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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.
Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
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.                
Pediatric diet formula food vs traditional foodAccording to the World Health Organisation, it is unnecessary to give your baby rice cereals at the age of four months as breast milk can provide all the nourishment a baby needs in the first year. No other solid food is required. Breast milk has all the nutrients like fats, protein, cholesterol, carbohydrates, vitamins and minerals which are required in the first year of life. According to most studies,formula foods are not the healthiest option to begin solid foods on. Doctors prefer that babies be given boiled vegetables and mashed fruits like bananas and not formula cereals that contain simple carbohydrates. It is not a good idea to give babies processed and refined foods that are found in all formula foods. Formula foods do have nutrients, but they are not as easy to absorb as nutrients from foods prepared at home. You can also ensure quality in food that is prepared at home. Formula foods cannot imitate the natural taste of foods. Babies like to choose foods according to taste just like the adults and you can give them a wide variety of choices like offering them different fruits and vegetables rather than the similar tasting formula. You will be surprised to know that mother's milk has the taste of the foods she eats and so babies develop taste for a variety and may like the insipid taste of formula. Another reason why formula foods may not work that well is that they contain cereals. However, the enzymes that are required to digest carbohydrates are not fully developed in babies until they are more almost three years old. Cereals and breads are very difficult for babies to digest. Undigested grains can throw off the balance of bacteria in the gut and this is the reason for a lot of digestive issues once they are grown up. Solids should not be introduced until six months of age, as studies now reveal that if solid foods are given early on then it increases the likelihood of allergies, especially of those foods introduced. Babies produce only few enzymes and digestive juices that are mainly required to digest protein and fats. This is because mother's milk has 50 to 60% healthy fat which is a must for the babies' mental and physical growth. Most baby infant nutritionists feel that formula feed is not a complete food. Babies will get deficiency,such as iron, as it is difficult to absorb them from formula foods. The debate continues as many feel that the marketing gimmicks are what selling these foods and not the nutritional value they provide to babies. A note of caution, excessive amount of juices are harmful for babies as these can lead to obesity.
What is megalomania?Bertrand Russell's quote on megalomania perfectly describes the condition:"The megalomaniac differs from the narcissist by the fact that he wishes to be powerful rather than charming, and seeks to be feared rather than loved. To this type belong many lunatics and most of the great men of history." Megalomania is a delusional bipolar disorder. The sufferer believes he is an all-powerful person and that he is superior to all other people. Megalomania comes from the Greek words megalo which means large or great and mania which means madness. It is a psychopathological disorder that has delusional fantasies of power, exaggerated self esteem and a sense of omnipotence. The sufferer may believe he is God or some famous athlete. Although megalomania is a term used for power hungry people, it is clinically described under the mental disorder of narcissism. Narcissism is self-love. Though self-love is a healthy concept, narcissism is a pathological state where one loves oneself to the extent that he starts despising others. Megalomania is caused by certain phobias and mental conditions associated with emotions and personality. In everyday life, megalomania can be a person's mental way of reacting to frustration, abandonment or some serious loss. In the social world, the term megalomaniac is often synonymous with control freaks, power-drunk army generals, executives and politicians. The treatment of megalomania includes medications. The challenge here is that the person may not believe he has anything wrong with him. He, in fact, believes that he is so great that no harm can come to him, so talking him into getting himself treated is very difficult. Adolf Hitler, the German dictator, was a power-hungry control freak. He believed that he was the supreme commander and that his race was the only race suited to inhabit earth. All other races, especially Jews, were inferior and had to be wiped off the face of the earth. Adolf Hitler was megalomaniac.
Not very chummy! Menophobia - The fear of periodsMenstruation or periods begin as female reaches puberty. This is the time when there are hormonal changes which occur in the body as nature takes the girl and makes her ready for womanhood. The onset of periods can be distressful with lots of mood swings accompanied by abdominal cramps, bloated feet as the menstrual blood flows. This is also a time when the girl needs to be comforted and educated the most, as it can be truly a terrifying experience. Normally mothers or elder women in the family ensure that they take complete care of the girl in this transition phase. For some women, their initial experience with periods may not have been particularly pleasant, causing them to actually dread those 4 days and this fear can then take the shape of a full blown phobia -Menophobia! The reason could vary. For some the pain factor could be the reason for menophobia, while for others, it could be the memory of embarrassing red stains on the clothes which could set it off. In menophobia, just before the onset of the periods, the person starts getting anticipatory anxiety and the pain which could be normal period pain, is then imagined to be ten times worse. This brings on panic attacks and feeling of utter dread which while is entirely psychological can be utterly distressful and downright crippling. Counseling can help greatly along with pain medication to manage the pain and the fear of this natural phenomenon called periods. In therapy, this is what is iterated. That menstruation is a completely natural process and if there is a fear of menstrual blood then gradually, the woman is encouraged to accept it as a natural body function which plays a major part of her being a woman.
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
Thyroid may make your heart flutter!Thyroid is a small gland situated in the area of neck. In Greek, thyroid means the shape of a shield. Yes, thyroid gland is vital to a variety of important body functions and does act as a shield. But what happens when the shield is disturbed and goes weak? Thyroid dysfunction is recorded in approximately one to four people out of hundred Thyroid link to heart A research study was conducted in 2009 by Weill Cornell Medical College researchers. It was done to investigate and analyze the genetic link behind rhythm control of heartbeat. They found that the genes that are responsible for synchrony and rhythm in the functioning of heart are also closely connected to the thyroid hormone synthesis and could cause dysfunction of the thyroid. Thyroid activity directly influences the metabolism, blood flow and electrical activity of the heart. When there isn't enough thyroid hormone (low levels), the patients complain of low energy levels, fatigue and reduced heart rate. On the other hand, with increased thyroid hormone levels in the blood, patients report symptoms of hyperactivity of systems. There is diarrhea, palpitations, increased heartbeats and advanced cases show arrhythmias of heart, where normal beating rhythm of heart is disturbed and becomes irregular. Thyroid hyperactivity can be appropriately controlled with regular medication. Understanding arrhythmias When the rhythm of the heart is disturbed, it becomes irregular - this is called cardiac arrhythmia. There are various types of loss of rhythm - heartbeat is too slow (that is, the cycles are taking too long to complete), too fast (the cycles are repeating too quickly), too early (that is, before a cycle is even completed, another starts), too irregular (this is called fibrillation, where no specific pattern may emerge). The patients who have arrhythmia will often come with complaints of dizziness, shortness of breath, suddenly feeling weak or lightheaded, fainting and feeling of a flutter in chest (flutter can be understood as light but quick flapping of wings by a bird). Arrhythmias are usually harmless and most people would continue to live a healthy life for years with arrhythmias. But that does not mean it can be ignored. There is a battery of tests available to diagnose and indicate the seriousness of arrhythmias and let your doctor take a call on the line of treatment. If you have a thyroid dysfunction, get your heart checked immediately. And if you have faced arrhythmias, get your thyroid checked immediately. Both the conditions are controllable and treatable; there is no cause to worry over what could go wrong. Just be vigilant and informed.
A fine spine - Common disorders of the spineThe spine is made up of small bones called vertebrae that are stacked one upon the other. When viewed from the side, the normal spine has gentle curves to it. Because the spine is a complex structure and happens to be at the center of all our activities, it is subjected to a lot of diseases. A common misconception of low backache is that you should rest. In fact, rest is not recommended at all. Keep up with light non-strenuous activities after the symptoms have subsided. Given here are a few common conditions of the spine: Loss of curvature: The spine, when seen sideways has gentle curves to it. The curves, when lost, can lead to pain and imperfect posture. Kyphosis and Scoliosis are the commonest form of spine curvature abnormalities.Kyphosis is the abnormal and excessive curving of the upper part of the spine. It is commonly called as a hump. It may be present since birth or may develop during the teenage years. The most common symptoms seen are a hump, back pain and muscle stiffness. The pain remains constant and does not worsen over time. If the curvature is too much, then the thoracic cage may get compressed and pressed for space. This may cause cardio-thoracic problems like chest pain, shortness of breath and even death. Compression of spinal nerves may cause loss of bladder and bowel control, loss of sensation and muscle weakness. Kyphosis is treated with physiotherapy, anti-inflammatory drugs and in severe cases, with bracing.Scoliosis is the side-to-side curvature that occurs during growth spurts before puberty. It may also be caused by spinal cord injuries and arthritis. Scoliosis develops gradually. The symptoms seen are usually by people other than the patient, where they may notice a slight slouch while walking. At times it may be seen that clothes that used to fit earlier are now ill-fitting. The pants seem to have shortened on one side. The curvature if mild responds well to physiotherapy. Physiotherapy is also useful as it helps to stretch and strengthen the muscles. This helps in stopping the progression of curvature. Severe cases require bracing and even surgical intervention with rods, hooks, wires and screws to correct the curvature. Sciatica: Sciatica is a condition that arises when the sciatic nerve is pressed upon. This condition arises when a degenerated vertebra presses upon the disc below it, or when there is a disc prolapse.  Abnormally tight piriformis muscle of the buttocks and a tumor in the spine may also cause sciatic pain. The hallmark symptom is the characteristic pain along the leg that starts from the hip and radiates all the way down. The pain is worsened by sitting and tingling numbness also develops. Treatment includes anti-inflammatory medicines and physiotherapy. Spondylolisthesis: When the spine is subjected to the pressures of daily activity, there is a lot of wear and tear that goes on in the vertebrae. This may cause the vertebra to move forward and slide on the vertebra below it. As a result, you may experience a constant backache. Spondylolisthesis can be congenital, it may occur due to trauma to the vertebral column, due to a tumor in the vertebra or due to degenerative changes in the vertebra and cartilage as a result of diseases like arthritis. Low backache is the hallmark of this disease. The pain is typically worse after any exercise that involves the lower back. The motions of low back are restricted and if there is nerve compression then tingling and numbness along the leg may also be seen.Rest and avoiding exertion of back muscles helps reduce the symptoms. Physiotherapy helps in restoring the strength and improving the range of motions. Spinal Stenosis: Degenerative diseases like osteoarthritis cause development of bone spurs in the vertebral column leading to its narrowing. This puts pressure on the nerves and leads to pain and tingling and numbness. Cervical Spondylosis: This condition occurs due to degenerative changes in the vertebrae of the neck region. Commonly seen as neck stiffness with pain that radiates all the way down the arm.  The pain occurs as the nerves get compressed by disc prolapse or bone outgrowths in the vertebra. Treatment includes neck immobilization, cervical traction, medications for pain and physiotherapy. Ways to reduce spine problems and backache are: Quit smoking Adopt a perfect posture Do exercises that will strengthen your core, lower back muscles and abs. Do not ignore or overlook the pains. Consult your doctor at the earliest. Spinal problems are the ones that are frequently overlooked. Ignoring the symptoms may lead to worsening of the problem. See your doctor at the earliest to be safe. The spine is the backbone of our body, in the true sense of the word. It is up to us to keep our spine in good condition as an unhealthy spine will interfere with almost all our body functions.
Smoking causes impotence!Men who smoke heavily are twice as likely to suffer from impotence or erectile dysfunction. The link between smoking and ED has been established beyond reasonable doubt. Smoking causes a hardening of the arteries or blood vessels. For a penis to grow erect or tumescent there has to be a healthy blood supply. Now imagine the cross-section of a smoker's penis where there are plenty of blockages and hardening of the blood vessels. Can the penis then grow erect with so many hindrances to the blood? There is also an acute loss of sensitivity to the penis which is a direct contribution of smoking! Previously, alcohol was a hot favorite of the medical lobby when it came to 'impotence.' Wish smokers could say the same thing about moderate smoking! Even moderate smoking can make an existing condition of impotence worse. One could make changes to one's lifestyle and diet and curb stress to treat ED (erectile dysfunction), but all these will come to naught unless one really resolves to give up smoking permanently. Just within a few hours of kicking the butt, the body starts to repair itself. Of course, it may take longer for the blood vessels to actually undo the blockages and have a free run for the penis, but it will certainly happen, slowly and surely. Smokers may have an underlying condition of anxiety, which is made worse by nicotine, which in turn causes performance anxiety, not greatly helped by blocked blood arteries. So smoking not just makes you physically impotent, but also mentally impotent too. It is a powerful narcotic which is hateful to the body and spiteful to its salubrity. Please enroll into a 'stop smoking now' campaign with the help of friends or family. Check for any 'nicotine anonymous' programs in your neighborhood or just do it all by yourself. Otherwise, the only thing hard about your penis will be hardened arteries and lots of hard luck!
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