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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
10 pregnancy risk factors that every pregnant woman should be aware ofFollowing are the possible risk factors for pregnant women: Hypertension: Blood pressure rises during pregnancy due to changes in osmotic level. Persistent high blood pressure leads to a condition called as pre-eclampsia. It retards the growth of the baby in the womb and can even result into death of foetus. It can lead to convulsions in mother. Exposure to medicines and drugs: Self medication is a strict NO NO during pregnancy. Certain drugs have harmful effect on the growth and development of baby. Take gynaecologist's opinion and ask a doctor before taking any medication.  Smoking: Smoking retards the growth of foetus (baby in womb). Moms who indulge in smoking give birth to babies with a very low birth weight. It also increases chances of miscarriage. Mother's weight: It is important to make sure that there is a steady weight gain during pregnancy. A weight gain of 11 kilograms is expected over a period of 9 months. Watch for a steady weight gain for a healthy pregnancy sake. Anaemia: There is an increase in blood volume during pregnancy. This can cause the iron levels to drop down resulting in anaemia. Haemorrhoids add further to the iron loss. Iron and folic acid are therefore prescribed. Haemorrhoids: Haemorrhoids are common during pregnancy and after pregnancy due to constipation which is because of hormone induced reduced motility of intestine. The pressure of gravid uterus on intestine may also cause it. Increased consumption of green leafy vegetables and laxative would relieve it. Alcohol: Drinking can cause a harmful effect on the growth and nourishment of child. Child may be born with a serious medical problem. Sexual intercourse: It's strictly not advised during last trimester. Radiation exposure: Exposure to radiotherapy or chemicals in the surrounding should be avoided. Bleeding per vagina: Consult your gynaecologist soon, if you have problem of bleeding per vagina. It could be a sign of abortion.  
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Dealing with obsessive thinking and worriesAn old adage goes - 'Worry is like a rocking chair. It gives you something to do but it doesn't get you anywhere'. This is absolutely true for many of us who have developed the habit of worrying unnecessarily over outcomes and circumstances. Thinking about things and over our course of action is a good thing because you should always think twice before acting. What about obsessive thinking? Is it good for you? Anything in extremity is a bad thing, whether it is your favorite food or your thoughts. Worrying incessantly is a part of obsessive thinking where you cannot let go of negative thoughts and they circulate in your mind continuously. Obsessive thinking is a negative infinite loop, a broken record that is stuck without having anyone to click the stop button. So how should you deal with this obsessive thinking that is sure to spell your doom in the long run? Though psychologists have devised various scientific methods of overcoming obsessive thoughts and worries, here we have listed down some easy to follow rituals that will help you deal with such worries and thoughts. Meditation - Yoga swears by the art of meditation as it is thought to release all negative energy from the mind and soul. Concentrating on your breathing and also absorbing a positive source of energy is the essence of meditation. So whenever you are obsessed about something, sit down, calm your nerves and meditate. Physical activity - Exercising always helps. Engage in physical activity which increases the body's metabolism and requires effort. Indulge in those dance lessons or swimming or maybe cycling and you will divert your mind from those negative thoughts. Indulge in your hobbies - So you thought you don't have time for your hobbies, but your hobbies relax your mind and body. Moreover, a hobby also takes out the creative side in you. So, whether you like to collect coins or stamps, or lean towards arts and crafts, a hobby is sure to occupy your mind and take you away from worries. Socialize - Friends and relatives are your lifeline as they help you in those tough situations. Even if you are mentally not at peace, making social calls on your friends and relatives will take the edge off.  Try to meet people who can empathize with you and help you move out of it. Socializing will give you that much needed break from the vicious cycle of your thoughts. Though a short-term relief, going out for movies or taking a weekend getaway with your near and dear ones or even indulging your wife in shopping, can be helpful. Confide - Talking to someone close who understands you helps you in expressing your troubles. Thinking obsessively, you usually tend to ignore your feelings and emotions. Your mind remains trapped in the net of those obsessive thoughts and your emotional well-being takes a backseat. When you talk to another person, he or she will hear you out and help you relieve the stress that is on your mind. They would understand your state of well-being and support you emotionally. Be mindful - You may find it easy to go back into the same negative thought process. Don't let your mind chatter. Stop your mind by standing up for yourself. Stand in front of the mirror and say, "I am not a victim. I have the power and strength to move ahead" Do this whenever you become aware that you are going back into the same thought process.  This will give you the mental strength needed to come out of it.  Be mindful and aware but don't be too harsh on yourself. Be responsible -Your mind can make you or break you. If you understand this truth you will find it easier to manage your thoughts. Take responsibility of your thoughts good or bad.  The mind can create thoughts to project blame or judgments about others.  When you own your thoughts, you will find it easier to shape them the way you want. Create a higher vision of your life - When you keep a higher vision in your life, you can move ahead easily.  By developing a higher vision, you are asking yourself, who am I?and finally working towards it. You take positive actions and thus there would be more gratitude for what you have and less resentment for things that do not work.   This stops your mind from working unnecessarily. Obsessive worrying is a psychological disorder which in extreme cases has to be dealt with pathologically. Do not let your condition to reach the extreme end of the spectrum. Follow the above mentioned suggestions and try to deal with those thoughts yourself. It may take some time but rest assure, it will be effective in the long run.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
Aerobics: dancing your way to healthAerobic exercise is any comprehensive activity that makes you breathe hard while exercising your large muscle groups at a standard, even pace. The body uses stored carbohydrates and fats for energy. What is aerobics? Aerobic literally means having or providing oxygen or an activity that takes place only in the presence of oxygen. What is aerobic exercise? Aerobic exercise is any comprehensive activity that makes you breathe hard while exercising your large muscle groups at a standard, even pace. The body burns stored carbohydrates and fats for energy. Thus aerobic exercises help the body to utilize oxygen efficiently with increase in respiration and heart rate. What are the best ways to do aerobic exercises? There are number of ways by which you can exercise aerobically. Some easy and best ways are: walking, running, biking, using stationary bike, using stair stepper, elliptical machines or rowing machines, or joining an aerobic exercise class Benefits of aerobic exercises Fat reduction: Aerobics burns calories and body fats directly while using oxygen to produce energy. So this is the healthiest way to get rid of extra fat.  Strong heart: Aerobic exercises not only use your larger muscle groups like hamstrings, but also strengthen the heart muscles. This improves heart function resulting in improvement of blood and oxygen supply to all body parts, which provides healthy nourishment to body cell and removes toxins. Improves breathing: Exercises improve your lung capacity and function,which improves oxygenation, or competence of respiratory system to deliver oxygen to all body parts. It also improves overall health of the respiratory system. Cholesterol control: LDL cholesterol is bad cholesterol mostly responsible for clogging of arteries and HDL is good cholesterol. Aerobic exercises invariable increase the amount of HDL and lower LDL cholesterol thus preventing fat deposition and plaque formation and maintaining optimal blood supply to heart. Other benefits: Aerobics is the best exercise when it comes to prevention of various diseases like hypertension, diabetes, stroke and arthritis and osteoporosis. It helps to keep mood elevated and cures depression and boosts immunity. Make sure to incorporate some form of aerobic exercise in your daily routine.  
Diet to help manage stressYou cannot avoid stress, as it has now become an integral part of modern lifestyle. Children are worried about their exams and performances in the cultural events, teenagers are stressed out about their looks and body shape, adults take stress owing to competition at work, and so on. One thing is sure that you cannot stay away from stress. So, how can you avoid the side effects caused due to stress? You can include certain foods in your diet that help manage your level of stress. Researchers are already on to it, studying the effects of various foods on the stress levels. It is always better to choose from the organically harvested nuts, veggies, fruits, and fish for better health benefits. Nori Sushi nori is a type of seaweed that is rich in magnesium that contains anxiety-fighting properties. Magnesium is also known for stress reducing abilities. Apart from this, it also carries other essential health nutrients that are necessary for the overall development of health. Vitamin C Foods Cantaloupe is composed of vitamin C that is a renowned stress buster. Another great stress busting food is orange. When you are under stress, adrenal glands in your body start producing cortisol that lowers your immune system's capacity. This leads to breaking down of muscle tissue. Vitamin C in oranges have the ability to return the high blood pressure to normal level. Moreover, when you are stressed there are chances of this vitamin getting used up and hence the need to increase your intake of vitamin C rich foods. Another popular vitamin C enriched food is blueberries that are also packed with lots of antioxidants which relieve stress. Almonds Almond is a treasure trove of essential nutrients such as vitamin E, B2, zinc, and magnesium. Although they are high in fat, they provide your body with all these essential nutrients. You can easily have a handful of almonds every day and still feel less guilty about.  Apart from the fat, energy, and the essential nutrients, almonds give the brain and its memory a shot in the arm. Broccoli Broccoli is rich in vitamin B and folic acid, both proven stress busters that helps in giving you relief from panic, anxiety, stress, and depression. Bananas Bananas contain one of the most important amino acids - tryptophan that gets transformed into serotonin which is a stress-busting hormone that is known to induce a feeling of well being. This makes you happier and gives you relief from stress. Banana is also rich in potassium. Potassium regulates the heart due to which the blood pressure can be kept under control. That is why many health experts recommend inclusion of a potassium-rich diet, as it normalizes your heart rate and help you calm down in stressful situations. This makes banana an essential food addition to your diet. Chocolate The dark chocolates are bitter and give you a feeling of satiation despite the little amount you devour. Due to this feeling, you eat less, but you still enjoy the flavor of the chocolate, much more than the milk chocolate varieties. When you are under stress, most of your body organs are vulnerable to damage. The antioxidants polyphenols that are present in the dark chocolate slow down the damage and also contribute in its repair. Studies have also revealed that 40 grams of dark chocolate per day helps reduce stress-causing hormones such as catecholamine and cortisol. Increasing the intake of stress busting foods in your daily diet can help control diabetes and hypertension.
A guide to earwax impactionBiologically, the earwax which builds up over time moves through the ear canal from movement caused by chewing or other jaw motions. It is also extricated through the inside-out motion of the skin of the ear canal - it reaches the outer ear and peels away. The cerumen is produced in the outer regions of the ear and not in the inner recesses. Earwax impaction refers to the condition where the ear wax builds up to such an extent or in such a manner that it causes discomfort to the entire body. In many cases, earwax impaction occurs when patients use cotton swabs or safety pins to clean their ears, only causing the wax to drop deeper into the ears. The main symptoms of earwax impaction include difficulty in hearing, faintness, ache in the ear, foul smell in the ear region, ringing or sound in the ear (also known as tinnitus), a sensation of fullness in the ear, and lastly, discharge from the affected ear. The most vulnerable groups for this condition include those who use hearing aids or ear plugs, elderly people, and those who insert cotton swabs or other items into their ears, as well as those who have an odd ear shape which could negatively affect the discharge of the earwax and those suffering from development incapacities. Did you know that one of the most common methods used by people to clear excessive earwax is ear candling where a candle (in shape of a cone) is placed inside the ear canal and set alight to warm up and remove the wax? This is one of the most dangerous methods causing burns, worsened blocks, and damaged eardrums; this should be clearly avoided. The diagnosis of this condition can be done by an ear specialist using an instrument called otoscope. Earwax impaction is treated in many ways. While at home, you could try to clean the outer region of the ear by wiping with a cloth, the physician could irrigate or syringe the ear to wash out the ear canal with saline. This procedure is generally done once the wax has been softened by the use of cerumenolytic solutions aimed at dissolving the wax like mineral oil, peroxide-based ear drops, and hydrogen peroxide. Physicians also use special instruments to remove the built-up earwax like forceps, cerumen spoon, and suction tool. The best way to prevent cerumen impaction is by not inserting anything into the ears to clean it up. Cotton swabs should only be used in the outer part of the ear. In case you feel that the buildup is regular, then you can fix an annual appointment with your physician for cerumen removal.
10 simple ways to get rid of hiccupsHiccups are simply a sudden involuntary contraction of the diaphragm. Diaphragm is the muscle on which the lungs rest and it is above the stomach. The contractions happen several times within a minute and goes on for several minutes. Every contraction is followed by the sound 'hic'. And hence the name - hiccups. Sometimes hiccups can occur in the most awkward situations - just before an important interview, just as you lie down on the bed to sleep, or even during a meeting. Hiccups in difficult situation can be a big problem. Some simple tricks could help you get rid of them. It helps to know different techniques you can use to stop hiccups, for only one may not always work. Hold your breath: Inhale deep and long, and then hold on to the breath. This may help the diaphragm to relax and hiccups will stop. Drink warm water: Take about ten or more big gulps of water, with quick swallowing. This will help the irritation of diaphragm to go away. Close your ears: Use a thick small roll of cotton or use your fingers to plug your ears and close it. Do this for about 30 seconds. Alternatively, you can also firmly press upon the soft tissue of the ears from behind, next to the ear lobes. This helps to relax a nerve which then relaxes the diaphragm. Take your tongue out: Pull out your tongue, as out as you can and keep it that way for a few seconds. This helps in better breathing, relaxing any spasms that may be causing the hiccups. Breathe with mouth covered: Press both your palms over your mouth to close it and continue breathing only through the nose. This intends to create a discomfort that will cause some distraction for the nerves and the hiccups will stop. Breathe in a paper bag: Breathe deeply into a paper bag. Do not cover your whole face with the paper bag, just the nose and mouth. Hug yourself: Pull your knees up, close to the chest and wrap your arms around. Hug yourself tight for a couple of minutes. The pressure also helps to relax the diaphragm. Have some sugar: Have a spoonful of plain grainy sugar and keep it in the mouth. Swallow slowly. Lemon at your service: Pick a piece of lemon, put it in your mouth, and let it be there. Do not chew; just suck it slowly for a few minutes. This will also help the hiccups go away. Just wait:  Nine out of ten times, the hiccups will go away on their own, after giving you a little trouble, of course. If you are not too uncomfortable with hiccups, be patient and give them a few minutes. Most likely, they will pass off as spontaneously as they had come. "I think hiccup cures were really invented for the amusement of the patient's friends." - Bill Watterson
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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