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Male infertility : An overview of the causesWhy men shy away from infertility tests? However, it is ideal for both the man and woman of a relationship to get infertility tests done. This would not only avoid unnecessary tests and expenditure later and could also result in prompt medical treatment of the problem. Following an appointment with a urologist/andrologist, the patient is instructed to provide a semen sample for analysis of the quantity and quality of the sperms in the semen. An additional semen test might be recommended for confirmation of the initial results. The semen analysis is an effective method of knowing what is going wrong in the reproductive system : No-sperm count (azoospermia) - Absence of production of sperms or the non-appearance of sperms in the semen. Sperm Morphology Issues - Issues related to the structure and form of the sperm. Low-Semen Production (oligospermia) - Production of low amount of sperms. Sperm Motility Problems - Abnormal movement of sperms resulting in incapacity to fertilize egg. Did you know that use of laptops placed on your thighs can result in increase of scrotal temperature? This could lead to abnormality with sperm production. Thus, using laptops is best when they are located on table or desks, away from constant contact with your genital region. There could also be a primary medical condition, the symptom of which could be manifested reproductively. The physician will suggest blood and urine tests, among others, for the same. There can be 10 major causes of male infertility : Semen : Semen refers to the ejaculated fluid containing sperms during sexual intercourse. There could be low or no count of sperm. It is also possible that the mobility of sperm is restricted. Sterilization : The cutting and sealing off the vas deferens (the tubes which carry the sperms from testicles to the semen) ensuring that your semen does not contain sperms is known as vasectomy. Though this process can be reversed, they are mostly not fruitful. Lack of sperms : Even though the testicles are producing quality sperms, it is possible that they do not reach the semen. The lack of sperms in the semen is medically known as obstructive azoospermia. Such a condition could be caused due to the blocking in one of the constitutive tubes of the reproductive system. This could be further resulting from an infection or a previous surgery. Ejaculation issues : Some men might find it challenging to ejaculate normally due to retrograde (ejaculation of semen into bladder) or premature (ejaculation in very short period of sexual activity) ejaculation. Medicine and drugs : Certain medications have been found to catalyze the onset of infertility. These include sulfasalazine, chemotherapy, anabolic steroids, and herbal remedies (for instance, the consumption of root derivates of Tripterygium wilfordii). The quality of semen can also be negatively affected by illegal drugs like cocaine and marijuana. Testicles : The function of production and storage of the semen lies with the testicles. In case of injury to them, the quality of the semen could be negatively affected. Causes of injury to testicles include a congenital defect, testicular infection, physical trauma, testicular surgery or cancer and undescended testicles (case where one or both of the testicles do not descend into the scrotum). Hypogonadism : This refers to the presence of a very low level of testosterone (male sexual hormone) which plays a major role in production of sperms. This could be due to tumors, Klinefelter's syndrome, or consumption of illegal drugs. Sexually transmitted diseases (STDs) : A series of sexually transmitted illnesses can result in male infertility, for example, chlamydia. Alcohol and weight : Consumption of over 3 to 4 units of alcohol per day can result in infertility in men. Both men and women are affected adversely due to obesity. Occupational factors and stress : Contact with certain types of pesticides, solvents, and metals can result in deterioration of sperm quality. Stress has also been associated with the loss of sexual drive resulting in lesser instances of sexual intercourse. Moreover, in case of severe stress, sperm production can be unfavorably affected.
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.
Yoga to strengthen women's lifeEveryone expects from a women for all their necessities. The husband needs to go to office and she has to prepare for this, the son or daughter needs to go to school, tiffin needs to be packed, and the in-laws need her attention for the morning tea and breakfast. Along with this she has to rush to office on time. Then while returning, she has buy vegetables and other things for household, then go home and cook, and sleep late after all the chores are done. For such a multi-tasking working-women, the time available is very less to replenish the energy she uses to do such work. Multitasking leads to stress and tension and causes headaches, stiff neck, tight shoulders, poor posture, shortness of breath, clenched teeth and fatigue. What is the solution for this? The only solution is YOGA.  We all know that yoga has many positive effects on ones well-being; it brings about both physiological and psychological benefits. It is beneficial for body, mind, and spirit. It needs only 10 minutes. Yoga helps to relieve your stress and tension. Yoga in Sanskrit means 'YOG' that is to join or unite. It is the union of mind, body, spirit, and breath with our surroundings and our universe. One should start yoga gradually with a comfortable speed and limits. Breathing exercises are excellent way to reduce stress and tension. It can be done along with asanas. For this you have to sit comfortably with relaxed shoulders and with your chin level at the floor. Inhale through the nose expanding your abdomen, rib cage, then expand your chest, then begin to exhale by contracting your abdomen, ribs and then lastly relax your chest. Now continue to breath in this fashion, this improves the quality and quantity of oxygen that enters our body and helps to relieve the shortness of breath and relieves the tension. The yoga mudra is helpful to relieve the stress, for this sit down crossed legged on the mat and keep the back straight, then take the arms behind your back and hold the left wrist with the right hand. Then by exhaling, bend forward to touch your left knee, while doing this focus on the feeling of surrendering to God, which protects you all the time, then while inhaling come back to the normal position and repeat this on the right side. Then finally, complete this pose by touching the forehead to the ground in front in the centre, while doing this exhale, then when you feel like inhaling come back to the normal position. This posture increases the energy and stimulates your respiration, improves your digestion calms your nerves. But this should be avoided by pregnant women, hernia patients, and patients with retinal disorder. The shavasana also helps you to relax your body before you get to work. In this you have to lie down on your back on the mat. Keep your arms a foot away from your body and your feet separated two feet apart.  Then close your eyes and focus on your breathing and feel free of thoughts and tension. Breathe normally and focus on your body parts, toes, legs, abdomen, head and finally the scalp and try to relax each muscle group. It improves your breathing, concentration, gives inner peace. You should avoid this if you are suffering from low blood pressure.  
Tips and tricks to deal with my toddler's tantrumsWhen your child is having a tantrum, it may usually be for something that it wants and cannot have. Throwing a tantrum is a child's way of getting what it wants. Conversely, giving in to the child's demands may be the easy way out for the parents too. But always remember that giving in is not right. The child may get habituated to this and it may prove quite a nuisance to you too. Learn to say no, gently but firmly. Giving an acceptable reason for your 'no' and also an option at the same time works wonders. All said and done, children are not that easy to handle. If your child doesn't fall in line and is adamant, let it pass the phase. Screaming out the rage, throwing away things may help the child. When the anger subsides, looking at the destruction and the obvious uselessness of it may help the child realize his efforts were futile. But be careful that the child doesn't get physically hurt in this process. For some kids, a gentle hug helps soothe the anger pent up. Tantrums in public places can be extremely embarrassing. In such situations, do not argue or scold your child or order him to hush up. It will only end up making the child more adamant. Wait till the storm subsides. Take him out to a quieter place and talk gently but firmly. One thing to remember here is to never let the child know of your embarrassment and concern that you are in a public place. Children are very smart and may end up using this to work things in their favour. It is not easy being a toddler and it is definitely not easy being a toddler's parent either. By the time your toddler is old enough to go school he will have overcome this stage.  
Obesity is not just an adult problemWith fast food chains multiplying in the country faster than you can say Maharaja Mac, there is an urgent need to monitor our diet. While most of the nutritional advice is directed at adults, kids too are exposed to the dangers of empty calories. Childhood obesity is on the rise across the world including India. How does obesity affect children? And what can parents do to ensure this doesn't happen? We will try to answer some of your questions. What are the causes of obesity in children? Lack of physical activity: Nowadays, children spend more time sitting at home - doing their homework, watching TV, and playing games on PC, console tablets or smartphones. Play time on the ground outside has shrunk. As a result, they don't get enough exercise. Unhealthy food choices: Our busy lifestyles leave us with little time to plan for or prepare every meal. The alternative is to go for quick-to-cook food like Maggi. Food ordered from outside too is invariably unhealthy. While having it once in  few days is not a problem, making it a way of life leads to problems. Overweight parents: The eating pattern and lifestyle of parents has a big influence on a child's health and weight. Obesity can be hereditary. Lifestyle and environment: When parents are unable to pay much attention on their children due to their busy schedules. As a result children rely more on ready-to-eat food or junk food. Genetic factors:  For some kids, genetic factors may be the reason behind obesity. A rare genetic disorder called as Prader-Willi syndrome causes severe weight gain in kids. What health problems can obesity cause among children? Type-2 diabetes Eating disorders like bulimia or binge eating (excessive eating or drinking) Problems with foot structure Liver problems Respiratory disorders - breathlessness during exercise Difficulty in breathing while sleeping causing snoring or poor sleep What can parents do to prevent or control obesity in children? Parents must make kids understand the ill-effects of eating junk food. They must limit their snacking on junk foods. Encourage the kids to participate in physical activities and outdoor games. Make exercising a routine for the children. Join them during exercising to make it a fun time for the family. Set an example for your kids by following a healthy diet and eating habits yourself. Limit TV time and playing videogames. Parents must include whole grains, fruits and vegetables in the diet of their children. Limit fats intake to not more than 25%-30% of total calories. Make sure to go through the nutritional label while purchasing any processed food.  
Afraid of the dark? understand your fear and cure it!Scotophobia, more commonly known as Nycotophobia, is a psychological illness, where the patient is afraid of the dark. Children are more prone to this fear, though it does affect quite a few adults as well. The dark often represents insecurity and uncertainty to children, and it symbolizes their entrance into an unknown territory. If the children are alone during their first few encounters with darkness, the absence of parents (who exemplify safety), tends to amplify this crippling fear. While most of us do actually possess this fear in relatively small amounts, as we grow up the fear diminishes. However, there are those of us who might carry this fear of the dark into their adulthood and in such cases, the fear is usually accompanied by quite a few intricate issues. People often tend to externalize a set of conflicting feelings about a certain situation, towards something else. For instance, you might be worried about your children; but your mind may externalize this fear, via your inefficiency at work. This process is called externalization. So, when it comes to the root of your fear of darkness, it is possible that at some point in your past, you experienced something untoward, which through externalization, inculcated this fear of darkness, deep into your psyche. Evolutionary Ties to Darkness: Many scientists have pointed out that this phobia might be linked to the process of evolution. Since predators hunt for their prey at night, we might have inherited this fear of darkness from our ancestors, who believed that darkness was a space where they could be attacked by wild animals. However, recent studies have shown that  Scotophobia begins at approximately the age of two in children, and thus, it cannot be said to be innate to us. In a study done by Ryerson University involving over 90 students, it was found that people who are afraid of the dark, are more likely to be poor sleepers, than those who are not afraid of it. More interestingly, it was discovered that any kind of noise made while the people with this phobia were asleep, frightened them the most.. Symptoms of Scotophobia: The first symptoms of this fear are the resistance to visit dark places and the yearning for company when such situations arise. However, many a times adults who are suffering from this fear, do not reveal it due to the added fear of embarrassment and this, sometimes, results in outbursts of rage when they are forced to go out for an event at night, or to confront the dark under any such circumstances. A person battling this fear may experience panic attacks, sweating and trembling prior to, or while staying in the dark. The blood pressure also rises, accompanied by chest pain and lastly, a difficulty in breathing. Diagnosis of Scotophobia: In children, this fear can be easily verified by their behaviour. However, adults might require further assistance, due to their natural resistance to openly admit to such a fear. Scotophobia can be diagnosed through a comprehensive psychiatric evaluation. Following this, your psychologist would be able to give you an idea of the source of your fear as well. Pursue a course of treatment immediately after the discovery of the phobia, which will ensure a faster and more effective recovery. Treatment of Scotophobia: The process of 'desensitization' is most commonly used to help with such a phobia. In this form of treatment, the patient is slowly exposed to the object of fear, in a situation where she/he will not feel vulnerable. This is done by asking the patient to confront the dark along with another individual who symbolizes safety for him/her. This could be a parent or a friend. Night lights can also be installed to gradually reduce the fear. You may try certain breathing exercises, which will reduce the panic attacks that accompany this fear. Hypnosis has also been said to be very effective in dealing with this phobia. If your psychologist sees fit, you might be also prescribed some medicines; antidepressants are given in some cases. Joining a self-help group is also a good option, in addition to your psychological treatment.  
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.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Penis healthHere's a quick one on how to go about doing the good work The function of penis is primarily passing urine and intercourse. So from the hygiene point of view it becomes imperative that the penis, testicles and scrotum should be washed regularly with mild soap and toweled dry to keep out any odor causing bacteria. The foreskin should pull back to expose the glans or it can cause bleeding while having sexual intercourse. The foreskin is that protective sheath around the glans. It appears a simple task to pull the foreskin back about a quarter of an inch. But it is difficult. So for those men whose foreskin isn't exactly the 'spirit of co-operation'. Soap and lubrication can ease the way down. Try it slowly and gently over a few days and then ease down with practice. It is important to slide the foreskin back while bathing to wash off the 'smegma', sticky substance that tends to accumulate there. Don't wear underwear which is too tight or it may restrict the blood flow to the penis. Besides that is not very good from the point of view of the quality of sperm generated by the testicles. 'It's really surprising how many men don't clean underneath their foreskin', says Patrick French, sexual health expert. A penis, for once, isn't a muscle and you could do some serious damage in trying to bend it. Secondly, it is meant to have erections so there is nothing abnormal about that. The penis has no bones in them but don't ever try to apply strength and/or fold your penis away. It is like a tube with blood vessels which fill up and give an erection. If you were to rough handle the penis by twisting it violently it can actually cause the vessels to rupture and cause a swelling which can be painful. Do not ignore any swellings, lacerations or spots on the penis as they could be symptoms of sexual disease or infection. Even circumcised men should wash under the glans regularly.
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.
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