Doctor's Advice:Is smoking killing my sex life?

Q: Is it true that smoking can eventually ruin a person's sex life as I have heard?

A: There is now no doubt that in the long term, smoking can be very bad for a guy's sex life and make him lose his nature. This is because of the disastrous effect that nicotine has on the arteries, that is, the tubes which supply blood to the penis. They get 'furred up' so that it becomes difficult for the blood to travel through them. And that makes it difficult to get good erections.

At the moment, not much research has been done on the effect of smoking on women's sex lives. But the probability is that cigarettes must also affect the arteries which supply blood to the female genitals. And it seems quite likely that this could have a bad effect on a woman's sexual functions.

Pimples or STI?

Q: Hi, Doc. Every month before my menses, I get one painful pimple on my labia, and another on my lip. This has been happening like clockwork for years. Is it normal, or do I have a sexually transmitted infection (STI)?

A: Well, it certainly isn't normal to have spots on your private parts and on your lip each month. I don't think that this is an STI.

However, there is just a chance that what you are describing is herpes, which often does flare up at the time of the menses. But herpes causes blisters, and what you are describing doesn't really sound like that.

There is only one way to sort this out. At your next period, when, presumably, you will again have the pimple on the vulva, plus the thing on your lip, you must go and consult a doctor, who will will inspect these two lesions and tell you exactly what the problem is.

My guess is that you have a minor problem like a small infection in a hair follicle near the vaginal opening. If so, it will be easy to treat.

Will rape affect my life?

Q: I am a guy of 19, and to my embarrassment, I have to say that I was raped by some men who carried a gun. That was when I was 16. I still have regular nightmares about it. Will this affect my sex life, Doc? I have a girlfriend, and at the moment everything seems to be going OK in bed.

A: Then I think your sex life will probably be all right. But when a guy is raped by another male, this often has a very bad effect on his mind, lasting for years afterwards. I guess that is why you are having these frequent nightmares.

One of the commonest effects of male rape is that the victim gets the idea that the attack was somehow his own fault. If you have any ideas like that, try to dismiss them from your mind.

Also, victims sometimes think that being raped means that they are subconsciously homosexual. Again, that is a false assumption.

In view of the fact that you keep getting these bad nightmares, I feel that you should see a youth counsellor or therapist and talk the matter over with that person. You may need quite a few sessions.

Finally, there is an outside chance that this violent episode might have given you an STI, or even just possibly HIV. I hope that has not happened, but maybe you should also see a doctor and do some blood tests. Good luck!

13-year itch

Q: I am 23 years old, and I have a vaginal infection, which doesn't smell, but itches a lot. I have had it for the last 13 years non-stop. I have been to many doctors, and all of them say that I have a yeast infection. They all gave me Canesten inserts and cream, but this doesn't help me one bit. What is wrong with me? And won't this infection go away?

A: I am very sorry to hear that you have had such a bad time, apparently since the age of 10.

If this problem has repeatedly failed to respond to Canesten, then I do not think it can be a yeast infection. There are other causes of itching of the vagina and vulva. Very importantly, one of them is allergy to Canesten, which gives some girls intense soreness and itching.

I am slightly puzzled by the fact that you do not mention any discharge. Most vaginal infections, including yeast problems, do cause an obvious discharge. However, allergies don't usually cause this symptom.

I really think that what you need to do now is to see a gynaecologist, who will examine you, and send swabs to the lab for testing. A diagnosis will then be made, and with luck can get you cured.

Please don't have sex till you have seen the gynaecologist.

How can she be pregnant?

Q: A girl in St James has told me that I am the father of her baby, which is expected sometime in the spring of 2013. Doc, I admit I had a little sex with her at a party. But I was only inside her for a couple of minutes, and I did not discharge. So how can I be the father?

A:This is a surprisingly common situation. Please consider these possibilities:

1. You may have leaked some sperm inside her;

2. You may actually have had a small orgasm - and not noticed it - which occasionally happens in young guys;

3. You may have climaxed, but have conveniently forgotten about it, especially if you had been drinking.

But she claims that you are the babyfather, and people may well believe her. So your best course is to ask for DNA testing to be done after the baby has been born. That should establish with absolute certainty whether you are responsible for this pregnancy.

Do I have an infection?

Q: Last Saturday, for the first time in my life, I let a boy have sex with me. Now I find that I am rushing to the toilet to pass urine. And it hurts me when I pass water. Is this a sexual infection, Doc?

A:It's probable that you just have cystitis, which is an inflammation of the bladder. It is common in young women, particularly after their first sexual experiences. That is why it used to be known as honeymoon cystitis.

However, I must be frank and say that there is a chance that you have an STI, especially as the bug called chlamydia is so common these days.

I suggest you buy a course of anti-cystitis medication from a pharmacy. But if that does not clear up your symptoms within five days, then you must see a doctor. Take with you a sample of your urine in a sterile container.

No germs in urine

Q: I am a guy of 16. Last week, a female relative was staying at our home, and she left a drop of her urine on the toilet seat. Doc, I accidentally touched it. Could this give me the clap or anything like that?

A: Relax. Contrary to what many people think, urine is usually sterile. That means it normally contains no germs.

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