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Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
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.    
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
Perfect partners in crime - Midlife crisis and dementiaThe responses we have to common stressful events in our daily lives have a lasting impact on our brain structure. The effects of a stressful event last a very long time, though apparently we seem to have recovered from it. Researchers say that the stress hormones keep circulating in our body long after the stress has passed. According to a recent Swedish research study, our response to common life events may trigger long-lasting physiological changes in the brain. These interestingly shocking findings come from the Prospective Population Study of Women in Gothenburg, a long term study on 800 women that lasted for almost forty years. The women who were a part of this study were all born before 1930, and underwent regular neuropsychiatric tests. The study started in 1968 assessed women for any baseline stressors like workplace problems, widowhood, alcoholism and illness in the family. Women who had serious issues at the start of the study had a 21% higher risk of developing Alzheimer's Disease and 15% higher risk of developing dementia later on in life. Interestingly, having to take care of a mentally ill family member like a sibling or mother, was found to be a major cause for development of dementia later on in life. The findings of this study show that accumulated stress from common life events has severe physiological and psychological consequences. These physiological consequences include adverse effects on the central nervous, cardiovascular and endocrine and immune systems. There have been several studies that state that the effects of stressful events like earthquakes, cyclones and floods can have a lasting impact on life and often shape the person's personality. What makes this study interesting is its finding that daily stressors accumulated over a period of time and often left unresolved, have a lasting impact that shows up in later stages of life!
Teenage troubles for autistic kidsTeenage brings along with it a lot of physical and psychological problems. Your body undergoes a lot of changes, the way the world looks at you is changing and you are not in the position to accept all this. Teenage is one of the most painful periods in one's life.  For an autistic child teenage can be compared to living a nightmare day in and day out. Here is a look at the problems of teenage from an autistic kid's point of view: Social Interaction The ability to interact socially is absent in autistic kids. They are loners who prefer to be left alone and undisturbed in their own worlds. Such a child is a natural target for bullying and ragging by other kids of his age group. At times even if the autistic child wants to come out and make friends, he is not able to do so due to lack of the required skills. Teenage is a period where you need at least one friend to confide in. It can be an extremely difficult phase when you are all alone. Puberty This is the dramatic time in life dilled with hormones and emotions. Your body undergoes lots of changes and you are confused about so many things. You don't know whom to ask or whom to turn to for guidance. Autistic children do not have the maturity to understand this phase. Special issues for autistic teens and sexuality include: Knowledge of physical changes in body. Knowledge of 'good' and 'bad' touch. Ability to communicate about a 'bad' touch or action. Keeping 'safe' distance from others. Handling menstrual cycles. Avoiding 'self-touch' in public. It can be a phase of emotional turmoil for the parents. They need to work closely with their child's special teachers to chalk out a plan that will be best suited to the child in handling puberty successfully. Self-help skills Simple self-help skills like hygiene can be a challenge for teenagers with autism. Improper motor skills, compliance, and sensory problems may interfere with a teen's progress. The proper training of hygiene and grooming can help to add these elements into the daily routine. The right approach is to simplify each task into simple small steps. The positive reward system is a great source of encouragement, as positive motivation always help the teenagers. Higher Functions Autistic teenagers are socially awkward. They lack the power to comprehend and process complex social cues which includes sarcasm, body language, humor, emotional responses and facial expressions. What complicates the problem is that the autistic child lacks empathy and hence may appear rude. Such kids are likely to be teased a lot in school settings.
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.
Top 10 tips for weight maintenanceTIP 1: Stay Calm and PlanDon't worry about your weight excessively. This will only result in stress which can be counter-productive to your pursuit. Remember that you have reached the goal you had to and you are strong enough to sustain it. Take one day at a time. Do not think about how you are going to keep it forever. Just focus on the next day. TIP 2: Health JournalKeep a journal where you note down your eating and exercising patterns. Write down what you eat, plan your meals, drink adequate water, and form an exercise regime. Did you know that you can include an activity within your life as a habit by performing it for 21 days? Do these things not because you have to but because they are good for your health. Slowly, they will become a part of who you are. TIP 3: Being Healthy Is A Lifetime DealOne of the greatest mistakes that people do is to think that once they have lost weight, they can return to their early eating habits. Remember that your health is with you for life. Shift your perspective from 'I have to become thin' to 'I have to be healthy.' Once you do this, you will find it easier to stay healthy for the well-being of your body. TIP 4: Be RealisticWhen you are planning your lifestyle, don't take up unrealistic goals. This is one of the reasons why weight-trainers say that the best way to reduce and sustain right weight is to make it 'your life.' Eat right, sleep well, and drink lots of water. These three, if done properly, can help you to have the right body weight. If you have any rules like 'don't eat cake or pastries ever,' 'quit drinking,' then rethink about them. Are you going to be able to never eat sweets? The primary goal is to make a balance, choose the middle path. TIP 5: Get An Idea Of Your Weight-PatternMany people stop weighing their body once they have reached the ideal weight. They think that the scales are only for the fat ones. A person with such a perspective is only looking for slim bodies and not healthy ones. Remember that your weight is not a judgment of your appearance, but a barometer of your health. So do not stop doing the weekly weight checks. Keep a report of your weight every week and check out the causes for any abnormal changes. TIP 6: Accept Your Limitations And Learn From ThemEveryone has their ups and downs. Don't get discouraged and be angry at yourself if you binged on a donut on a cloudy day. Everyone makes mistakes. It is not the end of your weight maintenance. It is simply a blip. Learn from it. Know what the causes are for it and work on making sure you react to the cause differently next time. TIP 7: Thirst And HungerYour body could confuse your thirst for hunger. So, if you are feeling hungry really soon after your previous meal, then start by drinking a glass of water and check if you feel better. If you do not, then it is time for a light healthy snack. TIP 8: Inspire YourselfWeight maintenance is primarily a psychological task. Till the time you were reaching the ideal weight, you learn everything you had to about being healthy. Now, you have to make sure you don't let obstructions stop you from sustaining this healthy lifestyle. So, join other people who are only in the process of maintaining their weight. Become part of the running blub or catch up with a health conscious friend regularly. TIP 9: Mind Over MatterBalance your eating patterns. If you think that you will be going out for lunch, then have a healthy breakfast and cut down on the dinner. You might be craving for a dessert, so you can have salad for the main course and treat your sweet tooth. Talk to yourself about what you are going to eat. Ask yourself if you really want to eat it because you are hungry or are there any other reasons for it. How would you feel about it after you are done eating? TIP 10: Celebrate Your AchievementsLastly, be proud of your weight maintenance program. Celebrate the fact that you worked hard towards making sure you have a healthy body and invite people who were part of your pursuit. Embrace your body and toast to the next year of a healthy lifestyle.
10 bedtime beauty essentials! Here are the beauty essentials you need to take into consideration, before you hit the bed: Baby-soft soles :Before you sleep, apply Vaseline on the sole of your feet. This will adequately moisturize your soles and you can wake up to the great opportunity of wearing those heels you have been dying to try out! Healing the puffy eyes : If you are worried about waking up with puffy and tired eyes (even after 6 to 8 hours of sleep), then put on a little eye cream. You can also keep an extra pillow and make sure you sleep on your back. This will allow the fluids around your eyes to drain easily and reduce the puffiness. Trying out wavy hairstyle : Bedtime is the best time to work on your hairstyle. Before you sleep, shower and fashion your hair into the style you want. Apply a styling cream on your hair gradually, after having air-dried it. Now, decide if you would like to put them up in buns or braids. Stylize them into the pattern and wake up to wavy hair! Let your skin breathe : Those who are suffering from dry skin can apply moisturizer. A humidifier is also a great accessory for help in these cases. You can switch on the humidifier before you go to sleep. This will help your skin to retain its moisture through appropriate hydration. Keep aging at bay :Did you know that sleeping on cotton pillowcases can increase the chances of creases and wrinkles on your skin? Prevent wrinkles by using silk or satin bed clothing. This will also reduce hair breaking. Wake up, miss white smiles: If you want to take off the yellows from your teeth, then brush some baking soda and let them stay for about 8 minutes. Afterwards, thoroughly rinse your mouth. Do not perform this beauty tip more than once a week, it will negatively affect the structure of your enamel. Work on your complexion :During the day, sunlight might disable some face creams from working effectively on your complexion. Make the most use of night and apply a face cream containing retinal and vitamin C. Lengthen your lashes : Eye lashes depth and grace to your eyes. You might feel that working on your lashes will require way too much effort. But, much to your surprise, everything your lashes need is contained in a natural ingredient - castor oil. Consisting of Omega-3 fatty acids, which are highly hydrating, they will avoid your lashes from breaking and also strengthen them. Apply castor oil on your lashes before you sleep and watch them grow thick and healthy within a few weeks! Taking care of your hair : Skim leave-in conditioner through your hair in the evening and let them stay on till the morning. This will let them become soft and shiny. You can also use coconut oil as an alternate conditioner. Readying your nails for polish : Depending on the skin type, the nails of certain people become dry. If you are one of them, it would be best to apply a cuticle cream or oil on them before you sleep to wake up to polish-ready nails.
Flash the pearliesRemember the lines from the song, Words? Smile an everlasting smile, a smile can bring you near to me.  Well, ideally, you wouldn't want your teeth to be yellow when you flash that smile. So for those who have shades of yellow on their teeth, here's how you can go back to white. It's first important to understand what causes yellowing of the teeth. Eating habits: Carbonated drinks dissolve teeth enamel. Tea, coffee and other caffeinated drink stain the teeth yellow.In addition, alcohol and cigarette smoking too can stain teeth. Tobacco chewing especially produces stains that are difficult to remove.Food rich in artificial sweeteners are harmful for teeth. They not only make the teeth yellow but also produce cavities. Chocolates, pastries, ice-creams and all such sugar-rich foods are sticky. They stick to teeth and have corroding effect on tooth enamel and dentin and cause yellow teeth, decay and toothache. Oral hygiene: Poor hygiene of oral cavity leads to stains and caries. Take good care of your teeth. Brush teeth twice. Floss them and use a mouthwash. Ageing: Gradual loss of enamel and wear and tear lead to yellow teeth. Medicines: Medicines like iron tablets, tetracycline too can lead to yellow teeth. Injury: Trauma to teeth can sometimes lead to yellowing. This is common amongst kids. Preventing yellowing of teeth Maintain a good dental hygiene. Brush twice for atleast 3-4 minutes. But be gentle while brushing teeth. Gargle every time after you eat.This removes the leftover food particles and keeps the teeth clean. Avoid use of local powders or corrosive substances. They damage enamel. Fruits like apple, cucumber, and carrot act like cleansing agents and keep teeth clean. Fruits like sweet lime are rich in vitamin C and help to keep gums and teeth healthy.
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!
How to talk about STDsThese are dangerous times that we live in. Just the sheer number of people affected by sex related problems, diseases and conditions all over the world is simply terrifying. AIDS, venereal infections like syphilis and gonorrhea, herpes, HPV etc. are rampant and it calls for some responsible sexual behavior. However, that's a utopian world where humans will be monogamous and will behave responsibly. Even single people might get exposed to these diseases through indulging in risky sexual contact. Imagine doling out $750,000, as a woman in the US got from her husband because he gave her herpes. Even if you are not held legally accountable, what about moral responsibility to own up and discuss a possible STD infection with your partner! Take the case of Jack a happily married man for ten years who had casual sex when out of town on an official trip. He showed no obvious symptoms of any infection but in a month, his wife showed signs of herpes and his marriage crumbled as his wife struggled to come to terms with her husband's obvious infidelity and his callous manner in exposing her to a serious sexual infection. Call it ignorance but sometimes a person might engage in sexual intercourse and contract a disease which he might even not be aware of until the symptoms start appearing. (Refer article on Syphilis on www.topdoctorsonline.com) By then, he might have, in all probability, passed it on to his regular sexual partner or spouse. Or perhaps, there is another possibility that the person knows that he has contracted a sexual infection but doesn't know how to break the news to his partner.  If a person is aware of his infection, yet exposes another person knowingly, it is akin to premeditated murder. Yes, it is going to be a difficult thing to tell your partner which might even signal the end of the relationship or cause severe strain on it. So, if you are caught in a situation like this, what would you do? The option would be to visit a sex therapist and confide in him and then take an appointment for both and let the professional break it to the partner. That is of course if you are in a stable relationship. For those who both party to casual sex, the infected person generally won't be that open about his infection and may even choose not to care particularly if the other person is a complete stranger. A report in MedlinePlus news reveals some more shocking statistics: Many people said they occasionally, rarely or never got tested before having sex with casual partners (50 percent) or long-term partners (39 percent). Of the people who did discuss STD testing, very few discussed concurrent sexual partners or when partners' testing occurred in relation to their last sex act. Only half explained what types of STDs their partner had been tested for. These issues are important components of assessing STD risk, the researchers said. About one-third of participants reported telling a partner they didn't have an STD even though they hadn't been tested since their last sexual partner. One U.S. woman was awarded $750,000 in court from her ex-husband because he gave her herpes, and the legal trend is to make people accountable. (http://www.dummies.com/how-to/content/how-to-talk-to-a-partner-about-stds.html) Remember even wearing a condom is not a 100% guarantee that the infection won't pass on to the other person but that's the least that you can do if you don't have the courage to spill the beans about your condition. If you feel that your partner may be indulging in sexual activity with multiple partners and if you feel he might be infected, then you are well within your rights to decline to have sex with him until he/she gets tested. If you notice sores around the genitals do not indulge in oral or anal sex or any kind of sex and insist on a condom always; it could save your life.
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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