Doctor's Advice - 'Balled'

Q. This is very embarrassing, Doc, but last week during a game of football, I was kicked very hard in the testicles. I was carried off the pitch and could not stand up for half an hour. It was several days before my interest in sex returned because I was in pain, but I was able to sleep with my girlfriend yesterday. Tell me, Doc, is there any danger that a heavy blow like this could make me lose my nature, or maybe make me sterile?

A. Sorry to hear about this injury. Getting hit in the testicles is, of course, very painful for any man. Fortunately, in most cases, everything turns out OK.

However, I have seen a few guys who developed a large swelling, called a 'haematoma', as a result of such a blow. These swellings are filled with blood, and they gradually go down after a few weeks as the blood is absorbed back into the system. Also, very rarely, an injury results in a testicle getting split through the middle, much as you would split a mango. Fortunately, the split can usually be stitched up.

It sounds to me as though you are going to be fine. But if you still have pain or swelling, you should go to a doctor and have him check out your scrotum. If there is any doubt about whether you have any serious injury, he or she could arrange an ultrasound scan for you.

As it relates to the question of sex, it seems to me that you are saying that your libido (i.e. sexual desire) has returned, and that you were able to get an erection with your girlfriend. So I think it is very unlikely that your injury has done you any severe harm sex-wise.

Trauma to the testicles can occasionally interfere with sexual function, but I don't think that is at all likely in your case.

Q. I am 18. I get terrible period pain each month, Doc, and it is ruining my life. Painkillers don't help. Could this be due to cancer - as I greatly fear?

A. No. Menstrual pain is hardly ever due to cancer. And at your age, it is almost unthinkable that your pain is caused from anything cancerous. Sounds like you have tried the standard painkillers without success. So really, it is now time to consult a doctor who will either give you more powerful tablets, or perhaps hormone medication similar to the Pill. That should wipe out your menstrual pain altogether.

Q. I am a guy of 19 and I have led quite an active sex life. During the last week, I have noticed blood coming from my anus when I go to the toilet. Could this be some form of sexually transmitted infection, Doc?

A. No, it couldn't. At your age, far and away the likeliest diagnosis is piles - also known as haemorrhoids. Ask a doctor to check out your anus. He will then give you some medication that will help you.

Q. I am a female university student age 21, and to be frank with you, Doctor, I am enjoying a vigorous sex life, but I don't want to get pregnant! So which method of contraception would be best for me?

A. Well, I hope you are practising safe sex. These are a lot of STIs around these days. You should seriously consider using condoms - male or female - which considerably reduce the chances of getting an infection.

Other methods of birth control do not prevent infections, but they do work very well in preventing an unwanted pregnancy. At your age, the main possibilities are:

• The Pill - almost 100 per cent effective if you don't forget to take them.
• The mini-Pill - milder than the Pill, so it has a slightly higher failure rate;
• The shot (the Jab) - again, almost 100 per cent effective, provided you turn up for your next jab on time!
• The coil (the IUD) - quite painful to have inserted into the womb if you have never been pregnant, but very effective.
• Mirena - a hormone-loaded IUD, which makes the menses lighter.

There are also one or two other possibilities like the contraceptive skin patch and the contraceptive implant. Any doctor can tell you more.

Q. I have been seeing a girl who was desperate to get pregnant by me. For that reason, I dumped her last week. Now, a friend has told me that she has been saying the most alarming things, Doc. Apparently, the last time we were fooling around in my car, she managed to collect some of my sperm and later put it in her vagina. Could she have got herself pregnant in this way?

A. Possible, but unlikely. Sperm does not survive for very long outside the human body unless it is stored in ideal conditions. I suspect that if this girl collected your seminal fluid then kept it in a jar, or something similar, the spermatozoa probably died. You will just have to wait and see what happens. But I doubt that she could have managed to successfully inseminate herself in this way.

Q. Last week, after having sex with a guy for the first time in my life, I got a urinary infection. My doctor put me on antibiotics. How long should I take them for, and how soon can I have sex again, Doctor?

A. The length of the course depends on what the antibiotic is. Generally, a urinary tract infection requires treatment for three to seven days. You shouldn't have sex until you are completely better and all tenderness has gone. Even then, please tell your new boyfriend to take things easy. I think it would be a good idea to insist that he washes his hands before touching you.

Q. Tell me, Doc, are there really foods which boost a person's sexual desire? My fiancée is not very keen on sex, and we want to fix this before we get married later this year. Friends have suggested that I encourage her to eat aphrodisiac foods. But what are they?

A. Well, the word aphrodisiac just means 'increasing sexual desire'. Unfortunately, there are no foods which really do this. Some people strongly believe that shellfish such as oysters and lobsters can somehow augment libido, but there is no proof of that at all. So what I would strongly suggest is that you and your fiancée go to a good psychotherapist or counsellor who can discuss with you both the reasons why she has so little interest in sex. It would be a good idea to try and get all this properly sorted out before you go ahead with the wedding. Good luck!

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