I can't discharge inside her

Q: Hello Doc. I am a guy of 21, and my fiancée is 22. I love her very much. We are hoping to get married soon. But there is one problem. When we have sex, I just cannot discharge inside her. She is not happy about that. She keeps on saying: "But how are we going to have children?" At other times, Doc, I am OK. I can masturbate without difficulty, and that will always give me an orgasm. And sometimes when we are fooling around, she makes me climax with her hands. But when it comes to full sex - in other words intercourse - I can try and try for an hour. But still there is no orgasm. What is wrong with me Doc? Please help.

A: I am assuming that you are not on any drugs which might prevent orgasm. There are several chemical agents, both legal and illegal, which can do this.

But if you are not taking any drugs, then it is clear that you are suffering from a well-known male disorder called delayed ejaculation (DE). It used to be called ejaculatory incompetence or EI.

To be frank with you, this is a psychological condition. You may have guessed this yourself because of the fact that you can orgasm when you are outside the vagina - but not when you are inside it.

Guys who have DE tend to be very restrained and controlled in personality. They find it really hard to let go, especially when other people are around.

So that is why you cannot discharge inside your fiancée. Your best move now would be to find yourself a counsellor or therapist who knows about sexual matters and have some psychotherapy sessions with him or her.

The counsellor will try to help you relax more so that you can let yourself go in sexual situations. To be honest, that may not be easy. You will really have to work at it!

Finally, let me deal with the question of having children. Your fiancée is quite right in being concerned about this because at the moment, you simply cannot become a babyfather.

However, experts in the United States of America and in France have worked out a method whereby a guy who has DE can reach a climax through masturbation or petting, after which his sperm is inseminated into the lady, so as to make her conceive.

But maybe you won't have to do that as long as you can find a therapist or counsellor who can help you defeat the DE. Good luck!

Q: I am a little concerned about my brother, who does not seem to have reached puberty yet. He is 14 and a half. What are the changes which take place in the body to indicate that puberty is occurring?

A: Are you sure it is your brother you are enquiring about and not you? Anyway, I am glad to try and help. Guys vary in the order in which physical changes occur in the body when they are in their early teens. But most often, the chronological order in which these alterations happen is as follows:

1. Testicular volume increases, though the guy may not notice this;

2. The penis starts to lengthen and thicken;

3. Pubic hair begins to arrive;

4. The young man's height starts to increase fairly rapidly;

5. Hair develops in the armpits and on the face;

6. The voice gets deeper.

And somewhere in the middle of all this, the young guy usually starts to develop a passionate interest in girls. He begins to get a lot of erections, and then he suddenly gains the capacity to reach orgasm and to produce seminal fluid.

If these changes are not obviously under way by the age of 15, it is a good idea to consult a doctor.

Q: My menses have become very painful in the last two to three years. But I have noticed where having an orgasm actually eases the agony for me. Is this abnormal, Doc?

A: No, not at all. It has been known for many years that orgasms can ease period pain. However, I think that as you describe your own pain as agony, it is definitely time that you went to see a doctor.

Q: I am a female university student, and last week I did something rather unwise and gave another student oral-sex relief. A friend of mine has told me that this means that I will probably get cancer of the throat. Is that true, doctor?

A: No. However, I should make it clear that recent medical research has shown that oral sex does sometimes lead to transmission of the Human Papilloma Virus. This is a cancer-inducing virus, and it does seem that it may be linked to a recent increase in cancers of the head and neck among middle-aged people in Western countries.

Nevertheless, I do not think that one episode of giving someone oral relief is at all likely to give you cancer in later life. But you should avoid any kind of promiscuous oral sex.

Q: I gave my virginity to a boy in Mandeville last week. Now I have pain and discomfort in passing urine and have to keep rushing to get to the toilet in time to pass it. Is this a sexually transmitted infection Doc?

A: No, it is not. Sounds like you just have cystitis, which is very common in young women soon after they become sexually active. It is an inflammation of the bladder, and often of the tube leading out of it.

You should now collect a specimen of your urine - preferably in a sterile container - and take it to a doctor for testing. If necessary, you will be treated with antibiotics.

Q: I am a little worried about my daughter, age 11, who has just had some blood loss that looked very much like a period. Is that possible, doctor? I did not reach puberty till 14 or 15. So I cannot understand how a girl could get there at 11.

A: Scientists say that the age of puberty in girls is getting lower. Statistics suggest that it is dropping by about four months in every decade. So the average age is now thought to be about 12 and a half.

Therefore, it would not be at all surprising if your daughter started her menses at age 11. She may well have another period soon.

So you must tell her all about menstruation, and about the changes that are about to take place in her body. I think you should also advise her about the risks of sex.

Q: Doctor, I am real embarrassed to say that I am a guy who has absolutely no interest in girls. I am 20, and all I think about is handsome men. I dream about them. And although when I masturbate I try to think about women, it is images of male film stars that arrive in my mind. Be frank, Doc, am I gay?

A: I think it is extremely likely that you are. So I suggest that you see a youth counsellor and have a long chat about your feelings.

Email questions to Doc at saturdaylife@gleanerjm.com and read more in the Outlook Magazine tomorrow.