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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
Breast lumps- myths busted!The rise in the occurrence of breast cancer in women, since past decade or so, has made women, especially in the urban areas, very cautious about lumps in their breasts. Whenever there is a small lump in the breast, the first thought that comes to mind, is may be this is cancerous. However, instead of taxing your brain with worries, it is better to take action and consult your caregiver. Here are some of the myths that are regularly associated with breast lumps and the real facts related to the same. Myth: If there is a breast lump, it must be cancerous Statistics reveal that out of 10 cases of breast lumps in women, only 2 are cancerous. More often, these lumps are due to fibroadenoma or cysts. In many women, lumps are formed during the menstrual cycle and they go away after it ends. It is not simply possible to tell exactly what kind of lump it is, just by feeling through hands. However, it is important to detect the composition of the lump and to do so at the initial stages, so that if it is detected cancerous, early diagnosis and treatment can save your life. Myth: If your mammogram is normal, you are safe and the lumps are not cancerous This is not particularly true. To detect the presence of cancerous cells, you need to get more tests done; an ultrasound, an MRI and also a follow up mammogram, to get a second view of the lump. Doctors also suggest a biopsy to be 100 percent sure of the diagnosis. If the lumps persist but there is no detection, your doctor may ask you to keep doing the tests at frequent intervals, to assess the development. Myth: Malignant breast lumps do not cause any pain Although breast cancer patients do not suffer from much pain, this does not mean that if you do not have pain, the lump is non-cancerous. There are different types of breast cancers; and in some types such as the inflammatory breast cancer, the patient can suffer from warmth, tenderness, redness and swelling, followed by pain in the lumps. Myth: If you get a lump while breastfeeding, it is not cancerous It is true that breastfeeding reduces the chances of development of cancerous cells. But there is still a possibility and hence you should not ignore the formation of lumps. It is advisable to immediately get an ultrasound to confirm the condition of the lump. Myth: Lump in young women cannot be cancerous Women can develop breast cancer at any age. Hence, if you have a breast lump at a young age, or even if your teenage daughter has developed a suspicious lump in her breast, you should always get it checked, at the earliest. Most often, cancer develops in the breast when women are past their menopause period. But this, in no way means, that they cannot get it at younger age. Myth: Only a larger lump can be cancerous, not a smaller one Lumps in the breasts can be of all sizes; and the size, does not determine the presence of cancerous cells. According to breast-imaging specialist at New York's Manhattan Diagnostic Radiology, Melissa Scheer MD, you must immediately see a doctor, whenever you feel the presence of even a tiny lump, because, a small lump too may turn out to be aggressively cancerous. Most often, the lump in the breast is non-cancerous; however, it is advisable to consult your caregiver immediately, once you discover the lump for the first time.
Ageing gracefully and happilyEverywhere we look there are constant reminders that we are growing old each passing day. There are creams that tell us that will make our wrinkles vanish and make us look younger. There are hair care products dyes that claim to cover our grey hair so that we can look and feel young. Our doctors tell us about how we have to take care of all our body parts to keep several diseases at bay in the old age! It is a rare and difficult attainment to grow old happily and gracefully. Is there anything good about old age? It doesn't seem so, going by the look of things. Here we give you 5 reasons that will make you look forward to old age! Old age is the happiest time in life: You are constantly living life to the fullest when you are young. Survival is your prime priority. You work hard to keep yourself and your family happy and financially stable. Too many responsibilities bog you down. Old age is the time when there is nothing of this sort. You are retired, free from all responsibilities. You have passed the baton to the younger lot. Now is the time to sit back and enjoy. Now is the time to relax and do the thing you always wanted to do. Imagine living with not a care in the world? That is old age for you. Old age is when the brain functions the best: It is a proven fact now. It was believed that we lose more brain cells as we age. Now it has been proven that our cognitive functions peak between the ages of 48 to 60. Old people make the wisest and toughest decisions quickly. People may call them worldly wise. Have you ever given a thought to how all the judges are old men? And how when someone says the word 'wise' the picture formed is usually of an old man with a beard? No more fashion policing: When you are young, there is a lot of stereotyping involved! Going to a board meeting, wear formals? Going for a lunch meeting, wear something that is suitable keeping in mind the place. Are you at a certain position in life? Dress accordingly! So many restrictions! Old age comes with none of this. You can wear what you please and no one will really mind! Only when you actually get to do it will you realize how much f a relief it is! Relationships improve: According to a 2011 study; married oldies are more satisfied and positive about their marriages than young couples are. Arguments involve less anger, and senior spouses show more positive emotions and affection than middle-aged couples. It's not only marriages, however, that benefit in older age. Seniors also seem to be happier with their other social relationships too. They have a smaller but closer circle of friends and gain more benefits from these close, emotional bonds. Old Age makes you feel better on the whole: You have lived life to its fullest, your kids have now flown the coop and you have seen it all. As you age, you start feeling better about things in general. You look at things more positively and make the fullest of every situation presented to you. You live in the moment and are not worried about future repercussions. Old age is a happy place to be. Look forward to aging positively.
Avoiding nappy rash - A few words of adviceNappy rash is a skin condition that takes its name from the nappy in which a baby is wrapped. It is a reddish rash, or tender skin around the buttocks and inner thighs of babies, which occurs due to prolonged wetness from either urine, or stools, or both. Nappy rash may be in the form of an unusually tender bottom on a child, or an inflammation around the genitals, and inner thighs, or folds of the skin. It generally occurs in really small babies, less than a year old. Most times, nappy rash is not a very serious condition, provided care is taken. No matter what type of nappy you use, whether promising complete dryness, or absorbent nappies, your baby is likely to develop 'nappy rash' at least once. The rash can make the baby feel uncomfortable, and cranky as a result. Steps to avoid nappy rash: Always ensure that your baby's bottom remains dry by changing nappies at regular intervals. Use a mild medicated baby soap which will help in keeping the skin around the inner thighs and buttocks soft. Give your baby some nappy free hours. You will be the best judge to know when she is likely to have comparatively dry spells, which can allow the skin and parts below the waist some breathing space. Regular bathing should take care of most rash related problems. Use an emollient, or medicated soap for bathing. Sometimes, nappy rash is a result of a thrush or yeast infection. The baby's resistance at these times is low so that it allows the yeast to thrive in the form of ugly red patches. Always show a medic to rule out the possibility of bacterial infections. Anti-fungal creams should also take care of normal nappy rashes.    
Cranky kids in a diner? dealing with them made a bit easy!This has happened to many a parent. They make a reservation at a fine dining restaurant, perhaps with friends and relatives. But their kid screams, and cries,disturbing the entire restaurant, and spoiling the general mood. For this reason, many parents avoid going out altogether, especially to fancy places. But there are ways in which you can handle the toddler when you are at a restaurant. We will show you how. Carry toys Restaurant may be boring at times for toddlers. That's why they turn peevish and may start playing with forks, spoons or knife. So carry some toys, crayons, notebooks, or even a story book, which will keep them busy and you can have a good time. Order something yummy and healthy for the kid A hungry kid is an angry kid. So, order something which is your kid's favorite and also healthy at the same time. Or you can carry something along with you like fruits breads, cherries or other nutritious treats. Keep responding to what kid says The best way to keep childrenwell behavedis to talk to them and respond whenever the child speaks. Don't avoid them or get too engrossed with other people. They get cranky when they don't get a response from you. Take a round with your kid When the kid becomes difficult to handle, just pick him in your arms and take a mini tour of the restaurant or walk outside. This will distract him and relieve his boredom. Don't tolerate any bad behavior If the bad behavior of the kids is intolerable, then firmly tell them that they need to adopt good manners if they want to visit restaurants again. Disturbing other diners is not acceptable. But it doesn't mean that you punish them.You just have to remove them to a place where they don't bother anyone. Make your outing relaxed and enjoyable Above all, don't forget to have fun and make it an enjoyable evening. Don't get too carried away disciplining the kid. You can afford to be a bit silly and enjoy the time with your child.
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
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.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
A guide to earwax impactionBiologically, the earwax which builds up over time moves through the ear canal from movement caused by chewing or other jaw motions. It is also extricated through the inside-out motion of the skin of the ear canal - it reaches the outer ear and peels away. The cerumen is produced in the outer regions of the ear and not in the inner recesses. Earwax impaction refers to the condition where the ear wax builds up to such an extent or in such a manner that it causes discomfort to the entire body. In many cases, earwax impaction occurs when patients use cotton swabs or safety pins to clean their ears, only causing the wax to drop deeper into the ears. The main symptoms of earwax impaction include difficulty in hearing, faintness, ache in the ear, foul smell in the ear region, ringing or sound in the ear (also known as tinnitus), a sensation of fullness in the ear, and lastly, discharge from the affected ear. The most vulnerable groups for this condition include those who use hearing aids or ear plugs, elderly people, and those who insert cotton swabs or other items into their ears, as well as those who have an odd ear shape which could negatively affect the discharge of the earwax and those suffering from development incapacities. Did you know that one of the most common methods used by people to clear excessive earwax is ear candling where a candle (in shape of a cone) is placed inside the ear canal and set alight to warm up and remove the wax? This is one of the most dangerous methods causing burns, worsened blocks, and damaged eardrums; this should be clearly avoided. The diagnosis of this condition can be done by an ear specialist using an instrument called otoscope. Earwax impaction is treated in many ways. While at home, you could try to clean the outer region of the ear by wiping with a cloth, the physician could irrigate or syringe the ear to wash out the ear canal with saline. This procedure is generally done once the wax has been softened by the use of cerumenolytic solutions aimed at dissolving the wax like mineral oil, peroxide-based ear drops, and hydrogen peroxide. Physicians also use special instruments to remove the built-up earwax like forceps, cerumen spoon, and suction tool. The best way to prevent cerumen impaction is by not inserting anything into the ears to clean it up. Cotton swabs should only be used in the outer part of the ear. In case you feel that the buildup is regular, then you can fix an annual appointment with your physician for cerumen removal.
Winter - When your heart feels the cold too!As per a study in America, 193.6 people of every 10000 people die of a heart disease every year. 53% of the heart attacks occur in the winter months. Heart diseases have a seasonal trend as found by medical research recently. A team of medical researchers recently conducted a survey which saw 10,000 participants between the ages 35 to 80 from around seven European countries. The study was conducted to see if there is any seasonal variation in the presentation of heart diseases. The participants were measured on the parameters of blood pressure, waist circumference, body mass index, blood glucose levels and blood lipid levels. The parameters were later adjusted for sex, age and smoking. The results revealed that the incidence of heart disease shows an upward trend in the winter month [Jan to Feb] as compared to the summer months [June-Aug]. The researchers accept that there is no logical explanation to these findings. A plausible cause being the fact that the eating habits change in winter. One tends to eat more which in turn increases the cholesterol levels leading to heart diseases. Several other theories are being put forth. According to one, during the winter months the body undergoes hormonal imbalance. The day and night variation in the hormone levels, especially that of cortisol varies. This results in a lower threshold for heart attacks. Yet another theory says that the cold temperature tends to constrict the arteries narrowing the blood flow to the heart tissue and this result in a heart attack. On the basis of this study, scientists advise that more attention is to be paid to heart health during the winters.
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.
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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