Should testing be compulsory?

There's an interesting campaign building in Tamil Nadu. For those of you whose geography is not strong, Tamil Nadu is one of the states in India and it has a large population. It's also very socially conservative. This means that "family values" are very strong. Marriage is definitely only for heterosexual couples with divorce strongly disapproved. So far, India matches the Western model but here the similarities end because the usual form of marriage is arranged between the families without the need for the happy couple to meet before the ceremony. Marriage is seen as building links between families of comparable status and wealth. For most, marriage for love is an alien concept.

The problem with this system is that it can trap women in marriages that are, at best, loveless and, at worst, violent and dangerous. There are a number of reasons for this. Because the marriages are often made to consolidate property ownership, the welfare of the couple is irrelevant. Once the marriage has been celebrated and the title to the land transferred, the couple are left to their own devices. The reason why divorce is discouraged is because the courts might disturb the ownership of property. Indeed, wives who threaten divorce can be relentlessly bullied to keep quiet. A further problem is that homosexuality is still concealed. Thus, sons are married off without regard to their sexual preferences. This can leave wives in unconsummated marriages. The same result is achieved by the men who are impotent but dare not go to a doctor to admit the problem and get treatment. The worst possibility is that the men have been routinely engaging in unprotected sex with prostitutes before marriage and have picked up a sexually transmitted disease (STD). When the marriage is consummated, this can leave the wives with serious health problems.

A politically active group of Bollywood women is campaigning for all men to produce evidence of potency and freedom from STDs before being allowed to marry. Although the idea of a certificate of erectile function is never going to be practical - just how would the evidence be collected? - there's great merit in screening tests to ensure that both parties are free from sexually transmitted disease. Because many couples still prefer unprotected sex, the incidence of STDs has been rising quite sharply over the last ten years. Testing would therefore be a good thing not only in India but around the world. In the West, since there's no real need for gay men to marry for the sake of appearances, all men who have problems of erectile dysfunction simply rely on levitra. This drug produces the best erections in most men no matter what the physical or psychological problems. This is somewhat ironic since the leading manufacturers of the generic form of levitra are based in India but local distribution is limited by a culture that refuses to discuss sexual matters openly. Unlike the West, it's also quite difficult to buy levitra online. This unfairly leaves many Indian men struggling to cope with their impotence.

Are men and women the same when it comes to pain?

In these more modern times of sexual equality, it may not be politically correct to talk about differences between men and women. Unfortunately, the medical profession cannot ignore the increasing volume of scientific evidence that there are important differences, particularly when it comes to pain management. In this, it is important to distinguish between biological sex and gender. There are visual tests for the presence or absence of reproductive organs, and lab tests for chromosomes that help to say whether this is a man or woman. Gender, on the other hand, is a list of the social roles society defines for people. This can be complicated when people choose to act or behave in ways considered more appropriate for the opposite sex. As an example of the problem, you only have to look at the complaints that Caster Semenya is not a woman. How can this muscular person from South Africa suddenly beat the word record for the 800m by one second and be a woman?

The last decade has seen a rapid rise in the volume of research into gender differences in the response to pain. There is clear evidence that women are more likely to consult a doctor about pain and to take drugs to relieve that pain. As a result, the national statistics show more women than men suffering from the more common medical conditions causing pain such as arthritis, irritable bowel syndrome, fibromyalgia, etc. In tests involving healthy volunteers, women are more likely to report higher levels of pain than men. This applies regardless of the other factors of age, race, ethnicity and religion. Interestingly, brain scans have shown that pain affects different parts of the brain. In women, the limbic area which also affects emotions is stimulated more than in men.

The speculation is that the differences in brain activity flow from early human development. Men were the stronger group with responsibility to fight to defend the community. This means being prepared to accept pain. Women were expected to respond to danger by nurturing and protecting the young, running away if necessary. Today, men remain less willing to admit to feeling pain and are reluctant to seek medical help. It does not matter whether this is a biological or gender difference, the statistical evidence for this unwillingness to seek help is absolutely clear. But, equally clear is that tramadol relieves the pain of both a macho man and an emotional woman. Even though there may be gender differences, the biological effect of tramadol is the same on a human body. It relieves moderate to severe pain. So, perhaps it is time for all men suffering in silence to overcome the cultural conditioning that threatens their self-esteem if they admit to pain. Once you have clearance from your local healthcare provider that there are no problems in you taking this drug, go online and buy tramadol from the privacy of your own home. This relieves the pain and preserves your image.