The attitude of flexion is extremely suitable when deep penetration of the male organ is desired. It has a two-fold advantage. It gives direct access to the male’, and more pleasure to the female who prefers the penis to nestle deeply into the folds of the vagina. This in turn stimulates the male partner resulting in a stronger erection. In this position, the female partner lies on her back with both legs lifted at right angles from the hips with the feet resting on her partner’s shoulders. As the lower spine becomes bent forwards and upwards, the vulva slopes vertically, the vagina points downwards and the male organ enters the rear of the vagina (near the perineum) without contact with the clitoris. However, the male can digitally stimulate it manually during coitus. There is one risk in this position. If the vagina is comparatively small, an attempt at deep penetration with a well-endowed penis can easily lacerate the vaginal wall or in rare cases even rupture it.
In another variant of extreme flexion the male kneels, bringing his partner’s thighs and legs almost parallel to the abdominal wall and continues the thrusting. However, such extreme attitudes of flexion require very supple joints, and everybody cannot do them.
A modification of the position of extreme flexion is the ‘lithotomy’ position which doctors find convenient for visual and internal examination of the female genitalia, for minor operations like dilation and curettage, and during confinement. The female partner lies on her back and bends her thighs, keeping both legs as apart as possible with the knees bent and the toes and heels touching the back of the thighs. Intercourse in this position is more convenient than in extreme flexion.
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The bright yellow, star-shaped flowers of St. John’s wort (SJW) have had a rich and varied history of use in Europe, Asia, and Africa. The name for this herb is believed to date back to early Christian times and relates to the red oil that is secreted by special glands in the flowers of SJW when they are pinched or cut. Christians believed that the flowers secreted this blood-red oil on August 29, the anniversary of the beheading of St. John the Baptist and that they bloomed on June 24, St. John’s birthday. The term wort is Old English for “plant.” In addition, John the Baptist represents light, and the flowers themselves seemed to represent the bright yellow light of the sun. Colonists to the United States brought SJW with them, only to find that Native Americans were already using it for everything from snake bite to a general health enhancer. In the United States, SJW grows in abundance in northern California and southern Oregon and is also referred to as klammath weed.
Today, SJW enjoys a global popularity that finds it the favored therapy for depression in a number of countries around the world, including Germany, actually surpassing most standard antidepressants as the first mode of treatment for clinical depression. German researchers report that it is decidedly better than placebos in medical trials and at least as good as some prescription antidepressants for treatment of the milder forms of depression. It is also cheaper and appears to cause fewer side effects than drugs such as Prozac, Paxil, and Zoloft. SJW is also believed to have the following effects:
-    Acts as a positive mood enhancer by helping maintain serotonin levels, and as natural neurotransmitters that help brain function and calm the body
-    Helps as a sleep enhancer for those having difficulty sleeping
-    Supports immune functioning by suppressing the release of interleukin-6, a protein that controls certain aspects of the immune response
A review of 23 well-designed clinical trials published in The British Medical Journal concluded that extracts of SJW “are more effective than placebo for the treatment of mild to moderately severe depressive disorders.” This review also found evidence from eight other studies that SJW may work as well as some other drugs in countering mild depression. However, noting that most of the studies done to date did not control rigidly for levels of depression, that they varied the dosage and method of delivery, and that the trials were all less than 8 weeks in length, the research team called for more rigorously controlled, larger sample-sized studies comparing this herb with prescription doses of Prozac. Like most antidepressants, SJW’s benefits are not even felt for about 4 weeks. With the trials so short in nature, and the variability of other factors, few conclusions may be made about short- or long-term effectiveness. While some improvements in participants’ depression were noted, the efficacy of subjecting people to higher doses, longer time periods, and other variables pose important questions about long-term risks for use that have been largely unanswered.
Like other plants, SJW contains a number of different chemicals, many of which are not clearly understood. Why it seems to lift depression and to have antiviral properties remains largely unknown. Taking any drug that has not been thoroughly tested and for which safe and effective doses are not clear will have risks. What we do know is that there is more to SJW than myth and the simplistic explanations that many health food stores tend to give to consumers.
Unfortunately, rigorous testing has not been done in the United States because the herb is sold as a dietary supplement, which does not fall under the watchful eye of the FDA. What side effects have been noted? Most have been more bothersome than severe and range from slight gastrointestinal upset to fatigue, dry mouth, dizziness, skin rashes, and itching. Some people have noted some sensitivity to sunlight. Most of these side effects are minor, however, when compared with those of major antidepressant medicines.
In spite of the apparent positive news about SJW, consumers should proceed with caution when considering its use. First, little is known about the herb and its compounds. Second, for more severe forms of depression, SJW may not be enough to prevent potentially negative outcomes. Anyone suffering from clinical depression should be under a psychologist’s care and should be monitored for progress or difficulties. In fact, the combination of therapy and medications is typically the most effective way to achieve any improvement.
In addition, SJW should never be taken in combination with prescription antidepressants. When combined with other serotonin-enhancing drugs, such as Prozac, SJW may result in serotonin overload, leading to tremors, agitation, or convulsions. SJW also should not be used by pregnant women or women who are nursing, by young children, or by the frail elderly, because the safety margins have not been established.
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According to preliminary double-blind studies, the herb devil’s claw can reduce pain and inflammation in people with various types of arthritis. The recommended dose is 600 to 800 mg of a devil’s claw extract (standardized to contain 2 to 3% of iridoid glycosides or 1 to 2% harpagosides) 3 times daily. Devil’s claw causes few side effects other than occasional mild digestive distress.
Preliminary evidence suggests that Boswellia serrata may reduce the pain and swelling of rheumatoid arthritis. A typical dose is 400 mg 3 times a day of an extract standardized to contain 37.5% boswellic acids. The full effect may take as long as 4 to 8 weeks to develop. Few side effects have been reported with boswellia, other than an occasional allergic reaction or a mild upset stomach.
Several other herbs may also be useful for arthritis (either rheumatoid arthritis or osteoarthritis), including willow bark tea, capsaicin cream, curcumin (from turmeric), bromelain (from pineapple), ginger root, and the root of Bupleurumfalcatum (Chinese thorough-wax). The supplements pantothenic acid and selenium may also be helpful.
A diet high in wtamin C, vitamin E, and beta-carotene may slow the progression of osteoarthritis. Boron supplements may reduce symptoms of osteoarthritis, but the evidence is weak, and there are significant safety concerns.
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