DOCTOR'S ADVICE - How did I get gonorrhoea?

• How did I get gonorrhoea?

Q Doctor, I am a troubled man. I have been married to my wife for over 11 years, during which time I have been totally faithful to her. Honestly, I have never even looked at another woman.

But two months ago, I suddenly started feeling some pain while urinating. Shortly after that, I developed a slight whitish or greyish discharge from my penis. That really scared me, Doc. But I did not tell my wife.  But as a precaution, I did not have sex with her, and have not done so for around eight weeks now.

Eventually, I went to a clinic, saw a doctor and did some tests. To my horror, he told me that I had gonorrhoea. He gave me some antibiotic treatment right away, and that has stopped my symptoms.

But what is making me worry, Doctor, is where did I get gonorrhoea? I have not had sex with anyone but my wife. I have never slept with another woman, not even once!  The second possibility that occurred to me is that maybe I could have picked up the germ from some toilet seat. I have heard men talk about that. But is it really possible? Or could I have caught it while swimming in the sea or in a pool?

Seeing that I have not been with anyone except my wife, could that mean that she has had an affair and caught the germ - and then passed it on to me? I am at my wit's end, Doc. I don't know what to do. Please advise me.

A This must be terrible for you. Well, let us look at the possibilities which you have raised.

(a) Could you have caught it from a toilet seat? That is the traditional excuse many people have used after catching VD. But it would be very difficult to get 'the clap' from a toilet seat. Personally, I have never seen such a case.

(b) Could you have caught it while swimming? No, that is impossible.

(c) Did your wife have an affair, and catch gonorrhoea from her lover? Sadly, that has to be, by far, the likeliest answer.

But there is one other slight possibility, and it is that somehow, the doctor or the lab made a mistake and perhaps mixed up your specimen with somebody else's. But that really does not strike me as very probable. Unfortunately, there is no point in my advising you to have further tests, because now you have the antibiotics, so doing more tests would be of no value.

My advice to you is to tell your wife what has happened and have a frank and thorough talk with her. That will not be easy. Prepare yourself for the fact that she might accuse you of adultery!  On the other hand, she might frankly admit to you that she has been playing around. If she makes such a revelation, please keep calm.

From a medical viewpoint, what is certain is that your wife must have a series of tests as well for various types of sexually transmitted diseases, especially gonorrhoea. She may initially be reluctant to do this, especially if she has no vaginal or urinary symptoms. But please tell her that the tests are essential, for her health. If they are positive, she, too, will need antibiotic treatment. Please write to me again if you need further help.

• Should I tell my husband that I masturbate?

Q I am a housewife and my husband is away a lot. Sometimes I masturbate, Doc, and that certainly relieves my frustration.  But I am wondering whether I should tell him about this. How would a man react to that revelation?

A. Well, men react in various ways. Some men get 'turned on' by the idea of their female partner pleasuring herself. That is why a lot of 'porn' has images and stories of women masturbating. However, other men can be very different. Some husbands are shocked at the idea of their wives masturbating and may feel threatened by it.

So, I do not think you should be in a rush to tell your spouse. But one possible way around the difficulty would be to raise the subject of vibrators with him. You could ask him how he feels about them. And if he reacts positively, then you could perhaps ask him to buy you one.

• Tying my tubes

Q. I am thinking of having my tubes tied, but could I be sure that this would mean absolute and total protection against pregnancy?

A. Not quite. Female sterilisation has a very small risk of failure, generally about one in every 2,000.

• Sore foreskin

Q. I have just developed a very sore foreskin, and my doctor says it is 'fungal' and has prescribed some anti-fungus cream, which seems to be working.  Should I assume that I caught this fungus from my girlfriend? And does that mean that she has been cheating on me?

A. There are fungi all over the place, including on many areas of the human body. So you certainly cannot assume that you got this fungus through having sex with your girlfriend. And there is no evidence at all that she has been 'playing around'.

• 'Emergency contraceptive' at 34?

Q. I am a 34-year-old divorcée, and I must admit that I occasionally have passionate affairs with attractive men. I am not on the Pill, but a friend has suggested that I should use the 'emergency contraceptive'. But would it be safe for me to do so at my age?

A. I must say that I believe that people should arrange reliable contraception before having sex, rather than using the 'morning after pill', also known as 'emergency contraception' or Postinor-2. However, I do appreciate that, for many women, the availability of a tablet taken after unprotected sex can be very reassuring.

Postinor-2 is mainly used by younger women in their teens or early 20s. But, in fact, there is no reason at all why a woman in her 30s should not employ it. Unlike the contraceptive Pill, it does not carry risks of thrombosis (clotting) for more mature women. Finally, please bear in mind that the protection it offers is quite short of 100 per cent.

• Natural contraceptive

Q. We are a couple living in St Andrew and we have heard that there is a natural way of having sex without the risk of pregnancy. Is that true, Doctor?  We have been told that it is called 'the caressa' or something like that.

A. It's an old method, actually called 'the karezza'. The basic idea is that the man keeps his penis inside the woman for an extended time, but without climaxing. This is pretty difficult to achieve.