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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Smell like roses, without the thornsYou bathe regularly and use the best possible deodorants, underarm anti-perspirants, panty perfume but the bad odour just doesn't go away. Pat yourself dry Very often you have a leisurely bath with scented bubbles and what not but when it comes to drying your body thoroughly, well you just pat yourself quickly, for you are in a hurry. The moisture on your body then attracts bacteria with fungi and they cause that embarrassing mouldy kind of stench on your body. So make sure you dab yourself thoroughly dry all over your body. Especially in places like the lower back where it is difficult to reach without some really flexible shoulder joints. Use the archer's swipe (The towel extended between the right hand over the head with  the left hand extended back to form the bottom grip, which looks like an archer reaching for a bow from the quiver). In case you are endowed with love handles and folds of fat then be generous with the patting, as those are the parts most susceptible to host bacteria. Change clothes often If you wear the same set of clothes and lingerie then you are surely going to have an odour which is lingering. So for those ladies who occasionly wear the same set of clothes without washing, the sweat is going to accumulate in there and raise a stink. Remember the Celine Dion song? It's a new day, a new start! Menstruation + Stress = Bad smell There is nothing that you can really do about your periods. Instead, try and be a little more extra careful during those 4 days. You can have an extra jab at the deo bottle or perfume lotion. However stress, nervousness and fear also leave chemical traces which come out along with the sweat. This adds to the bad odour. Humble pie for dessert? What you eat also affects the way you smell. Go easy on the garlic, onion rings and fish for they can make you smell slightly worse than an open sewer. Always rinse your mouth after eating and use a good minty mouthwash if at all you choose to pepper your meal with onion and garlic to ward offthe evil eye. You can add conditions like diabetes to cause a fruity kind of odour. Well in that case make sure you exercise regularly so that the skin sweats out the toxins. In case you are the extra-sweaty types then use medicated soaps or ensure you use steam baths regularly to keep your skin pores open.
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Stress - Even kids cannot escape!Often when we feel overwhelmed with stress, we go back in the past and reflect. We miss our golden days of childhood.We think of those days with fondness, miss the free and carefree times. We feel like becoming kids again. But the truth is that at no age are we free of stress and worries. It is just that with time, we move on to newer situations and every new stressor seems worse than the previous one. Children stress out too, some more than the others. Stressors Simple things like a test in school, a Physical Training class or poem recital could mean a lot of stress for the little ones. The desire to meet the expectations of parents or teachers also creates tremendous pressure on the children. They are eager to do well at all the times and the smallest failures can upset these kids immensely. Peer groups are difficult to manage. In childhood, the social maturity is not sufficiently developed to handle day-to-day conflicts. Trivial fights or comments from classmates and friends can lead to a long-lasting impact on the vulnerable minds. They get easily influenced by their friends. Elder siblings also play a major role. Some act as mentors, some as bullies. Some cause damage unknowingly, some are plain indifferent. Life is full of new things and childhood is a fast-track learning lesson. Every other day, there is something new a child has to do. Meet a new kid, learn a new subject, try to dodge a ball differently or ride a bicycle without side wheels; there is too much to learn. These cause anxiety and may make the child nervous. Performance pressures, technology, precocity, media influences, etc. are some of the other factors that add to the stress in childhood. Signs Watch out for subtle changes in moods and behaviour. With adults, it is easier to identify the stress and hence rectify it. But with children, it is quite a challenge. Most of the children are themselves unaware of the stress they are facing, they don't understand why they are feeling sad or angry or fearful. They are just not at ease. Inordinate crying or screaming is a common sign. Being withdrawn, aloof and quiet is another way by which kids express their tensions. Physical signs can be seen in basic physiological changes - in sleep patterns (oversleeping or inability to sleep), eating habits (not eating or eating too much), frequent aches and pains, especially digestion disturbances and headaches, etc. Managing childhood stress Pay attention to your child. Listen to what he/she is saying, but also try to listen to what he/she is not saying in words, although only in action. Help the kids open up to you, spend quality time with them and talk to them about everything under the sun. Be well connected with their school teachers and parents of their closest friends. If the need be, please don't hesitate to reach out and seek professional help from psychologists and child counsellors. "One of the luckiest things that can happen to you in life is, I think, to have a happy childhood." - Agatha Christie  
Afraid of the dark? understand your fear and cure it!Scotophobia, more commonly known as Nycotophobia, is a psychological illness, where the patient is afraid of the dark. Children are more prone to this fear, though it does affect quite a few adults as well. The dark often represents insecurity and uncertainty to children, and it symbolizes their entrance into an unknown territory. If the children are alone during their first few encounters with darkness, the absence of parents (who exemplify safety), tends to amplify this crippling fear. While most of us do actually possess this fear in relatively small amounts, as we grow up the fear diminishes. However, there are those of us who might carry this fear of the dark into their adulthood and in such cases, the fear is usually accompanied by quite a few intricate issues. People often tend to externalize a set of conflicting feelings about a certain situation, towards something else. For instance, you might be worried about your children; but your mind may externalize this fear, via your inefficiency at work. This process is called externalization. So, when it comes to the root of your fear of darkness, it is possible that at some point in your past, you experienced something untoward, which through externalization, inculcated this fear of darkness, deep into your psyche. Evolutionary Ties to Darkness: Many scientists have pointed out that this phobia might be linked to the process of evolution. Since predators hunt for their prey at night, we might have inherited this fear of darkness from our ancestors, who believed that darkness was a space where they could be attacked by wild animals. However, recent studies have shown that  Scotophobia begins at approximately the age of two in children, and thus, it cannot be said to be innate to us. In a study done by Ryerson University involving over 90 students, it was found that people who are afraid of the dark, are more likely to be poor sleepers, than those who are not afraid of it. More interestingly, it was discovered that any kind of noise made while the people with this phobia were asleep, frightened them the most.. Symptoms of Scotophobia: The first symptoms of this fear are the resistance to visit dark places and the yearning for company when such situations arise. However, many a times adults who are suffering from this fear, do not reveal it due to the added fear of embarrassment and this, sometimes, results in outbursts of rage when they are forced to go out for an event at night, or to confront the dark under any such circumstances. A person battling this fear may experience panic attacks, sweating and trembling prior to, or while staying in the dark. The blood pressure also rises, accompanied by chest pain and lastly, a difficulty in breathing. Diagnosis of Scotophobia: In children, this fear can be easily verified by their behaviour. However, adults might require further assistance, due to their natural resistance to openly admit to such a fear. Scotophobia can be diagnosed through a comprehensive psychiatric evaluation. Following this, your psychologist would be able to give you an idea of the source of your fear as well. Pursue a course of treatment immediately after the discovery of the phobia, which will ensure a faster and more effective recovery. Treatment of Scotophobia: The process of 'desensitization' is most commonly used to help with such a phobia. In this form of treatment, the patient is slowly exposed to the object of fear, in a situation where she/he will not feel vulnerable. This is done by asking the patient to confront the dark along with another individual who symbolizes safety for him/her. This could be a parent or a friend. Night lights can also be installed to gradually reduce the fear. You may try certain breathing exercises, which will reduce the panic attacks that accompany this fear. Hypnosis has also been said to be very effective in dealing with this phobia. If your psychologist sees fit, you might be also prescribed some medicines; antidepressants are given in some cases. Joining a self-help group is also a good option, in addition to your psychological treatment.  
Cleanliness - A clean body, clean mindPhysical Benefits: Killing of Germs: Disinfecting your living area allows negligible scope for breeding and spreading of germs and bacteria. Though not visible to your eyes, many of these can cause severe illnesses. Prevention of Food Contamination: Clean cooking utensils and counter tops allow for low risk for contamination of food. The parts of the utensils which have come in contact with fish, raw meat, or eggs are recommended to be washed with hot water and soap. Make sure you wash your hands to avoid spreading of any bacteria in your house.  Keeps Illnesses and Allergies at Bay: Many allergies could be caused due to dirty mattresses, carpets, sheets, walls, and furniture. In order to keep away mold, dust mites, cobwebs, and mildew, make sure you dust, mop, and vacuum the house on a regular basis. The sheets should be washed at least once a week with hot water and detergent. Floors and walls, wardrobes, and refrigerator should be cleaned using disinfectant sprays up to 2 to 3 times per month. Thoroughly clean your carpet and upholstery at regular intervals. Psychological Benefits: Association of Non-Cleanliness with Moral Lapse: In a review by Current Directions in Psychological Science, it has been found that physical cleanliness does not only physically benefit a being, it also results in weighing the person on a moral radar. When we perceive a physical contamination, we respond in the same way as we would in case of an act of moral disobedience. This response includes repulsion and disgust accompanied by their behavioural components like scowling and frowning. Sense of Accomplishment: Those who clean their house and living space have been found to have a consequent sense of accomplishment that adds to the way one feels about oneself. Clarity and Organization of Thoughts: It has been discovered that those living in a clean and neat environment tend to have a greater capacity to think than those who live in a messy and unclean atmosphere. Proactive Sanitation Teaching for Children: Start with your own home. A child emulates its parents, and if the parents practice cleanliness as part of their lives, children would notice and follow suit. Children tend to connect who they are with their home environment and as they grow up they ensure that such a cleanliness of their world around is maintained.  towards their immediate surroundings, thus ensuring that they do not contribute towards pollution and environmental degradation, at least on an individual level.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
When the grey matters!Greying of hair happens to all of us at some point in life. Some may get it early and other fortunate ones may get it when they are 50. Premature greying and hair fall is a common problem faced by 70% of females in India these days. What are the causes of greying of hair and what can be done if your hair starts to go grey early? What are the probable causes of grey hair and hair fall? Deficiency of nutrients in diet. Excessive stress. Dandruff. Diseases like thyroid disorders, anemia, and vitiligo. Side effects of certain medication. Hair problems are seen more in women who smoke or drink. Childbirth and menopause are the periods of life when most of the women invariably have hair loss. Hereditary pattern of premature greying. Today's beauty procedures like coloring, bleaching, dyeing, perming, and straightening cause hair problems at a young age. Environmental pollution. Treatment and prevention Have a balanced diet. Ensure proper nutrients reach your body in every meal. If you are anemic, treat it with proper medication. This can be an underlying cause. Have a good sleep. Avoid tension and stress. Apply oil regularly and massage. Drink lots of water. Avoid exposure to chemicals. What can be done to hide the grey hair? Apply amla oil to your hair to make it healthy. Apply henna, lemon juice, fenugreek seeds paste, made in an iron container, on your hair to give them a color and reduce greying. Boil gooseberry pieces in coconut oil. When they turn black apply it on the hair. If you have 45-50% grey hair then you can use a permanent hair color.
Treating sore throatTest and diagnosisPatients with sore throat are examined by ENT specialists. At first, the doctor performs a local examination of throat. Clinical examination usually guides the doctor towards diagnosis. Although in order to confirm the diagnosis, the doctor may ask for culture and sensitivity test of the throat swab. Treatment Home remedies: Mild cases of sore throat are usually cured by home remedies. Following remedial measures can be adopted at home: Warm saline gargle – Gargle with warm saline water helps to relieve the discomfort and irritation of the throat. Half to one teaspoonful of salt is added to one full glass of warm water and the patient is advised to gargle. This process may be repeated 3 to 4 times a day to have a soothing effect on throat. Additionally, smoking and use of other tobacco products must be avoided. The patient must drink adequate amount of fluids. Warm liquid and semi-solid food must be consumed to provide a soothing effect on the throat. Cough lozenges to help relieve irritation and pain in the throat. Seeking advice of the doctor: If the signs and symptoms persist and are not adequately controlled by home remedies, the patient must seek advice of a specialist doctor. Viral infections usually do not require treatment. They are usually cured in 5 to 7 days. Bacterial infections require treatment as per the advice of a specialist doctor. Bacterial infections may require treatment by antibiotics. The treating doctor selects an antibiotic which is suitable for the patient depending on factors such as the age of the patient, report of the culture and sensitivity of throat swab, previous drug history of the patient, etc. Antibiotics usually effective in bacterial infection with sore throat are from the group of penicillins, cephalosporins, and macrolides. PreventionViral and bacterial infections are contagious. Good hygienic lifestyle and habits help prevent infections. Following things to be noted are: Frequent and thorough hand washes before consumption of food, after using toilet, and after sneezing and coughing. Use of a hand sanitizer during consumption of food outside home. Avoid sharing food and drinks from same glasses and utensils. Use a tissue paper or handkerchief while sneezing and coughing. Avoid close contact with patients with sore throat. If sore throat develops, few home remedies may prove to be curative. If sore throat persists, advice of a specialist doctor must be sought.
Stay healthy, keep flu at bayKeep the influenza virus away from you by following these simple routines : Wash your hands!Hands are a germ factory. Innumerable things are touched by us through the course of a day and that lends the germs a perfect breeding ground. Hence, it becomes imperative that we clean our hands thoroughly, especially before eating. Always keep a sanitizer handy in case you don have access to water and soap. Even while you wash your hands with soap and water, do not rush with the process. Wash thoroughly at least for 20 seconds. Clean the surfaces!Computer keyboards, tables, pens and pencils, shared stationary are all great places to find the flu virus. Regularly clean these surfaces with an alcohol-based disinfectant that will kill these germs. Exercise!Nothing can be as good as regular physical exercise for maintaining good health. Regular exercising boosts the immunity. This makes you fall ill less often. It also gives you greater resistance against viruses so you will not be affected by them no matter how strong the exposure. Top up on vitamin C!Vitamin C is known to boost your immunity levels. It also increases the resistance against viruses. Eat a lot of citrus fruits like oranges and tomatoes. Amla, that is a rich source of vitamin C, can also be consumed in the form of juice or eaten raw! Chicken soup for the ill-soul!Chicken soup is known to be the most effective against the flu virus. So if you feel you are coming down with a flu fever, rush to the kitchen and fix up some nourishing chicken soup for yourself. Nothing works as effectively as this does. Try poking yourself!The ancient Chinese system of medicine, acupuncture, has been known to treat everything from headaches to nausea to arthritis. Acupuncture experts may prick at particular pressure points with hair like needles to keep flu at bay and to reduce the severity if already infected. Though there is no significant scientific evidence against it, there is absolutely no harm in trying it, if you can tolerate the pain from the needles!. OTC drugs!Over-the-counter medications are available in plenty for flu symptoms. The achy feeling all over the body, the sore throat, and the muscle pain are the worst symptoms of flu. Doctors suggest that you do not over-medicate yourself. Instead of going for multi-drug combinations, doctors advise you go for generic medicines like acetaminophen for fever and a cough suppressant. Garlic pods!These smelly things can be of great use when it comes to prevent a lot of diseases, the flu included. Studies show that people who ate two or three pods of garlic daily had better resistance against the flu virus and fell ill less often. Proactive Probiotics!The strength of your immune system lies in your gut, called gut-associated lymphoid tissue or GALT. Almost 80% of the immunity comes from your gut. To keep the gut healthy, eat a lot of probiotic, pro-GALT foods like yoghurt. Sleep well!Sleep is the most essential component of staying healthy. A well-relaxed body is fitter and stronger and will have better immunity against diseases! Prevention is always the better form of cure. Stay protected and stay healthy.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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