DOCTOR'S ADVICE - My wife's orgasms

A: No, I do not. I suppose there is a remote chance that your wife's new-found interest in sex has been 'triggered' by a mysterious boyfriend. But you really have no evidence of that at all. I feel that it is most likely that she is relaxed and happy with you - and that you are doing a good job in sexually satisfying her.

I need you to understand the fact that quite a lot of married women do become more enthusiastic about sex as the years go by. I have often seen wives who learned to have a true orgasm for the first time when they are their 30s or 40s. Some of them subsequently became multi-orgasmic. So I think you should 'pat yourself on the back', and take pride in the fact that you are obviously making your wife very happy.

Q: Good day, Doctor. I am a successful businesswoman, and I suppose I lead a pretty sophisticated lifestyle, travelling the world. Most people would think that I knew all about men and sex! But in reality, I don't have a lot of knowledge about sexual matters. Well, I have met a very exciting American man, and it seems like a long-term relationship is 'in the air' - maybe even marriage. But for the first time in my life, I really do need to find a good contraceptive.

However, there is one problem - I have absolutely no idea about what birth control methods are available for women. I do have a gynaecologist in Philadelphia, so I suppose I could ask him. But if you could just tell me what the options are, that would be a great help.

A: These days there are many possible methods of contraception available for women.

So there you have 11 different 'female' methods of contraceptive. I have not listed sterilisation because it is a permanent thing. Also, please bear in mind that your partner could use male condoms. I wish you well in your new relationship.

Q: I am a little worried about my husband's breasts. They are slightly swollen. He is 30 years old. I have read on the Internet that slight swelling around the nipples is quite common in men. But in his case, he is actually producing white milk from the both the nipples. It is just a few drops at a time, but it is definitely there. Do you think he has some form of male breast cancer?

A : No. Cancer of the breast does occasionally occur in males, but it is unlikely to affect both breasts.

However, if a male starts producing milk that can be a serious sign. It suggests that his body is producing far too much of a hormone called 'prolactin'. It is one which stimulates milk-production. Prolactin comes from a tiny gland called the pituitary, which is located at the base of the brain. When a person has too much of it, that is called 'hyperprolactinaemia'.

And hyperprolactinaemia is often due to a swelling which is developing in the pituitary gland. If necessary, that swelling can be removed by a surgeon. Alternatively, it is possible to have medication. Your husband must be seen by a gland specialist (an endocrinologist) as soon as possible. He must not delay.

Q: My daughter's menses have stopped altogether. She is training hard as an athlete, and her coach thinks it could be due to this. Is that possible, Doctor?

A: Yes. Arduous and prolonged training can temporarily abolish periods in young women. But your daughter should check with a doctor to make sure that this is the real cause of the absent of her menstrual cycle.

Q: Doctor, I am a man who is engaged to be married, and I love my fiancée. But I seem to have got myself in the grip of some kind of 'porn addiction'. In fact, every single day I spend at least four-five hours gazing at the many 'adult' websites on the Internet. I do not know why I am acting like this. I just keep on wanting to see pretty girls having sex.

A: This is one of the most common problem of today. An extraordinary number of men have 'Internet sex addiction'. You must do something to break this habit because otherwise you may ruin your relationship with your fiancée.

You do not say whether you are having sex with her. If you are, then you should try and concentrate on her sexual charms, rather than on those of the young women on the Web.

Most importantly, you should find yourself a therapist and spend a few sessions discussing this sex addiction with him/her. And I would strongly suggest that until you have seen the therapist, you should disconnect your computer completely, so that you are unable to watch these acts.

Q: Doctor what is the best treatment for period pain?

A: Generally speaking, it is a good idea to begin with either paracetamol ( aka acetaminophen), or aspirin. Please note that aspirin should never be taken on an empty stomach because it can irritate the stomach.

If those medications are not sufficient, you should try one of the 'anti-rheumatic' painkillers, such as ibuprofen or indomethacin. All of them can cause stomach pains, so again they must not be taken on an empty stomach. Have something to eat first.

But if those simple measures fail, then it is time to consult a doctor about your menstrual pain. She can give you stronger painkiller. She can also give you some hormone treatments, which often eradicate the pain altogether. Sometimes the Pill is used for this purpose.

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