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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.
Marrying late in lifeConventionally, the marriage age is determined according to the linear formula of happiness that we have constructed and believe to be true. The formula being: getting married by 24 --> having children by 27 --> working (optional) --> becoming a grandparent (that too, real soon!). However, time and again, men and women wandering in their 40s-50s have woken up from the deep disturbed slumber to realize that maybe- just maybe, they had walked into things too fast. They had been unable to know who they are and to become a self-conscious human being before being ready to fuse their lives with another. The prime point of being single and marrying later in life is not to go on some form of egoistic joy-trip but to be able to know oneself and become ready to be the right person for the other. By marrying late, you give yourself time to experience freely what you like and dislike. You get to explore the world at your own terms- travel whenever you want and involve yourself in festivals and activities that manifest who you are. Marrying early doesn't allow for time to explore one's being, as marriage generally immediately follows the time you finish your studies or begin working. One of the most important aspects of adulthood today is travelling. However, every individual has unique wants of travelling and being a single adult will allow you to experience the world fully. You will also get in touch with yourself, exploring how you would like to live. The decision will arise from a ground of experiences which would clearly tell you what repels and what appeals to you. Such experiences are rarely findable once you begin living with another, as you would have to schedule your days and basically, your routine around the other's life as well. Financially, you have reached a point where you know how to take care and manage finances, allowing you to plan your wedding pragmatically. Marrying at a later point in your life allows you to be clear about when you would like to be a parent. Your experiences also ready you to be a considerate and understanding parent who can guide a child. As you grow older, you tend to become more tolerant and the propensity towards differences turning into unnecessary fights is lowered. As our ways of looking at the world change, every person as an individual has the need to learn to see the world as a home. This feeling of being at home is created only through series of experiences one has to go through as a responsible adult. In the face of inexperience, two individuals coming together often find themselves incapable of being happy with one another. Marrying later allows you to have grown into a wiser person yourself before sharing your life with another.
Pregnancy myths bustedChances of getting pregnant each month gets increased by 50% in the women of the age of early 20's: This not right, for a women to get pregnant is not easy. When a woman is below 25 the chances of hitting baby bingo are only 20 to 25 %, while the women above 35 years of age the chances are 15%.   The baby's gender could be understood by the shape and size of the belly. It is believed that woman carrying a girl has high belly: False again. The shape of belly depends on original shape of the abdomen, amount and the distribution of the fat, strength of the abdominal muscles, the number of babies conceived and the position of the baby... but in no way possible can the shape or size of a belly give away the sex of the baby inside.   The best fertility lubricant to be used for conceiving is saliva: This is totally wrong, actually saliva is the sperm killer, most of the lubricants and massage oil are also not good for fertility, so it is better to go without using any lubricant.   Sperm production is impaired by laptops: This is true. Heat is not good for male fertility when laptops are used on laps they may generate heat and affect the fertility. So it is good to use the laptops as desktops.   The conceiving period of most of the couples is 3 months: This is not right, most of the couples take about 6 - 12 months of active efforts to conceive if they are not having any fertility problems.   There are more chances of conceiving, if you do more sex on the fertile days: This is true, the man having normal sperm count to have sex during her partners fertile days is good for conception. Having everyday sex was suggested in earlier days but anything which is done in excess is always more.   The egg can be fertilized within two days after it is released: This not true, an egg has the shelf life of only 12 to 24 hour, and the sperm have to meet with egg within that time, though it has the shelf life of 3 days or more.   Position during conception matters: This is not true, the sperms which are healthy are good swimmers, they can make you pregnant in any condition.   Eating oysters is good for getting pregnant: This is true, oysters are the good source of zinc, which is the most fertile mineral, it is also a good booster for libido, it can be used by both sexes.   Having cough medicine is good for getting pregnant: This is true, cough expectorants loosens up the cervical mucus as it does with the mucus in the chest, and the looser cervical mucus gives the sperm an easier and faster way to get pregnant. But some cough medicines contains an antihistamine that dries up all the mucus, which makes for a difficult swim for the sperms.   The sex of the baby is known by the glow on the face of the mother: This is not true, as the morning sickness of the mother is stopped, she starts eating well, the blood circulation also improves and in general the mother feels good, which gives the glow on the face. There is no relation between the glow on face and delivery of a baby.   The baby having lots of hair causes heartburn to their mother: Completely false, heartburn is the common complaint of the mother during pregnancy, this is due to reflux in oesophagus, in this the food particles come up through the food pipe and due to its acidic nature it causes heart burn. There is no relation between baby having lots of hair and heartburn.   The food intake of the pregnant woman should be doubled, for baby and the mother: This is not true, the pregnant woman, should take a balanced nutritious diets containing ample of proteins, vitamins, and minerals, small meals should eaten for every two hours rather than eating only 3 times the bulky meals.   Labor can be induced having sex during pregnancy: Not true, if the woman is physically fit during pregnancy can have sex as advised by the doctor only the position during sex should be taken care of, it should not cause discomfort to the woman.   Regular breastfeeding is a barrier for getting pregnant: Again a myth, the women can get pregnant even in the lactational ammenorrhea before the first menstrual cycle. You should always use contraception to avoid pregnancy.   Using computer during pregnancy can harm baby: This is not true, there may be backache if you continuously work for a long time on computer, but there is no direct effect of computer on the baby.   Source: What to Expect Before You're Expecting
Obesity is not just an adult problemWith fast food chains multiplying in the country faster than you can say Maharaja Mac, there is an urgent need to monitor our diet. While most of the nutritional advice is directed at adults, kids too are exposed to the dangers of empty calories. Childhood obesity is on the rise across the world including India. How does obesity affect children? And what can parents do to ensure this doesn't happen? We will try to answer some of your questions. What are the causes of obesity in children? Lack of physical activity: Nowadays, children spend more time sitting at home - doing their homework, watching TV, and playing games on PC, console tablets or smartphones. Play time on the ground outside has shrunk. As a result, they don't get enough exercise. Unhealthy food choices: Our busy lifestyles leave us with little time to plan for or prepare every meal. The alternative is to go for quick-to-cook food like Maggi. Food ordered from outside too is invariably unhealthy. While having it once in  few days is not a problem, making it a way of life leads to problems. Overweight parents: The eating pattern and lifestyle of parents has a big influence on a child's health and weight. Obesity can be hereditary. Lifestyle and environment: When parents are unable to pay much attention on their children due to their busy schedules. As a result children rely more on ready-to-eat food or junk food. Genetic factors:  For some kids, genetic factors may be the reason behind obesity. A rare genetic disorder called as Prader-Willi syndrome causes severe weight gain in kids. What health problems can obesity cause among children? Type-2 diabetes Eating disorders like bulimia or binge eating (excessive eating or drinking) Problems with foot structure Liver problems Respiratory disorders - breathlessness during exercise Difficulty in breathing while sleeping causing snoring or poor sleep What can parents do to prevent or control obesity in children? Parents must make kids understand the ill-effects of eating junk food. They must limit their snacking on junk foods. Encourage the kids to participate in physical activities and outdoor games. Make exercising a routine for the children. Join them during exercising to make it a fun time for the family. Set an example for your kids by following a healthy diet and eating habits yourself. Limit TV time and playing videogames. Parents must include whole grains, fruits and vegetables in the diet of their children. Limit fats intake to not more than 25%-30% of total calories. Make sure to go through the nutritional label while purchasing any processed food.  
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.
Boost your self-esteemSimply believe in yourself. Life need to be made lighter. Pulling yourself down over trivial mistakes and not reaching certain standard definitely does not help.  Your self-esteem affects the way you interpret messages from others. It affects relationships, academic achievement, and living life to the fullest. Thus, recognize your true potential in life and work towards it. Those who have a high self-esteem always have an “I think I can” or “I will” attitude! This makes life much happier for them. Ups and downs in life are inevitable, but this should not bring down your self-esteem. One should work towards maintaining a high self-esteem at all times.  You need to have the power to control your self-esteem. It should not suffer from negative messages from others; in fact, negative messages should be viewed as constructive criticism. There are many ways in which self-esteem can be given a boost. Accept yourself and increase your inner stability so that you will not need validation or attention from other people. Meet new people. Follow examples of successful people. Don’t worry about how others might judge you. Don’t be afraid to try something new. Failures may come your way, but they are the best teachers in life. Make a list of your strengths and weaknesses. Make the most with what you are best at, and strengthen your weaknesses. Focus on the positives and practice positive self-talk for encouragement. Avoid doing things just to “go along with the crowd.” Gather courage to express yourselves and ‘stand out’ from the crowd, as every new encounter is a learning experience. Develop a support system of friends. They will give due emotional back-up. Put into place good healthy habits; ensure the right kind of diet. Controlling the mind is essential for a healthy body. A stress-free mind is healthy and calm, which will incorporate positive thoughts. Give credit where the credit is due. Praise others and accept compliments in good spirit. This builds confidence. Keep criticism to a minimum, as it brings about negativity. Appreciate life. Look your best to feel your best. It is important to be well groomed. Improve your personal living space. Perfect your skills and practice your talents. Reward yourself often. It’s nice to pamper yourself once in a while. Stop comparing yourself to others; this will increase your stress levels unnecessarily. Your self-worth should not be based upon what others think of you, but how you feel about yourself. Communicate with others, colleagues, neighbors, family, and friends. Be social. Do something for someone else – a random act of kindness! They fill up the void and bring about a different level of happiness. It is beneficial to spend some time alone by yourself. Review your mistakes and analyze the experiences in your life. This should be carried out as a self-therapy, and not as a habit. Do not become a loner. Everyone is a unique. No one else is like you in the whole wide world. This makes you special already! Everything starts with you and ends with you. Remember, nobody can insult you without your permission!! A low self-esteem gives rise to health problems like depression, loss of interest in life, and stress. It is not difficult to correct this stage which comes in everyone’s life. Learn to rise above these shortcomings and improve your outlook about yourself. Confidence comes from not always being right, but learning to be wrong. - Peter T. McIntyre.
Causes and treatment of sleep talkingIt is usually believed that sleep talking is associated with dreaming, but there is no scientific evidence available to support this hypothesis. In few cases, it may be associated with sleep disorders or any other diseases. Sleep terrors and REM sleep behavior disorder (RBD) are two sleep disorders associated with sleep talking. Sleep terrors are associated with frightening scream, kicking, and thrashing. It is commonly seen in children. Awakening becomes difficult during sleep terror. Patients with RBD utter a sudden loud cry, grunt, shout, or act out their dreams, usually violently. Other causative factors of sleep walking are emotional stress, mental health illnesses, substance abuse, fever, and certain medications. Treatment: Evaluation of the patient Patients with sleep talking should be evaluated by a specialist doctor especially if it is seen in adults or associated with violent actions, screaming, or intense fear. If children with sleep talking have disturbed sleep pattern, they should be evaluated by the pediatrician. The doctor asks questions to the parents, roommates, and bed partners about the nature and the extent of sleep talking. There is no definitive treatment available for sleep talking, although the doctor may test to record the sleep pattern of the patient to identify any sleep disorder. This test is known as polysomnogram. Management Sleep talking usually does not require treatment. Avoidance of stress and plenty of sleep at night may help to decrease sleep talking. However if any sleep disorder is identified by polysomnogram, it is treated accordingly by the doctor. If underlying causes like mental illnesses, substance abuse, or medications are identified, they are also managed accordingly. Mental illnesses like depression should be treated with proper counseling and medications. The patients should refrain from alcohol, heavy meals, fatty meals, etc. The patients are advised to follow regular sleep schedule, get adequate amount of sleep, and practice proper sleep hygiene so that severity and frequency of sleep talking is decreased.
Arthritis friendly workoutsRheumatoid arthritis is more common in women over 60, and is the inflammatory type of arthritis where the synovial fluid functioning is disrupted. The synovial fluid maintains the health of joints, bones, and cartilages. Osteoarthritis is the most commonly occurring type in both men and women, and in this type there is gradual wearing away of the bone cartilages, which, in turn, causes stiffness, and pain in the muscles, joints and tendons. There is a classic catch 22 situation in arthritic patients and that is they avoid exercise or are advised extreme caution while exercising. The pain and soreness which comes from exercising can be extremely discouraging, so some shun exercise altogether. Now, the lack of exercise is going to precipitate the condition further, and could even increase the soreness, and lead to deformity. This is what challenges most arthritic patients. Should someone with arthritis be allowed to exercise? And if yes, then what type of exercise will prove to be most beneficial? Main question is: Are there any arthritis friendly workouts? Doctors now recommend that exercising could actually work wonders for arthritis patients. The right method and type of exercise can help ease the inflammation and soreness of the joints, and build overall health, strength and flexibility of the bones, and joints as well. What would be a good exercise routine? The arthritis foundation recommends routines which exercise the flexibility of the joints, and build muscle mass, for better shock absorption, coupled with physical endurance should be specially designed for arthritics. Regular walking: Walking is a great exercise for arthritics. Walking at a steady pace for about 30 minutes, thrice a week, can help keep the limbs active, and could reduce the swelling at the knees, and hip joints. Warm up is absolutely essential in any work out, and here it is of paramount importance that you go through a warm up routine before you begin your walk. Simple leg raises, hand to toe stretches, and light back bends can be done to warm up the muscles and joints for your walking activity. That will also reduce the possibilities of strain or sprains of the ankles along the way. Choose your exercise route to ensure that you don't walk up a gradient, and put unnecessary pressure on your knees and ligaments. Aquatic Exercises: Exercising in water is perhaps the best possible alternative, as water is absolutely low impact. This is great for arthritic patients to reap the benefits of a swimming pool workout. The easiest for chronic arthritis patients would be to simply walk, or wade in water for about 20-30 minutes. This can help greatly with building strength, and endurance in the extremities. For enhancing co-ordination you can even try walking backwards in water, or simply float and relax the body. Avoid water which is too cold, as that might adversely affect your condition. Stretching and Yoga: All easy stretches for the limbs and joints will be helpful to facilitate ease in movements, and dealing with joint pain. Standing leg raises, shoulder raises, wrist rolls are exercises which can be done quite easily, and can help keep the body supple. Though yoga also enhances flexibility, it goes way beyond just that, and actually aims at harmonizing the life force in the internal and external organs as well. No matter what type of exercise suits you, always remember: Proper warm up exercises are a must for the arthritic patient, as that can help reduce, and eliminate the possibility of injuries while working out. Do not force your body into an exercise regimen, if you are experiencing pain. It is quite ok to take a day off if the joints are sore. Get into an exercise routine slowly as your body might take a little longer to recover from it. Always seek the advice of an expert or a doctor before making any alterations to your regimen.
The earlier yearsSexual concerns experienced during the drastic body changes and feelings of adolescence are often carried into adulthood. Sexual desires are powerful and frequently go beyond the earlier popular forms of sexual expression - kissing, hugging and petting without being aware of the consequences. Anxiety the commonest case of erectile dysfunction is compounded by the present life style - get-togethers, parties, with alcohol and drugs, visits to sex workers or massage parlours which offer other sexual services leading to unplanned, unprotected sex. Consequently seen are unwanted pregnancy, abortions, drug addiction, sexually transmitted diseases, anxiety and depression leading sometimes to suicide. Males seem to have more concerns then females. A common concern is nocturnal emission (night fall, Swapana Dosh) of semen and length of penis. Nocturnal emission of spermatic fluid is falsely believed to weaken a person. Really all that's happening is that excess of sperms is being thrown out to make place for the new ones. The length of the penis troubles many. Young people fall prey to advertisements that claim to lengthen it. The fact of the matter is that a penis an erection of 2.5 wide (10cms) is enough for a sexual intercourse for a person who knows the art to satisfy a partner. Ignorance about masturbation is widely prevalent among males of all ages leading to guilt, anxiety, depression and at times to suicide. Older men erroneously think their cause of erectile dysfunction or premature ejaculation is masturbation. Masturbation is a highly pleasurable act in males. It does not harm the body or exhaust the sperms. In fact it is a safe way to satisfy. Females also masturbate but the percentage to men is much less. They also seem more comfortable with the activity. Masturbation has gone through years of superstition fear of ill effects, considered as a unhealthy practice and considered sin by some religions. Fifty or more years ago doctors and activities thought it caused harm to the body. It is said that corn flakes, the popular breakfast cereal was specifically formulated by Mr. Keleog to help a person not to masturbate. Today thinking has changed. It is now thought that it is an activity that does not cause any harm to the body. It does not finish all the vital sperms over the years so that it will not hinder having children in future. Its wide misuse is common. Persons use it indiscriminatingly when they cannot sleep, when they are tense for e.g. before an examination, some do it more than four to six times a day, which only indicates their immaturity. When done to satisfy a natural sexual urge it is a healthy activity. It keeps the person safe from infection and is said to teach the person skill for sexual intercourse. Technology has helped in many ways but sometimes it creates problems. A person hooked on to porno sites to arouse his desire is found to cause a loss of self confidence conflict with the partner sexual intimacy and intercourse. Before marriage or a partnership both male and female have concerns. Females if they have a previous partner but are getting married to another worry about the husband finding out of their loss of virginity, others worry about the size of their breasts, excessive hair on body or excessive fear of pain at intercourse. Men worry about whether their penis is long enough whether their long standing masturbation will hinder intercourse or prevent them of being a father. The absent hymen a false notion for virginity can be congenitally absent, split by exercise like swimming, cycling etc. or most commonly by masturbation. The hymen therefore is no proof of virginity. Learning to do with what they have making full use of their points and feeling comfortable and proud of their bodies help a lot to overcome the concern. Adopting a safe sex policy is best achieved by masturbation; avoiding sex with an unknown person and multiple partners; during intercourse with sex workers not using condoms every time and being careful of oral sex. Satisfying each other by caressing, hugging, kissing etc. with clothes on is safe; without clothes extra vaginal sex by mutual masturbation is safe with a trusted partner and finally not so safe is vaginal intercourse unless done with a condom correctly worn.
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