DOCTOR'S ADVICE: Painful intercourse

Q Doctor, I get a pain in my belly when my partner penetrates me deeply. Is it true that switching to another position could ease the pain and discomfort?

A Yes. But any woman who has repeated pain during sex should see a doctor to find out what is wrong.

However, I would strongly recommend that you also switch to some other positions in the hope that you will find one that does not cause you such discomfort. Quite often, one of these two positions will help:

The Spoons: So called because the couple are close together like two spoons in a drawer. Lie on your left side and have your partner lie close behind you on his left side. He then enters your vagina from behind.

The Free As Air: Your man lies on his back. Then you lie face upwards on top of him. This enables you to control the degree of penetration, and to ease back if you feel any discomfort.

Q At age 37, am I too old to be cured of premature ejaculation?

I have suffered with this all my life. Now, I have met a wonderful woman and would like to marry her. But the problem is that I have never been able to last longer than about 45 seconds.

Is there any hope for me?

A There certainly is! Men can be successfully treated for premature ejaculation (PE) at any age. I would strongly recommend that you get yourself retrained to last much longer by using the Masters-Johnson method. You can find descriptions of this on the Internet, but you really need a professional, such as a therapist or psychologist, to do it. And you require your partner's cooperation too.

Alternatives include taking amitriptyline or one of the other antidepressant drugs which delay orgasm. But they do not provide a permanent cure, because you would have to take the drug every time you wanted to make love.

As you probably know, the 'China brush' is widely used in Jamaica for PE. This, like similar products, relies on slightly numbing the penis, so that the sensations a man feels are reduced. Working in a similar way are the 'long love' condoms which are laced with a paste that has a local anaesthetic effect on the man's penile skin.

My best suggestion is that you ask your partner if she would be willing to attend a joint counselling session in which a counsellor or therapist helps you both to understand the Masters-Johnson method. I wish you well with this relationship.

Q I am a 40-year-old female and I am about to resume my sex life after a long period of chastity. Do you think it would be a good idea if I obtained a female lubricant, Doctor?

A Yes. When a machine has not been used for some time, it is generally helpful to oil it.

In the same way, if a woman has not had sex for quite a while, there is a lot to be said for employing a good, sensuous, erotic lubricant on the first few occasions.

Q I found your reply to a woman who has endometriosis quite interesting. I was diagnosed with this condition nine years ago.

At the time, I was told that there is no cure. Yet, you said the disease can be treated successfully.

When I was diagnosed, I was told that the disease made the possibility of becoming pregnant very limited. But, eventually, I conceived.

My symptoms include intensely painful periods and excessive flow. So I would like to know more about possible therapies for endometriosis.

Quite frankly, your comments about possible treatment have brought me some hope.

A Well, I am delighted that what you have read here in the Outlook Magazine has given you some encouragement. Let me first explain that endometriosis is a real common female disorder, which is particularly likely to strike women over 30 years old.

It provokes severe pain in the lower part of the belly, including pain during sex. Often, it causes infertility and also menstrual problems.

It is a condition in which little pieces of womb-lining turn up in places where they should not be, like on the back of the womb, or in the ovaries, or on the rectum. During your monthly period, these little bits of lining swell up and try to bleed. But there is nowhere for the blood to go to. So the result is intense pain.

Now, it is not true that endometriosis is incurable. However, it can't be put right overnight, as if one were treating an infection with penicillin.

Nevertheless, over a spell of months or years, it is often possible to make endometriosis much, much better, so that it causes the woman relatively little pain. Also, there is a tendency for the disease to burn itself out, so that many women find that after they reach menopause, it no longer troubles them at all.

There are various treatments now available.

Drugs called 'gonadotrophin-releasing hormone analogues';

Tablets containing the group of hormones called 'progestogens' are also helpful; these include the Pill.

Sometimes the hormone-loaded coil called 'Mirena' helps;

Surgery to remove patches of endometriosis is often possible;

Gynaecologists can use lasers or electrical instruments to 'burn off' a patch of endometriosis.

There are other treatments which are gradually coming into use. But what I feel you should do now is to consult a gynaecologist and see what he thinks is the best way forward for you. Good luck.

Q I am a 38-year-old man and I find that when I have sex, my organ gets very sore. Even though I am a man, would it be OK to use a lubricant?

A Certainly. The sex lubricants which are available from large pharmacies or on the Internet can be used by men as well as women.

However, a man who has a sore penis should have himself checked out by a doctor, just in case he has caught any infection.

Q I am a 28-year-old male who has had many sexual experiences with women. In some cases, we tried for a pregnancy, but failed.

I notice that when I ejaculate my seminal fluid is very thick, almost like a gel. Is this what has stopped me from getting any woman pregnant?

A Well, a thick gel-like appearance in the seminal fluid is not generally an indication of something wrong.

You may have no fertility problems at all. After all, it is possible that the women you have been with were secretly taking precautions because they did not really want to become pregnant by you.

Anyway, there is one simple method for settling this matter. Contact a doctor, and ask him to arrange a sperm test for you. The result will give you a good indication of whether you are fertile or not.

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