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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.
Smell like roses, without the thornsYou bathe regularly and use the best possible deodorants, underarm anti-perspirants, panty perfume but the bad odour just doesn't go away. Pat yourself dry Very often you have a leisurely bath with scented bubbles and what not but when it comes to drying your body thoroughly, well you just pat yourself quickly, for you are in a hurry. The moisture on your body then attracts bacteria with fungi and they cause that embarrassing mouldy kind of stench on your body. So make sure you dab yourself thoroughly dry all over your body. Especially in places like the lower back where it is difficult to reach without some really flexible shoulder joints. Use the archer's swipe (The towel extended between the right hand over the head with  the left hand extended back to form the bottom grip, which looks like an archer reaching for a bow from the quiver). In case you are endowed with love handles and folds of fat then be generous with the patting, as those are the parts most susceptible to host bacteria. Change clothes often If you wear the same set of clothes and lingerie then you are surely going to have an odour which is lingering. So for those ladies who occasionly wear the same set of clothes without washing, the sweat is going to accumulate in there and raise a stink. Remember the Celine Dion song? It's a new day, a new start! Menstruation + Stress = Bad smell There is nothing that you can really do about your periods. Instead, try and be a little more extra careful during those 4 days. You can have an extra jab at the deo bottle or perfume lotion. However stress, nervousness and fear also leave chemical traces which come out along with the sweat. This adds to the bad odour. Humble pie for dessert? What you eat also affects the way you smell. Go easy on the garlic, onion rings and fish for they can make you smell slightly worse than an open sewer. Always rinse your mouth after eating and use a good minty mouthwash if at all you choose to pepper your meal with onion and garlic to ward offthe evil eye. You can add conditions like diabetes to cause a fruity kind of odour. Well in that case make sure you exercise regularly so that the skin sweats out the toxins. In case you are the extra-sweaty types then use medicated soaps or ensure you use steam baths regularly to keep your skin pores open.
The post-delivery bluesA baby being born is cause for celebration. Especially in a country like India, where the family ties tend to be close, there is a festive atmosphere at home. However, sometimes the mothers may not share the same enthusiasm. This wave of negative emotions in the middle of what is clearly a happy occasion can be confusing for the new mother. Interestingly these feelings are not abnormal, as many new moms face postpartum depression, which is also called baby blues. It is an emotional reaction that begins a few days after delivery and lasts not more than 2 weeks. What are the symptoms of postpartum depression? Feelings of anger or irritability. Lack of interest in the baby. Lack of appetite and sleep disturbance. Crying and sadness. Irritability or hypersensitivity. Feelings of guilt, shame or hopelessness. Loss of interest, joy or pleasure in the things you used to enjoy. Possible thoughts of harming the baby or yourself. What are the causes of postpartum depression? Postpartum depression can occur due to a combination of factors. Hormonal changes: Changes in the level of hormones can leave you feeling tired, sluggish and depressed. Changes in your blood volume, blood pressure, immune system and metabolism can contribute to fatigue and mood swings. Emotional factors: Feeling overwhelmed with the new arrival in the family, and taking care of the baby day and night, may leave you sleep deprived, overexerted, and anxious. New mothers also feel that they look less attractive after pregnancy. You may feel that people around you are concerned with the baby more than you, and that you are being neglected. All these emotional factors may lead to postpartum depression. Other factors: Issues like breast feeding, financial strain, and relationship troubles can also contribute to postpartum depression. How does one deal with postpartum depression? Take complete rest and sleep for sufficient hours Spend quality time with your husband Go for healthy diet Take morning or evening walk for fresh air Try to follow yoga or other exercises Share your feelings with your husband or friends Do not overexert Join some groups for new moms Go for individual therapy or counsellors Remember, postpartum depression is not an incurable problem. It is just a temporary state of mind, which can be overcome if you are sufficiently aware of the problem.                
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Afraid of the dark? understand your fear and cure it!Scotophobia, more commonly known as Nycotophobia, is a psychological illness, where the patient is afraid of the dark. Children are more prone to this fear, though it does affect quite a few adults as well. The dark often represents insecurity and uncertainty to children, and it symbolizes their entrance into an unknown territory. If the children are alone during their first few encounters with darkness, the absence of parents (who exemplify safety), tends to amplify this crippling fear. While most of us do actually possess this fear in relatively small amounts, as we grow up the fear diminishes. However, there are those of us who might carry this fear of the dark into their adulthood and in such cases, the fear is usually accompanied by quite a few intricate issues. People often tend to externalize a set of conflicting feelings about a certain situation, towards something else. For instance, you might be worried about your children; but your mind may externalize this fear, via your inefficiency at work. This process is called externalization. So, when it comes to the root of your fear of darkness, it is possible that at some point in your past, you experienced something untoward, which through externalization, inculcated this fear of darkness, deep into your psyche. Evolutionary Ties to Darkness: Many scientists have pointed out that this phobia might be linked to the process of evolution. Since predators hunt for their prey at night, we might have inherited this fear of darkness from our ancestors, who believed that darkness was a space where they could be attacked by wild animals. However, recent studies have shown that  Scotophobia begins at approximately the age of two in children, and thus, it cannot be said to be innate to us. In a study done by Ryerson University involving over 90 students, it was found that people who are afraid of the dark, are more likely to be poor sleepers, than those who are not afraid of it. More interestingly, it was discovered that any kind of noise made while the people with this phobia were asleep, frightened them the most.. Symptoms of Scotophobia: The first symptoms of this fear are the resistance to visit dark places and the yearning for company when such situations arise. However, many a times adults who are suffering from this fear, do not reveal it due to the added fear of embarrassment and this, sometimes, results in outbursts of rage when they are forced to go out for an event at night, or to confront the dark under any such circumstances. A person battling this fear may experience panic attacks, sweating and trembling prior to, or while staying in the dark. The blood pressure also rises, accompanied by chest pain and lastly, a difficulty in breathing. Diagnosis of Scotophobia: In children, this fear can be easily verified by their behaviour. However, adults might require further assistance, due to their natural resistance to openly admit to such a fear. Scotophobia can be diagnosed through a comprehensive psychiatric evaluation. Following this, your psychologist would be able to give you an idea of the source of your fear as well. Pursue a course of treatment immediately after the discovery of the phobia, which will ensure a faster and more effective recovery. Treatment of Scotophobia: The process of 'desensitization' is most commonly used to help with such a phobia. In this form of treatment, the patient is slowly exposed to the object of fear, in a situation where she/he will not feel vulnerable. This is done by asking the patient to confront the dark along with another individual who symbolizes safety for him/her. This could be a parent or a friend. Night lights can also be installed to gradually reduce the fear. You may try certain breathing exercises, which will reduce the panic attacks that accompany this fear. Hypnosis has also been said to be very effective in dealing with this phobia. If your psychologist sees fit, you might be also prescribed some medicines; antidepressants are given in some cases. Joining a self-help group is also a good option, in addition to your psychological treatment.  
Crave for non-food substances to put in your mouth? Go ahead take your pica!We all have strong cravings in some form or the other, especially for food. Just thinking of a chocolate cake or ice cream can set the mouth watering and the hand creeping to open the refrigerator. However, some people have an unusual craving and it is to consume non-food items. Everyone knows that children are known to eat chalk, dirt or lick walls but at times, even adults have this unusual craving for non-food items. This condition is termed as 'Pica'. One can understand a child popping something into its mouth as it's discriminatory skills are not developed, but what about fully grown adults who have this habit? Is it a mental ailment? One can't really call it a full blown mental condition as it occurs commonly in pregnant women. The cravings are as strong as any other food craving and sometimes these people go out of the way to satiate their cravings. So, right from paint thinner, to chalk to ink, ice, plaster, paint, linoleum to plastic bits can form the obsession or craving. Pica is a combination of psychological and biochemical processes and is generally a deficiency which sets about these intense cravings.  When pica strikes pregnant women, then it could be a cause for much concern and the doctor should be kept informed. While it is easier to indulge a pregnant woman's ice cream cravings if she also develops a thing for iron fillings on top of her ice cream, then obviously it can be a rather dangerous thing to do. Ice and chalk are comparatively harmless and other than affecting the teeth and the taste, do nothing much else, but what about turpentine and toxic materials? They can definitely interfere with the body's digestive processes and can even spread harmful toxins in the body to cause blood poisoning, intestinal infections, bowel blockages and lead poisoning or arsenic poisoning.  If you have such strong non-food cravings then before you give in to them talk about it to a medical practitioner. It could well be an iron deficiency or perhaps even anemia which is attracting you to chew pencils up or making you pop dirt in your mouth. If you are pregnant then certainly the doctor will need to address the underlying issue and ensure that the pica goes away before you deliver. Wouldn't want you chewing up the baby's soother now would we?
Diet to help manage stressYou cannot avoid stress, as it has now become an integral part of modern lifestyle. Children are worried about their exams and performances in the cultural events, teenagers are stressed out about their looks and body shape, adults take stress owing to competition at work, and so on. One thing is sure that you cannot stay away from stress. So, how can you avoid the side effects caused due to stress? You can include certain foods in your diet that help manage your level of stress. Researchers are already on to it, studying the effects of various foods on the stress levels. It is always better to choose from the organically harvested nuts, veggies, fruits, and fish for better health benefits. Nori Sushi nori is a type of seaweed that is rich in magnesium that contains anxiety-fighting properties. Magnesium is also known for stress reducing abilities. Apart from this, it also carries other essential health nutrients that are necessary for the overall development of health. Vitamin C Foods Cantaloupe is composed of vitamin C that is a renowned stress buster. Another great stress busting food is orange. When you are under stress, adrenal glands in your body start producing cortisol that lowers your immune system's capacity. This leads to breaking down of muscle tissue. Vitamin C in oranges have the ability to return the high blood pressure to normal level. Moreover, when you are stressed there are chances of this vitamin getting used up and hence the need to increase your intake of vitamin C rich foods. Another popular vitamin C enriched food is blueberries that are also packed with lots of antioxidants which relieve stress. Almonds Almond is a treasure trove of essential nutrients such as vitamin E, B2, zinc, and magnesium. Although they are high in fat, they provide your body with all these essential nutrients. You can easily have a handful of almonds every day and still feel less guilty about.  Apart from the fat, energy, and the essential nutrients, almonds give the brain and its memory a shot in the arm. Broccoli Broccoli is rich in vitamin B and folic acid, both proven stress busters that helps in giving you relief from panic, anxiety, stress, and depression. Bananas Bananas contain one of the most important amino acids - tryptophan that gets transformed into serotonin which is a stress-busting hormone that is known to induce a feeling of well being. This makes you happier and gives you relief from stress. Banana is also rich in potassium. Potassium regulates the heart due to which the blood pressure can be kept under control. That is why many health experts recommend inclusion of a potassium-rich diet, as it normalizes your heart rate and help you calm down in stressful situations. This makes banana an essential food addition to your diet. Chocolate The dark chocolates are bitter and give you a feeling of satiation despite the little amount you devour. Due to this feeling, you eat less, but you still enjoy the flavor of the chocolate, much more than the milk chocolate varieties. When you are under stress, most of your body organs are vulnerable to damage. The antioxidants polyphenols that are present in the dark chocolate slow down the damage and also contribute in its repair. Studies have also revealed that 40 grams of dark chocolate per day helps reduce stress-causing hormones such as catecholamine and cortisol. Increasing the intake of stress busting foods in your daily diet can help control diabetes and hypertension.
Hypertension and Vitamin DVitamin D is one of the essential vitamins that are required for strong and healthy bones. The body synthesizes it in the skin from cholesterol when there is adequate exposure to sunlight. Over the past decade, vitamin D has been intriguing medical researchers the world over. Several studies were conducted and interesting results found. One of them being that vitamin D may be implicated in influencing blood pressure levels. As per studies conducted, it was found that low levels of vitamin D lead to high blood pressure levels. People living in high altitudes where sunlight is at a minimum level were found to be hypertensive. Also, the winter season showed an increase in hypertension cases which was again attributed to the low sunlight levels. What exactly does vitamin D do to affect the blood pressure? Renin is an enzyme secreted by the kidneys that constricts the blood vessels and increases the blood pressure. Vitamin D acts by inhibiting this renin. Insulin resistance causes high blood pressure, which is why hypertension often has co-morbidity with diabetes mellitus. Vitamin D helps in improving the body's sensitivity to insulin. Calcium deposits on the arterial walls harden them and make them lose their elasticity leading to an increase in the pressure of blood flowing through them. Vitamin D helps the body to better absorb and metabolize the calcium. The role of vitamin D in strengthening bones is very clear. Though the studies have shown that people having deficiency in vitamin D tend to develop hypertension, the role of vitamin D in this case is still not very clear. Also, whether vitamin D supplements help in lowering blood pressure levels is still to be found out! But all said and done, the research findings cannot be ignored. Moreover, a morning walk is beneficial in many other ways as well! So, get up early, put on your walking shoes and say Hello to the sun! Vitamin D alone will not help you control your BP. You need to keep taking the medications along with the other dietary and life-style changes! An early morning walk is a blessing for the whole day!
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.
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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