Doctor's Advice - Can medication boost our love life?

Q Doctor, my husband and I love each other very much. We have always had a wonderful sex life. But now that we are older, he has been having trouble getting an erection.

He went to the doctor recently and was told there was nothing wrong with him. He does not have diabetes but he will have to use erection-inducing drugs in the future. We can afford to pay for this.

Which is the best one? Are there side effects?

A There are really three principal drugs which are used for the treatment of erectile dysfunction (ED).

Others have been tried over the last 20 years, but they have mostly been abandoned.

They are: Viagra (also known as sildenafil), Cialis (tadalafil) and Levitra (vardenafil).

They all work pretty well, and give satisfactory results in around 80 per cent of men. If one of them does not work for your husband, it would certainly be worth trying the others.

I cannot honestly say that one is better than the other because they all have much the same side effects, which include:

Blocked nose;

Headache;

'Full' feeling in the face;

Indigestion;

Faint feelings on getting out of bed quickly.

In addition, Cialis and Levitra can sometimes cause muscle pain and/or backache. All three drugs can sometimes cause a temporary greenish or bluish distortion of vision.

I have rarely seen a man who discontinued the drugs because of the side effects. These men are mostly too delighted to have their 'nature' back!

It is worth noting that Cialis differs from the other two, because its effects last a lot longer.

Very often, it works for about 24 hours. That can be quite useful, because it means that the man does not have to time things so that he has to take the pill shortly before having sex.

It is good that both of you are still in love and wish to continue having sex. I wish you both well.

Q My doctor keeps insisting on checking my cholesterol. Why?

A It is because a high cholesterol level is associated with a high risk for heart attack - and other health problems.

The story is a little more complicated than that, because there is such a thing as 'good' cholesterol, as well as 'bad' cholesterol.

But the most important thing is that your total cholesterol should be kept within normal limits. You can do this through regular exercise, reducing your intake of saturated fats in your diet, and, if necessary, by medication.

Q I am a 28-year-old woman, and I have absolutely no idea about male anatomy. I am a virgin and have never been to bed with a man.

However, I am thinking about getting married in the next couple of years, so I suppose I had better learn something about the subject! I am particularly puzzled by the foreskin that men keep talking about.

What is it? And where could I get some basic information about how men are made?

A The foreskin is a sort of cover which helps to protect the end (that is, the 'head') of the male organ. It should roll back when the guy gets sexually excited, and so becomes erect.

It is quite a sensitive part of the male body, so you will probably find that your future husband would like you to stroke it during foreplay. To find out more about the anatomy, I think you should look at the website www.circumstitions.com.

However, please be aware that it does contain pictures of men's penises. If you think that you would be shocked by this, do not go to that site.

Q I am a 27-year-old woman. At a party in Kingston recently, I kissed a man from Haiti. Could this give me cholera?

A That is almost impossible. Cholera is caused from a germ which is passed out in the bowel motions of an infected person.

If this contaminates water, anyone who drinks that water is likely to get cholera.

Unfortunately, the disease causes copious, watery diarrhoea. And in a country like Haiti, it is very easy for that diarrhoea to find its way into the drinking water source.

Q I am a 49-year-old man: Last week, I was injured when I was the victim of a robbery. Now I can feel a painful lump in my scrotum.

Could this be cancer?

A I do not think so. In Jamaica, cancer of the testicle is very rare at your age. If you were injured in this attack, and got hit in the testicles, it is likely that what you have now is a haematoma in the scrotum.

A haematoma is a swelling caused by a collection of blood, like a large bruise. What you must do now is have your scrotum checked by a doctor. He may well want you to take an ultrasound scan, since this is a very good way of diagnosing testicular swellings.

If this is a haematoma, it will almost certainly go down soon, and disappear over the next few months.

Q I am approaching menopause, but I don't want to take hormone replacement therapy (HRT) drugs. Is it true that there are natural products which are supposed to help a woman through menopause?

A Yes, that is true. There are various herbal and plant products which claim to help women deal with menopausal symptoms. They include chaste berry (Agnus castus), black cohosh, and milk thistle.

Ask the staff at a pharmacy or health food shop for details.

However, if you have very bad symptoms, like hot flashes and night sweats, I hope you would consider taking a short course of HRT.

Q Last month, I had sex with a beautiful woman who I met in Portland. But I took care not to discharge.

Can I assume that there is no risk I could have made her pregnant?

A I am afraid that you cannot be certain of that. It would be wise to call her, and discreetly enquire whether she has seen her monthy period.

Q I am a 55-year-old woman and I have three occasional boyfriends.

Am I right in thinking that at my age, there is no risk of catching any sexually transmitted infections?

A No, you are entirely wrong. In fact, during recent years there has been a worldwide increase in the cases of STIs among persons over 50. That is possibly because so many persons have made the same mistake.

Send feedback and questions to: editor@gleanerjm.com. Also, read Doctor's Advice in the Saturday Gleaner.