DOCTOR'S ADVICE - Not so mature

• Not so mature

Q. I am male, 23 years old, and having a problem concerning my body. This is so frustrating and embarrassing. You see, Doc, I don't think that I have gone through puberty, and I wonder if it's ever going to happen. My penis has not increased in size, and my testicles are small. I only have a little bit of hair in the pubic region and under my arms, and there is very little on the face. I look mature, but really, I am not. Otherwise, I am healthy. Doc, I wonder if something is wrong with my hormones, or is it my testosterone?

A: Testosterone is a hormone. Indeed, it is the male sex hormone, and I am afraid that you may be seriously lacking in it. The combination of small genitals and lack of body and facial hair makes this likely.

I am sorry to hear about your troubles. Seems like you are suffering from a case of 'delayed puberty'. You should have gone through puberty at the age of 13 or 14, but for some reason, that just did not happen.  You don't say whether you have any sexual desire or get erections. However, I suspect that unless you have treatment, it is unlikely that you can become a babyfather.

What you should do urgently is to get a doctor to refer you to an endocrinologist at the University Hospital of the West Indies. An endocrinologist is a gland specialist. He will check you over and do blood tests that will reveal the level of your testosterone and other hormones.  I have high hopes that after that, you can be treated with hormones pills, skin patches, or injections. These should help you to reach sexual maturity. I wish you the very best of luck.

• What is a Mirena?

Q. I am female, 19, and lead a vigorous sex life with two boyfriends in different towns. The menses are not good and are very heavy. My doctor is concerned about me and wants to fit me with something called Mirena. But what is that, please?

A: First, may I say that you are walking a slightly dangerous path by having two boyfriends, even if they are in different towns.

Mirena is a very good method of contraception. It is a sort of coil to which a female-type hormone has been added. The hormone, which is called levo-norgestrel, gives you a high degree of protection against pregnancy, though not as good as the Pill does. Also, it is very effective against heavy menses, making them much lighter and more manageable. So I think you should go ahead.

• Obsessed with anal sex

Q. I am a male in my early 20s and completely straight, but recently, I have become obsessed with performing anal sex on my girlfriend. She gets furious when I ask her. Is something wrong with me?

A: Well, I don't think you are gay if you are secretly wondering about that. Unfortunately, a lot of young men do get this idea that they want to sodomise their girlfriends. The reasons why they have this desire include the following:

• They have seen this activity so often in porn movies that they wrongly think it's quite normal;
• They are aware of the fact that the anus is tighter than the vagina, and they imagine that it will give them more pleasure (which is unlikely);
• In some cases, they subconsciously want to degrade women.

You had better decide which of these alternatives apply to you. As for your girlfriend, I am not surprised that she is furious!  Most younger women find this activity to be intensely painful, and quite a few think that it is distasteful or repugnant.  I must admit that some females don't mind rectal intercourse, but they tend to be older ladies whose muscles are relaxed and who have tried it before and got used to it. My advice: Stop bothering your poor girlfriend with your rather self-centred desires.

• When is her safe zone?

Q. My girlfriend has a 28-day cycle. On what days could we safely have sex without any risk whatsoever of pregnancy, Doc?

A: It's possible to become pregnant on any day of the cycle, but for a young woman whose menses are dead regular and 28 days apart, there is a much reduced risk if you steer clear of the time between Day Eight and 17 of the cycle, counting the first day of the period as Day One. That last bit is most important: Always count from the first day of the menses - not the last.

If you two really want to use this rhythm method, it would be much safer if you talked with a nurse or doctor who could give you more precise instructions.

There are various pointers which make it clear when the girl's 'safe time' is. For instance:

• The young lady's vaginal secretions have a different consistency at varying times of the month;
• Her body temperature changes slightly at the time of ovulation;
• A chemical-based ovulation test can pinpoint the day of egg release.

Summing up, I don't think that any young couple should risk using 'Rhythm and Blues' without expert help.

• Are Fordyce spots serious?

Q. Doc, I was fretting about the appearance of my penis. I went to see a female doctor, and she told me I just had 'Fordyce spots'. Is that serious?

A: No, thousands of young men have Fordyce spots. These are very tiny yellowish or white accumulations of sebaceous (that is, oily) fluid which occur on the shaft or head of the male organ. They can also often be found around the mouth. Fordyce spots are totally harmless, and it is not worth bothering to try to remove them.

• Forget the Postinor-2?

Q. Doctor, I had sex with my fiancé, and I forgot to take the Postinor-2 drug that day, so I took it the next morning. Will it still work?

A: Very probably it will. Postinor-2 ideally should be taken within 24 hours of unprotected sex. If you take it as promptly as that, the medication will prevent 85 per cent of pregnancies.  But it can actually be taken as late as three days after sex. However, that would make the failure rate higher. Why don't you and your fiancé pick a regular method of contraception like the condom, the Pill, or the Mini-Pill?

• Am I there?

Q. I have had no other partners but my present girlfriend. I am very concerned because I feel that when having sex with her, I am not really penetrating to the far end of her vagina. Is this possible?

A: Well, the vagina is only four inches long when it is in a relaxed state. Admittedly, it lengthens during intercourse, but I think it is unlikely that you are not reaching to the far end.

Are you really saying that you suspect your penis is too small? If so, then you should go and have it checked out by a doctor. Take with you a photo of your erection, taken on your mobile phone, and show it to him. Before snapping the picture, you should put a ruler next to your organ so that the doctor can see the exact length.

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