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Health check up checklist for men Prostate Cancer - Prostate cancer is the lesser known killer in men. It is a slow growing cancer, but at times, its symptoms can be aggressive as well. Detecting prostate cancer at its onset can help in treating it effectively. Tests include a digital rectal exam and a blood test for Prostate Specific Antigens (PSA). Testicular Cancer - This uncommon cancer can affect any male between the ages 21 to 55. A physical exam during yearly medical checkups is recommended for all men. Men having a higher risk, with family history, should speak to their doctors regarding additional tests for screening. Self-examination through regular gentle palpation of the testicles to notice any change in shape or size, presence of lumps is also suggested by doctors. Colorectal Cancer - This is the second most common cancer in men. Men over 50 and younger, if they have a familial risk, are suggested to get a screening colonoscopy done to detect this cancer. It usually starts as a polyp that grows and invades the nearby areas to develop into a full-blown cancer. The polyps, if detected early, can be removed and cancer prevented. A CT scan or a double barium enema can also help in detecting polyps. High Blood Pressure - With the kind of lifestyle men lead today, almost every other man is bound to have BP issues. Regularly checking the BP is essential as it helps detect high BP which may lead to a variety of other problems including stroke and heart attacks. The sooner the detection, the sooner the measures for control. Cholesterol Levels - Bad eating habits, sedentary lifestyle, and mental stress can all lead to lots of cholesterol roaming around in your arteries. This will eventually clog the arteries and cause diseases like high blood pressure and atherosclerosis which can be life-threatening. Get your total cholesterol, LDL, VLDL, HDL, and triglyceride levels checked regularly and initiate timely interventions to bring them under control. HIV - This is the most commonly spreading STD among men. Due to its chronic nature, HIV is often detected accidentally when it may be too late. Regular tests for HIV detection are essential if one is physically active with multiple partners. Be safe though and use a condom. Glaucoma - It is extremely common and is one of the leading causes of blindness. Glaucoma has no cure, but it can be controlled well with timely detection. Screening tests should be undertaken by men under 40 years at an interval of 2 to 3 years after 35. A yearly test is recommended for older men.
Urinary tract infections in menUrinary tract infections are most commonly seen in the bladder in men. The symptoms include: Pain or burning during urination The urge to urinate often Pain in the lower abdomen Urine that is cloudy or foul-smelling Fever with chills and vomiting If the infection has spread to the kidneys, there may be pain in the back in the region of the kidney along with high grade fever, nausea and vomiting. UTI occurs very commonly and is not a medical emergency, but it is advisable to see the doctor immediately to avoid further complications. Elderly people and people suffering from diabetes should report instantly as they are at a higher risk for complications. The main risk is of the infection spreading up and affecting the kidneys. This could result in severe damage to the kidney and in people already suffering from any kidney disease, it could mean even kidney failure. There is also a small chance of the bacteria entering the blood stream and reaching other organs. Risk Factors for developing UTI: Not drinking enough water Holding in urine for long Kidney stones Taking frequent baths These factors may increase your chances of developing UTI A urine test is the only way to diagnose UTI. It not only checks for bacteria in the urine but also for abnormal cells like pus cells and red blood cells. Dipsticks are accurate. Home test kits are also available but they do not boast of 100% accuracy. Stealth or Asymptomatic UTI is the same as UTI, except that the symptoms are not seen. The bacterial infection is revealed in a routine urine test. This is serious and since it affects elderly people and immune-compromised people, needs immediate treatment. UTI is treated symptomatically. Specific antibiotics are prescribed for killing the bacteria. Symptomatic treatment is offered for the fever and pain if present. Along with this you will be recommended to drink plenty of water and fluids and regularly empty your bladder. Men with diabetes need to take special care due to several reasons. Since their immune system is weak, they are prone to infection easily. The high amount of sugar in the blood and urine may encourage the bacteria to flourish. Also, the diabetic neuropathy affects the nerves of the bladder and there may be no proper signals for emptying the bladder fully. All these add up as potential risk factors for UTI. Urinary Tract Infections are easily preventable. Here's how: Drink Plenty of water Empty your bladder at regular intervals Take showers instead of baths Visit the toilet before and after sex Avoid strong smelling soaps and washes to wash the genitals Wash from front to back.
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.   
Even women can kick up a storm - Martial arts and the modern womanMartial arts! Yup you have seen enough of Bruce Lee, Jackie Chan and Jet-Li films on the telly to know there is a lot of hard work involved. All that glass breaking, torso-twisting, nun chucks, whirling to kicking ten opponents at once. Is that all for real? Can a dainty woman go about hurling armed robbers off their shoulders? Or does that happen only in Kung Fu films with real weird names like 'Shaolin Temple Monks down ....' or something equally corny. That apart! Won't you need to learn a bit of Chinese or Japanese to even imitate those shrieks that women in those films emit? Worse still! Imagine they will need sub-titles to even know that you mean business! Jokes apart and no offense to the masters of Muay Thai, Akido and Tae Kwon Do! Martial arts is way beyond just fighting and is in fact a great way of disciplining the body, mind and soul. As a woman too martial arts can have a tremendous impact on your self confidence and awareness about dynamics of the mind. True what they show in martial arts film is all about smashing bones and tables but martial arts goes way beyond that. Through different movements, kicks and punches and holds one may learn to overpower an opponent using his own weight, but martial arts is ALL ABOUT CONQUERING THE SELF AND DESTROYING THE ENEMY WITHIN! So if you are intent on learning martial arts be ready for some action-packed exercise routines that Promote flexibility Increase strength, stamina and endurance Help you gain better control over yourself Help you deal with any problem that life may throw your way Help you be competitive and assertive There are different types of martial arts which have evolved over several centuries. The main forms are Kung-Fu, Karate, Akaido, Judo, Tae Kwon Do, Kalayraipatu amongst others. There is also centuries of philosophies behind the exercises recommended by these disciplines. Some martial arts concentrate only on unarmed combat while there are others which blend both armed combat with weapons like swords, sticks and nun chucks. Martial arts can indeed go a long way today in equipping women with the art of warfare so that they can defend themselves against any assailant armed or unarmed. It will go a long way in shaping societies and culture if the womenfolk are empowered both physically and mentally too. These days it is not uncommon to see martial arts blended with aerobics dance steps. It may not exactly be pure martial arts but that too isn't a bad idea at all. It will only go a long way in developing interest in these ancient art forms and help in their promotion. Just as much as any martial arts movie can. Or maybe even more!
Bow legsCauses: Physiological - As mentioned before, bow legs are normal below 18 months of age. Thereafter as the child continues to grow the bowing begins to improve slowly. By the age of 3 to 4 the deformity usually gets corrected. Blount’s disease - This disease results in bowing of legs due to abnormality of the growth plate of the upper part of shinbone known as tibia. Growth plates are the growing end of the bones. It is diagnosed after the child is 3 to 4 years old. Rickets - Rickets is a group of diseases that occurs due to deficiency of vitamin D. Rickets is characterized by bow legs and other bony deformities. Most commonly rickets occurs in children due to deficient intake of vitamin D. Signs and symptoms: The bony deformity becomes visible when the affected child walks or stands. The uncommon walking pattern of the child is the commonest symptom. Bow legs usually do not cause any pain. However, persistent and severe bow legs cause discomfort to other bony structures like spine and hip. Test and diagnosis: The doctor at first asks questions to the parents regarding the development of the child. This is followed by physical examination of the child. Physical examination often suggests bow legs. If the doctor suspects an underlying disease, necessary laboratory tests are done. The doctor always asks for an x-ray of the affected legs to evaluate the severity and extent of bowing. Treatment: If the bow legs persist after 3 to 4 years or an underlying disease is detected, treatment is undertaken. Medical and non-surgical treatment- In cases of physiological bow legs, no treatment is required. The parents are reassured by the doctor and spontaneous resolution takes place by the age of 2 years. Continuous followup is advised for borderline cases. Children with Blount’s disease need treatment with a brace. Children with rickets need medical management by a specialist doctor. Additionally, they need advice and regular followup by an Orthopedic surgeon. Surgical treatment  - If the bony defects persist in children with bow legs even after medical and nonsurgical treatment, surgery is required to correct the bowing. Two types of surgery is advocated to correct bony deformity of the legs. Guided growth:  Growth of the healthy part of the growth plate is stopped and that of the abnormal part is promoted. This allows straightening of the legs. Tibial osteotomy: The shinbone (tibia) is cut and reshaped to correct the deformity. Then bone is fixed with screws and plate. In both surgeries a cast is applied to promote healing of the bone. Crutches may be required for a few weeks to prevent weight bearing on the limb. Later, physical therapies are advised for complete recovery of range of movements and regular activities. Prevention The parents need to be vigilant about appearance of any bony deformity in legs of their child. The child must be given adequate amount of vitamin D in diet or vitamin D supplementation to prevent development of rickets.
Cranky kids in a diner? dealing with them made a bit easy!This has happened to many a parent. They make a reservation at a fine dining restaurant, perhaps with friends and relatives. But their kid screams, and cries,disturbing the entire restaurant, and spoiling the general mood. For this reason, many parents avoid going out altogether, especially to fancy places. But there are ways in which you can handle the toddler when you are at a restaurant. We will show you how. Carry toys Restaurant may be boring at times for toddlers. That's why they turn peevish and may start playing with forks, spoons or knife. So carry some toys, crayons, notebooks, or even a story book, which will keep them busy and you can have a good time. Order something yummy and healthy for the kid A hungry kid is an angry kid. So, order something which is your kid's favorite and also healthy at the same time. Or you can carry something along with you like fruits breads, cherries or other nutritious treats. Keep responding to what kid says The best way to keep childrenwell behavedis to talk to them and respond whenever the child speaks. Don't avoid them or get too engrossed with other people. They get cranky when they don't get a response from you. Take a round with your kid When the kid becomes difficult to handle, just pick him in your arms and take a mini tour of the restaurant or walk outside. This will distract him and relieve his boredom. Don't tolerate any bad behavior If the bad behavior of the kids is intolerable, then firmly tell them that they need to adopt good manners if they want to visit restaurants again. Disturbing other diners is not acceptable. But it doesn't mean that you punish them.You just have to remove them to a place where they don't bother anyone. Make your outing relaxed and enjoyable Above all, don't forget to have fun and make it an enjoyable evening. Don't get too carried away disciplining the kid. You can afford to be a bit silly and enjoy the time with your child.
Algophobia: The fear of painAlgophobia is the fear of pain:  an abnormal and consistent feeling that is far beyond what would be considered normal. The term is derived from the Greek words, Algos meaning pain and Phobos meaning fear. Our bodies are designed in a way that when there is a painful stimulus it reacts. How the body reacts to the pain is an individualistic phenomenon. Some people have a very low threshold for pain, and even the slightest pain evokes a huge response in them. Where as others can withstand a good amount of physical pain before their bodies give in. Some people dread even the tiniest amount of pain. They foresee situations that will cause pain in them. The way they react to even the smallest amount of pain is far more than the normal level of acceptance. Such people are said to be suffering from Algophobia. Algophobia is a learned behaviour, say behavioral psychologists. For example you may have heard from several people how hitting your shin on the furniture in the dark is the worst possible pain ever. So you tend to keep a watch and if it is dark, you move around extra-carefully to avoid bumping into the furniture and getting hurt. This would be considered normal, cautious behaviour. But if the same thought keeps buzzing in your head continuously and you go to extreme lengths to avoid that pain, you could be algophobic. Old people are the ones who have excessive fear. The age factor along with fear of death plays a vital role in old people developing this fear. For example an old lady may hear about all the ailments and pains that afflict old age people and may become apprehensive about it. She may develop irrational fears that more often than not, are also imaginary. She may start experiencing the pains even before anything actually happens to her. It may seem unrealistic to a normal person, but for algophobics pain can be a severely dreaded thing. Therefore they will go to great lengths to avoid pain at all levels, including day-to-day activities. They will not go into the dark, handle tools, avoid lifting heavy objects or even avoid playing any type of contact sports. If a task has a scope for injury and pain, they will avoid it! Frequently a pathological complaint of Hyperalgesia occurs along with algophobia. Hyperalgesia is a condition of increased sensitivity to pain due to damage to the peripheral nerves and pain receptors. Pain in such cases may be directly in the damaged tissues or in the surrounding areas. An interesting fact is that hyperalgesia can occur due to long term use of painkillers especially strong ones like opium and its derivatives. Algophobia is treated with behavioural therapy, psychotherapy and anti-anxiety medications. Hypnotherapy also has shown beneficial effects.  
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.
High fiber foods and their benefitsFiber has many health benefits and that is why it is important to include fiber in your diet. However, if you are not used to fiber in your diet then introduce it slowly or it could cause indigestion and gas. Fibers are good for overall health and help to boost the immune system and help prevent a number of diseases. The digestive health benefits of fiber : If bowel movements are regular, then fibers will prevent both constipation and diarrhea. Regular movements flush out excessive cholesterol as well as harmful toxins from the intestines which could also be carcinogenic. Fiber helps to reduce inflammation of the intestines, could bring relief from irritable bowel syndrome and prevent piles, ulcers, and acidity. The benefits to the heart Soluble fiber is good for the heart. Fiber reduces the bad cholesterol levels (LDL). It helps to lower blood pressure, improves the levels of good cholesterol (HDL). Fibers reduce the risk of stroke also. These factors are good for heart heath. Weight Loss Fiber can help you to lose weight as it makes you feel fuller for longer which means you will eat less. High-fiber fruits and vegetables have lower calories, so by adding these to your diet cuts calories which could aid in weight loss. Eat 21 to 38 grams of fiber per day depending on your age and gender. Diabetes If you already suffer from type II diabetes then you should have soluble fiber as it slows down the absorption of sugar and can help to maintain blood sugar levels. Regulating blood sugar can also reduce the risk of kidney and gallbladder stones. Cancer prevention Though research is still ongoing, but the general conclusion is that eating fiber foods keeps the colon in a better condition and this could prevent colon cancer. However, it does prevent digestive tract cancer. The more fiber you eat the more fluids you should drink as that helps to absorb fiber better. Good for the skin Eating fiber is good for the skin as they help to flush out toxins from your body which otherwise cause acne. Besides eating a lot of fruits and vegetables produce antioxidants that are good for your skin. Some tips Start your day with fiber as it keeps you full and sugar levels just right to keep you energetic. Try to replace white rice, bread, and pasta with brown rice and whole grain products. Eat seeds, nuts, and flaxseeds either whole or ground and sprinkle some on fruit, yoghurt, or cereal. Add beans and legumes to your diet as often as possible. Eat whole fruits instead of juice. Insoluble fiber can be found in foods like whole grains, wheat, cereals, and vegetables such as carrots, celery, and tomatoes. Whereas soluble fibers are found in barley, oatmeal, beans, nuts, and fruits such as apples, berries, citrus fruits, and pears. Foods like meat, dairy, and sugar have no fiber and some foods like white rice, white bread, and pastries have no fiber either because it has got removed because of refining.
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.
A primer on heart attacksIndians around the world have one of the highest rates of heart diseases. Heart attack, also called as myocardial infarction, is mainly caused by a blockage that prevents oxygen-rich blood supply to your heart muscle. In other words, it is the death of the heart muscle. What causes a heart attack? When cholesterol deposition, plaques of calcium and proteins on the walls of your coronary artery cause blockage of the artery, your heart fails to receive sufficient nutrient-rich blood. This leads to the permanent death of heart muscle, and it is unable to pump the blood to your vital organs. Symptoms that signal a heart attack   Chest pain is a symptom of a heart attack.  This pain can feel like tight ache, pressure on the heart as if an elephant is sitting across the chest. However, you may get confused with the symptom chest pain - whether it is a heart attack or an angina pain. Chest pain lasts for a longer time in heart attack whereas the chest pain in angina lasts for few seconds and goes away after rest. The pain experienced during a heart attack sometimes feels like indigestion or heart burn. Other warning signs of heart attack are: Shortness of breath. Lightheadedness or fainting. Upper body discomfort in arm, the back, neck, and jaw. Nausea, vomiting, dizziness. Sleep problems or fatigue. Not every person will have the same symptoms of the heart attack. But if you have any of these warning signs, you have to act fast and get the right treatment.
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.
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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