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What causes male balding?They say there are 3 types of men: the ones that go bald at the top are thinkers, the ones who go bald at the back are lovers, and the ones who grow bald at both places... only think they are lovers. If pregnancy and menstruation are a female's burden, then baldness is a great inconvenience to men. Some men lose their hair in their youth and thus lose their confidence along with their hair. So what is with baldness and men? Men start having a receding hairline by the time they hit 30, though it could begin in their 20s as well. The most common type of baldness is the mid-frontal type resembling a horseshoe. Earlier it was thought that baldness is caused only by genetic factors, but apparently emotions, lifestyle and diseases also contribute largely to hair loss and baldness. This hair loss can be temporary or permanent. Some medications like anticoagulants, antidepressants, antifungal medicines, chemotherapy etc can cause baldness. Certain diseases like thyroid disease, Crohn's disease, lupus can cause hair loss and baldness. Poor nutrition is an important factor in hair loss. Vitamin and mineral deficiencies along with poor nutrition can pave the path sooner than most other things. Then there are some conditions like Alopecia Areata which cause baldness in patches -- on the head or beard. It is temporary and the hair grow back in about 6 months to 1 year. Corticosteroid injections are used to treat the condition. Air and water pollutants, environmental toxins, conventional styling products have the potential to build up on the scalp. These affect hair cuticle, cause dryness, and weaken the hair causing them to easily break off before their natural lifecycle has ended. If you notice your hairline receding more than usual, then check if you are getting enough nutrition. Exercises like the headstand and handstand send the blood rushing to the scalp and can help with hair growth. Massaging the head with warm oil helps to increase blood circulation as well. Use a shampoo that suits your hair along with a conditioner. Oil your hair overnight at least thrice a week. Keep yourself well hydrated and try vitamin C which can help arrest hair fall. Use a clean comb and ensure that you sun your scalp, as vitamin D is an essential tonic for skin, bones, teeth and even hair.    
Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
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.
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
Algophobia: The fear of painAlgophobia is the fear of pain:  an abnormal and consistent feeling that is far beyond what would be considered normal. The term is derived from the Greek words, Algos meaning pain and Phobos meaning fear. Our bodies are designed in a way that when there is a painful stimulus it reacts. How the body reacts to the pain is an individualistic phenomenon. Some people have a very low threshold for pain, and even the slightest pain evokes a huge response in them. Where as others can withstand a good amount of physical pain before their bodies give in. Some people dread even the tiniest amount of pain. They foresee situations that will cause pain in them. The way they react to even the smallest amount of pain is far more than the normal level of acceptance. Such people are said to be suffering from Algophobia. Algophobia is a learned behaviour, say behavioral psychologists. For example you may have heard from several people how hitting your shin on the furniture in the dark is the worst possible pain ever. So you tend to keep a watch and if it is dark, you move around extra-carefully to avoid bumping into the furniture and getting hurt. This would be considered normal, cautious behaviour. But if the same thought keeps buzzing in your head continuously and you go to extreme lengths to avoid that pain, you could be algophobic. Old people are the ones who have excessive fear. The age factor along with fear of death plays a vital role in old people developing this fear. For example an old lady may hear about all the ailments and pains that afflict old age people and may become apprehensive about it. She may develop irrational fears that more often than not, are also imaginary. She may start experiencing the pains even before anything actually happens to her. It may seem unrealistic to a normal person, but for algophobics pain can be a severely dreaded thing. Therefore they will go to great lengths to avoid pain at all levels, including day-to-day activities. They will not go into the dark, handle tools, avoid lifting heavy objects or even avoid playing any type of contact sports. If a task has a scope for injury and pain, they will avoid it! Frequently a pathological complaint of Hyperalgesia occurs along with algophobia. Hyperalgesia is a condition of increased sensitivity to pain due to damage to the peripheral nerves and pain receptors. Pain in such cases may be directly in the damaged tissues or in the surrounding areas. An interesting fact is that hyperalgesia can occur due to long term use of painkillers especially strong ones like opium and its derivatives. Algophobia is treated with behavioural therapy, psychotherapy and anti-anxiety medications. Hypnotherapy also has shown beneficial effects.  
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Muscle build up dietYou may think that you need fatty foods to bulk up, but this is not true. Fatty foods will do just that make you fat. Lean meats, fruits and vegetables will actually build muscle. Take a balanced diet of vegetables and lean meats to achieve your muscle building goals. Changing your diet to build muscle will help with your overall health. Eating food that helps build muscle will ensure that you are not wasting all that hard work you are doing in the gym. Workout utilizes considerable energy. Food is the only way to replace this energy. So what happens if you fail to eat the right type of food to build muscle mass? It will take longer to build muscle, and it may even prevent muscle building altogether once you reach a certain point. Is protein important or not? You bet it is. Protein provides the building blocks to build that muscle. What types of protein are best? Chicken, eggs, steak (with the fat cut off), fish, cheese (especially cottage cheese), and nuts are all great sources of protein. Finding out how much protein to eat when you are interested in building muscle fast is actually not difficult. First, you will need to find out your lean body mass weight in kilos, and then you simply multiply that figure by 2.75 to determine your daily protein requirement. Calculating your lean body mass uses some complex formulae, so ask a professional at the gym if you do not already have this figure. Carbohydrates, in moderation, are also essential when finding foods that build muscle. Do not eat too much, though, unless you choose high fibre carbohydrates, and then you can indulge in much larger amounts. High fibre carbs include rice, potatoes, oatmeal and bananas. Reducing fat in your diet is of course necessary to build bigger muscle on a body that appears lean and has a low body fat ratio. If you are focusing on what foods build muscle mass, you also need to bear in mind that it pays to reduce fat as well. Although proteins are essential, it is really important to select proteins that are low in fat, or that you can cut the fat off. So eat your chicken without the skin, and go for lean steaks rather than more fatty cuts of meat. Opting for cottage cheese or other reduced fat cheeses, and low fat milk also helps reduce your fat intake. You may argue that drinking has no effect on what to eat to build muscle. But you would be wrong. Hydration is critical to general health and wellbeing. Two litres of water a day is what most experts recommend for maintaining optimal health. To drink that amount, you need to drink up to 12 glasses of water a day, which is quite a lot. So start early in the day, and space your water consumption out throughout the day. Foods that build muscle are great and an essential component of your bodybuilding program. But do not be lulled into a false sense of security and think you can slow down on your workouts. Both bodybuilding exercises and bodybuilding diets are required to get a body to die for as quickly as you possibly can. Even if you are working on improving your physique slowly, you should combine a bodybuilding diet with bodybuilding workouts for best results. Sample Diet: 7:00am: Breakfast: 4 eggs + toast or oatmeal + milk with protein powder mixed in (a lot). 9:30am: Snack: 1 Meal replacement supplement + milk. 12:00: Lunch: Tuna sandwich (1 whole can) + green apple. 3:00pm: Snack:  2 Meal replacement supplement + milk. 5:30pm: Workout: Have water (or carb drink if you want), within 30 mins of end of workout (on workout days only) Meal replacement supplement + milk. (If you are going to have Creatine - put it in this Meal replacement supplement at the end of your workout). 8:30pm: Dinner: A chicken breast (aprox 8 oz + some rice or other starch carb + if you want also eat some veggies) Before Bed:  Meal replacement supplement + milk.
Hypertension and Vitamin DVitamin D is one of the essential vitamins that are required for strong and healthy bones. The body synthesizes it in the skin from cholesterol when there is adequate exposure to sunlight. Over the past decade, vitamin D has been intriguing medical researchers the world over. Several studies were conducted and interesting results found. One of them being that vitamin D may be implicated in influencing blood pressure levels. As per studies conducted, it was found that low levels of vitamin D lead to high blood pressure levels. People living in high altitudes where sunlight is at a minimum level were found to be hypertensive. Also, the winter season showed an increase in hypertension cases which was again attributed to the low sunlight levels. What exactly does vitamin D do to affect the blood pressure? Renin is an enzyme secreted by the kidneys that constricts the blood vessels and increases the blood pressure. Vitamin D acts by inhibiting this renin. Insulin resistance causes high blood pressure, which is why hypertension often has co-morbidity with diabetes mellitus. Vitamin D helps in improving the body's sensitivity to insulin. Calcium deposits on the arterial walls harden them and make them lose their elasticity leading to an increase in the pressure of blood flowing through them. Vitamin D helps the body to better absorb and metabolize the calcium. The role of vitamin D in strengthening bones is very clear. Though the studies have shown that people having deficiency in vitamin D tend to develop hypertension, the role of vitamin D in this case is still not very clear. Also, whether vitamin D supplements help in lowering blood pressure levels is still to be found out! But all said and done, the research findings cannot be ignored. Moreover, a morning walk is beneficial in many other ways as well! So, get up early, put on your walking shoes and say Hello to the sun! Vitamin D alone will not help you control your BP. You need to keep taking the medications along with the other dietary and life-style changes! An early morning walk is a blessing for the whole day!
Some tips to prevent night blindnessHere are some foods and eating tips, which will help improve vision and prevent night blindness: Eat dark green leafy vegetables like spinach and collards. These contain high amount of lutein and zeaxanthin, the nutrients for healthy eyes. Do not smoke. A glass of red wine daily is fine but drinking is not. Stay away from hydrogenated oils, refined carbohydrates and sugars in excess. Always wear sunglasses while going out in bright light to avoid potential sun damage to eyes.  Amber and grey-coloured lenses are effective against ultraviolet rays. See an eye specialist and get prescription glasses for driving at night, if required. Do not ride in dim light at night and see if you can postpone the work until next day. Even good lighting conditions at night even in a big city, can be troublesome to someone with night blindness. Vitamin A rich foods like spinach, carrot, papaya, broccoli, and mangoes should be added to your daily diet. Fish oil is a great source of vitamin A. Cod-liver oil is used as medicine too. Some wild plants are said to be rich in vitamin Abut they are seasonal, available in small quantities and there isn't much known about them. Beans are another fairly common source of vitamin A. These are consumed especially during autumn. Eggs are a good source of vitamin A. Eat eggs daily. People with high cholesterol should, however, limit their egg intake. Hot pepper is contains vitamin A too, but the preservation method, sun-drying, decreases the vitamin A content. Carrots are another good source. They are high in vitamin A and arenot expensive as well.
Reasons for skipping sexThe most important satisfaction brick in a marriage's foundation, sex is where we show the greatest trust, most openly express intimacy and make ourselves most vulnerable. It is the most personal and private area of our relationship. It is the one area that separates this relationship from all others. Yet, there are times for both husbands and wives when sex becomes a burden and not a blessing, an inconvenience instead of intimacy, and a job instead of jubilee. Curious as to why people might be skipping sex? This is only a partial list and far from exhaustive. Reasons related to your body: I have a migraine. I have a stomachache. My body is too tired. My breasts are too sore. I am too sleepy. I can't keep my eyes open. I just need to take a little nap first. Okay, but I have a rash. Okay, but I have several weird looking cold sores. Reasons related to your emotions: I am depressed. I am worried. I am sad. Cry Reasons related to your kids: The kids are still up. We might wake up the kids. I just had a baby. This baby is wearing me out. Reasons related to your experts: My therapist said I need to give myself some time. My counselor said I should create some boundaries. I have to see my Gynecologist tomorrow. The Doctor gave me these sleeping pills for stress and I just took one. Reasons related to your spouse: Who was that girl / guy you were talking to on the phone? Sex, Sex, Sex All you ever want is sex! Why can't you just hold me? You should have asked in a more romantic way! Why do you have to use such crude language? Reasons related to your weather: It's just too hot. It's just too cold. It's too humid. Reasons related to your economy: When the economy improves. When the interest rates go down. When inflation goes down Reasons related to your special circumstances: We just got back from vacation! When I lose 20 kgs. Reasons related to your friends: I need to make a call first. My friend said they only do it once a month. Reasons related to your pets: The dog can see us. The cat is on the bed. Reasons related to your finances: Okay, but first we need to talk about the bills. Why did you charge this hotel room on our credit card? Reasons related to your job or boss: I have to get up early tomorrow. I was up all night last night. I had a long day at work today. The boss just gave me a new project and I have a lot of work to do Reasons related to your religion: Doesn't the Bible warn against having too much sex. I am sorry, but I just took a vow. I am giving up sex for Lent. Reasons related to your in-laws: We are in your parent's house. I have not been able to concentrate since your mother Your parents will hear us. Offer an alternative: Can I just take care of you in the shower? Okay, but you have to drive the kids to school in the morning. Use evasive tactics: Sneak in and go to sleep early. Okay, but let's watch this movie first. It's just too late. I'll be there in a minute. (Take an hour) Can we just cuddle? I just need you to hold me. Ask a sensitive question: Did you go to the bank and make our deposit today? Have you seen the kid's report cards? Wait for your spouse to tease you and then say coldly, well, you just lost whatever you were going to get tonight.
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.
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