How does the Pill work?

Should I take the Pill?

I am thinking of going on the Pill, Doc, but I do not understand how it works. Please advise. Do you have to take a break each month? I am 19.

A: The Pill contains two female-type hormones. The effect is to fool the ovaries into behaving as if the woman was pregnant. As a result, the ovaries do not release an ovum (egg).

Therefore, as long as you do not miss any of the pills, it is most unlikely that you will get pregnant. But please note that if you start forgetting to take the tablets, particularly towards the end of a pack, there is a real danger that the ovaries will suddenly 'wake up' and release an egg.

If that happens near to a time when you have had sex, there is a high chance of conception. Moral: do not miss any pills!

As it relates to the 'break', with most brands of the Pill, you take the tablets for 21 days and then have a pill-free week. You are protected during that little break. During those seven days, you should find that you have a fairly short, light, and pain-free period.

Email me again if there is anything that you do not understand.

Is my girlfriend pregnant?

Hello, Doc. Yesterday morning, I had sex with my girlfriend. Two hours later, she threw up. Does this mean she is pregnant?

A: I think you have got a little muddled here. Admittedly, pregnant women do often vomit. It frequently happens in the morning, and that is why people talk about morning sickness.

But morning sickness does not occur till around the sixth week of pregnancy! It certainly doesn't happen two hours after being impregnated.

However, you and your young lady are obviously taking very serious risks. If she doesn't become pregnant this month, she will become so very soon. So I urge you to go out and buy yourself some condoms. Please use them every time you have intercourse with her.

Coil queries

I am planning to get married next year, but my fiancé and I don't want to conceive a child before then, so we are thinking of using that 'coil' thing. I have looked at some pictures of it, but I cannot work out two problems: 1. How big is it? I would hate to have something huge inside my womb. 2. We can see that there is a 'tail' hanging down into the vagina. But doesn't this interfere with intercourse?

A: The coil (intra-uterine device, or IUD) is a good method and is almost as reliable as the Pill. Also, once it is in, you don't have to think about taking tablets every day!

But if you have never been pregnant, the insertion of the device by a doctor or nurse can be quite painful. However, once that initial pain is over, most women are pleased to know that they are protected by the coil.

The chief drawback of the IUD is that it tends to make the menses heavier and lon-ger. But a lot of women don't mind that. Now, let me answer your two questions.

1. The coil is about the length of a matchstick, which is much smaller than many people imagine. You can easily hold one in the palm of your hand.

2. The thread which dangles down into the vagina is very thin and short. Most men cannot detect it, but some guys get a tickling feeling, which they usually like. Just occasionally, the end of a thread is a little sharp, and that may give the male a jabbing sensation in the tip of his penis. When that happens, it is easy for the doctor to trim the thread back a little.

Hope this advice helps you and your fiancé.

Is masturbation the cause of my pain?

I'm a guy 20 years old. I often masturbate twice a day. Could this be the cause of the pain in my gonads?

A: I presume you mean your testicles. There is no way that masturbation can give you any kind of pain anywhere.

In young men, the commonest cause of pain in the testicles is sexual frustration. In other words, if you get sexually excited but don't climax, the testicles can become congested and tender. This is is known medically as orchitis amorosa.

It's most unlikely that you have anything physically wrong with you, but if the pain continues, have a doctor check out your genitals.

Will pre-come make me pregnant?

I had first-time sex with my boyfriend yesterday. It was unprotected sex, but he pulled out before he penetrated my vagina. What's worrying me is that he might have left some 'pre-come' there. Could this make me pregnant? I took Postinor-2 around 16 hours later and another one 12 hours after that.

A: OK, you acted pretty promptly in taking the post-coital pill. That makes it fairly unlikely that you will turn out to be pregnant.

I am not sure what you mean by saying that he pulled out before he penetrated the vagina. I am guessing you mean that he only went in a little bit.

Be that as it may, it is perfectly possible that he left some pre-ejaculate ('pre-come') inside you. Now, can this liquid make a girl pregnant?

There has been much debate about this among scientists in recent years. For decades, doctors believed that it contained sperm, but about 10 years ago, some researchers reported that they couldn't find any spermatozoa in pre-ejaculate.

However, two years back, this view was challenged when an American-British team announced that it had found sperm in the 'pre-come' of some men, but not in the fluid of others.

In light of that finding, my advice to young couples is to assume that pre-ejaculate is potentially 'dangerous' and not to take any risks with it! In your case, I very much hope that you will embark on some reliable form of contraception before you allow your boyfriend any further favours.

I wish you well.

Nine-day wonder

My menses arrive every 28 days and last nine days each time. Is this too long?

A: Yes, nine days really is too long. It must be rather inconvenient for you. Also, the fact is that you must be losing a great deal of iron each month. So if something isn't done to shorten your period, you will probably get anaemic.

You should, therefore, see a doctor fairly soon.

Cheesy stuff alarm

Good day. I'm a 19-year-old guy with not much experience of sex. Recently, I have been alarmed to see some white, cheesy stuff appearing under my foreskin. It is particularly on the side nearer to me when I am erect. Is this serious, Doc? Have I caught anything bad?

A: No, you haven't. This white stuff is called smegma. All young men produce a little of it. It is secreted by tiny glands located just below the head of the organ.

It does contain some germs, and for hygiene reasons, it should be washed away each day when you are in the shower. But there is no need to fret about it.

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

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