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Make no bones about this - Men have osteoporosis tooOsteoporosis is a condition in which the bones of the body lose their strength gradually and become thin and brittle. This is most commonly seen in women who have attained menopause. The reason being the decrease in the hormonal levels, particularly estrogen. Studies reveal that 20% of sufferers are men. Falling levels of testosterone are one of the causes for men developing brittle bones. Men's bodies convert some amount of testosterone into estrogen, which is very essential in maintaining the bone mass. Genetic deficiency of the enzyme that helps the conversion of testosterone to estrogen also is a major factor for men developing osteoporosis. Calcium and vitamin D play an important role in developing the bone mass and in helping the bone grow. Exercising helps too. When you exercise, the muscle gets pulled and the bone responds by growing. Too much of indoors and sedentary work may make men get the less of all three and it eventually leads to weak bones and osteoporosis. Studies reveal that 20% of sufferers of osteoporosis are men. Certain medications like anti-seizure drugs, drugs for prostate cancer and steroids have side-effects that make it impossible for the body to use vitamin D. Using them for a long time reduces the bone mass density and leaves the bones brittle making them easily prone to fractures. Smoking is a vice that has to be quit for more reasons than one. An analysis of several major studies on the effects of smoking shows that smokers have a 55% higher risk of hip fractures and low bone mineral density than non-smokers. Nicotine has also shown to have a direct effect on bone cells. A long list of medical conditions like diabetes, rheumatoid arthritis, and digestive and blood disorders can take a toll on your bones. Long term medications for the same also have side-effects on the bones. How to prevent osteoporosis? Exercise- As young boys, men have usually been exposed to a lot of bone building exercises through sports. This helps in building up on the bone strength and comes in handy in the later years. A brisk walk for 30 minutes 5 times a week and moderate impact exercises help in maintain the bone mass and reduce the thinning of bones. Calcium intake- The daily calcium needs for men is the same as women. Hence, the dietary recommendations remain the same too. 1,000 mg of calcium a day from ages 19 to 50 and 1200 mg of calcium a day if you're over 50.Along with this, make sure you get the required dose of vitamin D too, so that the calcium you eat is absorbed properly. The standard recommended dietary allowance is 400 IU. Some doctors advise to increase the intake to 800 IU. Regular medical checkups will help you to know beforehand about the risk factors and the necessary precautions you will need to take.Osteoporosis in men is as much a reality as in women. However, there are ways to avoid it too. Awareness about the condition and about the ways to prevent it can help keep osteoporosis at bay. Bone mass matters. It could mean the difference between a hip fracture later in life - or keeping an active, high-energy lifestyle.
Are you the proud owner of this beer belly?While you must have earned a lot of 'brownie pints', a beer gut is not quite something one can be awfully proud of, as it is positively dangerous for your health. Well for one this condition seems to be a common affliction amongst men more than women (though it isn't entirely unknown for women to guzzle beer). A beer gut is normally found in middle aged men as a token for services rendered to a sedentary lifestyle and hours spent accumulating empty calories. How is a beer belly formed? A protruding mid-section in men is generally formed when they consume more than they burn off. So given a busy lifestyle with very little exercise and discretion one generally can end up consuming lot many calories than one is willing to toss out. According to Dr Michael Jensen MD, endocrine and obesity expert at the Mayo clinic, the liver burns calories earned from alcohol instead of the existing fat. So say, if an average beer is around 150 calories plus all the tiny appetizers one has along with the beer (Pizzas, cuts, chips etc.) one can easily understand how these go about accumulating around the belly area in to a paunch. And because the liver was all too busy burning the calories guzzled from the beer, the rest finds a cozy place to settle around the tummy. This is exactly what gives majority of men and some women the infamous paunch or beer gut! GIVE YOUR PAUNCH A PUNCH IN THE FACE Well for starters be a giver and not a taker. Which means give more time to exercise like running, cycling, swimming, skipping, dancing or aerobics which should take care of visceral fat (which is easiest to shake off, by the way). As one ages their calorie needs go down, but then so do their physical activity levels and this is where the fat creeps in. Stick to light beer if you must but do not miss your exercise regimen for anything in the world.  
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
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.   
High blood pressure in the little onesIf you are asked to paint a picture of a patient of hypertension, how would it look? Leave the details aside, would you paint an old person, a young person or a child? Most likely, you will paint an old person or may be a middle-aged person. But a child, who would think of a child to have high blood pressure! It may be difficult to believe for most but not only is it possible, its incidence is also increasing gradually. In fact, hypertension in kids is becoming quite common. Studies in USA show that up to 5% children and adolescents have hypertension. What is it? High blood pressure in children and adolescents is also called as pediatric hypertension. Pediatric hypertension is defined by the blood pressure recorded on the mercury, in comparison to the given standard range. As a child grows, there is rapid development in all the milestones. For children, there are percentiles defined for all parameters for various age groups. In children, when the blood pressure is above the 90th percentile but below the 95th, it is called prehypertension. When it is above 95th percentile, it is diagnosed as hypertension. There are no distinguishing symptoms of pediatric hypertension, so it may easily be missed. Please make it a practice to get your child's blood pressure checked on routine visits for medical examination. Why does it happen? High blood pressure in children under ten years of age is usually secondary to some other health condition. It could be due to an underlying heart disease, kidney disease, hormonal disorders or genetic abnormalities. This demands treatment of the main problem. Primary hypertension is noted in older children, over 6-10 years of age and adolescents. There is no specific cause identified for this, other than lifestyle, obesity, rich foods and family history. How bad could it get? Children may show a disordered sleep pattern when they have hypertension. They may suffer from sleep apnea, reflected by snoring or abnormal breathing. Besides sleep, the other effects of hypertension are the known ones. In the long run, it could lead to heart disease, stroke or kidney disease. What to do? It is very important to control the blood pressure from a young age. Regular check-ups and monitoring of the BP is needed. Thorough examination is a must to identify whether the hypertension is primary or secondary. Treatment by medicines is recommended in secondary hypertension, where the underlying condition is to be tackled along with the management of blood pressure. In cases of primary hypertension, medication is suggested only in extreme cases. Otherwise, lifestyle management is the key. It is not a healthy option to start anti-hypertensives this early in life. Give your child healthy food, help him/her maintain the ideal body weight and make sure he/she gets enough exercise physically. The sooner we identify the problem, the better are the results with a disciplined lifestyle. The unhealthy lifestyle is creating chaos in all our lives. How long the kids would have escaped? Our lifestyle reflects on our kids. Follow a healthy routine and keep the family healthy!
Your child is ready for school... but are you?It was still okay. Just 2-3 hours which you could utilize for other things while your child was away briefly. Now you will have to compete along with teachers, textbooks and homework for your child's attention. Well Mother, we know this is going to be difficult for you, but let's see if we can try and make it any easier. Think of school as an extension of the tender loving care that you provided. The only difference is that the TLC will go towards nurturing and developing his/her brain and help it learn important skills which will help gain a balanced development. At this point your child feels bad and completely unsafe in this new hostile world of teachers and uniforms and what not! If you weaken at this point your child will cop on and then will come the emotional blackmail. So explain the importance of school to your child as it will make the transition easier. It is always good for mothers to accompany their children to school but imagine watching mother walk away and all hell can break loose. So if your child's school has a school bus facility you can walk him to the bus stop and then say your goodbyes there. A lump in the throat at the bus stop is preferable any day than a scene at school with a child holding on to mother for dear life. Do not criticize your child's school or assignments given by them as children can catch on quite quickly and that can be reason enough for them not to concentrate on school activities. Always encourage your child to talk about what he did at school and ask him questions about his friends and teachers. This gives the impression that school is as important as home and gradually even you will reconcile yourself to the fact that school is here to stay.
Not very chummy! Menophobia - The fear of periodsMenstruation or periods begin as female reaches puberty. This is the time when there are hormonal changes which occur in the body as nature takes the girl and makes her ready for womanhood. The onset of periods can be distressful with lots of mood swings accompanied by abdominal cramps, bloated feet as the menstrual blood flows. This is also a time when the girl needs to be comforted and educated the most, as it can be truly a terrifying experience. Normally mothers or elder women in the family ensure that they take complete care of the girl in this transition phase. For some women, their initial experience with periods may not have been particularly pleasant, causing them to actually dread those 4 days and this fear can then take the shape of a full blown phobia -Menophobia! The reason could vary. For some the pain factor could be the reason for menophobia, while for others, it could be the memory of embarrassing red stains on the clothes which could set it off. In menophobia, just before the onset of the periods, the person starts getting anticipatory anxiety and the pain which could be normal period pain, is then imagined to be ten times worse. This brings on panic attacks and feeling of utter dread which while is entirely psychological can be utterly distressful and downright crippling. Counseling can help greatly along with pain medication to manage the pain and the fear of this natural phenomenon called periods. In therapy, this is what is iterated. That menstruation is a completely natural process and if there is a fear of menstrual blood then gradually, the woman is encouraged to accept it as a natural body function which plays a major part of her being a woman.
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
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.
4 super foods to keep you healthy this winterWinter is here. It is time for lazy mornings and blanket hideouts. It is also the time when the markets are lined up with a variety of fresh fruits and vegetables, all juicy, healthy and colorful. Discover four such super foods for the cold winter evenings. Citrus fruits: Oranges, sweet lime, lemons; bring them all and have them all. Bright yellow or orange, they are like the bright sunny mornings which you need after a cold night. Rich in vitamin C, antioxidants, flavonoids and several other nutrients, citrus fruits are the perfect measure for your daily dose. Peel it off and chew it up, or slice it off and lick it on, or squeeze it strong and drink it down - choose the way you like. Citrus fruits help in taking care of your cholesterol, as well. Potatoes: Potatoes are the victims of most diet plans. It is loaded with carbohydrates, we should not eat potato, and so on and so forth. Potato is not that bad actually. In fact, its nutritional value may come as a surprise to many. The content of vitamins B6, C and folate is high in potatoes. Potatoes are rich in essential minerals like potassium, zinc and magnesium. The starch content may be significant, but so is the fiber content. They are known to protect against colon cancer. What are you waiting for? Have some potatoes, will you? Make sure there is no guilt. Kidney Beans: Kidney bean is our favorite Indian 'Rajma'. They are a rich source of carbohydrates and proteins, are known to lower the cholesterol levels and reduce the risk of heart disease. They are particularly known for helping to replenish the iron stores of your body. It can be the food of choice even if you have diabetes, as it is almost fat-free and doesn't send a sudden rush of glucose in the blood. When combined with rice, kidney beans make a very healthy meal. So, is it rajma-chawal (kidney beans with rice) for dinner today? Green leaves: Yes, yes, you are bored of reading and listening to the benefits of green leafy vegetables. But, we have to remind you, for the advantages are too many to be ignored. They are the greenest, freshest and leafiest in the winters. Even if you are not a fan, you will feel like picking up a bunch from the grocery store. Spinach (palak), fenugreek (methi), cabbage (gobhi) are the ones that we can commonly find. Others to look for are lettuce, mustard greens, etc. The green leaves are a rich source of a variety of vitamins, mineral, fiber and water content. They are suitable for all ages and can be easily digested. Entertain that potato lying in your kitchen, cook up a dish with the green leafy ones. Alternatively, you could try it in the form of salads, soups, juices, flour fillings, and any other creative ideas that you chefs have.  
Treating sore throatTest and diagnosisPatients with sore throat are examined by ENT specialists. At first, the doctor performs a local examination of throat. Clinical examination usually guides the doctor towards diagnosis. Although in order to confirm the diagnosis, the doctor may ask for culture and sensitivity test of the throat swab. Treatment Home remedies: Mild cases of sore throat are usually cured by home remedies. Following remedial measures can be adopted at home: Warm saline gargle – Gargle with warm saline water helps to relieve the discomfort and irritation of the throat. Half to one teaspoonful of salt is added to one full glass of warm water and the patient is advised to gargle. This process may be repeated 3 to 4 times a day to have a soothing effect on throat. Additionally, smoking and use of other tobacco products must be avoided. The patient must drink adequate amount of fluids. Warm liquid and semi-solid food must be consumed to provide a soothing effect on the throat. Cough lozenges to help relieve irritation and pain in the throat. Seeking advice of the doctor: If the signs and symptoms persist and are not adequately controlled by home remedies, the patient must seek advice of a specialist doctor. Viral infections usually do not require treatment. They are usually cured in 5 to 7 days. Bacterial infections require treatment as per the advice of a specialist doctor. Bacterial infections may require treatment by antibiotics. The treating doctor selects an antibiotic which is suitable for the patient depending on factors such as the age of the patient, report of the culture and sensitivity of throat swab, previous drug history of the patient, etc. Antibiotics usually effective in bacterial infection with sore throat are from the group of penicillins, cephalosporins, and macrolides. PreventionViral and bacterial infections are contagious. Good hygienic lifestyle and habits help prevent infections. Following things to be noted are: Frequent and thorough hand washes before consumption of food, after using toilet, and after sneezing and coughing. Use of a hand sanitizer during consumption of food outside home. Avoid sharing food and drinks from same glasses and utensils. Use a tissue paper or handkerchief while sneezing and coughing. Avoid close contact with patients with sore throat. If sore throat develops, few home remedies may prove to be curative. If sore throat persists, advice of a specialist doctor must be sought.
Stinky feet? Learn why!Most of us have experienced a bad smelly foot at least once in our lives. We all have that one friend or relative who has such smelly feet that he can clear off a room as soon as he kicks off his shoes! With more than 250,000 sweat glands in each foot, the feet are the most highly sweating parts of the body. What causes this bad smell? The feet contain thousands of sweat glands. During warm days or when you wear socks and tight shoes, the sweating increases in due proportion. The resulting sweat does not find an outlet and starts accumulating in the spaces available and this warm and moist area breeds bacteria. The bacteria start feasting on your sweat and dead skin. They digest their food and release the waste products. These waste products are toxic organic acids that cause the feet to smell so bad. About 10 to 15% of people suffer from this horribly bad smell. Why? This is because their feet are extra sweaty and become a home ground for certain bacteria called as Micrococcus sedantarius. Along with stinky organic acids, the bacteria produce volatile sulphur compounds. Sulphur compounds are powerful and extremely awful smelling almost like a dirty rotten egg. Teenage years also see extra amounts of sweating on the feet. Medical conditions like Hyperhidrosis can also make your feet sweat more. If you are suffering from a fungal infection of the foot, then rest assured that your feet will smell horrible. Smelly feet can be an embarrassing problem. It puts everyone in a spot. Hence, foot hygiene is important to avoid smelly feet. Always wash and dry your feet well every morning. Dab some antiperspirant powder on your feet and between the toes to soak the perspiration. Never wear the same shoes for more than 2 days in a row. Wear a fresh pair of socks daily. Keep your feet exposed to fresh air. Avoid tight-fitting shoes. Use an antibacterial soap to wash your feet if you have smelly feet. Visit your doctor if simple home measures do not prove very effective. Excessive sweating is often considered the cause for foot odor. This is not true. Sweating in itself is harmless; it is the bacteria that grow there that are responsible for the awful odor.
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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