DOCTOR'S ADVICE - Guilty husband

Q Doctor, late last year while my wife was away I did something very stupid. I had a brief affair with a woman who is an old school friend. I visited her several afternoons and we had sex. It was great while it lasted, but now she has brought our relationship to a close. Deep inside, I am glad about that because I felt bad. And now I am left with a deep sense of guilt about what I did. I have become very depressed. These feelings have become worse lately because recently my wife has been ill. So I feel that I want to get it all 'off my chest'. Please advise me. Would I feel better if I told my wife about this affair?

A Well, you might feel better. But your wife certainly would not. I appreciate that you want to get things off your chest, and you have made a start by writing to me. But please do not do this to your poor wife, who could become very upset by hearing of your sexual liaison.

As you want to 'make a clean breast of it', I strongly suggest that you talk to either a minister of religion or a relationship therapist. Spilling the beans about the whole affair would certainly help you.

It also sounds that became you have become so depressed, you should see a doctor and give him a very honest account of what has been going on in your life. He may or may not advise that you go on antidepressant medication for a short time. But please do not burden your wife with the knowledge of your affair - especially as she is ill.

Q My husband recently started having trouble getting a good erection. This is very frustrating for both of us. So I have suggested that he take Viagra. But he is afraid because he suffers from high blood pressure. Is he right in thinking that the Viagra would make this worse?

A. No, he is wrong. In the early days of Viagra, doctors were quite concerned that it might increase blood pressure. However, we now know that Viagra actually lowers the blood pressure and generally that is a good thing for men with hypertension.

However, there are circumstances when a man is already on blood pressure medication and the addition of Viagra makes it lower - so that he feels faint. Any man who is on a medication for hypertension should ask his doctor before deciding to take Viagra. But your husband has no need to worry.

However, a word of caution is that Viagra does interact with some other medications. And sometimes, the interaction can be serious! In particular, Viagra can interact dangerously with certain pills which are given for chest pain or angina.

So, a man who is already on medical treatment should consult his doctor before starting the use of Viagra. Also, sickle-cell disease can cause problems with this drug. I strongly recommend that all men who are have erectile problems should first get a good check-up. That is because there is often an underlying reason for the erectile dysfunction. And it might be possible for the doctor to put that right.

Q I have been engaged to my fiancé for six months, and during that time he seems to have been faithful to me. But yesterday, I came home early, and found him on the Internet looking at naked women wrestling! Does this indicate that he is some sort of pervert?

A One of the big problems of our age is that so many men spend a lot of time looking at pornography on the Internet - and very often, their partners resent it.

There are many types of pornography available, at the click of a mouse. Programmes in which nude women are wrestling are very popular in America, and with some men in Jamaica.

I would not describe your fiancé as a pervert, but it may be that his ideas about sex do not really fit very well with yours. So I feel that you should have a long and very serious talk with him before you agree to go ahead with your marriage.

Q When I have sex with my husband, I have some difficulty having an orgasm. But I can do it if I fantasise about various forms of sexual activity. Am I abnormal?

A No. A survey in the United States has shown that around 57 per cent of wives sometimes fantasise during sex with their husbands. Studies have shown that the common topics for these fantasies include:

• Having sex with a film star;
  
• Having sex with an attractive male friend;
  
• Having sex with another woman;
  
• Having sex in some exotic place.

There are two dangers connected with these sex fantasies:

1. You must be careful not to try making your fantasies reality. In other words, you should not write to the celebrity offering sex nor should you have sex with your handsome neighbour! That could lead to problems.

2. You should try to avoid using the same fantasy every time. People who do that can become 'hooked' on the fantasy, and they may eventually find that they cannot achieve an orgasm without that fantasy.

Q My wife is 33 years old and has recently become diabetic. Since then, we have noticed that during sex, she has not been producing as much lubrication as she used to. Is this due to the diabetes?

A There is evidence that some diabetic women produce less vaginal fluid. What may help is for your wife to ensure that she maintains and controls her blood sugar. Her doctor could advise her on this.

The doctor could also do a vaginal examination to make sure that all is well. He/she may advise your wife that the best thing to do is to use artificial lubricants. If your local pharmacy does not stock these, they are easily obtainable on the Internet.

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