Doctor's advice - Tummy trouble

Q. Doctor, please help me. I am a worried woman. I am happily married, with three adult children, and until recently I have been in very good health. But soon after Christmas, I began to get 'distended' feelings in the lower part of my belly. I still feel kind of bloated in that area.

At about the same time, I began to experience pain and discomfort whenever I have sex with my husband. He has been very kind and understanding about that, and we have not had sex for two-three months now.

I should add that on more than one occasion, I have had to rush to the bathroom to urinate. But a doctor has tested my urine and has not found anything wrong with it. I thought that the problem was just gas, so I got some anti-gas medication at the pharmacy. But it has not helped. What do you think the problem is, Doctor? I am worried that it may be something serious.

A. You are quite right in being concerned. You are a woman who has the following symptoms:

• A 'blown-out' or bloated feeling in the lower part of the belly;
  
• Discomfort and pain on intercourse;
  
• Having to rush to pass urine.

All these symptoms can have an innocent explanation, like some minor disturbance in the bowels or the urinary system.

But to be frank, they can also have a much more sinister cause, which is cancer of the ovaries. This is the fourth biggest cause of cancer-related deaths in women. Sadly, a lot of women know nothing at all about it. It is often called 'the silent killer' because very often the symptoms which it produces are rather vague, and can easily be dismissed due to gas or indigestion.

Now, I am not saying that you definitely have ovarian cancer. But your symptoms are quite alarming and, therefore, it is vital to take some tests which can detect this disease. I would strongly recommend that you consult a gynaecologist right away.

The tests that he will do are:

• An ultrasound 'scan' of your ovaries;
  
• A blood test for a protein called 'CA-125'.

With the results of these tests, he should be able to tell you if it is likely that you have ovarian cancer. If you do, then urgent surgical treatment can save your life. Ovarian cancer is pretty rare in women under the age of 40. The chances of the cancer developing in that age group increases as they years go by, so younger women need not worry. But women in the over 40 age group who have a feeling of being bloated or 'puffed out' in the lower part of the belly should never be ignored.

Q. Doctor, I have a problem that I think no other man has. All my life I have been very popular with women because of my stamina. In fact, I can have sex for hours without climaxing. As a result, I have been able to make my partners have multiple orgasms. You might say that that is 'no problem'. But the fact is that I am about to get married to a very beautiful woman who wants to have children. But she is concerned that I just cannot climax inside her. We have sex for hours but I just can't seem to orgasm while I'm inside her. Why?

A. You have a well-known male condition called delayed ejaculation (DE). A few cases are due to some medication that the man maybe taking. But in most instances, the problem is psychological. You can find out a lot more about DE by simply googling the two words - 'delayed ejaculation'. After that, I suggest you see a psychotherapist or counsellor who can help you conquer the feelings which are preventing you from climaxing in the vagina.

Also, please talk this matter over with your fiancée. If the two of you desperately want to have children soon, it might be necessary to perform 'artificial insemination'. This means inserting your seminal fluid into your partner's vagina.

Q.  Doctor, I am a 30-year-old woman, and although men seem to find me very attractive, I very rarely allow them to have sex with me. But, last week, I gave in to a handsome and charming foreign businessman. I have strong feelings for him and I think maybe I love him. Today I have discovered a most alarming thing. He has some kind of skin disease. I think it is called eczema or maybe psoriasis. What I want to know is this, could I have caught it during sex?

A  Please relax and don't worry. Eczema and psoriasis are very common skin disorders, particularly in certain overseas countries. But neither of them are infectious. In other words, you could not possibly have caught either of those conditions while having sex with this man. I hope your relationship will prosper.

Q. I am a 27-year-old man and I have fallen deeply in love with an older woman. She is a very clever and intellectual woman, who is pretty distinguished in her field of study. Although I am so much younger than her, I am hoping that we could get married one day. But one thing worries me, Doctor. She is quite open about the fact that she keeps several battery-powered vibrators in her bedroom. When I asked her why, she replied very frankly that from time to time she uses them to pleasure herself. Also, apparently they help her get off to sleep. Is her behaviour normal? Or is she kinky in some way?

A. Well, these days there is an enormous market for vibrators. You can see this for yourself by just glancing at the Internet. For instance, if you type the words 'vibrators for sale' into your search engine, you will be offered over three million websites.

What this means is that tens of millions of women throughout the world are using these devices. Some employ them with their partners, while others use them for solo sex. Many have found that a vibrator is very efficient in inducing orgasm. And some women are like your current lady love in discovering that a vibrator-induced orgasm can help them fall asleep. Vibrators are not as common in Jamaica as they are in some other countries, such as the United States and France. But the fact that your new partner is using one does not mean that she is kinky in any way.

Q. I am a 32-year-old female and, recently, I have had a brown discharge. Why?

A .  A brown discharge usually indicates some kind of bleeding inside you. So please see a doctor this week for an internal check-up.