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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.
10 pregnancy risk factors that every pregnant woman should be aware ofFollowing are the possible risk factors for pregnant women: Hypertension: Blood pressure rises during pregnancy due to changes in osmotic level. Persistent high blood pressure leads to a condition called as pre-eclampsia. It retards the growth of the baby in the womb and can even result into death of foetus. It can lead to convulsions in mother. Exposure to medicines and drugs: Self medication is a strict NO NO during pregnancy. Certain drugs have harmful effect on the growth and development of baby. Take gynaecologist's opinion and ask a doctor before taking any medication.  Smoking: Smoking retards the growth of foetus (baby in womb). Moms who indulge in smoking give birth to babies with a very low birth weight. It also increases chances of miscarriage. Mother's weight: It is important to make sure that there is a steady weight gain during pregnancy. A weight gain of 11 kilograms is expected over a period of 9 months. Watch for a steady weight gain for a healthy pregnancy sake. Anaemia: There is an increase in blood volume during pregnancy. This can cause the iron levels to drop down resulting in anaemia. Haemorrhoids add further to the iron loss. Iron and folic acid are therefore prescribed. Haemorrhoids: Haemorrhoids are common during pregnancy and after pregnancy due to constipation which is because of hormone induced reduced motility of intestine. The pressure of gravid uterus on intestine may also cause it. Increased consumption of green leafy vegetables and laxative would relieve it. Alcohol: Drinking can cause a harmful effect on the growth and nourishment of child. Child may be born with a serious medical problem. Sexual intercourse: It's strictly not advised during last trimester. Radiation exposure: Exposure to radiotherapy or chemicals in the surrounding should be avoided. Bleeding per vagina: Consult your gynaecologist soon, if you have problem of bleeding per vagina. It could be a sign of abortion.  
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.   
Stress - Even kids cannot escape!Often when we feel overwhelmed with stress, we go back in the past and reflect. We miss our golden days of childhood.We think of those days with fondness, miss the free and carefree times. We feel like becoming kids again. But the truth is that at no age are we free of stress and worries. It is just that with time, we move on to newer situations and every new stressor seems worse than the previous one. Children stress out too, some more than the others. Stressors Simple things like a test in school, a Physical Training class or poem recital could mean a lot of stress for the little ones. The desire to meet the expectations of parents or teachers also creates tremendous pressure on the children. They are eager to do well at all the times and the smallest failures can upset these kids immensely. Peer groups are difficult to manage. In childhood, the social maturity is not sufficiently developed to handle day-to-day conflicts. Trivial fights or comments from classmates and friends can lead to a long-lasting impact on the vulnerable minds. They get easily influenced by their friends. Elder siblings also play a major role. Some act as mentors, some as bullies. Some cause damage unknowingly, some are plain indifferent. Life is full of new things and childhood is a fast-track learning lesson. Every other day, there is something new a child has to do. Meet a new kid, learn a new subject, try to dodge a ball differently or ride a bicycle without side wheels; there is too much to learn. These cause anxiety and may make the child nervous. Performance pressures, technology, precocity, media influences, etc. are some of the other factors that add to the stress in childhood. Signs Watch out for subtle changes in moods and behaviour. With adults, it is easier to identify the stress and hence rectify it. But with children, it is quite a challenge. Most of the children are themselves unaware of the stress they are facing, they don't understand why they are feeling sad or angry or fearful. They are just not at ease. Inordinate crying or screaming is a common sign. Being withdrawn, aloof and quiet is another way by which kids express their tensions. Physical signs can be seen in basic physiological changes - in sleep patterns (oversleeping or inability to sleep), eating habits (not eating or eating too much), frequent aches and pains, especially digestion disturbances and headaches, etc. Managing childhood stress Pay attention to your child. Listen to what he/she is saying, but also try to listen to what he/she is not saying in words, although only in action. Help the kids open up to you, spend quality time with them and talk to them about everything under the sun. Be well connected with their school teachers and parents of their closest friends. If the need be, please don't hesitate to reach out and seek professional help from psychologists and child counsellors. "One of the luckiest things that can happen to you in life is, I think, to have a happy childhood." - Agatha Christie  
Your child is ready for school... but are you?It was still okay. Just 2-3 hours which you could utilize for other things while your child was away briefly. Now you will have to compete along with teachers, textbooks and homework for your child's attention. Well Mother, we know this is going to be difficult for you, but let's see if we can try and make it any easier. Think of school as an extension of the tender loving care that you provided. The only difference is that the TLC will go towards nurturing and developing his/her brain and help it learn important skills which will help gain a balanced development. At this point your child feels bad and completely unsafe in this new hostile world of teachers and uniforms and what not! If you weaken at this point your child will cop on and then will come the emotional blackmail. So explain the importance of school to your child as it will make the transition easier. It is always good for mothers to accompany their children to school but imagine watching mother walk away and all hell can break loose. So if your child's school has a school bus facility you can walk him to the bus stop and then say your goodbyes there. A lump in the throat at the bus stop is preferable any day than a scene at school with a child holding on to mother for dear life. Do not criticize your child's school or assignments given by them as children can catch on quite quickly and that can be reason enough for them not to concentrate on school activities. Always encourage your child to talk about what he did at school and ask him questions about his friends and teachers. This gives the impression that school is as important as home and gradually even you will reconcile yourself to the fact that school is here to stay.
Dealing with obsessive thinking and worriesAn old adage goes - 'Worry is like a rocking chair. It gives you something to do but it doesn't get you anywhere'. This is absolutely true for many of us who have developed the habit of worrying unnecessarily over outcomes and circumstances. Thinking about things and over our course of action is a good thing because you should always think twice before acting. What about obsessive thinking? Is it good for you? Anything in extremity is a bad thing, whether it is your favorite food or your thoughts. Worrying incessantly is a part of obsessive thinking where you cannot let go of negative thoughts and they circulate in your mind continuously. Obsessive thinking is a negative infinite loop, a broken record that is stuck without having anyone to click the stop button. So how should you deal with this obsessive thinking that is sure to spell your doom in the long run? Though psychologists have devised various scientific methods of overcoming obsessive thoughts and worries, here we have listed down some easy to follow rituals that will help you deal with such worries and thoughts. Meditation - Yoga swears by the art of meditation as it is thought to release all negative energy from the mind and soul. Concentrating on your breathing and also absorbing a positive source of energy is the essence of meditation. So whenever you are obsessed about something, sit down, calm your nerves and meditate. Physical activity - Exercising always helps. Engage in physical activity which increases the body's metabolism and requires effort. Indulge in those dance lessons or swimming or maybe cycling and you will divert your mind from those negative thoughts. Indulge in your hobbies - So you thought you don't have time for your hobbies, but your hobbies relax your mind and body. Moreover, a hobby also takes out the creative side in you. So, whether you like to collect coins or stamps, or lean towards arts and crafts, a hobby is sure to occupy your mind and take you away from worries. Socialize - Friends and relatives are your lifeline as they help you in those tough situations. Even if you are mentally not at peace, making social calls on your friends and relatives will take the edge off.  Try to meet people who can empathize with you and help you move out of it. Socializing will give you that much needed break from the vicious cycle of your thoughts. Though a short-term relief, going out for movies or taking a weekend getaway with your near and dear ones or even indulging your wife in shopping, can be helpful. Confide - Talking to someone close who understands you helps you in expressing your troubles. Thinking obsessively, you usually tend to ignore your feelings and emotions. Your mind remains trapped in the net of those obsessive thoughts and your emotional well-being takes a backseat. When you talk to another person, he or she will hear you out and help you relieve the stress that is on your mind. They would understand your state of well-being and support you emotionally. Be mindful - You may find it easy to go back into the same negative thought process. Don't let your mind chatter. Stop your mind by standing up for yourself. Stand in front of the mirror and say, "I am not a victim. I have the power and strength to move ahead" Do this whenever you become aware that you are going back into the same thought process.  This will give you the mental strength needed to come out of it.  Be mindful and aware but don't be too harsh on yourself. Be responsible -Your mind can make you or break you. If you understand this truth you will find it easier to manage your thoughts. Take responsibility of your thoughts good or bad.  The mind can create thoughts to project blame or judgments about others.  When you own your thoughts, you will find it easier to shape them the way you want. Create a higher vision of your life - When you keep a higher vision in your life, you can move ahead easily.  By developing a higher vision, you are asking yourself, who am I?and finally working towards it. You take positive actions and thus there would be more gratitude for what you have and less resentment for things that do not work.   This stops your mind from working unnecessarily. Obsessive worrying is a psychological disorder which in extreme cases has to be dealt with pathologically. Do not let your condition to reach the extreme end of the spectrum. Follow the above mentioned suggestions and try to deal with those thoughts yourself. It may take some time but rest assure, it will be effective in the long run.
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.
10 best and worst appetizersWhen you are munching on appetizers before your meal, the idea is to eat something that can trigger off the production of your digestive juices in the intestine, so that what you eat next, the food is easily digested. However sometimes, the appetizers are much more complex and heavier on your tummy and can actually reduce the metabolic activity and imbalance the digestion process. Here are some of the best and worst appetizers that are commonly served: Best Appetizers Vegetable Kababs: These highly nutritious and low calorie appetizers are a good alternative to fried items. Grilled vegetables or kababs are prepared by skewering red and green bell peppers, onions, tomatoes, mushrooms and zucchinis. To add to the taste, you may brush over some low-fat herbs and even garlic marinade. Two delicious vegetable kababs, will get you only 75 calories. Crab Cakes: Seafood offers you high nutrition and the best way to include the properties of seafood in your diet, is by choosing crab cakes as appetizers since these offer only 20gms of fat and 300 calories, while providing you with a high level of sodium (960mg). Spinach Salad: The best thing about good appetizers is that they are low calorie foods and provide great flavor and satisfaction while eating. One such fulfilling appetizer, is spinach salad. You can also use other green leafy vegetables to add more nutrition to the recipe. If you eat this appetizer before your meal, chances are, you will eat 10 to 15 percent less of the main course, which is certainly a great way to cut down on the calories. A cupful of fresh salad gives you only 80 calories. Beef Skewers: If you are in the mood to pamper your taste buds, but still want to stick to eating healthy, then beef skewers is the right option for you, in the appetizers section. These are usually served with peanut sauce in restaurants. You can opt for lean beef along with soy, garlic, hoisin, onions and barbeque sauce to make this dish yourself. Quarter to the pound is the recommended serving, which consists of 5 gms of fat, 130 calories and a high sodium content of 803 mg. Stuffed Mushrooms: Potato skins are a common appetizer people go in for, but these add more calories. Instead, you should opt for stuffed mushrooms that are way more delicious. The caps of mushrooms are stuffed with breadcrumbs and the cheese of your choice; and they provide only 50 calories per cup. This means that even if you eat six stuffed mushrooms, you are still within the limit of 300 calories. The worst appetizers are deceptive yet tempting in their looks and taste. But you should always keep a check on the ingredients before gorging on them, for your own benefit. Worst Appetizers Onion Blossom: Fried onions are certainly bad for your waistline. It is always better to eat a starter stuffed with more vegetables, instead of fried things. A restaurant preparation of onion blossom consists of 161 gms of fat, 1,049 calories and around 4100 mg sodium, which is more than double the limit required by an adult, making this appetizer a completely unhealthy choice. Cheese Fries: Cheese fries are one of the worst appetizers; these can be even more overwhelming than your meal itself, which is why health experts advise not to include this appetizer in any type of menu. Sometimes cheese fries actually come with more melted cheese on top, which is obviously worse. Spinach Artichoke Dip: Although this starter starts with the word 'Spinach', it is in no way a healthy appetizer. One dip of spinach contains loads of calories-1600, fat-100 g and 2500 mg sodium. It is certainly not the spinach but the cream base that is rich in saturated fat. Potato Skins: Potato skins have all the high calorie foods such as meats, sour cream and cheese. When you take one pop of these, you will be adding 150 calories, which is quite a big number. Moreover, these appetizers are not filling. A plateful of potato skins adds 1,340 calories, 1,850 mg sodium and 94 gm fat and yet leaves you hungy. Cheeseburger Skins: Although these appetizers look small, there are loads of calories packed in them. One order of Cheeseburger skins can total up to 1270 calories, with an added 2310 mg sodium and 82 gm of fat.
5 Mistakes yoga beginners makeYoga is a science that has been developed by the ancient Indian sages after a lot of research and study. That is why yoga is difficult to master immediately and one needs a lot of practice to achieve every posture or asana in the perfect manner. So, it is very important to learn the yogic techniques from an expert and one must avoid performing yoga on your own, at least in the initial stages to ensure that you do not suffer from any physical injuries by wrongly straining or stretching your muscles during practice. Yoga can benefit you only if you perform the asanas according to right techniques. Hence, you should try to avoid mistakes right from the beginning. Here are the five most common mistakes people make while performing yoga as beginners: Learning How to Breath Inhalation and exhalation, some say is the most important process that you need to control while performing yoga. While trying to achieve certain asanas, you have to hold your breath for a while and because of this, your muscle fibers are deprived of oxygen for that time. And one needs to do this while holding one's body in that particular posture. With less strength in your muscles, there are chances that you may fall down or get injured. Hence, as a beginner, when you do not have proper control over your breath, it is best to inhale in short breaths, instead of going for the full belly breaths. Just as you slowly inhale, remember to exhale slowly as well, so that the rhythm of the yogic posture is not disturbed. Do not push Yourself Too Hard Most of the contemporary exercises are based on the principle of 'more pain, more gain'. These exercises tell you to stretch more and push harder to get the best results from your workout routine. However, in the case of yoga, the opposite holds true. If you push yourself beyond your limits to attain a particular posture in yoga, you might actually end up straining and injuring your muscles instead. . So, when you are doing yoga come what may, do not push yourself beyond your natural limits. Do Not Compare Some people are naturally gifted with super-flexibility, while the rest of us may not achieve it despite practicing yoga for years together. Each of us has a different type of body and hence, you should not try to compete with those who are highly flexible, especially, if you are trying yoga for the first time or after a long time. You must give your body some time to loosen up its rigidness and become flexible enough. Trying to compare your body's abilities with others and forcefully pushing yourself to perform postures, just to match up, will hurt you eventually. Where to Place the Mat? The best place to put the mat is at the back of your yoga class, especially if you are new to yoga. If you keep your mat at the front, you will become more conscious and will never be able to concentrate on the asana. Instead, if you are at the back, you will always have the front row to follow, just in case you miss the instructions by the instructor. Go easy on the Food! Yoga postures can be intense and if you go into class with a full belly, you will, most definitely find it difficult and uncomfortable to perform the asanas. The key is to eat about an hour before and almost half the size of your usual portion; so that you can perform the asanas comfortably and get the exact fuel necessary for performing them.
How to communicate with a patient who has a strokeThe first and the most important thing to communicate with the patient, is to give undivided attention. Give attention to his activities, gestures, his facial expressions through which he may try to communicate so his feelings could be understood. Eye contact is also important but the patient having stroke may look at you square in the eyes but he may not respond to your conversation. While communicating with the patient you should always stand in front and tune out all the other sights and sounds in the room. Maintain full silence around the patient in the room, turn down the volume of the television, radio and ask other people in the room to be silent. You may communicate with the patient by making contact by touching the hand, chin, cheek or areas which are not affected by stroke. As the side which is affected by stroke, does not have any sensations. You may communicate with the patient through his family member by telling the family member to communicate with patient by saying, "Look at my face"; through this we can gain the patient's concentration. You should always speak clearly with the patient in a normal soft volume. Express your ideas in simple terms, form simple sentences, do not use complex words. You may repeat the sentences or an important term again. For example to ask if the patient wants tea, repeat the word 'tea'. More complex thoughts can also be similarly conveyed and repeated. You may also use hand gestures with clarification like doing Hello by waving your hand or through your hand action, you may ask questions like, How are you? Are you ok? What do you want? Through this both caregiver and stroke patient can benefit. You may ask your patient to point out whatever he wants or if he needs anything. And gradually he will develop the habit of pointing the daily items like television, newspaper, remote, eyeglasses radio, drapes an uncomfortable foot, the patient can indicate any pain or headache. Through this communication we can make the patient learn, use mechanical lifts to get in and out of the bed, and with the help of the attendant by demonstrating the patient how to use it. Sometimes when the communication does not work, take a break, give it time and try again, do not get frustrated and reassure the patient that yes, he or she can do it. Good communication with the patient is very important as they cannot speak their basic wants and needs clearly. The patients suffered a stroke also have slurred speech. There is a deviation of the angle of mouth. They are mostly bed ridden and could not carry out the routine activities.
Female circumcision - Health EffectsThe procedure is carried out by either snipping off a piece of the clitoris or removal of all external genitalia for non-medical reasons. The procedure is carried out outside hospitals and the environment may not be effectively clean and could lead to infection. The painful procedure causes a lot of fear and distress. Some countries have begun to use healthcare personnel to cut the genitals, which reduces pain, bleeding and infection but it does not mean that it is acceptable by the United Nations. Even though the United Nation has termed female circumcision as a violation of human rights, there are millions of girls suffer because it is a requirement for girls so that they remain pure. It is supposed to lower female libido so that they do not indulge in any kind of sexual activity before marriage. Immediate complicationsGirls are likely to suffer severe pain besides the fear that accompanies such a procedure. It can cause them more pain when they try to urinate. If there is severe bleeding, it can lead to haemorrhage. The tissues that form the genitals are severely damaged and healing may not take place immediately and sores can form leading to more pain. Girls can retain urine for fear of the pain. There is always a chance of contracting tetanus or other bacterial infections like sepsis which lead to formation of pus. Besides cutting, procedures can include pricking, piercing, incising, scraping, and cauterizing the genital area. Long term health problemsBesides the immediate problems, female circumcision can lead to long term effects including infertility. The girls can be subjected to urinary tract infections and bladder infections that can recur again and again. Sometimes cysts may also form. There are chances that there could be increased risk of problems during childbirth which could in extreme cases result in the death of the newborn baby. According to UN estimates more than 125 million girls and women are living with female circumcision. Women may be subjected to continuous surgeries especially in those cases where the vagina has been stitched to make it narrow as part of the circumcision process. Once the girls are married, the vagina is unstitched to have sexual intercourse. During childbirth, the vagina may need to be cut again to deliver the child and then stitched up again. This is a continuous problem and women should be spared from this pain and trauma.
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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