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The moody man - Mood swings in menMen, such jokes on a woman's monthly mood swings are passe. Recent research proves that men are equally prone to have mood swings. Have you experienced a myriad of emotions? Angry, irritated, feeling helpless, self-pity, an irrational urge to throw things and cry and be depressed all at the same time? These are signs of mood swings. And the point of interest here is that you don't have to be a woman to experience mood swings. Men face their share of mood swings too! Men undergo hormonal influence too. And like women this causes them too to be irritable and cranky. The difference here is that the hormonal fluctuations are not as severe in men as in women. So the mood change lasts for a lesser time compared to a woman. Men's moods are also affected by psychological and physiological stressors. So a man who has to work against time to meet a deadline will be very irritable. A man who is deprived of sleep will end up snapping at you for no apparent reason. The myth that men don't cry, is something that men take to heart. Men are emotional beings and it is okay to show some of the emotions. The male stereotypical image is such that if a man is expressive of his emotional side, he isn't considered macho enough. Hence men tend to internalize their emotions and feelings. Often this leads to chronic depression. Taming the mood swings. Any form of physical exercise helps keep the mood in balance. This helps in keeping the aggressiveness under check. Sex is also a great way to release the stress and feel better, rather than snapping and using profanities. Another helpful way is to ask yourself 'why'. Whenever you feel that you are doing something irrational or out of character, ask yourself why. The answer you get from yourself will help clear the situation and you will end up handling it in a mature fashion. The irritable male syndrome. This is the male equivalent of the female menopause - The Andropause. It covers the symptoms seen in middle-aged men that occur due to the drop in testosterone levels. Like women, men show mood changes, bouts of irritability, grumpiness, hypersensitivity, anxiety and frustration. The recent research on men having mood swings and the society's acceptance of these findings is very encouraging. It helps stress in the fact that men are emotional too. There is nothing anti-macho about a man crying his heart out at times. It only shows he is human, after all.
Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
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!
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.
Boost your mood after a long day at workUp before the sun rise, rush to get ready, say hurried goodbyes to the family and crawl like a tortoise through traffic to get to work. Go through a long day of meetings, calls, deadlines, reviews, and then crawl back again through traffic at a snail's pace. Does this sound like a day out of your life? Then surely, weekends go by faster for you than you can say lickety-split, leaving with no time for yourself, your family or your hobbies. Social life is definitely a far cry from possible. This rigorous schedule eventually catches up with the mind and body and lethargy sets in, discouraging any sort of activity that breaks the monotony of day-to-day life. Is there no escape from this? Yes, there is. At the end of the day, when your mind is tired, you do not feel like taking anything more than you already have on your plate. Only the warmth of your bed allures you. However, if you were feeling fresh and enthusiastic, surely, you'd be ready to do a lot more - move mountains or at least drive to meet friends, anyway. An energetic life full of happy times with families without the constant desire of solitude after a long day's work is what you seek, then try these mood boosters to uplift your mood and get your feet tapping right away! The Aroma of Good Mood:Scents play a great role in the way we feel. They have the power to turn the mood around completely. Light a few scented candles or set up an oil diffuse of your favorite oil and you will feel lighter and De-stressed soon enough. You can also mix a few drops of rosemary and bergamot to create an energizing and refreshing infusion. Walk it Off:Most of us work in functional buildings in temperature-controlled environments. The lack of windows makes natural light and ventilation scarce and aids the buildup of gloom and tiredness. A good way to turn the mood around is to walk it off. A short walk around the block or in the building compound can bring you back in touch with nature. If you are lucky to be living in a green community, you have the added benefit of watching the trees and bird life in them. The exercise also helps release hormones in the body that uplift your mood immediately. A Good Deed Begets Good Mood:Giving is the greatest joy! So perform a good deed - if you see someone who needs help on the way back from work, stop for a few moments and help them. Or simply help your spouse, children, parents or neighbor out. And voila! You will find yourself feeling a lot better than how you did when you entered the house. Clear the Clutter:Organizing things and creating neat, clean spaces is a great mood booster. As you clean the clutter, you will find the clutter of thoughts in your head also clearing. Neat, well-kept spaces invite good vibes and energies, which again makes you feel better in turn. Petting a Furry Friend:Petting a dog for even 15 minutes releases the feel good, happy hormones. It does wonders for the stress level too. So the next time your furry friend comes rushing to the door, to welcome you back home, take time to give it some love. The Human Touch:We spend 10-12 hours a day away from our family and familiar touch. The human touch releases uplifting hormones such as serotonin and reduces heart rate and blood pressure making you relaxed. So when you get home, remember; a nice warm hug to your spouse or children will make you both feel better.Remember you work to live and not the other way. So when you get home from a long, tiring day, just boost your mood so you can thoroughly enjoy life with your family!
Fruit diet can be dangerousFruits are healthy and provide lots of nutrition, vitamins, antioxidants, carbohydrates, fibre and bioflavanoids to the body.These things together protect your body from different health conditions and heart disease. However if you only eat fruit, you miss many other essential nutrients such as fats and protein. This can upset your stomach and lead to indigestion. Hence it is very important to take a well-balanced diet to remain healthy. Check out why you should not rely solely on fruits for living. Fruits do not provide protein Protein is highly important for your growth and development. By eating only fruits, you are restricting your intake of proteins that can stop your overall development process. Your body requires calories and energy on a regular basis. Each cell of your body contains protein. To keep your body cells in top working condition it is important that you include protein-rich foods such as lentils, soy products,  nuts and beans in your regular diet. You can also consume low-fat dairy, lean meat, fish and skinless poultry to provide required amount of protein to your body. Fruits do not provide fat Although excess of fat is not good for health, it is essential that your body requires on daily basis to ensure smooth functioning of your immune system and also to help your body absorb various minerals and vitamins provided by other foods like fruit. If you continue being a fruitarian for long duration, the chances of stroke due to brain haemorrhage increases. According to health experts, you should get around 20 to 35 percent of your daily calories from fat. To provide your body with good fats you should include soybean, sunflower, olive or canola oil in your diet. Fish and poultry also provide good amount of healthy fats to the body. Too much of fruits can lead to digestive problems Fruits provide fibres to the body in large amounts. Although your body needs fibre as it is one of the essential nutrients, getting too much of fibre can lead to side effects. Fibre works as broom to clear of your abdomen and aid in the digestion process. However, too much of fibre leads to stomach problems and cause symptoms such as gas, cramps and bloating. Sometimes it may also lead to chronic diarrhoea, dehydration and loose stools. On a regular basis, a woman requires only 22 to 28 gm of fiber per day and a man needs 34 to 38 gm. Apart from fruits, seeds, vegetables and whole grains also provide fibre to the body. Other considerations If you limit your intake to fruits, you may not get enough calories required for producing the required amount of energy. Consuming calories less than 1100 per day can lead to lot of side-effects such as intolerance to cold, gallstones, hair loss and fatigue. So although fruits taste wonderful and are very tempting, being a fruitarian is not the best thing for your health. Your body needs all the nutrients for carrying out its different activities and hence you should include variety of foods in your diet.  
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
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
Impact of sexual dissatisfaction on mental healthIn an idyllic world, this may sound all "sugar and spice and everything nice," but in reality the matter of having sex is considered to be a taboo, something that is looked down upon - not just in third world countries, but in some parts of the  developed world as well. Add to that the effects of being sexually dissatisfied, which is also looked down upon and frowned upon. When a couple finally decides to take the plunge, there are the normal worries such as sexual compatibility, satisfaction, frequency, taboos, etc. What if your spouse/partner is dissatisfied? What if he/she doesn't consider it a pleasurable experience? These questions often arise in any relationship and it is only natural, but what happens when these worries often turn into realities? The dissatisfaction takes a toll on your mental health. Yes, your mental health suffers thanks to your sexual dissatisfaction. Every partner has some amount of expectations as far as sex is concerned, and when those expectations are not matched, dissatisfaction begins to set in. Generally speaking, when a person is sexually satisfied, he or she is always in a better frame of mind, but when they are not, their behavior around people goes downhill. Not just that, but their frustration and angst builds up, taking a toll on their mental health and their relationships as well. Many a times when the couple is incompatible, they decide to keep quiet rather than talk about it. This takes a toll on their mental health, which then turns into stress and its build up can lead to depression, or worse. Even the memories of past transgressions and the guilt after can lead to sexual dissatisfaction, which can either make or break any relationship. There are multiple reasons as to why a person is dissatisfied sexually, be it due to sexual dysfunctions, lower stamina, sexual orientation, or so forth! Rather than accepting that there is a problem, people usually turn to drugs, alcohol, or even someone else for dependency, which also causes mental as well as hormonal imbalance. Most people when asked about sexual dissatisfaction shy away than deal with it, as they are ashamed of it and are afraid to talk to about it. However, what they don't realize is that not talking about it will only lead to problems such as depression, anxiety, dependency, and bouts of sudden outburst which can lead to a severed relationship, not just with your spouse or partner, but also with your family and friends. Sexual dissatisfaction is often the primary cause of depression, which, if not treated, can lead to a host of other problems. So if you are suffering from sexual dissatisfaction and are under great amount of mental strain, it is always better to be open about it to your partner or consult a therapist. Prevention is always better than a cure! Talking about it to someone can lead to you releasing your mental strain and the end result will be your personal satisfaction.
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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