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Broad chest, weak lungs - Are men more prone to respiratory diseases?The long-standing, chronic afflictionof the respiratory disease is called as COPD, i.e., Chronic Obstructive Pulmonary Disease. COPD is the obstruction within the lung tissue, causing improper circulation and entrapment of air. This limits the space for air to move in and out, directly affecting the quality of inhalation. A small reminder here may be necessary - breathing is synonymous with life, why? Because that's how we get oxygen, which is vital for the functioning of each and every cell within the body. With COPD, the ability to take in oxygen gets compromised increasingly. Continued cough, sputum, and shortness of breath are the main symptoms. COPD is more common in men. Does it have to do anything with being a male? Not necessarily. No specific link has been established to say that COPD risk is higher for you solely because you are a man. Then, what could it be? A study conducted in 2011 in USA showed that the number of men who smoke is 5% more than the women who do. To understand the reason behind this, let us see the primary causes of this disease. Air pollution, some genetic predispositions, frequent acute infections, exposure to harmful chemicals for a long time (usually occupational) - are some of the main causes, and the number one cause is smoking, owing to almost 80-90% of the cases. Park this thought. Next piece of information is simply revisiting some facts you may already know: #The gender classification ofsmokers - Men are known to smoke more than women all over the world, not only in numbers, but also in quantity. Whether it is a developing country or a developed one, 2011 studies say there are more male smokers everywhere than female smokers. Not only there are more men who smoke, they smoke for longer periods and more number of cigarettes than female smokers. This may vary from country to country, like India has much less women smokers than USA does, but the difference between the two genders holds true everywhere, only the ratios differ. #Occupational exposure to harmful chemicals and gases - These are industries of mining, textile, chemical engineering, welding, etc. The number of men working in such industries is way higher than women. #Air pollution - Men are more exposed to air pollution since they are outdoors more than women. This may not apply to all countries and societies, but is generally true. Now, we can put the pieces together and understand why COPD is more common in men? Yes, they are at a higher risk because of higher exposure to smoking, pollutants and irritants. Cigarette smoking is the leading cause of lung diseases and male smokers outnumber women across the world. You can figure out the math here!
Honeymoon cystitisHoneymoon cystitis is a term for urinary tract infections that occur commonly during early marriage. Sexual intercourse is the primary reason for developing this infection. The infection occurs when the E. coli bacteria that are normally present in the bowel are introduced into the urethra. This may happen through sexual intercourse, inserting unclean fingers or objects into the vagina. Women who wash their private parts from the back to front also have an increased chance of developing infection. Symptoms of honeymoon cystitis may include a burning or painful sensation during urination, the urge to urinate frequently, cloudy urine, blood-tinged urine, and/or pain above the pubic bone. Any of these is enough o play a spoilsport and dampen your honeymoon mood! Symptoms of honeymoon cystitis generally emerge within a day or two after bacteria are introduced into the urethra. A physician can confirm the diagnosis of infection through a simple urine test. The treatment usually involves antibiotics and pain-killers. What care should you take to avoid honeymoon cystitis from recurring? Use water based lubricant during sexual intercourse Urinate before and immediately after intercourse to flush out the bacteria from the urethra. Drink plenty of water to keep the urine normal Avoid coffee, tea and aerated drinks See a gynaecologist or a urologist if the problem recurs.  Urinary tract infections are extremely common in women and are the leading cause for visits to the doctor.
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
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.
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
Fair skin - A modern obsession!History of Complexion - Complexion generally refers to the natural color, appearance, and texture of the skin, particularly on the face. Originated from the late Latin term 'complexio', complexion is traditionally referred to the temperament which was determined on the basis of the proportion of qualities of hot, wet, dry, and cold in the human body. It was believed that the body carried these qualities depending on the climate in which the individual lived. Thus, a person living in a cold climate was seen to have 'colder and moister' complexion and so on. The biological facet of complexion mentioned below tells us how the skin adapts its color according to the climate it finds itself in. Moreover, it was also seen to represent the character of the person into different categories like melancholic, choleric, sanguine, and phlegmatic. Complexion was the center which reflected the qualities which make a balanced person. Skin color is determined by the presence of pigment melanin. Located in the outer skin layer called epidermis, it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. The Biology of Complexion - The complexion of the body ranges from very dark brown of Africa and Aboriginal Australia to pink with yellowish hue of the Northern Europeans. In actuality, there is no skin which is black, yellow, red or white in absolute - it is generally a hue of many colors with one dominating over the other. Our biological actuality is not reflected by the words we use for our complexion these days. Skin color is determined by the presence of pigment melanin. This pigment is under the control of 6 genes. Both complexions of dark and light have melanin. Spatially located in the outer skin layer (called epidermis), it is produced by cells called melanocytes. These cells contain receptors which are photosensitive and which detect the ultraviolet (UV) radiation from sun and other factors. In response to this detection, they give out melanin after exposure. Those in tropical latitudes, where there is highest exposure to sun, have darker skin which contains melanin acting as a protective biological envelope against UV radiation. This protective layer prevents sunburns and other damages including those that could increase the risk of melanoma. The UV radiation reaching the earth increases during summers and reduces in winters. The skin adapts to this change by tanning - tanning indicates that your skin is increasing the size and amount of melanin grains to protect against the UV. Thus, your skin color is essentially determined by genetics and the geography of the place you live in. Biological Fact to Social Conclusion - We generally mold the biological fact of adaptability of our skin into a social meter of beauty. The complexion is a biological wonder of the nature which allows the skin to absorb enough vitamin D, prevent many illnesses like anemia, osteoporosis, and rickets determined by its environment. Thus, to claim that a certain skin color is superior to others is to only deny the reality of biology related to our skin and body, thus falling into the fallacy of unjustifiably jumping from a biological fact to a social conclusion. The health of your skin must be the starting point to declaring its beauty, not a presupposed social standard unrepresentative of the reality of the body. Taking Care of Your Skin - Every skin color is determined by its biological framework placed within the environmental setup. It is essential to take care of your skin to ensure that it is healthy and well taken care of : Make sure you eat a well-balanced and nutritious diet. Stay away from junk and heavily processed food items. Sleep for at least 7-8 hours daily to ensure that your skin gets enough time to recharge its mechanism. Drink loads of water to keep your skin hydrated. Go through the daily care routine: cleanse, tone, moisturize, and exfoliate. Use rose water to remove your make-up and ensure that you do not go to bed with make-up on. Keep dirt and germs away from your skin. The best way is to avoid touching your face with hands when you are out. A clean environment is the fertile ground for a healthy skin. Make sure you wash your pillows, their covers and clean the house regularly to keep away pollutants. Stress is one of the main causes of your skin's health withering. Your skin is the outer reflection of your inner mental state. Work towards mental detoxification to cheer up your skin and body.
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.
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.
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.
Pulling out - Is it an effective option for contraception?What is the 'Pulling out' method? 'Pulling out', 'Withdrawal' and 'Coitus Interruptus' are all the different names for probably one of the safest methods of contraception. It involves the male partner withdrawing or pulling out his penis just before ejaculation. This ensures that no semen has been ejaculated into the vagina or vulva of the female partner. Since there are no sperms travelling inside, the result is - No Pregnancy! Is this method really effective? Like all methods of contraception, the effectiveness of the pulling out method also depends on how correctly it is done. This method requires a lot of mutual understanding between the partners. The male partner must also exercise great self-control and accuracy in knowing when he will reach the highest point of sexual excitement so he can pull out at the right moment. Statistics have the following things to say Of women whose partners use withdrawal, 4% become pregnant each year if they always do it correctly, and 27% become pregnant each year if they don't always do it correctly. Ejaculating close to the vagina or vulva would mean that the sperms still have a way to travel inside the vagina. At times the pre-ejaculate fluid may also contain a few sperms from the previous ejaculation that may end up causing pregnancy. As a precaution against this, experts suggest the male partner pass urine before the sexual act. Withdrawal method of contraception is the best option for members of religious groups in which using contraceptive devices like pills, condoms or IUDs are a form of sin. Withdrawal method does not protect you from HIV/AIDS and other STDs. What are the advantages and disadvantages of this method? Advantages It is simple, safe and convenient. It is the best method when no other contraceptive method is available. It has no side-effects It does not require a medical prescription. It does not alter the menstrual cycle. It does not affect future fertility. Disadvantages Requires great self-control, experience and trust. Not suitable for men who suffer from premature ejaculation Not suitable for teenagers and sexually inexperienced people. Does not ensure protection from sexually transmitted diseases and HIV/AIDS. Less effective than other methods of birth control. May interfere with sexual pleasure due to nervousness and anticipation of pulling out at the right time. The pull out method is thus one of the safest methods of contraception, provided one has a thorough understanding of one's body, trust in the partner and a huge amount of self-control.
Reasons for skipping sexThe most important satisfaction brick in a marriage's foundation, sex is where we show the greatest trust, most openly express intimacy and make ourselves most vulnerable. It is the most personal and private area of our relationship. It is the one area that separates this relationship from all others. Yet, there are times for both husbands and wives when sex becomes a burden and not a blessing, an inconvenience instead of intimacy, and a job instead of jubilee. Curious as to why people might be skipping sex? This is only a partial list and far from exhaustive. Reasons related to your body: I have a migraine. I have a stomachache. My body is too tired. My breasts are too sore. I am too sleepy. I can't keep my eyes open. I just need to take a little nap first. Okay, but I have a rash. Okay, but I have several weird looking cold sores. Reasons related to your emotions: I am depressed. I am worried. I am sad. Cry Reasons related to your kids: The kids are still up. We might wake up the kids. I just had a baby. This baby is wearing me out. Reasons related to your experts: My therapist said I need to give myself some time. My counselor said I should create some boundaries. I have to see my Gynecologist tomorrow. The Doctor gave me these sleeping pills for stress and I just took one. Reasons related to your spouse: Who was that girl / guy you were talking to on the phone? Sex, Sex, Sex All you ever want is sex! Why can't you just hold me? You should have asked in a more romantic way! Why do you have to use such crude language? Reasons related to your weather: It's just too hot. It's just too cold. It's too humid. Reasons related to your economy: When the economy improves. When the interest rates go down. When inflation goes down Reasons related to your special circumstances: We just got back from vacation! When I lose 20 kgs. Reasons related to your friends: I need to make a call first. My friend said they only do it once a month. Reasons related to your pets: The dog can see us. The cat is on the bed. Reasons related to your finances: Okay, but first we need to talk about the bills. Why did you charge this hotel room on our credit card? Reasons related to your job or boss: I have to get up early tomorrow. I was up all night last night. I had a long day at work today. The boss just gave me a new project and I have a lot of work to do Reasons related to your religion: Doesn't the Bible warn against having too much sex. I am sorry, but I just took a vow. I am giving up sex for Lent. Reasons related to your in-laws: We are in your parent's house. I have not been able to concentrate since your mother Your parents will hear us. Offer an alternative: Can I just take care of you in the shower? Okay, but you have to drive the kids to school in the morning. Use evasive tactics: Sneak in and go to sleep early. Okay, but let's watch this movie first. It's just too late. I'll be there in a minute. (Take an hour) Can we just cuddle? I just need you to hold me. Ask a sensitive question: Did you go to the bank and make our deposit today? Have you seen the kid's report cards? Wait for your spouse to tease you and then say coldly, well, you just lost whatever you were going to get tonight.
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