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Weight gain and prostate cancerOne of the hormone therapies involves increasing the production of LH-RH. Luteinizing Hormone-Releasing Hormone (LH-RH) is a hormone which is produced by your body. This lessens the production of testosterone. The drug given induces the generation of this hormone. One of the side effects of this therapy is weight gain. Along with this, breast pain, hot flashes, nausea, and growth of male breast tissue might occur. Apart from hormone therapy side effects, the presence of fatigue can also stop a patient from regularly exercising, thus, resulting in gaining weight. However, it is important that this weight gain is averted as the chance of cancer returning is a possibility. You can keep your weight in check by following these tips: Ask your doctor if your hormone therapy can lead to weight gain. If you receive an affirmative answer, then ask for a diet chart to be followed. You can also keep a food and activity journal to get an idea of how your body is reacting to the treatment. Inculcate physical activity in your schedule. This will not only help to reduce fatigue, but also keep at bay the chances of becoming constipated or feeling nauseous. Medical studies have shown that cancer patients must have at least 2-1/2 hours of moderate physical exercise per week. Have about 2.5 cups of fruits and vegetables every day. Also, shift to whole grain food items. You should also consume at least a cup of legumes, for example, beans, to keep up your protein levels. It is best to opt for lean protein snacks like yogurt and chicken. You must stay adequately hydrated during your treatment. Drink about 10 to 12 glasses of water everyday. Do not consume excessive amount of sweetened beverages like coffee and cola. Have a small portion of nut and nut seeds. If you feel distressed due to the therapy, go for a massage. These have been proved to reduce anxiety and stress caused during the treatment of cancer. Most importantly, keep up with your appointments with the doctor and convey the bodily changes that you may notice. Have an optimistic outlook towards the treatment and do not repress any emotional disturbance. Weight gain in men who had been previously healthy often leads to depression regarding weight issues. Being proactive and focusing on keeping your weight under check is the key here. You could also approach a psychologist if you have been feeling low. The LH-RH therapy is also known as Androgen Deprivation Therapy (ADT). This therapy leads to a weight gain of around 9 pounds within a year of starting treatment. You can make sure that your weight is controlled by altering your lifestyle and getting adequate physical exercise everyday.
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.
Obesity is not just an adult problemWith fast food chains multiplying in the country faster than you can say Maharaja Mac, there is an urgent need to monitor our diet. While most of the nutritional advice is directed at adults, kids too are exposed to the dangers of empty calories. Childhood obesity is on the rise across the world including India. How does obesity affect children? And what can parents do to ensure this doesn't happen? We will try to answer some of your questions. What are the causes of obesity in children? Lack of physical activity: Nowadays, children spend more time sitting at home - doing their homework, watching TV, and playing games on PC, console tablets or smartphones. Play time on the ground outside has shrunk. As a result, they don't get enough exercise. Unhealthy food choices: Our busy lifestyles leave us with little time to plan for or prepare every meal. The alternative is to go for quick-to-cook food like Maggi. Food ordered from outside too is invariably unhealthy. While having it once in  few days is not a problem, making it a way of life leads to problems. Overweight parents: The eating pattern and lifestyle of parents has a big influence on a child's health and weight. Obesity can be hereditary. Lifestyle and environment: When parents are unable to pay much attention on their children due to their busy schedules. As a result children rely more on ready-to-eat food or junk food. Genetic factors:  For some kids, genetic factors may be the reason behind obesity. A rare genetic disorder called as Prader-Willi syndrome causes severe weight gain in kids. What health problems can obesity cause among children? Type-2 diabetes Eating disorders like bulimia or binge eating (excessive eating or drinking) Problems with foot structure Liver problems Respiratory disorders - breathlessness during exercise Difficulty in breathing while sleeping causing snoring or poor sleep What can parents do to prevent or control obesity in children? Parents must make kids understand the ill-effects of eating junk food. They must limit their snacking on junk foods. Encourage the kids to participate in physical activities and outdoor games. Make exercising a routine for the children. Join them during exercising to make it a fun time for the family. Set an example for your kids by following a healthy diet and eating habits yourself. Limit TV time and playing videogames. Parents must include whole grains, fruits and vegetables in the diet of their children. Limit fats intake to not more than 25%-30% of total calories. Make sure to go through the nutritional label while purchasing any processed food.  
Not very chummy! Menophobia - The fear of periodsMenstruation or periods begin as female reaches puberty. This is the time when there are hormonal changes which occur in the body as nature takes the girl and makes her ready for womanhood. The onset of periods can be distressful with lots of mood swings accompanied by abdominal cramps, bloated feet as the menstrual blood flows. This is also a time when the girl needs to be comforted and educated the most, as it can be truly a terrifying experience. Normally mothers or elder women in the family ensure that they take complete care of the girl in this transition phase. For some women, their initial experience with periods may not have been particularly pleasant, causing them to actually dread those 4 days and this fear can then take the shape of a full blown phobia -Menophobia! The reason could vary. For some the pain factor could be the reason for menophobia, while for others, it could be the memory of embarrassing red stains on the clothes which could set it off. In menophobia, just before the onset of the periods, the person starts getting anticipatory anxiety and the pain which could be normal period pain, is then imagined to be ten times worse. This brings on panic attacks and feeling of utter dread which while is entirely psychological can be utterly distressful and downright crippling. Counseling can help greatly along with pain medication to manage the pain and the fear of this natural phenomenon called periods. In therapy, this is what is iterated. That menstruation is a completely natural process and if there is a fear of menstrual blood then gradually, the woman is encouraged to accept it as a natural body function which plays a major part of her being a woman.
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.
How to say 'Bye' to split ends? Check out these 10 tips!One of the main reasons for split ends is the use of curling irons and other heat-induced styling treatments. When you go for hair products like hair colors or perms, the shield over your hair's shaft that protects it can get stripped off, thus making your hair liable to split ends. You could also be mechanically stressing your hair by pulling them too much while combing or combing repeatedly. Remember that rubbing your hair up towards the direction of the scalp does not lead to split ends. While there is no remedy to treat split ends, there are ways in which you can keep them away. Did you know that a medical research showed that the only way to keep split ends away is to put a stop on the excessive use of chemical on it? Hairdresser, Holly Kensen, says that split ends are the results of pushing out the natural process and pulling in too many chemicals. It is best to stay away from the styling products and embrace your natural hair! TIP 1 : Get hold of a piece of rosemary (fresh ones are the best!) and immerse them in a cup of hot water for 30 minutes. Once the temperature of the water is back to normal, whisk an egg into it. Mix this blend onto your hair. Rinse after 15 minutes using a light shampoo. TIP 2 : Bring home a ripe papaya and cut it into halves. Choose the part which you believe will be sufficient for your hair. Take off the skin and seeds. Mash it until it becomes a paste. Then, drop a cup of yogurt and stir them into a smooth paste. Apply it on your hair and let it hold for about 30 minutes. Use cold water to rinse it off. TIP 3 : Condition your hair with castor oil. Mix equal amounts of castor, almond, and olive oil and apply it on your hair generously. Wrap your hair in a towel and let it stay for 30 minutes. Then, shampoo your hair. TIP 4 : After you have shampooed your hair, apply a mix of cream and milk on them for about 20 minutes. Focus especially on the ends. Rinse your hair with cold water. TIP 5 :If you decide to trim your hair on your own, then don't use the paper scissors! They are called 'paper' scissors for a reason. Get hold of hair shears which will not leave your ends damaged. TIP 6 : Trim your hair every six to eight weeks at least up to ¼ to 1 inch. Due to our environment, it is natural for the hair to get damaged in a few weeks. It is important to remove the split ends and let them grow healthy. TIP 7 : Do not trust products which say that they can 'cure' your split ends. Split ends are not curable. They are preventable. The only thing that these products do is to seal up the splits which only makes your hair unhealthy. TIP 8 : Try to stay away from chemicals as much as you can. Chemicals only tamper with your natural hair and ruin their texture. If you really have to use it then make sure you condition them regularly. TIP 9 : Use coconut oil to fix your split ends. Buy an extra-virgin and organic coconut oil. Before washing your hair, apply about 2 spoons of the oil on your dry hair. Emphasize on the hair ends. If you want, you can steam your hair for some time (about 20 minutes). Then, wash your hair with a light shampoo and condition them. TIP 10 :This is one of the best ways to help your split ends stay away: Get hold of chamomile tea and brew it on a pot. Then pre-rinse your hair with it. After you have rinsed them, wash and condition your hair normally.
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.
Adrenaline rush - Feel it inside!Imagine yourself at a great height, either scaling a dangerous cliff-hanger of a rock face or on a bungee jumping platform. Some of us who have had the pleasure of doing high adventure sports like racing or indulging in perilous activities like giving out an acceptance speech for the first time are well aware of that strange feeling in the solar plexus, the clammy hands and intensely thudding heart, and the rush of blood to the head just as you are about to take the plunge! The heart beats faster than ever, breathing goes rampant, the senses seem to become supercharged, and the fear, the joy, and the excitement meddles with the mind. That’s adrenaline rush! So what do you want to do? Fight? Or flight? Either ways, adrenaline does it for you. Speaking medically, the two small adrenal glands on top of the pair of kidneys release a magic chemical that gives the animals way towards the fight-or-flight response to counter certain high-intensity situations, called adrenaline or epinephrine. The chemical entity is a hormone, a neurotransmitter as well as a medicine and is too complex to explain its behavior. However, when it works the heart pumps out the blood to the excited muscles and all the juices surge up inside the body. There is more to this topic than just the physiological mumbo-jumbo. The hormone acts every day in the normal course of life, but not regularly to the extent when it produces side effects such as shakiness, palpitation, high anxiety, and profuse sweating! Thats kept for special situations like physical threat, excitement, bright lights, noise, and really high temperature – in good or bad ways. Let us surf through some of the rewarding and a few of the nasty situations where the jolting juice takes charge of our body! The Good ones: Countering Stress: In extreme stress conditions like accidents or fracture, the body needs to react fast and is at its highest awareness. Adrenaline keeps the muscles up and kicking to help the victim fight with the stress. High Energy Requirement: In majority of sports, more specifically in contact sports like Rugby, Boxing, Mixed Martial Arts, etc., the player needs to be in his full sense and topmost concentration level. The adrenaline rush runs in the background to keep them at their extreme self. The Push Mode: Often the daily chores aren enough to excite us and we tend to search for some adventure. In such pursuit of excitement, there are times when the road is a dead end or there is only one way forward – the impossible or most difficult one! The hormone pumps the brain both ways with fear and with the push to conquer the fear and proceed. Adventure Sports often sounds fun, but at times when running ahead of a raging bull, or hanging off a cliff, or rafting down the rough waters of a cascade – feels like the heart shall come out and scream!! It is the rush of adrenaline that keeps one ahead of the fear and explore the high-energy fun of winning over it. Life Saving Moments: In cases of life-threatening emergencies such as drug overdose, cardiac arrest, or pulmonary failure, where the heart and lungs suddenly cease to function and the body gets into a shock –– the epinephrine shots are considered as a life-saving medication to bring the patients back to life (only to be used judiciously by a qualified medical practitioner). The important medical use of adrenaline is in treatment of acute anaphylaxis and allergies under medical supervision. The Bad Ones: Disorders of the Adrenal: Tumors and cancers of the adrenal gland can cause hyperactivity of this high-performance hormone affecting the normal functioning of the heart and the blood vessels by increasing heart rate and creating anarchy in the body systems. Over-Stressed Adrenaline Rush: The demand-supply mismatch in the present world scenario requires one to perform at his/her epitome of mental and physical strengths. In that constant urge of performance, the brain and the body is stressed out so intensely that the adrenaline surge symptoms are experienced by the individual even in the absence of threatening situations. Sudden sweating of palms, shortness of breath, pounding heartbeats, or chest pains without a justifiable reason can be a result of constant stress.
Hypertension and Vitamin DVitamin D is one of the essential vitamins that are required for strong and healthy bones. The body synthesizes it in the skin from cholesterol when there is adequate exposure to sunlight. Over the past decade, vitamin D has been intriguing medical researchers the world over. Several studies were conducted and interesting results found. One of them being that vitamin D may be implicated in influencing blood pressure levels. As per studies conducted, it was found that low levels of vitamin D lead to high blood pressure levels. People living in high altitudes where sunlight is at a minimum level were found to be hypertensive. Also, the winter season showed an increase in hypertension cases which was again attributed to the low sunlight levels. What exactly does vitamin D do to affect the blood pressure? Renin is an enzyme secreted by the kidneys that constricts the blood vessels and increases the blood pressure. Vitamin D acts by inhibiting this renin. Insulin resistance causes high blood pressure, which is why hypertension often has co-morbidity with diabetes mellitus. Vitamin D helps in improving the body's sensitivity to insulin. Calcium deposits on the arterial walls harden them and make them lose their elasticity leading to an increase in the pressure of blood flowing through them. Vitamin D helps the body to better absorb and metabolize the calcium. The role of vitamin D in strengthening bones is very clear. Though the studies have shown that people having deficiency in vitamin D tend to develop hypertension, the role of vitamin D in this case is still not very clear. Also, whether vitamin D supplements help in lowering blood pressure levels is still to be found out! But all said and done, the research findings cannot be ignored. Moreover, a morning walk is beneficial in many other ways as well! So, get up early, put on your walking shoes and say Hello to the sun! Vitamin D alone will not help you control your BP. You need to keep taking the medications along with the other dietary and life-style changes! An early morning walk is a blessing for the whole day!
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.
The earlier yearsSexual concerns experienced during the drastic body changes and feelings of adolescence are often carried into adulthood. Sexual desires are powerful and frequently go beyond the earlier popular forms of sexual expression - kissing, hugging and petting without being aware of the consequences. Anxiety the commonest case of erectile dysfunction is compounded by the present life style - get-togethers, parties, with alcohol and drugs, visits to sex workers or massage parlours which offer other sexual services leading to unplanned, unprotected sex. Consequently seen are unwanted pregnancy, abortions, drug addiction, sexually transmitted diseases, anxiety and depression leading sometimes to suicide. Males seem to have more concerns then females. A common concern is nocturnal emission (night fall, Swapana Dosh) of semen and length of penis. Nocturnal emission of spermatic fluid is falsely believed to weaken a person. Really all that's happening is that excess of sperms is being thrown out to make place for the new ones. The length of the penis troubles many. Young people fall prey to advertisements that claim to lengthen it. The fact of the matter is that a penis an erection of 2.5 wide (10cms) is enough for a sexual intercourse for a person who knows the art to satisfy a partner. Ignorance about masturbation is widely prevalent among males of all ages leading to guilt, anxiety, depression and at times to suicide. Older men erroneously think their cause of erectile dysfunction or premature ejaculation is masturbation. Masturbation is a highly pleasurable act in males. It does not harm the body or exhaust the sperms. In fact it is a safe way to satisfy. Females also masturbate but the percentage to men is much less. They also seem more comfortable with the activity. Masturbation has gone through years of superstition fear of ill effects, considered as a unhealthy practice and considered sin by some religions. Fifty or more years ago doctors and activities thought it caused harm to the body. It is said that corn flakes, the popular breakfast cereal was specifically formulated by Mr. Keleog to help a person not to masturbate. Today thinking has changed. It is now thought that it is an activity that does not cause any harm to the body. It does not finish all the vital sperms over the years so that it will not hinder having children in future. Its wide misuse is common. Persons use it indiscriminatingly when they cannot sleep, when they are tense for e.g. before an examination, some do it more than four to six times a day, which only indicates their immaturity. When done to satisfy a natural sexual urge it is a healthy activity. It keeps the person safe from infection and is said to teach the person skill for sexual intercourse. Technology has helped in many ways but sometimes it creates problems. A person hooked on to porno sites to arouse his desire is found to cause a loss of self confidence conflict with the partner sexual intimacy and intercourse. Before marriage or a partnership both male and female have concerns. Females if they have a previous partner but are getting married to another worry about the husband finding out of their loss of virginity, others worry about the size of their breasts, excessive hair on body or excessive fear of pain at intercourse. Men worry about whether their penis is long enough whether their long standing masturbation will hinder intercourse or prevent them of being a father. The absent hymen a false notion for virginity can be congenitally absent, split by exercise like swimming, cycling etc. or most commonly by masturbation. The hymen therefore is no proof of virginity. Learning to do with what they have making full use of their points and feeling comfortable and proud of their bodies help a lot to overcome the concern. Adopting a safe sex policy is best achieved by masturbation; avoiding sex with an unknown person and multiple partners; during intercourse with sex workers not using condoms every time and being careful of oral sex. Satisfying each other by caressing, hugging, kissing etc. with clothes on is safe; without clothes extra vaginal sex by mutual masturbation is safe with a trusted partner and finally not so safe is vaginal intercourse unless done with a condom correctly worn.
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