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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
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.  
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
Yoga to strengthen women's lifeEveryone expects from a women for all their necessities. The husband needs to go to office and she has to prepare for this, the son or daughter needs to go to school, tiffin needs to be packed, and the in-laws need her attention for the morning tea and breakfast. Along with this she has to rush to office on time. Then while returning, she has buy vegetables and other things for household, then go home and cook, and sleep late after all the chores are done. For such a multi-tasking working-women, the time available is very less to replenish the energy she uses to do such work. Multitasking leads to stress and tension and causes headaches, stiff neck, tight shoulders, poor posture, shortness of breath, clenched teeth and fatigue. What is the solution for this? The only solution is YOGA.  We all know that yoga has many positive effects on ones well-being; it brings about both physiological and psychological benefits. It is beneficial for body, mind, and spirit. It needs only 10 minutes. Yoga helps to relieve your stress and tension. Yoga in Sanskrit means 'YOG' that is to join or unite. It is the union of mind, body, spirit, and breath with our surroundings and our universe. One should start yoga gradually with a comfortable speed and limits. Breathing exercises are excellent way to reduce stress and tension. It can be done along with asanas. For this you have to sit comfortably with relaxed shoulders and with your chin level at the floor. Inhale through the nose expanding your abdomen, rib cage, then expand your chest, then begin to exhale by contracting your abdomen, ribs and then lastly relax your chest. Now continue to breath in this fashion, this improves the quality and quantity of oxygen that enters our body and helps to relieve the shortness of breath and relieves the tension. The yoga mudra is helpful to relieve the stress, for this sit down crossed legged on the mat and keep the back straight, then take the arms behind your back and hold the left wrist with the right hand. Then by exhaling, bend forward to touch your left knee, while doing this focus on the feeling of surrendering to God, which protects you all the time, then while inhaling come back to the normal position and repeat this on the right side. Then finally, complete this pose by touching the forehead to the ground in front in the centre, while doing this exhale, then when you feel like inhaling come back to the normal position. This posture increases the energy and stimulates your respiration, improves your digestion calms your nerves. But this should be avoided by pregnant women, hernia patients, and patients with retinal disorder. The shavasana also helps you to relax your body before you get to work. In this you have to lie down on your back on the mat. Keep your arms a foot away from your body and your feet separated two feet apart.  Then close your eyes and focus on your breathing and feel free of thoughts and tension. Breathe normally and focus on your body parts, toes, legs, abdomen, head and finally the scalp and try to relax each muscle group. It improves your breathing, concentration, gives inner peace. You should avoid this if you are suffering from low blood pressure.  
Where does your happiness lie? - Importance of emotional well-beingAn emotionally well person is characterized by ability to handle and adapt to changes, to efficiently deal with stress, has a positive self-image and can take decisions independently to cater to his needs. Striving forward with a sense of purpose, an emotionally strong person has the capacity to build and sustain fruitful relationships without over-dependence. Being emotionally well does not imply that you do not experience pain and suffering. Pain and suffering is an essential part of every person's life. The strength of your emotional well-being is determined by how you look at and react to them. Those who are emotionally well can treat their adversities as opportunities to change and move ahead with greater strength. Signs of an emotionally ill person include stress, frustration, discomfort with changes, negativity in thoughts, and unreasonable paranoia about the intention of other's actions, discontent, and depression. There is also the feeling of guilt over inability to hold relationships and of not being able to keep others happy. You may also find yourself unworthy and feel that you do not deserve to be happy. Such sensation of low self-worth fuels the need to look for other ways to feel relaxed - thus, resulting in substance dependence. In cases of severe emotional ill-being, one could experience sleeplessness, hopelessness, suicidal, and uncontrollable negative thoughts. Relation between emotional and physical well-being: Emotional well-being is closely related to your physical body. They share a symbiotic relation with one another.By taking care of your body, you allow balanced production of hormones and smooth functioning of the other body parts - allowing them to respond efficiently during tough situations and also assisting the body to cope with physically challenging conditions. By being emotionally strong, you will also contribute towards faster and effective treatment of your body from illnesses. Your emotional well-being is determined by the following factors: family background, companionships, past history of relationships, sensitivity to nature and genetic dispositions. Those who come from troubled family background find it harder to associate in a healthy way with others during their adulthood. In many cases genetically, a person has greater propensity towards being emotionally weak - though this can be controlled and molded into strength by one's own actions. Depending on the type of educational institutions you attended, your companionships could be those which built your self-image positively or which hindered your capacity to take care of yourself (due to instances of bullying and teasing). Past romantic relationships also determine how you deal with your emotions in the present. Those who are sensitive to nature have been found to have greater consideration for human beings as well as non-human beings around them. Every factor is a condition which can be shaped by the efforts of the individual. Emotional well-being is primarily built on the belief that you can create your own reality by choosing your actions. How to promote your emotional well-being? Be optimistic :  Emotional and mental well-being is majorly decided by how you look at your life. Even though you have many sufferings, are you able to accept them and find ways to get through them, knowing that the good is yet to come? Flip through the inspiring stories of people around you to motivate optimism. Find your beauty : Listen to the needs of your body and do not impose your mental ideas of beauty on it. Beauty of each person is determined by their unique characteristics. Do not let the conventional standards of beauty pull you down. Know that you are unique and beauty is not necessarily an external but an inner state of mind. Stay with those who care for you : You might see the need to sacrifice your happiness for others in some instances. However, if you find yourself doing that 8 out of 10 times in any relationship, it is time to seriously reconsider how you wish to live. Is your happiness being taken for granted? Are you running this relationship because you are afraid of being alone, knowing that it is going nowhere in the future? Those who care for you will show it through their actions. The best way to love yourself is by being able to see yourself through their eyes. Take care of your body :  Get adequate sleep daily and make sure your body gets lots of nutritious food. Don't let the advertisements decide the needs of your body. Try out different cuisines and let your body tell you which one it feels is most suitable. Exercise moderately everyday by taking a walk in a green area with your loved one (Remember that the point of exercising is not only to lose weight, but to sweat away your stress daily in fun ways!) Follow your heart : Do what you love. There is nothing that could harm your emotional well-being more than doing something which you know is not right and which you do not want to do. Confucius has dropped us a fortune cookie of happiness when he said that in choosing a job you love, you will never have to work a single day of your life. Get a pet companion :  Adopt an animal and take care of it. In taking care of the pet, you will realize and gradually get in touch with yourself, becoming aware of who you are as a human being. This could be the starting point of discovering your true potentials. Volunteer at social services : Let your creativity and emotions flow by connecting to those around you. Depending on your interests, choose a type of social service - old age home, orphanage, animal shelter, being with terminally ill people, and so on. Such activities will help to positively channelize your emotions.
How to say 'Bye' to split ends? Check out these 10 tips!One of the main reasons for split ends is the use of curling irons and other heat-induced styling treatments. When you go for hair products like hair colors or perms, the shield over your hair's shaft that protects it can get stripped off, thus making your hair liable to split ends. You could also be mechanically stressing your hair by pulling them too much while combing or combing repeatedly. Remember that rubbing your hair up towards the direction of the scalp does not lead to split ends. While there is no remedy to treat split ends, there are ways in which you can keep them away. Did you know that a medical research showed that the only way to keep split ends away is to put a stop on the excessive use of chemical on it? Hairdresser, Holly Kensen, says that split ends are the results of pushing out the natural process and pulling in too many chemicals. It is best to stay away from the styling products and embrace your natural hair! TIP 1 : Get hold of a piece of rosemary (fresh ones are the best!) and immerse them in a cup of hot water for 30 minutes. Once the temperature of the water is back to normal, whisk an egg into it. Mix this blend onto your hair. Rinse after 15 minutes using a light shampoo. TIP 2 : Bring home a ripe papaya and cut it into halves. Choose the part which you believe will be sufficient for your hair. Take off the skin and seeds. Mash it until it becomes a paste. Then, drop a cup of yogurt and stir them into a smooth paste. Apply it on your hair and let it hold for about 30 minutes. Use cold water to rinse it off. TIP 3 : Condition your hair with castor oil. Mix equal amounts of castor, almond, and olive oil and apply it on your hair generously. Wrap your hair in a towel and let it stay for 30 minutes. Then, shampoo your hair. TIP 4 : After you have shampooed your hair, apply a mix of cream and milk on them for about 20 minutes. Focus especially on the ends. Rinse your hair with cold water. TIP 5 :If you decide to trim your hair on your own, then don't use the paper scissors! They are called 'paper' scissors for a reason. Get hold of hair shears which will not leave your ends damaged. TIP 6 : Trim your hair every six to eight weeks at least up to ¼ to 1 inch. Due to our environment, it is natural for the hair to get damaged in a few weeks. It is important to remove the split ends and let them grow healthy. TIP 7 : Do not trust products which say that they can 'cure' your split ends. Split ends are not curable. They are preventable. The only thing that these products do is to seal up the splits which only makes your hair unhealthy. TIP 8 : Try to stay away from chemicals as much as you can. Chemicals only tamper with your natural hair and ruin their texture. If you really have to use it then make sure you condition them regularly. TIP 9 : Use coconut oil to fix your split ends. Buy an extra-virgin and organic coconut oil. Before washing your hair, apply about 2 spoons of the oil on your dry hair. Emphasize on the hair ends. If you want, you can steam your hair for some time (about 20 minutes). Then, wash your hair with a light shampoo and condition them. TIP 10 :This is one of the best ways to help your split ends stay away: Get hold of chamomile tea and brew it on a pot. Then pre-rinse your hair with it. After you have rinsed them, wash and condition your hair normally.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
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.
Advantage of the average - Automated continuous blood pressure monitoring technologyAlthough mercury sphygmomanometers (though a deadline is set for them to be phased out due to environmental concerns) are still considered the gold standards, the Aneroid and Digital counterparts represent the future of blood pressure monitoring. The need of long-term blood pressure monitoring arises with disorders and health conditions that demand more attention from the medical teams. Experts say that the fluctuations in BP in conditions like cardiovascular diseases, pregnancy, etc., if tracked at regular intervals, can reduce 22% of risks due to delay and no treatment. This necessity pushed the invention of invasive arterial blood pressure to be used during surgical procedures and further a continuous noninvasive arterial pressure measurement (CNAP) system. There have been multiple researches to overcome some of the roadblocks in measuring the arterial blood pressure in the noninvasive and external approach. Among these developments, the need for measurement of mean blood pressure was felt and the 24-hour BP variation in the patient was taken into account. The 24-hour model eliminates the errors in readings taken during clinic visits due to factors such as fluctuations as a result of white coat fear or after-effects of some stress or exertion. Trendsetting New-age Technology : In 2004, the medical world received the BpTRU non-invasive automatic blood pressure monitoring device. BpTRU devices proved to be a superior and more precise alternative when compared to other manual BP assessment techniques and even other 24-hour ABPM alternatives. The automated oscillometric devices precision and accuracy of assessed BP and heart rate is earmarked with a unique automatic technique - the device records 6 consecutive BP readings of the patient, discards the earliest, and the rest of the five values are put to average function and instantly the resultant mean BP reading flashes on the screen. Compatible with guidelines of American National Standard/Association for the Advancement of Medical Instrumentation (ANSI/AAMI EC13:2002) this is a time-saving, portable, and user-friendly device. A compact and automatic wrist cuff BP monitor, the smart blood pressure monitor that can be synchronized with with Apple’s iOS devices and a Bluetooth connectable and Android compatible blood pressure monitor marks the revolution of CNAP in modern times.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
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.
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