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Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
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.
Importance of breastfeedingBreastfeeding is a natural act and that is why it is also one of the most beneficial acts for a baby. Breastfeeding provides essential nourishment and is the best food for the baby's stomach to digest. No matter how many infant formulas enriched with vitamins and minerals you provide to your baby, it can never replicate mother's milk. As for the mother, there is nothing more joyous than providing your baby with the best start that it can get in the long journey of life. The bond that the mother and the baby share through breastfeeding is one of the most special bonds. For the first six months, breastfeeding your baby is recommended for all mothers whether they are working or at home. Most working mothers are given leave, whether paid or unpaid, so they must ensure they provide their babies with regular breast milk. Breast milk protects the child against diarrhea, respiratory infections, pneumonia, ear infections, and helps to reduce chronic constipation and colic that the babies are prone to. Research also points to the fact that breastfed babies are immunized and protected against allergies, asthma, sudden death, diabetes, and obesity. They remain much healthier than those babies who are formula fed. In India, only 41% mothers begin early breastfeeding even though it has so many benefits. Mothers who exclusively breastfeed their babies help them to survive better. They also gift them with better brain development and these babies are likely to perform well intellectually. No matter which economic section of society the mother comes from, she can provide her baby with the best start in life by breastfeeding it and make sure that the child develops to its full potential. Breastfeeding is natural, simple, and cost-effective way to ensure your baby is healthy and continues to develop healthily. Since the breastfeeding campaign began on a large scale, child mortality has decreased. Immediate breastfeeding within one hour of birth has helped to significantly reduce sudden baby deaths. The colostrum, the first thick yellow breast milk is what protects babies from many diseases as it is filled with goodness. Lack of nutrition or malnutrition is another aspect that leads to infant deaths. Breastfeeding can significantly lower infant deaths from malnutrition as the mother's milk is one of the most nutritious foods provided by nature for the baby's healthy growth. A mother has the full ability to provide adequate nutrition for the baby, therefore breastfeeding needs to be encouraged fully. Employers need to create an appropriate space within their premises and should encourage new mothers to breastfeed their child. Breastfeeding also has a number of benefits for the mother. It helps to burn calories and the mother can return to her former pre-pregnancy state. Breastfeeding helps mothers to reduce their risk of breast, uterine, and ovarian cancer;high blood pressure;diabetes; and heart diseases. So for the first six months, mothers must make sure to breastfeed their baby and do not substitute it with baby food products.
Infertility at workplaceSince infertility among the younger age is increasing, it is important that a couple decides an early suitable date to attempt conception. Time and again it has been found that infrequency of intercourse is the cause of delayed pregnancy. It is advisable that the woman has a thorough examination by the gynecologists to identify the ovulation dates and for the man to have a thorough spermatic fluid check.  If both are normal then they could wait for a suitable date later. Should there be a problem the quicker it is attended to better. Also, early in the marriage they should start a fund which could be utilized for matters related to conception. For the male, the main treatment covers his personal sex life and a detailed examination of his spermatic fluid. It is the female who has to undergo many detailed tests and possibly surgeries which are expensive. It is often seen that not only the procedures for both take a toll on their personal and intimate relationship but also severely affect their finances which may come to a point that it does not allow them to complete the treatment as for e.g. the woman undergoing IVF may costs several lakhs of rupees. The treatment of infertility has improved greatly, but interferes severely with the work schedule. Working couples particularly women may have a hard time keeping to their schedules. Depending on their infertility diagnosis, many workplace challenges exist including the need to take time off to undergo tests and other appointments. It is difficult to balance the medical and surgical procedures with daily life and work. This is a difficult issue for many people as they fear their employer may discriminate against them for taking time off from work. Sadly in India there are very few employers who include medical benefits and cost of treatment for infertility. Suggestions have been given on stress dealing with infertility treatment and work. Here are few pitfalls to avoid: Do Your Homework: Review your organization's HR policies so you understand the amount of leave you have and other policies that pertain to your situation. You may be able to arrange for flex time or work from home on the days of your appointments, so that you do not actually miss any work. Be Honest:  Go to supervisor and let her or him know that you will be using your leave time and will give as much notice as possible. Honesty is the best policy. Remember people are inherently curious about the disease of infertility. If you feel the questions are invasive and make you feel uncomfortable, remember you do not have to answer the questions. You can respond nicely and let them know that you appreciate their concern but you are not ready to answer any questions. Your co-workers are asking question because it is human nature to be curious. In conclusion, not everyone needs to know what is happening with your reproductive health. At work place should medical help be available do take advantage of it.  This treatment has nothing to do with your performance at work. Go to work feeling confident that you will be able to perform your job and handle your workload during this time.
Anger management for your teenaged daughter - Handling difficult teenage times If one fine day you find your daughter suddenly reacting differently to a particular situation, do not be surprised, especially if she is in her teens. The outburst is beyond her control and she herself is confused by her own behavior, at times. It's important rather than scolding her for her misbehavior, one must wait for her to calm down and then speak to her regarding the incident when she is in a jolly mood. It is impossible to forgive such behavior if it repeats regularly, though. Here are some ways to deal with your daughter if she strays the limits of accepted norm for a behavior. You can seek the help of a counselor and understand why this is happening and solve her queries so that she could handle them better in the future. Why do Teenage Girls Lose Temper?By the time, the girls enter their teens they would have become aware about the social etiquettes, importance of looks, acting in an acceptable manner in social scenarios and creating a 'cool' image about themselves when they are outside their homes. So, even if they are hurt, or are angry at something, they do not let it go public, lest their 'cool' image gets shattered. However, the same anger becomes bottled up and vents itself out when they reach home. It's much like the workplace anger showing up at home. This is the place where they can behave wildly and still expect forgiveness. However, that does not mean that you should let your daughter get away with such kind of madness. After she has cooled down, you need to talk to her to find out what is bothering her or making her behave in such a manner. Probably, she may not accept that she has a problem, but you will have to find a way to reach to the root of the issue. More often girls want to be like someone in their college or peer group. They want to fit into a particular group and being unable to do so makes them nervous and distraught. Teach your daughter to believe in herself. Make her understand that she is a unique person on her own and do not need to convert herself into someone else. It may take consistent effort on your part to imbibe all these things into her mind, but you have to work hard to make her understand. Self-Control is the KeyMany young girls do not know how to solve a particular problem when they are faced with it. Apart from taking her to a good counselor, you can discuss problem solving techniques with her. Ask her to understand the situation first, put a foot backwards, relax, and then find a solution to the problem. This habit will make her probe into the problem in a better way and she will be able to handle similar situations when they occur again. You can ask her to write down the problems that are bothering her and ponder over them. You can assist her initially, but as she matures she will find her own solutions depending on her past experiences. Adolescent girls have sometimes trouble keeping their anger, rage, and fear under control and hence their problems should be handled patiently. Brainstorming SolutionsOnce she has ripped apart every aspect of the problem and has come to a brainstorming solution, advise her to write down the plan of action. For example, if she is disturbed due to a particular teacher who does not seem to like her grades, she may do well seeking help through friends who are better in that subject, or for that matter, a bad remark by someone in a group might unsettle her, thereby venting her anger at home. With restraint on your part, make her understand that anger will only block her process to think or find a solution. If you teach her to find answers for the problems in a calm manner, your teenage daughter will surely learn to control her anger and behave normally as she grows into an adult.
Balancing marriage and work: The top 5 tricksFor women juggling between home and work is very difficult. Yet, the number of women choosing to go out and work, while managing their homes, has increased over the years. This is because a successful career helps a woman establish her identity in society, gain respect and do justice to her inherent qualities, passions and dreams. So, a successful working woman, is a happy woman and statistics show that such women also keep their kids and spouses happy. More stable marriages During the seventies, when women started entering the workforce in large numbers, there was an instant rise in the divorce rates. However, over the past decade, the divorce rates among working couples have actually declined. Today, men have extensively adjusted to the idea of having a working woman, as a partner. In many countries, men actually share the domestic chores and devote time to childcare, so that their women can successfully handle both, work and home. However, the main responsibility of the home and the kids is still primarily, in the hands of the women. Here are the six keys to manage your work and marriage successfully: Find the right job You can ease out the stress of managing the work and home front, if you make the right decisions. Studies indicate that couples having access to less demanding work, have better sex and better relationships and hence, are less likely to be stressed out. However, in case the working hours are long, the situation can become the opposite. Hence, it is important to find an exciting job, over which you can still have control, especially when you have small kids at home. Adjust the working hours Most women have to leave their careers halfway because their husbands work for long hours and there is no one available to care for the kids. If the wife too is good at work then, the couple should take up jobs that provide an opportunity for both of them to work, since doing this will keep both of them satisfied. There is a possibility that the husband, or the wife, may lose a bit on the income in this adjustment, but ultimately it increases the chances of having a happier marriage. The negative impact of leaving work If a career-oriented woman leaves her job due to family demands, it can shake the very base of the marriage, while also leaving her, depressed. Also taking a break, means you have to catch up very fast when you want to restart your career, which in reality, is quite difficult. In these situations, there is also a huge wage gap, between what you used to get before your break, and what you are getting after, that can lead to depression. Working moms help fortify the relationships between kids and their fathers When the father spends time babysitting the children, a closer bond develops between the kids and the father, which is usually not possible in families where the dad goes to work, full time. Studies show that children raised with equal devotion from both father and mother, have higher goals and aspirations and are even more empathetic. Feel less guilty A working woman usually feels guilty because she cannot spend as much time with her children, compared to the dedicated housewives. However, if the husband shares the duties related to bringing up the children both parents can be happy while playing their parts well for their kids. A woman with a successful career is positive and confident about everything she does, which ultimately makes her family happier.
The male ego: Fragile male self-esteemIn a world where men are constantly competing with one another, adding a woman to this dynamic changes the perception for majority of men. The fact that a woman is doing better than a man can largely affect relationships at a personal and professional level. Simple things like opening a door for men or even pulling a chair for him can make him feel self-insufficient. The whole concept of a woman doing something/anything better than him brings down his self-esteem. In a relationship the roots go deeper and men who are making less money or not doing as well as their partners have a more fragile self-esteem. The mental insecurity that a woman may be a better provider for the family and has more potential than he does, changes the dynamic of his relationship, while for women this does not seem to be the case. Fragile self-esteem alters your everyday determination and persistence. Without being determined, the only way to go is downwards. When self-esteem is affected by women doing things that he can do, men seem to take it in a negative manner and lower their self-esteem. Small examples of this in our day to day life are - driving your own car as compared to having a driver, being physically weaker than a woman, etc. Men are creating rules to ensure that women who are considered lower than them cannot perform or do better than them. Systems and frameworks are made which ensure that situations never come up where a "lower person" does better than a man can, all out of the fear that they can't perform! From the day we are born to the rest of our lives, we are drilled with the fact that men are better, stronger, and smarter than women. So when situations arise where she is doing or has done better than you, the male self-esteem is questioned and, most of the time, drops. Being the person you are meant to be, you would automatically create a system by your choice and influence it to reduce the possibility of any other to be able to achieve what you have, in turn increasing your self-esteem. However, when the other overcomes or surpasses this obstacle, your self-esteem will be hit hard causing a drop in your self-esteem like the stock exchange does on its bad days. Self-esteem is a very personal topic and completely dependent on the situations you have encountered across your life. However, when majority of these are leaning in one direction then there is no question of failure. Consider a world dominated by women, What would happen to your self-esteem? Do you think you would survive in this kind of world, a world in which all your thoughts are limited by restrictions and rules you have to adhere too, to ensure things like your family name is kept out of shame. So let us all do as the women have been doing for centuries, embrace it, and learn to maintain our self-preservation and esteem irrespective of our surroundings. This may sound hard but let us work towards a world where women and men are equal. Don't let your self-esteem be affected by your surroundings, if you know your surroundings are not the best for the future.
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.
Good and bad calories-How do they affect weight loss?Not all calories are bad calories. Surprisingly very few people are aware that good calories are quintessential for burning fat and can rather help you in losing weight. So, it's very important to know how to differentiate between good calories and the bad ones. What is a Calorie? In scientific terms, one calorie equals to one unit of energy. When the term calorie is being used in relation to nutrition, it means consumption of energy through what you drink and eat and use of energy for carrying physical activity. Many people think that in nutritional terminology, calories are only associated with drink and food; but the truth of the matter is that everything has energy is calories. For example, since coal provides you energy it contains calories. 7,004,684,512 calories are equal to energy produced by 1-ton of coal. Coming back to weight loss, 100 calories of fiber and protein is not similar to 100 calories of a cake. This is because there are good and bad calories and much like us humans all calories are not equal. Calories are the measuring units of energy that are produced by the food once it reaches your body. This energy works on the law of physics and hence less energy intake leads to weight loss and vice versa. Varying types of Calories Different types of food provide varying calories or energy amount to the body. The analysis of a tightly scrutinized weight loss experiment has revealed that when people of two different groups were fed the same measure of calories albeit from varying food sources, the weight loss was almost similar. However, the effects of weight loss were variable; like uncontrolled emotions, cravings, hunger and more. This happened for the same reason that some calories are good and some calories are bad. Good and bad calories Sugar is a powerhouse of energy. But if you keep on eating only sugar all day long it will be suicidal. This is because; the calories present in the sugar are devoid of any nutrients and your body cannot function without the right balance of different minerals, nutrients and vitamins. Most food not only carry calories but they also constitute a complex mixture of additives, fiber and nutrients. These mixtures of varying components directly affect the leptin hormone that controls the hunger trigger in your body. These hormones tell the body to either burn the fat or store it. The process of weight loss is made complicated by the fact that biologically our body is programmed to protect the fat stores so that they can be utilized during starvation. So, the question remain, which calories should you eat to lose weight but still keep on getting the required amount of energy? Eating lean protein, healthy fats and unrefined and unprocessed carbohydrates such as fruits, beans and vegetables are the best for losing weight. Calories with more nutrients are the best The foods that do not store fat and make us eat again and again, are the ones you should eat as good calorie food. Choosing them is simple. These are the same food that humans used to eat before processed food was invented. For example; avoid using the processed whole grains and switch over to brown rice instead of the polished white rice. Also, stone-ground whole wheat, oats or quinoa bread is much better than the white bread. Replace the processed carbohydrates from your platter with whole grains and vegetables to lose weight, control hypertension and blood sugar. Use fats derived from plant sources such as olive oil or nut oil. Eat lean protein more such as chicken and fish.
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.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
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.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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