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Sunshine for busy executivesMost people working in corporate offices, spend long hours within the confines of concrete buildings. Some business sectors like IT and manufacturing even have their employees working in night shifts. What we don't realize is that, in such a setup, our bodies do not get adequate dosage of sunlight. Lack of exposure to sunlight is responsible for a range of diseases and health conditions. The body requires sunlight just as much it requires food for its nourishment. Long hours of work in glazed business buildings under artificial lighting, deprive the body of this most basic need, thereby creating a deficiency of the vitamin D group. This deficiency then goes on to create several imbalances in the body, and contributes to diseases. Besides these, Vitamin D deficiency can also cause general muscle weakness, muscle and bone aches and pains and osteoporosis, due to the inability to utilize calcium. The best source of Vitamin D is natural sunshine, and that's why it is called the sunshine vitamin. Vitamin D can be had in the supplement form too, but it is still no match for natural sunlight. In a paper titled 'Vitamin D Deficiency' published in The New England Journal, M F Holick writes that, arms and legs should get exposure to sun for 10-15 minutes every day. "The amount of vitamin D produced depends on the intensity of the UVB in the sun and many other factors. Darker-skinned individuals may need 5-10 times more exposure than a fair-skinned person, in order to make the same amount of vitamin D." Tap that sunlight Early morning is the best time to get out in the sun. There's no better time to get that walk, than in the morning. Park your car a little away from the office building if possible, and walk to your office in the sun. When you take a tea break in the evening, head outside, instead of going to the in-house cafeteria.
Weight gain and prostate cancerOne of the hormone therapies involves increasing the production of LH-RH. Luteinizing Hormone-Releasing Hormone (LH-RH) is a hormone which is produced by your body. This lessens the production of testosterone. The drug given induces the generation of this hormone. One of the side effects of this therapy is weight gain. Along with this, breast pain, hot flashes, nausea, and growth of male breast tissue might occur. Apart from hormone therapy side effects, the presence of fatigue can also stop a patient from regularly exercising, thus, resulting in gaining weight. However, it is important that this weight gain is averted as the chance of cancer returning is a possibility. You can keep your weight in check by following these tips: Ask your doctor if your hormone therapy can lead to weight gain. If you receive an affirmative answer, then ask for a diet chart to be followed. You can also keep a food and activity journal to get an idea of how your body is reacting to the treatment. Inculcate physical activity in your schedule. This will not only help to reduce fatigue, but also keep at bay the chances of becoming constipated or feeling nauseous. Medical studies have shown that cancer patients must have at least 2-1/2 hours of moderate physical exercise per week. Have about 2.5 cups of fruits and vegetables every day. Also, shift to whole grain food items. You should also consume at least a cup of legumes, for example, beans, to keep up your protein levels. It is best to opt for lean protein snacks like yogurt and chicken. You must stay adequately hydrated during your treatment. Drink about 10 to 12 glasses of water everyday. Do not consume excessive amount of sweetened beverages like coffee and cola. Have a small portion of nut and nut seeds. If you feel distressed due to the therapy, go for a massage. These have been proved to reduce anxiety and stress caused during the treatment of cancer. Most importantly, keep up with your appointments with the doctor and convey the bodily changes that you may notice. Have an optimistic outlook towards the treatment and do not repress any emotional disturbance. Weight gain in men who had been previously healthy often leads to depression regarding weight issues. Being proactive and focusing on keeping your weight under check is the key here. You could also approach a psychologist if you have been feeling low. The LH-RH therapy is also known as Androgen Deprivation Therapy (ADT). This therapy leads to a weight gain of around 9 pounds within a year of starting treatment. You can make sure that your weight is controlled by altering your lifestyle and getting adequate physical exercise everyday.
Mammary duct ectasiaSigns and Symptoms In most of the cases, female patients do not have any symptom. In few cases, women may present with nipple discharge, tenderness or inflammation of the surrounding region. In some cases, there may be a lump over the breast or the nipple may get inverted. Causes Exact cause of mammary duct ectasia is unknown. But few possible cause or risk factors have been proposed by the doctors : Increasing age - Probability of developing mammary duct ectasia increases with age. With ageing, the breast changes its nature. Glandular tissue is replaced by fatty tissue. This change may lead to duct ectasia. Smoking- Milk ducts are widened due to smoking. This increases risk of inflammation which may lead to duct Ectasia. Inverted nipple - Inverted nipple obstructs the milk duct. It may lead to inflammation followed by duct ectasia. Complications Complications of duct ectasia may be may be of varying severity. They are usually minor, but sometimes become serious. Localized discomfort- Discomfort occurs due to pain and swelling around the nipple. Nipple discharge - Ectasia is frequently associated with discharge of thick and sticky fluid from nipple. Infection- Bacterial infection may develop due to stagnation of fluid in the milk duct. If it is neglected, it may lead to localized collection of pus known as abscess. Abscess requires surgical treatment. Abscess is drained surgically. Diagnosis The doctor usually diagnoses duct ectasia by clinical examination. However, few investigations may be required. Mammography- X-ray of the breast tissue is known as mammography. It helps the doctor to evaluate the breast tissue. Ultrasound- Ultrasound enables the doctor to evaluate milk ducts beneath the nipple. Treatment Duct ectasia is usually relieved by treatment. Following are the treatment options : Medications: The doctor prescribes antibiotic therapy for 10 to 14 days. It may be accompanied by mild painkillers like ibuprofen, etc. for initial few days till the remission of the disease sets in. Most of the cases are usually relieved by medications. Surgery: If duct ectasia is not controlled with medications then the doctor chooses to remove the duct ectasia surgically. Surgery is required very rarely.  Self care measures Following self-care measures often provides relief to the patients. These remedies can be adopted at home. The patient may wear a breast pad or support bra. The patient may apply warm compression to the affected region. The patient must stop smoking. The patient may be advised to sleep on the opposite side of the affected breast. Female patients should be educated regarding mammary duct ectasia so that they can detect possible symptoms of duct ectasia themselves. This will help to prevent possible complications of mammary duct ectasia and early diagnosis will provide early cure.
Perfect partners in crime - Midlife crisis and dementiaThe responses we have to common stressful events in our daily lives have a lasting impact on our brain structure. The effects of a stressful event last a very long time, though apparently we seem to have recovered from it. Researchers say that the stress hormones keep circulating in our body long after the stress has passed. According to a recent Swedish research study, our response to common life events may trigger long-lasting physiological changes in the brain. These interestingly shocking findings come from the Prospective Population Study of Women in Gothenburg, a long term study on 800 women that lasted for almost forty years. The women who were a part of this study were all born before 1930, and underwent regular neuropsychiatric tests. The study started in 1968 assessed women for any baseline stressors like workplace problems, widowhood, alcoholism and illness in the family. Women who had serious issues at the start of the study had a 21% higher risk of developing Alzheimer's Disease and 15% higher risk of developing dementia later on in life. Interestingly, having to take care of a mentally ill family member like a sibling or mother, was found to be a major cause for development of dementia later on in life. The findings of this study show that accumulated stress from common life events has severe physiological and psychological consequences. These physiological consequences include adverse effects on the central nervous, cardiovascular and endocrine and immune systems. There have been several studies that state that the effects of stressful events like earthquakes, cyclones and floods can have a lasting impact on life and often shape the person's personality. What makes this study interesting is its finding that daily stressors accumulated over a period of time and often left unresolved, have a lasting impact that shows up in later stages of life!
Be positive. Here's howAs someone so very rightly said, "We are the sum total of our thoughts". So the more positive thoughts you have, or are capable of thinking, the more positive will be the outcome of your life journey. Here are a few tips to think more positively and empower yourself: Have a daily positive thinking routine. Generally the time when you are just waking up, i.e., the half awake state, is best for you to start feeding positive thoughts about yourself. The mind is more accepting of suggestion at that time. You can just feed your brain with happy and positive thoughts about your situation and what you hope to achieve for yourself and your family. Creative positive visualization is another great method of positive thinking. At a set time, just picture your life in the way you want it to go. This is different from daydreaming. Creative visualization gears you up for action while daydreaming remains just wishful thinking. If you have difficulty in certain areas of your life, say at work or with your relationship, visualize a positive outcome. This will engage your mind in thinking of various action plans to get about that positive result. Positive affirmations are a great way of reminding yourself that all is well. Have patience with yourself as your mind will probably not even believe half the things that you are affirming. That's what affirmations are all about.They are statements that you feed your mind about what you are and what you can achieve. Positive affirmations can help you reprogram your mind to what your heart really desires. Let go. Feel that delicious sense of surrender as you just indulge in mentally letting go of things. As a busy person you probably end up trying to control the outcomes of every situation and feel bad when things don't go the way you expect them to. Remember things can go wrong from time to time. Like you, life is also not perfect, so why expect perfection from others? Learn to let go of that emotional baggage that you are carrying. The weight of the world needn't rest on your shoulders. Collective consciousness is where you should try to tap into. Think of situations where things can go horribly wrong for someone else. Send out a silent prayer for those unfortunate people in this world. Chances are that your prayers just might help some stranger badly in need of a prayer or two. This can only come back to you manifold. Help someone else become a positive person. This can only reaffirm your faith in positive thinking. Positive energy is what everyone naturally seeks and we can for sometime blame our friends or family for being a negative influence on our lives. This line of thinking will get you nowhere. Instead think what's the next best option? Think of how you can convert negative energy or experiences into positive ones. Initially you might meet with resistance, but remember if you are positive then positivity is yours for keeps.
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.
Muscle build up dietYou may think that you need fatty foods to bulk up, but this is not true. Fatty foods will do just that make you fat. Lean meats, fruits and vegetables will actually build muscle. Take a balanced diet of vegetables and lean meats to achieve your muscle building goals. Changing your diet to build muscle will help with your overall health. Eating food that helps build muscle will ensure that you are not wasting all that hard work you are doing in the gym. Workout utilizes considerable energy. Food is the only way to replace this energy. So what happens if you fail to eat the right type of food to build muscle mass? It will take longer to build muscle, and it may even prevent muscle building altogether once you reach a certain point. Is protein important or not? You bet it is. Protein provides the building blocks to build that muscle. What types of protein are best? Chicken, eggs, steak (with the fat cut off), fish, cheese (especially cottage cheese), and nuts are all great sources of protein. Finding out how much protein to eat when you are interested in building muscle fast is actually not difficult. First, you will need to find out your lean body mass weight in kilos, and then you simply multiply that figure by 2.75 to determine your daily protein requirement. Calculating your lean body mass uses some complex formulae, so ask a professional at the gym if you do not already have this figure. Carbohydrates, in moderation, are also essential when finding foods that build muscle. Do not eat too much, though, unless you choose high fibre carbohydrates, and then you can indulge in much larger amounts. High fibre carbs include rice, potatoes, oatmeal and bananas. Reducing fat in your diet is of course necessary to build bigger muscle on a body that appears lean and has a low body fat ratio. If you are focusing on what foods build muscle mass, you also need to bear in mind that it pays to reduce fat as well. Although proteins are essential, it is really important to select proteins that are low in fat, or that you can cut the fat off. So eat your chicken without the skin, and go for lean steaks rather than more fatty cuts of meat. Opting for cottage cheese or other reduced fat cheeses, and low fat milk also helps reduce your fat intake. You may argue that drinking has no effect on what to eat to build muscle. But you would be wrong. Hydration is critical to general health and wellbeing. Two litres of water a day is what most experts recommend for maintaining optimal health. To drink that amount, you need to drink up to 12 glasses of water a day, which is quite a lot. So start early in the day, and space your water consumption out throughout the day. Foods that build muscle are great and an essential component of your bodybuilding program. But do not be lulled into a false sense of security and think you can slow down on your workouts. Both bodybuilding exercises and bodybuilding diets are required to get a body to die for as quickly as you possibly can. Even if you are working on improving your physique slowly, you should combine a bodybuilding diet with bodybuilding workouts for best results. Sample Diet: 7:00am: Breakfast: 4 eggs + toast or oatmeal + milk with protein powder mixed in (a lot). 9:30am: Snack: 1 Meal replacement supplement + milk. 12:00: Lunch: Tuna sandwich (1 whole can) + green apple. 3:00pm: Snack:  2 Meal replacement supplement + milk. 5:30pm: Workout: Have water (or carb drink if you want), within 30 mins of end of workout (on workout days only) Meal replacement supplement + milk. (If you are going to have Creatine - put it in this Meal replacement supplement at the end of your workout). 8:30pm: Dinner: A chicken breast (aprox 8 oz + some rice or other starch carb + if you want also eat some veggies) Before Bed:  Meal replacement supplement + milk.
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.
A fine spine - Common disorders of the spineThe spine is made up of small bones called vertebrae that are stacked one upon the other. When viewed from the side, the normal spine has gentle curves to it. Because the spine is a complex structure and happens to be at the center of all our activities, it is subjected to a lot of diseases. A common misconception of low backache is that you should rest. In fact, rest is not recommended at all. Keep up with light non-strenuous activities after the symptoms have subsided. Given here are a few common conditions of the spine: Loss of curvature: The spine, when seen sideways has gentle curves to it. The curves, when lost, can lead to pain and imperfect posture. Kyphosis and Scoliosis are the commonest form of spine curvature abnormalities.Kyphosis is the abnormal and excessive curving of the upper part of the spine. It is commonly called as a hump. It may be present since birth or may develop during the teenage years. The most common symptoms seen are a hump, back pain and muscle stiffness. The pain remains constant and does not worsen over time. If the curvature is too much, then the thoracic cage may get compressed and pressed for space. This may cause cardio-thoracic problems like chest pain, shortness of breath and even death. Compression of spinal nerves may cause loss of bladder and bowel control, loss of sensation and muscle weakness. Kyphosis is treated with physiotherapy, anti-inflammatory drugs and in severe cases, with bracing.Scoliosis is the side-to-side curvature that occurs during growth spurts before puberty. It may also be caused by spinal cord injuries and arthritis. Scoliosis develops gradually. The symptoms seen are usually by people other than the patient, where they may notice a slight slouch while walking. At times it may be seen that clothes that used to fit earlier are now ill-fitting. The pants seem to have shortened on one side. The curvature if mild responds well to physiotherapy. Physiotherapy is also useful as it helps to stretch and strengthen the muscles. This helps in stopping the progression of curvature. Severe cases require bracing and even surgical intervention with rods, hooks, wires and screws to correct the curvature. Sciatica: Sciatica is a condition that arises when the sciatic nerve is pressed upon. This condition arises when a degenerated vertebra presses upon the disc below it, or when there is a disc prolapse.  Abnormally tight piriformis muscle of the buttocks and a tumor in the spine may also cause sciatic pain. The hallmark symptom is the characteristic pain along the leg that starts from the hip and radiates all the way down. The pain is worsened by sitting and tingling numbness also develops. Treatment includes anti-inflammatory medicines and physiotherapy. Spondylolisthesis: When the spine is subjected to the pressures of daily activity, there is a lot of wear and tear that goes on in the vertebrae. This may cause the vertebra to move forward and slide on the vertebra below it. As a result, you may experience a constant backache. Spondylolisthesis can be congenital, it may occur due to trauma to the vertebral column, due to a tumor in the vertebra or due to degenerative changes in the vertebra and cartilage as a result of diseases like arthritis. Low backache is the hallmark of this disease. The pain is typically worse after any exercise that involves the lower back. The motions of low back are restricted and if there is nerve compression then tingling and numbness along the leg may also be seen.Rest and avoiding exertion of back muscles helps reduce the symptoms. Physiotherapy helps in restoring the strength and improving the range of motions. Spinal Stenosis: Degenerative diseases like osteoarthritis cause development of bone spurs in the vertebral column leading to its narrowing. This puts pressure on the nerves and leads to pain and tingling and numbness. Cervical Spondylosis: This condition occurs due to degenerative changes in the vertebrae of the neck region. Commonly seen as neck stiffness with pain that radiates all the way down the arm.  The pain occurs as the nerves get compressed by disc prolapse or bone outgrowths in the vertebra. Treatment includes neck immobilization, cervical traction, medications for pain and physiotherapy. Ways to reduce spine problems and backache are: Quit smoking Adopt a perfect posture Do exercises that will strengthen your core, lower back muscles and abs. Do not ignore or overlook the pains. Consult your doctor at the earliest. Spinal problems are the ones that are frequently overlooked. Ignoring the symptoms may lead to worsening of the problem. See your doctor at the earliest to be safe. The spine is the backbone of our body, in the true sense of the word. It is up to us to keep our spine in good condition as an unhealthy spine will interfere with almost all our body functions.
How to talk about STDsThese are dangerous times that we live in. Just the sheer number of people affected by sex related problems, diseases and conditions all over the world is simply terrifying. AIDS, venereal infections like syphilis and gonorrhea, herpes, HPV etc. are rampant and it calls for some responsible sexual behavior. However, that's a utopian world where humans will be monogamous and will behave responsibly. Even single people might get exposed to these diseases through indulging in risky sexual contact. Imagine doling out $750,000, as a woman in the US got from her husband because he gave her herpes. Even if you are not held legally accountable, what about moral responsibility to own up and discuss a possible STD infection with your partner! Take the case of Jack a happily married man for ten years who had casual sex when out of town on an official trip. He showed no obvious symptoms of any infection but in a month, his wife showed signs of herpes and his marriage crumbled as his wife struggled to come to terms with her husband's obvious infidelity and his callous manner in exposing her to a serious sexual infection. Call it ignorance but sometimes a person might engage in sexual intercourse and contract a disease which he might even not be aware of until the symptoms start appearing. (Refer article on Syphilis on www.topdoctorsonline.com) By then, he might have, in all probability, passed it on to his regular sexual partner or spouse. Or perhaps, there is another possibility that the person knows that he has contracted a sexual infection but doesn't know how to break the news to his partner.  If a person is aware of his infection, yet exposes another person knowingly, it is akin to premeditated murder. Yes, it is going to be a difficult thing to tell your partner which might even signal the end of the relationship or cause severe strain on it. So, if you are caught in a situation like this, what would you do? The option would be to visit a sex therapist and confide in him and then take an appointment for both and let the professional break it to the partner. That is of course if you are in a stable relationship. For those who both party to casual sex, the infected person generally won't be that open about his infection and may even choose not to care particularly if the other person is a complete stranger. A report in MedlinePlus news reveals some more shocking statistics: Many people said they occasionally, rarely or never got tested before having sex with casual partners (50 percent) or long-term partners (39 percent). Of the people who did discuss STD testing, very few discussed concurrent sexual partners or when partners' testing occurred in relation to their last sex act. Only half explained what types of STDs their partner had been tested for. These issues are important components of assessing STD risk, the researchers said. About one-third of participants reported telling a partner they didn't have an STD even though they hadn't been tested since their last sexual partner. One U.S. woman was awarded $750,000 in court from her ex-husband because he gave her herpes, and the legal trend is to make people accountable. (http://www.dummies.com/how-to/content/how-to-talk-to-a-partner-about-stds.html) Remember even wearing a condom is not a 100% guarantee that the infection won't pass on to the other person but that's the least that you can do if you don't have the courage to spill the beans about your condition. If you feel that your partner may be indulging in sexual activity with multiple partners and if you feel he might be infected, then you are well within your rights to decline to have sex with him until he/she gets tested. If you notice sores around the genitals do not indulge in oral or anal sex or any kind of sex and insist on a condom always; it could save your life.
Painful intercourseSome of the causes affecting women can be: Going too fast, penetrating from an awkward position. Do not hesitate to tell your partner that it hurts and he needs to slow down or change position in order to make you comfortable and prevent pain. Dry vagina or lack of natural lubrication in the vagina. This dry vagina is caused due to some medications, changes at the menopause. Sometimes just increasing the time of foreplay can help vaginal lubrication. Use water-based lubricant to reduce pain. Failure to fire off. Sometimes failure of the vagina and uterus to respond to sexual arousal can lead to irritation and tenderness. The vagina may be too tight for the intercourse sometimes or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Using other penetration methods can be helpful to explore the level of arousal before engaging in intercourse. Vaginismus can be the cause of discomfort. Muscles surrounding vagina are sometimes very tight and lead to pain and intercourse to be painful. Woman can examine herself with her fingers to see if vaginal walls are tighter than normal. It can be vaginismus. Normal cause is nervousness or anxiety. It is reversible. Good foreplay before intercourse will help to relax the muscles and help lubricate. Just relaxing before the act can be helpful. Vaginal infection and inflammation due to yeast, herpes, etc. can make intercourse uncomfortable. Fabrics, creams, perfumes may cause irritation in area in some women. Avoid these. First-time sex can be a little painful. Rupture of the hymen can cause discomfort during penetration. Start slowly or begin with forms of penetration other than intercourse. Psychological pain. Sexually traumatic experiences or feelings of guilt associated with sex can make the act painful. Consult a sex therapist or psychiatrist. Discomfort during intercourse is experienced by men too, various causes affecting this outcome for men are: Tight foreskin. During first attempt at intercourse, tight foreskin will make retraction painful. After sometime, the foreskin will become loose and make intercourse comfortable. Any lesion on the penis skin can make intercourse painful. These may result from non-lubricated masturbation or rapid intercourse or STDs. The blisters due to herpes infection can make intercourse extremely painful.
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