Thu | Sep 20, 2018

doc advice

Published:Saturday | February 7, 2015 | 12:00 AM

Q Doc, I have recently read where 'woman on top' is a dangerous sex position for a man. But I do not know why. And this is making me fret because my girlfriend really likes to be on top of me.

Thank you for your advice.

A There is no need for you to fret. What you are referring to is some recent American research into the fairly rare condition of 'fracture of the penis'. This is not like a fracture (i.e., a break) in a bone, because there is actually no bone in the male organ.

What happens is that the blood vessels (that is, tubes) inside the penis are packed full with blood, which is the normal situation during an erection. But a sudden, powerful twist breaks these vessels. That is painful! There is a 'cracking' sound, and a lot of the blood flows into the parts of the penis where it should not ordinarily be.

If such a disaster occurs, the guy must get to a hospital as soon as possible, so that the doctors can treat his injured penis.

Why does this injury occur? Occasionally, a fractured penis happens because somebody violently attacks a man who has an erection. But much more often, it occurs when a couple is engaging in excessively acrobatic sex - in which the penis gets very sharply twisted to one side during intercourse.

Now the US researchers found that:

n Fifty per cent of penis fractures happened when the female was on top;

n Twenty nine per cent happened when the couple was doing it 'doggy-fashion' - that is, with the woman on all fours;

n Only 21 per cent happened when the guy was on top of the woman and face-to-face, in the 'regular' way.

So, penile fracture is most likely when the lady is on top. Why? Well, it seems that when the woman is sitting on top, most of her body-weight is applied to the guy's organ. If she suddenly leans to the right or the left (or backwards), that puts enormous strain on the poor guy's penis, so it may fracture.

Men should not be alarmed about these findings, since penile fracture is pretty rare. But female partners should heed this advice: if you are sitting on top of your man and having sex, do not suddenly lunge off to one side or lean backwards.

Q Doc, if a man takes a Viagra, does he get an erection that lasts for four hours? Or does the erection go and come back again?

How does it work?

A The first thing I must say is that if you are a young guy who is thinking that he may need Viagra, then you should go to a doctor so that he can establish what is causing your problems with erection.

Now, a lot of people have the idea that if you take a Viagra tablet, you will get a ramrod-hard erection which goes on for four hours or so. That is not the case!

Viagra works by opening up the tubes which carry blood to the penis. That makes it much easier for the guy to get an erection. But as a rule, it will only work if some physical stimulus (like rubbing) is applied to the organ.

Like you suggest, the erection may go away, and then return again. Generally, you will lose the stiffness soon after discharging. But it may soon return again - particularly in the case of a young man.

Q I'm male, and my age is 21. During sex, my girlfriend sometimes puts a finger into my butt, using a condom. I think she is trying to achieve a 'prostate orgasm'.

But is there any health problem in doing this?

A The practice you describe is known by the French term postillionage. People do it because of the fact that, for some guys, it causes increased sexual stimulation.

Women who are very experienced may use it to massage the guy's prostate gland. This does not cause an orgasm, but it may increase the force of the man's ejaculation. It is not very easy to do, and may be uncomfortable for some men.

The big health problem with postillionage is that because the anus is a very 'germ-laden' area of the body, the woman's finger will almost certainly become contaminated with bowel 'bugs'. That is not a great idea, since the germs can easily be spread to other parts of the body.

However, it seems like your girlfriend is using a condom on her finger, so I would say that this cuts down on the risk of infection.

Q Good day. I have a major concern. Can a woman at (say) 45 have a fulfilling sex life after doing a hysterectomy?

A Yes, she certainly can. It is important to realise that a hysterectomy operation removes the womb - not the vagina or the clitoris.

Therefore, once she has healed, the lady can have sexual intercourse, and can also orgasm. But some women do say that the climax feels a little different after the womb has been taken away.

Q I read in a US magazine where the Pill can cause brain tumours. Is that true, Doc?

A Well, this is some new Danish research. It suggests that if women are on the Mini-Pill ('progestogen-only Pill', or 'progestin-only Pill') for a long time, they may have a higher chance of getting a rare kind of brain cancer.

The Danish findings also suggest that the ordinary Pill might be associated with a very small increase in risk. But you have to remember that the Pill also protects you against certain types of cancer, notably cancer of the womb.

Q I recently had my first contraceptive shot, Doc. But since then, my menses have been quite irregular.

Is this normal?

A Yes, I am afraid that this often happens after a young woman has had the Jab. The problem should soon settle down. But if it doesn't, then please go back and see your doctor.

n Email questions to Doc at and read more in the Outlook Magazine tomorrow.