Doctor's Advice - How do I slow my daughter down?

Q. Doc, it has been suggested that my teenage daughter should go on the contraceptive jab. In some ways, this would be a relief to me, because the plain fact is that she is a girl who can't seem to stop herself from having sex. I have tried to bring her up to be good, but it seems like I have failed.

I know for a fact that she went to bed with three different guys last month, and I feel that it can only be a matter of time before she gets pregnant. I have repeatedly warned her about this, but she just pays me no mind.

She is supposed to be on the Pill, but she is not very good at taking it. Sometimes I find the pack lying around, and I can see where she has missed three or four days at a time.

So my own doctor has suggested that he could put her on 'the jab'. I have talked to her about it, and she is willing. But she is a girl who knows a lot about various scientific things, and she told me that the injection can have side effects. She said that it can affect the menses adversely.

But what she is really fretting about, Doc, is the fact that the shot can alter a girl's bones in some bad way.

So what is the truth, Doc? Is it safe for her to take this injection? Does it harm the bones?

A. Well, your daughter is obviously an intelligent young woman, and it is a pity that she is risking her health by sleeping around. If she continues like this, then she will almost certainly catch something before very long.

I must tell you that teenage girls who behave like this often do it because they are lacking in self-esteem. And they think that if guys want to go to bed with them, that will at least prove that they are desirable and sexy.

So, before we move on to the subject of the jab, I would strongly suggest that you try and get your daughter to see a good youth counsellor. The counsellor may be able to help her to see that she does not have to go to bed with men in order to prove that she is a worthwhile human being.

Now, as it relates to 'the shot', this is certainly a very good method of contraception. If your daughter takes this injection, it is virtually 100 per cent certain that she will not get pregnant during the next three months. And all she has to do is to remember to turn up at the doctor's office for the next jab, in 12 weeks' time.

But what about the effect of the jab on the menses? Well, at least 40 per cent of young women who go on the injection will have altered periods over the next few months. The possible menstrual effects can be as follows:

Some women lose their periods completely for several cycles; but most of them are quite glad about that.

Other women have heavy menstruation, and that can be a nuisance;

Others have irregular periods for a while - though it can be treated by medication.

Now what about this business of the bones? Well, your daughter is quite right. There are concerns about the long-term effect which the drug might have on the female bone structure.

You are probably aware that a great many women develop brittle bones as they get older. That is why so many ladies who are aged over 50 suffer broken wrists or broken hips. Their skeletons have become so thin that the bones fracture easily.

Regrettably, it does appear that the contraceptive injection causes some thinning of a young woman's bones. Very rarely, fractures occur as a result of this. But we do not yet know whether this bone-thinning will continue throughout life, and make the person liable to dangerous breaks when she is older.

At the moment, it seems unlikely that the jab will have serious long-term effects on a girl's bones. But many doctors think that teenage girls should just use it for a couple of years, after which the situation can be reviewed.

Summing up, I think it would be perfectly reasonable for your daughter to use the injection for a while. But it is also important that she tries to avoid sleeping around.

Getting back on track

Q I am a 19-year-old young lady who has missed her last three periods. What can I do to get back a regular cycle?

A The first thing to do is to find out why you missed your last three menses.

Are you pregnant? If you have been with any guy in the last four months or so, you should immediately do a pregnancy test.

If it turns out that you are not pregnant, then you must consult a doctor for a good check-up. She may well find some important reasons why you are missing your menses - for instance, a hormone problem or anaemia or stress.

She can then give you treatment to put the problem right. It could be that she suggests you take some regular hormone treatment to make the menses arrive on time.

Worried about organ

Q Doctor, I am very worried by the appearance of my penis. I am 17. Recently, I have noticed that it is not like the penises of other guys.

Of course, I have not seen them erect. But when mine is erect, the head of it bends right forward, so it is pointing towards the ground. Also, my foreskin does not go back well.

What is wrong with me, Doctor? Please ease my concerns.

A There is a little string on the side of the organ which is further away from the guy's belly when he is erect. This string is called the fraenum or fraenulum.

In some young guys, the fraenum is a little too short (a condition called fraenum breve), and this pulls the head of the penis forward. I suspect that this is what is happening in your case. If so, you would need to take a very minor operation, in order to release the fraenum.

What you should do now is to consult a doctor who will examine your organ. Of course, he cannot see it when it is erect. Therefore, you should show him a close-up photo of your erection, taken with your mobile phone. I am sure he will be able to give you good advice.

When will she be due?

Q Last month, I got my girlfriend pregnant. Both of us are very pleased about this, as we had been trying for two years.

But how do we know when the baby will be due, Doc?

A Just take the date of the start of her last menstrual period then add nine months and one week to that.

A midwife could give you a more accurate estimate, but generally, the 'nine months and one week' rule, works pretty well.

Treating the discharge

Q I am constantly having this thick, white, heavy vaginal discharge. Should I use vinegar douche to treat it, Doc?

A No. Vinegar is an old remedy, intended to make the vagina more acid. It would be better to go to the doctor and ask her to send some swabs to the lab, to find out what is causing this incessant discharge.

Creatures in bedroom

Q Doctor, I am female aged 19 and I have a new boyfriend. Sometimes he is a little strange.

The most puzzling thing about him is this. When we go to bed together, he wants to bring animals into the bedroom. For instance, last week, he took a small kitten into bed with us, and wanted it to walk across my breasts while he had sex with me.

He has plans for bringing other creatures in, too. What do you think, Doc? Should I agree?

A This boy is indeed strange. In fact, as it relates to sex, I feel he could be slightly crazy.

He may well need therapy, but it is not your job to arrange that.

If he goes on introducing animals into your sex life, who knows what may happen next? He might want to bring in dogs or galliwasps or even insects - like (say) roaches!

I feel you can do a lot better than this guy. Frankly, I feel you should tell him goodbye. Eventually, you can find someone else. There are plenty of nice, sane young men around.

Could sex toy infect me?

Q I am a guy who was recently seduced by an older woman. What is concerning me Doc, is that she used sex toys on me. That was a bit of a surprise, though I must admit that I did enjoy it.

But could these vibrator things have given me any kind of sex infection?

A Vibrators and other sex toys can carry germs, but not if they are carefully washed after use. I imagine that this lady took care to keep her toys clean, so you should be OK.

However, if you notice any symptoms, like pain on passing urine or a discharge, you should check with a doctor.

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