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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
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.
Importance of breastfeedingBreastfeeding is a natural act and that is why it is also one of the most beneficial acts for a baby. Breastfeeding provides essential nourishment and is the best food for the baby's stomach to digest. No matter how many infant formulas enriched with vitamins and minerals you provide to your baby, it can never replicate mother's milk. As for the mother, there is nothing more joyous than providing your baby with the best start that it can get in the long journey of life. The bond that the mother and the baby share through breastfeeding is one of the most special bonds. For the first six months, breastfeeding your baby is recommended for all mothers whether they are working or at home. Most working mothers are given leave, whether paid or unpaid, so they must ensure they provide their babies with regular breast milk. Breast milk protects the child against diarrhea, respiratory infections, pneumonia, ear infections, and helps to reduce chronic constipation and colic that the babies are prone to. Research also points to the fact that breastfed babies are immunized and protected against allergies, asthma, sudden death, diabetes, and obesity. They remain much healthier than those babies who are formula fed. In India, only 41% mothers begin early breastfeeding even though it has so many benefits. Mothers who exclusively breastfeed their babies help them to survive better. They also gift them with better brain development and these babies are likely to perform well intellectually. No matter which economic section of society the mother comes from, she can provide her baby with the best start in life by breastfeeding it and make sure that the child develops to its full potential. Breastfeeding is natural, simple, and cost-effective way to ensure your baby is healthy and continues to develop healthily. Since the breastfeeding campaign began on a large scale, child mortality has decreased. Immediate breastfeeding within one hour of birth has helped to significantly reduce sudden baby deaths. The colostrum, the first thick yellow breast milk is what protects babies from many diseases as it is filled with goodness. Lack of nutrition or malnutrition is another aspect that leads to infant deaths. Breastfeeding can significantly lower infant deaths from malnutrition as the mother's milk is one of the most nutritious foods provided by nature for the baby's healthy growth. A mother has the full ability to provide adequate nutrition for the baby, therefore breastfeeding needs to be encouraged fully. Employers need to create an appropriate space within their premises and should encourage new mothers to breastfeed their child. Breastfeeding also has a number of benefits for the mother. It helps to burn calories and the mother can return to her former pre-pregnancy state. Breastfeeding helps mothers to reduce their risk of breast, uterine, and ovarian cancer;high blood pressure;diabetes; and heart diseases. So for the first six months, mothers must make sure to breastfeed their baby and do not substitute it with baby food products.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
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.
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
Communicate to strengthen the family tiesA family that talks to each other stays together. Sounds easy? But how often does your family sit down together in the week to spend time with each other? How about breakfasts and dinners? Are you all able to match your meal times or are you catching each other by the end of the coats in the fast paced world that has us spinning us on our heels constantly? As the family members run in and out of the house, like in a hotel, engulfed in their daily routines they slowly start drifting away from each other. Somewhere pushed to the depths of the heart are old connections and affections with the family. Ideal conversations during childhood, encouragements received during tough times, sibling squabbles in adolescence and many a wonderful memories tug at the heart keeping the family from disintegrating altogether. On the contrary, improper communication and bottled feelings singe the heart in such circumstances and lead to the tumbling of the family ecosystem. Understanding how to build effective communication within the family is important as it helps build a stronger, inseparable family. Here are some effective practices: Communicate Frequently:With the limited time that you have with your family, make communication a common and frequent activity.  While traveling in the car, during meal times, replace TV time with talking, talk to your young ones at bedtime. Keep designated time for informal family meetings and encourage conversations among the family members. Keep the cell phones and laptops in the other room when the whole family is sitting together. Communicate Clearly and Directly:Develop an environment where the family members feel okay to communicate clearly and directly. Allow them to express their thoughts and feelings without having to mask and filter them. This is important in a parent-child relationship and sibling-sibling relationship. It also helps build confidence, family intimacy and bonding among the family members. On the other hand, veiled, indirect or vague communication is ineffective and harmful as it increases confusion and communication gaps. Active Listening:Open and free communication flows only when it is received well and the other person's perspective is acknowledged and respected. Active listening is the cornerstone of effective communication. Whether listening to your partner or child, it is necessary to pay attention to not just the words but tell-tale signs in the tone of communication and non-verbal messages too. Nodding of the head, or words of acknowledgment like, "I understand" make the other person feel that what they are saying is valued and received. Asking questions and requesting clarifications for the parts of the message you do not understand is a very important part of active listening. Trust and Honesty:Only when the family members feel that they can trust each other, can they communicate honestly. Trust is the key for strong familial relationships. Trust is propagated through openness and honesty. Understanding the Individual:The way each individual of the family feels and communicates is different. The way you communicate with the different family members should vary accordingly. Especially in case of young children, as their maturity levels are different than the young adults and adults in the family. The unspoken messages:Not everything might be said in words. Learning to read non-verbal communication such as expressions and body language are very important in understanding the entire message being conveyed to you or the parts being held back. Stay Positive:Many complications and problems between family members can be avoided or solved by effective communication. When dealing with undesired or negative situations, it is important that the words and tonality of the communication is positive. Avoid engaging in negative communication like criticism, defensiveness or contempt. Such negative communication patterns discourage communication.Communication is essential to successful family functioning. Taking inventory of how well the family is doing and readjusting course and practices will help improve the family environment and build a happy family that shares openly and honestly with each other.
Good and bad calories-How do they affect weight loss?Not all calories are bad calories. Surprisingly very few people are aware that good calories are quintessential for burning fat and can rather help you in losing weight. So, it's very important to know how to differentiate between good calories and the bad ones. What is a Calorie? In scientific terms, one calorie equals to one unit of energy. When the term calorie is being used in relation to nutrition, it means consumption of energy through what you drink and eat and use of energy for carrying physical activity. Many people think that in nutritional terminology, calories are only associated with drink and food; but the truth of the matter is that everything has energy is calories. For example, since coal provides you energy it contains calories. 7,004,684,512 calories are equal to energy produced by 1-ton of coal. Coming back to weight loss, 100 calories of fiber and protein is not similar to 100 calories of a cake. This is because there are good and bad calories and much like us humans all calories are not equal. Calories are the measuring units of energy that are produced by the food once it reaches your body. This energy works on the law of physics and hence less energy intake leads to weight loss and vice versa. Varying types of Calories Different types of food provide varying calories or energy amount to the body. The analysis of a tightly scrutinized weight loss experiment has revealed that when people of two different groups were fed the same measure of calories albeit from varying food sources, the weight loss was almost similar. However, the effects of weight loss were variable; like uncontrolled emotions, cravings, hunger and more. This happened for the same reason that some calories are good and some calories are bad. Good and bad calories Sugar is a powerhouse of energy. But if you keep on eating only sugar all day long it will be suicidal. This is because; the calories present in the sugar are devoid of any nutrients and your body cannot function without the right balance of different minerals, nutrients and vitamins. Most food not only carry calories but they also constitute a complex mixture of additives, fiber and nutrients. These mixtures of varying components directly affect the leptin hormone that controls the hunger trigger in your body. These hormones tell the body to either burn the fat or store it. The process of weight loss is made complicated by the fact that biologically our body is programmed to protect the fat stores so that they can be utilized during starvation. So, the question remain, which calories should you eat to lose weight but still keep on getting the required amount of energy? Eating lean protein, healthy fats and unrefined and unprocessed carbohydrates such as fruits, beans and vegetables are the best for losing weight. Calories with more nutrients are the best The foods that do not store fat and make us eat again and again, are the ones you should eat as good calorie food. Choosing them is simple. These are the same food that humans used to eat before processed food was invented. For example; avoid using the processed whole grains and switch over to brown rice instead of the polished white rice. Also, stone-ground whole wheat, oats or quinoa bread is much better than the white bread. Replace the processed carbohydrates from your platter with whole grains and vegetables to lose weight, control hypertension and blood sugar. Use fats derived from plant sources such as olive oil or nut oil. Eat lean protein more such as chicken and fish.
Aids defining cancersIn fact the presence of such aids defining cancers is an indication of advanced AIDS having developed in these patients. However, the reasons for these cancers are unclear. It is possible that since people with AIDS have low immunity, they become more susceptible to these cancers. The double attack of these already complex diseases complicates treatment plans too. Thus, it needs care under experienced doctors who specialize in these diseases. The cancers that define AIDS are: Kaposi's Sarcoma:This is a type of skin cancer. It was usually found usually in people who have received organ transplants. Nowadays it is also most prevalent in homosexual men with HIV/AIDS and is also called epidemic Kaposi's Sarcoma.  It causes lesions to show up in multiple points in the body such as skin, lymph nodes, liver, lungs, spleen and digestive tract. Non-Hodgkin Lymphoma:This is the second most commonly associated cancer with HIV/AIDS. The various sub types of NHL are primary central nervous system lymphoma and primary effusion lymphoma. Approximately 4-10% people with HIV/AIDS develop NHL. Other kinds of cancers are anal cancer, liver cancer, mouth cancer, Hodgkin's lymphoma, testicular cancer, melanoma, throat cancer, colorectal cancer and multiple skin cancers.  Treating Cancer in HIV people: Till anti-HIV medication were not discovered the future for infected people was bleak. They were already sick and their bodies weak even before their cancer treatment were started. Presently the cancer treatment is mixed with anti-HIV drugs. However, depending upon the extent of cancer and the need of AIDS care, variations are made between chemotherapy and other HIV related drugs needed. Treating Kaposi's Sarcoma: Often anti-HIV drugs are enough to treat this cancer. The lesions, which are viral, shrink, as the immune system gets better. Sometimes chemotherapy and radiation may also be needed if the lesions are internal. Treating Non-Hodgkin Lymphoma: AIDS related NHL is fast growing and needs intense chemotherapy treatment. Introduction of highly active anti-retroviral therapy and use of drugs that help the infected body make new blood cells has relieved a major concern for HIV patients where previously due to their low blood cell count, chemotherapy could not be administered to them. But with these advances, acutely monitored chemotherapy treatments can be administered now. Treating Cervical Cancer: In case of women who have a good immune system and invasive cervical cancer can still be treated similarly as non-HIV women. They can even do well in surgeries and other conventional treatments. Discovering Cancer Early: Screening helps discover presence of cancer when no symptoms are evident. However AIDS defining cancers cannot be detected through screening. Thus, close monitoring, regular checkups and a keen lookout for symptoms of these cancers can help discover the ailment if present. Pap tests help discover cervical cancer in women. However, in case of HIV women, these should be undertaken more often. Even as often as 2 tests a year, 6 months apart in the first year of HIV detection. If the tests are clear, they should get Pap tests done regularly once a year henceforth. For other AIDS related cancers, the screening tests are still being devised. Lowering Cancer Risk: HIV ruins the body's immune system making it susceptible to a variety of diseases. Good health practices are a must for those detected with HIV in order to ward off cancer. They should surely not smoke or consume alcohol. Injection drugs and unsafe sexual practices also pose increased threat of cancer. Maintaining balanced diets, physical activity and proper body weight are extremely important and helpful too.
Reasons for skipping sexThe most important satisfaction brick in a marriage's foundation, sex is where we show the greatest trust, most openly express intimacy and make ourselves most vulnerable. It is the most personal and private area of our relationship. It is the one area that separates this relationship from all others. Yet, there are times for both husbands and wives when sex becomes a burden and not a blessing, an inconvenience instead of intimacy, and a job instead of jubilee. Curious as to why people might be skipping sex? This is only a partial list and far from exhaustive. Reasons related to your body: I have a migraine. I have a stomachache. My body is too tired. My breasts are too sore. I am too sleepy. I can't keep my eyes open. I just need to take a little nap first. Okay, but I have a rash. Okay, but I have several weird looking cold sores. Reasons related to your emotions: I am depressed. I am worried. I am sad. Cry Reasons related to your kids: The kids are still up. We might wake up the kids. I just had a baby. This baby is wearing me out. Reasons related to your experts: My therapist said I need to give myself some time. My counselor said I should create some boundaries. I have to see my Gynecologist tomorrow. The Doctor gave me these sleeping pills for stress and I just took one. Reasons related to your spouse: Who was that girl / guy you were talking to on the phone? Sex, Sex, Sex All you ever want is sex! Why can't you just hold me? You should have asked in a more romantic way! Why do you have to use such crude language? Reasons related to your weather: It's just too hot. It's just too cold. It's too humid. Reasons related to your economy: When the economy improves. When the interest rates go down. When inflation goes down Reasons related to your special circumstances: We just got back from vacation! When I lose 20 kgs. Reasons related to your friends: I need to make a call first. My friend said they only do it once a month. Reasons related to your pets: The dog can see us. The cat is on the bed. Reasons related to your finances: Okay, but first we need to talk about the bills. Why did you charge this hotel room on our credit card? Reasons related to your job or boss: I have to get up early tomorrow. I was up all night last night. I had a long day at work today. The boss just gave me a new project and I have a lot of work to do Reasons related to your religion: Doesn't the Bible warn against having too much sex. I am sorry, but I just took a vow. I am giving up sex for Lent. Reasons related to your in-laws: We are in your parent's house. I have not been able to concentrate since your mother Your parents will hear us. Offer an alternative: Can I just take care of you in the shower? Okay, but you have to drive the kids to school in the morning. Use evasive tactics: Sneak in and go to sleep early. Okay, but let's watch this movie first. It's just too late. I'll be there in a minute. (Take an hour) Can we just cuddle? I just need you to hold me. Ask a sensitive question: Did you go to the bank and make our deposit today? Have you seen the kid's report cards? Wait for your spouse to tease you and then say coldly, well, you just lost whatever you were going to get tonight.
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
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