Dear Doc: Spoiling my sex life

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Sorry to hear about this. Prolapses are very common, but they can be successfully treated.

Prolapse is a condition in which the womb sags downwards. Sometimes nearby organs, like the bladder, may sag a bit too.

Your womb is roughly the size and shape of an avocado, with the narrow end pointing downwards into the top end of the vagina. Ordinarily, it is held in position by a complex 'scaffolding' of muscles and ligaments.

But if those muscles and ligaments become weakened, then the womb starts moving a little bit downwards. It may only be a few inches, but that is enough to cause problems, particularly with your sex life.

What happens is that the cervix (which is the tip of the womb) descends through the vagina. In very severe cases, the cervix may actually emerge through the opening of the vagina (the vulva), so that it can be seen outside. That is very distressing for women.

Inevitably, this descent tends to create an obstacle to intercourse. Sex may be painful, or even impossible.

The reason for this is simply childbirth. Prolapse is almost unknown in women who have never had children. But it is common in those who have. And the more children you have, the more likely you are to develop prolapse.

Mild cases can be treated with simple pelvic exercises, carried out daily over a few months. Any doctor, midwife or nurse, could show you how to do these.

Another possibility is the use of a device called a 'ring pessary'. This is a little device which you put inside the vagina, to act as a sort of 'prop' that keeps the womb up.

It stays inside for three months at a time.

However, in your case I suspect you may need surgery. So you need to consult a gynaecologist. There are various operations which a gynaecologist can do for prolapse.

They include:

Putting a sort of 'mesh' into you to support the sagging tissues;

Hysterectomy - removal of the womb

Surgical closure of the vagina - I would not recommend that in your case, since it would mean that you could no longer have sex.

So your prolapse can be fixed. And I urge you to see a gynaecologist as soon as possible. Good luck.

I am a male with a lot of problems. I used to masturbate often when I was younger. Could this affect my sexual performance and the length of my penis?

No. People still have this idea that masturbation could harm them. The medical fact is that it does not do anything 'bad' to you. So there is no way that your past masturbating habits could have affected your size or your 'sexual performance'.

I have been advised to take hormone replacement therapy. But I have heard that the ingredients in these pills are obtained from the urine of pregnant horses. I find this idea so disgusting that I cannot entertain the idea of taking those tablets.

But is this true, Doc?

There is only one brand of HRT which has anything to do with horses. It is called 'Premarin', and as the name suggests, it is made from the urine of pregnant mares. The female horses have to wear a sort of diaper, so that their urine can be collected. Hormones are then extracted from the urine and made into tablets.

But all other HRT products, including tablets, skin patches, and vaginal creams are made from synthetic sources, and not from horses.

As a very young man, I caught gonorrhoea. I have not thought about it until recently when I discovered that I was having trouble passing urine. I seem to have a very poor 'stream', and sometimes I cannot go at all.

I am only 32, so I do not think it could be prostate problems. Could it be some after-effect of the gonorrhoea?

I am afraid so. As you say, you are really too young for it to be related to your prostate. But the fact that you had gonorrhoea ('the clap') when you were very young is probably significant.

You see, that particular infection does having a nasty way of 'coming back' years after the original episode - particularly if it wasn't thoroughly treated. That is the case for both men and women.

I fear that you may have a narrowing of the urinary pipe, caused from that infection. But do not worry, it can be treated.

My advice to you it that you should see a surgeon specialising in urology (a urologist) at the University Hospital. He will be able to help you. He may have to stretch your urinary passage so that you will be able to urinate without any issue.

Doc, all my life my left nipple has been inturned. I am now 25. My boyfriend told me that there is some device that would make it stick out, instead of going inwards.

Is that correct?

Yes, it is. You are talking about a suction device called the 'Niplette'. The idea is that it sucks the nipple out, so that it takes on a more regular appearance. That should also make breastfeeding easier for you when you have children.

If you Google the word 'Niplette', you will see how you can buy one online.

Send your questions to deardoc@gleanerjm.com