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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.
Preparing for fatherhoodFrom the time you decide to go for a baby, all the attention is concentrated on the mother-to-be. And this is not without reason, since she is the one that's going to bear the child for the next nine months. But that doesn't mean that the man's role is any less important. It is important for the father-to-be to ready himself for the next phase of his life. Following a healthy lifestyle Fertility is a growing problem. As per statistics more than 45% of infertility issues are related to men. Therefore, eating healthy food, exercising and living the healthy way will boost your chances of getting over these problems. Nutrition has an impact on the sperm production. So scrap the junk food for a while and get on to a healthy lifestyle. Men need to get at least 12 to 15 mg of zinc each day. Even short-term zinc deficiencies can reduce semen volume and testosterone levels, much needed for healthy sperms. Good sources of zinc include baked beans (a one-cup serving has 3.55 mg), nuts, cereals, seafood, and chicken meat (2.38 mg per three ounces). Regular intake of vitamins and calcium is a must to improve male fertility and prevent sperm defects. Natural sources of calcium such as fat-free milk and curd can be consumed. Get atleast 90mg of vitamin C daily. This boosts immunity. More will be needed if you smoke. Folic acid is a fuel for healthy sperms. Dads need 400 micrograms of it and green leafy vegetables are good sources of this nutrient. Dads-to-be can take the liberty to grab the extra cup of mocha. Caffeine may help men by stimulating sperm motility. Quit smoking and drinking The party's over for your partner once you start trying for a baby, but what about you? Same goes for men. Now is the time to stop smoking, and to stop any excessive consumption of alcohol. A man who smokes has a lower sperm count and a misshapen sperm, incapable of creating a child. Heavy or binge drinking can seriously affect ability to produce quality sperm. Exercise Add exercise session to your daily routine if you aren't doing them already. Exercise improves general health, stamina, and sperm quality. Start with walking for 15 minutes and increase it gradually if you have never exercised before. If you are trying for a baby, avoid exercising in tight-fitting briefs. It causes damage to sperms. Frequent sessions in a sauna or hot tub, long bicycle rides, or any such activity that could cause the testicles to become overheated can compromise the health of sperm and should be avoided. Medical examinations It is a good idea for the father-to-be to have a complete check-up to assess if there are any issues that need to be addressed before trying for a baby. Some conditions to watch out for include: Varicocele, a condition of varicose veins on the scrotum, the sac of skin that contains the testicles. It can lead to infertility. The condition is entirely treatable, so talk to your doctor about the options. Conditions like erectile dysfunction, diabetes, and prostatitis can cause infertility. Sexually transmitted infections, which may cause male infertility. Your doctor can help you get tested and treated. Your doctor can refer you to urologist or a male fertility specialist if you need additional testing or treatments. Remember to discuss possible hereditary birth defects with your doctor. Share with her the medical history of yours and your wife's family. Get finances organized Plan a baby budget. You surely want to give the best to your child. Start planning now. Consider expenses like baby food, diapers, toys, doctor visits, clothes, and day care. This will help you in the future. And this is the perfect time as you are just in the planning phase of baby making. Take advantage of this time before the baby arrives to get things in order concerning your job, insurance and budget plan. If you and your spouse discuss and agree on expectations, goals and strategies now, you can avoid arguments on money later. After all, you don't want baby to pick up on any tension. Dump your stress Chilling out can increase your potency. So the 'go for a holiday' advice actually works. Practise regular meditation or any exercise that will help bring down your stress levels. Try reading books on fatherhood or parenting and learn tips and advices well in advance. So gear up and start preparing for the change from being the coolest dude to the coolest dad.It is your responsibility to help your partner in all possible ways and make her feel that you are equally excited and keen for having a baby.
Pregnancy and HIVMothers with higher level of viral load have been found to deliver infected babies. However, no amount of viral load can be safe as infections can occur any time during pregnancy. A high level of precaution is necessary during this phase. Mostly infection occurs during delivery but that's not the only way through which it can spread. HIV-infected mothers should not breast-feed, as virus can transmit through breast milk too. Antiretroviral medications are used to reduce chances of transmission of HIV. Keeping delivery time shorter can reduce the risk of transmission. Most of the times babies born to positive mothers are positive for HIV. Babies infected with HIV will have antibodies made in their system and will continue to test positive. But if babies aren't infected, the mother's antibodies in baby's blood will eventually disappear and babies will test negative after about one to one and half year. HIV positive women should consider possible problems with antiretroviral medications for HIV before getting pregnant. Talk to the doctor about choice, indications, and contraindications of these drugs. There's a risk of missing doses due to nausea and vomiting during early pregnancy, hence giving HIV a chance to develop resistance. Some doctors prefer the practice of stopping or modifying medications during pregnancy to lower the risk of birth defects. Short course of treatments can help eliminate or reduce risk of transmitting HIV to a newborn; but, short treatments increase the risk of resistance to the drugs used too. There is a risk of birth defects due to antiretroviral drugs during the first 3 months of pregnancy. Pregnancy does not worsen mother's HIV disease, but any HIV positive woman planning to get pregnant should discuss treatment options thoroughly and all the pros and cons with her doctor.   
Cranky kids in a diner? dealing with them made a bit easy!This has happened to many a parent. They make a reservation at a fine dining restaurant, perhaps with friends and relatives. But their kid screams, and cries,disturbing the entire restaurant, and spoiling the general mood. For this reason, many parents avoid going out altogether, especially to fancy places. But there are ways in which you can handle the toddler when you are at a restaurant. We will show you how. Carry toys Restaurant may be boring at times for toddlers. That's why they turn peevish and may start playing with forks, spoons or knife. So carry some toys, crayons, notebooks, or even a story book, which will keep them busy and you can have a good time. Order something yummy and healthy for the kid A hungry kid is an angry kid. So, order something which is your kid's favorite and also healthy at the same time. Or you can carry something along with you like fruits breads, cherries or other nutritious treats. Keep responding to what kid says The best way to keep childrenwell behavedis to talk to them and respond whenever the child speaks. Don't avoid them or get too engrossed with other people. They get cranky when they don't get a response from you. Take a round with your kid When the kid becomes difficult to handle, just pick him in your arms and take a mini tour of the restaurant or walk outside. This will distract him and relieve his boredom. Don't tolerate any bad behavior If the bad behavior of the kids is intolerable, then firmly tell them that they need to adopt good manners if they want to visit restaurants again. Disturbing other diners is not acceptable. But it doesn't mean that you punish them.You just have to remove them to a place where they don't bother anyone. Make your outing relaxed and enjoyable Above all, don't forget to have fun and make it an enjoyable evening. Don't get too carried away disciplining the kid. You can afford to be a bit silly and enjoy the time with your child.
Anxious about anxiety?Anxiety disorder is a term that almost everyone has heard and experienced in some form or the other. It is a generic term used to describe different forms of a mental disorder wherein those afflicted show typical characteristics of great apprehension, fear and trepidation. The symptoms, of course, vary depending on the severity of the affliction. So you can have 'anxious moments' when you narrowly escape an accident while driving - that's temporary and natural, while some others might have chronic anxiety which might need medical aid. Types of anxiety disorders Generalized anxiety disorder: There is no specific reason for the symptoms of anxiety i.e. restlessness, apprehension, worry, and panic. Thus the term general anxiety disorder (GAD) is any irrational worry which is disproportionate to the source of anxiety. GAD is a state of perpetual irrational and persistent fear which absorbs a person's time or can disrupt his normal functioning. The symptoms of GAD are light headedness, sweating, difficulty breathing, nausea, and numbness. Phobias: Phobias are an irrational morbid fear for certain things or objects. The list of phobias is exhausting as it is anything that a human being is capable of being afraid of. Thus you have arachnophobia which is the fear of spiders, homophobia, which is the fear of homosexual people orxenophobia,the fear of foreigners. Phobias can completely paralyze and terrorize a person and is a form of anxiety disorder. Obsessive compulsive disorder: This is the classic loop where a person is afraid of certain situations arising constantly and thus takes precautionary measures to ensure that it won't. Only thing is that this turns in to a compulsive ritual which can throw her in a loop. Thus a person can be said to have OCD if she persistently checks to see if the gas valve is off as she has a fear that she will set fire to her home. It is a particularly distressful anxiety disorder. Post-traumatic stress disorder: This is anxiety arising out of a traumatic incident which the person undergoes. It could be a horrific accident or an extremely brutal incident which the person has witnessed. The trauma is revisited again and again in the mind and manifests as anxiety. This disorder is based on real events that the person has experienced or undergone and can take a long time to heal. Panic disorder: This is characterized by panic attacks or episodes where great terror or discomfort is experienced. It is a very unsettling experience as the patient feels he is about to go unhinged or something dangerous or embarrassing is going to happen to him. Thus the sensation or feelings of panic build up and reach a crescendo resulting in a panic attack. Sometimes in a panic attack, the patient's reality and perceptions are distorted and blurred and can thus put him in danger. According to the National Institute of Mental Health there could be a number of reasons for anxiety disorders. They vary from early childhood environment to lifestyle causes, heredity and even environment.    
Cleanliness - A clean body, clean mindPhysical Benefits: Killing of Germs: Disinfecting your living area allows negligible scope for breeding and spreading of germs and bacteria. Though not visible to your eyes, many of these can cause severe illnesses. Prevention of Food Contamination: Clean cooking utensils and counter tops allow for low risk for contamination of food. The parts of the utensils which have come in contact with fish, raw meat, or eggs are recommended to be washed with hot water and soap. Make sure you wash your hands to avoid spreading of any bacteria in your house.  Keeps Illnesses and Allergies at Bay: Many allergies could be caused due to dirty mattresses, carpets, sheets, walls, and furniture. In order to keep away mold, dust mites, cobwebs, and mildew, make sure you dust, mop, and vacuum the house on a regular basis. The sheets should be washed at least once a week with hot water and detergent. Floors and walls, wardrobes, and refrigerator should be cleaned using disinfectant sprays up to 2 to 3 times per month. Thoroughly clean your carpet and upholstery at regular intervals. Psychological Benefits: Association of Non-Cleanliness with Moral Lapse: In a review by Current Directions in Psychological Science, it has been found that physical cleanliness does not only physically benefit a being, it also results in weighing the person on a moral radar. When we perceive a physical contamination, we respond in the same way as we would in case of an act of moral disobedience. This response includes repulsion and disgust accompanied by their behavioural components like scowling and frowning. Sense of Accomplishment: Those who clean their house and living space have been found to have a consequent sense of accomplishment that adds to the way one feels about oneself. Clarity and Organization of Thoughts: It has been discovered that those living in a clean and neat environment tend to have a greater capacity to think than those who live in a messy and unclean atmosphere. Proactive Sanitation Teaching for Children: Start with your own home. A child emulates its parents, and if the parents practice cleanliness as part of their lives, children would notice and follow suit. Children tend to connect who they are with their home environment and as they grow up they ensure that such a cleanliness of their world around is maintained.  towards their immediate surroundings, thus ensuring that they do not contribute towards pollution and environmental degradation, at least on an individual level.
21 foods for a healthy heartFollowing is a list of heart-healthy food substances: Garlic: Did you ever think that the commonly available garlic in your kitchen can be heart healthy? It may be smelly for some, but for the heart it is a soothing substance. Garlic is known to control blood pressure, serum triglyceride level & cholesterol level. Carrot: Carrots, though taste sweet, have the ability to control blood sugar levels because of high level of antioxidants in them. So include carrots in your diet, especially in salads. Orange: This juicy fruit has cholesterol-lowering ability because of fibre pectin in it and also helps control blood pressure. Almonds: Though all nuts are believed to be nutritious, almonds are considered to be heart healthy. Almonds are rich in vitamin E, calcium, plant sterols, fibre and antioxidants. Almonds help in lowering LDL cholesterol and reducing risk of diabetes. Walnuts: Walnuts are rich in omega 3 fatty acids, monounsaturated fats which help in lowering cholesterol levels.  Oatmeal: Oats are very healthy & help in lowering the bad LDL cholesterol. You can have one bowl of oatmeal mixed in milk along with nuts as breakfast. Flaxseed: This honey coloured shiny seeds contain substances which are heart healthy, such as lignans, ALA and omega 3 fatty acids. It helps in lowering cholesterol level and controlling diabetes. Tofu: It is a type of soybean protein which can be replaced with paneer. Tofu is rich in fibre and polyunsaturated fats which prevent clogging of arteries.  Barley: The fibre in barley is believed to lower cholesterol and blood glucose levels.  Tuna fish: Tuna fish is rich in omega 3 fatty acids which helps in lowering cholesterol levels.  Salmon: It is very good for heart as it is rich in omega 3, EPA and DHA. It lowers and reduces the risk of inflammation in arteries. It is also believed to maintain the ratio of good cholesterol to bad cholesterol. Red wine: Red wine contains catechins and resveratrol, good for heart health.  Black beans: They are a rich source of magnesium which helps in lowering blood pressure. It also contains folate, antioxidants and fibre which is helpful in controlling blood sugar and cholesterol levels. Fresh herbs: If you are hypertensive and want to control your salt intake then try using fresh herbs as a substitute for salt. It also contains antioxidants which are good for heart. Herbs include rosemary, sage, oregano and thyme. Extra virgin olive oil: This is rich in heart-healthy polyphenols & monounsaturated fats. As it's very costly you can use it as a topping for bread or salad. Sweet potatoes: White potatoes are believed to increase glycemic index so you can replace them with sweet potatoes. It is heart healthy as it has low glycemic index and also contains fibre, vitamin A and lycopene. Low fat yoghurt: You can include this in your breakfast safely as it contains calcium & potassium which helps in lowering blood pressure. Dried cherries: They are rich in anthocyanins and antioxidants which help in neutralizing the action of enzymes which cause plaque formation. In winter you should opt for strawberries, blueberries for a healthy heart. Cayenne chili pepper: Your blood sugar normally increases post a meal. By sprinkling cayenne chili pepper over your food can help preventing insulin level spike post meals. Hot cocoa: Coffee helps in patients with type 2 diabetes. Hot cocoa contains antioxidants helpful for heart. Kosher salt:  This is very beneficial for heart patients as it contains half the amount of sodium as compared to table salt and thus helps in controlling high blood pressure.
Good and bad calories-How do they affect weight loss?Not all calories are bad calories. Surprisingly very few people are aware that good calories are quintessential for burning fat and can rather help you in losing weight. So, it's very important to know how to differentiate between good calories and the bad ones. What is a Calorie? In scientific terms, one calorie equals to one unit of energy. When the term calorie is being used in relation to nutrition, it means consumption of energy through what you drink and eat and use of energy for carrying physical activity. Many people think that in nutritional terminology, calories are only associated with drink and food; but the truth of the matter is that everything has energy is calories. For example, since coal provides you energy it contains calories. 7,004,684,512 calories are equal to energy produced by 1-ton of coal. Coming back to weight loss, 100 calories of fiber and protein is not similar to 100 calories of a cake. This is because there are good and bad calories and much like us humans all calories are not equal. Calories are the measuring units of energy that are produced by the food once it reaches your body. This energy works on the law of physics and hence less energy intake leads to weight loss and vice versa. Varying types of Calories Different types of food provide varying calories or energy amount to the body. The analysis of a tightly scrutinized weight loss experiment has revealed that when people of two different groups were fed the same measure of calories albeit from varying food sources, the weight loss was almost similar. However, the effects of weight loss were variable; like uncontrolled emotions, cravings, hunger and more. This happened for the same reason that some calories are good and some calories are bad. Good and bad calories Sugar is a powerhouse of energy. But if you keep on eating only sugar all day long it will be suicidal. This is because; the calories present in the sugar are devoid of any nutrients and your body cannot function without the right balance of different minerals, nutrients and vitamins. Most food not only carry calories but they also constitute a complex mixture of additives, fiber and nutrients. These mixtures of varying components directly affect the leptin hormone that controls the hunger trigger in your body. These hormones tell the body to either burn the fat or store it. The process of weight loss is made complicated by the fact that biologically our body is programmed to protect the fat stores so that they can be utilized during starvation. So, the question remain, which calories should you eat to lose weight but still keep on getting the required amount of energy? Eating lean protein, healthy fats and unrefined and unprocessed carbohydrates such as fruits, beans and vegetables are the best for losing weight. Calories with more nutrients are the best The foods that do not store fat and make us eat again and again, are the ones you should eat as good calorie food. Choosing them is simple. These are the same food that humans used to eat before processed food was invented. For example; avoid using the processed whole grains and switch over to brown rice instead of the polished white rice. Also, stone-ground whole wheat, oats or quinoa bread is much better than the white bread. Replace the processed carbohydrates from your platter with whole grains and vegetables to lose weight, control hypertension and blood sugar. Use fats derived from plant sources such as olive oil or nut oil. Eat lean protein more such as chicken and fish.
Dos and don s during heat crampsHeat cramps can affect people who exercise or work in the heat. It could be due to dehydration, so if you are going to be active in the heat then you need to drink a lot of water even if you are not thirsty. Before going out, find out what the temperature is and do not exercise outdoors in the heat. Heat cramps may not be as serious as heat exhaustion or heat stroke, but the condition needs to be treated with the same urgency. People who are on low-sodium diets may be affected more than others. Heat cramps may seem mild, but they can be the first sign of heat exhaustion, so pay attention and stop all activity, and rest. Here is what you can do and what you should avoid if you suffer from heat cramps: Dos : If you have muscle spasms and the muscles are unable to function properly, then immediately stop all activity. Get inside a room or go into the shade and take some rest. Raise the feet to 12 inches above the body. Gently massage and stretch the muscles. Wet a paper towel or handkerchief and drape it around your face, at the back of your neck and underarms. Drink a clear natural juice or a sports drink to get the electrolyte balance back. Do not go out in the sun again even if the spasms have subsided. If the cramps last more than an hour then go to a doctor. If you are on a low-sodium diet then tell the doctor about it. Don s : Don take any painkillers or fever tablets as they could cause harm. Avoid caffeine, alcohol, and sugary soda drinks. Don rub alcohol on the muscles. Don drink ice cold drinks as they can cause stomach cramping. Don take salt tablets unless the doctor has prescribed them. Don do your full quota of exercises if the heat is getting on to you. Don stop drinking water even if you do not feel thirsty. Don resume any strenuous activity for several hours after a heat cramp. Prevention:Prevention is always better, so it’s a good idea to reduce exercise in the summer, especially when it is extremely hot. If people are working outside, like construction workers, then they must take more breaks, keep their heads covered and sip on water after every 10 minutes to prevent heat cramps. Always plan ahead and get acclimatized if you know you have to do a physical activity in the heat that could cause sweating. If you are an athlete, then do take a mix of sports drink, water, and juices to maintain the electrolyte balance. Always carry water with you if you are playing any sport in the heat. All events must be planned at a time when the heat is bearable and not when it is too hot. Keep a close watch on the person if there are signs of vomiting and nausea along with flushed skin. Rush them to the hospital.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
Smoking causes impotence!Men who smoke heavily are twice as likely to suffer from impotence or erectile dysfunction. The link between smoking and ED has been established beyond reasonable doubt. Smoking causes a hardening of the arteries or blood vessels. For a penis to grow erect or tumescent there has to be a healthy blood supply. Now imagine the cross-section of a smoker's penis where there are plenty of blockages and hardening of the blood vessels. Can the penis then grow erect with so many hindrances to the blood? There is also an acute loss of sensitivity to the penis which is a direct contribution of smoking! Previously, alcohol was a hot favorite of the medical lobby when it came to 'impotence.' Wish smokers could say the same thing about moderate smoking! Even moderate smoking can make an existing condition of impotence worse. One could make changes to one's lifestyle and diet and curb stress to treat ED (erectile dysfunction), but all these will come to naught unless one really resolves to give up smoking permanently. Just within a few hours of kicking the butt, the body starts to repair itself. Of course, it may take longer for the blood vessels to actually undo the blockages and have a free run for the penis, but it will certainly happen, slowly and surely. Smokers may have an underlying condition of anxiety, which is made worse by nicotine, which in turn causes performance anxiety, not greatly helped by blocked blood arteries. So smoking not just makes you physically impotent, but also mentally impotent too. It is a powerful narcotic which is hateful to the body and spiteful to its salubrity. Please enroll into a 'stop smoking now' campaign with the help of friends or family. Check for any 'nicotine anonymous' programs in your neighborhood or just do it all by yourself. Otherwise, the only thing hard about your penis will be hardened arteries and lots of hard luck!
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