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The moody man - Mood swings in menMen, such jokes on a woman's monthly mood swings are passe. Recent research proves that men are equally prone to have mood swings. Have you experienced a myriad of emotions? Angry, irritated, feeling helpless, self-pity, an irrational urge to throw things and cry and be depressed all at the same time? These are signs of mood swings. And the point of interest here is that you don't have to be a woman to experience mood swings. Men face their share of mood swings too! Men undergo hormonal influence too. And like women this causes them too to be irritable and cranky. The difference here is that the hormonal fluctuations are not as severe in men as in women. So the mood change lasts for a lesser time compared to a woman. Men's moods are also affected by psychological and physiological stressors. So a man who has to work against time to meet a deadline will be very irritable. A man who is deprived of sleep will end up snapping at you for no apparent reason. The myth that men don't cry, is something that men take to heart. Men are emotional beings and it is okay to show some of the emotions. The male stereotypical image is such that if a man is expressive of his emotional side, he isn't considered macho enough. Hence men tend to internalize their emotions and feelings. Often this leads to chronic depression. Taming the mood swings. Any form of physical exercise helps keep the mood in balance. This helps in keeping the aggressiveness under check. Sex is also a great way to release the stress and feel better, rather than snapping and using profanities. Another helpful way is to ask yourself 'why'. Whenever you feel that you are doing something irrational or out of character, ask yourself why. The answer you get from yourself will help clear the situation and you will end up handling it in a mature fashion. The irritable male syndrome. This is the male equivalent of the female menopause - The Andropause. It covers the symptoms seen in middle-aged men that occur due to the drop in testosterone levels. Like women, men show mood changes, bouts of irritability, grumpiness, hypersensitivity, anxiety and frustration. The recent research on men having mood swings and the society's acceptance of these findings is very encouraging. It helps stress in the fact that men are emotional too. There is nothing anti-macho about a man crying his heart out at times. It only shows he is human, after all.
Is male menopause a reality?As opposed to the sudden drop in ovulation and hormonal levels in women, menopause in men is a gradual process. The consequences in men aren't that clear. The health risks, though, are significant and it is important to recognize the symptoms of male menopause early on. Read along to know more. A testosterone level of 300-1200 ng/dL is considered normal in a healthy male. As one ages, the testosterone levels too drop gradually. After 30 years of age, the levels drop by 1% per year. By the time a man crosses 50 years of age, he is in menopause. Look out for the following signs to know if your testosterone levels are dropping : Low Libido : A low sex drive or decrease in inclination to have sex is the first sign of decreasing testosterone levels. Erectile Dysfunction : Testosterone is responsible for releasing nitric oxide that leads to erection. As the levels of testosterone decrease with age, getting an erection and maintaining it for longer periods of time may become difficult. Low Semen Level : The normal amount of semen ejaculated each time varies between 0.1 and 10 mL. This normal level is due to the efficient functioning of the testes, seminal vesicles, and prostate, all of which work under the influence of testosterone. As you age, the testosterone levels drop and the amount of semen ejaculated also drops. Orgasm Troubles : As you age, having an orgasm every time may be a bit difficult due to the dropping testosterone levels. Mood Swings : This happens in men as much as in women! The interesting thing here is that the man who suffers from it is the last one to note it and acknowledge. So, if you find yourself snapping and getting irritated at the smallest of things, get your testosterone levels checked. Depression : When you feel dull and demotivated at all times, and even doing the slightest of activity seems like a chore, it means that your testosterone levels have dropped to a significantly low level. Abdominal Fat : This is again an early sign of decreasing testosterone level. Belly fat is a sign of advancing age. Low testosterone levels are a sign of advancing age. Not all men who have low testosterone levels may show symptoms. In such cases, there is no need for any kind of treatment. Low testosterone may also be due to some other conditions like thyroid disease, excessive alcohol use, sleep apnea, etc. After 30 years of age, the levels of testosterone drop by 1% per year. By the time a man crosses 50 years of age he is in menopause. Identifying and eliminating these causes will restore the testosterone levels to normal. However, if no cause can be attributed to the low testosterone levels, it is a clear indication of normal aging and 'menopause.' As with women, men too have the option of hormone replacement therapy. However, this treatment is controversial. In some men, the testosterone replacement may relive several symptoms, but the risks far outweigh the benefits. An increased chance of heart attack, prostate cancer, and other health problems are associated with testosterone replacement therapy. Herbal supplements for problems associated with decreasing testosterone levels are generally considered safe, but they too have no proven health benefits and are known to increase the risks for prostate cancer. Male menopause isn't as dramatic and abrupt as the menopause in women, but it is a reality. It happens gradually over a period of several years.
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
The post-delivery bluesA baby being born is cause for celebration. Especially in a country like India, where the family ties tend to be close, there is a festive atmosphere at home. However, sometimes the mothers may not share the same enthusiasm. This wave of negative emotions in the middle of what is clearly a happy occasion can be confusing for the new mother. Interestingly these feelings are not abnormal, as many new moms face postpartum depression, which is also called baby blues. It is an emotional reaction that begins a few days after delivery and lasts not more than 2 weeks. What are the symptoms of postpartum depression? Feelings of anger or irritability. Lack of interest in the baby. Lack of appetite and sleep disturbance. Crying and sadness. Irritability or hypersensitivity. Feelings of guilt, shame or hopelessness. Loss of interest, joy or pleasure in the things you used to enjoy. Possible thoughts of harming the baby or yourself. What are the causes of postpartum depression? Postpartum depression can occur due to a combination of factors. Hormonal changes: Changes in the level of hormones can leave you feeling tired, sluggish and depressed. Changes in your blood volume, blood pressure, immune system and metabolism can contribute to fatigue and mood swings. Emotional factors: Feeling overwhelmed with the new arrival in the family, and taking care of the baby day and night, may leave you sleep deprived, overexerted, and anxious. New mothers also feel that they look less attractive after pregnancy. You may feel that people around you are concerned with the baby more than you, and that you are being neglected. All these emotional factors may lead to postpartum depression. Other factors: Issues like breast feeding, financial strain, and relationship troubles can also contribute to postpartum depression. How does one deal with postpartum depression? Take complete rest and sleep for sufficient hours Spend quality time with your husband Go for healthy diet Take morning or evening walk for fresh air Try to follow yoga or other exercises Share your feelings with your husband or friends Do not overexert Join some groups for new moms Go for individual therapy or counsellors Remember, postpartum depression is not an incurable problem. It is just a temporary state of mind, which can be overcome if you are sufficiently aware of the problem.                
Avoiding nappy rash - A few words of adviceNappy rash is a skin condition that takes its name from the nappy in which a baby is wrapped. It is a reddish rash, or tender skin around the buttocks and inner thighs of babies, which occurs due to prolonged wetness from either urine, or stools, or both. Nappy rash may be in the form of an unusually tender bottom on a child, or an inflammation around the genitals, and inner thighs, or folds of the skin. It generally occurs in really small babies, less than a year old. Most times, nappy rash is not a very serious condition, provided care is taken. No matter what type of nappy you use, whether promising complete dryness, or absorbent nappies, your baby is likely to develop 'nappy rash' at least once. The rash can make the baby feel uncomfortable, and cranky as a result. Steps to avoid nappy rash: Always ensure that your baby's bottom remains dry by changing nappies at regular intervals. Use a mild medicated baby soap which will help in keeping the skin around the inner thighs and buttocks soft. Give your baby some nappy free hours. You will be the best judge to know when she is likely to have comparatively dry spells, which can allow the skin and parts below the waist some breathing space. Regular bathing should take care of most rash related problems. Use an emollient, or medicated soap for bathing. Sometimes, nappy rash is a result of a thrush or yeast infection. The baby's resistance at these times is low so that it allows the yeast to thrive in the form of ugly red patches. Always show a medic to rule out the possibility of bacterial infections. Anti-fungal creams should also take care of normal nappy rashes.    
High blood pressure in the little onesIf you are asked to paint a picture of a patient of hypertension, how would it look? Leave the details aside, would you paint an old person, a young person or a child? Most likely, you will paint an old person or may be a middle-aged person. But a child, who would think of a child to have high blood pressure! It may be difficult to believe for most but not only is it possible, its incidence is also increasing gradually. In fact, hypertension in kids is becoming quite common. Studies in USA show that up to 5% children and adolescents have hypertension. What is it? High blood pressure in children and adolescents is also called as pediatric hypertension. Pediatric hypertension is defined by the blood pressure recorded on the mercury, in comparison to the given standard range. As a child grows, there is rapid development in all the milestones. For children, there are percentiles defined for all parameters for various age groups. In children, when the blood pressure is above the 90th percentile but below the 95th, it is called prehypertension. When it is above 95th percentile, it is diagnosed as hypertension. There are no distinguishing symptoms of pediatric hypertension, so it may easily be missed. Please make it a practice to get your child's blood pressure checked on routine visits for medical examination. Why does it happen? High blood pressure in children under ten years of age is usually secondary to some other health condition. It could be due to an underlying heart disease, kidney disease, hormonal disorders or genetic abnormalities. This demands treatment of the main problem. Primary hypertension is noted in older children, over 6-10 years of age and adolescents. There is no specific cause identified for this, other than lifestyle, obesity, rich foods and family history. How bad could it get? Children may show a disordered sleep pattern when they have hypertension. They may suffer from sleep apnea, reflected by snoring or abnormal breathing. Besides sleep, the other effects of hypertension are the known ones. In the long run, it could lead to heart disease, stroke or kidney disease. What to do? It is very important to control the blood pressure from a young age. Regular check-ups and monitoring of the BP is needed. Thorough examination is a must to identify whether the hypertension is primary or secondary. Treatment by medicines is recommended in secondary hypertension, where the underlying condition is to be tackled along with the management of blood pressure. In cases of primary hypertension, medication is suggested only in extreme cases. Otherwise, lifestyle management is the key. It is not a healthy option to start anti-hypertensives this early in life. Give your child healthy food, help him/her maintain the ideal body weight and make sure he/she gets enough exercise physically. The sooner we identify the problem, the better are the results with a disciplined lifestyle. The unhealthy lifestyle is creating chaos in all our lives. How long the kids would have escaped? Our lifestyle reflects on our kids. Follow a healthy routine and keep the family healthy!
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.
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.
High heels can walk you to the hospital bedHigh heels make a fashion statement which makes us look tall, elegant and good but they cause injuries on a regular basis. High heel shoes have been luxury item once upon a time; today high heels have made themselves a part of every girl's life thanks to supermodels and stars. You will not find any health warning on shoes but they ought to, as they seriously put you at a high risk of numerous health problems. How are high heels and low back painrelated? High heels significantly affect your natural posture and your spine. The natural arch of spine becomes acute when walking in high heels. This poses high risk to the spine getting injured. This not only wears  and tears intervertebral cushions called discs but cause injury to the nerves too.  High heels put strain on muscles of lower back causing pain after a long day of wearing high heels. Nerve trapping, nerve pain and radiculopathy can result from wearing high heels for a long period. This is exhibited     as tingling, numbnessand pain. Arthritis, nerve pain, hammer toes, ingrown toenails and bunions are all common problems due to high heels. Calf muscle shortens and tightens after prolonged use. Jogging, playing, running with high-heeled shoes can tear and rupture calf muscles. What can you do to prevent damage? Firstly ensure your body is in top shape before you start. There is a much less chance of developing low back pain if you are strong and fit. So do activities like swimming, pilates, circuit class, box-exercise and whatever else thatmakes you feel good. Focus on activities that make the abdominal area strong includingyour deep core muscles. Secondly a regular regime of stretching will prevent a lot of problems occurring. Either get involved in a yoga class or make sure you do 10-15 minutes of stretching every day. Stretch your back, your calves and hamstrings especially. Thirdly get sports massage at leastonce-a-month. This will loosen the tightened structures, realign the spine and lengthen the hamstrings, calves and Achillestendon
Beating the weight loss plateauThere comes a stage when you stop losing any weight in spite of strict exercise and diet regimen. This is called as weight loss plateau. When calorie intake is reduced along with exercise, the energy required is obtained from stored fat which eventually leads to weight loss. This rate of weight loss slows down and eventually stops once body reaches its set point of metabolism. This set point varies from person to person. So what can you do next? Here are some easy ways to get the weighing scale budging: Modify diet pattern: Metabolism slows down with lowering calorie intake. To reset metabolism, you need to have an adequate amount of calories. This can be done by including fruits and vegetables, whole grains, and proteins in diet. More energy is needed to burn proteins than carbohydrates or fats. Eat within half an hour or hour after exercising. Add proteins and carbohydrates to diet. Sip water: Increase total water intake in a day. Drink water before, during and after exercise and throughout the day. Change the workout: Change the exercises you do daily. Muscles get accustomed to a routine workout. Switching exercises and continually challenging helps burn more fat and build lean tissue. Change the type and time or duration of exercise. Try cycling instead of running if you have been doing it for long. Running, swimming, dancing, and Pilates too are good options. Skipping and brisk walking help in burning calories too and break the plateau. In the gym, change the exercise or number of repetitions. If you have been working on machines for long, try weight training or floor exercises. Take rest: Adequate rest is essential for the body to rejuvenate. Muscles, tendons, and ligaments get slight internal and external injuries which can be healed by rest. Proper rest helps repair and regenerate the tissue and makes them strong. Make these changes and get the needle on that weighing scale to budge.
Dos and don s during heat crampsHeat cramps can affect people who exercise or work in the heat. It could be due to dehydration, so if you are going to be active in the heat then you need to drink a lot of water even if you are not thirsty. Before going out, find out what the temperature is and do not exercise outdoors in the heat. Heat cramps may not be as serious as heat exhaustion or heat stroke, but the condition needs to be treated with the same urgency. People who are on low-sodium diets may be affected more than others. Heat cramps may seem mild, but they can be the first sign of heat exhaustion, so pay attention and stop all activity, and rest. Here is what you can do and what you should avoid if you suffer from heat cramps: Dos : If you have muscle spasms and the muscles are unable to function properly, then immediately stop all activity. Get inside a room or go into the shade and take some rest. Raise the feet to 12 inches above the body. Gently massage and stretch the muscles. Wet a paper towel or handkerchief and drape it around your face, at the back of your neck and underarms. Drink a clear natural juice or a sports drink to get the electrolyte balance back. Do not go out in the sun again even if the spasms have subsided. If the cramps last more than an hour then go to a doctor. If you are on a low-sodium diet then tell the doctor about it. Don s : Don take any painkillers or fever tablets as they could cause harm. Avoid caffeine, alcohol, and sugary soda drinks. Don rub alcohol on the muscles. Don drink ice cold drinks as they can cause stomach cramping. Don take salt tablets unless the doctor has prescribed them. Don do your full quota of exercises if the heat is getting on to you. Don stop drinking water even if you do not feel thirsty. Don resume any strenuous activity for several hours after a heat cramp. Prevention:Prevention is always better, so it’s a good idea to reduce exercise in the summer, especially when it is extremely hot. If people are working outside, like construction workers, then they must take more breaks, keep their heads covered and sip on water after every 10 minutes to prevent heat cramps. Always plan ahead and get acclimatized if you know you have to do a physical activity in the heat that could cause sweating. If you are an athlete, then do take a mix of sports drink, water, and juices to maintain the electrolyte balance. Always carry water with you if you are playing any sport in the heat. All events must be planned at a time when the heat is bearable and not when it is too hot. Keep a close watch on the person if there are signs of vomiting and nausea along with flushed skin. Rush them to the hospital.
Bile block - Understanding gallbladder problemsRavi was a young intern working the night shifts in a government hospital when he was asked to examine a patient who had just been brought in. The patient was a 45-year-old, a fat man, who was complaining of pain in the right side of the abdomen along with nausea and vomiting. On inquiry it was revealed that he had eaten a very heavy fat-laden dinner. Remembering what his surgery professor had taught him about cholelithiaisis, Ravi immediately guessed what the diagnosis could be. He, however, sent the patient for a blood test and an abdominal scan. The reports confirmed Ravi’s suspicions- cholelithiasis, gallstones. The gallbladder is a tiny pear shaped organ that lies just below the liver. It is responsible for storing the bile that is produced by the liver for digesting food. It ensures the smooth outflow of the bile from the bile ducts. When the bile components aggregate in the gallbladder, they build up to form gallstones, similar to kidney stones. The gallstones are usually small enough to pass on to the intestines and be eliminated without causing too much trouble. At times, these stones may be big enough to block the outflow of the bile and give rise to a variety of symptoms depending on the size of the stone and severity of the block. The symptoms include -  Intermittent colic. A bloated sensation with constant nausea. Inability to tolerate fats. Vomiting.  Fever with chills if the stone becomes infected. Gall stones though found in both sexes, is more common in females. The risk factors for developing gallstones include - Diabetes. Organ transplant. Diseases like hemolytic anemia, sickle cell anemia. Liver cirrhosis. Failure of the gallbladder to empty properly, e.g., during pregnancy. Rapid weight and nutrition loss due to any reason. Gallstones are confirmed by a blood test to check the liver function and by an abdominal scan. Medications to dissolve the stones, and surgery in case of large stones that do not dissolve with medications, are the treatment options.
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.
Pulling out - Is it an effective option for contraception?What is the 'Pulling out' method? 'Pulling out', 'Withdrawal' and 'Coitus Interruptus' are all the different names for probably one of the safest methods of contraception. It involves the male partner withdrawing or pulling out his penis just before ejaculation. This ensures that no semen has been ejaculated into the vagina or vulva of the female partner. Since there are no sperms travelling inside, the result is - No Pregnancy! Is this method really effective? Like all methods of contraception, the effectiveness of the pulling out method also depends on how correctly it is done. This method requires a lot of mutual understanding between the partners. The male partner must also exercise great self-control and accuracy in knowing when he will reach the highest point of sexual excitement so he can pull out at the right moment. Statistics have the following things to say Of women whose partners use withdrawal, 4% become pregnant each year if they always do it correctly, and 27% become pregnant each year if they don't always do it correctly. Ejaculating close to the vagina or vulva would mean that the sperms still have a way to travel inside the vagina. At times the pre-ejaculate fluid may also contain a few sperms from the previous ejaculation that may end up causing pregnancy. As a precaution against this, experts suggest the male partner pass urine before the sexual act. Withdrawal method of contraception is the best option for members of religious groups in which using contraceptive devices like pills, condoms or IUDs are a form of sin. Withdrawal method does not protect you from HIV/AIDS and other STDs. What are the advantages and disadvantages of this method? Advantages It is simple, safe and convenient. It is the best method when no other contraceptive method is available. It has no side-effects It does not require a medical prescription. It does not alter the menstrual cycle. It does not affect future fertility. Disadvantages Requires great self-control, experience and trust. Not suitable for men who suffer from premature ejaculation Not suitable for teenagers and sexually inexperienced people. Does not ensure protection from sexually transmitted diseases and HIV/AIDS. Less effective than other methods of birth control. May interfere with sexual pleasure due to nervousness and anticipation of pulling out at the right time. The pull out method is thus one of the safest methods of contraception, provided one has a thorough understanding of one's body, trust in the partner and a huge amount of self-control.
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