DOCTOR'S ADVICE: Should she get married?

Q Doctor, I need your advice. I am 28 years old and I am supposed to be getting married later this year. My fiancé is a good man. He is very good in bed and he is the first man to make me have an orgasm. He is really looking forward to the wedding.

So is his family, who are quite rich. They are spending a lot of money on 'the big day'. His mother seems to regard it as the greatest event of her life!

But there is a problem. I am not absolutely sure that I want to get married to this man. I like him, and he says he loves me. I know that life would be very comfortable with him, because of his money.

In addition, there is the question of sex. It is good to think that he would keep me sexually satisfied for the rest of my life!

But I just have a feeling deep inside of me that maybe I still have a lot of living to do. I want to travel, and see the world, and he does not.

He wants to have a lot of children and at the moment, I am not interested in children.

We have argued about this, and he wants me to stop taking the Pill when we get married.

I would not mind going through with the wedding celebration, just to please his family. But I am beginning to wonder what are the chances of us having a successful marriage?

A This is not very good, Let us look at the facts and the possible outcomes.

● You don't appear to love this man;

● You don't feel sure about marrying him;

● You want to experience more of life;

● You want to travel the world - and he doesn't;

● You don't want children - and he does;

● He is trying to get you to stop taking the Pill so that you can conceive.

In contrast, what are the points in favour of the marriage?

● He is a nice man;

● He is good in bed, and makes you orgasm;

● He is well off.

Looking at those two lists, there is no doubt in my mind as to which one wins. The points against the marriage seem to me to be much more important than the ones which are in favour of it.

I must admit that it is good that the two of you seem to be so sexually compatible. But in fact, there are a lot of men who are experienced in bed, and who know precisely what to do in order to 'turn women on' and to make them climax. As you approach the age of 30, you will probably find that you meet other nice men who understand a woman's physical needs.

Frankly, it makes no sense to say that you 'wouldn't mind' going through with the marriage ceremony - just to please his mother and his family! No matter how much money they have spent so far, this wedding is not about them. It is about you, and of course this poor man.

So I think you should tell him that you have had 'second thoughts', and that the marriage must be either postponed or cancelled.

Q I am a 25-year-old man who had an unfortunate sexual experience with a tourist in Negril last month. Now I have a fever, a sore throat and a rash on the skin.

Should I get tested for an STI ?

A Definitely. You do not say whether this 'unfortunate sexual experience' was with a woman or a man. If it was with a man, then my thoughts immediately turn to the risks of HIV.

You have three symptoms: fever, a sore throat and a rash. That 'triad' of things can sometimes be a warning of early HIV infection.

Let us hope that you do not have HIV. But in any case, anyone who has had an unwise sexual encounter should assume that they might have caught a sexually transmitted infection (STI).

Therefore, I think you should definitely see a doctor right away, and have a check-up. You should have a number of tests done for gonorrhoea and chlamydia, as well as a blood test for HIV and syphilis.

Q I am a 36 year-old woman and every time I have sex, I get an infection. I only have sexual relations around twice a year.

I went to a doctor the last time, and he told me there was nothing wrong.

A Well, you didn't say exactly what the 'infections' are. But I wonder if you are being reinfected by your partner. Could you persuade him to go to the doctor and have some tests done?

Also, in order to protect yourself from infection, it would be a good idea if you insisted on the use of a condom every time you have intercourse. I would also strongly recommend that you use a good lubricant (which you can buy from a pharmacy), in order to protect yourself against excessive friction during sex.

If these measures do not work, please email me again.

Q I have been trying to get my wife pregnant for 10 years, but no luck. Recently, I agreed to do a sperm test.

To my surprise, it showed that I have no sperms at all! Is there anything I can do about that, doctor?

A Sorry to hear about this. I think you should have the sperm test repeated, just in case there was a mistake. A good tip: it is essential that your seminal fluid specimen gets to the lab while fresh and still warm. 'Cold' specimens can give false results.

But if you really have no sperms at all, then I am afraid that cannot be cured. It is occasionally possible to use some very complex and expensive techniques to obtain sperms by putting a needle into the testicle. But for most couples in your situation, adopting a child is perhaps the best answer.

An alternative is for your wife to have 'AID' (artificial insemination by a donor sperm), but that is not acceptable to everyone.

Q I am 33 and I've suddenly found that I experience deep pain in my womb when I have sex with my husband in the 'woman on top' position.

The pain does not happen when we do it other ways. What is going on?

A For a woman in her 30s, the sudden onset of deep pain during sex always suggests that there is some disease of the womb, cervix or ovaries.

And pain which occurs in the 'female superior' position is suggestive of the common gynaecological condition called 'endometriosis'. That is a disorder in which painful patches of tissue develop in the lower part of the body. It can be treated successfully.

What you need to now do is consult a gynaecologist, who can assess your condition and make an accurate diagnosis. Good luck.

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