DOCTOR'S ADVICE: He left me after 20 years

Q. Three months ago, my man left me. We had been together for nearly 20 years. He has gone abroad, and is going to marry someone else.

Doctor, I just feel so awful about this. I am not sure that any man will want me again. It seems to me that my body has become ugly, and that my breasts and vagina are now totally unattractive. I lie awake for hours at night, worrying about this.

Do you think there is any hope for me? At 38, I just feel so ugly. And I used to be a pretty sexy lady.

A. Well, my guess is that you will again be a 'sexy lady' in the future. It is quite clear from your email that you are suffering from low self-esteem, which is very common among women who have been dumped.

I strongly suspect that you have a depressive illness at the moment. Your difficulty in sleeping makes this quite likely, since that is often a symptom of clinical depression.

I would like you to do two things:

Go see a doctor who can assess whether you are depressed, and who will then probably give you a course of anti-depressant medication

Try and find a therapist or counsellor who can help to boost your self-esteem.

I am sure he or she will stress to you that the idea that you are 'on the shelf' at age 38 doesn't make much sense. Statistically, the odds are that there are a lot of men who will be interested in you.

At the moment, you feel that you are ugly. You also think that your breasts and your vagina are 'totally unattractive'. I hope that a good therapist can show you that those beliefs are not rational, and are simply caused from the fact that your boyfriend left you.

I wish you well, and I hope that in the near future, your life will be much happier.

Q. Doctor, I am 36 years old and I would like your expert advice about the hardness of my erections. I know that sounds a little crazy, but I am really worrying about this. It seems like they are just not as firm as they used to be, so I am extremely worried about the possibility of losing my nature.

Would Viagra help?

My wife says that everything is OK, but I am not so sure. Please advise.

A. Well, if your wife is happy, then it is probable that all is well. However, it is definitely the case that male erections do tend to get slightly less firm as men get older. That is nothing to worry about, and it certainly does not indicate that you are going to have erectile problems.

But as you have been so worried, I think that you should now get a good check-up from a doctor, just to make sure that your general health is OK. This check-up should include a test for diabetes. If necessary, the doctor will give you some advice about getting healthier - doing some exercise, and losing weight. If you are a smoker, I am sure he will try to help you to stop.

All these health measures do tend to have a good effect on a man's virility, and can assist him to obtain excellent erections whenever he wants to.

Finally, you ask about Viagra. I really do not think that you need it. However, in the United States some men in their 30s to 50s do now use the drug in order to improve the hardness of their erections. If you decide to do that, you must talk it over with your doctor first, and make sure you understand what the possible side effects of the drug are.

Q. Doctor. I have a breast problem. I'm 30 years old, and have very small breasts. In fact, my daughter's breasts are bigger than mine, and she has only just turned an adolescent!

What I want to know is whether the 'breast enlargement' pills I hear about would work for me?

A. I am real sorry but I have seen absolutely no medical evidence which shows that 'breast enlargement' tablets really work. If they did, doctors all over the world would be prescribing them. That is not the case!

The only certain method of enlarging your breasts would be to have a cosmetic procedure in which the surgeon inserts a little 'bag' into each mammary gland, working through a small cut in the under-side of the breast.

In the hands of a good plastic surgeon, this operation is usually very successful.

Q. I am to have a rupture operation soon. Please tell me frankly: will this operation affect my nature?

A. It really should not. Unless the surgeon makes some terrible mistake, which is most unlikely, your sex life will be unaffected by the operation.

However, you will be sore and bruised for a little while afterwards. So it might be a few weeks before you feel like having sex again.

Q. Doctor, I have had very heavy menses all my life, and they make things very difficult for me. On two-three days per month, I cannot work.

A. friend of mine who is a nurse has suggested I should have a coil or IUD. But surely that would just make things worse, wouldn't it?

A. An ordinary coil (IUD) would indeed be likely to make your periods even heavier. But I imagine your friend was talking about the intra-uterine system or IUS, also known as Mirena.

The Mirena is a special hormone-loaded coil; and it generally does a very good job of reducing the flow of heavy periods. I think you should definitely consider giving it a try.

Q . My wife is 39 and recently she has been saying that she would like to try a vibrator when we have sex.

Doctor, I am rather offended by this! Is she saying that I am not good enough for her?

A.  No, she is not saying that at all! Millions of couples, all over the globe, use vibrators. The reason is that these little devices vibrate very very fast. In fact, the vibration is far quicker than any human being could manage with fingers, tongue or any other part of the body.

Therefore, vibrators are extremely effective in giving women pleasure, and in helping them to reach orgasm. Some men like them too.

Q.  I am 36 and I have never had sex. This is mainly because of the fact that apparently I have a hymen which is too tough for penetration.

Now I have met a great new man, and I love him. Could anything be done about my hymen?

A. If the hymen (the virgin's veil) really is too tough, it would be easy for a gynaecologist cut through it for you. However, it may be that he will say that your real problem is an inability to relax the vaginal muscles. He could help you with that too.

Email comments/feedback to editor@gleanerjm.com and read more Doctor's Advice in the Saturday Gleaner.