DOCTOR'S ADVICE - Pregnant and cheating

Q: Doc, I cannot believe that I have been so stupid. I am three months' pregnant, and my husband has been away in America for a week. I have been feeling very 'horny' and I did the craziest thing and had sex with an old friend from my schooldays. Could I have hurt the baby?

A: Fortunately, that is unlikely, but the big danger is the risk of infection. So you should go to a doctor or clinic and have tests for sexually transmitted diseases (STD). Good luck.

Q: Doctor, I recently got married, at the age of 29. I am proud to say that I maintained my virginity until then. My husband is slightly older than I and I thought that he was sexually experienced, but now I am not so sure.  Our wedding night was not a great success. You see, he orgasmed before he even entered my body. Fortunately, he did manage it later in the night, so that was the end of my virginity. I cannot say I enjoyed it a lot.

Since then, we have tried to have sex, maybe two to three times for the week, but I am still not getting much pleasure from it. Every time, he seems to be unable to stop himself from climaxing. Often, he will orgasm within 10 seconds after entering me. My big aim in life is to have children, and I suppose he will be able to give me those. But I thought that sexual intercourse was supposed to be very satisfying and fulfilling, and at the moment, it isn't.

A: Poor you. As you probably realise, your new husband has a bad case of the condition called 'premature ejaculation', often known as PE.

This is not his fault (or yours). But he really must do something about it. If he doesn't, your marriage may not survive. The first thing he should do is talk to you about the problem. Please try to encourage him verbally and assure him that you will try to help him. Then, he should see a doctor or therapist who is experienced in dealing with PE. In fact, it would be best if you went along, too.

Possible ways of helping PE include the following:

• The Masters-Johnson 'retraining' method, featuring their famous anti-orgasm grip; you will find this described on the Internet.
• Dapoxetine - a fairly new drug which is taken before sex and which delays ejaculation;
• Antidepressant pills such as clomipramine - many doctors are willing to prescribe these now, and they are quite cheap;
• Condoms containing a local anaesthetic - these 'deaden' the sensation in the penis, but they are not very satisfactory.

I wish you both well.

Q: I am a man who has been having trouble urinating. My doctor says that my prostate gland is slightly enlarged.  Will this affect my sex life, Doc?

A: Probably not. As a rule, mild enlargement of the prostate will only affect the urinary system, not the man's sexual activity. Please continue to be advised by your doctor.

Q: I have to do a hysterectomy operation next month. I have always had a great sex life. Does this mean the end of it?

A: No. In a hysterectomy, the surgeon removes the womb and not the vagina. And he certainly does not go anywhere near the clitoris.  Most women who have a hysterectomy report that, once the stitches have healed, they are able to enjoy a very good sex life. They generally say that orgasms feel 'different', but they can still have them.

One other point: if the gynaecologist has to remove your ovaries as well as your womb, then it is possible that you will get some vaginal dryness after. That can make intercourse difficult or even painful. But it is quite easily treated - for instance, with female hormone vaginal cream.

Q: Doc, I must tell you in the greatest confidence that earlier this month, I cheated on my husband. This was two weeks ago. It was just once, and I will never do it again. It happened because I was mad at him about looking at another woman.  Now I am worried that I could be pregnant. Is it too late to take the morning-after pill?

A: Far too late, I'm afraid. The post-coital Pill ('the morning after pill', or 'emergency contraception') generally has to be taken within three days of unprotected sex. There is another version of it which can be taken five days after sex. And it is also possible to have a 'post-coital coil' - that is, an intra-uterine device (IUD) which is put in within five days of sexual intercourse.

But you are much too late for those things. You are in the unhappy position of waiting to see if your cycle arrives. If it doesn't, then please do a pregnancy test right away.

Are you still having sex with your husband? If so, then, if you become pregnant, it might actually be your husband's. I hope you manage to get this sorted out. A lesson which can be drawn from your story is this, when you are mad with your spouse, it is never a good idea to respond by having sex with someone else.

Q: I am a 41-year-old man. Is it still safe for me to have sex three times for the night, Doc?

A: Perfectly safe, if you can still manage it.

Q: I am thinking of using Mirena, which I understand provides contraception with good period control.

But does it have any side-effects, Doc?

A: Well, everything in medicine can have side effects. Mirena is no exception, but most women are pretty happy with it. As you probably realise, it is a sort of coil (IUD), but one which contains a small dose of a female-type hormone called 'levo-norgestrel'. It works extremely well in preventing pregnancy, with only a small pregnancy rate.

The big bonus is the fact that, after it has been in your womb for a few months, it usually starts to have a very good effect on the menses. It makes them lighter and shorter.  In my experience, most women do not get serious side effects with Mirena. But a few do get symptoms such as backache, vaginal discharge, breast tenderness, and (very occasionally) loss of interest in sex.

Q: I am a 33-year-old man and my doctor has just prescribed me some ointment which I am supposed to put on my penis three times for the day. But is there any danger that I could 'transfer' it to my wife during sex, Doc?

A: Yes, there is every chance that this could happen, and the consequences for her could be serious.  Please talk to your doctor and wife about this. One solution might be to wear a condom whenever you have sex.