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Weight gain and prostate cancerOne of the hormone therapies involves increasing the production of LH-RH. Luteinizing Hormone-Releasing Hormone (LH-RH) is a hormone which is produced by your body. This lessens the production of testosterone. The drug given induces the generation of this hormone. One of the side effects of this therapy is weight gain. Along with this, breast pain, hot flashes, nausea, and growth of male breast tissue might occur. Apart from hormone therapy side effects, the presence of fatigue can also stop a patient from regularly exercising, thus, resulting in gaining weight. However, it is important that this weight gain is averted as the chance of cancer returning is a possibility. You can keep your weight in check by following these tips: Ask your doctor if your hormone therapy can lead to weight gain. If you receive an affirmative answer, then ask for a diet chart to be followed. You can also keep a food and activity journal to get an idea of how your body is reacting to the treatment. Inculcate physical activity in your schedule. This will not only help to reduce fatigue, but also keep at bay the chances of becoming constipated or feeling nauseous. Medical studies have shown that cancer patients must have at least 2-1/2 hours of moderate physical exercise per week. Have about 2.5 cups of fruits and vegetables every day. Also, shift to whole grain food items. You should also consume at least a cup of legumes, for example, beans, to keep up your protein levels. It is best to opt for lean protein snacks like yogurt and chicken. You must stay adequately hydrated during your treatment. Drink about 10 to 12 glasses of water everyday. Do not consume excessive amount of sweetened beverages like coffee and cola. Have a small portion of nut and nut seeds. If you feel distressed due to the therapy, go for a massage. These have been proved to reduce anxiety and stress caused during the treatment of cancer. Most importantly, keep up with your appointments with the doctor and convey the bodily changes that you may notice. Have an optimistic outlook towards the treatment and do not repress any emotional disturbance. Weight gain in men who had been previously healthy often leads to depression regarding weight issues. Being proactive and focusing on keeping your weight under check is the key here. You could also approach a psychologist if you have been feeling low. The LH-RH therapy is also known as Androgen Deprivation Therapy (ADT). This therapy leads to a weight gain of around 9 pounds within a year of starting treatment. You can make sure that your weight is controlled by altering your lifestyle and getting adequate physical exercise everyday.
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.
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
High blood pressure in the little onesIf you are asked to paint a picture of a patient of hypertension, how would it look? Leave the details aside, would you paint an old person, a young person or a child? Most likely, you will paint an old person or may be a middle-aged person. But a child, who would think of a child to have high blood pressure! It may be difficult to believe for most but not only is it possible, its incidence is also increasing gradually. In fact, hypertension in kids is becoming quite common. Studies in USA show that up to 5% children and adolescents have hypertension. What is it? High blood pressure in children and adolescents is also called as pediatric hypertension. Pediatric hypertension is defined by the blood pressure recorded on the mercury, in comparison to the given standard range. As a child grows, there is rapid development in all the milestones. For children, there are percentiles defined for all parameters for various age groups. In children, when the blood pressure is above the 90th percentile but below the 95th, it is called prehypertension. When it is above 95th percentile, it is diagnosed as hypertension. There are no distinguishing symptoms of pediatric hypertension, so it may easily be missed. Please make it a practice to get your child's blood pressure checked on routine visits for medical examination. Why does it happen? High blood pressure in children under ten years of age is usually secondary to some other health condition. It could be due to an underlying heart disease, kidney disease, hormonal disorders or genetic abnormalities. This demands treatment of the main problem. Primary hypertension is noted in older children, over 6-10 years of age and adolescents. There is no specific cause identified for this, other than lifestyle, obesity, rich foods and family history. How bad could it get? Children may show a disordered sleep pattern when they have hypertension. They may suffer from sleep apnea, reflected by snoring or abnormal breathing. Besides sleep, the other effects of hypertension are the known ones. In the long run, it could lead to heart disease, stroke or kidney disease. What to do? It is very important to control the blood pressure from a young age. Regular check-ups and monitoring of the BP is needed. Thorough examination is a must to identify whether the hypertension is primary or secondary. Treatment by medicines is recommended in secondary hypertension, where the underlying condition is to be tackled along with the management of blood pressure. In cases of primary hypertension, medication is suggested only in extreme cases. Otherwise, lifestyle management is the key. It is not a healthy option to start anti-hypertensives this early in life. Give your child healthy food, help him/her maintain the ideal body weight and make sure he/she gets enough exercise physically. The sooner we identify the problem, the better are the results with a disciplined lifestyle. The unhealthy lifestyle is creating chaos in all our lives. How long the kids would have escaped? Our lifestyle reflects on our kids. Follow a healthy routine and keep the family healthy!
Exercise to fight off depression in school kidsBefore concluding on the effects of different forms of exercise on children, it is important to note the distinction between fitness and exercise. Fitness encompasses most importantly a healthy lifestyle of which exercise forms a part. For this reason, when researchers examined the impact of fitness on emotional being of a child, most of them covered three main determining factors, namely the body mass index, the child's feeling about fitness, and a shuttle-run test. Depression is characterized by recurrent feelings of despair and hopelessness. The main symptoms of depression include sensations of unworthiness, dysfunctional thinking, lack of concentration, low level of sleep, anger, social isolation, crying, physical grievances like headaches which do not react to treatments, reduced interest in social activities, and thoughts on suicide. It is not necessary that every child will undergo all the symptoms. If most of the symptoms recur continuously, then it is a warning sign. The propensity towards chronic depression is higher in those who suffer from depression during childhood. A healthy lifestyle is accompanied by a range of psychological benefits. When you exercise, your body produces endorphins which stimulate positive sensations about the self. Produced by the brain, they also reduce the sensation of pain. A healthy lifestyle boosts the sleep cycle and helps in coping better with tough situations. A medical study conducted by University of Texas revealed the positive effects of physical activity on middle-school graders. It was found that there is a robust link between depression and fitness in girls. Even though boys show association, it is not explicit.  Conclusively, it was pronounced that exercise helps in reducing the chances of depression in school-going children. The best way to help your child is by introducing activities that she or he finds interesting. Initially, you might face resistance. The most important task is to communicate with your child. In the face of such resistance, you can attempt to find a hybrid therapy to reach out to your child. Apart from scheduling appointment with a child psychologist, you can also meet up with a physical health advisor. Emphasize on activities which will also help your child to meet new people. According to the Center for Disease Control and Prevention, one of the main benefits of physical activity is betterment of academic achievement and conduct in children.
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
The male ego: Fragile male self-esteemIn a world where men are constantly competing with one another, adding a woman to this dynamic changes the perception for majority of men. The fact that a woman is doing better than a man can largely affect relationships at a personal and professional level. Simple things like opening a door for men or even pulling a chair for him can make him feel self-insufficient. The whole concept of a woman doing something/anything better than him brings down his self-esteem. In a relationship the roots go deeper and men who are making less money or not doing as well as their partners have a more fragile self-esteem. The mental insecurity that a woman may be a better provider for the family and has more potential than he does, changes the dynamic of his relationship, while for women this does not seem to be the case. Fragile self-esteem alters your everyday determination and persistence. Without being determined, the only way to go is downwards. When self-esteem is affected by women doing things that he can do, men seem to take it in a negative manner and lower their self-esteem. Small examples of this in our day to day life are - driving your own car as compared to having a driver, being physically weaker than a woman, etc. Men are creating rules to ensure that women who are considered lower than them cannot perform or do better than them. Systems and frameworks are made which ensure that situations never come up where a "lower person" does better than a man can, all out of the fear that they can't perform! From the day we are born to the rest of our lives, we are drilled with the fact that men are better, stronger, and smarter than women. So when situations arise where she is doing or has done better than you, the male self-esteem is questioned and, most of the time, drops. Being the person you are meant to be, you would automatically create a system by your choice and influence it to reduce the possibility of any other to be able to achieve what you have, in turn increasing your self-esteem. However, when the other overcomes or surpasses this obstacle, your self-esteem will be hit hard causing a drop in your self-esteem like the stock exchange does on its bad days. Self-esteem is a very personal topic and completely dependent on the situations you have encountered across your life. However, when majority of these are leaning in one direction then there is no question of failure. Consider a world dominated by women, What would happen to your self-esteem? Do you think you would survive in this kind of world, a world in which all your thoughts are limited by restrictions and rules you have to adhere too, to ensure things like your family name is kept out of shame. So let us all do as the women have been doing for centuries, embrace it, and learn to maintain our self-preservation and esteem irrespective of our surroundings. This may sound hard but let us work towards a world where women and men are equal. Don't let your self-esteem be affected by your surroundings, if you know your surroundings are not the best for the future.
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
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.
Treating sore throatTest and diagnosisPatients with sore throat are examined by ENT specialists. At first, the doctor performs a local examination of throat. Clinical examination usually guides the doctor towards diagnosis. Although in order to confirm the diagnosis, the doctor may ask for culture and sensitivity test of the throat swab. Treatment Home remedies: Mild cases of sore throat are usually cured by home remedies. Following remedial measures can be adopted at home: Warm saline gargle – Gargle with warm saline water helps to relieve the discomfort and irritation of the throat. Half to one teaspoonful of salt is added to one full glass of warm water and the patient is advised to gargle. This process may be repeated 3 to 4 times a day to have a soothing effect on throat. Additionally, smoking and use of other tobacco products must be avoided. The patient must drink adequate amount of fluids. Warm liquid and semi-solid food must be consumed to provide a soothing effect on the throat. Cough lozenges to help relieve irritation and pain in the throat. Seeking advice of the doctor: If the signs and symptoms persist and are not adequately controlled by home remedies, the patient must seek advice of a specialist doctor. Viral infections usually do not require treatment. They are usually cured in 5 to 7 days. Bacterial infections require treatment as per the advice of a specialist doctor. Bacterial infections may require treatment by antibiotics. The treating doctor selects an antibiotic which is suitable for the patient depending on factors such as the age of the patient, report of the culture and sensitivity of throat swab, previous drug history of the patient, etc. Antibiotics usually effective in bacterial infection with sore throat are from the group of penicillins, cephalosporins, and macrolides. PreventionViral and bacterial infections are contagious. Good hygienic lifestyle and habits help prevent infections. Following things to be noted are: Frequent and thorough hand washes before consumption of food, after using toilet, and after sneezing and coughing. Use of a hand sanitizer during consumption of food outside home. Avoid sharing food and drinks from same glasses and utensils. Use a tissue paper or handkerchief while sneezing and coughing. Avoid close contact with patients with sore throat. If sore throat develops, few home remedies may prove to be curative. If sore throat persists, advice of a specialist doctor must be sought.
Importance of sex educationOur society is beset with a lot of myths about Human Sexuality and hence the family relationships are affected adversely. A man is considered (mistakenly) as a man only when he performs effectively in bed. In other words a man hangs his self-esteem on his male organ. Hence whenever there is a problem in performing sex, he becomes frustrated and depressed. In order to cover up his inadequacy he may blame his wife for his problems. This attitude will adversely affect the martial relationship, leading to unhappiness in nonsexual aspects of marriage. He may become violent when the wife retaliates. Marital break down, even if not ending in legal separation will be a very messy affair. Sexual behavior is determined by information or knowledge one has on hand and the parameters of comfort zone. Unfortunately we are dealing with a behavior that is besmirched with myths and misconceptions, and a breeding ground for stigmas and taboos, which leads to unhealthy sex life. These barriers have to be broken; otherwise healthy sexual and family life cannot be achieved. It is guesstimated that one in every three couples have some sexual problem or other and they do not know how and where to seek help. The media gives them anonymity and guides them in proper direction. The three main enemies of sexual satisfaction are guilt, anxiety and fear. All these stem from ignorance. Due to the stigmatization sex education is not available. Hence the streets have become not only the libraries for knowledge on sex but also the laboratories. When one of the dimensions (recreation) becomes problematic it impacts the health of the other two dimensions (procreation and relation). Magazine columns endeavor to dispel sexual ignorance and empower people with scientific knowledge. The aim is twofold: First, to inform in simple language, the scientific aspects of sexual problems and clarify myths surrounding sexuality; Second, to help people become comfortable with their own sexual life and elaborate on various treatment options available. People will thus be empowered to take responsibility for their own health and happiness. Have an open mind. All dimensions of human life are important. To consider one as unimportant and attach a stigma will hamper the development of the full potential of an individual. Understanding sexuality will enrich our lives and relationships.
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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