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Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
Health check up checklist for men Prostate Cancer - Prostate cancer is the lesser known killer in men. It is a slow growing cancer, but at times, its symptoms can be aggressive as well. Detecting prostate cancer at its onset can help in treating it effectively. Tests include a digital rectal exam and a blood test for Prostate Specific Antigens (PSA). Testicular Cancer - This uncommon cancer can affect any male between the ages 21 to 55. A physical exam during yearly medical checkups is recommended for all men. Men having a higher risk, with family history, should speak to their doctors regarding additional tests for screening. Self-examination through regular gentle palpation of the testicles to notice any change in shape or size, presence of lumps is also suggested by doctors. Colorectal Cancer - This is the second most common cancer in men. Men over 50 and younger, if they have a familial risk, are suggested to get a screening colonoscopy done to detect this cancer. It usually starts as a polyp that grows and invades the nearby areas to develop into a full-blown cancer. The polyps, if detected early, can be removed and cancer prevented. A CT scan or a double barium enema can also help in detecting polyps. High Blood Pressure - With the kind of lifestyle men lead today, almost every other man is bound to have BP issues. Regularly checking the BP is essential as it helps detect high BP which may lead to a variety of other problems including stroke and heart attacks. The sooner the detection, the sooner the measures for control. Cholesterol Levels - Bad eating habits, sedentary lifestyle, and mental stress can all lead to lots of cholesterol roaming around in your arteries. This will eventually clog the arteries and cause diseases like high blood pressure and atherosclerosis which can be life-threatening. Get your total cholesterol, LDL, VLDL, HDL, and triglyceride levels checked regularly and initiate timely interventions to bring them under control. HIV - This is the most commonly spreading STD among men. Due to its chronic nature, HIV is often detected accidentally when it may be too late. Regular tests for HIV detection are essential if one is physically active with multiple partners. Be safe though and use a condom. Glaucoma - It is extremely common and is one of the leading causes of blindness. Glaucoma has no cure, but it can be controlled well with timely detection. Screening tests should be undertaken by men under 40 years at an interval of 2 to 3 years after 35. A yearly test is recommended for older men.
Leg toning exercises for womenFor those women who will leave 'no stone unturned', here are a few great exercises which work superbly on the legs and whole body. For those who have always wanted a great pair of legs, don't change your jeans brand. Just change your brand of exercise. Here are great leg toning exercises that can make your legs attention grabbers. Well-shaped legs are what every woman desires especially as it signifies 'movement', 'mobility' and 'strength'. When we say legs we mainly mean the thighs, the calves and the feet. To get more precise the quadriceps of the thighs the hamstrings and the hip adductors are the prime targets of most exercises. A complete leg work out would also include the 'Tibialis Anteriors' or the shin muscles. Exercising the legs can be quite a frustrating thing especially if the leg muscles don't show any cosmetic improvement. Here is an exercise regimen which will ensure that you will get those attention-grabbing legs along with the strength, flexibility and tone which you have always desired. The stand This is probably the most undermined exercise of them all since it doesn't involve lugging heavy weights around or running for miles or squatting! It is a foundation exercise for the legs.  Choose your favorite spot on the floor and just stand erect with both feet together and toes pointing forward. Hold the hands straight at the elbows and keep the shoulders square. Tuck the chin in and do not bend your knees. Feel the ground under the feet. Now flex your thigh muscles and keep your feet firmly on the ground. Direct your attention towards the back of your thighs and keep your knees taut. Stand firm for about 3-5 minutes initially and gradually extend to five minutes or more. This exercise is simpler than it actually is as it keeps the thighs taut and firm. The entire leg gets a marvelous stretch and any faulty standing or postural habits create unnecessary tension and uneven hip alignment. The standing pose will be your first step towards trim and well-sculpted legs. The One Leg Extension After you perfect the stand, here is another great leg exerciser - The one leg extension Perform a stand as in the previous exercise for about 30 seconds. Once you get your grounding and feel your foundations beneath the feet, take a deep breath. Now flex your thigh muscles and keep the kneecaps taut without feeling any strain. Bend the left leg at the knee and raise it without bending at the right leg. Now catch hold of the big toe with the left hand and hold the pose for a few breaths. You will initially struggle for balance as you have to keep the other leg straight. Now that you have caught the big toe of the flexed leg gradually straighten the leg out without letting go of your grip. This is a challenging pose especially for the hamstrings, the hip flexors and the calves since the leg muscles are going to be a little tight especially around the hips and the hamstrings. With regular practice, the pain will ease and then you can even try and take the toe towards as high as you can with the aid of your left hand. Repeat with other leg following the same sequence. One Legged Squat The one legged squat is a superior exercise to the two legged variety is that it doesn't require many repetitions as it is quite a strenuous exercise even for advanced exercisers. Stand with the back of a chair within easy reach initially. Extend the right leg out first and squat down to your heel with your left. Once you have reached the end of the squat try not to touch extended leg as there comes the difficult part - getting up to standing position without touching the floor with your hands for support. Raise yourself to standing position and repeat with other leg. You can do about 3-4 sets with the same leg or alternate legs using the back of a chair for hand support as you squat deeply. The single legged squat exercises the gluteus, the knees and the entire hip joint and also gives lower back strength. Initially your knees might hurt so don't try this without support of a chair or a partner. Stop in case of intense pain. Step Training If plain jogging doesn't do the trick for shapely legs for you, try using stadium stairs or any gradient which is at 30 degrees and comprises even steps. Your regular apartment stairwell or even a pedestrian over bridge can do the trick. First set only walk up one step at a time. Second set do alternate stairs. For the third set you can sprint up as fast as you can the entire flight of stairs or halt for exactly ten seconds when tired and start again. You have the option of stopping as many times you wish as long as you start again after ten seconds. This can work up quite a sweat and regular step training works out and touches muscle groups that even normal running or squats cannot reach.
Activities to help your toddler talkWe understand how eager parents are to talk to their kid. They want to hear their soft voice and babble talks. So start teaching them as soon as possible to help them to speak fast and clear. Here are some activities which will help you to teach your kid to talk. The playful ways: The best way of teaching your kid to speak is to, well,play. Most of the learning is done through playing. Be a child with your child. Act playfully foolish --kids enjoy that a lot. And when the kid is happy and in playful mood, they try to talk. Building vocabulary: Use a word in more than one sentence to make them understand the meaning of the word. For example, 'The color of leaves is green' and 'Your father is wearing a green colored shirt.' If the kids hear a word used often in different sentences, it becomes a permanent part of their vocabulary. Give them practical examples: Teach them the names of the things they see around. Or get actual objects and be descriptive to teach them the name of the object and talk about the object's features. Use a toy phone: You must have seen kids trying to talk over phone to their dads or friends. They try to copy you the way you talk over phone. It can be a great way to teach them to speak. Pretend that you are talking to the kid's dad or grandparents, and pass over the phone to the kid and encourage them to chitchat over the phone. Story telling: Kids listen to the stories very carefully. Show them the pictures in the storybook and describe them with the story. Then repeat the same story the next day. Ask your child if she/he remembers what was there in the story by showing them the picture. Help them if they get stuck. Sing together with the child: Music is another amusing way to teach the child to speak. Listen to a song, sing and dance along. Encourage the child to dance and sing with you. Children are great at learning lyrics of a song. Reward the child on completing a task: When you reward the child with his/her favourite toy or snack, they understand the benefit of performing the task. And they take effort to get the reward. Ask your child to recite a poem for you, or speak a certain word or sentence and entice the child by showing him the reward he will get on completing the task.  
Balancing marriage and work: The top 5 tricksFor women juggling between home and work is very difficult. Yet, the number of women choosing to go out and work, while managing their homes, has increased over the years. This is because a successful career helps a woman establish her identity in society, gain respect and do justice to her inherent qualities, passions and dreams. So, a successful working woman, is a happy woman and statistics show that such women also keep their kids and spouses happy. More stable marriages During the seventies, when women started entering the workforce in large numbers, there was an instant rise in the divorce rates. However, over the past decade, the divorce rates among working couples have actually declined. Today, men have extensively adjusted to the idea of having a working woman, as a partner. In many countries, men actually share the domestic chores and devote time to childcare, so that their women can successfully handle both, work and home. However, the main responsibility of the home and the kids is still primarily, in the hands of the women. Here are the six keys to manage your work and marriage successfully: Find the right job You can ease out the stress of managing the work and home front, if you make the right decisions. Studies indicate that couples having access to less demanding work, have better sex and better relationships and hence, are less likely to be stressed out. However, in case the working hours are long, the situation can become the opposite. Hence, it is important to find an exciting job, over which you can still have control, especially when you have small kids at home. Adjust the working hours Most women have to leave their careers halfway because their husbands work for long hours and there is no one available to care for the kids. If the wife too is good at work then, the couple should take up jobs that provide an opportunity for both of them to work, since doing this will keep both of them satisfied. There is a possibility that the husband, or the wife, may lose a bit on the income in this adjustment, but ultimately it increases the chances of having a happier marriage. The negative impact of leaving work If a career-oriented woman leaves her job due to family demands, it can shake the very base of the marriage, while also leaving her, depressed. Also taking a break, means you have to catch up very fast when you want to restart your career, which in reality, is quite difficult. In these situations, there is also a huge wage gap, between what you used to get before your break, and what you are getting after, that can lead to depression. Working moms help fortify the relationships between kids and their fathers When the father spends time babysitting the children, a closer bond develops between the kids and the father, which is usually not possible in families where the dad goes to work, full time. Studies show that children raised with equal devotion from both father and mother, have higher goals and aspirations and are even more empathetic. Feel less guilty A working woman usually feels guilty because she cannot spend as much time with her children, compared to the dedicated housewives. However, if the husband shares the duties related to bringing up the children both parents can be happy while playing their parts well for their kids. A woman with a successful career is positive and confident about everything she does, which ultimately makes her family happier.
Expression forbidden! - Human emotionsSome people have a perpetual 'bee in their bonnets'! They maintain a demeanor and a mask which is virtually impenetrable. They are generally highly competent and efficient and occupy high positions of authority. They believe in living life set to a routine, and the worst part is that they expect others to adhere to it as well! God help those who have a boss like that, as their immediate liberty is at stake, and unless they are honing to be perfectionists, life is going to be a series of disasters with Captain Ice around! Nothing wrong with perfectionism per se, but when someone is a hard task master then he could well earn himself the epithet of being "a crashing bore," especially if he doesn't allow others to express themselves properly. Take a more intimate scenario - Mr. Bright Harry meets tepid Sally. The sparks fly only on Harry's side with Sally stonewalling his every effort to get to know her mind, body, and soul. A tough ask for poor Harry, as he is yet to touch first base with Sally. Know what? They have been married 5 years and she seems to be fond of him, yet has never as much admitted it to him. Quite frankly, the two could pass off for siblings rather than 'man and wife.' Why are some people such rotten spoilsports, especially where emotions are concerned?  It may well be a natural mindset for some to have an emotional guard up and emote, or have an emotional connect only with certain types of people. Fair enough and good show, we say! After all one can't be wearing one's emotions on a sleeve or you end up been taken advantage of. That's a mask that most 'tough guys with soft centre' wear anyway. Nowadays with the rules being somewhat relaxed with men been given liberty and allowances to display their gentler feminine emotional side, we find men going over the top with the sheer display of emotional expression. One is at sea wondering which one was worse off-the tough, cynical cop look or the "let me weep my heart out for you" kind of contrived emotion. That apart, it is bad enough for us having to contend with a person who has difficulty with expressing himself properly. We don't mean articulation or even well-developed linguistic ability - we mean being able to be spontaneous and congenial and a little forthcoming and nice to be with sort of an emotional person. So, unless someone has a romantic angle towards this guy (there are weirdoes all over the world, who go asking for it!) or girl, he is going to be feared, hated, despised, unloved, and uninvited by everybody. So why do people behave like they are going to be flogged for even attempting a ghost of a smile or a cheerful greeting to a fellow co-worker? Why do some people find it difficult even to open up on a psychiatrist's couch? The Mask The most common reason for Mr. or Ms. Grumpy is that they have probably been emotionally brutalized in their formative years by an authoritative parent and this has caused them to lock themselves up double quick in a shell and throw away the key. Now, that can be tough and extremely painful. It is a prison of their own making through which nobody can see that once bright-n-chirpy personality frozen, much like the curse of the wicked witch in those fairy tales we read. The person is dying to let his emotions out and let people see who he is, but since very little light escapes out due to the tough mask and veneer, that it is an uphill task. Then the sheer anger at not being understood, subconsciously plays havoc and then he gets to be the more demanding boss at work or that sullen wife or lone stranger staring in to nothingness on the park bench. These are the people that have a series of relationship disasters as their defence mechanisms are too solid to be penetrated. Some people may be naturally distant, and for them the finer and higher emotions probably don't register as much as they do in the average person. These guys are cut out for careers ranging from lighthouse keepers to morgue attendants to hangmen, where being emotional has no place. There are still others who swing the other extreme by showing so much of emotion that it is scary for others to take them on. Their emotional side is so overwhelming and demanding that it is actually a clever subterfuge on their part to drive people away as they subconsciously do not want people to get to know their real side. They generally don a mask of humor and good cheer and are great fun to be with. In reality, they are alone and scared and perhaps hurt emotionally. So, they feel safe to display emotions to masses rather than individuals. These people make good evangelists and rock stars as they can safely display and get an emotional discharge without running the risk of a one-on-one emotional exchange where they are afraid they would be hurt. If you encounter such a person who looks askance at you displaying your emotions, then it is better for you to talk things out and maybe put things in perspective. Of course, this all depends on whether you are emotional enough to maybe give someone a chance by understanding what drives them to do the things they do. Let me assure you the ice will thaw if the intention is genuine and well meant.
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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