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What causes male balding?They say there are 3 types of men: the ones that go bald at the top are thinkers, the ones who go bald at the back are lovers, and the ones who grow bald at both places... only think they are lovers. If pregnancy and menstruation are a female's burden, then baldness is a great inconvenience to men. Some men lose their hair in their youth and thus lose their confidence along with their hair. So what is with baldness and men? Men start having a receding hairline by the time they hit 30, though it could begin in their 20s as well. The most common type of baldness is the mid-frontal type resembling a horseshoe. Earlier it was thought that baldness is caused only by genetic factors, but apparently emotions, lifestyle and diseases also contribute largely to hair loss and baldness. This hair loss can be temporary or permanent. Some medications like anticoagulants, antidepressants, antifungal medicines, chemotherapy etc can cause baldness. Certain diseases like thyroid disease, Crohn's disease, lupus can cause hair loss and baldness. Poor nutrition is an important factor in hair loss. Vitamin and mineral deficiencies along with poor nutrition can pave the path sooner than most other things. Then there are some conditions like Alopecia Areata which cause baldness in patches -- on the head or beard. It is temporary and the hair grow back in about 6 months to 1 year. Corticosteroid injections are used to treat the condition. Air and water pollutants, environmental toxins, conventional styling products have the potential to build up on the scalp. These affect hair cuticle, cause dryness, and weaken the hair causing them to easily break off before their natural lifecycle has ended. If you notice your hairline receding more than usual, then check if you are getting enough nutrition. Exercises like the headstand and handstand send the blood rushing to the scalp and can help with hair growth. Massaging the head with warm oil helps to increase blood circulation as well. Use a shampoo that suits your hair along with a conditioner. Oil your hair overnight at least thrice a week. Keep yourself well hydrated and try vitamin C which can help arrest hair fall. Use a clean comb and ensure that you sun your scalp, as vitamin D is an essential tonic for skin, bones, teeth and even hair.    
Self grooming tips for men Get rid of unnecessary body hair:Hair on your ears, back, underarms, or uni-brows does not appeal at all. If you have them, then try and get a hair removing gel or wax away gently. Nose hairs can be trimmed from time to time, so that it's not visible. Hair in the underarms can either be waxed, or removed by using a razor. Hair on the back can also be removed through proper waxing. Shave properly:Keep a beard if it suits you, but do trim it regularly. If you do not want a beard, but just a moustache, then that requires customary trims as well. Try and keep yourself clean shaven, if you can't easily manage the styles mentioned above. Avoid bad breath:Bad breath can really get you into trouble, especially during office presentations, client meetings, or even at a date with your girlfriend. Use mouth washes to avoid this problem, and floss after every meal. Mouth fresheners can also come handy, so maintain a regular stock at all times. Brush regularly:Maintain a brush and floss routine twice a day to avoid awkward situations. Cut and clean your nails:Long nails look great on girls, but they are a big turn off in guys. Men need to keep their nails small and trimmed always. Use nail clippers to cut them properly, and cleaners to keep them clean. Take care of your skin:Buy a good sun care and moisturising lotion, and use it always, after a face wash and shower. This shall give you a nice glowing skin. Exercise regularly:A good body can attract everybody's attention. Eat healthy food and exercise regularly to be active and healthy. Get rid of body odour:Instead of colognes, try using deodorants and talcum powders to get rid of body odour. For underarms, always keep a roll-on with you, and apply it regularly. If the issue persists, then consult a doctor for help. Wear well fitting clothes:Wearing unfit or loose clothes will make you look older than you are. Hence, wear clothes which fit you the best. Correct your posture:While standing, walking, and even sitting, keep a straight back. This shall give u a better posture. You will look more pleasing and charming. Grooming is not just a thing for women. It is all about looking after yourself. So, read on to know some self grooming tips for men These were a few tips which can help you look after yourself better, and also give you that much needed edge over others. So, try them out right away!
Fitness mantras during pregnancyYou must be wondering how Shilpa Shetty maintained her fitness even after bearing a child. The simple answer is that she never gave up exercising. Exercising during and after pregnancy is the best way to stay in shape and ensure your mental and physical healthiness. It also helps you in preparing for labour pain and delivery, and quick recovery postpartum. However, there are some things you need to keep in mind while exercising during pregnancy: Measure your fitness You need to determine how fit you are. This will help in determining the type and duration of exercising during pregnancy and post pregnancy. Also, before you continue your old exercise routine or begin a new one, you should talk to your doctor about exercising while you're pregnant. Pregnancy is a balancing act After the fourth month of pregnancy, it's likely you will lose balance while you exercise. Though your baby is well protected with amniotic sac, it is better to be safe than sorry. Safe exercises Activities such as swimming, walking, yoga, pilates, and low-impact aerobics are good choices. Pregnancy is not the right time to start any new intensive exercise, but it is safe to continue with most types of exercise if you're used to them. The things you should avoid Avoid exercises where you are likely to lose your balance or could make you fall or slip. Vigorous or extreme activities such as horse riding, skiing, mountain climbing are out of the question. They carry too high a risk of injury to your tummy. Avoid exercises such as: Sit-ups Standing on one leg Separating your legs widely You should also avoid most contact sports, such as football, basketball and so on. Finally, give racket sports a miss if you're not a regular player as they can be tough on your knees and ankles. Check with your doctor Consult the doctor before starting with any new or unusual exercise. Check for any complications or unusual conditions. Also, discuss for any concern such as: Pregnancy-induced high blood pressure Early contractions Vaginal bleeding Premature rupture of your membranes, also known as waters (the fluid in the amniotic sac around the fetus) breaking early The best outfit for exercise Clothes should be comfortable and loose fitting while exercising. Wear a supportive bra which protects the breasts and is also relaxing. If your shoe size has changed because of mild swelling, you may want to buy a new one. Duration of the exercise Exercising three to four times a week is necessary. This reduces stress, fights fatigue, and stabilizes emotions in early pregnancy. Start gradually, may be with only five minutes a day, if you were totally inactive before. Add five minutes each day till you reach 30 minutes. Also keep in mind to avoid exercise on an empty stomach. Eat a snack 30 minutes before exercise. Never over do Listen to your body when it says 'stop'. Over exercising causes overheating. Raising your core temperature too much can affect the baby adversely. Always sip water before, during and after exercising. Listening to your body when something hurts or doesn't feel right - that means stop. Drink a lot of water Try to drink about two glasses of water two hours before you begin exercising. Take a sports bottle of water with you when you exercise and take frequent sips from it. It's important you don't get dehydrated. This may raise your body temperature, which may not be good for you or your baby.  Keeping these points in mind, exercise to stay healthy and fit. We hope you soon give birth to a healthy kid.  
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.   
Teenage troubles for autistic kidsTeenage brings along with it a lot of physical and psychological problems. Your body undergoes a lot of changes, the way the world looks at you is changing and you are not in the position to accept all this. Teenage is one of the most painful periods in one's life.  For an autistic child teenage can be compared to living a nightmare day in and day out. Here is a look at the problems of teenage from an autistic kid's point of view: Social Interaction The ability to interact socially is absent in autistic kids. They are loners who prefer to be left alone and undisturbed in their own worlds. Such a child is a natural target for bullying and ragging by other kids of his age group. At times even if the autistic child wants to come out and make friends, he is not able to do so due to lack of the required skills. Teenage is a period where you need at least one friend to confide in. It can be an extremely difficult phase when you are all alone. Puberty This is the dramatic time in life dilled with hormones and emotions. Your body undergoes lots of changes and you are confused about so many things. You don't know whom to ask or whom to turn to for guidance. Autistic children do not have the maturity to understand this phase. Special issues for autistic teens and sexuality include: Knowledge of physical changes in body. Knowledge of 'good' and 'bad' touch. Ability to communicate about a 'bad' touch or action. Keeping 'safe' distance from others. Handling menstrual cycles. Avoiding 'self-touch' in public. It can be a phase of emotional turmoil for the parents. They need to work closely with their child's special teachers to chalk out a plan that will be best suited to the child in handling puberty successfully. Self-help skills Simple self-help skills like hygiene can be a challenge for teenagers with autism. Improper motor skills, compliance, and sensory problems may interfere with a teen's progress. The proper training of hygiene and grooming can help to add these elements into the daily routine. The right approach is to simplify each task into simple small steps. The positive reward system is a great source of encouragement, as positive motivation always help the teenagers. Higher Functions Autistic teenagers are socially awkward. They lack the power to comprehend and process complex social cues which includes sarcasm, body language, humor, emotional responses and facial expressions. What complicates the problem is that the autistic child lacks empathy and hence may appear rude. Such kids are likely to be teased a lot in school settings.
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.
Have that chocolate without any guiltYou may find this hard to believe, but chocolate is actually good for your health. Hold on, before you faint. Let's first get to the crux of the matter. Chocolate can actually be good for you if you eat it in moderate quantities. So what about all the bad effects of chocolate that people always talk about? Let's fume them all one by one:  Chocolate causes dental caries: Dear mummy, dental caries (cavities) are caused due to poor oral hygiene and consumption of foods rich in fermentable carbohydrates. When these carbohydrates are left in the tooth for a long time, they release an acid. This may damage the tooth enamel and cause tooth decay. In fact, chocolate contains tannin which actually prevents cavities from forming. So next time, dear mommies, let your child enjoy a small piece of chocolate. You can also join them in the treat.  Chocolate is loaded with fats and sugar:Yes, chocolate comprises of both saturated and unsaturated fats, but a majority of themare in the form of oleic acid and stearic acid. Now, oleic acid (present in olives) and stearic acid are good to lower the blood cholesterol levels. Also, the fat that is found in chocolate is added later, after the chocolate has been processed. So the higher content of cocoa in any bar ensures that there is less fat in the chocolate. So, what about the sugar?Sugar is bad, but the darker variety of chocolate has less sugar compared to the regular sweet chocolate. Dark means higher cocoa content and hence no room for other fillers likes cocoa butter, sugar, nuts, etc.  Chocolate contains no nutrients: On the contrary, it is rich in antioxidants.What is the work of an antioxidant? They scavenge the body of free radicals, which roam in body and cause ageing and diseases. Antioxidant flushes these free radicals out of your body. So, if you want to stay young, bite on a piece of chocolate once a week. Secondly, diets rich in antioxidants have been proven to lower the incidences of heart attacks, strokes, cardiovascular diseases, hyperlipidemia, and arthritis. Hence, I stand by the bar full of antioxidants;it's actually good for you.  Chocolate contains caffeine: Caffeine content in chocolatesis low as compared to your tea, coffee, or cola drinks. Now, having counted the amazing health benefits of chocolate, it is important to tell you which chocolate is healthy for you. The one which is in its purest form - thebittersweet one, which is high in cocoa content, is the clue to your healthy bar. So next time you crave a dessert, indulge in a small piece of chocolate to satisfy your sweet tooth and forget that guilt.  
Sunburn: Overview and treatmentSunburns could also be accompanied by allergic responses to medicines, exposure to sun and sunscreen products, sight-related issues like reduced or complete loss of vision, as well as heatstroke. Over a long period of time, frequent cases of sunburn can result in cold sores, cataracts, skin cancer, and lupus.  The factors which will decide the vulnerability to sunburns are: Type of skin - The type of skin determines the vulnerability and intensity of the sunburn. The most vulnerable groups are those with freckled and fair skin as well with blonde or red hair. Regardless of the color of the skin, all skin types are vulnerable to skin cancer and proper sun protection must be used during times of sun exposure. Season - Summer days carry with them a higher probability of burning the skin. UV Index - This refers to the forecast of the strength of UV light on a particular day. This will let you know the cautionary measures you need to take in order to avoid skin damage. This is put forward on a scale of 0 to 11+ with 0 being the lowest exposure. Latitude - As you move to locations closer to the equator, the sunlight directly passes through the atmosphere to a greater extent. Age - Those who are younger than 6 years of age and those over 60 years are at a greater risk of getting sunburns. Altitude - As you climb higher and higher, the chances of sunburn are also greater since the amount of Earth's atmosphere to keep away the sunlight reduces. Every elevation of approximately 1000 feet, the UV exposure is amplified by about 4%. Location - If you are close to reflective surfaces like snow, water, ice, concrete and white sand, rays of the sun which get reflected off these might harm you. Time of the day - The rays of the sun are strongest between 10 in the morning and 4 in the evening. Though, the probability of getting sunburn are lower on cloudy days, it is possible for the UV rays of the sun to pass through the clouds and negatively affect your skin health. Here are the precautionary steps you can take to avoid getting sunburn: Avoid staying in the sun for a long period of time. Make use of sunscreen and choose clothing which cover your skin. In case you are suffering from sunburn, here are ways to treat it: An over-the-counter pain reliever: In order to lower the inflammation and relieve pain, use ibuprofen or aspirin. Anti-inflammatory condiment: Cortisone cream and aloe vera are two primary ways of reducing the inflammation. Cool bath: Take bath for about 10-20 minutes in water of cool temperature (make sure the water is not too cold). This will cut back the pain and irritation in affected area.  Do not use any bath oil, soap or detergent as this might increase the chances of allergic reactions and irritation to the injury. When drying yourself after the bath, do not rub with towel. Cold compressions: Try application of cold and wet compressions on the concerned region for about 20-30 minutes. Adequate hydration: Make sure you drink at least 8-12 glasses of water to help your skin to recover from the sun damage. Moisturizer: Once your skin begins to heal, use a gentle moisturizer without any scent. Blister treatment: In case you have blisters, do not try to pop them. This will lead to infection and marks.However, if you have large blisters which require to be drained, then pop them using a sterilized needle. Follow this by cleaning the area dry with gauze. After applying ointment to the area (Aloe vera or antibiotic ones like bacitracin and polymyxin B), wrap the area loosely using a gauze bandage. Make sure you do not tie it tightly and change the gauze daily to avoid infection. Medical attention: In case you feel nauseous along with fever, rashes and chills, then make a visit to the doctor. The following symptoms also require you to seek medical attention immediately: Pain in eyes with sensitivity to light, dizziness, high thirst without proper urination, painful blisters, and pale/cool skin.
A guide to earwax impactionBiologically, the earwax which builds up over time moves through the ear canal from movement caused by chewing or other jaw motions. It is also extricated through the inside-out motion of the skin of the ear canal - it reaches the outer ear and peels away. The cerumen is produced in the outer regions of the ear and not in the inner recesses. Earwax impaction refers to the condition where the ear wax builds up to such an extent or in such a manner that it causes discomfort to the entire body. In many cases, earwax impaction occurs when patients use cotton swabs or safety pins to clean their ears, only causing the wax to drop deeper into the ears. The main symptoms of earwax impaction include difficulty in hearing, faintness, ache in the ear, foul smell in the ear region, ringing or sound in the ear (also known as tinnitus), a sensation of fullness in the ear, and lastly, discharge from the affected ear. The most vulnerable groups for this condition include those who use hearing aids or ear plugs, elderly people, and those who insert cotton swabs or other items into their ears, as well as those who have an odd ear shape which could negatively affect the discharge of the earwax and those suffering from development incapacities. Did you know that one of the most common methods used by people to clear excessive earwax is ear candling where a candle (in shape of a cone) is placed inside the ear canal and set alight to warm up and remove the wax? This is one of the most dangerous methods causing burns, worsened blocks, and damaged eardrums; this should be clearly avoided. The diagnosis of this condition can be done by an ear specialist using an instrument called otoscope. Earwax impaction is treated in many ways. While at home, you could try to clean the outer region of the ear by wiping with a cloth, the physician could irrigate or syringe the ear to wash out the ear canal with saline. This procedure is generally done once the wax has been softened by the use of cerumenolytic solutions aimed at dissolving the wax like mineral oil, peroxide-based ear drops, and hydrogen peroxide. Physicians also use special instruments to remove the built-up earwax like forceps, cerumen spoon, and suction tool. The best way to prevent cerumen impaction is by not inserting anything into the ears to clean it up. Cotton swabs should only be used in the outer part of the ear. In case you feel that the buildup is regular, then you can fix an annual appointment with your physician for cerumen removal.
Diabetes paves the way to cancer!Diabetes mellitus is common across the world. So common, that people don't take it seriously. It appears relatively benign on a day-to-day basis. It is just a sugar level that you notice on the outward. Controlling diabetes means a change in the lifestyle. It is easy to pop in some pills to battle a disease. The difficulty lies in making long-term changes in our daily routine. We tend to get lazy and make excuses for not being able to follow a discipline in lifestyle. This happens more so with diabetes because we do not see an apparent damage that is being done by the high blood sugar. Unless the levels go really high or drop very low, there are no major symptoms that affect our activities from morning to evening. What we are unaware of is that the disease is making some serious damage insidiously. It affects multiple organs and processes. These effects cannot be directly noticed but are continuously ongoing. By the time we wake up, a lot of injury has already occurred. Here is some more bad news. A large number of scientists in all countries are working day and night to study the course of diabetes and bring new facts to light.  Recent researches have established a new link - cancer. Yes, diabetes increases the risk for breast cancer and colon (intestinal) cancer. A woman who has diabetes, is at 20 times more risk for developing breast cancer. Breast cancer A peculiar association of diabetes and breast cancer has come in the picture in the last few years. Factors contributing to these are many - sedentary lifestyle, overweight, rich food, etc. Another important contributor is hormonal imbalance due to diabetes. As a result of high sugar and high insulin in the body, twofold changes occur in the hormonal cycles which ultimately lead to excess estrogen circulation in blood. This, in turn, may act as a trigger for breast cancer. Breast cancer is relatively easy to diagnose. When detected in early stages, treatment has shown remarkable affects. Colon cancer Cancer of the intestine is one of the most common cancers worldwide. Scientists are still working on finding the exact cause but a clear relationship between diabetes and colon cancer has been proven. Patients suffering from high blood sugar have a higher risk of developing intestinal cancer than those with normal blood sugar. Colon cancer is often seen to be fatal and rate of recurrence is quite high. Worldwide several researches have shown a strong connection between diabetes mellitus and occurrence of breast and colon cancer. Suggestions If you have normal blood sugar levels, please put in your best effort to maintain the same. If you are at risk for diabetes because of significant medical history, take extra care and precaution to prevent or delay the onset of the disease. This can be done by regular and adequate exercise, along with the balanced food options. If you have been diagnosed with diabetes, work on your lifestyle to keep the sugar levels in control. Regular check-ups and frequent monitoring of blood sugar levels are a must. If you are a diabetic, please go for periodical screening of related health conditions. Specific to the topic at hand, please get regular breast examinations. Physician recommended and supervised mammograms and colonoscopies would be extremely helpful. Eyes wide open? Now, will you pay attention to all the restrictions advised by your doctor? Please do. Get that lifestyle which is recommended. Compromise on your work and cravings; focus on exercise and eating healthy. Diabetes is not a killer if managed effectively. Don't let cancer get a hold on you.
Your questions about contraception, answeredFew couples want to have babies as soon as they are married. Most want to enjoy their sex life without having to worry about conceiving a child in the process. If you are in this group, then here are answers to the most commonly asked questions about contraception. What is contraception? Contraceptionis use of various methods to control and prevent the pregnancy. It allows you to choose when you want to have a baby. What are the various methods of contraception? There are two main methods. Temporary contraception: Caps, combined pills, male condoms, female condoms, contraceptive implant, contraceptive injection, contraceptive patch, diaphragms, intrauterine device (IUD), intrauterine system (IUS), natural family planning, progesteron-only pill, vaginal ring. Permanent contraception: Female sterilisation(tubectomy), Male sterilisation (vasectomy). No contraceptive is 100% reliable and some can have side effects. Find out about all the methods listed here, so you can decide which method is right for you. How soon can I conceiveafter stopping the birth control pills? It is difficult to predict exactly how long it will take for a woman to start ovulating again. Some women are fertile as soon as the pills are stopped and others might take couple of months. Once the periods return and are normalised with normal ovulation, you can conceive a child. What if my period doesn't resume after I stop taking oral contraception pills? If you don't get your periods for several months, you may have what's known as post pill amenorrhea. The pill prevents your body from making hormones involved in ovulation and menstruation. When you stop taking the pill, it can take some time for your body to return to normal production of these hormones. Normally, periods should start again within three months of stopping the pill. But some women, especially those who took the pill to regulate their menstrual cycles, may not have periods for many months. If you don't have a period within three months, take a pregnancy test to make sure you're not pregnant, and then see your doctor.
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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