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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.   
Menopause and mental health!Menopause is the period in a woman's life when her man claims she is going crazy. It is also the time when her period is on the decline and hormones are in complete disarray. Depression, insomnia, irritability, mood swings and lack of concentration are few symptoms that the lady has to battle with. These symptoms may begin as early as 4 years before the actual menopause and may continue for several years after that! For women, menopause is a significant turning point in their lives. The dropping levels of oestrogen and the resultant physical and mental symptoms can be like a cycle of events, only adding to their woes! Depression: Depression affects every middle-aged woman. An estimated 20% of women have depression at some point during menopause. The peak period for depression is during the perimenopausal years, when the woman is approaching menopause. The reason for this, say experts, is the fact that most women dread menopause. Even though for some it means an end to years of menstrual cramps, for most others it signifies an end to their womanhood. The very idea is sufficient enough to bring on lots of negative thoughts and depression. Not only this, the reason for depression during perimenopausal and menopausal age is the fluctuating hormones. Research shows that the levels of reproductive hormones, specifically oestrogen are responsible for the mental changes. Changes in the sleep pattern: Insomnia is seen in 40 to 50% of women in the menopausal transition phase. Women who spend sleepless nights are more likely than others to show irritability, crankiness, stress and depressive symptoms. Sleep disturbances during menopause have been linked to the decreasing oestrogen levels. Indeed this claim can be held true as several women respond positively to exogenous hormone therapy. One study claims that sleep changes are linked to the Luteinizing Hormone levels, which also results in increased body temperature. Sleep apnea too occurs in the menopausal transition age. This is due to decreased progesterone level, as progesterone plays an important role in respiration. The weight gain that happens during menopause has also been shown to cause sleep apnea. Panic disorder: Panic disorder is commonly seen during the perimenopause stage. Existing disorder may worsen or new disorder may arise. Panic disorder is usually manifested in women who show several physical symptoms of menopause. The panic attacks are usually associated with negative life events, pre-existing medical diseases and decreased daily functionality. Obsessive compulsive disorder: New onset of OCD, worsening of the existing condition or change in the pattern of symptoms is seen during menopause. OCD changes are also observed during pregnancy and during the menstrual changes, suggesting the impact of hormones on symptoms of OCD. Bipolar disorder: Women with bipolar disorder experience an exacerbation of symptoms during the perimenopausal stage. These women are also the ones that are highly likely to experience severe depression in the menopausal phase. Schizophrenia: Schizophrenia usually manifests itself in young adulthood. The rate of new cases decreases gradually thereafter, in both men and women. In women, however, there is a second peak in the 45-50 years age group. This peak is not observed in men. This suggests that oestrogen may play a significant role in triggering schizophrenia or worsening the pre-existing condition.
16 myths about baby careA new mother experiences a range of emotions. Chief among these is fear, which is a result of the love and attachment that she feels for the baby. In such situations, mothers often tend to believe myths that make no logical or medical sense. Myth 1: If I don't breastfeed my baby immediately after the birth, I won't be able to bond with him adequately. Fact: Although the first few hours of a baby's life are important for both mother and child, sometimes due to unavoidable circumstances, the baby is kept away from the mother. For instance, in cases of cesarean delivery, the new born babies need immediate medical attention, and hence are kept away from the mothers.  However, the love and care you show the child over the years will more than make up for the loss of attachment with the baby during its first few hours. Myth 2: Pinching the baby's nose will make it pointed. Fact: Pinching the nose will only hurt the baby. It will not make the nose pointed. It is possible for a baby to be born with a flat or tilted nose if it gets pressed during delivery. But this is temporary and the nose becomes normal as the nasal bridge develops completely. Myth 3: Mothers should not use yellow clothes and yellow food while breastfeeding as it causes jaundice in the newborn.  Fact: The color of the mother's clothes can't affect the baby's health. There isn't any evidence to show the relationship between yellow food, clothes and jaundice. Myth 4: Umbilical cord stump should be cleaned with alcohol swab every time after changing diaper.  Fact: Alcohol may delay the healing. It is recommended to keep stump clean and dry till it falls off. Myth 5: Some babies can be allergic to mother's milk.  Fact: No. A baby is never allergic to mother's milk. Myth 6: Baby should be wrapped up tightly. This helps to straighten the hands and feet.  Fact: A child's limbs develop faster when they are free to move and not wrapped. Myth 7: Holding the baby all the time will spoil him. Fact: Babies cry to express pain, anger, irritability, hunger, sleep everything. Holding or picking him up to comfort won't make him a spoiled child. Myth 8: Do not take your newborn baby outside. Always keep him in the house.  Fact: Fresh air is good for the baby too. Just avoid heat, crowds and unhygienic places. Myth 9: Vaccines cause autism. Do not vaccinate the baby.  Fact: It is a rumor. Immunization is very important to protect the baby against a number of diseases. Myth 10: Babies do not spit up if they are breastfed.  Fact: It is normal for the babies to burp, spit up, and drool. Do not worry about it if the baby is gaining weight normally. Myth 11: Sleeping on the head causes flat head.  Fact: It is advised medically that all babies should sleep on the back to prevent sudden infant death syndrome. Alternate the head position daily as flat head can be caused only if baby sleeps in same position daily for long time. It is an occasional occurrence.  Myth 12: Putting few drops of oil in baby's ears will keep it clean.  Fact: Do not put oil in the baby's ears. It can hurt the tiny eardrums leading to pain, soreness, and even hearing loss. Oil can cause ear infection too. Myth 13: Use crib bumpers to protect head of your baby. Fact: They are not advisable. The baby's head can get wedged against a bumper causing strangulation or suffocation. Bumpers are dangerous. Myth 14: Stop mother's milk if baby fed only on breast milk has loose motions.  Fact: Passing 5-6 loose motions is normal in a baby. Continue to breastfeed. Do not stop it. Myth 15: Attention span is very short in babies.  Fact: Babies, in fact, have excellent attention spans and have interest in the all things around them. This is why babies learn things so quickly.  Myth 16: Wrap up the baby in blanket if he has fever. Sweating will bring the fever down.  Fact: The fever will rise if you wrap the baby in a blanket. Try to keep the child cool and sponge him with cold/warm water to bring down the fever with the doctor's advice.    
Mood disordersMood disorder is a category of mental health problems, and it includes all types of depression and bipolar disorder. The cause of mood disorder is not well known. Endorphins in brain are responsible for positive moods. The neurotransmitters regulate endorphins. Depression and other mood disorders are caused by a chemical imbalance in the brain. Life events such as unwanted changes in life may also contribute to a depressed mood. Mood disorders are inherited. Children, adolescents, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. Symptoms: Prolonged feeling of sadness Helpless feeling Low self-esteem Intense guilt Suicidal thoughts Loss of interest in daily activities Difficulty with relationships Disturbed sleep Change in appetite or weight Low energy Inability in concentrating Inability to make decisions Frequent physical complaints (i.e., headache, stomach ache, fatigue) Threats of running away from home Hypersensitivity to failure or rejection Irritability Aggressive behaviour Hostility In mood disorders, these feelings appear more intense than what a person may normally feel from time to time. Treatment Psychotherapy: It is focused on changing the individual's distorted views of themselves and the environment around them, working through difficult relationships, and identifying stress triggers in their environment and how to avoid them. Family therapy: Families play a vital supportive role in any treatment process. Antidepressant medications: Medications in combination with psychotherapy has shown to be very effective in the treatment of depression.
Accepting your flawsThere are basically two kinds of 'flaws,' one that is physical and the other that is in your personality. A physical 'flaw' like being too short, fat, or darkis never a person's fault. Thus accepting what you are can only boost your self-esteem and confidence. Despite these 'shortcomings,' it is your character and your achievements that stand out in the long run and not the way you look. The first step in creating a better life is accepting if you are wrong! Personality traits and habits are mostly visible to others but not to you. These are those faults that can cause bitterness in relationships or cause problems at work or in our social interactions. Some people lose their temper easily, some are lazy, and some are rude, while some are either introverts or extroverts. If you have flaws that can cause problems for others then the best thing you can do is to change those negative traits in yourself. Character flaws might be natural, but they can affect others negatively. The first thing in making improvements is to analyze yourself. What are you so angry about ? Is it really some other person's fault or that you have had a bad day at the office? Give it a thought and once you find the answers, you will feel relieved. Accept your physical flaws and love yourself for what you are, as this is the key to lasting happiness. Major flaws like alcoholism, splurging money, borrowing money, or addictions are what one should be willing to overcome. If you accept you have any of these major flaws and need help to overcome them, then you need to seek help. There are professionals who can help out, provided you are a willing party to the process. Improvement will come only if you are willing to change. Remember that flaws are easy to acknowledge and to change;the only thing required is the desire within you to do so.
21 foods for a healthy heartFollowing is a list of heart-healthy food substances: Garlic: Did you ever think that the commonly available garlic in your kitchen can be heart healthy? It may be smelly for some, but for the heart it is a soothing substance. Garlic is known to control blood pressure, serum triglyceride level & cholesterol level. Carrot: Carrots, though taste sweet, have the ability to control blood sugar levels because of high level of antioxidants in them. So include carrots in your diet, especially in salads. Orange: This juicy fruit has cholesterol-lowering ability because of fibre pectin in it and also helps control blood pressure. Almonds: Though all nuts are believed to be nutritious, almonds are considered to be heart healthy. Almonds are rich in vitamin E, calcium, plant sterols, fibre and antioxidants. Almonds help in lowering LDL cholesterol and reducing risk of diabetes. Walnuts: Walnuts are rich in omega 3 fatty acids, monounsaturated fats which help in lowering cholesterol levels.  Oatmeal: Oats are very healthy & help in lowering the bad LDL cholesterol. You can have one bowl of oatmeal mixed in milk along with nuts as breakfast. Flaxseed: This honey coloured shiny seeds contain substances which are heart healthy, such as lignans, ALA and omega 3 fatty acids. It helps in lowering cholesterol level and controlling diabetes. Tofu: It is a type of soybean protein which can be replaced with paneer. Tofu is rich in fibre and polyunsaturated fats which prevent clogging of arteries.  Barley: The fibre in barley is believed to lower cholesterol and blood glucose levels.  Tuna fish: Tuna fish is rich in omega 3 fatty acids which helps in lowering cholesterol levels.  Salmon: It is very good for heart as it is rich in omega 3, EPA and DHA. It lowers and reduces the risk of inflammation in arteries. It is also believed to maintain the ratio of good cholesterol to bad cholesterol. Red wine: Red wine contains catechins and resveratrol, good for heart health.  Black beans: They are a rich source of magnesium which helps in lowering blood pressure. It also contains folate, antioxidants and fibre which is helpful in controlling blood sugar and cholesterol levels. Fresh herbs: If you are hypertensive and want to control your salt intake then try using fresh herbs as a substitute for salt. It also contains antioxidants which are good for heart. Herbs include rosemary, sage, oregano and thyme. Extra virgin olive oil: This is rich in heart-healthy polyphenols & monounsaturated fats. As it's very costly you can use it as a topping for bread or salad. Sweet potatoes: White potatoes are believed to increase glycemic index so you can replace them with sweet potatoes. It is heart healthy as it has low glycemic index and also contains fibre, vitamin A and lycopene. Low fat yoghurt: You can include this in your breakfast safely as it contains calcium & potassium which helps in lowering blood pressure. Dried cherries: They are rich in anthocyanins and antioxidants which help in neutralizing the action of enzymes which cause plaque formation. In winter you should opt for strawberries, blueberries for a healthy heart. Cayenne chili pepper: Your blood sugar normally increases post a meal. By sprinkling cayenne chili pepper over your food can help preventing insulin level spike post meals. Hot cocoa: Coffee helps in patients with type 2 diabetes. Hot cocoa contains antioxidants helpful for heart. Kosher salt:  This is very beneficial for heart patients as it contains half the amount of sodium as compared to table salt and thus helps in controlling high blood pressure.
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.
Winter - When your heart feels the cold too!As per a study in America, 193.6 people of every 10000 people die of a heart disease every year. 53% of the heart attacks occur in the winter months. Heart diseases have a seasonal trend as found by medical research recently. A team of medical researchers recently conducted a survey which saw 10,000 participants between the ages 35 to 80 from around seven European countries. The study was conducted to see if there is any seasonal variation in the presentation of heart diseases. The participants were measured on the parameters of blood pressure, waist circumference, body mass index, blood glucose levels and blood lipid levels. The parameters were later adjusted for sex, age and smoking. The results revealed that the incidence of heart disease shows an upward trend in the winter month [Jan to Feb] as compared to the summer months [June-Aug]. The researchers accept that there is no logical explanation to these findings. A plausible cause being the fact that the eating habits change in winter. One tends to eat more which in turn increases the cholesterol levels leading to heart diseases. Several other theories are being put forth. According to one, during the winter months the body undergoes hormonal imbalance. The day and night variation in the hormone levels, especially that of cortisol varies. This results in a lower threshold for heart attacks. Yet another theory says that the cold temperature tends to constrict the arteries narrowing the blood flow to the heart tissue and this result in a heart attack. On the basis of this study, scientists advise that more attention is to be paid to heart health during the winters.
Flash the pearliesRemember the lines from the song, Words? Smile an everlasting smile, a smile can bring you near to me.  Well, ideally, you wouldn't want your teeth to be yellow when you flash that smile. So for those who have shades of yellow on their teeth, here's how you can go back to white. It's first important to understand what causes yellowing of the teeth. Eating habits: Carbonated drinks dissolve teeth enamel. Tea, coffee and other caffeinated drink stain the teeth yellow.In addition, alcohol and cigarette smoking too can stain teeth. Tobacco chewing especially produces stains that are difficult to remove.Food rich in artificial sweeteners are harmful for teeth. They not only make the teeth yellow but also produce cavities. Chocolates, pastries, ice-creams and all such sugar-rich foods are sticky. They stick to teeth and have corroding effect on tooth enamel and dentin and cause yellow teeth, decay and toothache. Oral hygiene: Poor hygiene of oral cavity leads to stains and caries. Take good care of your teeth. Brush teeth twice. Floss them and use a mouthwash. Ageing: Gradual loss of enamel and wear and tear lead to yellow teeth. Medicines: Medicines like iron tablets, tetracycline too can lead to yellow teeth. Injury: Trauma to teeth can sometimes lead to yellowing. This is common amongst kids. Preventing yellowing of teeth Maintain a good dental hygiene. Brush twice for atleast 3-4 minutes. But be gentle while brushing teeth. Gargle every time after you eat.This removes the leftover food particles and keeps the teeth clean. Avoid use of local powders or corrosive substances. They damage enamel. Fruits like apple, cucumber, and carrot act like cleansing agents and keep teeth clean. Fruits like sweet lime are rich in vitamin C and help to keep gums and teeth healthy.
Know your safe period for low-risk sexNot every act of sexual intercourse will result in pregnancy. There are days when your chances of conception are very high and days when the chances are almost nil. Know these days to help you enjoy a rocking sex life! The menstrual cycle starts from the day the bleeding starts and ends about 28 days after that, on an average ovulation occurs around 14th day of the menstrual cycle. The 14th day is the ideal day theoretically. Since every woman's menstrual cycle differs, the day of the ovulation also differs. Hence doctors calculate the fertile period as the 12th day to the 18th day of the menstrual cycle. This is the period when the chances of ovulating and hence getting pregnant are very high. The 1st to the 7th day and the 19th day to the start of the next cycle are the days when the ovulation chances are very less. This means if you make love during these days, there are very less chances of getting pregnant. This is the case with women who have regular period cycles. In case the cycles are irregular, then you would need to do a bit of math for calculating the safe period. For example, if your shortest cycle is of 26 days and the longest cycle has been of 31 days, then- 26-18= 8 and 31-10=21 The 8th day to the 21st day are the fertile days; 1st day to the 7th day and then the 21st day until the day the next cycle starts are the days that are safe to enjoy sex without fear of getting pregnant. Opting to have sex during the 'safe period' isn't fool-proof though. A lot of women have irregular cycles and the cycle length can vary from women to women. That's why the so-called 'safe period' is, in truth, not that safe! And it's better to use condoms or other contraceptive methods like the oral pill to prevent unwanted pregnancies.
What, how, and why of the sex muscle answeredWhat the Penis is made up of? The penis is made up of several parts. The head: This is also called as the 'glans'. The glans is coated with soft pinkish tissue called the mucosa. The protective covering of the glans is called the foreskin. The foreskin is retractable. In circumcised men, it is the foreskin that is removed. The shaft: The shaft or the body of the penis has two surfaces. The dorsal part i.e. the upper part of an erect penis and the ventral part i.e. the lower part that faces backwards in a flaccid penis. The root: This is the attached part of the penis. Corpus cavernosum: This is the tissue that lines the shaft on two sides on the dorsal side. During sexual excitement, this corpus cavernosum fills with blood that results in the stiff erect penis. Corpus spongiosum: This is the tissue layer running in between the two layers of corpus cavernosum on the ventral side of the shaft. The urethra: This is a narrow tube that runs through the corpus spongiosum. The urethra's main function is to excrete the urine out of the body. How the Penis does what it is supposed to do? Urination: The process of expelling urine is a coordinated act involving the bladder muscles, the central and the somatic nervous systems. The urethra present in the penis serves as a tube for the urine to pass out. Erection: A erect penis is required for the successful insertion into the vagina. During the height of sexual excitement, there occurs dilatation or enlargement of the blood vessels in the corpus cavernosum causing a rush of blood into it. This elongates the penis and makes it hard and stiff. Erection angles: The way a normal penis points when erect is called the erection angle. The penis is either pointing straight to the front or it may be facing up or down to the feet. An upward angle is most common. A study published in 'Journal of Sex and Marital Therapy', shows the erectile angles in standing males from 20 to 69 age groups in the following table In the table, zero degrees is pointing straight up against the abdomen, 90 degrees is horizontal and pointing straight forward, while 180 degrees would be pointing straight down to the feet. Angles from vertically upwards: 0-3 - 5% of male 30-60 - 30% of males 60-85 - 31% of males 85-95 - 10% of males 95-125 - 20% of males 120-180 - 5% of males Ejaculation: Ejaculation is when the semen is pushed out of the penis. During the sexual act, the process of ejaculation forms the culmination with the male achieving an orgasm immediately after. At times, there is ejaculation of semen spontaneously during sleep, called Wet Dreams. Normal Variations- When you have what others don't (and it is completely normal to have them)! Curvatures: While most penises are straight, it is not abnormal to have a curved penis. Curvatures up to 30 degrees are considered normal and no medical attention is advised. Over 45 degrees may need you to get yourself checked for certain diseases, though. Phimosis: This is the inability to retract the fore-skin fully. It is harmless and occurs in about 8% of boys. The British Medical Association suggests that no medical treatment may be required till 19years of age. Pearly Penile Papules: These are small pale bumps that are found around the tip of the penis. They are very common in men aged 20 to 40 years and may be mistaken for warts. Unlike warts though, they are completely harmless and require no treatment. The human penis has one of the most advanced designs through eons of natural selection for high sperm competition. Disorders of the Penis: When you have what others don't (and it is not normal to have them)! Paraphimosis: This is the inability to retract the foreskin. It may be extremely painful when retracted. This condition occurs when there is leftover fluid accumulated n the foreskin due to some previous surgery. Peyronie's Disease: This is a condition where the penis is extremely curved. It is caused due to a scar tissue running through the shaft of the penis. There is an option of surgical correction. Herpetic Eruptions: This can happen when there is unprotected intercourse with an infected partner. It shows as painful ulcers and eruptions on the head and shaft of the penis. Absence of sensations and erection: This is a condition where one is not able to feel any kind of sensation in the penis and a total lack of erection. This occurs secondary to diabetes mellitus and also as an after-effect of past falls on the back or injuries to the groin area. Erectile Dysfunction: This is a condition that happens due to psychological stress, performance anxiety, natural ageing and diabetes mellitus. It is expressed as an inability to get aroused or inability to maintain the erection for a time enough for proper sexual activity. Priapism: This is a serious condition requiring immediate medical attention. Here the erect penis fails to return to its flaccid state and as a result may lead to potentially serious conditions like a thrombosis or gangrenous state. Severe cases may require amputation too. The causative mechanisms are not well-known but involve complex neurological and vascular factors. The condition is associated with drugs like sildenafil, commonly known as Viagra. Pudendal Nerve Entrapment: Too tight pants and underwear, arrow hard bicycle seats, accidents can lead to this condition. The symptoms include loss of sensation and ability to achieve orgasm along with pain in the penis during sitting. Infections: Common infections of the penis include balanitis, urethritis, syphilis and gonorrhea. Theya re characterized by burning, itching and foul discharge. Lasting longer in bed is every man's desire. How do you go about it is very important. Follow the right diet and exercises along with lifestyle changes to achieve the desired effect in bed. Stay away from medications that claim to make you last long. Ref: Sparling J (1997). "Penile erections: shape, angle, and length". Journal of Sex & Marital Therapy 23 (3): 195-207
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