seen in this modern context, and viewed as an activity that is pleasant, fulfilling, acceptable, normal - and very safe. In fact, masturbation is the safest form of sex there is, and very much safer - and often more satisfying - than one-night stands.

The only time masturbation is not safe is on those rare occasions when young men decide to experiment by masturbating with potentially harmful objects - such as a vacuum cleaner! This is extremely dangerous, and definitely not to be recommended.

Men and masturbation

The vast majority of men masturbate - even if they're in a long-term and happy sexual relationship.

Masturbation comes pretty naturally to most guys. Let's face it; a male child discovers that his penis feels good before he can talk! So it's not surprising that boys fondle this area of their bodies a lot, and then, at the age of around 14, discover that masturbation can lead to orgasm and ejaculation - all of which they find extremely exciting and pleasurable.

There are some men who don't masturbate, but these are mainly people who don't want to do it because of religious reasons, or because they're a bit uptight about sex. Also, some guys who have a fairly low sex drive don't masturbate.

Some men - mostly from eastern cultures - try to avoid masturbating, as they believe it depletes their energy, and may shorten their lives. But there is no truth whatsoever in this belief.

Most men masturbate by rubbing the penis with their ‘dominant’ hand - slowly at first and then more vigorously. Many guys grasp the shaft of their penis by wrapping their whole hand round it. Others grasp it between their thumb and first or middle finger. But however they do it, they don't usually have much doubt that they'll achieve orgasm as a result. This is quite a contrast to women, who may experience considerable anxiety about whether they will actually 'make it'.

Some young men worry that they masturbate too much. The fact is that it's almost impossible to do this. Obviously, if a young guy is staying home and masturbating on the hour every hour, one might want to try to persuade him to get out more! But when a teenager first discovers sex it's quite common for him to want to masturbate several times a day, on some days. And this certainly won't do him any harm. ( However, masturbating constantly over a period of hours can produces some swelling or ‘puffiness’ of this penis. This is called ‘oedema’ and is due to fluid leaking into the tissues; it will disappear after some hours, as the fluid goes back into the bloodstream.)

Other boys will masturbate quite rarely, especially if they don’t have a high sex drive - but that is normal for them.

Some men in their 70s and 80s are still masturbating several times a week, but in general terms, men masturbate most in their teens and gradually do it less and less as their life progresses - depending partly on whether or not they have a partner at the time.

As we have already indicated, many men still like to masturbate even when they are involved with a partner. They often feel that the orgasm they achieve through masturbation is less complex and more locally intense than climaxes achieved through sexual intercourse. Furthermore, they can control the pressure and speed of movement very accurately.

In recent years, we have encountered a number of couples who achieve considerable satisfaction through the woman watching the man masturbate in front of her (or vice versa). Also, this practice is certainly helpful when – for some medical reason – intercourse is difficult or impossible.

Masturbation and pornography

At some point in their lives, almost all men will masturbate while looking at newspaper pin-ups, top-shelf magazines, or sexy videos.

For a single guy, this is seen as a pretty normal activity nowadays. Some single men do worry that they might get fixated on porn, but the majority of them have no trouble in transferring most of their sexual focus to a real, warm, sexy female when they meet one.

Masturbation using porn is more of an issue when a guy who is in a committed relationship. Some of these men worry that what they're doing is wrong - even if they don't want to stop. And of course many female partners have a problem with this sort of activity and can feel bitterly rejected and threatened by it.

However, most men who are in relationships are able to compartmentalise this kind of sexual behaviour. They may only do it occasionally, and they feel it has no bearing whatsoever on their love and desire for their partners.

But - and this is important - this kind of sexual indulgence ceases to be normal when a man actually prefers it to having sex with his partner. When this happens, the relationship is usually in some trouble. Today, it is increasingly common for Internet porn to create that kind of relationship problem (see below).

In such cases it's not uncommon for men to use porn more and more for relief, rather than face up to sorting out sexual or relationship difficulties. This kind of avoidance behaviour almost invariably worsens an already problematic situation.

If a man wants to save his relationship, but feels increasingly dependent on pornography, then he should seek help. (See Further information for more details.)

Masturbation and the Internet

Since round about the beginning of the 21st century, more and more men have been masturbating while using the Internet. When this involves viewing the sort of pornographic images you can also get on video, then the situation is much the same as it is when the guy uses magazines or blue movies – in other words, he’s not getting involved with anybody else.

However, when the activity involves masturbating to orgasm while 'talking' by use of the keyboard with another person, then this cannot honestly be judged as a solo activity, or as simple masturbation. In fact, it can be seen as an act of infidelity - if the man in question is married or committed to a serious sexual relationship.

Male masturbation and its use in helping sex problems

Two of the common sex problems that men experience can be helped to some extent by masturbating.

Premature ejaculation (PE), which is the condition where the man ejaculates too quickly when he has sex with a partner, is an enormously common problem.

PE usually needs some sort of specialist help, but some men are able to help themselves to some degree by gaining more control over their climaxes while masturbating.

What such a man should do to is to practise beginning to masturbate and allowing himself to get almost to the point of no return, but then stopping and calming down a bit, before carrying on. If a guy can do this several times before giving in and having a climax, it might well help him to develop the necessary control he's been lacking to delay his climax during intercourse - especially if he practises this stop-start technique on a regular basis.

The other male sex problem that can be helped to some extent by masturbation is 'delayed ejaculation', 'ejaculatory incompetence', or as it's also called, 'retarded ejaculation'.

When men have this particular problem they can maintain an erection for a long time during sex, but they can't relax enough to let go and climax inside their partner. Many such men are quite uptight about sex. And if they can learn to masturbate with their partner, this can help them a great deal. Again this is a problem that needs specialist help. But if a man can first of all learn to masturbate in the next room to his partner and then after a week or so manage to do it the same room, they will both feel he is making progress.

Eventually he should be able to masturbate right beside her, and in time masturbate so close to her that he can place his penis into her vagina at the crucial moment.

Women and masturbation

Teenage girls do not tend to masturbate as automatically as boys do. Of course plenty of girls do discover that they get pleasant feelings from their genitals at quite an early age. And many of these girls do discover how to masturbate to orgasm in their mid to late teens.

But many girls and young women simply do not feel many strong sexual urges. Indeed it is quite common for a woman not to reach orgasm until she is about 19 years of age. And there are plenty of females who don't reach one for years after that - either through sex with a partner, or by masturbating.

When we wrote our book The Big 'O', our research showed that a few women did not learn to achieve orgasm until their 40s - but when they did, they were very pleased about it, and quickly made up for lost time! So it's never too late to learn.

But why is there this discrepancy between male and female orgasmic ability? One reason seems to be that a woman's sex drive simply appears to take longer to develop than that of men. Of course a woman's orgasm is not essential in nature - that is to say a woman does not need to orgasm to conceive, whereas a man does have to climax to produce the all-important sperm.

Another reason for women's slower development may be that their genitals are much more hidden away than the male genitals - and this in turn may be why women do not have the same emotional and mental focus on the vulva that men have on the penis.

Methods of female masturbation

The average woman masturbates by stimulating her clitoris. She usually does this in little circular motions, either with her index or middle finger. Generally, women begin by touching themselves just above or below the clitoris, but as their excitement mounts they can tolerate more intense stimulation right on top of it.

Some women find they like the feeling of 'bulk' created by having something in the vagina at the same time. This could be two or three fingers of her other hand, or some kind of object. One word of caution: it is best to use fingers, or a sex aid designed for the purpose. Women sometimes get into trouble if they use unwashed fruit, or other items that may introduce infection into the vagina. And they should definitely always avoid anything that is breakable, like glass - for obvious reasons.

In recent years, there has been a bit of a vogue among some young women for using an electric toothbrush in the vagina. Pleasant though this may be, it could certainly cause damage to those delicate tissues and should be avoided.

Whether or not anything is introduced into the vagina - and this certainly does increase the excitement in a lot of women - the vast majority of females need to keep stimulating their clitoris at the same time in order to have a climax.

A few women are so highly sexed they can orgasm simply by rubbing their nipples - but this is just a tiny minority of highly-talented females! Other women discover that they can bring themselves to a climax through squeezing their thighs together. Again they are in the minority.

Vast numbers of women nowadays enjoy using a vibrator some or all of the time. There are some truly amazing products around these days and the fair sex is becoming much less timid about trying them. When a vibrator is used, sometimes a woman will use it to stimulate her clitoris. At other times she will use it in her vagina. There is no right or wrong way of pursuing solo pleasure - and a woman should experiment to find what she likes best.

Fortunately, it is now quite easy to purchase good sex aids from reputable companies. (See Further information for more details.)

The use of female masturbation in achieving orgasm

As we have already mentioned, the female orgasm in not as reliable or as automatic as the male orgasm generally is. For that reason many women consult psychosexual specialists, family planning doctors and so on in the hope that they can be helped to achieve the elusive 'Big O'.

Nowadays most experts agree that if a woman can reach orgasm through her own efforts, she can then learn to climax with a partner either during love play or intercourse. Learning to climax through masturbation gives a woman confidence and satisfaction - and also educates her about how she likes to be touched and stimulated. Once she knows these things, she can communicate them to a loving partner.

Some females have a real problem in touching their genitals. This is usually because they had restrictive upbringings where they were taught that 'nice girls don't touch themselves there'. Or that 'sex is for beasts'. Or that 'sex is dirty'.

However, if a woman is prepared to give time and effort to learning about her own body, she can often overcome these unhelpful beliefs.

If you are a woman who has trouble in reaching orgasm - even through masturbation - you might like to follow the advice given below.

How to achieve orgasm through masturbation - even if you've never managed it before

* Allocate some time - at least an hour, twice a week - when you know you'll have the house to yourself and can guarantee being undisturbed. (Arranging this can be the hardest part of the exercise!)

* Take a leisurely bath, using your favourite bath oil. Relax. Enjoy soaping your whole body. Give your breasts and your genitals plenty of attention.

* Dry yourself with love and care and continue to explore your body as you do so.

* Move to the bedroom. Make sure it's warm and that it looks nice and is a pleasant place to be. Put some favourite music on if you'd like. Lie on the bed and carry on touching yourself, anyhow and any place that you like. All sorts of parts of your body might give you pleasant feelings. Find them! Give them attention. Be aware of pleasure.

* Rub baby oil into your breasts and into your neck and throat. Enjoy the feeling.

* Gradually allow you hands to travel lower in your body. Caress your abdomen, and then use some more baby oil and touch yourself between your legs. There is no wrong or right way of doing this. Just let your instinct take over.

* Slip your fingers into your vagina. Try tightening your muscles round your fingers. Then relax. Try gently stretching the vaginal opening - this is something that gives exquisite pleasure to many women.

* Start circling the area where your clitoris is. Don't hurry this. As you become more focused on your genitals, you may well find that you start applying more and more pressure to your clitoris, and that your breathing is quickening, and - best of all - that you're really enjoying yourself.

* Don't worry if you don't get any further than this on the first few occasions. So long as you feel that you are loving your body and appreciating it and experiencing some good sensations, then that's fine.

* Don't forget that the most powerful part of a woman's arousal equipment is in her mind. So it can be helpful to introduce some mental stimulation into the exercise. Try thinking of things that turn you on. Or, while you're stimulating yourself, read from one of those erotic novels written for women. You might even like to try caressing yourself while viewing a sexy video - if you have a video recorder in your bedroom or somewhere else in the house where you can feel uninhibited and comfortable. One of Betty Dodson’s famous videos on assisting women to reach orgasm through masturbation may help.

* You may like to use a vibrator - as many women find this increases their arousal quite magically. If you don't know where to get good books, videos or sex aids, see the Further information section.

* Each time you start caressing your body, try to keep going for longer and to increase your delight in what you're finding out about yourself. Don't panic if you still sometimes have feelings that what you're doing is wrong. Just breathe deeply and tell yourself that it is every woman's right to love and enjoy her own body - and that masturbation is healthy and good and normal.

* One day you will find that your caresses become more insistent and that you are breathing heavier and that you feel a desperate urge to carry on what you're doing. It's common to feel a bit frightened at the intensity of what's happening if you've never felt it before, but go with the feelings. You deserve to have them. If rubbing your clitoris alone doesn't quite get you to your climax, try putting one or two fingers of your other hand into your vagina. Or use a vibrator in your vagina or on your clitoris. Your instinct should take over and tell you what to do.

Hopefully these powerful feelings will lead to your first orgasm. And once you've had one - you'll find you can have others - maybe even on the same day!

Most women like to practise having orgasms a few times on their own before involving a partner, but once you do choose to try with the person you care for, make sure you incorporate what you've been doing into your love play. Show your partner what you like and let him or her help you to experience this great joy.

If you follow this plan, without putting pressure on yourself to succeed you will become more sexually aware, and it shouldn't be too long before you join the ranks of the orgasmic. Good Luck.

Further information

For women who have not yet managed to experience orgasm, there is more advice and help for you in our article: 'Are you having trouble reaching orgasm? A guide for women'.

If you have other specific sexual problems - including emotional ones - and you want to get some professional help, please refer to our fact sheet 'Who to contact for sex therapy'.

If you have problems with sex addiction - including dependence on porn - contact Sex Addicts Anonymous: 020 8946 2436.

For supplies of videos, erotic/sex education books, lubricants, sex aids, etc there are now several reliable and helpful companies run by women, for women (and their partners). They include:

* Passion 8. Now an extensive mail order business, run very efficiently by its ebullient boss, Stephanie. Check out their website on: www.passion8shop.com.

* Sh! This is a shop in North London, for women. It is also open to any man, so long as he's accompanied by a responsible woman! It's also a mail order business.Call for more details on: 020 7613 5458. Their website is www.sh-womenstore.com.

* Tickled. A very jolly shop in Brighton’s famous ‘Lanes’ district. Men may enter the top floor unaccompanied, but the lower floor is for females (and accompanied males) only. Telephone: 01273 628725. Website:www.tickledonline.com.

penis size....size matters...should i get operated to have big sizes?

Facts about penis size
Written by Dr David Delvin, GP and family planning specialist and Christine Webber, psychotherapist

Even in this supposedly enlightened century, men fret about penis size. Though the vast majority of guys have more than enough bulk to perform well as lovers, there is a widespread masculine obsession that 'more would be better'.

We get a constant flow of emails and letters from males who are worried that they are 'too small'. Vast sums of money can be made by exploiting this obsession, but other than surgery, there is little that is clinically proven to increase penis size.

Any woman reading this article may find it puzzling that so many men are concerned about the length of their penis and wish they had 'just a couple of inches more'. But that's the way that a lot of men are.

Size matters

To the average man, his penis is, consciously or unconsciously, one of the most important things in the whole world. At an early age he discovers it and immediately becomes fascinated by it.

But then a note of uncertainty enters his mind: 'Isn't mine rather small?' Look at Dad's, look at big brother's, look at those in the men's changing room - and he asks himself if he will be as big as that.

And so he goes on through life, always a tiny bit sensitive about the size of his organ, always convinced that it would be nicer if it were just that little bit longer.

No matter how often it's written that penile size doesn't matter, and that women aren't attracted to a man because of the length of his organ, the average male continues to think the same way.

The average female cannot understand this obsession with penile measurement. So if you're a woman, never belittle a man's penis in bed, even as a joke, or say anything to indicate that you think it's small. The guy may take you seriously, and if he does, he'll be deeply hurt.

We have known men who have gone on to have problems with impotence (erectile dysfunction) after someone made an unthinking remark about their dimensions. But almost all of these men had a perfectly normal male organ. Each one just thought he was very small compared with other men.

A question of perspective

The trouble is that every man sees his own penis in a foreshortened view. The angle at which you look down inevitably makes your penis seem shorter than it is.

But when you glance at another man's organ, there's no such foreshortening effect, so very often it'll look as though the other guy is slightly better endowed.

A lifetime of comparison of this sort (and virtually every male does a quick mental check on each naked man he sees) can easily make you feel a bit inadequate. But it's important to realise the facts about penis length.

Average penis length

A non-erect penis usually measures between 8.5cm and 10.5cm (3-4 inches) from tip to base.

The average figure is about 9.5cm (3.75 inches), but this kind of precise measurement is rather valueless. Many factors can cause a temporary shrinkage of two inches or more, for instance cold weather or going swimming, so you needn't worry if you happen to fall short of the average figure.

Of course, it's true that some men have big penises and some have smaller ones, just as some men have small feet and some have big feet, but the measurement is not - repeat not - an index of virility.

Most people think that a tall man will usually have a large penis, but this is not true. The distinguished American researchers Masters and Johnson measured the penile lengths of more than 300 men.

* The largest organ was 14 cm (5.5 inches) in the flaccid state. It belonged to a slim man who was 5' 7" tall (170 cm).

* The smallest penis measured 6cm (2.25 inches). It belonged to a fairly heavily built man of 5' 11" (180cm).

It's also worth pointing out that there is no correlation between penile size and race.

Average size of erections

We've talked about the length of the penis in its ordinary non-erect state, but how long should it be when it's erect?

Interestingly, most penises are very much the same size when erect.

* The man whose non-erect penis is smallish will usually achieve about a 100 per cent increase in length during sexual excitement.

* The man whose non-erect penis is on the largish size will probably manage about a 75 per cent increase.

* This means the great majority of penises measure between 15cm and 18cm (6-7 inches) when erect, with the average figure being about 16.5cm (6.5 inches).

So you can see that even if a man has got a 'small' penis, he's got a built-in compensating factor that will bring him up to about the same size as the guy who appears to be 'better equipped' in the shower room.

Sex and women

Virtually every man forgets that it doesn't matter how long or how short your penis is, because the vagina will accommodate itself to any length.

* The vagina of a woman who hasn't had a child is only 7.5cm (3 inches) long when she's not sexually excited. The figures for women who have had babies are only slightly different.

* Even when aroused, a woman's vagina usually extends only to a length of about 10cm (4 inches).

This means any man's penis will fill her vagina completely, unless you happen to be one of those rare guys with an erect penile length of less than four inches.

You're probably now wondering how the average man with an erection of six inches manages to insert his penis into the vagina at all.

The vagina has the most remarkable capacity for lengthening if something is introduced into it gradually.

So the exceptional man whose erect penis is eight inches long can still make love to any woman, providing he excites her properly and introduces his organ very slowly. If he does this, her vagina will lengthen by 150 or 200 per cent to accommodate him.

What if I'm not happy about my penis size?

If you're really worried that your penis is the wrong size, go and see your doctor.

If you're not happy about consulting your GP on such an intimate matter, you could see one of the medics who spend their entire day checking men's penises. You can find these doctors at:

* private 'well-man' clinics, but take care: a few of these are run by quacks

* NHS urology clinics

* NHS sexual medicine clinics

* NHS genitourinary medicine (GUM) clinics

* NHS family planning clinics, although these tend to be oriented towards women and don’t have much time to deal with males.

* Brook advisory clinics (for the under 25s).

What treatments are there to increase penis size?

Many companies claim they know how to enlarge your penis - for a price.

We have been to several medical conferences this year at which leading experts have spoken about penis size and penis enlargement.

Their opinions on the various methods that are so widely advertised to the public can be summed up as follows.

* Pills or patches for increasing penis size: a complete waste of time.

* Penile enlargement surgery: of uncertain value and sometimes dangerous.

* Penile enlargement exercises: probably pretty futile.

* Penile suction devices: probably of little use.

Several European experts say that the relatively new stretcher or extender devices may sometimes be of value in giving a man a little extra length.

Surgery to increase penis size

A number of private clinics now offer operations that claim to make the penis look bigger. The expense of this type of surgery is very great and there is a risk of complications like bleeding, infection or deformity.

One surgical procedure that has become popular since 2005 is slicing through the ligament that supports the penis.

This makes the penis dangle more, so it looks longer when not erect. But it will make no difference to the size of your erection - and it won’t come up as high as it used to before the op.

Another type of surgery involves injecting your own fat into your penis to make it more bulky. This may not work, and it can lead to complications.

We recommend that you do not agree to undergo any surgery unless you have seen an NHS consultant urologist who feels that you really need it.

Penis stretchers (extenders)

Some urologists are beginning to use a special extending frame to try to stretch the penis.

These ‘stretchers’ are small rectangular frames that you wear on your penis for hours at a time, every day. They pull your organ out to its maximum length, and the idea is that it will gradually remain longer.

The devices are said to be undetectable under trousers.

There have been several reports from Italy and Spain by surgeons who claim a modest degree of improvement in length from this kind of traction.

We don't think these devices are some sort of miracle discovery, but one surgeon reported that a group of men achieved an average increase in length of 1.8cm after using the device daily for four months. This is less than three-quarters of an inch, but for some men this would be significant.

Stretchers cost between £150 and £200.

What treatments are there to reduce penis size?

Occasionally, a man with a big penis feels that he wants it reduced in size. This can be done, but there is quite a risk that the operation might go wrong.

Again, we advise you not to have this operation unless an NHS consultant urologist has said it is necessary.