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Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
Fairness scream: The new male obsession"Mirror, Mirror on the wall, who's the fairest one of all?" The words at once evoke images of the evil queen as she strikes a vain pose at the looking glass. However, these days one needs to be more accommodating and make way for a preening gent to put forth the above query. All these days, fairness would be a quality an Indian male would look for in his wife. Just see the Fair & Lovely ads to know what we mean. But today, this very obsession has turned on itself. More and more men are being just as exacting about their own skin color, complexion and tone as their female counterparts. Just take a look at all those TV commercials where celebrity endorsements dangle the bait of fairness creams, lotions and body wash specially designed for teenagers and young men seeking to take them to the promised land of social and sexual success. But before you rush to buy that cream, here's what that fairness is all about Fairness is skin cell deep Fair, ruddy, dark or wheatish is all determined primarily by the melanin content in our skin cells. Some races like the Africans have a high melanin content thereby giving them a dark colour while Europeans are of a lighter skin colour due to low melanin content. So whether you use an expensive fairness cream or go in for beauty treatments at luxurious beauty spas, genetics will have a final say on the matter. How fairness creams work...or do they? Fairness creams contain chemicals which block the production of melanin in the skin and thus enable a lighter skin tone and a fairer complexion. Mostly melanin production in men is more than females, which is why women's fairness creams don't have so much of an effect on men. The cosmetic industry recognized this factor and thus developed products designed for the male skin. However, some of these "men's only" fairness brands are glorified sunblock creams which block the harmful ultra violet radiation of the sun which blackens the skin. The dark side of fair Some of the beauty treatments and fairness creams contain chemicals like hydroquinone, mercury, and even steroids, which could do more harm than good. If you are obsessed about fairness, the least you could do is use a branded product (though that is no guarantee of its efficacy!). First sample it to check of it suits your skin. If a rash breaks out, consult a skin specialist immediately. Finally, it is the health of the skin which is more important than colour. So exercise regularly or use natural skin treatments like orange peels, cucumber patches to enhance your skin tone. Don't give in to peer pressure. The obsession for fairness can lead to low self-esteem and needless rivalry. Cosmetologists and marketers of fairness products are the only ones who will laugh their way to the bank at your cost. So, if you have a darker skin colour you don't have to go in for expensive remedies just because men in your age group find it cool. Self-acceptance is much better remedy than any beauty treatment in the world.  
Perfect partners in crime - Midlife crisis and dementiaThe responses we have to common stressful events in our daily lives have a lasting impact on our brain structure. The effects of a stressful event last a very long time, though apparently we seem to have recovered from it. Researchers say that the stress hormones keep circulating in our body long after the stress has passed. According to a recent Swedish research study, our response to common life events may trigger long-lasting physiological changes in the brain. These interestingly shocking findings come from the Prospective Population Study of Women in Gothenburg, a long term study on 800 women that lasted for almost forty years. The women who were a part of this study were all born before 1930, and underwent regular neuropsychiatric tests. The study started in 1968 assessed women for any baseline stressors like workplace problems, widowhood, alcoholism and illness in the family. Women who had serious issues at the start of the study had a 21% higher risk of developing Alzheimer's Disease and 15% higher risk of developing dementia later on in life. Interestingly, having to take care of a mentally ill family member like a sibling or mother, was found to be a major cause for development of dementia later on in life. The findings of this study show that accumulated stress from common life events has severe physiological and psychological consequences. These physiological consequences include adverse effects on the central nervous, cardiovascular and endocrine and immune systems. There have been several studies that state that the effects of stressful events like earthquakes, cyclones and floods can have a lasting impact on life and often shape the person's personality. What makes this study interesting is its finding that daily stressors accumulated over a period of time and often left unresolved, have a lasting impact that shows up in later stages of life!
Marrying late in lifeConventionally, the marriage age is determined according to the linear formula of happiness that we have constructed and believe to be true. The formula being: getting married by 24 --> having children by 27 --> working (optional) --> becoming a grandparent (that too, real soon!). However, time and again, men and women wandering in their 40s-50s have woken up from the deep disturbed slumber to realize that maybe- just maybe, they had walked into things too fast. They had been unable to know who they are and to become a self-conscious human being before being ready to fuse their lives with another. The prime point of being single and marrying later in life is not to go on some form of egoistic joy-trip but to be able to know oneself and become ready to be the right person for the other. By marrying late, you give yourself time to experience freely what you like and dislike. You get to explore the world at your own terms- travel whenever you want and involve yourself in festivals and activities that manifest who you are. Marrying early doesn't allow for time to explore one's being, as marriage generally immediately follows the time you finish your studies or begin working. One of the most important aspects of adulthood today is travelling. However, every individual has unique wants of travelling and being a single adult will allow you to experience the world fully. You will also get in touch with yourself, exploring how you would like to live. The decision will arise from a ground of experiences which would clearly tell you what repels and what appeals to you. Such experiences are rarely findable once you begin living with another, as you would have to schedule your days and basically, your routine around the other's life as well. Financially, you have reached a point where you know how to take care and manage finances, allowing you to plan your wedding pragmatically. Marrying at a later point in your life allows you to be clear about when you would like to be a parent. Your experiences also ready you to be a considerate and understanding parent who can guide a child. As you grow older, you tend to become more tolerant and the propensity towards differences turning into unnecessary fights is lowered. As our ways of looking at the world change, every person as an individual has the need to learn to see the world as a home. This feeling of being at home is created only through series of experiences one has to go through as a responsible adult. In the face of inexperience, two individuals coming together often find themselves incapable of being happy with one another. Marrying later allows you to have grown into a wiser person yourself before sharing your life with another.
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.
CryophobiaCold or hot can be a very subjective term as every person's tolerance for either heat or cold can vary. When some of us react in an extreme manner to all things cold, then it could be a case of cryophobia - the fear of catching cold or the fear of cold weather. Derived from the Greek "kryos" + phobos gives us cryophobia, which is a mental aberration where the mind develops a nagging and persistent fear of all things cold - be it cold weather, ice-cream, or maybe even a cold shoulder! Jokes apart, a person suffering from this condition could really experience 'hot weather' in his relationships as he will completely avoid any contact with anything cold. If the weather is a bit nippy then that's a veritable disaster for Mr. 'Avoid De Cold' as he will do everything in his power to stay indoors, for instance - turn on the central heating and wrap himself up until the mercury rises to an agreeable level. Though it is decidedly different from your run-of-the mill phobias, cryophobia could be of various types. There are some who are only afraid of cold in the 'weather' sense and are otherwise cool about touching cold objects or even having an ice-cream. While there are some who would probably break out into, if you will excuse the term, 'cold sweat,' even while watching floating icebergs on a Nat-Geo documentary. So, the sensation of cold is quite subjective, and hence the various strains of cryophobia. Generally, this fear would manifest quite logically for those who have occasioned to be trapped under ice accidently or maybe those who have suffered frost bite from exposure to cold weather during a skiing holiday. Under such circumstances, avoidance, though irrational, could be perfectly logical. If you monitor weather reports constantly and experience discomfort even in moderate climates, then you should get yourself checked for cryophobia, as chances are that soon you will be restricting yourself indoors and cutting yourself off from the rest of the world. Some people might just overcome fear or anxiety by wearing an extra layer of the woolens or turning up the central heating. For deep seated fears, it may require long-term counseling or medication. Some people might just have this morbid fear of developing pneumonia from a common cold and hence may take elaborate measures to avoid going out during cold days. This too can be quite normal since most of us don't want to call a day off from work due to a nasty cold. But despite adequate protection if you are still afraid of venturing out to work or are avoiding social contact just because of an irrational fear of catching cold when the weather outside is made for the beach and you are in the middle of summer! Then the catchphrase is - You have cryophobia!
Faking illnesses - An illness in itself?In 2008, a 28 years old woman in the US shared some shocking news with her friends. She had been detected with cancer. She posted updates on social networking sites and wrote blogs on her illness. Sympathy poured in from all corners. Some even sent in monetary help to cover her expenses. The saddest part of the incident though was not her cancer; it was the fact that she had faked it! Police investigations revealed her little trick when no evidences or records were found at the hospitals! Apparently, this isn't a unique case;  faking illnesses or malingering is a very common occurrence. All of us have done it at some point in our lives. While we may have done it to escape a school punishment or to take undue advantage of the office 'sick leaves' for personal purposes, it is usually done on a harmless level. But faking illness can be a chronic disorder too and  medical professionals even have a name for it-; Munchausen's Syndrome. People suffering from this syndrome fake illnesses that they don't actually have, to gain sympathy or simply to be the center of attention. Usually gaining sympathy is the main reason why people fake illnesses. It gives them a chance to be in the spotlight. Everyone calls and visits, expresses concern and fusses over them. Lots of love is showered upon them. Another common reason for faking illnesses, is money and at times, the monetary benefits are higher than the emotional ones. No one hesitates to fulfill the last wish of a dying person, however expensive it may be. Often there are mixed motivations and the person faking an illness has many reasons to keep up the pretense of being sick, for as long as possible. Some people really do have a disease — a mental illness known as a factitious disorder. People with this disorder pretend to have an illness, which is usually a terminal one and often go to great lengths to maintain their hoax. Munchausen syndrome by proxy, is another form of faking illness. People with this disorder, fake illnesses of people under their care; and they usually do this, for monetary benefits. Children are the most common victims in this disease. When you tell someone that your child has cancer, you will receive a great amount of sympathy and all the money you want, no questions asked! People with these disorders are extremely cunning. They go to great extents to maintain their lies. They will build grand stories, complain of fake pains and aches, get admitted to hospitals and undergo a battery of tests, numerous times. Interestingly, they never allow and frequently discourage medical professionals, from talking to any of their family members. Since they know they are faking the illness, they will refuse to undergo treatment, for obvious reasons. . If you think a loved one may be exaggerating or faking their health issues, attempt a gentle conversation, voicing your concerns. Avoid anger, judgment or confrontation, while offering support and care and if possible, help them in finding a treatment. Treatment includes empathy, helping in identifying feelings and issues that led to the development of the disorder and finding  alternative healthy ways to deal with those feelings and issues.
Fruit diet can be dangerousFruits are healthy and provide lots of nutrition, vitamins, antioxidants, carbohydrates, fibre and bioflavanoids to the body.These things together protect your body from different health conditions and heart disease. However if you only eat fruit, you miss many other essential nutrients such as fats and protein. This can upset your stomach and lead to indigestion. Hence it is very important to take a well-balanced diet to remain healthy. Check out why you should not rely solely on fruits for living. Fruits do not provide protein Protein is highly important for your growth and development. By eating only fruits, you are restricting your intake of proteins that can stop your overall development process. Your body requires calories and energy on a regular basis. Each cell of your body contains protein. To keep your body cells in top working condition it is important that you include protein-rich foods such as lentils, soy products,  nuts and beans in your regular diet. You can also consume low-fat dairy, lean meat, fish and skinless poultry to provide required amount of protein to your body. Fruits do not provide fat Although excess of fat is not good for health, it is essential that your body requires on daily basis to ensure smooth functioning of your immune system and also to help your body absorb various minerals and vitamins provided by other foods like fruit. If you continue being a fruitarian for long duration, the chances of stroke due to brain haemorrhage increases. According to health experts, you should get around 20 to 35 percent of your daily calories from fat. To provide your body with good fats you should include soybean, sunflower, olive or canola oil in your diet. Fish and poultry also provide good amount of healthy fats to the body. Too much of fruits can lead to digestive problems Fruits provide fibres to the body in large amounts. Although your body needs fibre as it is one of the essential nutrients, getting too much of fibre can lead to side effects. Fibre works as broom to clear of your abdomen and aid in the digestion process. However, too much of fibre leads to stomach problems and cause symptoms such as gas, cramps and bloating. Sometimes it may also lead to chronic diarrhoea, dehydration and loose stools. On a regular basis, a woman requires only 22 to 28 gm of fiber per day and a man needs 34 to 38 gm. Apart from fruits, seeds, vegetables and whole grains also provide fibre to the body. Other considerations If you limit your intake to fruits, you may not get enough calories required for producing the required amount of energy. Consuming calories less than 1100 per day can lead to lot of side-effects such as intolerance to cold, gallstones, hair loss and fatigue. So although fruits taste wonderful and are very tempting, being a fruitarian is not the best thing for your health. Your body needs all the nutrients for carrying out its different activities and hence you should include variety of foods in your diet.  
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Adrenaline rush - Feel it inside!Imagine yourself at a great height, either scaling a dangerous cliff-hanger of a rock face or on a bungee jumping platform. Some of us who have had the pleasure of doing high adventure sports like racing or indulging in perilous activities like giving out an acceptance speech for the first time are well aware of that strange feeling in the solar plexus, the clammy hands and intensely thudding heart, and the rush of blood to the head just as you are about to take the plunge! The heart beats faster than ever, breathing goes rampant, the senses seem to become supercharged, and the fear, the joy, and the excitement meddles with the mind. That’s adrenaline rush! So what do you want to do? Fight? Or flight? Either ways, adrenaline does it for you. Speaking medically, the two small adrenal glands on top of the pair of kidneys release a magic chemical that gives the animals way towards the fight-or-flight response to counter certain high-intensity situations, called adrenaline or epinephrine. The chemical entity is a hormone, a neurotransmitter as well as a medicine and is too complex to explain its behavior. However, when it works the heart pumps out the blood to the excited muscles and all the juices surge up inside the body. There is more to this topic than just the physiological mumbo-jumbo. The hormone acts every day in the normal course of life, but not regularly to the extent when it produces side effects such as shakiness, palpitation, high anxiety, and profuse sweating! Thats kept for special situations like physical threat, excitement, bright lights, noise, and really high temperature – in good or bad ways. Let us surf through some of the rewarding and a few of the nasty situations where the jolting juice takes charge of our body! The Good ones: Countering Stress: In extreme stress conditions like accidents or fracture, the body needs to react fast and is at its highest awareness. Adrenaline keeps the muscles up and kicking to help the victim fight with the stress. High Energy Requirement: In majority of sports, more specifically in contact sports like Rugby, Boxing, Mixed Martial Arts, etc., the player needs to be in his full sense and topmost concentration level. The adrenaline rush runs in the background to keep them at their extreme self. The Push Mode: Often the daily chores aren enough to excite us and we tend to search for some adventure. In such pursuit of excitement, there are times when the road is a dead end or there is only one way forward – the impossible or most difficult one! The hormone pumps the brain both ways with fear and with the push to conquer the fear and proceed. Adventure Sports often sounds fun, but at times when running ahead of a raging bull, or hanging off a cliff, or rafting down the rough waters of a cascade – feels like the heart shall come out and scream!! It is the rush of adrenaline that keeps one ahead of the fear and explore the high-energy fun of winning over it. Life Saving Moments: In cases of life-threatening emergencies such as drug overdose, cardiac arrest, or pulmonary failure, where the heart and lungs suddenly cease to function and the body gets into a shock –– the epinephrine shots are considered as a life-saving medication to bring the patients back to life (only to be used judiciously by a qualified medical practitioner). The important medical use of adrenaline is in treatment of acute anaphylaxis and allergies under medical supervision. The Bad Ones: Disorders of the Adrenal: Tumors and cancers of the adrenal gland can cause hyperactivity of this high-performance hormone affecting the normal functioning of the heart and the blood vessels by increasing heart rate and creating anarchy in the body systems. Over-Stressed Adrenaline Rush: The demand-supply mismatch in the present world scenario requires one to perform at his/her epitome of mental and physical strengths. In that constant urge of performance, the brain and the body is stressed out so intensely that the adrenaline surge symptoms are experienced by the individual even in the absence of threatening situations. Sudden sweating of palms, shortness of breath, pounding heartbeats, or chest pains without a justifiable reason can be a result of constant stress.
All you need to know about angioplasty!Why would you need coronary angioplasty? The walls of the arteries are being constantly lined with a fatty material called plaque. This plaque increases in certain conditions like atherosclerosis. When the build-up is too high, the artery gets blocked and the subsequent tissue receives very less or no blood, causing it to die. The plaque at times may be dissolved by medicines but if it is too big, medicines prove ineffective. This is manifested outwardly as a heart attack. This is the time when the doctor would recommend the coronary angioplasty as a treatment for you. How is it done? A thin catheter with a deflated tiny balloon at one end is inserted into the affected artery. Once the exact location of plaque build-up is reached, the balloon is inflated causing the plaque to get pushed against the artery wall and creating free space for the blood to flow. A small mesh called a stent may be placed to hold the artery in place. Some stents are coated with medicines that prevent the scar tissue formation following the angioplasty procedure. The procedure may be done as an emergency or it may be planned. If it is a planned procedure: You will have to get hospitalized and stop eating or drinking 6 to 8 hrs before the procedure. Once the procedure is done, the doctor would prefer you staying in the hospital overnight to watch for any adverse events that may happen. What happens after the surgery? The surgery lasts for 1 to 2 hours and you would be allowed to go home the next day. You will be advised not to undergo vigorous and strenuous exercises and to rest adequately. Most people are fit to return to work a week after the surgery.
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.
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
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