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Handling post retirement bluesYou have given the best years of your life to your career, and now it's time to say goodbye and get ready for the retired life. It is a phase laden with expectations of all things you were too busy to do while working - spending more time with family, going on that fishing expedition, or going on leisure trips around the world. However, despite the wonderful things to come, retirement can get unusually trying and mentally taxing. After all, how many of us really have the flexibility of mind to take this period as a challenge and be the master of our destinies? Just because you are retired doesn't mean you have to wither away and wait for death to claim you. So, here's what you can do to beat the retirement blues Catching up: This is really a bewildering time, as you have a lot of catching up to do, with a lot of things. Prioritize the things you want to do and proceed confidently. You may want to spend time with children, spouse, friends, etc. Go easy on yourself, as you may not be able to fit in as many things in your schedule all at the same time. Boost your self-esteem: Retirement is particularly trying for those who have occupied important positions in office. Such people are known to throw tantrums, as they feel less wanted than before. So don't ever make the mistake of treating your family like you treated subordinates at work. That was a role that you played then, and without reducing your importance or self-esteem you can now play a different role with your family as a friend, philosopher and guide. In fact, you can use your contacts and keep the old network alive by involving youth in your field of expertise and help them benefit from you. Catch up on exercise: The more physically fit you are the less likely that retirement will be a painful process. Perfect time for you to catch up on the fun times with your spouse to remind you of all the great times you have had all these years. If your spouse is not in the best of health then just being together is such a wonderful experience in the golden years. Financial health: Your peace of mind and self-esteem largely depend on how independent you are financially. You can take up a part time job or think of innovative ways to let your hobbies and interests generate money for you. This should be an enjoyable process by which your self-esteem can really benefit. Support groups: There are informal or formal associations of retired people that do various activities like travelling. Make yourself available to them. Sometimes retired people withdraw into a shell and that only makes things worse. These support groups give a fresh perspective on all things in life.
Too much of these can be detrimental to healthModeration is the mantra for everything in life. There are a lot of things in our daily life that we do. Excess of these can be detrimental for your health. Let's see how: Television, Laptop, Mobile: That screen is torture for your eyes. Looking at the TV/ laptop/ mobile screen for too long can cause dryness of the eyes. It also makes the mind dull and inactive. Even though you have not done anything much, you feel tired. It is also unhealthy for your social and personal life. Gadgets are meant to add convenience to your life, and not alienate you from real people. These also lead to sedentary lifestyle which further triggers obesity, hypertension, diabetes and other chronic ailments. Travelling: Many of us travel for work, for education. Frequent meetings are a part of work life. Some like to holiday a lot. But too much traveling upsets routine for the body. It changes schedules too often, adds new stressors to an ordinary day. Food options also get limited and sleeping patterns are influenced. If your job demands excessive travel, make sure you consciously put an effort to choose a healthy lifestyle when away from home. Worrying: Worry is unavoidable. Think of a day you did not worry about anything, isn't it difficult? Normal stress is a part of life, but if you are worrying too much, you are weakening your immune system in more ways than one. It makes you weak, susceptible to infections, prone to lifestyle diseases, and also affects your social life and relationships. Vitamin supplements: Supplements are not your daily diet. Have them in moderation and with due consultation from a doctor. Some vitamins get stored in the body when taken in excess quantities. This can result in condition called as hypervitaminosis and various health problems. Exercise: Body is not a mechanical machine that can keep functioning at the click of a switch. Even a machine needs oiling and repairs. If you love to exercise, that's great. But don't do it all day. Too much physical exercise is strain on the body. It can lead to muscle exhaustion, weakness, breakdown and may even damage the kidneys. Sleeping: Sleeping is the rest the body needs but too much of rest means rusting. Oversleeping makes you dull and may even trigger your migraines. It annoys the body clock and may create metabolic disturbances Social Networking: This is not good for your mental health. Those two hundred friends who like and comment are not your world; the one whom you call when you want to cry is your friend. Posting images and sharing updates on social media is fine, but it is more important to talk to those who live with you, who are physically around. Many peer pressures and image issues also arise from excessive social networking and people may tend to live in a 'make believe' world.
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.   
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.
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.
Expression forbidden! - Human emotionsSome people have a perpetual 'bee in their bonnets'! They maintain a demeanor and a mask which is virtually impenetrable. They are generally highly competent and efficient and occupy high positions of authority. They believe in living life set to a routine, and the worst part is that they expect others to adhere to it as well! God help those who have a boss like that, as their immediate liberty is at stake, and unless they are honing to be perfectionists, life is going to be a series of disasters with Captain Ice around! Nothing wrong with perfectionism per se, but when someone is a hard task master then he could well earn himself the epithet of being "a crashing bore," especially if he doesn't allow others to express themselves properly. Take a more intimate scenario - Mr. Bright Harry meets tepid Sally. The sparks fly only on Harry's side with Sally stonewalling his every effort to get to know her mind, body, and soul. A tough ask for poor Harry, as he is yet to touch first base with Sally. Know what? They have been married 5 years and she seems to be fond of him, yet has never as much admitted it to him. Quite frankly, the two could pass off for siblings rather than 'man and wife.' Why are some people such rotten spoilsports, especially where emotions are concerned?  It may well be a natural mindset for some to have an emotional guard up and emote, or have an emotional connect only with certain types of people. Fair enough and good show, we say! After all one can't be wearing one's emotions on a sleeve or you end up been taken advantage of. That's a mask that most 'tough guys with soft centre' wear anyway. Nowadays with the rules being somewhat relaxed with men been given liberty and allowances to display their gentler feminine emotional side, we find men going over the top with the sheer display of emotional expression. One is at sea wondering which one was worse off-the tough, cynical cop look or the "let me weep my heart out for you" kind of contrived emotion. That apart, it is bad enough for us having to contend with a person who has difficulty with expressing himself properly. We don't mean articulation or even well-developed linguistic ability - we mean being able to be spontaneous and congenial and a little forthcoming and nice to be with sort of an emotional person. So, unless someone has a romantic angle towards this guy (there are weirdoes all over the world, who go asking for it!) or girl, he is going to be feared, hated, despised, unloved, and uninvited by everybody. So why do people behave like they are going to be flogged for even attempting a ghost of a smile or a cheerful greeting to a fellow co-worker? Why do some people find it difficult even to open up on a psychiatrist's couch? The Mask The most common reason for Mr. or Ms. Grumpy is that they have probably been emotionally brutalized in their formative years by an authoritative parent and this has caused them to lock themselves up double quick in a shell and throw away the key. Now, that can be tough and extremely painful. It is a prison of their own making through which nobody can see that once bright-n-chirpy personality frozen, much like the curse of the wicked witch in those fairy tales we read. The person is dying to let his emotions out and let people see who he is, but since very little light escapes out due to the tough mask and veneer, that it is an uphill task. Then the sheer anger at not being understood, subconsciously plays havoc and then he gets to be the more demanding boss at work or that sullen wife or lone stranger staring in to nothingness on the park bench. These are the people that have a series of relationship disasters as their defence mechanisms are too solid to be penetrated. Some people may be naturally distant, and for them the finer and higher emotions probably don't register as much as they do in the average person. These guys are cut out for careers ranging from lighthouse keepers to morgue attendants to hangmen, where being emotional has no place. There are still others who swing the other extreme by showing so much of emotion that it is scary for others to take them on. Their emotional side is so overwhelming and demanding that it is actually a clever subterfuge on their part to drive people away as they subconsciously do not want people to get to know their real side. They generally don a mask of humor and good cheer and are great fun to be with. In reality, they are alone and scared and perhaps hurt emotionally. So, they feel safe to display emotions to masses rather than individuals. These people make good evangelists and rock stars as they can safely display and get an emotional discharge without running the risk of a one-on-one emotional exchange where they are afraid they would be hurt. If you encounter such a person who looks askance at you displaying your emotions, then it is better for you to talk things out and maybe put things in perspective. Of course, this all depends on whether you are emotional enough to maybe give someone a chance by understanding what drives them to do the things they do. Let me assure you the ice will thaw if the intention is genuine and well meant.
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.
4 super foods to keep you healthy this winterWinter is here. It is time for lazy mornings and blanket hideouts. It is also the time when the markets are lined up with a variety of fresh fruits and vegetables, all juicy, healthy and colorful. Discover four such super foods for the cold winter evenings. Citrus fruits: Oranges, sweet lime, lemons; bring them all and have them all. Bright yellow or orange, they are like the bright sunny mornings which you need after a cold night. Rich in vitamin C, antioxidants, flavonoids and several other nutrients, citrus fruits are the perfect measure for your daily dose. Peel it off and chew it up, or slice it off and lick it on, or squeeze it strong and drink it down - choose the way you like. Citrus fruits help in taking care of your cholesterol, as well. Potatoes: Potatoes are the victims of most diet plans. It is loaded with carbohydrates, we should not eat potato, and so on and so forth. Potato is not that bad actually. In fact, its nutritional value may come as a surprise to many. The content of vitamins B6, C and folate is high in potatoes. Potatoes are rich in essential minerals like potassium, zinc and magnesium. The starch content may be significant, but so is the fiber content. They are known to protect against colon cancer. What are you waiting for? Have some potatoes, will you? Make sure there is no guilt. Kidney Beans: Kidney bean is our favorite Indian 'Rajma'. They are a rich source of carbohydrates and proteins, are known to lower the cholesterol levels and reduce the risk of heart disease. They are particularly known for helping to replenish the iron stores of your body. It can be the food of choice even if you have diabetes, as it is almost fat-free and doesn't send a sudden rush of glucose in the blood. When combined with rice, kidney beans make a very healthy meal. So, is it rajma-chawal (kidney beans with rice) for dinner today? Green leaves: Yes, yes, you are bored of reading and listening to the benefits of green leafy vegetables. But, we have to remind you, for the advantages are too many to be ignored. They are the greenest, freshest and leafiest in the winters. Even if you are not a fan, you will feel like picking up a bunch from the grocery store. Spinach (palak), fenugreek (methi), cabbage (gobhi) are the ones that we can commonly find. Others to look for are lettuce, mustard greens, etc. The green leaves are a rich source of a variety of vitamins, mineral, fiber and water content. They are suitable for all ages and can be easily digested. Entertain that potato lying in your kitchen, cook up a dish with the green leafy ones. Alternatively, you could try it in the form of salads, soups, juices, flour fillings, and any other creative ideas that you chefs have.  
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
10 simple ways to get rid of hiccupsHiccups are simply a sudden involuntary contraction of the diaphragm. Diaphragm is the muscle on which the lungs rest and it is above the stomach. The contractions happen several times within a minute and goes on for several minutes. Every contraction is followed by the sound 'hic'. And hence the name - hiccups. Sometimes hiccups can occur in the most awkward situations - just before an important interview, just as you lie down on the bed to sleep, or even during a meeting. Hiccups in difficult situation can be a big problem. Some simple tricks could help you get rid of them. It helps to know different techniques you can use to stop hiccups, for only one may not always work. Hold your breath: Inhale deep and long, and then hold on to the breath. This may help the diaphragm to relax and hiccups will stop. Drink warm water: Take about ten or more big gulps of water, with quick swallowing. This will help the irritation of diaphragm to go away. Close your ears: Use a thick small roll of cotton or use your fingers to plug your ears and close it. Do this for about 30 seconds. Alternatively, you can also firmly press upon the soft tissue of the ears from behind, next to the ear lobes. This helps to relax a nerve which then relaxes the diaphragm. Take your tongue out: Pull out your tongue, as out as you can and keep it that way for a few seconds. This helps in better breathing, relaxing any spasms that may be causing the hiccups. Breathe with mouth covered: Press both your palms over your mouth to close it and continue breathing only through the nose. This intends to create a discomfort that will cause some distraction for the nerves and the hiccups will stop. Breathe in a paper bag: Breathe deeply into a paper bag. Do not cover your whole face with the paper bag, just the nose and mouth. Hug yourself: Pull your knees up, close to the chest and wrap your arms around. Hug yourself tight for a couple of minutes. The pressure also helps to relax the diaphragm. Have some sugar: Have a spoonful of plain grainy sugar and keep it in the mouth. Swallow slowly. Lemon at your service: Pick a piece of lemon, put it in your mouth, and let it be there. Do not chew; just suck it slowly for a few minutes. This will also help the hiccups go away. Just wait:  Nine out of ten times, the hiccups will go away on their own, after giving you a little trouble, of course. If you are not too uncomfortable with hiccups, be patient and give them a few minutes. Most likely, they will pass off as spontaneously as they had come. "I think hiccup cures were really invented for the amusement of the patient's friends." - Bill Watterson
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.
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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