Doctor's Advice - Explain a pelvic exam, please

Q. What is a pelvic examination? I have been told that I will have to do one when I go to the hospital next week, but I do not know what it is! I am only 19.  So kindly advise, Doc. I would appreciate a personal reply by email.

A. Please do not worry. A pelvic examination is no big deal. It is the same thing as a vaginal examination or as some folks call it, an internal examination.

The object of the pelvic examination is for the doctor to check out your vagina and your cervix and the organs which are nearby. The doctor does this by putting gloved fingers inside you to see if he or she can feel anything abnormal.

In addition, he or she may wish to have a look at your cervix. That is done by slipping an instrument called a speculum into the vagina. It has two parts which the doctor can spread apart so as to get a clear view of the cervix.

Now, when you go to the hospital for that pelvic examination, you will be shown into a consulting room. The doctor or the nurse should explain what is going to happen and should do his or her best to make you feel at ease. If you like, you can have a friend come in with you and sit beside you during the examination. This is called chaperoning.

You will be asked to remove everything below the waist, but you may keep your skirt on. Next, you will be requested to get up on an examination couch on which there is a fresh, clean sheet of paper. You lie on this. Most doctors will ask you to lie flat on your back, but some will suggest that you lie on your left side.

The doctor then puts gloved fingers inside and checks the vagina and the cervix and usually the ovaries as well. That procedure only takes around one minute. After that, the doctor will usually put the speculum in and take a look at the cervix. At this stage, the doctor might take a laboratory swab if there is any suspicion that you may have an infection.

To be frank, having a speculum inside you is uncomfortable, and some women dislike it a lot. But just try to relax and soon it will be all over. After you have had the pelvic examination, the doctor should tell you what he or she has found. If you have any questions about what he or she has told you, please don't hesitate to email me again. I am afraid that I cannot give personal replies by email or post, but I will try to deal with your queries in this column.

Q Doc, I have been told by a couple of the other guys at university that there is an American process called ballooning, which helps a guy's sex life. They told me that it can help a man to last longer, get harder, and possibly achieve an increase in length. Is this all true, Doctor? What exactly is ballooning?

A Many young men fret about their penises. They are willing to go through a lot of trouble, and maybe spend a lot of money, in order to improve their organ. Alas, they are usually wasting their time!

Ballooning is a technique which has become quite popular among American college men. It is claimed that it makes the organ bigger, improves stamina, and increases firmness. It is an exercise in rubbing something called 'the magic spot' in a circular fashion while contracting your pelvic muscles. You do this until you are near the point of orgasm, and then stop for a while before starting again.

You can find ballooning described in great detail on the Internet. Frankly, I can see no reason why it would make a guy larger or firmer; however, my medical opinion is that it might just possibly help a young man to get better control over his orgasms, and might, therefore, be of some use in mild cases of premature ejaculation.

Q I am female, age 22, and I have a contraceptive implant which is supposed to last for three years. In the first year, my cycle was regular and the bleeding was little spots. Now I am in the second year and my periods are really bad. They are cramping - so painfully that I feel like passing out. And there is no blood. Also, I feel like I am pregnant, Any movement makes me feel sick. Should I have the implant taken out? And is all this normal?

A. No, it is certainly not normal. The implant is a good method of contraception, and pregnancies are pretty rare among women who use it. So it is unlikely that you are pregnant. Nevertheless, I feel you should have a pregnancy test done this week - just in case.

The implant is like a little matchstick. A doctor inserts it under the woman's skin, usually on the upper part of the left arm. It contains a female hormone, and this keeps the woman from getting pregnant. As you say, the implant usually lasts for three years.

Some patients get no side effects at all. But among the common unwanted effects are:

• Headaches;
• Spots on the face;
• Weight changes;
• Increased appetite.

Very occasionally, the implant appears to cause ovarian cysts. And now and then, it is associated with period pain, which is what you are experiencing.

I feel that your various symptoms are probably not a result of the implant, but of something else that might be wrong in the lower part of your body. Therefore, I think that once you have done that pregnancy test, it is essential that you go and see a doctor in order to get a good check-up. The doctor will be able to tell you the best course of action and to advise you whether to continue with the implant. I wish you well at this difficult time.

Q Doc, I am a guy in my late teens and last night when I was fooling around with my girlfriend, she told me she thought she could feel three testicles. So I checked myself, and there does seem to be three things there. What should I do? Is this cancer?

A. Cancer is very unlikely. Very rarely, a guy is born with three testicles, but I have never seen such a case in my life. So I feel it is likely that the third swelling is something else.

The only wise course to take here is to go and see a doctor who can check out these three things and see what they are. I imagine that he will probably want to do an ultrasound scan, which gives a very clear picture of what is going on in your scrotum. Don't fret! I am sure all will be well.

Q. I am 21 and have not yet achieved simultaneous orgasm with my new boyfriend. Is this normal?

A Yes. Many couples take at least two years to achieve simultaneous climax.

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