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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.
Tips for the new fatherWhen a baby is born, all the attention is on the mother and the baby. And rightfully so, since the two need all the care in the world. However, the role of the father is very important even at this stage. The new dad has lot of responsibilities on his hand - he has to take care of both mom and the baby without getting annoyed or irritated. Here's how to do your best as husband and dad: Playing an active role in your child's life is vital for his emotional, physical, and cognitive development. Hold your baby as often as possible. By directly caring for your infant, you will learn about the baby's needs, how he communicates, and what comforts him best. Be prepared to feel left out at times. Your wife utilizes most of her energy and attention on the new baby. Be extra supportive and patient. Delivering a baby can be traumatic. Hormones ebb and flow. If there is ever a time to understand and care for your wife, this is it. Dads need to be more supportive and helpful. Share tasks like changing diapers, help around in the house by doing some household work like laundry. Talk to other new fathers about your experience and theirs. Most new parents experience a loss of sexual intimacy. Abstinence during pregnancy, pain, perineal tear, and breastfeeding can inhibit a woman's desire to have sex. Men can feel betrayed if rejected physically and mentally. It is important to talk about your feelings. Choose ways like cuddling, kissing, and holding hands to be physically intimate. One of main roles of a father is that of a protector. There are many ways you need to do this. Safety is one: child-proof your home. Dads now need to take care of driving, diet, and risk taking. Your baby needs you for a long time. Being healthy and happy dad is one of the greatest gifts you can give your kid. Dads need to provide financial protection to the new child. So get a life insurance, car insurance, an emergency fund, and a will. Try your best to spend as much time as possible with your new baby. While work may be your passion, it won't be long before children grown and no longer want to spend time with you. Take advantage of these years. Give the tiny tot gentle hugs. Dads shouldn't be afraid to show affection. Babies need physical contact, and not just from their moms. Snuggle with them, hug them, and kiss them. Read a baby-book to your child. Babies do understand. Sing him a gentle song or play a very soft music. Find out what makes your baby happy. Be good to the mom. Dads should be good and loving to mother of their new baby. Give her some time alone and babysit while she goes out, show affection to her, and give her little surprises. Because when the mom is happy, the baby is happy and the dad will be happy too.  
Making babies, the best way!Some couples get pregnant easily. But many couples have to wait months before the baby is conceived. There are several factors that affect conception right from fertility to the position during intercourse. Some believe that positions have nothing to do with conceiving a child. This is not true. Some positions are ideal to help the sperm meet the ovum. Let's see what some of these positions are. Missionary position:The best position for getting pregnant fast is the missionary position.Here the man is lying on top of the woman allowing for the deepest possible penetration, making it possible for the sperm to get deposited closest to the cervix. It is also the most common and comfortable position preferred by couples. Raise your hips high: Your hips have a lot to do in helping you get pregnant. Raise your hips high during sex by placing a pillow below you. This helps to expose the female cervix to as much semen as the male can release. Doggy position: Considered to be the most erotic and pleasurable position,this rear-entry position where the man enters the woman from behind is also recommended for increasing the chances of getting pregnant. In this position too, the sperm is deposited closest to the cervix, thereby increasing the chances of conception. Side-by-side: You can also try having intercourse while lying side by side. This position, likewise, causes the most exposure of the cervix to the male sperm. While these positions certainly improve your chances of getting pregnant, there is no guarantee that you will conceive. The most important thing is to enjoy this special time and have fun with your partner. So keep enjoying and keep trying!
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
Tips and tricks to deal with my toddler's tantrumsWhen your child is having a tantrum, it may usually be for something that it wants and cannot have. Throwing a tantrum is a child's way of getting what it wants. Conversely, giving in to the child's demands may be the easy way out for the parents too. But always remember that giving in is not right. The child may get habituated to this and it may prove quite a nuisance to you too. Learn to say no, gently but firmly. Giving an acceptable reason for your 'no' and also an option at the same time works wonders. All said and done, children are not that easy to handle. If your child doesn't fall in line and is adamant, let it pass the phase. Screaming out the rage, throwing away things may help the child. When the anger subsides, looking at the destruction and the obvious uselessness of it may help the child realize his efforts were futile. But be careful that the child doesn't get physically hurt in this process. For some kids, a gentle hug helps soothe the anger pent up. Tantrums in public places can be extremely embarrassing. In such situations, do not argue or scold your child or order him to hush up. It will only end up making the child more adamant. Wait till the storm subsides. Take him out to a quieter place and talk gently but firmly. One thing to remember here is to never let the child know of your embarrassment and concern that you are in a public place. Children are very smart and may end up using this to work things in their favour. It is not easy being a toddler and it is definitely not easy being a toddler's parent either. By the time your toddler is old enough to go school he will have overcome this stage.  
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.
Where does your happiness lie? - Importance of emotional well-beingAn emotionally well person is characterized by ability to handle and adapt to changes, to efficiently deal with stress, has a positive self-image and can take decisions independently to cater to his needs. Striving forward with a sense of purpose, an emotionally strong person has the capacity to build and sustain fruitful relationships without over-dependence. Being emotionally well does not imply that you do not experience pain and suffering. Pain and suffering is an essential part of every person's life. The strength of your emotional well-being is determined by how you look at and react to them. Those who are emotionally well can treat their adversities as opportunities to change and move ahead with greater strength. Signs of an emotionally ill person include stress, frustration, discomfort with changes, negativity in thoughts, and unreasonable paranoia about the intention of other's actions, discontent, and depression. There is also the feeling of guilt over inability to hold relationships and of not being able to keep others happy. You may also find yourself unworthy and feel that you do not deserve to be happy. Such sensation of low self-worth fuels the need to look for other ways to feel relaxed - thus, resulting in substance dependence. In cases of severe emotional ill-being, one could experience sleeplessness, hopelessness, suicidal, and uncontrollable negative thoughts. Relation between emotional and physical well-being: Emotional well-being is closely related to your physical body. They share a symbiotic relation with one another.By taking care of your body, you allow balanced production of hormones and smooth functioning of the other body parts - allowing them to respond efficiently during tough situations and also assisting the body to cope with physically challenging conditions. By being emotionally strong, you will also contribute towards faster and effective treatment of your body from illnesses. Your emotional well-being is determined by the following factors: family background, companionships, past history of relationships, sensitivity to nature and genetic dispositions. Those who come from troubled family background find it harder to associate in a healthy way with others during their adulthood. In many cases genetically, a person has greater propensity towards being emotionally weak - though this can be controlled and molded into strength by one's own actions. Depending on the type of educational institutions you attended, your companionships could be those which built your self-image positively or which hindered your capacity to take care of yourself (due to instances of bullying and teasing). Past romantic relationships also determine how you deal with your emotions in the present. Those who are sensitive to nature have been found to have greater consideration for human beings as well as non-human beings around them. Every factor is a condition which can be shaped by the efforts of the individual. Emotional well-being is primarily built on the belief that you can create your own reality by choosing your actions. How to promote your emotional well-being? Be optimistic :  Emotional and mental well-being is majorly decided by how you look at your life. Even though you have many sufferings, are you able to accept them and find ways to get through them, knowing that the good is yet to come? Flip through the inspiring stories of people around you to motivate optimism. Find your beauty : Listen to the needs of your body and do not impose your mental ideas of beauty on it. Beauty of each person is determined by their unique characteristics. Do not let the conventional standards of beauty pull you down. Know that you are unique and beauty is not necessarily an external but an inner state of mind. Stay with those who care for you : You might see the need to sacrifice your happiness for others in some instances. However, if you find yourself doing that 8 out of 10 times in any relationship, it is time to seriously reconsider how you wish to live. Is your happiness being taken for granted? Are you running this relationship because you are afraid of being alone, knowing that it is going nowhere in the future? Those who care for you will show it through their actions. The best way to love yourself is by being able to see yourself through their eyes. Take care of your body :  Get adequate sleep daily and make sure your body gets lots of nutritious food. Don't let the advertisements decide the needs of your body. Try out different cuisines and let your body tell you which one it feels is most suitable. Exercise moderately everyday by taking a walk in a green area with your loved one (Remember that the point of exercising is not only to lose weight, but to sweat away your stress daily in fun ways!) Follow your heart : Do what you love. There is nothing that could harm your emotional well-being more than doing something which you know is not right and which you do not want to do. Confucius has dropped us a fortune cookie of happiness when he said that in choosing a job you love, you will never have to work a single day of your life. Get a pet companion :  Adopt an animal and take care of it. In taking care of the pet, you will realize and gradually get in touch with yourself, becoming aware of who you are as a human being. This could be the starting point of discovering your true potentials. Volunteer at social services : Let your creativity and emotions flow by connecting to those around you. Depending on your interests, choose a type of social service - old age home, orphanage, animal shelter, being with terminally ill people, and so on. Such activities will help to positively channelize your emotions.
Diet to help manage stressYou cannot avoid stress, as it has now become an integral part of modern lifestyle. Children are worried about their exams and performances in the cultural events, teenagers are stressed out about their looks and body shape, adults take stress owing to competition at work, and so on. One thing is sure that you cannot stay away from stress. So, how can you avoid the side effects caused due to stress? You can include certain foods in your diet that help manage your level of stress. Researchers are already on to it, studying the effects of various foods on the stress levels. It is always better to choose from the organically harvested nuts, veggies, fruits, and fish for better health benefits. Nori Sushi nori is a type of seaweed that is rich in magnesium that contains anxiety-fighting properties. Magnesium is also known for stress reducing abilities. Apart from this, it also carries other essential health nutrients that are necessary for the overall development of health. Vitamin C Foods Cantaloupe is composed of vitamin C that is a renowned stress buster. Another great stress busting food is orange. When you are under stress, adrenal glands in your body start producing cortisol that lowers your immune system's capacity. This leads to breaking down of muscle tissue. Vitamin C in oranges have the ability to return the high blood pressure to normal level. Moreover, when you are stressed there are chances of this vitamin getting used up and hence the need to increase your intake of vitamin C rich foods. Another popular vitamin C enriched food is blueberries that are also packed with lots of antioxidants which relieve stress. Almonds Almond is a treasure trove of essential nutrients such as vitamin E, B2, zinc, and magnesium. Although they are high in fat, they provide your body with all these essential nutrients. You can easily have a handful of almonds every day and still feel less guilty about.  Apart from the fat, energy, and the essential nutrients, almonds give the brain and its memory a shot in the arm. Broccoli Broccoli is rich in vitamin B and folic acid, both proven stress busters that helps in giving you relief from panic, anxiety, stress, and depression. Bananas Bananas contain one of the most important amino acids - tryptophan that gets transformed into serotonin which is a stress-busting hormone that is known to induce a feeling of well being. This makes you happier and gives you relief from stress. Banana is also rich in potassium. Potassium regulates the heart due to which the blood pressure can be kept under control. That is why many health experts recommend inclusion of a potassium-rich diet, as it normalizes your heart rate and help you calm down in stressful situations. This makes banana an essential food addition to your diet. Chocolate The dark chocolates are bitter and give you a feeling of satiation despite the little amount you devour. Due to this feeling, you eat less, but you still enjoy the flavor of the chocolate, much more than the milk chocolate varieties. When you are under stress, most of your body organs are vulnerable to damage. The antioxidants polyphenols that are present in the dark chocolate slow down the damage and also contribute in its repair. Studies have also revealed that 40 grams of dark chocolate per day helps reduce stress-causing hormones such as catecholamine and cortisol. Increasing the intake of stress busting foods in your daily diet can help control diabetes and hypertension.
Some tips to prevent night blindnessHere are some foods and eating tips, which will help improve vision and prevent night blindness: Eat dark green leafy vegetables like spinach and collards. These contain high amount of lutein and zeaxanthin, the nutrients for healthy eyes. Do not smoke. A glass of red wine daily is fine but drinking is not. Stay away from hydrogenated oils, refined carbohydrates and sugars in excess. Always wear sunglasses while going out in bright light to avoid potential sun damage to eyes.  Amber and grey-coloured lenses are effective against ultraviolet rays. See an eye specialist and get prescription glasses for driving at night, if required. Do not ride in dim light at night and see if you can postpone the work until next day. Even good lighting conditions at night even in a big city, can be troublesome to someone with night blindness. Vitamin A rich foods like spinach, carrot, papaya, broccoli, and mangoes should be added to your daily diet. Fish oil is a great source of vitamin A. Cod-liver oil is used as medicine too. Some wild plants are said to be rich in vitamin Abut they are seasonal, available in small quantities and there isn't much known about them. Beans are another fairly common source of vitamin A. These are consumed especially during autumn. Eggs are a good source of vitamin A. Eat eggs daily. People with high cholesterol should, however, limit their egg intake. Hot pepper is contains vitamin A too, but the preservation method, sun-drying, decreases the vitamin A content. Carrots are another good source. They are high in vitamin A and arenot expensive as well.
All you need to know about angioplasty!Why would you need coronary angioplasty? The walls of the arteries are being constantly lined with a fatty material called plaque. This plaque increases in certain conditions like atherosclerosis. When the build-up is too high, the artery gets blocked and the subsequent tissue receives very less or no blood, causing it to die. The plaque at times may be dissolved by medicines but if it is too big, medicines prove ineffective. This is manifested outwardly as a heart attack. This is the time when the doctor would recommend the coronary angioplasty as a treatment for you. How is it done? A thin catheter with a deflated tiny balloon at one end is inserted into the affected artery. Once the exact location of plaque build-up is reached, the balloon is inflated causing the plaque to get pushed against the artery wall and creating free space for the blood to flow. A small mesh called a stent may be placed to hold the artery in place. Some stents are coated with medicines that prevent the scar tissue formation following the angioplasty procedure. The procedure may be done as an emergency or it may be planned. If it is a planned procedure: You will have to get hospitalized and stop eating or drinking 6 to 8 hrs before the procedure. Once the procedure is done, the doctor would prefer you staying in the hospital overnight to watch for any adverse events that may happen. What happens after the surgery? The surgery lasts for 1 to 2 hours and you would be allowed to go home the next day. You will be advised not to undergo vigorous and strenuous exercises and to rest adequately. Most people are fit to return to work a week after the surgery.
Internet and sex : Decoding virtual pornographyPornography is broadly categorized as softcore or hardcore. While hardcore contains intensive and highly graphic forms of sexual content, softcore constitutes less intensive form of sexual content. Genres of pornography are determined on the basis of the type of content and the status of the participants. The common sub-genres are ethnic, fetish, reality, group, and amateur. There are also sexual content specially created for different sexual orientations: heterosexual, homosexual, and bisexual. While sexual needs are natural and part of our biological set-up, the use of pornography is widely criticized for putting forward a partial portrayal of who a human being is. Majority of the pornographic material express a human only in sexual terms- as being someone looking for sexual endeavors- without paying attention to and inclusion of the person's emotional and mental state. The explication of human beings as purely sexual beings closes the eyes of the viewers many a times to the emotional and mental aspect of sexual intercourse, thus perverting the way they look at sexual intercourse in their relationships. Since sex is not holistically discussed on public platform as part of a healthy relationship and one only has access to understanding sexual practice through pornography which portrays a certain mechanistic and physically-induced aspect of sexual acts, viewing of pornography comes with the risk of sex addiction. Moreover, since pornography generally engages participants whose possess bodies which are conventionally considered sexually appealing, the viewers could implicitly get dissatisfied with their sex lives due to non-duplication of the same form of bodies in real life. Medical researches have also found that apart from having unreal expectations from one's partners, the viewer might find themselves lowly in sexual matters due to the sexual practices performed on the pornographic content that can be difficult to duplicate or are disliked. The portrayal of women in pornography is generally of persons who have no issues with being dominated over and who find such domination also sexually arousing. However, such a view is overwhelmingly false and a viewer on a regular fodder of such pornography could end up with deeply flawed perspective on women. Lastly, pornography also expresses various types of perverse forms of sex which are harmful to society, especially vulnerable groups. These include child sex, office-related sexual content, rough and rape sex, and public sexual acts. While pornography is a sure avenue to possibility of sexual perversion, healthy ways of satisfying one's sexual needs must be acknowledged and taken up. Moreover, it is integral that socially, sexual intercourse is recognized as a healthy part of emotional relationship. It needs not only absorbed as a purely physical act which is morally judged and shunned- the latter approach only increases the probability of pornography being seen as a last resort to learn about sex. In talking about sex as a natural process between mutually approving adults and as part of emotional relationship, we reduce the chances of sex being seen as a non-emotional activity and allow for there to be holistic understanding of sexual intercourse. For adolescents who are entering the age of sexual maturation, it is integral to introduce the physical relation between persons as being a result of emotional relationships, with understanding of the body holistically - as a harmony between physical and mental states. In the case of non-presence of holistic guidance, the chances of teenagers falling prey to pornography to understand sexual intercourse is high and as has been earlier explored, such an understanding of sex as activity between solely sexually-charged beings could result in perverted view of emotional relationships as well.
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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