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Making the 30 the new 20 - Some healthy tips for men over 3030s for most men is the age of making money, a firm career and preparing a good and luxurious retirement plan. But in this race of minting money, getting a house, buying a new car, don't you feel you lose the verve to be young in body, health and spirit? Result, you are in the lap of one or the other lifestyle diseases. Well guys slow down and ponder a bit.Your age can be on your side when you try to maintain it not when you extract all energy and fill it with monotony and laziness. 30s can turn into new 20s for each one of you but that can't happen by sitting in front of the TV set watching your favourite game and gulping down a beer. So you need to put your mind and heart together and try to work out options to keep your mental and physical health optimized. Let's discuss few such ways which can be the key to your health post your 30s. Be a part of the maddening crowd Post 30s men have a habit of engaging themselves totally into their work, that very little time remains to socialize and meet people. Studies prove that people who are part of a big social group have fewer chances of heart diseases as they are supposed to be happier and stress-free compared to their counterparts who spend their time in their office files and TV. Be healthy, wealthy and always wise with exercise Hitting the gym would be a trend amongst teens and those in twenties, but you need it the most at 30 as this is the age staying fit is essential to keep all diseases away. If you are not a gym fan then you can try any of the other methods of exercise: Morning walks Joggings Yoga Aerobics Options can be innumerable but you need to choose what suits you and your lifestyle best. Avoid the idiot box Do you spend your evenings in front of the television set? Well that is definitely one of the unhealthy habits you are nurturing then. Television sets make you dependent, which mean very few body movements. The only exercise you get is when you reach for the popcorn or when you fiddle with the remote for the mute button in-between commercial breaks. Also it takes up your time which is meant to be spent with family and friends. So next time you get home from office, try and grab a game with your kid or a nice chat with your wife or walk down the road to your friend's house and go out for some fresh air instead. Say NO to the puff A very common habit which catches hold among men especially since their teenage is smoking. Men who have been smoking since their teens don't feel a need to change their ways and it just seems to get worse. Now in your middle-age you don't smoke for effect but rather as a refuge from all tensions and tribulations or sheer force of habit. You are aware that smoking and nicotine dependence whether through smoking to chewing tobacco can put you at risk of lung cancer, hypertension, heart valve blockages and much worse? Being a bit more sober than you were in your 20s is essential here. Stop the smoke and try to look into the clear air around you. Less alcohol, more life Alcohol not only hits your liver and takes you away from the real pleasures of your life but also makes you prone to all the diseases which starts showing its symptoms in the middle-age only. Increase in anxiety, blood pressure, high cholesterol or other cardiovascular diseases come into forefront more with age. Does that mean you should stop this within a day or two? No, you need to limit the number to one or two pegs maximum a day and you will be fit for a healthy life. Go fishing Now this does not mean you need to hunt for your own food or dangle the bait or go hungry. Just make fish a part of your daily diet. Fish or sea food after stepping in your 30s makes you able-bodied and increases immunity to fight diseases. The necessary proteins, vitamins, essential oils, zinc, selenium etc. can be had through just one source-fish! Bone mania Calcium deficiency a common disease in women in their 30s causes joints pain primarily, now this should never be neglected by men as well because with changing lifestyle, men also are falling prey to it. Declining calcium concentration in your bones post 30s makes them prone to more fractures and bone damages. The right balance between physiotherapy and food habits makes you more agile and keeps the joints squeaky clean! More sunshine Research prove that spending 15-20 min in the sun everyday helps one to keep away from diseases like osteoporosis, back pains, arthritis etc. Requirement for Vitamin D is fulfilled and all readily bodily deficiencies get mitigated. Thus step out in the sun for some time and experience the results yourself. Avoid the junk Pot bellies are a common sight among men as they hit their 30s. You don't have to live with it! Obesity is the starting point of most diseases. Thus what you require is just focus on a healthy diet plan. The burgers and pizzas which might be irresistible to you in your teens should be only looked at dispassionately without bringing your mouth a mile near them. Extra cheese and butter are now not to be served on your platter. A bit hard-hitting but to stay healthy needs to be done without any second thought. Thus the above mentioned pointers can be followed by guys at any age but should be followed rigorously when you hit 30! So, live your life healthiest and to the fullest!  
What causes male balding?They say there are 3 types of men: the ones that go bald at the top are thinkers, the ones who go bald at the back are lovers, and the ones who grow bald at both places... only think they are lovers. If pregnancy and menstruation are a female's burden, then baldness is a great inconvenience to men. Some men lose their hair in their youth and thus lose their confidence along with their hair. So what is with baldness and men? Men start having a receding hairline by the time they hit 30, though it could begin in their 20s as well. The most common type of baldness is the mid-frontal type resembling a horseshoe. Earlier it was thought that baldness is caused only by genetic factors, but apparently emotions, lifestyle and diseases also contribute largely to hair loss and baldness. This hair loss can be temporary or permanent. Some medications like anticoagulants, antidepressants, antifungal medicines, chemotherapy etc can cause baldness. Certain diseases like thyroid disease, Crohn's disease, lupus can cause hair loss and baldness. Poor nutrition is an important factor in hair loss. Vitamin and mineral deficiencies along with poor nutrition can pave the path sooner than most other things. Then there are some conditions like Alopecia Areata which cause baldness in patches -- on the head or beard. It is temporary and the hair grow back in about 6 months to 1 year. Corticosteroid injections are used to treat the condition. Air and water pollutants, environmental toxins, conventional styling products have the potential to build up on the scalp. These affect hair cuticle, cause dryness, and weaken the hair causing them to easily break off before their natural lifecycle has ended. If you notice your hairline receding more than usual, then check if you are getting enough nutrition. Exercises like the headstand and handstand send the blood rushing to the scalp and can help with hair growth. Massaging the head with warm oil helps to increase blood circulation as well. Use a shampoo that suits your hair along with a conditioner. Oil your hair overnight at least thrice a week. Keep yourself well hydrated and try vitamin C which can help arrest hair fall. Use a clean comb and ensure that you sun your scalp, as vitamin D is an essential tonic for skin, bones, teeth and even hair.    
Pamper the newborn without forgetting yourselfIf you are a new mom, chances are you are busy 24/7. The baby's complete dependence on you helps you bond with him/her and makes you aware of the responsibility that is now on you. But, your own health is an equally important responsibility. So, you need to give yourself permission to take care, or even pamper yourself from time to time. Here are simple ways for you to look out for yourself. Eat your favorite breakfast: As your day starts, you need fuel to keep your energy levels high. So, grab your hands on healthy and tasty breakfast options like whole grain cereal, skim milk and sliced strawberries or a banana. The combination of lean protein, whole-grain foods, and nutrient-rich fruit allows the brain to form more feel-good chemicals. Don't let stress come near you: We know that a lot of changes in your life have transpired, due to the entry of a baby in your world. The difficulty to cope with the changes may cause stress and depression. Try to avoid stress by asking for your husband's and relatives' support. Take a walk with your baby: Walking with your baby in nearby parks will give you fresh air and it is an excellent form of exercise. Don't be sleep deprived: Having a baby doesn't mean that you have to always sacrifice your sleep. Never miss an opportunity to sleep or take rest. This will keep your energy levels high for the day. Sleep when your baby sleeps. Delegate baby care: Parenting is not your sole responsibility. Ask your husband to lend a hand in taking care of the baby for some time. Not just the husband, if you live in a joint family, you can ask other relatives for help as well. Don't be a multi-tasking person: We know a woman has so many roles to play. But, it doesn't always have to be that way. Being a new mom, you must focus on one activity at a time. You can prioritize your tasks, if you have a lot of things to do. Exercise regularly: Add exercise to your daily routine. Choose the exercise which you love and enjoy, like walking, cycling, yoga, swimming or aerobic dance. Consult a doctor before starting any exercise program.    
Ageing gracefully and happilyEverywhere we look there are constant reminders that we are growing old each passing day. There are creams that tell us that will make our wrinkles vanish and make us look younger. There are hair care products dyes that claim to cover our grey hair so that we can look and feel young. Our doctors tell us about how we have to take care of all our body parts to keep several diseases at bay in the old age! It is a rare and difficult attainment to grow old happily and gracefully. Is there anything good about old age? It doesn't seem so, going by the look of things. Here we give you 5 reasons that will make you look forward to old age! Old age is the happiest time in life: You are constantly living life to the fullest when you are young. Survival is your prime priority. You work hard to keep yourself and your family happy and financially stable. Too many responsibilities bog you down. Old age is the time when there is nothing of this sort. You are retired, free from all responsibilities. You have passed the baton to the younger lot. Now is the time to sit back and enjoy. Now is the time to relax and do the thing you always wanted to do. Imagine living with not a care in the world? That is old age for you. Old age is when the brain functions the best: It is a proven fact now. It was believed that we lose more brain cells as we age. Now it has been proven that our cognitive functions peak between the ages of 48 to 60. Old people make the wisest and toughest decisions quickly. People may call them worldly wise. Have you ever given a thought to how all the judges are old men? And how when someone says the word 'wise' the picture formed is usually of an old man with a beard? No more fashion policing: When you are young, there is a lot of stereotyping involved! Going to a board meeting, wear formals? Going for a lunch meeting, wear something that is suitable keeping in mind the place. Are you at a certain position in life? Dress accordingly! So many restrictions! Old age comes with none of this. You can wear what you please and no one will really mind! Only when you actually get to do it will you realize how much f a relief it is! Relationships improve: According to a 2011 study; married oldies are more satisfied and positive about their marriages than young couples are. Arguments involve less anger, and senior spouses show more positive emotions and affection than middle-aged couples. It's not only marriages, however, that benefit in older age. Seniors also seem to be happier with their other social relationships too. They have a smaller but closer circle of friends and gain more benefits from these close, emotional bonds. Old Age makes you feel better on the whole: You have lived life to its fullest, your kids have now flown the coop and you have seen it all. As you age, you start feeling better about things in general. You look at things more positively and make the fullest of every situation presented to you. You live in the moment and are not worried about future repercussions. Old age is a happy place to be. Look forward to aging positively.
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.
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.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
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.
Good and bad calories-How do they affect weight loss?Not all calories are bad calories. Surprisingly very few people are aware that good calories are quintessential for burning fat and can rather help you in losing weight. So, it's very important to know how to differentiate between good calories and the bad ones. What is a Calorie? In scientific terms, one calorie equals to one unit of energy. When the term calorie is being used in relation to nutrition, it means consumption of energy through what you drink and eat and use of energy for carrying physical activity. Many people think that in nutritional terminology, calories are only associated with drink and food; but the truth of the matter is that everything has energy is calories. For example, since coal provides you energy it contains calories. 7,004,684,512 calories are equal to energy produced by 1-ton of coal. Coming back to weight loss, 100 calories of fiber and protein is not similar to 100 calories of a cake. This is because there are good and bad calories and much like us humans all calories are not equal. Calories are the measuring units of energy that are produced by the food once it reaches your body. This energy works on the law of physics and hence less energy intake leads to weight loss and vice versa. Varying types of Calories Different types of food provide varying calories or energy amount to the body. The analysis of a tightly scrutinized weight loss experiment has revealed that when people of two different groups were fed the same measure of calories albeit from varying food sources, the weight loss was almost similar. However, the effects of weight loss were variable; like uncontrolled emotions, cravings, hunger and more. This happened for the same reason that some calories are good and some calories are bad. Good and bad calories Sugar is a powerhouse of energy. But if you keep on eating only sugar all day long it will be suicidal. This is because; the calories present in the sugar are devoid of any nutrients and your body cannot function without the right balance of different minerals, nutrients and vitamins. Most food not only carry calories but they also constitute a complex mixture of additives, fiber and nutrients. These mixtures of varying components directly affect the leptin hormone that controls the hunger trigger in your body. These hormones tell the body to either burn the fat or store it. The process of weight loss is made complicated by the fact that biologically our body is programmed to protect the fat stores so that they can be utilized during starvation. So, the question remain, which calories should you eat to lose weight but still keep on getting the required amount of energy? Eating lean protein, healthy fats and unrefined and unprocessed carbohydrates such as fruits, beans and vegetables are the best for losing weight. Calories with more nutrients are the best The foods that do not store fat and make us eat again and again, are the ones you should eat as good calorie food. Choosing them is simple. These are the same food that humans used to eat before processed food was invented. For example; avoid using the processed whole grains and switch over to brown rice instead of the polished white rice. Also, stone-ground whole wheat, oats or quinoa bread is much better than the white bread. Replace the processed carbohydrates from your platter with whole grains and vegetables to lose weight, control hypertension and blood sugar. Use fats derived from plant sources such as olive oil or nut oil. Eat lean protein more such as chicken and fish.
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.
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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