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Handling post retirement bluesYou have given the best years of your life to your career, and now it's time to say goodbye and get ready for the retired life. It is a phase laden with expectations of all things you were too busy to do while working - spending more time with family, going on that fishing expedition, or going on leisure trips around the world. However, despite the wonderful things to come, retirement can get unusually trying and mentally taxing. After all, how many of us really have the flexibility of mind to take this period as a challenge and be the master of our destinies? Just because you are retired doesn't mean you have to wither away and wait for death to claim you. So, here's what you can do to beat the retirement blues Catching up: This is really a bewildering time, as you have a lot of catching up to do, with a lot of things. Prioritize the things you want to do and proceed confidently. You may want to spend time with children, spouse, friends, etc. Go easy on yourself, as you may not be able to fit in as many things in your schedule all at the same time. Boost your self-esteem: Retirement is particularly trying for those who have occupied important positions in office. Such people are known to throw tantrums, as they feel less wanted than before. So don't ever make the mistake of treating your family like you treated subordinates at work. That was a role that you played then, and without reducing your importance or self-esteem you can now play a different role with your family as a friend, philosopher and guide. In fact, you can use your contacts and keep the old network alive by involving youth in your field of expertise and help them benefit from you. Catch up on exercise: The more physically fit you are the less likely that retirement will be a painful process. Perfect time for you to catch up on the fun times with your spouse to remind you of all the great times you have had all these years. If your spouse is not in the best of health then just being together is such a wonderful experience in the golden years. Financial health: Your peace of mind and self-esteem largely depend on how independent you are financially. You can take up a part time job or think of innovative ways to let your hobbies and interests generate money for you. This should be an enjoyable process by which your self-esteem can really benefit. Support groups: There are informal or formal associations of retired people that do various activities like travelling. Make yourself available to them. Sometimes retired people withdraw into a shell and that only makes things worse. These support groups give a fresh perspective on all things in life.
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.
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.
High blood pressure in the little onesIf you are asked to paint a picture of a patient of hypertension, how would it look? Leave the details aside, would you paint an old person, a young person or a child? Most likely, you will paint an old person or may be a middle-aged person. But a child, who would think of a child to have high blood pressure! It may be difficult to believe for most but not only is it possible, its incidence is also increasing gradually. In fact, hypertension in kids is becoming quite common. Studies in USA show that up to 5% children and adolescents have hypertension. What is it? High blood pressure in children and adolescents is also called as pediatric hypertension. Pediatric hypertension is defined by the blood pressure recorded on the mercury, in comparison to the given standard range. As a child grows, there is rapid development in all the milestones. For children, there are percentiles defined for all parameters for various age groups. In children, when the blood pressure is above the 90th percentile but below the 95th, it is called prehypertension. When it is above 95th percentile, it is diagnosed as hypertension. There are no distinguishing symptoms of pediatric hypertension, so it may easily be missed. Please make it a practice to get your child's blood pressure checked on routine visits for medical examination. Why does it happen? High blood pressure in children under ten years of age is usually secondary to some other health condition. It could be due to an underlying heart disease, kidney disease, hormonal disorders or genetic abnormalities. This demands treatment of the main problem. Primary hypertension is noted in older children, over 6-10 years of age and adolescents. There is no specific cause identified for this, other than lifestyle, obesity, rich foods and family history. How bad could it get? Children may show a disordered sleep pattern when they have hypertension. They may suffer from sleep apnea, reflected by snoring or abnormal breathing. Besides sleep, the other effects of hypertension are the known ones. In the long run, it could lead to heart disease, stroke or kidney disease. What to do? It is very important to control the blood pressure from a young age. Regular check-ups and monitoring of the BP is needed. Thorough examination is a must to identify whether the hypertension is primary or secondary. Treatment by medicines is recommended in secondary hypertension, where the underlying condition is to be tackled along with the management of blood pressure. In cases of primary hypertension, medication is suggested only in extreme cases. Otherwise, lifestyle management is the key. It is not a healthy option to start anti-hypertensives this early in life. Give your child healthy food, help him/her maintain the ideal body weight and make sure he/she gets enough exercise physically. The sooner we identify the problem, the better are the results with a disciplined lifestyle. The unhealthy lifestyle is creating chaos in all our lives. How long the kids would have escaped? Our lifestyle reflects on our kids. Follow a healthy routine and keep the family healthy!
Lost in wonderland? - Absentmindedness!The Daily Telegraph reports that on an average every adult in UK forgets three things per day. Forgetfulness is a human tendency. If this absentmindedness or forgetfulness is limited to forgetting three to five things per day, then it can be left unattended. However, if you or a near one is facing a lot of trouble in your daily life due to this habit or problem, you should immediately have a consultation with your doctor. Mystery behind Absentmindedness According to Maria Jonsdottir, an investigating neuropsychologist from Iceland, absentmindedness is the mental lapses that usually happen in connection with the actions that are routine or well-rehearsed. You can perform these actions without any need to be careful. This includes regular actions such as squeezing out toothpaste or moisturizer from the tube. These action slips are very common and if you observe carefully, you do forget some such regular things every day unknowingly. Psychologists believe that an individual makes such mental lapses around 30 times in every week. On an average, the nervous system of a human brain runs quite efficiently. However, sometimes temporary fault may develop that may make you use incorrect word or slip to your native tongue while conversing. This does not mean however, that something is wrong with your brain. When the team of Jonsdottir surveyed around 200 people, they found out that on an average the slips are 6.4 per week although the number also greatly depends upon the gender, intelligence level, and age. One startling fact that was discovered is that most of the events of forgetfulness occurred before 8 p.m. that means people tend to forget more during the daytime than in the evening. Apart from a momentary lapse in the functioning of brain efficiency, other reasons that can lead to increase in the incidents of forgetfulness are high stress levels, mobile phones, e-mails, and busy lifestyles. Today, people are pressed for time and they have more work at hand than time and that has increased the occurrence of forgetfulness. Types of Absentmindedness A team of neuropsychologists has divided these mental lapses into five categories. The most common are the storage failures in which people cannot recall what they had planned for a particular occasion or they can recall the action, but cannot remember for whom it was meant. Another category is test failures in which people come back home to check whether they have turned the light off and find out that they have already done so. Discrimination failure is another category of absentmindedness wherein you for a moment fail to identify the difference between your things and others'. During the study, a male participant accepted that he picked up the jacket of his female partner thinking it to be his own. Sometimes you put books in the dustbin and the trash on the shelf and laugh at your behavior a moment later when you find out what you have done. This is discrimination failure. Another mix-up includes program assembly failure wherein you put salt in the tea instead of sugar or you just do not keep the right things at the right place. The fifth one is the sub-routine failure wherein you go to the market to buy tea and instead come back home with coffee. The research proves one thing that if you are absentminded, it does not mean that you have a bad memory or can suffer from dementia as is widely publicized in the media. It is perfectly all right to forget or being an absentminded person. Sometimes the incidences of absentmindedness can increase due to fatigue. A good sleep and rest can fix the problem easily.
Sleep tight at every good night!A good night's sleep! Oh, what would some of us give for that luxury! Sure, you can blame it on the fast paced world and the things you have to do to keep the competition off your turf, and millions of other reasons to be sleep deprived. Yes, sleeping soundly and regularly is well within our control. Maybe it has eluded you so far and you are caught in a vicious circle of staring at the ceiling for hours on end; so read on to see what simple things you can do to gently drift off in to the arms of nature's greatest restorative- beauty sleep. Do's and don'ts for beauty sleep Fix a regular bed time, so that your brain will adjust to this by sending sleep signals to the body. If your bedtime is completely at the mercy of your activities then even as fatigue sets in the body will refuse to obey. So, even as your body is screaming for rest, the mind does otherwise. This is where good old discipline comes in to play. Take in to consideration the activities which are absolutely necessary to do and note the frequency with which they are likely to interfere with your bedtime before setting a realistic bed time. Initially the mind will refuse to obey, and you are most likely to get up, after tossing and turning in bed, to switch on the computer or whatever it is that you do when you cheat your bedtime. Rest assured, in a couple of days the brain will get used to this sleep routine and prepare you for shut down. Sleeping well also largely depends on how stress free you are. If the mind is in a state of constant excitement or anxiety, sleep will elude you. So when you lie down to sleep you need to fade out and blank everything out- joy and sorrow; expectations and ambitions, all of these out for later access! Tell yourself that tomorrow is another day and what you need today, is a state of neutrality! That's what most Indian philosophers would want you to do anyway. A good eight hours of sleep may depend largely on our minds but external factors can matter too. Sleep comes easily when your mattress is comfortable and not too soft or too hard. Use a pillow that won't give you neck pain, as any discomfort in the neck is likely to throw sleep off gear. Wearing clean night clothes can give you better quality of sleep. That goes for the bed spread as well.  Try this for yourself. Tight and uncomfortable night clothing is not recommended as this will only make you wriggle about for comfort. A cozy blanket and some clean nightclothes make great bedtime mates. Some people have a nightcap to help them sleep better while others still, drink themselves to sleep. Alcohol in large doses can only numb but does not help you sleep and you will only find yourself waking up frequently. Sleeping pills can be habit forming and might have serious side effects in the long run. So try simple remedies like a glass of warm milk or hot chocolate before bedtime to help you sleep better. Avoid stimulants like coffee, tea or nicotine before bedtime as that can keep your nerves all hyper thus making sleep quite difficult to come by. Computers and television are also largely responsible for us staying up late and disrupting our sleep patterns. We often find ourselves mechanically flipping channels or browsing without any real need for it. Try and go offline before bedtime, especially if you want to be able to schedule your sleep time. Television or movies can excite the brain and then you will find it difficult to fall asleep. So about an hour before bedtime switch off the telly or computer and just sit quietly and do some deep breathing exercises. Just sit cross legged for about ten minutes and relax your body. You are now ready for a deep slumber.
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.
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.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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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