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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.
Sunshine for busy executivesMost people working in corporate offices, spend long hours within the confines of concrete buildings. Some business sectors like IT and manufacturing even have their employees working in night shifts. What we don't realize is that, in such a setup, our bodies do not get adequate dosage of sunlight. Lack of exposure to sunlight is responsible for a range of diseases and health conditions. The body requires sunlight just as much it requires food for its nourishment. Long hours of work in glazed business buildings under artificial lighting, deprive the body of this most basic need, thereby creating a deficiency of the vitamin D group. This deficiency then goes on to create several imbalances in the body, and contributes to diseases. Besides these, Vitamin D deficiency can also cause general muscle weakness, muscle and bone aches and pains and osteoporosis, due to the inability to utilize calcium. The best source of Vitamin D is natural sunshine, and that's why it is called the sunshine vitamin. Vitamin D can be had in the supplement form too, but it is still no match for natural sunlight. In a paper titled 'Vitamin D Deficiency' published in The New England Journal, M F Holick writes that, arms and legs should get exposure to sun for 10-15 minutes every day. "The amount of vitamin D produced depends on the intensity of the UVB in the sun and many other factors. Darker-skinned individuals may need 5-10 times more exposure than a fair-skinned person, in order to make the same amount of vitamin D." Tap that sunlight Early morning is the best time to get out in the sun. There's no better time to get that walk, than in the morning. Park your car a little away from the office building if possible, and walk to your office in the sun. When you take a tea break in the evening, head outside, instead of going to the in-house cafeteria.
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
Bonding with the babyIt is an immense pleasure to hold a baby in your arms, isn't it? The bonding between amotherand her baby starts within the womb itself. When the baby is born, a few parents bond with the baby within minutes. But for others this may take some time. If the baby is taking time to respond to your affections, don't worry, here are some tips to help you with the bonding. Babies respond to the mother by making sounds, grasping, smiling, or crying. Touching, holding, kissing, cuddling, talking and singing help build a bond with your child. Infants prefer a human face to any other stimuli. So face your child as much as possible. The attention span of a new born baby is quite short. Hang a colorful object on top of the pram, cradle,or cot. Your baby already likes toys of different shapes. Various reflexes develop by the fourth week after birth. These include sucking, grasping, searching for the nipple and blinking. Baby may gaze at you some time. Respond by nodding, smiling, and talking to the baby. Babies are sensitive to their surroundings. They respond to music or the phone ringing by staring at it quietly. They observe toys keenly, spot colours and become happy at times. These are heart warming moments for the parents. Father's care usually builds a protective and secured feeling in a child which he carries for life and prevents building of any unreal fears in him in later life. So dads should care for and make their babies feel secure. You love to touch your bundle of joy, right? Babies love, enjoy, and need it as well. Skin-to-skin touch helps growth and development of the child. Mom's touch soothes the baby when he is irritated. Start reading to your child. It is never too early. It helps the development of reading skills and language. Babies enjoy pictures in the book. Even if baby can't understand words, they love to hear the parents' voices. During the first few months, they understand little of it, but they are thrilled by listening to you. Have a short reading session with your child daily.Dads can try this trick to make the baby sleep. Carry her around while patting her very gently on back.
Dehydration: Prevention and curePlaying outside is great for the child's physical as well mental development. But if your child has spent the entire day outside and comes back with fever, diarrhea, or vomiting, and is sweating a lot, then watch out for the signs of dehydration. What is dehydration? Dehydration means abnormal loss of water from the body, especially from illness or physical exertion. Under normal conditions we all lose some body water through sweat, urine, and tears. Kids lose large amount of water and salt from body during fever, diarrhoea, vomiting, or long hours of physical activity or exercise without any water intake. How do I know it is dehydration? If your child has any of the fever, diarrhoea, vomiting or is sweating a lot on hot days then watch for these signs: Sunken eyes Dry or sticky mouth Dark urine or lack of urine output Tiredness, lethargy, irritability or fatigue How can I prevent dehydration? The best way to prevent dehydration is to ensure the child drinks plenty of fluids when they are sick or physically active. Get your kid in the habit of drinking enough water before he/she even feels thirsty.If it is very hot, explain to the kids the benefits of drinking water frequently. If possible, avoid going out in the sun. Give your kids a well-balanced meal to be sure that they are getting all the adequate nutrients. What if my kid gets dehydrated? If the kid is below 1 year, care should be taken to breast feed the baby often. If the dehydration is due to vomiting, feed small amounts frequently for it to absorb in between the vomiting episodes. Give a spoonful of ORS solution every 10 minutes to replace the lost fluids. For kids above 1 year, start with plain water initially when the kid complains of thirst. Later the kids may need drinks containing sugar and electrolytes. Also, the child should be made to rest at home in a cool environment until the lost fluid has been replaced. Once the child is rehydrated, resume to normal routine and diet.
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
Communicate to strengthen the family tiesA family that talks to each other stays together. Sounds easy? But how often does your family sit down together in the week to spend time with each other? How about breakfasts and dinners? Are you all able to match your meal times or are you catching each other by the end of the coats in the fast paced world that has us spinning us on our heels constantly? As the family members run in and out of the house, like in a hotel, engulfed in their daily routines they slowly start drifting away from each other. Somewhere pushed to the depths of the heart are old connections and affections with the family. Ideal conversations during childhood, encouragements received during tough times, sibling squabbles in adolescence and many a wonderful memories tug at the heart keeping the family from disintegrating altogether. On the contrary, improper communication and bottled feelings singe the heart in such circumstances and lead to the tumbling of the family ecosystem. Understanding how to build effective communication within the family is important as it helps build a stronger, inseparable family. Here are some effective practices: Communicate Frequently:With the limited time that you have with your family, make communication a common and frequent activity.  While traveling in the car, during meal times, replace TV time with talking, talk to your young ones at bedtime. Keep designated time for informal family meetings and encourage conversations among the family members. Keep the cell phones and laptops in the other room when the whole family is sitting together. Communicate Clearly and Directly:Develop an environment where the family members feel okay to communicate clearly and directly. Allow them to express their thoughts and feelings without having to mask and filter them. This is important in a parent-child relationship and sibling-sibling relationship. It also helps build confidence, family intimacy and bonding among the family members. On the other hand, veiled, indirect or vague communication is ineffective and harmful as it increases confusion and communication gaps. Active Listening:Open and free communication flows only when it is received well and the other person's perspective is acknowledged and respected. Active listening is the cornerstone of effective communication. Whether listening to your partner or child, it is necessary to pay attention to not just the words but tell-tale signs in the tone of communication and non-verbal messages too. Nodding of the head, or words of acknowledgment like, "I understand" make the other person feel that what they are saying is valued and received. Asking questions and requesting clarifications for the parts of the message you do not understand is a very important part of active listening. Trust and Honesty:Only when the family members feel that they can trust each other, can they communicate honestly. Trust is the key for strong familial relationships. Trust is propagated through openness and honesty. Understanding the Individual:The way each individual of the family feels and communicates is different. The way you communicate with the different family members should vary accordingly. Especially in case of young children, as their maturity levels are different than the young adults and adults in the family. The unspoken messages:Not everything might be said in words. Learning to read non-verbal communication such as expressions and body language are very important in understanding the entire message being conveyed to you or the parts being held back. Stay Positive:Many complications and problems between family members can be avoided or solved by effective communication. When dealing with undesired or negative situations, it is important that the words and tonality of the communication is positive. Avoid engaging in negative communication like criticism, defensiveness or contempt. Such negative communication patterns discourage communication.Communication is essential to successful family functioning. Taking inventory of how well the family is doing and readjusting course and practices will help improve the family environment and build a happy family that shares openly and honestly with each other.
Fair skin - A modern obsession!History of Complexion - Complexion generally refers to the natural color, appearance, and texture of the skin, particularly on the face. Originated from the late Latin term 'complexio', complexion is traditionally referred to the temperament which was determined on the basis of the proportion of qualities of hot, wet, dry, and cold in the human body. It was believed that the body carried these qualities depending on the climate in which the individual lived. Thus, a person living in a cold climate was seen to have 'colder and moister' complexion and so on. The biological facet of complexion mentioned below tells us how the skin adapts its color according to the climate it finds itself in. Moreover, it was also seen to represent the character of the person into different categories like melancholic, choleric, sanguine, and phlegmatic. Complexion was the center which reflected the qualities which make a balanced person. Skin color is determined by the presence of pigment melanin. Located in the outer skin layer called epidermis, it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. The Biology of Complexion - The complexion of the body ranges from very dark brown of Africa and Aboriginal Australia to pink with yellowish hue of the Northern Europeans. In actuality, there is no skin which is black, yellow, red or white in absolute - it is generally a hue of many colors with one dominating over the other. Our biological actuality is not reflected by the words we use for our complexion these days. Skin color is determined by the presence of pigment melanin. This pigment is under the control of 6 genes. Both complexions of dark and light have melanin. Spatially located in the outer skin layer (called epidermis), it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. Those in tropical latitudes, where there is highest exposure to sun, have darker skin which contains melanin acting as a protective biological envelope against UV radiation. This protective layer prevents sunburns and other damages including those that could increase the risk of melanoma. The UV radiation reaching the earth increases during summers and reduces in winters. The skin adapts to this change by tanning - tanning indicates that your skin is increasing the size and amount of melanin grains to protect against the UV. Thus, your skin color is essentially determined by genetics and the geography of the place you live in. Biological Fact to Social Conclusion - We generally mold the biological fact of adaptability of our skin into a social meter of beauty. The complexion is a biological wonder of the nature which allows the skin to absorb enough vitamin D, prevent many illnesses like anemia, osteoporosis, and rickets determined by its environment. Thus, to claim that a certain skin color is superior to others is to only deny the reality of biology related to our skin and body, thus falling into the fallacy of unjustifiably jumping from a biological fact to a social conclusion. The health of your skin must be the starting point to declaring its beauty, not a presupposed social standard unrepresentative of the reality of the body. Taking Care of Your Skin - Every skin color is determined by its biological framework placed within the environmental setup. It is essential to take care of your skin to ensure that it is healthy and well taken care of : Make sure you eat a well-balanced and nutritious diet. Stay away from junk and heavily processed food items. Sleep for at least 7-8 hours daily to ensure that your skin gets enough time to recharge its mechanism. Drink loads of water to keep your skin hydrated. Go through the daily care routine: cleanse, tone, moisturize, and exfoliate. Use rose water to remove your make-up and ensure that you do not go to bed with make-up on. Keep dirt and germs away from your skin. The best way is to avoid touching your face with hands when you are out. A clean environment is the fertile ground for a healthy skin. Make sure you wash your pillows, their covers and clean the house regularly to keep away pollutants. Stress is one of the main causes of your skin's health withering. Your skin is the outer reflection of your inner mental state. Work towards mental detoxification to cheer up your skin and body.
Advantage of the average - Automated continuous blood pressure monitoring technologyAlthough mercury sphygmomanometers (though a deadline is set for them to be phased out due to environmental concerns) are still considered the gold standards, the Aneroid and Digital counterparts represent the future of blood pressure monitoring. The need of long-term blood pressure monitoring arises with disorders and health conditions that demand more attention from the medical teams. Experts say that the fluctuations in BP in conditions like cardiovascular diseases, pregnancy, etc., if tracked at regular intervals, can reduce 22% of risks due to delay and no treatment. This necessity pushed the invention of invasive arterial blood pressure to be used during surgical procedures and further a continuous noninvasive arterial pressure measurement (CNAP) system. There have been multiple researches to overcome some of the roadblocks in measuring the arterial blood pressure in the noninvasive and external approach. Among these developments, the need for measurement of mean blood pressure was felt and the 24-hour BP variation in the patient was taken into account. The 24-hour model eliminates the errors in readings taken during clinic visits due to factors such as fluctuations as a result of white coat fear or after-effects of some stress or exertion. Trendsetting New-age Technology : In 2004, the medical world received the BpTRU non-invasive automatic blood pressure monitoring device. BpTRU devices proved to be a superior and more precise alternative when compared to other manual BP assessment techniques and even other 24-hour ABPM alternatives. The automated oscillometric devices precision and accuracy of assessed BP and heart rate is earmarked with a unique automatic technique - the device records 6 consecutive BP readings of the patient, discards the earliest, and the rest of the five values are put to average function and instantly the resultant mean BP reading flashes on the screen. Compatible with guidelines of American National Standard/Association for the Advancement of Medical Instrumentation (ANSI/AAMI EC13:2002) this is a time-saving, portable, and user-friendly device. A compact and automatic wrist cuff BP monitor, the smart blood pressure monitor that can be synchronized with with Apple’s iOS devices and a Bluetooth connectable and Android compatible blood pressure monitor marks the revolution of CNAP in modern times.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
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.
Reasons for skipping sexThe most important satisfaction brick in a marriage's foundation, sex is where we show the greatest trust, most openly express intimacy and make ourselves most vulnerable. It is the most personal and private area of our relationship. It is the one area that separates this relationship from all others. Yet, there are times for both husbands and wives when sex becomes a burden and not a blessing, an inconvenience instead of intimacy, and a job instead of jubilee. Curious as to why people might be skipping sex? This is only a partial list and far from exhaustive. Reasons related to your body: I have a migraine. I have a stomachache. My body is too tired. My breasts are too sore. I am too sleepy. I can't keep my eyes open. I just need to take a little nap first. Okay, but I have a rash. Okay, but I have several weird looking cold sores. Reasons related to your emotions: I am depressed. I am worried. I am sad. Cry Reasons related to your kids: The kids are still up. We might wake up the kids. I just had a baby. This baby is wearing me out. Reasons related to your experts: My therapist said I need to give myself some time. My counselor said I should create some boundaries. I have to see my Gynecologist tomorrow. The Doctor gave me these sleeping pills for stress and I just took one. Reasons related to your spouse: Who was that girl / guy you were talking to on the phone? Sex, Sex, Sex All you ever want is sex! Why can't you just hold me? You should have asked in a more romantic way! Why do you have to use such crude language? Reasons related to your weather: It's just too hot. It's just too cold. It's too humid. Reasons related to your economy: When the economy improves. When the interest rates go down. When inflation goes down Reasons related to your special circumstances: We just got back from vacation! When I lose 20 kgs. Reasons related to your friends: I need to make a call first. My friend said they only do it once a month. Reasons related to your pets: The dog can see us. The cat is on the bed. Reasons related to your finances: Okay, but first we need to talk about the bills. Why did you charge this hotel room on our credit card? Reasons related to your job or boss: I have to get up early tomorrow. I was up all night last night. I had a long day at work today. The boss just gave me a new project and I have a lot of work to do Reasons related to your religion: Doesn't the Bible warn against having too much sex. I am sorry, but I just took a vow. I am giving up sex for Lent. Reasons related to your in-laws: We are in your parent's house. I have not been able to concentrate since your mother Your parents will hear us. Offer an alternative: Can I just take care of you in the shower? Okay, but you have to drive the kids to school in the morning. Use evasive tactics: Sneak in and go to sleep early. Okay, but let's watch this movie first. It's just too late. I'll be there in a minute. (Take an hour) Can we just cuddle? I just need you to hold me. Ask a sensitive question: Did you go to the bank and make our deposit today? Have you seen the kid's report cards? Wait for your spouse to tease you and then say coldly, well, you just lost whatever you were going to get tonight.
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