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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.
Career advice for menGetting a job these days is extremely difficult. What is even more difficult is sticking around long enough at the job. No one is indispensable, and if you don't perform well, there are hundreds more waiting to get the job! Being the bread winner, men have to face this pressure more. Here are some tips that would do you good, if followed: Cracking The Interview: The golden rule here is to be honest. The interviewers do not want to hear what will please them; So, do not try to butter them up. They are also put off by boasting . Therefore, be honest about your views and opinions. Age:wise Attitude- When you are young, and have just entered the company, it is highly advisable to observe and learn as much as you can. Find yourself a professional mentor who can guide you. Try and build on your professional presence. Be active, spend more time with your boss, be helpful to your juniors. The golden advice for all, irrespective of seniority, is to stay clear of office gossip and politics. Keep a check on the attitude: There is no need to be arrogant, and a know-it-all. Be friendly, confident, and genuine. Learn to say no: You need to have a pleasing personality. But, avoid trying to please all. Try and learn the art of saying no firmly. Too much of 'yes' will make people take you for granted, and you will find yourself overloaded with a lot of work. Do not under price yourself: If you feel that you deserve a raise, go ahead and ask for it. Do not be afraid to ask for your worth. Often at interviews, employers cancel out candidates who under price themselves, as it shows that they will probably not perform to the expected levels. Blow your trumpet: With all humility make sure you take what is rightfully yours. If you don't take credit for the work, no one will give it to you. Worse, someone else may take it! Create boundaries: Keep your work at office. Do not bring work home. Often at the outset, to please bosses, one ends up working overtime or worse, working at home. It is important to keep both the parts of your lives separate. Keep fit too: Don't let your job take a toll on your health. Working late, sitting at the same place for hours, can be harmful for the heart. Learn to unwind periodically. Setting goals is easy. What is needed is the determination to follow the rules you have set for yourself. The way to success at work is taking the ladder, one step at a time. There is no elevator here.
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.   
Pamper the newborn without forgetting yourselfIf you are a new mom, chances are you are busy 24/7. The baby's complete dependence on you helps you bond with him/her and makes you aware of the responsibility that is now on you. But, your own health is an equally important responsibility. So, you need to give yourself permission to take care, or even pamper yourself from time to time. Here are simple ways for you to look out for yourself. Eat your favorite breakfast: As your day starts, you need fuel to keep your energy levels high. So, grab your hands on healthy and tasty breakfast options like whole grain cereal, skim milk and sliced strawberries or a banana. The combination of lean protein, whole-grain foods, and nutrient-rich fruit allows the brain to form more feel-good chemicals. Don't let stress come near you: We know that a lot of changes in your life have transpired, due to the entry of a baby in your world. The difficulty to cope with the changes may cause stress and depression. Try to avoid stress by asking for your husband's and relatives' support. Take a walk with your baby: Walking with your baby in nearby parks will give you fresh air and it is an excellent form of exercise. Don't be sleep deprived: Having a baby doesn't mean that you have to always sacrifice your sleep. Never miss an opportunity to sleep or take rest. This will keep your energy levels high for the day. Sleep when your baby sleeps. Delegate baby care: Parenting is not your sole responsibility. Ask your husband to lend a hand in taking care of the baby for some time. Not just the husband, if you live in a joint family, you can ask other relatives for help as well. Don't be a multi-tasking person: We know a woman has so many roles to play. But, it doesn't always have to be that way. Being a new mom, you must focus on one activity at a time. You can prioritize your tasks, if you have a lot of things to do. Exercise regularly: Add exercise to your daily routine. Choose the exercise which you love and enjoy, like walking, cycling, yoga, swimming or aerobic dance. Consult a doctor before starting any exercise program.    
Pediatric diet formula food vs traditional foodAccording to the World Health Organisation, it is unnecessary to give your baby rice cereals at the age of four months as breast milk can provide all the nourishment a baby needs in the first year. No other solid food is required. Breast milk has all the nutrients like fats, protein, cholesterol, carbohydrates, vitamins and minerals which are required in the first year of life. According to most studies,formula foods are not the healthiest option to begin solid foods on. Doctors prefer that babies be given boiled vegetables and mashed fruits like bananas and not formula cereals that contain simple carbohydrates. It is not a good idea to give babies processed and refined foods that are found in all formula foods. Formula foods do have nutrients, but they are not as easy to absorb as nutrients from foods prepared at home. You can also ensure quality in food that is prepared at home. Formula foods cannot imitate the natural taste of foods. Babies like to choose foods according to taste just like the adults and you can give them a wide variety of choices like offering them different fruits and vegetables rather than the similar tasting formula. You will be surprised to know that mother's milk has the taste of the foods she eats and so babies develop taste for a variety and may like the insipid taste of formula. Another reason why formula foods may not work that well is that they contain cereals. However, the enzymes that are required to digest carbohydrates are not fully developed in babies until they are more almost three years old. Cereals and breads are very difficult for babies to digest. Undigested grains can throw off the balance of bacteria in the gut and this is the reason for a lot of digestive issues once they are grown up. Solids should not be introduced until six months of age, as studies now reveal that if solid foods are given early on then it increases the likelihood of allergies, especially of those foods introduced. Babies produce only few enzymes and digestive juices that are mainly required to digest protein and fats. This is because mother's milk has 50 to 60% healthy fat which is a must for the babies' mental and physical growth. Most baby infant nutritionists feel that formula feed is not a complete food. Babies will get deficiency,such as iron, as it is difficult to absorb them from formula foods. The debate continues as many feel that the marketing gimmicks are what selling these foods and not the nutritional value they provide to babies. A note of caution, excessive amount of juices are harmful for babies as these can lead to obesity.
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.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
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!
5 Muscle building smoothiesProtein is highly important for muscle building as it repairs the muscles and help in their rapid recovery after a workout. That is why most of the trainers recommend taking protein smoothies after workouts. Generally, banana and peanut butter alternatively, are used to add the protein content to the smoothies. Apart from these, Chocolate is a hot favourite as well. But if these do get boring, here are some smoothie ideas, only for you. Hot Cocoa (bed-time and post workout) Ingredients: 1-cup milk (fat-free), 1 scoop whey protein chocolate, 1 packet Swiss Miss Diet hot Cocoa and ½-cup cottage cheese (low fat). Recipe Heat the milk and just when it gets to the boiling point, blend it in the blender with the protein, cottage cheese and cocoa until smooth. Ensure that the mixture has mixed well. This protein smoothie can be taken just before bedtime as well, because the cottage cheese contains slow digesting proteins that are great for overnight muscle repairing. Each glass of the Hot Cocoa smoothie contains: Calories-275 Protein-44 gms Carbs-20 gms Fat-1 gm Fiber-0gm Root Beer Float (post-workout) Ingredients: 1 scoop vanilla flavored whey protein, ½ cup vanilla yoghurt (fat free(, 1 scoop vanilla casein protein and 1 ½ cup root beer Recipe In a bowl mix all the protein powders into the yogurt slowly and stir well to avoid clumps. Now, pour the root beer in a large beer glass and add this mixture of yoghurt carefully, without stirring. Since the root beer starts carbonation process, the shake becomes quite frothy without having to use a blender for mixing. Each large glass of the Root Beer Float smoothie contains: Calories-443 Protein-48gms Carbs-61 gms Fat-1 gm Fiber-1 gm Post workout or pre-workout smoothies provide the necessary protein to the body that contributes in rapid muscle recovery and growth. Peach Cobbler (pre-workout) Ingredients: 1-cup water, ½ can of sliced peaches with juice, 1 scoop vanilla whey and 1 packet Quakers Instant Oatmeal (lower sugar maple and brown sugar) Recipe Mix all the ingredients in a blender and serve. Use an immersion blender for this one, to get a finely mixed smoothie. Each glass of the Peach Cobbler smoothie contains: Calories-305 Protein-24 gms Carbs-49 gms Fat- 2 gms Fiber-3 gms Orange Creamsicle (pre-workout) Ingredients: 1-cup orange juice, ½ cup fat-free yoghurt (vanilla flavor) and 1 scoop vanilla whey protein Recipe Mix all the ingredients in the blender and enjoy your smoothie. Ensure that you use real orange juice and not the flavored orange drinks for this one to get the desired result. One glass of the Orange Creamsicle smoothie contains: Calories-280 Protein-27gms Carbs-43 gms Fat-1 gm Fiber-2 gms Chocolate Almond Brownie (pre workout or early morning) Ingredients: 1 cup milk (fat-free), ¼ cup almonds (chopped), ½ Clif brownie bar (chocolate flavor-chopped finely) and 1 scoop of chocolate flavored whey protein Recipe Mix the milk and the flavored protein in the blender and serve with almonds and Clif bar topping. Use a spoon as you will be eating as well as drinking the shake, because the almonds and the bar chips can settle to the bottom. One glass of this Chocolate Almond Brownie smoothie contains: Calories -457 Protein-39 gms Carbs-41 gms Fat-17 gms Fiber-8 gms
MigraineA Severely painful persistent headache can put anyone in distress. Migraine symptoms vary from person to person. Some people get intimation before the pain begins. It can be sparkling flashes of light, blind spots, or distortions. Some others experience tingling or "pins-and-needles" sensation in hands or face. This is called an aura. The headache begins within 30 minutes of seeing an aura and may last for 4 to 72 hours. Extreme sensitivity to light, noise, smells, nausea and vomiting, loss of appetite and fatigue, numbness, tingling, or weakness are all-common in migraine. There is no permanent solution to migraines. People suffer for years together and keep on taking painkillers for a long time. Pain killer helps only if taken right at the beginning of the headache. Keep a watch on things that trigger the migraine and try to avoid them. Make some lifestyle changes that can help prevent migraines to some extent. Taking good sleep. Lack of sleep can cause migraine. Appropriate hours of sleep as a routine will help to prevent the attacks. Regular meals at fixed time help to prevent migraines in people who get headaches due to hunger or not eating on time. Regular exercises help to rejuvenate the body and prevent migraines along with many other diseases. Stress is another important cause for migraines. Avoid stress. Learning to manage it will keep migraine at bay. Caffeine triggers migraine in many. Avoid caffeine. Reduce it if quitting is not possible. Limiting alcohol will again be very beneficial as alcohol and hangovers can be the cause. Meditation and relaxation therapies may also help prevent migraine headaches.  
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.
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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