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Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
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.
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
Importance of breastfeedingBreastfeeding is a natural act and that is why it is also one of the most beneficial acts for a baby. Breastfeeding provides essential nourishment and is the best food for the baby's stomach to digest. No matter how many infant formulas enriched with vitamins and minerals you provide to your baby, it can never replicate mother's milk. As for the mother, there is nothing more joyous than providing your baby with the best start that it can get in the long journey of life. The bond that the mother and the baby share through breastfeeding is one of the most special bonds. For the first six months, breastfeeding your baby is recommended for all mothers whether they are working or at home. Most working mothers are given leave, whether paid or unpaid, so they must ensure they provide their babies with regular breast milk. Breast milk protects the child against diarrhea, respiratory infections, pneumonia, ear infections, and helps to reduce chronic constipation and colic that the babies are prone to. Research also points to the fact that breastfed babies are immunized and protected against allergies, asthma, sudden death, diabetes, and obesity. They remain much healthier than those babies who are formula fed. In India, only 41% mothers begin early breastfeeding even though it has so many benefits. Mothers who exclusively breastfeed their babies help them to survive better. They also gift them with better brain development and these babies are likely to perform well intellectually. No matter which economic section of society the mother comes from, she can provide her baby with the best start in life by breastfeeding it and make sure that the child develops to its full potential. Breastfeeding is natural, simple, and cost-effective way to ensure your baby is healthy and continues to develop healthily. Since the breastfeeding campaign began on a large scale, child mortality has decreased. Immediate breastfeeding within one hour of birth has helped to significantly reduce sudden baby deaths. The colostrum, the first thick yellow breast milk is what protects babies from many diseases as it is filled with goodness. Lack of nutrition or malnutrition is another aspect that leads to infant deaths. Breastfeeding can significantly lower infant deaths from malnutrition as the mother's milk is one of the most nutritious foods provided by nature for the baby's healthy growth. A mother has the full ability to provide adequate nutrition for the baby, therefore breastfeeding needs to be encouraged fully. Employers need to create an appropriate space within their premises and should encourage new mothers to breastfeed their child. Breastfeeding also has a number of benefits for the mother. It helps to burn calories and the mother can return to her former pre-pregnancy state. Breastfeeding helps mothers to reduce their risk of breast, uterine, and ovarian cancer;high blood pressure;diabetes; and heart diseases. So for the first six months, mothers must make sure to breastfeed their baby and do not substitute it with baby food products.
Your bundle of joy comes with bundles of fascinating facts Blue-eyed wonder: Most babies are born blue-eyed. The melanin pigment that decides the color of the eyes is not developed at the time of birth. So the babies are born with blue/light eyes irrespective of the genetic makeup. By the time the baby is 6-7 months old, the pigments start developing and the baby's eye colour changes as per the genetic makeup of the parents. Marked for life: One in every three infant is born with a birthmark! No tears: That is true! New born babies do not shed any tears. The lacrimal duct and the tear glands are well developed but they produce just enough tears for lubrication. Actual tears start appearing after one month of age. Crawling wonders: New research has found that babies can crawl almost as soon as they are born. When left to themselves, they are quite capable of using their limbs and find their way to food i.e. the mother's breast.And we thought that they are tiny helpless creatures! Temperature sensitivity: Babies are much more sensitive to temperature changes and body heat.Though the baby can't throw off the clothes to cool down, it is smart enough to do other things. When the baby is cold, it will move around more and if it is too hot it may just lie still as if sunbathing. Touch therapy: Touch is the most highly developed sensation in babies, even in premature ones. The touch sensation develops from head to toe with the mouth being the most sensitive. No wonder they tend to put everything in their mouths. Short-sighted: Babies are short sighted at birth. Their vision is set to a limit of 8-to-12 inches. They can see people and objects clearly only if they are within this range. Brain size: The brain grows at such a rate in newborns that by the end of the first year,the brain is double the birth size and half its final size! Palmar Grasp: New born babies have a strong grip, as strong as a monkey's. The grip is so strong that if you dangle them on one hand, they can support their own weight. This probably originated from the primitive survival instinct. This strong grasp reduces after a couple of months. Taste buds: Babies have more than 10,000 taste buds situated all over the tongue and even at the roof and sides. As they grow, these extra taste buds disappear.
A correctable disfigurement of face: Cleft lip and palateThe Times of India reports that "With an incidence of 7 per 1000 children, cleft lip and palate deformity is one of the most common deformities among Indian children." The number of infants born every year with cleft lip and cleft palate in India is 28,600. This means 78 affected infants are born every day or 3 infants with clefts are born every hour. Cleft lip and palate develop early in pregnancy where lack of adequate amounts of tissues lead to two parts of the face failing to join adequately at the middle. A cleft lip or hare lip (as it is commonly called) refers to separation of the two sides of the upper lip. There appears a narrow opening or gap over the skin of the upper lip. This separation may sometimes extend beyond the base of the nose and may involve the upper gum and/or the bones of the upper jaw. A cleft palate refers to the gap between the two edges of the roof of the mouth, causing it to remain open at birth. The bony front portion of the roof of the mouth or the hard palate may be involved alone, or along with the soft palate or the soft back portion of the roof of the mouth. Since lip and the palate develop separately, it is possible to have a cleft lip without a cleft palate or vice versa. Causes of developing cleft lip and cleft palate: The exact cause of cleft lip and palate is unknown. Some research, however, suggests that these clefts are caused by a combination of genetic and environmental factors. The risk of such clefts thus can be reduced by adopting a healthy lifestyle during pregnancy. This includes avoidance of smoking, alcohol and having a healthy diet to avoid excessive weight gain during pregnancy. Cleft lip and palate can occur alone with no other problems or defects. This is called non-syndromic clefts. They may also occur as part of other birth defects and then may be called part of a syndrome. Cleft lip and palate may occur on one side (unilateral) or may occur on both sides (bilateral). Unilateral cleft lip and palate is more common than bilateral cleft lip and palate. Left-sided cleft lip and palate is twice as common as right-sided cleft lip and palate. The reason for this is unclear. A cleft lip or combined cleft lip and palate are seen more commonly in male babies. Cleft palate alone is more common in female babies. The face of the baby usually develops around 5th and 9th weeks of pregnancy thus this defect may arise early in pregnancy. Treatment of cleft lip and palate: Cleft lip and palate is usually corrected using cosmetic or plastic surgery. Results are usually very good. After treatment, most children have a normal appearance. To prevent and correct associated speech problems and dental problems, treatment is also sought from speech and language therapists, as well as dental surgeons (orthodontic specialists). Excellent results may be seen if the specialists work in tandem.
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
How to remember everyone you meet?Now that would be quite a feat, would it not? To be able to recall the name and occupation of every person we ever encountered right down to the minutiae of how, where, and why we were introduced to them to begin with! Sometimes we raise the bar of forgetfulness to the extent of forgetting just who it was who introduced us to "Mr. what's-his-face!" If only there were ways to remember the modest and average people who leave virtually no impression on us, wouldn't that save us great embarrassment? Plus it will help us do away with those sheepish looks when it dawns upon the other person that you haven't the foggiest of notions as to who he is. Stranger: Hi! You remember me? How are you doing, Frankie? Frank: Umm! I am well (this guy's face looks mighty familiar, but for the life of me, I cannot recall ever having cast my eyes on him). Stranger: So, how was your annual bridge completion? Manage to beat the Swiss pairs this time? Frank: Atta boy! Got it! This guy happened to be kibitzing at the weekend bridge club at Aldermere. Whew! Stranger: You gave me quite a start there. You looked right through me and I was quite not pleased at the fact that just last week I happened to congratulate you. Frank: Well Martin, be tough to not remember you, of course I do! Just didn't think of bumping into you here. Martin: Well, I am Walther and I can now see that you don't remember me at all! How many times has the above scenario happened to us? While it is well-nigh impossible to remember every name or face that we come across, it would be  a good habit to at least attempt our 'mental name book' to avoid an occasion for future embarrassment! Now, how in the world does one do that? Simplest way would be to carry a small notebook with a pen to make note of someone that you have just been introduced to, at a meeting or a social do. Our friends often introduce us to people and chances are that if there is no occasion to remember that person, then the brain fades it out of its memory list, as it will only use up space on the brain's 'hard disk.' Human memory might be jogged to remember trivia from 25 years ago in great detail, but ask a simple question - remember what you had for lunch last Tuesday?  - and that would be very difficult to answer, especially if last Tuesday was just an ordinary day with no special reference points around lunchtime to help you remember. Maybe if something momentous had occurred on Tuesday last, like pretty Meg from next door, sharing lunch with you rather unexpectedly, then you can bet your bottom dollar you will remember what you had on the day in question. So create reference points! When you are introduced to someone, first and foremost, reference it with who introduced you and then try and make a reference of at least one unique distinguishing feature in that person. Now you don't really require the eye of a physiognomist, and it would be mighty impolite to stare hard for the "distinguishing feature" coin to drop. So a quick look and you got 'long nose Mary Gomez' all referenced and ready for recall at the next chance meeting. Make the reference phrases funny so that you won't have any problem whatsoever in recalling the name behind the funny phrase when you most require it. Alternatively, try associating a picture with the name if you aren't very good with phrase reminders. These techniques are called mnemonics, which is pronounced ni-mon-nics, and funnily enough the very curious spelling - Mnemonics makes you want to have a picture card memory association for the right pronunciation. A mnemonic for this could be 'knee-moan- knicks". Easy enough, i.e., if you remember the sequence right. You could also try memory exercises with names picked off from the telephone directory at random. Pick an A-lister say - 'Anderson' and then flick through to D and pick 'Dougherty' and so on until you have picked at least 10 names of a different alphabet. Now, try and write down the numbers that you must have undoubtedly memorized until now. You can consider yourself blessed even if you are able to memorize the number of the third person by the time you reach person number 10. This will give you a memory for names and numbers at least. Or, go through any university web sites and look at the photo galleries of past alumni. Give yourself 1 minute to quickly glance at all the names on the page. Then try and recall the name by applying the memory picture association or develop your own technique. With regular practice, you could well be in the employ of the local police to help identify criminals off a line up. If that's too dangerous for you, then at least that will  keep your brain alert and active with this brain gym and help avoid any boo-boos in the future.
10 bedtime beauty essentials! Here are the beauty essentials you need to take into consideration, before you hit the bed: Baby-soft soles :Before you sleep, apply Vaseline on the sole of your feet. This will adequately moisturize your soles and you can wake up to the great opportunity of wearing those heels you have been dying to try out! Healing the puffy eyes : If you are worried about waking up with puffy and tired eyes (even after 6 to 8 hours of sleep), then put on a little eye cream. You can also keep an extra pillow and make sure you sleep on your back. This will allow the fluids around your eyes to drain easily and reduce the puffiness. Trying out wavy hairstyle : Bedtime is the best time to work on your hairstyle. Before you sleep, shower and fashion your hair into the style you want. Apply a styling cream on your hair gradually, after having air-dried it. Now, decide if you would like to put them up in buns or braids. Stylize them into the pattern and wake up to wavy hair! Let your skin breathe : Those who are suffering from dry skin can apply moisturizer. A humidifier is also a great accessory for help in these cases. You can switch on the humidifier before you go to sleep. This will help your skin to retain its moisture through appropriate hydration. Keep aging at bay :Did you know that sleeping on cotton pillowcases can increase the chances of creases and wrinkles on your skin? Prevent wrinkles by using silk or satin bed clothing. This will also reduce hair breaking. Wake up, miss white smiles: If you want to take off the yellows from your teeth, then brush some baking soda and let them stay for about 8 minutes. Afterwards, thoroughly rinse your mouth. Do not perform this beauty tip more than once a week, it will negatively affect the structure of your enamel. Work on your complexion :During the day, sunlight might disable some face creams from working effectively on your complexion. Make the most use of night and apply a face cream containing retinal and vitamin C. Lengthen your lashes : Eye lashes depth and grace to your eyes. You might feel that working on your lashes will require way too much effort. But, much to your surprise, everything your lashes need is contained in a natural ingredient - castor oil. Consisting of Omega-3 fatty acids, which are highly hydrating, they will avoid your lashes from breaking and also strengthen them. Apply castor oil on your lashes before you sleep and watch them grow thick and healthy within a few weeks! Taking care of your hair : Skim leave-in conditioner through your hair in the evening and let them stay on till the morning. This will let them become soft and shiny. You can also use coconut oil as an alternate conditioner. Readying your nails for polish : Depending on the skin type, the nails of certain people become dry. If you are one of them, it would be best to apply a cuticle cream or oil on them before you sleep to wake up to polish-ready nails.
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.
Internet and sex : Decoding virtual pornographyPornography is broadly categorized as softcore or hardcore. While hardcore contains intensive and highly graphic forms of sexual content, softcore constitutes less intensive form of sexual content. Genres of pornography are determined on the basis of the type of content and the status of the participants. The common sub-genres are ethnic, fetish, reality, group, and amateur. There are also sexual content specially created for different sexual orientations: heterosexual, homosexual, and bisexual. While sexual needs are natural and part of our biological set-up, the use of pornography is widely criticized for putting forward a partial portrayal of who a human being is. Majority of the pornographic material express a human only in sexual terms- as being someone looking for sexual endeavors- without paying attention to and inclusion of the person's emotional and mental state. The explication of human beings as purely sexual beings closes the eyes of the viewers many a times to the emotional and mental aspect of sexual intercourse, thus perverting the way they look at sexual intercourse in their relationships. Since sex is not holistically discussed on public platform as part of a healthy relationship and one only has access to understanding sexual practice through pornography which portrays a certain mechanistic and physically-induced aspect of sexual acts, viewing of pornography comes with the risk of sex addiction. Moreover, since pornography generally engages participants whose possess bodies which are conventionally considered sexually appealing, the viewers could implicitly get dissatisfied with their sex lives due to non-duplication of the same form of bodies in real life. Medical researches have also found that apart from having unreal expectations from one's partners, the viewer might find themselves lowly in sexual matters due to the sexual practices performed on the pornographic content that can be difficult to duplicate or are disliked. The portrayal of women in pornography is generally of persons who have no issues with being dominated over and who find such domination also sexually arousing. However, such a view is overwhelmingly false and a viewer on a regular fodder of such pornography could end up with deeply flawed perspective on women. Lastly, pornography also expresses various types of perverse forms of sex which are harmful to society, especially vulnerable groups. These include child sex, office-related sexual content, rough and rape sex, and public sexual acts. While pornography is a sure avenue to possibility of sexual perversion, healthy ways of satisfying one's sexual needs must be acknowledged and taken up. Moreover, it is integral that socially, sexual intercourse is recognized as a healthy part of emotional relationship. It needs not only absorbed as a purely physical act which is morally judged and shunned- the latter approach only increases the probability of pornography being seen as a last resort to learn about sex. In talking about sex as a natural process between mutually approving adults and as part of emotional relationship, we reduce the chances of sex being seen as a non-emotional activity and allow for there to be holistic understanding of sexual intercourse. For adolescents who are entering the age of sexual maturation, it is integral to introduce the physical relation between persons as being a result of emotional relationships, with understanding of the body holistically - as a harmony between physical and mental states. In the case of non-presence of holistic guidance, the chances of teenagers falling prey to pornography to understand sexual intercourse is high and as has been earlier explored, such an understanding of sex as activity between solely sexually-charged beings could result in perverted view of emotional relationships as well.
Sex after 40Sexual changes in normal aging after 40: Erection takes longer time Require manual stimulation, particularly by partner Erection may subside during foreplay or coitus Decreased frequency of nocturnal erection Pre-ejaculatory fluid decrease or absent Ejaculation less forceful Seminal fluid volume decreases or absent Frequency of desire for sexual release decreases with age. Aged couples learn to cope with their own sexuality. Some are happy with foreplay and self masturbation, others insist on more usually it is the male. Frequency of sexual intercourse between 20-95 years : Sexual intercourse decreases with age as the study shows. Decreased during 5year interval after 34 years Weekly frequency: 30 - 34 years 2.2%; 60 - 64 years 0.7%; 65  - 74 years 0.4%; 75 - 79 years 0.3% Do we need to change this pattern with Viagra? I would say yes - sex can be  joyful till the last days. Nobody needs to be impotent now. Home devices like rubber bands, ribbons are also used to hold the blood back in the penis when the erection is not adequate. Vacuum pump to draw blood into penis with an application of a ring after erection is also found suitable by some. Active intervention by drugs (both allopathy, ayurvedic and unani) have been successfully developed. They may be applied topically (minidoxil), inhaled (amyl nitrate) inserted into the urethral passage, injected into the corpus cavernosa or taken orally (Sildenafil, Tadalafil, etc.). Finally if all fails silastic rods can be implanted in the penis to give permanent erection. The joy of living lasts a life time.
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