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Caught in the snore snare....A real nightmare!Snoring is caused due to obstructed air movement during breathing while sleeping. It may suggest an underlying medical problem like obstructive sleep apnea. Studies have also revealed a correlation between snoring and risk of heart attack. There are different reasons for snoring and to find out the exact reason and the right solution is important. Snoring affects the quality of sleep can cause irritability and fatigue. Snoring causes poor quality of sleep, irritability, lack of concentration the day after the deed. Snoring is a tad like fingerprints , no two sets are the same and so it is with snoring, There are different rhythms or snoring patterns and even the reasons for snoring vary. Snoring or that irritating sound which people make through their mouths and nose while asleep happens because of narrow airways failure of air to pass through the respiratory system easily. The air vibrates against the obstruction in airway causing the sound of snoring. The air is unable to escape normally through the airways and hence it causes that grating sound with each inhale and exhale. Yes that sound which makes you wish you could smother the fella with a pillow. We say fella because men are more prone to it than women. Snoring can happen due to various reasons: Habits: Those who smoke and drink regularly are likely to have a more relaxed set of jaw muscles causing them to snore readily and loudly. Weight: People with excess weight and poor muscle tone are likely to snore more. Age: The wide open mouthed gape kind of snoring usually happens in old people as the breathing muscles lose their tone somewhat. Posture: General posture and sleep posture in particular can affect snoring patterns. Especially, sleeping with the back flat against the bed constricts free exhalation. How to put a clamp on your snoring? If you have a snoring problem evaluate how serious it is and then take the necessary elimination strategies. Understand that your snoring can cause sleepless nights to your partners, family or whoever is within ear shot so instead of going in for fancy anti-snore devices which don't do a thing to help If this is a recent habit then consult your doctor and have him re-evaluate any medications that might be responsible. Try and establish a regular sleep time and ensure that you follow it to the T. Exercise to lose weight as losing flab around the throat can lead to better sleep. Ask a partner to awaken you if you snore too loudly as regular jabs in the gut can help train the mind to behave. Blow your nose out before bed time as clear air passages is what you need. Any nasal constriction or chest congestion is really what gets you started. Sleeping on your side is a better option than sleeping on your back. Before hitting the sack try and hum a few bars of the blues as singing can help tone the vocal cords and they are less likely to go into vibrate mode. According to help-guide.org there is a rather quaint method to cure snoring and that is to play on a certain musical instrument called the 'Didgeridoo' which is supposed to strengthen the soft palate and throat muscles. If you have no Australian connections then don't despair as rolling your tongue out from all sides before sleep can work just as effectively.
Make no bones about this - Men have osteoporosis tooOsteoporosis is a condition in which the bones of the body lose their strength gradually and become thin and brittle. This is most commonly seen in women who have attained menopause. The reason being the decrease in the hormonal levels, particularly estrogen. Studies reveal that 20% of sufferers are men. Falling levels of testosterone are one of the causes for men developing brittle bones. Men's bodies convert some amount of testosterone into estrogen, which is very essential in maintaining the bone mass. Genetic deficiency of the enzyme that helps the conversion of testosterone to estrogen also is a major factor for men developing osteoporosis. Calcium and vitamin D play an important role in developing the bone mass and in helping the bone grow. Exercising helps too. When you exercise, the muscle gets pulled and the bone responds by growing. Too much of indoors and sedentary work may make men get the less of all three and it eventually leads to weak bones and osteoporosis. Studies reveal that 20% of sufferers of osteoporosis are men. Certain medications like anti-seizure drugs, drugs for prostate cancer and steroids have side-effects that make it impossible for the body to use vitamin D. Using them for a long time reduces the bone mass density and leaves the bones brittle making them easily prone to fractures. Smoking is a vice that has to be quit for more reasons than one. An analysis of several major studies on the effects of smoking shows that smokers have a 55% higher risk of hip fractures and low bone mineral density than non-smokers. Nicotine has also shown to have a direct effect on bone cells. A long list of medical conditions like diabetes, rheumatoid arthritis, and digestive and blood disorders can take a toll on your bones. Long term medications for the same also have side-effects on the bones. How to prevent osteoporosis? Exercise- As young boys, men have usually been exposed to a lot of bone building exercises through sports. This helps in building up on the bone strength and comes in handy in the later years. A brisk walk for 30 minutes 5 times a week and moderate impact exercises help in maintain the bone mass and reduce the thinning of bones. Calcium intake- The daily calcium needs for men is the same as women. Hence, the dietary recommendations remain the same too. 1,000 mg of calcium a day from ages 19 to 50 and 1200 mg of calcium a day if you're over 50.Along with this, make sure you get the required dose of vitamin D too, so that the calcium you eat is absorbed properly. The standard recommended dietary allowance is 400 IU. Some doctors advise to increase the intake to 800 IU. Regular medical checkups will help you to know beforehand about the risk factors and the necessary precautions you will need to take.Osteoporosis in men is as much a reality as in women. However, there are ways to avoid it too. Awareness about the condition and about the ways to prevent it can help keep osteoporosis at bay. Bone mass matters. It could mean the difference between a hip fracture later in life - or keeping an active, high-energy lifestyle.
Mother can pass stress patterns to childThe stress patterns in the mother have shown to affect the mental development of children and have been found to play a role in autism and even schizophrenia. "Pressure and stress is the common cold of the psyche." - Andrew Denton There are several studies conducted in this area of research. The results are varied and present a set of multiple issues that children can face if their mothers have been under stress when they were in the womb. In later years, these babies grow into children who have a weak mental state. They cry easily, pick the escape route in conflicts and difficult situations, are anxiety prone and may get easily bullied in social environments. Their social adjustment gets hampered due to emotional weakness. These children are not good at handling weak moments and end up being rubbed off the wrong way, time and again. It pushes them into a vicious cycle. The incapability to tackle socially stressful situations further scares them. They get bullied and become even more vulnerable. What to do? The approach is twofold. Curb the problem in the beginning. Yes, it is natural to be stressed. Pregnancy can be tough, physically as well as mentally. With the modern life, the stressors have increased and there is always so much to do in such little time. Relationships, work, food, health, hormones - there is ample to trouble you. Find a release for the tensions. The one growing inside you needs you to be happy and healthy. Do things that make you happy, keep your happiness at the top priority. Everyone around you needs to understand that. Reader, if you are the husband, parent, sibling or friend of a pregnant lady - support her, understand her and do all you can to make her smile. Do not be the one who reprimands if she is worried, be the one who takes away her worries. Pave way for a baby who is happy and ready to start a new life. Second, do what you can at the given time. The child is already here and is facing emotional adjustment issues - extend your support to him/her. Give the kid the ground to grow strong roots and stand tall, without being disturbed easily by gushes of the wind. While it is difficult to avoid stress, you can always try to handle it better, for the sake of your child.Soon-to-be mothers who go through stressful situations may be passing on the stress patterns to their babies.
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Your child is ready for school... but are you?It was still okay. Just 2-3 hours which you could utilize for other things while your child was away briefly. Now you will have to compete along with teachers, textbooks and homework for your child's attention. Well Mother, we know this is going to be difficult for you, but let's see if we can try and make it any easier. Think of school as an extension of the tender loving care that you provided. The only difference is that the TLC will go towards nurturing and developing his/her brain and help it learn important skills which will help gain a balanced development. At this point your child feels bad and completely unsafe in this new hostile world of teachers and uniforms and what not! If you weaken at this point your child will cop on and then will come the emotional blackmail. So explain the importance of school to your child as it will make the transition easier. It is always good for mothers to accompany their children to school but imagine watching mother walk away and all hell can break loose. So if your child's school has a school bus facility you can walk him to the bus stop and then say your goodbyes there. A lump in the throat at the bus stop is preferable any day than a scene at school with a child holding on to mother for dear life. Do not criticize your child's school or assignments given by them as children can catch on quite quickly and that can be reason enough for them not to concentrate on school activities. Always encourage your child to talk about what he did at school and ask him questions about his friends and teachers. This gives the impression that school is as important as home and gradually even you will reconcile yourself to the fact that school is here to stay.
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
Fruit diet can be dangerousFruits are healthy and provide lots of nutrition, vitamins, antioxidants, carbohydrates, fibre and bioflavanoids to the body.These things together protect your body from different health conditions and heart disease. However if you only eat fruit, you miss many other essential nutrients such as fats and protein. This can upset your stomach and lead to indigestion. Hence it is very important to take a well-balanced diet to remain healthy. Check out why you should not rely solely on fruits for living. Fruits do not provide protein Protein is highly important for your growth and development. By eating only fruits, you are restricting your intake of proteins that can stop your overall development process. Your body requires calories and energy on a regular basis. Each cell of your body contains protein. To keep your body cells in top working condition it is important that you include protein-rich foods such as lentils, soy products,  nuts and beans in your regular diet. You can also consume low-fat dairy, lean meat, fish and skinless poultry to provide required amount of protein to your body. Fruits do not provide fat Although excess of fat is not good for health, it is essential that your body requires on daily basis to ensure smooth functioning of your immune system and also to help your body absorb various minerals and vitamins provided by other foods like fruit. If you continue being a fruitarian for long duration, the chances of stroke due to brain haemorrhage increases. According to health experts, you should get around 20 to 35 percent of your daily calories from fat. To provide your body with good fats you should include soybean, sunflower, olive or canola oil in your diet. Fish and poultry also provide good amount of healthy fats to the body. Too much of fruits can lead to digestive problems Fruits provide fibres to the body in large amounts. Although your body needs fibre as it is one of the essential nutrients, getting too much of fibre can lead to side effects. Fibre works as broom to clear of your abdomen and aid in the digestion process. However, too much of fibre leads to stomach problems and cause symptoms such as gas, cramps and bloating. Sometimes it may also lead to chronic diarrhoea, dehydration and loose stools. On a regular basis, a woman requires only 22 to 28 gm of fiber per day and a man needs 34 to 38 gm. Apart from fruits, seeds, vegetables and whole grains also provide fibre to the body. Other considerations If you limit your intake to fruits, you may not get enough calories required for producing the required amount of energy. Consuming calories less than 1100 per day can lead to lot of side-effects such as intolerance to cold, gallstones, hair loss and fatigue. So although fruits taste wonderful and are very tempting, being a fruitarian is not the best thing for your health. Your body needs all the nutrients for carrying out its different activities and hence you should include variety of foods in your diet.  
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
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
Sex during pregnancy? It's possible!One of the questions that arise when a woman gets pregnant is whether it is safe for the couple to have sex. We'll try to answer the most common questions couples tend to ask. Is sex safe during pregnancy? Sex is considered safe if the pregnancy is normal in all stages. However, even if it is safe, it doesn't mean the woman would want to have it. Desire for sex fluctuates during the various stages of pregnancy and sex becomes plain uncomfortable as the body gets larger. What is not safe? Two types of sexual behaviors are not safe during pregnancy. While having oral sex, the man should not blow air into his partners' vagina. It can lead to air blockage of blood vessels by an air bubble, which is called air embolism, and can be lethal for both mother and baby. The pregnant woman should strictly avoid sex with a partner with unknown sexual history or who may have a Sexually Transmitted Diseases (STD). What are the common risk factors? In case of significant complications with pregnancy, abstinence from sexual intercourse is advised. Common risk factors can be: Threat of miscarriage. One can have pre-term labor or signs indicating the risk of pre-term labor (such as premature contractions). Unexplained vaginal bleeding, discharge, or cramping. Leakage of fluid surrounding the baby, called as amniotic fluid. Placenta previa, a condition in which the placenta (the cord connecting mother to the baby and nourishes the baby) is located low down and covers the opening of the uterus. Cervix incompetency, a condition where cervix is weak and dilates before full term, increasing the risk of miscarriage or premature labor and delivery. Can sex during pregnancy harm the baby? The baby is always protected by the amniotic sac (a bag-like structure that holds the fetus and surrounding fluid) and uterine muscles. A thick mucus plug seals the cervix and protects the baby from infection. The penis does not come into contact with the fetus during sex. So, sex can't harm the baby directly. Can orgasm lead to miscarriage or contractions? The contractions felt by pregnant women during and just after orgasm are totally different from the contractions of labor. Therefore, in cases of normal and low-risk pregnancies, orgasm can't cause contractions and miscarriage, but always check with the doctor and make sure that your pregnancy is in the low-risk category. What are the safe positions for sex during pregnancy? The old standby missionary position for intercourse may not work for you now. Instead, try these options: Spooning: Lie side by side with him behind you. This will not put pressure on your belly, and makes for more shallow penetration. Female on top: There's no pressure on the belly, and the female can control the speed and depth of penetration. Side of the bed: The female lies on the back on the edge of the bed with knees bent and feet on the edge. The male stands facing her. It's like classic missionary, but the male won't be resting his body weight on the pregnant female. However, remember 'normal' is a relative term when it comes to sex during pregnancy. You and your partner need to discuss what feels right for both of you and take advice from the doctor.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
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