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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.
10 pregnancy risk factors that every pregnant woman should be aware ofFollowing are the possible risk factors for pregnant women: Hypertension: Blood pressure rises during pregnancy due to changes in osmotic level. Persistent high blood pressure leads to a condition called as pre-eclampsia. It retards the growth of the baby in the womb and can even result into death of foetus. It can lead to convulsions in mother. Exposure to medicines and drugs: Self medication is a strict NO NO during pregnancy. Certain drugs have harmful effect on the growth and development of baby. Take gynaecologist's opinion and ask a doctor before taking any medication.  Smoking: Smoking retards the growth of foetus (baby in womb). Moms who indulge in smoking give birth to babies with a very low birth weight. It also increases chances of miscarriage. Mother's weight: It is important to make sure that there is a steady weight gain during pregnancy. A weight gain of 11 kilograms is expected over a period of 9 months. Watch for a steady weight gain for a healthy pregnancy sake. Anaemia: There is an increase in blood volume during pregnancy. This can cause the iron levels to drop down resulting in anaemia. Haemorrhoids add further to the iron loss. Iron and folic acid are therefore prescribed. Haemorrhoids: Haemorrhoids are common during pregnancy and after pregnancy due to constipation which is because of hormone induced reduced motility of intestine. The pressure of gravid uterus on intestine may also cause it. Increased consumption of green leafy vegetables and laxative would relieve it. Alcohol: Drinking can cause a harmful effect on the growth and nourishment of child. Child may be born with a serious medical problem. Sexual intercourse: It's strictly not advised during last trimester. Radiation exposure: Exposure to radiotherapy or chemicals in the surrounding should be avoided. Bleeding per vagina: Consult your gynaecologist soon, if you have problem of bleeding per vagina. It could be a sign of abortion.  
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
Anger management for your teenaged daughter - Handling difficult teenage times If one fine day you find your daughter suddenly reacting differently to a particular situation, do not be surprised, especially if she is in her teens. The outburst is beyond her control and she herself is confused by her own behavior, at times. It's important rather than scolding her for her misbehavior, one must wait for her to calm down and then speak to her regarding the incident when she is in a jolly mood. It is impossible to forgive such behavior if it repeats regularly, though. Here are some ways to deal with your daughter if she strays the limits of accepted norm for a behavior. You can seek the help of a counselor and understand why this is happening and solve her queries so that she could handle them better in the future. Why do Teenage Girls Lose Temper?By the time, the girls enter their teens they would have become aware about the social etiquettes, importance of looks, acting in an acceptable manner in social scenarios and creating a 'cool' image about themselves when they are outside their homes. So, even if they are hurt, or are angry at something, they do not let it go public, lest their 'cool' image gets shattered. However, the same anger becomes bottled up and vents itself out when they reach home. It's much like the workplace anger showing up at home. This is the place where they can behave wildly and still expect forgiveness. However, that does not mean that you should let your daughter get away with such kind of madness. After she has cooled down, you need to talk to her to find out what is bothering her or making her behave in such a manner. Probably, she may not accept that she has a problem, but you will have to find a way to reach to the root of the issue. More often girls want to be like someone in their college or peer group. They want to fit into a particular group and being unable to do so makes them nervous and distraught. Teach your daughter to believe in herself. Make her understand that she is a unique person on her own and do not need to convert herself into someone else. It may take consistent effort on your part to imbibe all these things into her mind, but you have to work hard to make her understand. Self-Control is the KeyMany young girls do not know how to solve a particular problem when they are faced with it. Apart from taking her to a good counselor, you can discuss problem solving techniques with her. Ask her to understand the situation first, put a foot backwards, relax, and then find a solution to the problem. This habit will make her probe into the problem in a better way and she will be able to handle similar situations when they occur again. You can ask her to write down the problems that are bothering her and ponder over them. You can assist her initially, but as she matures she will find her own solutions depending on her past experiences. Adolescent girls have sometimes trouble keeping their anger, rage, and fear under control and hence their problems should be handled patiently. Brainstorming SolutionsOnce she has ripped apart every aspect of the problem and has come to a brainstorming solution, advise her to write down the plan of action. For example, if she is disturbed due to a particular teacher who does not seem to like her grades, she may do well seeking help through friends who are better in that subject, or for that matter, a bad remark by someone in a group might unsettle her, thereby venting her anger at home. With restraint on your part, make her understand that anger will only block her process to think or find a solution. If you teach her to find answers for the problems in a calm manner, your teenage daughter will surely learn to control her anger and behave normally as she grows into an adult.
Teenage troubles for autistic kidsTeenage brings along with it a lot of physical and psychological problems. Your body undergoes a lot of changes, the way the world looks at you is changing and you are not in the position to accept all this. Teenage is one of the most painful periods in one's life.  For an autistic child teenage can be compared to living a nightmare day in and day out. Here is a look at the problems of teenage from an autistic kid's point of view: Social Interaction The ability to interact socially is absent in autistic kids. They are loners who prefer to be left alone and undisturbed in their own worlds. Such a child is a natural target for bullying and ragging by other kids of his age group. At times even if the autistic child wants to come out and make friends, he is not able to do so due to lack of the required skills. Teenage is a period where you need at least one friend to confide in. It can be an extremely difficult phase when you are all alone. Puberty This is the dramatic time in life dilled with hormones and emotions. Your body undergoes lots of changes and you are confused about so many things. You don't know whom to ask or whom to turn to for guidance. Autistic children do not have the maturity to understand this phase. Special issues for autistic teens and sexuality include: Knowledge of physical changes in body. Knowledge of 'good' and 'bad' touch. Ability to communicate about a 'bad' touch or action. Keeping 'safe' distance from others. Handling menstrual cycles. Avoiding 'self-touch' in public. It can be a phase of emotional turmoil for the parents. They need to work closely with their child's special teachers to chalk out a plan that will be best suited to the child in handling puberty successfully. Self-help skills Simple self-help skills like hygiene can be a challenge for teenagers with autism. Improper motor skills, compliance, and sensory problems may interfere with a teen's progress. The proper training of hygiene and grooming can help to add these elements into the daily routine. The right approach is to simplify each task into simple small steps. The positive reward system is a great source of encouragement, as positive motivation always help the teenagers. Higher Functions Autistic teenagers are socially awkward. They lack the power to comprehend and process complex social cues which includes sarcasm, body language, humor, emotional responses and facial expressions. What complicates the problem is that the autistic child lacks empathy and hence may appear rude. Such kids are likely to be teased a lot in school settings.
The male ego: Fragile male self-esteemIn a world where men are constantly competing with one another, adding a woman to this dynamic changes the perception for majority of men. The fact that a woman is doing better than a man can largely affect relationships at a personal and professional level. Simple things like opening a door for men or even pulling a chair for him can make him feel self-insufficient. The whole concept of a woman doing something/anything better than him brings down his self-esteem. In a relationship the roots go deeper and men who are making less money or not doing as well as their partners have a more fragile self-esteem. The mental insecurity that a woman may be a better provider for the family and has more potential than he does, changes the dynamic of his relationship, while for women this does not seem to be the case. Fragile self-esteem alters your everyday determination and persistence. Without being determined, the only way to go is downwards. When self-esteem is affected by women doing things that he can do, men seem to take it in a negative manner and lower their self-esteem. Small examples of this in our day to day life are - driving your own car as compared to having a driver, being physically weaker than a woman, etc. Men are creating rules to ensure that women who are considered lower than them cannot perform or do better than them. Systems and frameworks are made which ensure that situations never come up where a "lower person" does better than a man can, all out of the fear that they can't perform! From the day we are born to the rest of our lives, we are drilled with the fact that men are better, stronger, and smarter than women. So when situations arise where she is doing or has done better than you, the male self-esteem is questioned and, most of the time, drops. Being the person you are meant to be, you would automatically create a system by your choice and influence it to reduce the possibility of any other to be able to achieve what you have, in turn increasing your self-esteem. However, when the other overcomes or surpasses this obstacle, your self-esteem will be hit hard causing a drop in your self-esteem like the stock exchange does on its bad days. Self-esteem is a very personal topic and completely dependent on the situations you have encountered across your life. However, when majority of these are leaning in one direction then there is no question of failure. Consider a world dominated by women, What would happen to your self-esteem? Do you think you would survive in this kind of world, a world in which all your thoughts are limited by restrictions and rules you have to adhere too, to ensure things like your family name is kept out of shame. So let us all do as the women have been doing for centuries, embrace it, and learn to maintain our self-preservation and esteem irrespective of our surroundings. This may sound hard but let us work towards a world where women and men are equal. Don't let your self-esteem be affected by your surroundings, if you know your surroundings are not the best for the future.
CryophobiaCold or hot can be a very subjective term as every person's tolerance for either heat or cold can vary. When some of us react in an extreme manner to all things cold, then it could be a case of cryophobia - the fear of catching cold or the fear of cold weather. Derived from the Greek "kryos" + phobos gives us cryophobia, which is a mental aberration where the mind develops a nagging and persistent fear of all things cold - be it cold weather, ice-cream, or maybe even a cold shoulder! Jokes apart, a person suffering from this condition could really experience 'hot weather' in his relationships as he will completely avoid any contact with anything cold. If the weather is a bit nippy then that's a veritable disaster for Mr. 'Avoid De Cold' as he will do everything in his power to stay indoors, for instance - turn on the central heating and wrap himself up until the mercury rises to an agreeable level. Though it is decidedly different from your run-of-the mill phobias, cryophobia could be of various types. There are some who are only afraid of cold in the 'weather' sense and are otherwise cool about touching cold objects or even having an ice-cream. While there are some who would probably break out into, if you will excuse the term, 'cold sweat,' even while watching floating icebergs on a Nat-Geo documentary. So, the sensation of cold is quite subjective, and hence the various strains of cryophobia. Generally, this fear would manifest quite logically for those who have occasioned to be trapped under ice accidently or maybe those who have suffered frost bite from exposure to cold weather during a skiing holiday. Under such circumstances, avoidance, though irrational, could be perfectly logical. If you monitor weather reports constantly and experience discomfort even in moderate climates, then you should get yourself checked for cryophobia, as chances are that soon you will be restricting yourself indoors and cutting yourself off from the rest of the world. Some people might just overcome fear or anxiety by wearing an extra layer of the woolens or turning up the central heating. For deep seated fears, it may require long-term counseling or medication. Some people might just have this morbid fear of developing pneumonia from a common cold and hence may take elaborate measures to avoid going out during cold days. This too can be quite normal since most of us don't want to call a day off from work due to a nasty cold. But despite adequate protection if you are still afraid of venturing out to work or are avoiding social contact just because of an irrational fear of catching cold when the weather outside is made for the beach and you are in the middle of summer! Then the catchphrase is - You have cryophobia!
10 Makeup myths bustedMyth 1: You do not need Primers if you have evenly applied foundation and moisturized your skin well. Fact: Primers are basically used to fill your fine lines, reduce the visibility of your pores and keep your foundation looking fresh and radiant, for longer. With age, your skin develops its natural flaws and the use of primers becomes mandatory. For best results, use your primer after moisturizing your facial skin and before applying your foundation. Myth 2: Red Lipstick does not look good on everyone. Fact: Generally, red can look good on everyone. The trick is to find the right shade of red that suits  your particular skin tone. However, to play it safe you may start using red lip colors with blue undertones, as they look good almost on everyone. But remember, learning to apply lipstick the right way, is just as important for the right effect. With just a little patience and practice, you can surely achieve those red hot lips, you've always dreamt of. Myth 3: Foundation should match your cheek, hand, neck or forehead. Fact: Getting the perfect shade of foundation is one of the toughest tasks, while choosing your makeup products. Your facial skin is much lighter than your hands; yet at the same time, it's a tad bit darker on the sides and forehead. Hence, the best way to select a foundation is to check the stripes on your jawline. But, always remember to step out into the natural light while making this crucial decision. Myth 4: You can change the lip-size using lip plumper. Fact: Ok Ladies, a lip plumper will definitely not change the size of your lips. The way they work is that they give your lips a swollen appearance, by stimulating the blood flow and irritating the lips. The main ingredients in a lip plumper are hot pepper, menthol, caffeine and cinnamon which results in the temporary pronounced pout, which soon wears off. Myth 5: Pumping the Mascara eliminates Clumps. Fact: If you pump your mascara tube, you're actually pumping in more air, due to which the mascara solution dries out quickly and allows germs to breed in your mascara. The best way to eliminate clumps is to rotate the brush inside the mascara tube and then wipe it down with a tissue, before application. Myth 6: Never wear an eye shadow matching the color of your eyes. Fact: It is true that if you use contrasting colors, your eyes will pop and look bolder. However, this does not mean that if you have brown eyes, you avoid your favorite brown eye shadow. Myth 7: Choose a concealer that is lighter than the foundation. Fact: Every woman has a different skin tone and depending upon your skin tone, you might need more or less, foundation coverage. So, it is always better to choose a concealer that comes closest to the shade of your foundation. Myth 8: Always choose a foundation that is lighter in color compared to your skin tone. Fact: If you choose a shade of foundation lighter than your skin tone, after a while your face will start showing two different skin shades. Always, test the foundation on your jaw line and if it blends in seamlessly with your skin tone, that's definitely the right shade for you. Myth 9:  Makeup leads to acne. Fact: No research, until date, has conclusively proved that makeup causes acne. Poor hygiene, sleeping with your makeup on, not cleaning your makeup brushes regularly, and using the products beyond their date of expiry is what leads to breakouts on the skin. New products may also cause skin irritation; which is why, it is better to test them on your elbow, before using them directly on your facial skin. Myth 10: Tingling makeup products are perfectly fine. Fact: Makeup products that make your skin tingle are sure to damage your skin and cause injury. It may also lead to bacterial infections and pimples, so you should certainly avoid such products. You should never compromise on the quality of makeup products, or else your skin may have to suffer the side effects.
Exercise, a healthy way to deal with hypertensionYou have not exercised for a long time. You took it easy when it came to physical activity. Now that you are diagnosed with high blood pressure, you will do anything to control it. Even exercise! Exercise, weight management, and a healthy diet are important ways to help prevent high blood pressure and lower the blood pressure that is already high. Benefits of exercise for people with hypertension include: Improve blood and oxygen circulation in the body Promotes sound sleep Improves stamina and endurance Keeps heart healthy Reduces stress and promotes mental health Exercise enhances the effectiveness of medication So how much should one exercise? An exercise session of atleast 30 minutes per day is important. Get started Start slowly and increase gradually. Start with 10 to 15 minutes of exercise and increase it, as youget comfortable. Choose exercises you enjoy and will do consistently. Avoid sudden vigorous activities; they can cause injuries and hamper the routine. Warm up Warming up helps the body adjust slowly from rest to exercise. A warm-up will reduce stress on the body muscles, increase heart rate and respiratory rate, and body temperature slowly. It will also decrease soreness of muscles. Best exercises for lowering blood pressure Stretching: It is the best. It relaxes and helps prepare the body and muscles for activity and prevents injury and muscle strain. Stretching regularly will make you flexible and improve motility. Aerobic exercise: This helps to improve circulation to the entire body. It improves heart function. It gives maximum benefits to the heart. They also help to reduce heart rate and blood pressure by improving breathing pattern thus lowering blood pressure. Walking, swimming, jogging, and skipping are all aerobic activities. Do aerobics for at least 30 minutes three times a week. Strengthening exercises: These include exercises that have repeated muscle contractions till the muscles are tired. These include side balance crunch, climbing a rope, and push-ups. Join a gym. Here are some  exercise guidelines for a better exercising routine in the gym:  Schedule a fixed time for exercise. Find a buddy to exercise with you. Select an exercise that you like. Make variations to avoid getting bored. Boredom can make you stop exercising. Start slowly and increase gradually, especially if you do not exercise regularly. You should wait for an hour after eating before you exercise. Ten minutes of warm up and ten minutes of cool down sessions are must Keep a record of daily exercise.
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
The earlier yearsSexual concerns experienced during the drastic body changes and feelings of adolescence are often carried into adulthood. Sexual desires are powerful and frequently go beyond the earlier popular forms of sexual expression - kissing, hugging and petting without being aware of the consequences. Anxiety the commonest case of erectile dysfunction is compounded by the present life style - get-togethers, parties, with alcohol and drugs, visits to sex workers or massage parlours which offer other sexual services leading to unplanned, unprotected sex. Consequently seen are unwanted pregnancy, abortions, drug addiction, sexually transmitted diseases, anxiety and depression leading sometimes to suicide. Males seem to have more concerns then females. A common concern is nocturnal emission (night fall, Swapana Dosh) of semen and length of penis. Nocturnal emission of spermatic fluid is falsely believed to weaken a person. Really all that's happening is that excess of sperms is being thrown out to make place for the new ones. The length of the penis troubles many. Young people fall prey to advertisements that claim to lengthen it. The fact of the matter is that a penis an erection of 2.5 wide (10cms) is enough for a sexual intercourse for a person who knows the art to satisfy a partner. Ignorance about masturbation is widely prevalent among males of all ages leading to guilt, anxiety, depression and at times to suicide. Older men erroneously think their cause of erectile dysfunction or premature ejaculation is masturbation. Masturbation is a highly pleasurable act in males. It does not harm the body or exhaust the sperms. In fact it is a safe way to satisfy. Females also masturbate but the percentage to men is much less. They also seem more comfortable with the activity. Masturbation has gone through years of superstition fear of ill effects, considered as a unhealthy practice and considered sin by some religions. Fifty or more years ago doctors and activities thought it caused harm to the body. It is said that corn flakes, the popular breakfast cereal was specifically formulated by Mr. Keleog to help a person not to masturbate. Today thinking has changed. It is now thought that it is an activity that does not cause any harm to the body. It does not finish all the vital sperms over the years so that it will not hinder having children in future. Its wide misuse is common. Persons use it indiscriminatingly when they cannot sleep, when they are tense for e.g. before an examination, some do it more than four to six times a day, which only indicates their immaturity. When done to satisfy a natural sexual urge it is a healthy activity. It keeps the person safe from infection and is said to teach the person skill for sexual intercourse. Technology has helped in many ways but sometimes it creates problems. A person hooked on to porno sites to arouse his desire is found to cause a loss of self confidence conflict with the partner sexual intimacy and intercourse. Before marriage or a partnership both male and female have concerns. Females if they have a previous partner but are getting married to another worry about the husband finding out of their loss of virginity, others worry about the size of their breasts, excessive hair on body or excessive fear of pain at intercourse. Men worry about whether their penis is long enough whether their long standing masturbation will hinder intercourse or prevent them of being a father. The absent hymen a false notion for virginity can be congenitally absent, split by exercise like swimming, cycling etc. or most commonly by masturbation. The hymen therefore is no proof of virginity. Learning to do with what they have making full use of their points and feeling comfortable and proud of their bodies help a lot to overcome the concern. Adopting a safe sex policy is best achieved by masturbation; avoiding sex with an unknown person and multiple partners; during intercourse with sex workers not using condoms every time and being careful of oral sex. Satisfying each other by caressing, hugging, kissing etc. with clothes on is safe; without clothes extra vaginal sex by mutual masturbation is safe with a trusted partner and finally not so safe is vaginal intercourse unless done with a condom correctly worn.
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