JamPersonals.com

Published: Sunday | September 29, 2013 0 Comments
Q. Doctor, I am 26 years old and have been sexually active since I was 17. I have a huge fear of giving birth.

My vagina is extremely tight. I haven't had sex recently, because I am single. I also do Kegel exercises.

I would want to have a child eventually, but I don't know how I am going to do it, because I have heard that childbirth is terrible and I just dread it.

I seriously don't think I could push out a baby, but I don't want to grow old without having a child.

A. You wrote to me last week about your fear of Pap smears, and today we turn to your fear of the pain of childbirth.

This is not unreasonable! We have to face the fact that giving birth is usually very painful - there is no point in pretending otherwise. Since the beginning of time, women have had to undergo considerable agony as they struggle during childbirth, delivering a child that weighs six, seven or eight pounds, through a fairly small aperture.

Some females do complete their labour with very little pain, but they are in the minority.

On the other hand, since anaesthesia was invented, things have been a lot easier for mothers, and the advent of good painkilling drugs has also made a tremendous difference. In addition, epidermal injections have helped a lot.

I do not deny that the pain of labour is bad, but it is survivable. And once it is over, most mothers are very happy with what they have achieved.

As it relates to you, I wonder why you are so very fearful of childbirth? When you were very young, did your mother or other relatives stress to you that it was agony? Did people tell you that you were going to experience tremendous pain? That kind of a remark does tend to 'condition' a girl to fear the process of giving birth.

Also, have you had any other experiences that made you fearful of anything to do with your vagina? Were you ever raped, or 'interfered with' sexually?

I know that you are afraid of Pap smears. And you also think that your vagina is 'extremely tight', though I don't know what evidence you have for this. Did some past boyfriend say it to you?

I am also puzzled by the fact that you are doing Kegel exercises. These are generally done in order to tighten the vagina. It is very unusual for a woman to do them when she has not had any children, especially if she thinks that her vagina is already tight.

Summing up, it is clear that you have an unusual degree of anxiety about childbirth. The first thing I think you should do is to talk to a number of women who have recently given birth and ask them to tell you what they experienced. You may be surprised at how positive some of them are.

Secondly, I think it would be a good idea if you had a course of (say) six sessions with a good counsellor or therapist. She could help you explore your feelings about your vagina and about childbirth and help you to achieve some peace of mind. I wish you well.

Q. Doctor, my wife is three months' pregnant. And I find that suddenly I do not want to have sex with her. It is almost as if I have lost my nature - but I do love her.

She is getting very frustrated, and wants me to have sex with her. She complains that she 'has not had an orgasm for weeks'. I would be really appreciate your advice.

A. You may be surprised to hear that some men actually like making love to pregnant women. But you are the opposite! You clearly cannot cope with the idea that a woman who is pregnant is sexually desirable.

And there are men who do share your viewpoint. They have grown up with the idea that pregnant women are in a sort of separate 'compartment' from other women, and that it is not right to want to have intercourse with them.

I think you should have some counselling sessions to try to sort out these feelings. By the time you finish the sessions, your wife's pregnancy would be over! But you need to get the problem fixed.

What I propose is this. Begin by talking to your spouse, and explaining to her how you feel. Stress that you still love her and that you want her to be happy.

Next, I think you should offer her some way in which she can have the orgasms that she badly wants. I suggest that the two of you set aside some time for a few quiet, romantic sessions in which you cuddle and where you use love play ('foreplay') techniques to let her climax. As I am sure you know, you can do this with your fingers or your mouth. An alternative would be to employ a vibrator.

I do hope that you can successfully get her to understand your problem. At all costs, you must reassure her that you are not 'scorning' her and that she is the woman you want to be with.

Q. Dear Doc, I am a 25-year-old female who has always had what I would call a normal cycle.

However, this year I have had menstrual cramps, but on one side only. I became very concerned and visited my family doc. He gave me a thorough check and a Pap smear, and he said that all was well, but I am still concerned.

Why do I only have cramps on one side of the belly? Should I visit a gynaecologist for a second opinion?

A. I tend to agree with your family doc. I think that this is only an unusual type of menstrual cramp. But one thing you could try is just going on the Pill for a few months and seeing if that gets rid of the pain. If it does, then that would suggest that this is just an uncommon form of period pain.

However, if you can afford it, there would certainly be no harm in getting a second opinion from a gynaecologist.

Q. Hi, Doc. I am a man who has developed a strange painless bump on my bottom, just at the side of my rectum.

Could this be connected with the fact that when I was in England last year, I let a woman touch me there during sex?

A. No, it couldn't. It is likely that you have what is termed an 'external pile'.

But you must see a doc and let him have a look at it.

If it is a pile, it will not be a serious thing and can be treated.







Will pills reduce my urge?
Q. Doctor, is there any tablet or medicine which will make a girl less interested in sex? I am female, age 17, and I have a boyfriend. I am sure I love him. And he adores me! The problem is that both of us want to 'be good' and not get ourselves into trouble or have a baby, but I am so highly sexed that I cannot keep my hands off him. All day, I dream about him. I want to hug and kiss him, and to be frank, I really, really want to have sex with him. He says he is desperate for my body, too. So far, we have not had a full sexual relationship, but we have gone in for a lot of petting. I try not to do that, but when I am with him, I just get carried away and feel so excited that I can scarcely stop myself. So if I went to a doctor, could I get any tablet that would make me less interested in having sex with him? Maybe hormones or a sedative?
A: Alas, there is no medication that will make a young woman less keen on sex! Neither hormones nor a sedative would work.

I do understand that it is very difficult for you at your age. You seem to be in love with this young guy, and it is not your fault that you are desperate for sex with him. Over the years, experts have come up with several tips for dealing with this common problem:

Try not to be left alone together, particularly in the evening;
When you go out with him, stick to places where there are plenty of people;
If possible, go out with a group of friends;
When you are with him, wear clothes that would be difficult for either of you to undo or to take off;
Avoid wearing the sort of flimsy pants that could be pulled down or pushed aside at a moment's notice!
From long experience in the consulting room, I would guess that no matter how hard you try, there will eventually come a time when the two of you decide to throw caution to the winds and have sexual intercourse. If and when that day arrives, please make sure that you are using adequate contraception.Good luck!

My foreskin is breaking away
Q. For the first time in my life, I had sex with a girl last week. Now it seems to me that my foreskin is kind of 'breaking away' from the head of the penis. Is this serious, Doc? Help me!

A: Do not fret. In many young men, the foreskin is still stuck to the head of the male organ by little bands of tissue called adhesions. When the guy starts having sexual activity, these adhesions break down, so the skin can then roll back farther away from the head. It sounds to me like you are perfectly normal.

I found a lump
Q. Last week, I had trouble getting a tampon out, so I put my finger inside me to try and hook the fingertip round it. To my horror, I found that there was a big lump deep inside me at the far end of the vagina. I am sure this is some kind of tumour. So what must I do, Doc? And is this some type of cancer?

A: No, you don't have cancer. Like many younger females, you have been alarmed by discovering your own cervix. That is just the lowest part of the womb, and it is normal to be able to feel it with your fingertip. So there is no need for you to fret.

I cannot finish!
Q. I am a guy of 22, and my big problem is that I just don't seem to be able to discharge inside a girl. I find this very concerning, Doc, because I don't see how I am ever going to be able to father any children. I have not lost my nature. I can keep an erection going for hours, but I just cannot 'finish'. The odd thing is that on the rare occasions when I masturbate, I reach an orgasm without any problem at all. So why can't I do it when I am with my current girlfriend?

A: Unfortunately, you have a male problem called delayed ejaculation. As you can see, if you look it up on the Internet, this is basically a psychological condition. You need some long-term psychotherapy to help you.

I can't conceive
Q. Doc, I am a female who has had four abortions. Now, I want to get pregnant, but I can't. Every time I try for a baby, my period still comes, so it seems like I cannot conceive. Is there a treatment for that?

A: This is a very sad story. I hope it will show other young women that there are considerable dangers in doing an abortion.

In particular, there is a great risk that the abortion process will introduce germs into the womb and the Fallopian tubes and thus cause a serious infection. Alas, these infections often block the tubes and so make conception almost impossible because of the fact that the sperm cannot find their way through to an ovum (egg).

As it relates to your case, I cannot diagnose what has been going on inside you, but there must be a high chance that infection has blocked your tubes. There may also be other causes for your fertility problems.

I would say that your best chance now is to go to a doctor who is interested in infertility and ask him or her to find out whether your Fallopian tubes are blocked by infection. It could be that the doctor will be able to help you. For instance, there is a chance that a course of antibiotics might get rid of the infection, and thus unblock the tubes. I wish you well in your quest to have a child.

I have three testicles
Q. I am a guy of 21, and my girlfriend recently told me that she could feel a third testicle in my scrotum. To begin with, I laughed at this idea, Doc, but when I felt my testicles, I discovered that there is truly a third lump there. Seems like it is kind of attached to my right testicle. I am sure it was not present until recently. So what should I do?

A: When a young man discovers an unexpected lump inside his scrotum, there is just a possibility that he is developing a cancer of the testicle. I hope that is not the case with you, and there is certainly a good chance that this swelling is something harmless. But you must not take any risks!

Please see a doctor this week. He will examine you, and see what this lump is. I am pretty sure he will want you to do an ultrasound scan, which is a good way of getting a clear picture of what is going on inside the scrotum. It does not hurt! So don't delay! Contact a doctor immediately.

Email questions to Doc at saturdaylife@gleanerjm.com

Doctor's Advice - Is waxing dangerous?
Published: Saturday | October 12, 2013 2 Comments



Q. Doc, are there health risks associated with waxing the vagina? If so, what are they? Before I do it, I would like to know if there are any physical dangers. Thank you.

A. Well, I can start by saying that no one waxes the vagina. The vagina is inside you. And there are definitely no hairs in it, so you wouldn't be waxing in there! So what you are talking about is the area of the vulva, and also, presumably, the lower part of the belly and the thighs. In recent years, huge numbers of young women have decided that they want to remove the hair from the vulval region.

Most of the time, they do this without causing any health problems; however, there have been some concerns voiced by doctors in the last few months. I must say that most of the 'waxed' young women who I have seen as patients have come to no harm whatever as a result of the procedure, but a few have developed minor infections of the hair follicles, which are the tiny 'pits' out of which the pubic hairs grow. That is not a very serious thing.

Nevertheless, I should draw your attention to some other risks:

Recently, several women in America have developed cellulitis (serious skin inflammation) in the lower part of the belly after waxing.
A French study found that women and men who had waxed that area were more liable to molluscum contagiosum, which is a common virus infection of the skin, producing pearly white lumps on it.
The French have also found that waxed young people were also more likely to get warts and other skin infections.

Admittedly, the French research project was very small. And when one considers the vast number of people who wax these days, it is clear that the danger must be statistically tiny.

Nevertheless, you can see that there are a few risks. A dermatologist said recently that the function of this hair is to protect the genital area. If you get rid of it, then that protection is gone!

Painful oral sex

Q I am a guy of 18, and most of my friends seem to be crazy about the idea of being given oral sex by girls, but I am not so sure. Doc, I have tried it twice, with different girls. On each occasion, I found it very painful because I got caught by the girl's teeth. I did not enjoy it. So am I abnormal?

A. Oral sex given by a woman to a man is called fellatio. Many young guys imagine that fellatio must be truly wonderful, but in fact, it is not always very successful, especially if the woman is inexperienced. In particular, it is very easy for the guy to get cut, especially if his partner's teeth are sharp.

There is no doubt that many men do find fellatio very pleasant, but surveys have shown that the majority of males actually prefer vaginal intercourse. Summing up: You are not abnormal, so you should not fret.

Where does the male fluid go?

Q. Good day, Doc. I am a girl of 17 and a virgin. I would like to know the answer to a question that is puzzling me and my friends. It is this: We understand that when a male and a female have sex, the man suddenly produces a lot of fluid, but where does this fluid go? We study biology, and in the diagrams in our textbooks, we cannot see any place in a woman's body where there is room for a lot of liquid to be stored.

A. Well, you are quite right. There is no space inside the female body where a large volume of male sex fluid could go. But in fact, the man only produces between five ml and 10ml of liquid, which equals one to two teaspoonfuls. This is deposited at the top of the vagina near the woman's cervix.

What happens to it? Well, most of it simply flows out again during the next half-hour or so. Many women are surprised by that, but it is what happens.

However, the fluid contains tens of thousands of tiny sperm, and some of these will swim up through the female's cervix and into her womb. If one of them can get as high as the Fallopian tubes, which lead out of the top corner of the womb, it may meet an ovum (egg) and fertilise it. And the result of that is that you are pregnant!

I think it is a very good thing that at age 17, you are still a virgin. When you eventually decide to have sexual intercourse, please take very great care to ensure that no sperm finds its way deep inside your body and fertilises your ovum.

Urinating too often

QI am a guy in my 20s, and I notice that I'm urinating too often, especially when I'm driving. I have to go every hour and a half. No matter how I try, I can't hold it any longer. I was treated for haemorrhoids four years ago. Is it anything to do with that? Or is it my prostate?

A. Your problem is nothing to do with haemorrhoids (piles), which are in a different department of the body, and prostate trouble is unlikely at your age.

When a young man suffers from frequent urination, the likeliest cause is a urinary infection. You should, therefore, see a doctor right away so that you can have a specimen of your urine tested for infection. The doctor will also want to check you for diabetes since 'sugar' can very often cause a young person to urinate more often than normal. Good luck!

Fluid from the breast

Q I am 25, and my girlfriend is 23. We have sex once a week. When we were in bed the other day, I sucked her breasts, and some liquid came into my mouth! This was alarming for both of us. Why did it happen?

A. Are you sure your girlfriend isn't pregnant? If she is not, then she should certainly have her breasts checked out by a doctor as soon as possible just in case there is some disorder in the nipple area. However, it is a medical fact that regular sucking on the breast will occasionally make a small amount of liquid come out of it. So I expect that this is all that has happened here.

Can you have a cycle and be pregnant?

Q. I had a short menstrual cycle last month, followed by pregnancy symptoms. Can you have a cycle and be pregnant, Doc?

A. I think you are asking me whether a girl who is pregnant can have a period. The answer is no. However, a pregnant woman can experience bleeding and think that she is menstruating. Could that be what has happened in your case? If you are in the slightest doubt, please get a pregnancy test done.

Can a man get pregnant?

Q. Is it possible for a man to become pregnant as I have heard?

A No, that is quite impossible, so please quit fretting.

Doctor's Advice -

My new lover and the Pill

Published: Sunday | October 20, 2013 0 Comments

Q. Doctor, I am a 32-year-old woman and I have decided to take a lover. I have not had sex for five years, so I am going to need some contraception by the time the man returns to the island next month. So I hope you can help me! What methods are available for a woman in my situation? I understand that, at the age of 32, the Pill can be a little dangerous for a woman. But I do not know much about this subject since my ex-husband and I rarely had sex.

A. I wouldn't describe the Pill as 'dangerous' for a woman in her early 30s, unless you are a heavy smoker. You see, the combination of cigarettes and the oral contraceptive makes a female much more liable to thrombosis (clotting).

If you decide to go on the Pill, you should first ask your doctor whether you have any other 'risk factors'. These might include high blood pressure, diabetes, and some inherited clotting disorders.

If you decide not to go for the Pill, there are other alternatives for women your age.

These include:

The Mini-Pill. This contains only one hormone instead of two, so it is 'milder' than the Pill, but has a slightly higher chance of pregnancy.
The Coil (IUD). Pretty effective, but it makes your menses difficult.
The Mirena (IUS). A hormone-loaded coil which usually has a very good effect on the periods.
The Patch (Evra). A skin patch containing similar hormones to those of the Pill. Therefore, it has the same risk of causing clotting.
The Shot (the Jab). A contraceptive injection given every three months. Can cause some menstrual problems, but highly effective.
The Implant (Jadelle). This is a small, hormone-loaded device, like two matchsticks, which a doctor inserts under the skin of your arm. May affect your menses.
The Ring (NuvaRing). NuvaRing is a vaginal device containing two hormones. Has similar risks to those of the Pill.
The Cap or Diaphragm. Caps and diaphragms are individually fitted devices which you put into your vagina shortly before having sex, and leave in place all night. Virtually no side effects.
The Female Condom (Femidom). Excellent method, now widely available in Jamaican pharmacies.

You can also insist that your new partner uses a male condom when you are having sex. I hope your relationship works out well.

Q. Doc, I cheated on my wife recently. I don't want to give her any infection. Would it be OK to have sex with her this weekend?

A. No, it would not. You may have picked up a sexually transmitted infection (STI) from the woman you cheated with. It is important that you do not risk your wife's health. For instance, you could easily give her the all-too-common 'bug' called chlamydia. A man who cheats on his spouse should have a check-up from a doctor before resuming intercourse with her.

Q. Whenever I have sex with my husband, I find that, just as I approach climax, I start thinking about a very well-known movie star. Am I unusual, Doc? Could this be bad for me?

A. Research has shown that a lot of women do fantasise in the way you describe. Often, they use the image of some handsome and sexy man in order to help them orgasm.

The danger with doing this is that your mind may become 'fixated' on this person. The result could be that eventually you cannot achieve a climax unless you think about this celebrity. So if you feel that you really must fantasise while having sex with your husband, then it would be wise to vary the images that you think about. That way, your emotions will not become 'stuck' on that star.

Q. Doc, I was very scared this morning when I found that my foreskin was puffy and swollen and a little itchy. Doc, I swear to you, I have not been with anybody except my wife. So could this be VD?

A. It is very unlikely. My best guess is that you have got a mild fungal infection. In men, this form of infection usually produces puffiness and itching of the foreskin.

What you really must do now is to have a doctor take a look at your foreskin. Also, please give him a specimen of your urine so that your sugar level can be tested. If it is indeed a fungus infection, then the doctor will be able to cure you with some anti-fungus cream or ointment. And please do not have sex until you have been successfully treated.

Q. My wife is 41 and has suddenly started having multiple orgasms, I am astonished by this, Doc. Is it a sign that she has been unfaithful?

A. Certainly not! Many women achieve the ability to have multiple orgasms when they're in their 40s. There are several reasons for this. In particular:

Mature women often feel more comfortable with their sexuality than they did when they were young.
Their partners have gained a lot of experience over the years, and have learned how to please them.

So I think you should just congratulate yourself on the fact that you are doing a good job in pleasing your wife.

Q. I am a 38-year-old man and I have fallen hopelessly in love with a beautiful young woman who is 19. She says she loves me and has given me her virginity. My friends laugh at me for 'cradle-snatching'. But is there any hope for a relationship in which the man is twice the woman's age to work?

A. Of course, there is hope. A lot of people in their late 30s have established successful relationships with partners who are 20 years younger. But please remember that the two of you are at very different stages of mental, emotional, and sexual development. So my advice is not to rush into marriage or any form of long-term commitment until you are both absolutely sure that you want to spend the rest of your lives together. Also, I would strongly advise against having any children until the situation is clearer. So please use reliable contraceptive precautions.

Q. I am engaged to a very wonderful man. We are both 31. But he has admitted to me that, 14 years ago, he had sex with another man. This has really upset me. Do you think it would be safe to go ahead with our marriage?

A./ Well, a lot of men do go through a brief 'bisexual' phase in their teens. But I feel that you need to be absolutely sure that your fiancé is now 'straight' before you proceed with the wedding. My advice is that both of you should see a counsellor before making up your minds.

Published: Saturday | November 2, 2013 0 Comments

My first go ... could I be pregnant?

Q. Doctor, I am 18, female, and on Wednesday night, I finally decided to let a guy have sex with me, but it was on the strict understanding that he would be very careful. I was a virgin till then. Well, we started, and I was a little surprised that I did not find it too interesting, but just plain uncomfortable! But he thought it was great, and he got more and more excited. After a couple of minutes, I realised that he was on the brink of having an orgasm. So I told him he must pull out, and he did. I think it must have been only just in time, Doc, because he covered the front of my thigh with his sex fluid. He said it was great, but I could not see what all the fuss was about! However, I am now fretting because I have realised that I could be pregnant. On that night, I did attempt to wipe the liquid downwards and away from my vagina. So do you think that I could have got pregnant? Is that likely, Doc?

A: You don't state what time of your monthly cycle this was. But I would say that the odds are that you are going to be OK. Nevertheless, the two of you took quite a risk.

Young couples do often rely on the guy pulling out at the very last moment and ejaculating on the girl's thigh or belly, but there are two big dangers here:

1. The young man may not quite manage to pull out fast enough, so some sperm might get deposited in the vagina. The problem is that there is a strong male instinct to stay in until the very last second.

2. When the seminal fluid is deposited on the young woman's skin, there is just a chance that sperm might manage to swim into her vagina. Fortunately, this does not happen very often. You did the right thing by wiping the fluid away from the area of your vulva.

Summing up, the odds are that your menses will arrive on time, but if you decide to have sex in the future, please do not use the pulling out or withdrawal method, also known as coitus interruptus. Instead, please employ a reliable method like the Pill, or use a condom.

STIs and blow jobs

Q. I wish to remain a virgin for some years, but I have given several boys oral sex, which they seem to like a lot. Am I right in believing that I cannot catch a sexually transmitted infection (STI) in this way?

A: No, I am afraid you are wrong. Providing oral sex for a guy can give a girl various forms of STIs, including gonorrhoea ('the clap'), chlamydia, herpes, and the Human Papilloma Virus, so I think you would be wise to abandon this form of petting.

No climax!

Q. I am 22, and I have had sex with four girls. Much to my surprise, none of them climaxed while I was having intercourse with them. Am I doing something wrong, Doc?

A: Like many young men, you have not realised one simple fact. It is this: Women do not usually orgasm as a result of intercourse alone. As a rule, they require a good deal of additional stimulation of the clitoris. Intercourse does not really provide that.

So there was nothing wrong with the four ladies you have bedded. My advice: Try and establish a stable relationship with a nice young woman. When matters eventually progress to sex, you should ask her what she would like you to do to her clitoris in order to promote orgasm.

Relieving my frustration

Q. I am female, and at the moment, I do not have a boyfriend. My last one suddenly left me and married someone else. Doctor, I have to confess that because of my frustration, I masturbate to orgasm around once per month. Two questions: First, will this harm my health? Second, will it distort the appearance of my genitalia as I have heard?

A: Sorry to hear your boyfriend dumped you, but masturbation will not harm your health, nor will it alter the appearance of your genitals. So you can quit fretting.

Painful orgasm

Q. I am a guy of 21, and recently, I have found that whenever I orgasm, I get quite a severe pain. This happens whether I do it with my girlfriend or by myself. Why is that, please?

A: Pain on ejaculation affects a fairly small number of young males. The common causes are problems (such as inflammation) in the testicles or the prostate gland. Rarely, this type of pain can occur when a guy is on an anti-depressant drug or some other medication.

I am sorry to hear about your problem, but it is essential that you go and see an experienced doctor who will examine your penis, testicles, and prostate. The prostate examination involves putting a gloved finger up your rectum. If the doctor finds inflammation, he will almost certainly be able to give you some medication to get rid of it. By the way, when you go to see him, please take a specimen of your urine with you.

DNA test incorrect?

Q. An American girl who visited Jamaica on holiday last Christmas is claiming that I am the father of her recently born baby. I find that hard to accept because I only had sex with her quite briefly, and I know that another guy, who is from St Catherine, also went to bed with her while she was here. But there have been DNA tests, and she says they show that the baby is mine. Doctor, could the tests possibly be wrong?

A: When a DNA test is performed by a reputable lab, the chances of it being wrong are less than one in a million. So it is virtually certain that you are indeed the babyfather. However, you should ask to see the actual lab reports rather than just rely on the young lady's word. Incidentally, your idea that you are unlikely to be the father because you "only had sex with her quite briefly" is a little naïve. Even having intercourse with a woman for 10 seconds can get her pregnant.

Yeast infection again

Q. Doctor, is there any reason why I keep getting yeast infections in the vagina? I douche regularly, but that does not seem to stop them.

A: Douching is a waste of time. Yeast infections are generally caused from a fungus called Candida albicans or 'thrush'. It loves warmth and moisture, which is why it flourishes in women's vaginas. Vast numbers of young women get it, especially in the years just after they lose their virginity. Fortunately, it tends to respond well to drugs such as clotrimazole.

But if infections keep recurring, then you should ask a doctor to help you find out why. A common reason for recurrent thrush is diabetes (sugar). Another is wearing underclothes that are too hot and too tight, thus creating the warm conditions that the fungus likes. Also, females are often re-infected by a male sex partner who is carrying the fungus in the skin folds of his organ.

Email questions to Doc at saturdaylife@gleanerjm.com

Doctor's Advice: Artificial 'love juice' for my lady love
Published: Saturday | November 9, 2013 0 Comments

I am a guy, 25 years of age. I need your help to know about the types of lubricants that can be used during sex. This is because my partner's vagina gets dry during intercourse, and this gives her pain at the entrance. So, Doc, please suggest to me the lubricants that are easily available.

A: Well, many younger women do not actually need any artificial lubrication because they produce so much fluid of their own, but they only secrete that natural lubrication when they are completely relaxed and happy as well as sexually excited.

So my guess is that when your girlfriend learns to relax completely, she will produce enough of her own 'love juices' to make intercourse free from discomfort. However, it is important for guys to realise that female juices do not flow very much unless women are given gentle and skilful stimulation by their partners. So are you doing enough foreplay, I wonder?

Having said all that, I must admit that many women do need a little help in the lubrication department. And in recent years, the availability of good artificial lubricants has transformed the sex lives of many couples. So I agree that you should buy some 'lube', as people call it these days!

In pharmacies in Jamaica, I have often seen the excellent K-Y Jelly, which is intended for this purpose, and which can be bought with little or no embarrassment. Also, it is quite cheap.

But there are a lot of other very good 'lubes' these days. You may find some of them in your local pharmacy, but all of them can be purchased online. Of course, ordering via the Internet removes any embarrassment you might feel about buying a sex lubricant over the counter.

Effective brands that you can easily obtain from the net include:

Pjur Woman;

Astroglide;

Liquid Silk;

Trojan;

Passion;

Pink Silicone.

One thing I would advise you not to use is Vaseline. Many young couples try this to help them with sex and to reduce discomfort, but its big drawback is that it makes holes in condoms.


Strong feelings for men

I am male and in my early 20s. I have been going through a tough time identifying who I am sexually. I do have a girlfriend; however, Doctor, at the same time, I do have these feelings for guys. This is stressing me out badly. I sometimes get an erection when I see a young man naked. I really need your advice, for what is happening makes me feel like hiding away somewhere where I don't have to see anyone anymore.

A: Sorry to hear about all the stress you have been suffering. I have not published the whole of your email because the details are so sensitive, but I have to say that there is quite a chance that you are either homosexual or possibly bisexual.

You do not say what is going on between you and your girlfriend. Are you actually having sex with her? If so, do you enjoy it? Do you orgasm? And how does she feel about everything? If you would like to email me again, giving details on these points, I will try and help.

For the moment, I am sure that you should try and take life as calmly as possible. Avoid stresses. Do not get involved in sexual relationships - male or female!

I feel that you could go on seeing your girlfriend for the time being, but it would be most unwise to get her pregnant at this difficult time in your life. Also, do not get involved in any ideas of marriage.

Finally, if there is a sympathetic and open-minded counsellor in your area, please make an appointment to see him or her. Don't hesitate to email me again.


Crazy about sex!

I am female, age nearly 19, and my problem is that I am crazy about sex! Doctor, I really love it! I cannot help myself. I just adore having intercourse with a handsome guy. And when there is no suitable male around, I find that I have to masturbate to orgasm. Are there any tablets that would stop me from being so sexy?

A: Alas, no! It is obvious that you are a highly sexed young woman, and that is not your fault. But if you keep hopping into bed with any good-looking guy who is around, then you are soon going to end up in trouble. You will get pregnant, and you will probably catch a sexually transmitted infection (STI).

There are two things you can do at the moment. First, you can try and analyse why you are so keen on sex. For instance, do you have the idea that as a person, you are only of value when you have a man between your thighs? That attitude is quite common in young women. And if you think carefully about it, you will see that it is pretty irrational.

Second, you can try and put all your sexual energy into some other field. That is called sublimation. For example, many young people manage to sublimate their sex urges by throwing themselves enthusiastically into sports. I have known quite a few youngsters who did so much sports training that they temporarily reduced their interest in sex!

But in the long run, the answer to your problem may be to find yourself a good and loving steady partner with whom you can have intercourse whenever you want to.

Make sure that he is as interested in sex as you are.


Healthy seminal fluid?

At university, I have met an older guy who is trying to convince me that his seminal fluid would be good for my cervix healthwise. Can I believe this, Doc?

A: No. This strange idea used to be common in popular medical books, and it is possible that he has read one, but it was all foolishness.


Will the Pill give me thrombosis?

I am 17. If I go on the Pill, will I get thrombosis? My mother says that the risk is very high for young women.

A: The Pill can indeed cause thrombosis, which is clotting. But in fact, the age group that is most at risk is aged over 35.

In young women, the danger of thrombosis is very low, except if they are smokers.


No kissing after oral

My girlfriend and I would value your advice. To be frank, Doctor, she loves oral sex. It makes her orgasm in a way that nothing else does. But after I have done it to her, I usually want to kiss her. She cannot stand this! You see, she hates the taste and smell of her vagina on my lips, so she shrieks and jumps out of bed. Help us, please!

A: This reaction is extremely common in younger women. Many of them really dislike the odour and taste of vaginal juices - even their own. Your girlfriend is not abnormal.

But all you have to do is pause for a minute after giving her cunnilingus. Wash your face, and clean your teeth. Then all will be well.

Email questions to Doc at saturdaylife@gleanerjm.com

Published: Saturday | November 16, 2013 0 Comments
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Should I take the Pill?

I am thinking of going on the Pill, Doc, but I do not understand how it works. Please advise. Do you have to take a break each month? I am 19.

A: The Pill contains two female-type hormones. The effect is to fool the ovaries into behaving as if the woman was pregnant. As a result, the ovaries do not release an ovum (egg).

Therefore, as long as you do not miss any of the pills, it is most unlikely that you will get pregnant. But please note that if you start forgetting to take the tablets, particularly towards the end of a pack, there is a real danger that the ovaries will suddenly 'wake up' and release an egg.

If that happens near to a time when you have had sex, there is a high chance of conception. Moral: do not miss any pills!

As it relates to the 'break', with most brands of the Pill, you take the tablets for 21 days and then have a pill-free week. You are protected during that little break. During those seven days, you should find that you have a fairly short, light, and pain-free period.

Email me again if there is anything that you do not understand.

Is my girlfriend pregnant?

Hello, Doc. Yesterday morning, I had sex with my girlfriend. Two hours later, she threw up. Does this mean she is pregnant?

A: I think you have got a little muddled here. Admittedly, pregnant women do often vomit. It frequently happens in the morning, and that is why people talk about morning sickness.

But morning sickness does not occur till around the sixth week of pregnancy! It certainly doesn't happen two hours after being impregnated.

However, you and your young lady are obviously taking very serious risks. If she doesn't become pregnant this month, she will become so very soon. So I urge you to go out and buy yourself some condoms. Please use them every time you have intercourse with her.

Coil queries

I am planning to get married next year, but my fiancé and I don't want to conceive a child before then, so we are thinking of using that 'coil' thing. I have looked at some pictures of it, but I cannot work out two problems: 1. How big is it? I would hate to have something huge inside my womb. 2. We can see that there is a 'tail' hanging down into the vagina. But doesn't this interfere with intercourse?

A: The coil (intra-uterine device, or IUD) is a good method and is almost as reliable as the Pill. Also, once it is in, you don't have to think about taking tablets every day!

But if you have never been pregnant, the insertion of the device by a doctor or nurse can be quite painful. However, once that initial pain is over, most women are pleased to know that they are protected by the coil.

The chief drawback of the IUD is that it tends to make the menses heavier and lon-ger. But a lot of women don't mind that. Now, let me answer your two questions.

1. The coil is about the length of a matchstick, which is much smaller than many people imagine. You can easily hold one in the palm of your hand.

2. The thread which dangles down into the vagina is very thin and short. Most men cannot detect it, but some guys get a tickling feeling, which they usually like. Just occasionally, the end of a thread is a little sharp, and that may give the male a jabbing sensation in the tip of his penis. When that happens, it is easy for the doctor to trim the thread back a little.

Hope this advice helps you and your fiancé.

Is masturbation the cause of my pain?

I'm a guy 20 years old. I often masturbate twice a day. Could this be the cause of the pain in my gonads?

A: I presume you mean your testicles. There is no way that masturbation can give you any kind of pain anywhere.

In young men, the commonest cause of pain in the testicles is sexual frustration. In other words, if you get sexually excited but don't climax, the testicles can become congested and tender. This is is known medically as orchitis amorosa.

It's most unlikely that you have anything physically wrong with you, but if the pain continues, have a doctor check out your genitals.

Will pre-come make me pregnant?

I had first-time sex with my boyfriend yesterday. It was unprotected sex, but he pulled out before he penetrated my vagina. What's worrying me is that he might have left some 'pre-come' there. Could this make me pregnant? I took Postinor-2 around 16 hours later and another one 12 hours after that.

A: OK, you acted pretty promptly in taking the post-coital pill. That makes it fairly unlikely that you will turn out to be pregnant.

I am not sure what you mean by saying that he pulled out before he penetrated the vagina. I am guessing you mean that he only went in a little bit.

Be that as it may, it is perfectly possible that he left some pre-ejaculate ('pre-come') inside you. Now, can this liquid make a girl pregnant?

There has been much debate about this among scientists in recent years. For decades, doctors believed that it contained sperm, but about 10 years ago, some researchers reported that they couldn't find any spermatozoa in pre-ejaculate.

However, two years back, this view was challenged when an American-British team announced that it had found sperm in the 'pre-come' of some men, but not in the fluid of others.

In light of that finding, my advice to young couples is to assume that pre-ejaculate is potentially 'dangerous' and not to take any risks with it! In your case, I very much hope that you will embark on some reliable form of contraception before you allow your boyfriend any further favours.

I wish you well.

Nine-day wonder

My menses arrive every 28 days and last nine days each time. Is this too long?

A: Yes, nine days really is too long. It must be rather inconvenient for you. Also, the fact is that you must be losing a great deal of iron each month. So if something isn't done to shorten your period, you will probably get anaemic.

You should, therefore, see a doctor fairly soon.

Cheesy stuff alarm

Good day. I'm a 19-year-old guy with not much experience of sex. Recently, I have been alarmed to see some white, cheesy stuff appearing under my foreskin. It is particularly on the side nearer to me when I am erect. Is this serious, Doc? Have I caught anything bad?

A: No, you haven't. This white stuff is called smegma. All young men produce a little of it. It is secreted by tiny glands located just below the head of the organ.

It does contain some germs, and for hygiene reasons, it should be washed away each day when you are in the shower. But there is no need to fret about it.

Email questions to Doc at saturdaylife@gleanerjm.com

DOCTOR'S ADVICE - 'Viagra party' ... a hard choice

Published: Saturday | November 23, 2013 0 Comments

'Viagra party' ... a hard choice

Q. Doc, I am a guy of 18 and I have just been invited to a 'Viagra party' in St Andrew. I understand that there will be bowls of Viagra on the tables, and that guests can help themselves. Should I go? Is it safe to take these pills?

A: The idea of 'Viagra parties' for young people has emerged in the last year or so, particularly in the Corporate Area. I must say that as a doctor, I think that the whole idea is completely crazy.

Why? Well, first of all, Viagra is a powerful drug. It is not suitable for some people, and it can react with certain other medications. Occasionally, it can cause serious side effects, so it is not a very good idea to take it unless it has been prescribed for you by a doctor.

Second thing is this: Taking Viagra is completely pointless for most young men. You see, all it does is make it easier to get an erection. Most younger guys have plenty of erections already, and they certainly don't need any little blue pills to help them get hard.

Third thing: Viagra has no effect on sexual desire or sexual enjoyment. It is just a 'stiffener', so if you take one, you will not find that sex suddenly becomes much more enjoyable than it was before.

Finally, I have heard that at these foolish parties, young women sometimes take Viagra pills. This is utterly pointless. Research has shown that Viagra has no effect at all on females, except sometimes to make them 'lubricate' rather more than usual. My advice: steer clear of these foolish parties.

Bad period pains

Q. Doctor, a few months ago, I started having a bad abdominal pain during my monthly period. Should I be concerned about this? It did not happen in the past.

A: No, there is no need to be concerned, but as the pain is clearly bad, you should do something about it. The reason why I say that there is no need for 'concern' is this. Well, over 40 per cent of young women get significant period pain, so you are far from alone. It is actually a pretty normal thing for teenagers and females in their 20s.

You may wonder why this menstrual pain has suddenly started. Seems like your periods were pain-free until quite recently. Well, the probable reason is this. Generally, dysmenorrhoea (period pain) does not occur unless the young woman has started to ovulate (that is, release an ovum, or egg).

And young teenagers often do not ovulate until they have been having menses for some time. Therefore, their menses are pain-free. But once they start ovulating, then menstrual pain begins. I expect that is what has happened with you.

So what should you do now? I presume you have tried simple remedies like aspirin and paracetamol (acetaminophen). If these are not working, then you should have a consultation with a doctor. She will almost certainly be able to prescribe something that will take the 'dysmen' away completely. I wish you well.

Shy guy blues

Q. I am a male virgin at age 26. I have to admit that there might be some reasons behind this. I feel hopeless about myself. And I don't actively pursue women, partly because I am shy. Also, I don't have the drive to meet women, and though I don't want to sound picky, although I see attractive women everywhere, I am not attracted to every one of them. I will admit that I am defensive with people when the subject of sex and virginity is brought up. I am really insecure about the whole thing. Also, I have it planted in my head that women don't like inexperienced guys. I have it in my mind that I should have 'done it' by now. Your advice, please.

A: Well, there is nothing to be ashamed of in being a virgin. You have certainly avoided a lot of possible trouble that way! Also, please note that a few generations ago, it was accepted as perfectly normal for many men of your age to have remained virgins. Admittedly, that is not so today.

You seem to me to have several problems. First, you say that you are shy and insecure. And also, you are obviously rather prickly and defensive about matters of sex. These feelings cannot be changed overnight, but they could be changed over a period of around six months, if you had regular sessions with a good therapist or counsellor. And that is what I would advise you to do. Finally, please do not rush into losing your virginity. That is never a good idea.

Early discharge, unsatisfied fiancée

Q. I recently got engaged to a wonderful girl and we love each other. My problem, Doc, is that I am unable to give her a good time in bed. The reason is this. I 'come' too soon. I can only last around four to five minutes before I have to discharge. So it is all over before she can really get going. What can I do? Is it true that there is some tablet that can help me?

A: Well, you obviously have a mild case of premature ejaculation (PE), which affects many young men. It can be cured. The best treatment is the famous Masters-Johnson method, which you can look up on the Internet. However, that does require the help of a cooperative and well-motivated partner.

Yes, there is a tablet, or rather a capsule, which can be of temporary help. It is actually an anti-depressant, but it has the additional effect of slowing down orgasms. It is called clomipramine (or Anafranil), and the usual dose is 25 milligrammes. Please note that it is not a cure. But if you take one about three hours before sex, there is a good chance that your orgasm will be significantly delayed.

This medication has many possible side effects, like dry mouth, constipation and blurred vision. Occasionally, it can cause serious health problems. So you should only take it if it has been prescribed by your doctor. Please do not buy illegal versions of this drug which are on sale in some bars, under the name of 'last-longer pills'.

Curious about meds

Q. I have terrible menses, and my doctor wants to put me on something called 'mefenamic acid' for them. But I am afraid of taking something that has acid. What do you advise, Doc?

A: Mefenamic acid is not the sort of acid that burns you. It is actually a very good drug for treating heavy or painful periods. Its main drawback is that it can cause belly problems, such as pain, diarrhoea and occasionally bleeding from the stomach. So please take it exactly as your doctor prescribes. And make sure that you have food in your belly when you swallow a tablet. But taking mefenamic acid should give you lighter and less painful menses.

Strange discharge

Q. Last week, I went with a girl in Black River, and now I have pain while passing urine, plus a strange discharge from the penis. What could be wrong, Doc?

A: Could be chlamydia, could be gonorrhoea ('the clap'). Please see a doctor at once. Meantime, no sex, please.

Email questions to Doc at saturdaylife@gleanerjm.com

Published: Saturday | November 30, 2013 0 Comments

Doctor, I am a girl who needs advice about oral sex. I have always believed that a female should keep herself pure until she gets married. So years ago, I resolved that I would stay a virgin until my wedding day, whenever that may be. But I must admit to you that I have strong sexual urges. So for a couple of years now, I have sometimes allowed boys to give me oral sex if they want to. Not all of them do, because some guys seem a little scared of it. But when someone skilful does it, I confess that I find it satisfying. It rapidly brings me to an orgasm, and this relieves my frustration. However, I am concerned by the fact that some of my friends say that oral sex can give a girl infections. Is that really true, doctor?

A: Unfortunately, it is. Cunnilingus, which is the form of oral sex that you are talking about, can transmit the following infections:

Gonorrhoea ('the clap')

Chlamydia

Herpes

HPV (Human Papilloma Virus)

There are other possible sexually transmitted infections (STIs), but they are much rarer. However, you can see that letting a variety of young men give you oral sex is not a good idea.

I do applaud your decision to stay a virgin until your wedding night. That will certainly protect you against 'pregnancy scares'! But what you are doing at the moment is rather dangerous for your health. Maybe you should consider finding yourself a nice, reliable, steady boyfriend who is totally faithful to you? That would be a great deal safer.


Curved organ

I am a guy of 18, and I am very worried by the fact that my organ seems to be curving up towards me. I have heard of something called 'Peyronie's disease of the penis', which I have read about on Google. It sounds pretty bad. Do you think I have it?

A: I feel that Peyronie's disease ('bent penis syndrome') is fairly unlikely at your age. In any case, that disease generally makes the organ bend away to the side. And you say that you are curving towards the belly.

In fact, a slight curve towards the belly is normal for a young man when he has an erection. So I think the great probability is that you are OK.

However, I do think that you should get your organ checked out by a doctor. Obviously, you cannot show him your erect penis. So experts recommend that in these cases, the guys should take a photo of the erection on his mobile phone, and show that to the doctor. Good luck.


Attracted or cheating?

A pleasant afternoon to you, Doc. My boyfriend and I are 24 and 23 years old, respectively. When we first got together two years ago, we would have sex, and then do it again half an hour or so later. But now, once he has ejaculated, he is 'dead'. In other words, he cannot get back his usual erection. My question is: could it be that he doesn't find me as attractive as prior? Or is he getting sexual gratification elsewhere?

A: Please quit fretting. What you have described is perfectly normal.

You don't realise that the human male's ability to reach repeated climaxes declines very rapidly with age. In their late teens, a lot of young men can do it repeatedly without much difficulty.

But by age 23 or 24, it is becoming rather more problematic for a man to orgasm again and again, except where there is a very strong stimulus to do so. What often happens is that at the beginning of a sexual relationship, a guy is so highly excited that he can make love several times. But as the couple become used to each other, he tends to settle into the pattern of 'once a night is enough …'.

So I don't think you need worry about your boyfriend. He is not losing his nature.


Looking like a dude

Hi. I'm a 24-year-old young lady who has been experiencing some strange things. For the past few years, I have noticed that I have hair growing on my face, chest, back and all over my body, except the foot bottom. What makes matters worse is that for over six months, I'm not having a menstrual cycle. It bothers me, because I would like to have a baby with my husband. I'm tired of shaving every morning, because I don't want to look like a dude.

A: Very sorry to hear about this. Clearly, there is some problem with your female hormones.

I suspect that you may perhaps have Polycystic Ovary Syndrome (PCOS), which is very common in Jamaica. So I urge you to see a doctor right away - preferably a gynaecologist.

You need an internal examination and some blood tests to find out about your hormone levels. I wish you well in your efforts to start a family.


Stretching my penis

I have seen an advertisement for a penis-stretching machine on an American website. It costs a lot. Should I try it, Doc?

A: Don't have anything to do with this crazy machine. You could end up damaging your male organ.


Strange secretion

Hello. I'm female, 19 years old. I had sex one week ago. Now I'm seeing a lot of white stuff coming out of my vagina. Is something wrong with me? And how do I stop from seeing it? I really need your help, please Doc!

A: There are several possible diagnoses here. But statistically, the likeliest thing is that you have acquired thrush (candida), which is a fungus infection. Many people in Jamaica call it yeast.

So I think you should go to a pharmacy and ask them for some clotrimazole - which is an anti-yeast medication. Ask them for both the clotrimazole cream and the clotrimazole pessaries (that is, vaginal tablets).

If that doesn't cure you in a week, then you must see a doctor. Oh … and no sex till you're cured, please.


Bloody semen

Doc, I have to confess that recently I was masturbating and I saw a little blood in my semen. Is this caused from masturbation?

A: No, it isn't. It indicates either a broken blood vessel (i.e., a blood tube) or an infection. Please see a doctor this week.

A broken blood vessel should heal itself. But an infection will require a course of antibiotics.


Infertile after Pill?

Would the Pill make me infertile when I stop taking it?

A: No, it won't. So relax. A few young women do have absent periods for a little while after quitting the Pill, but this is usually no big deal.


Can I take the Pill for her?

My girlfriend is scared of taking the Pill. So would it be possible for me to take it instead of her?

A: No, I'm afraid that just wouldn't work. The Pill is designed for females. And, so far, there is still no Pill for men.

Why don't you two just use condoms?

Email questions to Doc at saturdaylife@gleanerjm.com

Published: Saturday | December 7, 2013 0 Comments

Not so mature

Q. I am male, 23 years old, and having a problem concerning my body. This is so frustrating and embarrassing. You see, Doc, I don't think that I have gone through puberty, and I wonder if it's ever going to happen. My penis has not increased in size, and my testicles are small. I only have a little bit of hair in the pubic region and under my arms, and there is very little on the face. I look mature, but really, I am not. Otherwise, I am healthy. Doc, I wonder if something is wrong with my hormones, or is it my testosterone?

A: Testosterone is a hormone. Indeed, it is the male sex hormone, and I am afraid that you may be seriously lacking in it. The combination of small genitals and lack of body and facial hair makes this likely.

I am sorry to hear about your troubles. Seems like you are suffering from a case of 'delayed puberty'. You should have gone through puberty at the age of 13 or 14, but for some reason, that just did not happen. You don't say whether you have any sexual desire or get erections. However, I suspect that unless you have treatment, it is unlikely that you can become a babyfather.

What you should do urgently is to get a doctor to refer you to an endocrinologist at the University Hospital of the West Indies. An endocrinologist is a gland specialist. He will check you over and do blood tests that will reveal the level of your testosterone and other hormones. I have high hopes that after that, you can be treated with hormones pills, skin patches, or injections. These should help you to reach sexual maturity. I wish you the very best of luck.

What is a Mirena?

Q. I am female, 19, and lead a vigorous sex life with two boyfriends in different towns. The menses are not good and are very heavy. My doctor is concerned about me and wants to fit me with something called Mirena. But what is that, please?

A: First, may I say that you are walking a slightly dangerous path by having two boyfriends, even if they are in different towns.

Mirena is a very good method of contraception. It is a sort of coil to which a female-type hormone has been added. The hormone, which is called levo-norgestrel, gives you a high degree of protection against pregnancy, though not as good as the Pill does. Also, it is very effective against heavy menses, making them much lighter and more manageable. So I think you should go ahead.

Obsessed with anal sex

Q. I am a male in my early 20s and completely straight, but recently, I have become obsessed with performing anal sex on my girlfriend. She gets furious when I ask her. Is something wrong with me?

A: Well, I don't think you are gay if you are secretly wondering about that. Unfortunately, a lot of young men do get this idea that they want to sodomise their girlfriends. The reasons why they have this desire include the following:

They have seen this activity so often in porn movies that they wrongly think it's quite normal;
They are aware of the fact that the anus is tighter than the vagina, and they imagine that it will give them more pleasure (which is unlikely);
In some cases, they subconsciously want to degrade women.

You had better decide which of these alternatives apply to you. As for your girlfriend, I am not surprised that she is furious! Most younger women find this activity to be intensely painful, and quite a few think that it is distasteful or repugnant. I must admit that some females don't mind rectal intercourse, but they tend to be older ladies whose muscles are relaxed and who have tried it before and got used to it. My advice: Stop bothering your poor girlfriend with your rather self-centred desires.

When is her safe zone?

Q. My girlfriend has a 28-day cycle. On what days could we safely have sex without any risk whatsoever of pregnancy, Doc?

A: It's possible to become pregnant on any day of the cycle, but for a young woman whose menses are dead regular and 28 days apart, there is a much reduced risk if you steer clear of the time between Day Eight and 17 of the cycle, counting the first day of the period as Day One. That last bit is most important: Always count from the first day of the menses - not the last.

If you two really want to use this rhythm method, it would be much safer if you talked with a nurse or doctor who could give you more precise instructions.

There are various pointers which make it clear when the girl's 'safe time' is. For instance:

The young lady's vaginal secretions have a different consistency at varying times of the month; Her body temperature changes slightly at the time of ovulation; A chemical-based ovulation test can pinpoint the day of egg release.

Summing up, I don't think that any young couple should risk using 'Rhythm and Blues' without expert help.

Are Fordyce spots serious?

Q. Doc, I was fretting about the appearance of my penis. I went to see a female doctor, and she told me I just had 'Fordyce spots'. Is that serious?

A: No, thousands of young men have Fordyce spots. These are very tiny yellowish or white accumulations of sebaceous (that is, oily) fluid which occur on the shaft or head of the male organ. They can also often be found around the mouth. Fordyce spots are totally harmless, and it is not worth bothering to try to remove them.

Forget the Postinor-2?

Q. Doctor, I had sex with my fiancé, and I forgot to take the Postinor-2 drug that day, so I took it the next morning. Will it still work?

A: Very probably it will. Postinor-2 ideally should be taken within 24 hours of unprotected sex. If you take it as promptly as that, the medication will prevent 85 per cent of pregnancies. But it can actually be taken as late as three days after sex. However, that would make the failure rate higher. Why don't you and your fiancé pick a regular method of contraception like the condom, the Pill, or the Mini-Pill?

Am I there?

Q. I have had no other partners but my present girlfriend. I am very concerned because I feel that when having sex with her, I am not really penetrating to the far end of her vagina. Is this possible?

A: Well, the vagina is only four inches long when it is in a relaxed state. Admittedly, it lengthens during intercourse, but I think it is unlikely that you are not reaching to the far end.

Are you really saying that you suspect your penis is too small? If so, then you should go and have it checked out by a doctor. Take with you a photo of your erection, taken on your mobile phone, and show it to him. Before snapping the picture, you should put a ruler next to your organ so that the doctor can see the exact length.

Email questions to Doc at saturdaylife@gleanerjm.com

Doctor's Advice: How effective is the Pill?

Published: Saturday | December 14, 2013 0 Comments

Q. Hi, I'm a 24-year-old guy. My girl is 25 and a nurse. We have decided to use the Pill for contraception, because condoms cause her pain. I must admit that I like the idea of her being on the Pill, but I want to make absolutely sure that she won't get pregnant because we don't want any children right now. So my question to you is: can she use a secondary method of contraception, along with the Pill, to make sure that the chance of her getting pregnant is zero? For instance, what about having an IUD as well?

A. Your letter seems to concentrate on what you want. I am wondering what the young lady herself wants?

I'm a little puzzled that your nurse finds the condom painful, because that is unusual in women. Maybe she is allergic to it? So it would be worth buying a pack of the 'lo-allergy' condoms, which are available, and see how those work out.

However, let us assume that she opts for the Pill. If taken properly, this is so effective that very few women would want to bother with using any additional contraception. Admittedly, a few Pill-taking ladies do decide that they will also use pessaries, that is, little spermicidal tablets which are popped into the vagina a few minutes before sex.

I have never heard of any woman who chose to use an IUD (a coil) as well as the Pill. But if that is what your lady friend really wants, then she could probably find a doctor who would be willing to prescribe both the IUD and the Pill.

As she is a nurse and, therefore, must have a lot of medical knowledge, I suspect that she will not want to bother with using two good methods of contraception at the same time.


Can a vasectomy affect my semen level?

Q. A pleasant day to you, Doc. I have no problems getting an erection. However, since my vasectomy 15 years ago, I have been noticing a decline in the amount of semen which I produce during sex. As a result, it is difficult to convince my girlfriend that I am not faking a climax! This is because practically nothing comes out when I orgasm. I have read what you said in previous articles about how men must expect to 'slow down' a little as they get older. But I don't like this lack of seminal fluid. Also, lately I have been experiencing a lot of pain inside the shaft of the penis. I keep a supply of cranberry juice, and if I take it, the pain goes away after a few days. Should I be worried?

A. Well, it is a fact that guys produce rather less seminal fluid as they grow older. But you shouldn't be producing none at all. So that is a little worrying.

I am pretty sure that this has nothing to do with your vasectomy, assuming this was carried out by a competent surgeon who knew what he was doing.

Turning to your other symptom, you should not be having pain inside the shaft of the penis. This suggests that something physical must be wrong.

I cannot tell you what is going on, but I wonder if you have what is called a stricture. That is a narrowing of the urinary pipe inside the penis. It is often caused by gonorrhoea ('the clap'), acquired early in life. The symptoms do not appear for 10 to 15 years. So do you have any recollection of catching a sexually transmitted infection when you were 20 or so?

A stricture could make it difficult for your seminal fluid to squirt out. It would also interfere with the free flow of urine.

Clearly, you need medical help. I suggest that you begin by going to your local doctor, taking a specimen of urine with you in a very clean container. He can test this sample. After that, I think he may well send you to the type of surgeon-specialist called a urologist who deals with problems in the urinary pipe. I wish you good luck.


Can I catch an STI from 'hand contact' ?

Q. I am female, age 17, and at a party last week, for some reason, I let an attractive, older woman of around 25 kiss me, and put her hand up my skirt. The result was that I orgasmed. I think the reason was that I had too much to drink. I am fairly sure that I am not a lesbian. I like boys. But this experience has worried me. Also, could this 'hand contact' have done me any harm, Doc? Like, could it give me some kind of sexually transmitted infection (STI)?

A. It is very unlikely that that kind of 'hand-genital' contact could give you an STI.

Obviously, you have been alarmed by the fact that you orgasmed when you were caressed by this 25-year-old lady. But such episodes are much commoner than many people think. For instance, only last month, a large survey in England found that about 16 per cent of women had had a 'same sex' experience.

We shall have to see how life turns out for you. But as you say that you like boys, the odds must be that you are heterosexual. One final tip: in future, please avoid drinking too much.


Help! Having problems conceiving

Q. I was on family planning, namely Depo-Provera, for some time. I came off nine months ago. Since then, I have been trying to get pregnant, and it's not happening! My fiancé and I are becoming worried, as this is really strange. What do you think is wrong? What should we do? I see a regular period.

A. You used to be on Depo-Provera ('the Shot'). Many people don't realise that there is often a delayed return of fertility after stopping it. This delay averages around nine or 10 months.

So really, I don't think you have anything to fret about, especially as you are having regular menses. If your fertility has been temporarily lowered by the jab, it should soon return to normal.

Best thing to do is to have sex as near as you can to the day when ovulation should occur. Often, this is about 12 days after the start of a period.


Can masturbating affect my fertility?

Q. I have a regular girlfriend, but she is away a lot. When she is not around, I sometimes masturbate, Doc. Will this harm my fertility?

A. No, it won't. So you can quit fretting.


Should I have a laparoscopy?

Q. I am 26 years old, and ever since I started my menstrual cycle (age 13), it has been a complete nightmare. About five years ago, I consulted a gynaecologist, and he suggested I might have endometriosis. He proposed a laparoscopy, but I couldn't afford it at the time. I only became sexually active in June of this year, and it causes me great pain. Do you think I should now get that laparoscopy done?

A. Yes, I do. During a laparoscopy, the gynaecologist will look into your belly through a little 'telescope'. He should be able to see if you have endometriosis. And he may be able to cut it out, or laser it. I wish you well.

Email questions to Doc at saturdaylife@gleanerjm.com