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Make no bones about this - Men have osteoporosis tooOsteoporosis is a condition in which the bones of the body lose their strength gradually and become thin and brittle. This is most commonly seen in women who have attained menopause. The reason being the decrease in the hormonal levels, particularly estrogen. Studies reveal that 20% of sufferers are men. Falling levels of testosterone are one of the causes for men developing brittle bones. Men's bodies convert some amount of testosterone into estrogen, which is very essential in maintaining the bone mass. Genetic deficiency of the enzyme that helps the conversion of testosterone to estrogen also is a major factor for men developing osteoporosis. Calcium and vitamin D play an important role in developing the bone mass and in helping the bone grow. Exercising helps too. When you exercise, the muscle gets pulled and the bone responds by growing. Too much of indoors and sedentary work may make men get the less of all three and it eventually leads to weak bones and osteoporosis. Studies reveal that 20% of sufferers of osteoporosis are men. Certain medications like anti-seizure drugs, drugs for prostate cancer and steroids have side-effects that make it impossible for the body to use vitamin D. Using them for a long time reduces the bone mass density and leaves the bones brittle making them easily prone to fractures. Smoking is a vice that has to be quit for more reasons than one. An analysis of several major studies on the effects of smoking shows that smokers have a 55% higher risk of hip fractures and low bone mineral density than non-smokers. Nicotine has also shown to have a direct effect on bone cells. A long list of medical conditions like diabetes, rheumatoid arthritis, and digestive and blood disorders can take a toll on your bones. Long term medications for the same also have side-effects on the bones. How to prevent osteoporosis? Exercise- As young boys, men have usually been exposed to a lot of bone building exercises through sports. This helps in building up on the bone strength and comes in handy in the later years. A brisk walk for 30 minutes 5 times a week and moderate impact exercises help in maintain the bone mass and reduce the thinning of bones. Calcium intake- The daily calcium needs for men is the same as women. Hence, the dietary recommendations remain the same too. 1,000 mg of calcium a day from ages 19 to 50 and 1200 mg of calcium a day if you're over 50.Along with this, make sure you get the required dose of vitamin D too, so that the calcium you eat is absorbed properly. The standard recommended dietary allowance is 400 IU. Some doctors advise to increase the intake to 800 IU. Regular medical checkups will help you to know beforehand about the risk factors and the necessary precautions you will need to take.Osteoporosis in men is as much a reality as in women. However, there are ways to avoid it too. Awareness about the condition and about the ways to prevent it can help keep osteoporosis at bay. Bone mass matters. It could mean the difference between a hip fracture later in life - or keeping an active, high-energy lifestyle.
Ageing gracefully and happilyEverywhere we look there are constant reminders that we are growing old each passing day. There are creams that tell us that will make our wrinkles vanish and make us look younger. There are hair care products dyes that claim to cover our grey hair so that we can look and feel young. Our doctors tell us about how we have to take care of all our body parts to keep several diseases at bay in the old age! It is a rare and difficult attainment to grow old happily and gracefully. Is there anything good about old age? It doesn't seem so, going by the look of things. Here we give you 5 reasons that will make you look forward to old age! Old age is the happiest time in life: You are constantly living life to the fullest when you are young. Survival is your prime priority. You work hard to keep yourself and your family happy and financially stable. Too many responsibilities bog you down. Old age is the time when there is nothing of this sort. You are retired, free from all responsibilities. You have passed the baton to the younger lot. Now is the time to sit back and enjoy. Now is the time to relax and do the thing you always wanted to do. Imagine living with not a care in the world? That is old age for you. Old age is when the brain functions the best: It is a proven fact now. It was believed that we lose more brain cells as we age. Now it has been proven that our cognitive functions peak between the ages of 48 to 60. Old people make the wisest and toughest decisions quickly. People may call them worldly wise. Have you ever given a thought to how all the judges are old men? And how when someone says the word 'wise' the picture formed is usually of an old man with a beard? No more fashion policing: When you are young, there is a lot of stereotyping involved! Going to a board meeting, wear formals? Going for a lunch meeting, wear something that is suitable keeping in mind the place. Are you at a certain position in life? Dress accordingly! So many restrictions! Old age comes with none of this. You can wear what you please and no one will really mind! Only when you actually get to do it will you realize how much f a relief it is! Relationships improve: According to a 2011 study; married oldies are more satisfied and positive about their marriages than young couples are. Arguments involve less anger, and senior spouses show more positive emotions and affection than middle-aged couples. It's not only marriages, however, that benefit in older age. Seniors also seem to be happier with their other social relationships too. They have a smaller but closer circle of friends and gain more benefits from these close, emotional bonds. Old Age makes you feel better on the whole: You have lived life to its fullest, your kids have now flown the coop and you have seen it all. As you age, you start feeling better about things in general. You look at things more positively and make the fullest of every situation presented to you. You live in the moment and are not worried about future repercussions. Old age is a happy place to be. Look forward to aging positively.
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
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!
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Crossing the smoke screenWhy should someone quit smoking? Smoking is probably the worst sedentary lifestyle habit that we pick up. Quitting smoking changes everything right from the way you feel, taste and smell, your breath smells better and even your cough goes away. Quitting smoking cuts down the risk of cancer, stroke, neuropathy, heart disease and breathing disorders like bronchitis, pneumonia, and emphysema. Not just that, quitting saves money too... just one of the many financial rewards of quitting. Quit Smoking Tips Write down the reasons you want to quit for, and how it will benefit you: for e.g. live longer, feel better, family safety, save money, smell better, find a soul mate easily, etc. You know what's bad about smoking and you know what you'll get by quitting. Read the list daily. Ask for help from your family and friends. Help and support of family and friends without being judgmental helps a lot. You need their support when you become irritable and even irrational while you withdraw from your smoking habit. Set a Deadline. Set a quit date when you will extinguish forever. Prepare a plan. Talk with doctor and take his support and guidance. Exercise. Exercise helps relieve stress and recovers body from damage caused due to cigarettes. Start slow and increase up to 30 to 40 minutes. Begin to breathe. Daily deep breathing for 5-15 minutes will help cleanse the respiratory system and provide more oxygen repairing the damage caused to respiratory system and help cope with withdrawal symptoms. Do not quit abruptly. Cut down on cigarettes gradually. Plan everything about number of cigarettes you will smoke each day till the quit date, reduce the number each day. Buy single cigarette at a time. This helps a great deal to limit smoking. Change brands. This way you won't enjoy smoking as much. Undertake social commitment. Keep your packet of cigarettes with someone else, so that you have to ask for them each time you want to smoke. This way you'll feel guilty about asking and hence smoking; hence lowering the number of times you smoke. Find a mate who is trying to quit. This will boost the morale and keep up the positivity. Try finding a quitting chat room. Learn what triggers desire to smoke - like stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that's impossible, plan alternative ways to deal with the triggers. Now, after you have read this, sit down and write your own list suitable to your personality and way of doing things and create your own plan for quitting.  
Algophobia: The fear of painAlgophobia is the fear of pain:  an abnormal and consistent feeling that is far beyond what would be considered normal. The term is derived from the Greek words, Algos meaning pain and Phobos meaning fear. Our bodies are designed in a way that when there is a painful stimulus it reacts. How the body reacts to the pain is an individualistic phenomenon. Some people have a very low threshold for pain, and even the slightest pain evokes a huge response in them. Where as others can withstand a good amount of physical pain before their bodies give in. Some people dread even the tiniest amount of pain. They foresee situations that will cause pain in them. The way they react to even the smallest amount of pain is far more than the normal level of acceptance. Such people are said to be suffering from Algophobia. Algophobia is a learned behaviour, say behavioral psychologists. For example you may have heard from several people how hitting your shin on the furniture in the dark is the worst possible pain ever. So you tend to keep a watch and if it is dark, you move around extra-carefully to avoid bumping into the furniture and getting hurt. This would be considered normal, cautious behaviour. But if the same thought keeps buzzing in your head continuously and you go to extreme lengths to avoid that pain, you could be algophobic. Old people are the ones who have excessive fear. The age factor along with fear of death plays a vital role in old people developing this fear. For example an old lady may hear about all the ailments and pains that afflict old age people and may become apprehensive about it. She may develop irrational fears that more often than not, are also imaginary. She may start experiencing the pains even before anything actually happens to her. It may seem unrealistic to a normal person, but for algophobics pain can be a severely dreaded thing. Therefore they will go to great lengths to avoid pain at all levels, including day-to-day activities. They will not go into the dark, handle tools, avoid lifting heavy objects or even avoid playing any type of contact sports. If a task has a scope for injury and pain, they will avoid it! Frequently a pathological complaint of Hyperalgesia occurs along with algophobia. Hyperalgesia is a condition of increased sensitivity to pain due to damage to the peripheral nerves and pain receptors. Pain in such cases may be directly in the damaged tissues or in the surrounding areas. An interesting fact is that hyperalgesia can occur due to long term use of painkillers especially strong ones like opium and its derivatives. Algophobia is treated with behavioural therapy, psychotherapy and anti-anxiety medications. Hypnotherapy also has shown beneficial effects.  
Exercise, a healthy way to deal with hypertensionYou have not exercised for a long time. You took it easy when it came to physical activity. Now that you are diagnosed with high blood pressure, you will do anything to control it. Even exercise! Exercise, weight management, and a healthy diet are important ways to help prevent high blood pressure and lower the blood pressure that is already high. Benefits of exercise for people with hypertension include: Improve blood and oxygen circulation in the body Promotes sound sleep Improves stamina and endurance Keeps heart healthy Reduces stress and promotes mental health Exercise enhances the effectiveness of medication So how much should one exercise? An exercise session of atleast 30 minutes per day is important. Get started Start slowly and increase gradually. Start with 10 to 15 minutes of exercise and increase it, as youget comfortable. Choose exercises you enjoy and will do consistently. Avoid sudden vigorous activities; they can cause injuries and hamper the routine. Warm up Warming up helps the body adjust slowly from rest to exercise. A warm-up will reduce stress on the body muscles, increase heart rate and respiratory rate, and body temperature slowly. It will also decrease soreness of muscles. Best exercises for lowering blood pressure Stretching: It is the best. It relaxes and helps prepare the body and muscles for activity and prevents injury and muscle strain. Stretching regularly will make you flexible and improve motility. Aerobic exercise: This helps to improve circulation to the entire body. It improves heart function. It gives maximum benefits to the heart. They also help to reduce heart rate and blood pressure by improving breathing pattern thus lowering blood pressure. Walking, swimming, jogging, and skipping are all aerobic activities. Do aerobics for at least 30 minutes three times a week. Strengthening exercises: These include exercises that have repeated muscle contractions till the muscles are tired. These include side balance crunch, climbing a rope, and push-ups. Join a gym. Here are some  exercise guidelines for a better exercising routine in the gym:  Schedule a fixed time for exercise. Find a buddy to exercise with you. Select an exercise that you like. Make variations to avoid getting bored. Boredom can make you stop exercising. Start slowly and increase gradually, especially if you do not exercise regularly. You should wait for an hour after eating before you exercise. Ten minutes of warm up and ten minutes of cool down sessions are must Keep a record of daily exercise.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
How to communicate with a patient who has a strokeThe first and the most important thing to communicate with the patient, is to give undivided attention. Give attention to his activities, gestures, his facial expressions through which he may try to communicate so his feelings could be understood. Eye contact is also important but the patient having stroke may look at you square in the eyes but he may not respond to your conversation. While communicating with the patient you should always stand in front and tune out all the other sights and sounds in the room. Maintain full silence around the patient in the room, turn down the volume of the television, radio and ask other people in the room to be silent. You may communicate with the patient by making contact by touching the hand, chin, cheek or areas which are not affected by stroke. As the side which is affected by stroke, does not have any sensations. You may communicate with the patient through his family member by telling the family member to communicate with patient by saying, "Look at my face"; through this we can gain the patient's concentration. You should always speak clearly with the patient in a normal soft volume. Express your ideas in simple terms, form simple sentences, do not use complex words. You may repeat the sentences or an important term again. For example to ask if the patient wants tea, repeat the word 'tea'. More complex thoughts can also be similarly conveyed and repeated. You may also use hand gestures with clarification like doing Hello by waving your hand or through your hand action, you may ask questions like, How are you? Are you ok? What do you want? Through this both caregiver and stroke patient can benefit. You may ask your patient to point out whatever he wants or if he needs anything. And gradually he will develop the habit of pointing the daily items like television, newspaper, remote, eyeglasses radio, drapes an uncomfortable foot, the patient can indicate any pain or headache. Through this communication we can make the patient learn, use mechanical lifts to get in and out of the bed, and with the help of the attendant by demonstrating the patient how to use it. Sometimes when the communication does not work, take a break, give it time and try again, do not get frustrated and reassure the patient that yes, he or she can do it. Good communication with the patient is very important as they cannot speak their basic wants and needs clearly. The patients suffered a stroke also have slurred speech. There is a deviation of the angle of mouth. They are mostly bed ridden and could not carry out the routine activities.
Adrenaline rush - Feel it inside!Imagine yourself at a great height, either scaling a dangerous cliff-hanger of a rock face or on a bungee jumping platform. Some of us who have had the pleasure of doing high adventure sports like racing or indulging in perilous activities like giving out an acceptance speech for the first time are well aware of that strange feeling in the solar plexus, the clammy hands and intensely thudding heart, and the rush of blood to the head just as you are about to take the plunge! The heart beats faster than ever, breathing goes rampant, the senses seem to become supercharged, and the fear, the joy, and the excitement meddles with the mind. That’s adrenaline rush! So what do you want to do? Fight? Or flight? Either ways, adrenaline does it for you. Speaking medically, the two small adrenal glands on top of the pair of kidneys release a magic chemical that gives the animals way towards the fight-or-flight response to counter certain high-intensity situations, called adrenaline or epinephrine. The chemical entity is a hormone, a neurotransmitter as well as a medicine and is too complex to explain its behavior. However, when it works the heart pumps out the blood to the excited muscles and all the juices surge up inside the body. There is more to this topic than just the physiological mumbo-jumbo. The hormone acts every day in the normal course of life, but not regularly to the extent when it produces side effects such as shakiness, palpitation, high anxiety, and profuse sweating! Thats kept for special situations like physical threat, excitement, bright lights, noise, and really high temperature – in good or bad ways. Let us surf through some of the rewarding and a few of the nasty situations where the jolting juice takes charge of our body! The Good ones: Countering Stress: In extreme stress conditions like accidents or fracture, the body needs to react fast and is at its highest awareness. Adrenaline keeps the muscles up and kicking to help the victim fight with the stress. High Energy Requirement: In majority of sports, more specifically in contact sports like Rugby, Boxing, Mixed Martial Arts, etc., the player needs to be in his full sense and topmost concentration level. The adrenaline rush runs in the background to keep them at their extreme self. The Push Mode: Often the daily chores aren enough to excite us and we tend to search for some adventure. In such pursuit of excitement, there are times when the road is a dead end or there is only one way forward – the impossible or most difficult one! The hormone pumps the brain both ways with fear and with the push to conquer the fear and proceed. Adventure Sports often sounds fun, but at times when running ahead of a raging bull, or hanging off a cliff, or rafting down the rough waters of a cascade – feels like the heart shall come out and scream!! It is the rush of adrenaline that keeps one ahead of the fear and explore the high-energy fun of winning over it. Life Saving Moments: In cases of life-threatening emergencies such as drug overdose, cardiac arrest, or pulmonary failure, where the heart and lungs suddenly cease to function and the body gets into a shock –– the epinephrine shots are considered as a life-saving medication to bring the patients back to life (only to be used judiciously by a qualified medical practitioner). The important medical use of adrenaline is in treatment of acute anaphylaxis and allergies under medical supervision. The Bad Ones: Disorders of the Adrenal: Tumors and cancers of the adrenal gland can cause hyperactivity of this high-performance hormone affecting the normal functioning of the heart and the blood vessels by increasing heart rate and creating anarchy in the body systems. Over-Stressed Adrenaline Rush: The demand-supply mismatch in the present world scenario requires one to perform at his/her epitome of mental and physical strengths. In that constant urge of performance, the brain and the body is stressed out so intensely that the adrenaline surge symptoms are experienced by the individual even in the absence of threatening situations. Sudden sweating of palms, shortness of breath, pounding heartbeats, or chest pains without a justifiable reason can be a result of constant stress.
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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