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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
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.   
16 myths about baby careA new mother experiences a range of emotions. Chief among these is fear, which is a result of the love and attachment that she feels for the baby. In such situations, mothers often tend to believe myths that make no logical or medical sense. Myth 1: If I don't breastfeed my baby immediately after the birth, I won't be able to bond with him adequately. Fact: Although the first few hours of a baby's life are important for both mother and child, sometimes due to unavoidable circumstances, the baby is kept away from the mother. For instance, in cases of cesarean delivery, the new born babies need immediate medical attention, and hence are kept away from the mothers.  However, the love and care you show the child over the years will more than make up for the loss of attachment with the baby during its first few hours. Myth 2: Pinching the baby's nose will make it pointed. Fact: Pinching the nose will only hurt the baby. It will not make the nose pointed. It is possible for a baby to be born with a flat or tilted nose if it gets pressed during delivery. But this is temporary and the nose becomes normal as the nasal bridge develops completely. Myth 3: Mothers should not use yellow clothes and yellow food while breastfeeding as it causes jaundice in the newborn.  Fact: The color of the mother's clothes can't affect the baby's health. There isn't any evidence to show the relationship between yellow food, clothes and jaundice. Myth 4: Umbilical cord stump should be cleaned with alcohol swab every time after changing diaper.  Fact: Alcohol may delay the healing. It is recommended to keep stump clean and dry till it falls off. Myth 5: Some babies can be allergic to mother's milk.  Fact: No. A baby is never allergic to mother's milk. Myth 6: Baby should be wrapped up tightly. This helps to straighten the hands and feet.  Fact: A child's limbs develop faster when they are free to move and not wrapped. Myth 7: Holding the baby all the time will spoil him. Fact: Babies cry to express pain, anger, irritability, hunger, sleep everything. Holding or picking him up to comfort won't make him a spoiled child. Myth 8: Do not take your newborn baby outside. Always keep him in the house.  Fact: Fresh air is good for the baby too. Just avoid heat, crowds and unhygienic places. Myth 9: Vaccines cause autism. Do not vaccinate the baby.  Fact: It is a rumor. Immunization is very important to protect the baby against a number of diseases. Myth 10: Babies do not spit up if they are breastfed.  Fact: It is normal for the babies to burp, spit up, and drool. Do not worry about it if the baby is gaining weight normally. Myth 11: Sleeping on the head causes flat head.  Fact: It is advised medically that all babies should sleep on the back to prevent sudden infant death syndrome. Alternate the head position daily as flat head can be caused only if baby sleeps in same position daily for long time. It is an occasional occurrence.  Myth 12: Putting few drops of oil in baby's ears will keep it clean.  Fact: Do not put oil in the baby's ears. It can hurt the tiny eardrums leading to pain, soreness, and even hearing loss. Oil can cause ear infection too. Myth 13: Use crib bumpers to protect head of your baby. Fact: They are not advisable. The baby's head can get wedged against a bumper causing strangulation or suffocation. Bumpers are dangerous. Myth 14: Stop mother's milk if baby fed only on breast milk has loose motions.  Fact: Passing 5-6 loose motions is normal in a baby. Continue to breastfeed. Do not stop it. Myth 15: Attention span is very short in babies.  Fact: Babies, in fact, have excellent attention spans and have interest in the all things around them. This is why babies learn things so quickly.  Myth 16: Wrap up the baby in blanket if he has fever. Sweating will bring the fever down.  Fact: The fever will rise if you wrap the baby in a blanket. Try to keep the child cool and sponge him with cold/warm water to bring down the fever with the doctor's advice.    
Tips and tricks to deal with my toddler's tantrumsWhen your child is having a tantrum, it may usually be for something that it wants and cannot have. Throwing a tantrum is a child's way of getting what it wants. Conversely, giving in to the child's demands may be the easy way out for the parents too. But always remember that giving in is not right. The child may get habituated to this and it may prove quite a nuisance to you too. Learn to say no, gently but firmly. Giving an acceptable reason for your 'no' and also an option at the same time works wonders. All said and done, children are not that easy to handle. If your child doesn't fall in line and is adamant, let it pass the phase. Screaming out the rage, throwing away things may help the child. When the anger subsides, looking at the destruction and the obvious uselessness of it may help the child realize his efforts were futile. But be careful that the child doesn't get physically hurt in this process. For some kids, a gentle hug helps soothe the anger pent up. Tantrums in public places can be extremely embarrassing. In such situations, do not argue or scold your child or order him to hush up. It will only end up making the child more adamant. Wait till the storm subsides. Take him out to a quieter place and talk gently but firmly. One thing to remember here is to never let the child know of your embarrassment and concern that you are in a public place. Children are very smart and may end up using this to work things in their favour. It is not easy being a toddler and it is definitely not easy being a toddler's parent either. By the time your toddler is old enough to go school he will have overcome this stage.  
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.
Cleanliness - A clean body, clean mindPhysical Benefits: Killing of Germs: Disinfecting your living area allows negligible scope for breeding and spreading of germs and bacteria. Though not visible to your eyes, many of these can cause severe illnesses. Prevention of Food Contamination: Clean cooking utensils and counter tops allow for low risk for contamination of food. The parts of the utensils which have come in contact with fish, raw meat, or eggs are recommended to be washed with hot water and soap. Make sure you wash your hands to avoid spreading of any bacteria in your house.  Keeps Illnesses and Allergies at Bay: Many allergies could be caused due to dirty mattresses, carpets, sheets, walls, and furniture. In order to keep away mold, dust mites, cobwebs, and mildew, make sure you dust, mop, and vacuum the house on a regular basis. The sheets should be washed at least once a week with hot water and detergent. Floors and walls, wardrobes, and refrigerator should be cleaned using disinfectant sprays up to 2 to 3 times per month. Thoroughly clean your carpet and upholstery at regular intervals. Psychological Benefits: Association of Non-Cleanliness with Moral Lapse: In a review by Current Directions in Psychological Science, it has been found that physical cleanliness does not only physically benefit a being, it also results in weighing the person on a moral radar. When we perceive a physical contamination, we respond in the same way as we would in case of an act of moral disobedience. This response includes repulsion and disgust accompanied by their behavioural components like scowling and frowning. Sense of Accomplishment: Those who clean their house and living space have been found to have a consequent sense of accomplishment that adds to the way one feels about oneself. Clarity and Organization of Thoughts: It has been discovered that those living in a clean and neat environment tend to have a greater capacity to think than those who live in a messy and unclean atmosphere. Proactive Sanitation Teaching for Children: Start with your own home. A child emulates its parents, and if the parents practice cleanliness as part of their lives, children would notice and follow suit. Children tend to connect who they are with their home environment and as they grow up they ensure that such a cleanliness of their world around is maintained.  towards their immediate surroundings, thus ensuring that they do not contribute towards pollution and environmental degradation, at least on an individual level.
5 Mistakes yoga beginners makeYoga is a science that has been developed by the ancient Indian sages after a lot of research and study. That is why yoga is difficult to master immediately and one needs a lot of practice to achieve every posture or asana in the perfect manner. So, it is very important to learn the yogic techniques from an expert and one must avoid performing yoga on your own, at least in the initial stages to ensure that you do not suffer from any physical injuries by wrongly straining or stretching your muscles during practice. Yoga can benefit you only if you perform the asanas according to right techniques. Hence, you should try to avoid mistakes right from the beginning. Here are the five most common mistakes people make while performing yoga as beginners: Learning How to Breath Inhalation and exhalation, some say is the most important process that you need to control while performing yoga. While trying to achieve certain asanas, you have to hold your breath for a while and because of this, your muscle fibers are deprived of oxygen for that time. And one needs to do this while holding one's body in that particular posture. With less strength in your muscles, there are chances that you may fall down or get injured. Hence, as a beginner, when you do not have proper control over your breath, it is best to inhale in short breaths, instead of going for the full belly breaths. Just as you slowly inhale, remember to exhale slowly as well, so that the rhythm of the yogic posture is not disturbed. Do not push Yourself Too Hard Most of the contemporary exercises are based on the principle of 'more pain, more gain'. These exercises tell you to stretch more and push harder to get the best results from your workout routine. However, in the case of yoga, the opposite holds true. If you push yourself beyond your limits to attain a particular posture in yoga, you might actually end up straining and injuring your muscles instead. . So, when you are doing yoga come what may, do not push yourself beyond your natural limits. Do Not Compare Some people are naturally gifted with super-flexibility, while the rest of us may not achieve it despite practicing yoga for years together. Each of us has a different type of body and hence, you should not try to compete with those who are highly flexible, especially, if you are trying yoga for the first time or after a long time. You must give your body some time to loosen up its rigidness and become flexible enough. Trying to compare your body's abilities with others and forcefully pushing yourself to perform postures, just to match up, will hurt you eventually. Where to Place the Mat? The best place to put the mat is at the back of your yoga class, especially if you are new to yoga. If you keep your mat at the front, you will become more conscious and will never be able to concentrate on the asana. Instead, if you are at the back, you will always have the front row to follow, just in case you miss the instructions by the instructor. Go easy on the Food! Yoga postures can be intense and if you go into class with a full belly, you will, most definitely find it difficult and uncomfortable to perform the asanas. The key is to eat about an hour before and almost half the size of your usual portion; so that you can perform the asanas comfortably and get the exact fuel necessary for performing them.
Sleep tight at every good night!A good night's sleep! Oh, what would some of us give for that luxury! Sure, you can blame it on the fast paced world and the things you have to do to keep the competition off your turf, and millions of other reasons to be sleep deprived. Yes, sleeping soundly and regularly is well within our control. Maybe it has eluded you so far and you are caught in a vicious circle of staring at the ceiling for hours on end; so read on to see what simple things you can do to gently drift off in to the arms of nature's greatest restorative- beauty sleep. Do's and don'ts for beauty sleep Fix a regular bed time, so that your brain will adjust to this by sending sleep signals to the body. If your bedtime is completely at the mercy of your activities then even as fatigue sets in the body will refuse to obey. So, even as your body is screaming for rest, the mind does otherwise. This is where good old discipline comes in to play. Take in to consideration the activities which are absolutely necessary to do and note the frequency with which they are likely to interfere with your bedtime before setting a realistic bed time. Initially the mind will refuse to obey, and you are most likely to get up, after tossing and turning in bed, to switch on the computer or whatever it is that you do when you cheat your bedtime. Rest assured, in a couple of days the brain will get used to this sleep routine and prepare you for shut down. Sleeping well also largely depends on how stress free you are. If the mind is in a state of constant excitement or anxiety, sleep will elude you. So when you lie down to sleep you need to fade out and blank everything out- joy and sorrow; expectations and ambitions, all of these out for later access! Tell yourself that tomorrow is another day and what you need today, is a state of neutrality! That's what most Indian philosophers would want you to do anyway. A good eight hours of sleep may depend largely on our minds but external factors can matter too. Sleep comes easily when your mattress is comfortable and not too soft or too hard. Use a pillow that won't give you neck pain, as any discomfort in the neck is likely to throw sleep off gear. Wearing clean night clothes can give you better quality of sleep. That goes for the bed spread as well.  Try this for yourself. Tight and uncomfortable night clothing is not recommended as this will only make you wriggle about for comfort. A cozy blanket and some clean nightclothes make great bedtime mates. Some people have a nightcap to help them sleep better while others still, drink themselves to sleep. Alcohol in large doses can only numb but does not help you sleep and you will only find yourself waking up frequently. Sleeping pills can be habit forming and might have serious side effects in the long run. So try simple remedies like a glass of warm milk or hot chocolate before bedtime to help you sleep better. Avoid stimulants like coffee, tea or nicotine before bedtime as that can keep your nerves all hyper thus making sleep quite difficult to come by. Computers and television are also largely responsible for us staying up late and disrupting our sleep patterns. We often find ourselves mechanically flipping channels or browsing without any real need for it. Try and go offline before bedtime, especially if you want to be able to schedule your sleep time. Television or movies can excite the brain and then you will find it difficult to fall asleep. So about an hour before bedtime switch off the telly or computer and just sit quietly and do some deep breathing exercises. Just sit cross legged for about ten minutes and relax your body. You are now ready for a deep slumber.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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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