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Health check up checklist for men Prostate Cancer - Prostate cancer is the lesser known killer in men. It is a slow growing cancer, but at times, its symptoms can be aggressive as well. Detecting prostate cancer at its onset can help in treating it effectively. Tests include a digital rectal exam and a blood test for Prostate Specific Antigens (PSA). Testicular Cancer - This uncommon cancer can affect any male between the ages 21 to 55. A physical exam during yearly medical checkups is recommended for all men. Men having a higher risk, with family history, should speak to their doctors regarding additional tests for screening. Self-examination through regular gentle palpation of the testicles to notice any change in shape or size, presence of lumps is also suggested by doctors. Colorectal Cancer - This is the second most common cancer in men. Men over 50 and younger, if they have a familial risk, are suggested to get a screening colonoscopy done to detect this cancer. It usually starts as a polyp that grows and invades the nearby areas to develop into a full-blown cancer. The polyps, if detected early, can be removed and cancer prevented. A CT scan or a double barium enema can also help in detecting polyps. High Blood Pressure - With the kind of lifestyle men lead today, almost every other man is bound to have BP issues. Regularly checking the BP is essential as it helps detect high BP which may lead to a variety of other problems including stroke and heart attacks. The sooner the detection, the sooner the measures for control. Cholesterol Levels - Bad eating habits, sedentary lifestyle, and mental stress can all lead to lots of cholesterol roaming around in your arteries. This will eventually clog the arteries and cause diseases like high blood pressure and atherosclerosis which can be life-threatening. Get your total cholesterol, LDL, VLDL, HDL, and triglyceride levels checked regularly and initiate timely interventions to bring them under control. HIV - This is the most commonly spreading STD among men. Due to its chronic nature, HIV is often detected accidentally when it may be too late. Regular tests for HIV detection are essential if one is physically active with multiple partners. Be safe though and use a condom. Glaucoma - It is extremely common and is one of the leading causes of blindness. Glaucoma has no cure, but it can be controlled well with timely detection. Screening tests should be undertaken by men under 40 years at an interval of 2 to 3 years after 35. A yearly test is recommended for older men.
Strict parenting: When enough is enoughThe strict or authoritative style of parenting is where the parents hold their children's lives over a tight leash. Strict parents are high in control and low in nurturing qualities. They set high standards for all activities and expect strict obedience to the rules set by them. However, these parents display little or no warmth and affection. They love and affection they offer is also conditional love based on obedience and performance. Children of authoritarian parents turn out to be obedient, but this obedience is based on fear. Such parents very often use shame and guilt to make their children change their behaviour. They don't encourage verbal give-and-take and expect their orders to be obeyed without question. The children brought up in such a way are initially very obedient and polite but later all the suppressed emotions find an outlet. More often than not, such children end up being aggressive and tend to be bullies at school. Research shows that fathers who are extremely strict with their sons end up making their sons violent and aggressive, or indulge in non-physical aggressiveness like name calling. Strictly raised children have difficulty relating to their peer group. They either end up being aggressive or completely timid and submissive. At school teachers rate them as less socially competent, average or poor at studies and extra-curricular activities. They are also less accepted by their friends. The school dropout rates in such children are very high. Studies conducted on such dropouts revealed that they suffered from a huge inferiority complex and low self-esteem. Strict parenting can cause several problems in adolescence too. Children who are dominated by their parents are often found breaking the law. Alcohol and drug abuse rates are high in such children. Psychologically, these children are usually poor decision makers. Having had their parents make decisions for them all their lives, they find it very difficult to take a stand. They end up being indecisive. At the workplace too, they lack the competency to take up initiatives or show the lead. They make better team members than team leaders. Even if presented with an opportunity, they are likely to shy away from responsibility as they feel inferior and lack the requisite courage. Strict parenting can have a negative impact on the child's weight too. Studies show that an overly strict upbringing has a negative impact on weight because the children often fail to learn to eat on the basis of hunger and satiety. In such families parents use food as a reward, insist that children clean their plates, or restrict the kind or amount of food a child can eat. The studies showed that the children of authoritarian mothers were nearly five times as likely to be overweight compared to their counterparts!
Pamper the newborn without forgetting yourselfIf you are a new mom, chances are you are busy 24/7. The baby's complete dependence on you helps you bond with him/her and makes you aware of the responsibility that is now on you. But, your own health is an equally important responsibility. So, you need to give yourself permission to take care, or even pamper yourself from time to time. Here are simple ways for you to look out for yourself. Eat your favorite breakfast: As your day starts, you need fuel to keep your energy levels high. So, grab your hands on healthy and tasty breakfast options like whole grain cereal, skim milk and sliced strawberries or a banana. The combination of lean protein, whole-grain foods, and nutrient-rich fruit allows the brain to form more feel-good chemicals. Don't let stress come near you: We know that a lot of changes in your life have transpired, due to the entry of a baby in your world. The difficulty to cope with the changes may cause stress and depression. Try to avoid stress by asking for your husband's and relatives' support. Take a walk with your baby: Walking with your baby in nearby parks will give you fresh air and it is an excellent form of exercise. Don't be sleep deprived: Having a baby doesn't mean that you have to always sacrifice your sleep. Never miss an opportunity to sleep or take rest. This will keep your energy levels high for the day. Sleep when your baby sleeps. Delegate baby care: Parenting is not your sole responsibility. Ask your husband to lend a hand in taking care of the baby for some time. Not just the husband, if you live in a joint family, you can ask other relatives for help as well. Don't be a multi-tasking person: We know a woman has so many roles to play. But, it doesn't always have to be that way. Being a new mom, you must focus on one activity at a time. You can prioritize your tasks, if you have a lot of things to do. Exercise regularly: Add exercise to your daily routine. Choose the exercise which you love and enjoy, like walking, cycling, yoga, swimming or aerobic dance. Consult a doctor before starting any exercise program.    
Making babies, the best way!Some couples get pregnant easily. But many couples have to wait months before the baby is conceived. There are several factors that affect conception right from fertility to the position during intercourse. Some believe that positions have nothing to do with conceiving a child. This is not true. Some positions are ideal to help the sperm meet the ovum. Let's see what some of these positions are. Missionary position:The best position for getting pregnant fast is the missionary position.Here the man is lying on top of the woman allowing for the deepest possible penetration, making it possible for the sperm to get deposited closest to the cervix. It is also the most common and comfortable position preferred by couples. Raise your hips high: Your hips have a lot to do in helping you get pregnant. Raise your hips high during sex by placing a pillow below you. This helps to expose the female cervix to as much semen as the male can release. Doggy position: Considered to be the most erotic and pleasurable position,this rear-entry position where the man enters the woman from behind is also recommended for increasing the chances of getting pregnant. In this position too, the sperm is deposited closest to the cervix, thereby increasing the chances of conception. Side-by-side: You can also try having intercourse while lying side by side. This position, likewise, causes the most exposure of the cervix to the male sperm. While these positions certainly improve your chances of getting pregnant, there is no guarantee that you will conceive. The most important thing is to enjoy this special time and have fun with your partner. So keep enjoying and keep trying!
Your child is ready for school... but are you?It was still okay. Just 2-3 hours which you could utilize for other things while your child was away briefly. Now you will have to compete along with teachers, textbooks and homework for your child's attention. Well Mother, we know this is going to be difficult for you, but let's see if we can try and make it any easier. Think of school as an extension of the tender loving care that you provided. The only difference is that the TLC will go towards nurturing and developing his/her brain and help it learn important skills which will help gain a balanced development. At this point your child feels bad and completely unsafe in this new hostile world of teachers and uniforms and what not! If you weaken at this point your child will cop on and then will come the emotional blackmail. So explain the importance of school to your child as it will make the transition easier. It is always good for mothers to accompany their children to school but imagine watching mother walk away and all hell can break loose. So if your child's school has a school bus facility you can walk him to the bus stop and then say your goodbyes there. A lump in the throat at the bus stop is preferable any day than a scene at school with a child holding on to mother for dear life. Do not criticize your child's school or assignments given by them as children can catch on quite quickly and that can be reason enough for them not to concentrate on school activities. Always encourage your child to talk about what he did at school and ask him questions about his friends and teachers. This gives the impression that school is as important as home and gradually even you will reconcile yourself to the fact that school is here to stay.
Expression forbidden! - Human emotionsSome people have a perpetual 'bee in their bonnets'! They maintain a demeanor and a mask which is virtually impenetrable. They are generally highly competent and efficient and occupy high positions of authority. They believe in living life set to a routine, and the worst part is that they expect others to adhere to it as well! God help those who have a boss like that, as their immediate liberty is at stake, and unless they are honing to be perfectionists, life is going to be a series of disasters with Captain Ice around! Nothing wrong with perfectionism per se, but when someone is a hard task master then he could well earn himself the epithet of being "a crashing bore," especially if he doesn't allow others to express themselves properly. Take a more intimate scenario - Mr. Bright Harry meets tepid Sally. The sparks fly only on Harry's side with Sally stonewalling his every effort to get to know her mind, body, and soul. A tough ask for poor Harry, as he is yet to touch first base with Sally. Know what? They have been married 5 years and she seems to be fond of him, yet has never as much admitted it to him. Quite frankly, the two could pass off for siblings rather than 'man and wife.' Why are some people such rotten spoilsports, especially where emotions are concerned?  It may well be a natural mindset for some to have an emotional guard up and emote, or have an emotional connect only with certain types of people. Fair enough and good show, we say! After all one can't be wearing one's emotions on a sleeve or you end up been taken advantage of. That's a mask that most 'tough guys with soft centre' wear anyway. Nowadays with the rules being somewhat relaxed with men been given liberty and allowances to display their gentler feminine emotional side, we find men going over the top with the sheer display of emotional expression. One is at sea wondering which one was worse off-the tough, cynical cop look or the "let me weep my heart out for you" kind of contrived emotion. That apart, it is bad enough for us having to contend with a person who has difficulty with expressing himself properly. We don't mean articulation or even well-developed linguistic ability - we mean being able to be spontaneous and congenial and a little forthcoming and nice to be with sort of an emotional person. So, unless someone has a romantic angle towards this guy (there are weirdoes all over the world, who go asking for it!) or girl, he is going to be feared, hated, despised, unloved, and uninvited by everybody. So why do people behave like they are going to be flogged for even attempting a ghost of a smile or a cheerful greeting to a fellow co-worker? Why do some people find it difficult even to open up on a psychiatrist's couch? The Mask The most common reason for Mr. or Ms. Grumpy is that they have probably been emotionally brutalized in their formative years by an authoritative parent and this has caused them to lock themselves up double quick in a shell and throw away the key. Now, that can be tough and extremely painful. It is a prison of their own making through which nobody can see that once bright-n-chirpy personality frozen, much like the curse of the wicked witch in those fairy tales we read. The person is dying to let his emotions out and let people see who he is, but since very little light escapes out due to the tough mask and veneer, that it is an uphill task. Then the sheer anger at not being understood, subconsciously plays havoc and then he gets to be the more demanding boss at work or that sullen wife or lone stranger staring in to nothingness on the park bench. These are the people that have a series of relationship disasters as their defence mechanisms are too solid to be penetrated. Some people may be naturally distant, and for them the finer and higher emotions probably don't register as much as they do in the average person. These guys are cut out for careers ranging from lighthouse keepers to morgue attendants to hangmen, where being emotional has no place. There are still others who swing the other extreme by showing so much of emotion that it is scary for others to take them on. Their emotional side is so overwhelming and demanding that it is actually a clever subterfuge on their part to drive people away as they subconsciously do not want people to get to know their real side. They generally don a mask of humor and good cheer and are great fun to be with. In reality, they are alone and scared and perhaps hurt emotionally. So, they feel safe to display emotions to masses rather than individuals. These people make good evangelists and rock stars as they can safely display and get an emotional discharge without running the risk of a one-on-one emotional exchange where they are afraid they would be hurt. If you encounter such a person who looks askance at you displaying your emotions, then it is better for you to talk things out and maybe put things in perspective. Of course, this all depends on whether you are emotional enough to maybe give someone a chance by understanding what drives them to do the things they do. Let me assure you the ice will thaw if the intention is genuine and well meant.
High fiber foods and their benefitsFiber has many health benefits and that is why it is important to include fiber in your diet. However, if you are not used to fiber in your diet then introduce it slowly or it could cause indigestion and gas. Fibers are good for overall health and help to boost the immune system and help prevent a number of diseases. The digestive health benefits of fiber : If bowel movements are regular, then fibers will prevent both constipation and diarrhea. Regular movements flush out excessive cholesterol as well as harmful toxins from the intestines which could also be carcinogenic. Fiber helps to reduce inflammation of the intestines, could bring relief from irritable bowel syndrome and prevent piles, ulcers, and acidity. The benefits to the heart Soluble fiber is good for the heart. Fiber reduces the bad cholesterol levels (LDL). It helps to lower blood pressure, improves the levels of good cholesterol (HDL). Fibers reduce the risk of stroke also. These factors are good for heart heath. Weight Loss Fiber can help you to lose weight as it makes you feel fuller for longer which means you will eat less. High-fiber fruits and vegetables have lower calories, so by adding these to your diet cuts calories which could aid in weight loss. Eat 21 to 38 grams of fiber per day depending on your age and gender. Diabetes If you already suffer from type II diabetes then you should have soluble fiber as it slows down the absorption of sugar and can help to maintain blood sugar levels. Regulating blood sugar can also reduce the risk of kidney and gallbladder stones. Cancer prevention Though research is still ongoing, but the general conclusion is that eating fiber foods keeps the colon in a better condition and this could prevent colon cancer. However, it does prevent digestive tract cancer. The more fiber you eat the more fluids you should drink as that helps to absorb fiber better. Good for the skin Eating fiber is good for the skin as they help to flush out toxins from your body which otherwise cause acne. Besides eating a lot of fruits and vegetables produce antioxidants that are good for your skin. Some tips Start your day with fiber as it keeps you full and sugar levels just right to keep you energetic. Try to replace white rice, bread, and pasta with brown rice and whole grain products. Eat seeds, nuts, and flaxseeds either whole or ground and sprinkle some on fruit, yoghurt, or cereal. Add beans and legumes to your diet as often as possible. Eat whole fruits instead of juice. Insoluble fiber can be found in foods like whole grains, wheat, cereals, and vegetables such as carrots, celery, and tomatoes. Whereas soluble fibers are found in barley, oatmeal, beans, nuts, and fruits such as apples, berries, citrus fruits, and pears. Foods like meat, dairy, and sugar have no fiber and some foods like white rice, white bread, and pastries have no fiber either because it has got removed because of refining.
21 foods for a healthy heartFollowing is a list of heart-healthy food substances: Garlic: Did you ever think that the commonly available garlic in your kitchen can be heart healthy? It may be smelly for some, but for the heart it is a soothing substance. Garlic is known to control blood pressure, serum triglyceride level & cholesterol level. Carrot: Carrots, though taste sweet, have the ability to control blood sugar levels because of high level of antioxidants in them. So include carrots in your diet, especially in salads. Orange: This juicy fruit has cholesterol-lowering ability because of fibre pectin in it and also helps control blood pressure. Almonds: Though all nuts are believed to be nutritious, almonds are considered to be heart healthy. Almonds are rich in vitamin E, calcium, plant sterols, fibre and antioxidants. Almonds help in lowering LDL cholesterol and reducing risk of diabetes. Walnuts: Walnuts are rich in omega 3 fatty acids, monounsaturated fats which help in lowering cholesterol levels.  Oatmeal: Oats are very healthy & help in lowering the bad LDL cholesterol. You can have one bowl of oatmeal mixed in milk along with nuts as breakfast. Flaxseed: This honey coloured shiny seeds contain substances which are heart healthy, such as lignans, ALA and omega 3 fatty acids. It helps in lowering cholesterol level and controlling diabetes. Tofu: It is a type of soybean protein which can be replaced with paneer. Tofu is rich in fibre and polyunsaturated fats which prevent clogging of arteries.  Barley: The fibre in barley is believed to lower cholesterol and blood glucose levels.  Tuna fish: Tuna fish is rich in omega 3 fatty acids which helps in lowering cholesterol levels.  Salmon: It is very good for heart as it is rich in omega 3, EPA and DHA. It lowers and reduces the risk of inflammation in arteries. It is also believed to maintain the ratio of good cholesterol to bad cholesterol. Red wine: Red wine contains catechins and resveratrol, good for heart health.  Black beans: They are a rich source of magnesium which helps in lowering blood pressure. It also contains folate, antioxidants and fibre which is helpful in controlling blood sugar and cholesterol levels. Fresh herbs: If you are hypertensive and want to control your salt intake then try using fresh herbs as a substitute for salt. It also contains antioxidants which are good for heart. Herbs include rosemary, sage, oregano and thyme. Extra virgin olive oil: This is rich in heart-healthy polyphenols & monounsaturated fats. As it's very costly you can use it as a topping for bread or salad. Sweet potatoes: White potatoes are believed to increase glycemic index so you can replace them with sweet potatoes. It is heart healthy as it has low glycemic index and also contains fibre, vitamin A and lycopene. Low fat yoghurt: You can include this in your breakfast safely as it contains calcium & potassium which helps in lowering blood pressure. Dried cherries: They are rich in anthocyanins and antioxidants which help in neutralizing the action of enzymes which cause plaque formation. In winter you should opt for strawberries, blueberries for a healthy heart. Cayenne chili pepper: Your blood sugar normally increases post a meal. By sprinkling cayenne chili pepper over your food can help preventing insulin level spike post meals. Hot cocoa: Coffee helps in patients with type 2 diabetes. Hot cocoa contains antioxidants helpful for heart. Kosher salt:  This is very beneficial for heart patients as it contains half the amount of sodium as compared to table salt and thus helps in controlling high blood pressure.
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 link between oral sex and cancerSymptoms of oral cancer: The common symptoms of oral cancer include: Red and white spots on the tongue or the lining of the mouth, inflammation of the mouth which continues well over two weeks, mouth ulcers which take over three weeks to heal, discomfort and pain during swallowing food, and lastly, sensation that something is stuck in the throat. HPV types and their nature: There are over 100 different types of HPV. Out of these, 15 have been found to cause cancer. These 15 types of HPV are called high-risk HPV. The HPV types which are found in the mouth are sexually communicable and the primary means for its transference is considered to be oral sex. It could also be carried through anal and vaginal sex, causing laryngeal cancer, anal cancer, cervical cancer, tonsil cancer, vulval and vaginal cancer, and penile cancer. Some of the HPV types get passed through skin contact. These cause warts, especially in the genital region. These types of HPV which cause the warts are less likely to escalate and cause cancer. Though there is no determinate answer as to how common the HPV mouth infection is. Advanced studies during the 21st century have put forward the role of HPV16 in new types of cancer. This was done using DNA testing. Through a medical study, it was found that the most vulnerable groups are: People in the age group of 30 to 34 and 60 to 64 years old. People who have had over 20 sexual partners in their lifetime, around 20% suffer from HPV oral infection HPV leads to cancer?: HPV does not directly cause cancer. It stimulates modifications in the cells which it has infected, like those in the mouth or cervix and due to the modifications the cell becomes cancerous. In only 10% of the cases where the patient suffers from HPV infection does cancer develop. The infection generally treats itself and is removed naturally within 2 years by the body. The chances of progression of the HPV infection into cancer is increased by smoking and drinking. Smoking injures the immune surveillance cells. Due to this injury, they are not able to fight the virus and the virus continues to persist over 2 years, leading to cancer. Vaccinations: In the United Kingdom, girls (aged 12 and 13 years old) are vaccinated against HPV. This vaccination protects the women against cervical, vulval, and vaginal cancers. Men and boys also take vaccinations against HPV, though it is not pursued as strongly as in the case of women. This leaves men who have sex with other men at a greater risk of getting oral and anal cancer. Even though the link between oral sex and cancer is not completely proven, what we do know is that oral sex causes many other infections like gonorrhea, herpes, syphilis, and chlamydia. Did you know that a very low percentage of people (only 10%) who are infected with HPV virus develop cancer? In 90% of the cases, the infection is naturally cleared by the body within two years. The natural process is, however, obstructed in those who smoke and drink.    
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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