Dear Doc | Is my wife planning to cheat?
Q Good day Doc, I would like to know if my wife is planning to commit adultery.
You see, she has got it in her head that she must have a sterilisation operation, and I do not understand why.
Seems like she is tired of taking the Pill, and she doesn't want to try the contraceptive injection.
So could you kindly answer a few questions for me?
1. Is it true that a sterilisation operation leaves a woman free to have sex with anyone she wants?
2. Will it affect her sexual drive?
3. Will I be able to feel anything different when I have sex with her?
What do you think, Doc? Is this a good idea or not?
A Please don't worry, I am sure everything will be OK, as it is very unlikely that your wife is doing this so that she can cheat on you!
My guess is that she has been taking the Pill for quite some time and is genuinely fed up with it. Also, she is probably aware that the dangers of the Pill increases when a woman gets into her 30s.
You can discuss with her the fact that there are around 10 other methods of contraception that the two of you could use. They include:
• The condom
• The female condom
• The coil (IUD)
• Mirena (the hormone-loaded coil)
• A vasectomy for you.
Now, let us turn to your three questions:
1. Technically, it is true that if a woman takes the sterilisation operation, she is free to have sex with whomever she chooses without the risk of pregnancy. I did once have a patient who got sterilised so that she and her husband could participate in wife-swapping. But I find it almost unthinkable that your wife would want to be sterilised for that reason.
2. Will the operation affect your wife's sex drive? No. She might be even more keen on having sex with you because of the fact that she knows it is unlikely that she will get pregnant.
3. Will you be able to feel any difference when you have sex with her? No, you won't. Everything will feel just the same.
I think that you and your wife should talk over this matter calmly and reasonably. If she really wants the sterilisation, then she should go ahead.
But one final point. Are you both sure that you do not want any more children? Sterilisation is a pretty permanent thing - and if the couple change their minds, it is quite difficult to reverse.
Severe headaches after orgasm
Q I am a 31-year-old female and the last time I orgasmed, I got a severe pain in my head. It lasted for about five minutes.
Is this OK, Doc?
A It is probably nothing, but you should see a doctor this week and get a thorough check-up. In particular, you will want to ensure that your blood pressure is OK.
Which girlfriend should I choose?
Q I am in love with a fantastic woman. However, she is not very interested in sex. She will do it, but it is not very important to her.
On the other hand, I have a girlfriend who is 'the queen of sex'. She is just incredible in bed. She knows all sorts of positions, and she gets me very excited. She also has multiple orgasms.
So I am wondering, Doctor, which should I choose? I feel it is time I got married.
A I am sure you know the answer to that one. It would be crazy to choose (and presumably marry) the 'queen of sex'. just because she is good in bed!
You love the other woman, and if she loves you (which I hope she does), then you should think very seriously about settling down and marrying her.
Most importantly, you really must give up the 'queen of sex'. You cannot love one woman and continue having wild sex with another. It just will not work.
Getting a vaginal ring
Q I am a 30-year-old married woman and I would like to have that vaginal ring as a form of contraception. But how do I get it in? Does it have to be fitted by a
doctor? Can it get dislodged?
And does the man put it over his penis before he enters?
A No. The man definitely does not put the ring over his penis!
The vaginal ring is sold under the trade name of Nuva-Ring. It contains hormones - very much like those contained in the Pill. These prevent you from getting pregnant.
The ring has to be prescribed by a doctor, and you do not need a fitting, because in general, one size fits all.
What usually happens is that the doctor writes you a prescription and you take that to a pharmacy. They will give you the Nuva-Ring.
You put it in, and you keep it in the vagina for three weeks out of every four. Then you put in a new one. It does not usually interfere with sex, but occasionally a very vigorous sex partner may temporarily dislodge it, so that it comes out. All you do then is to rinse it in water and put it back in.
Am I losing my nature?
Q I am a 41-year-old man and I use to be able to have sex three times in one night. But now, I can only manage to orgasm once for the night.
Am I losing my nature? Should I get my hormones checked?
A No, you are not losing your nature. A man's sexual performance does tend to diminish slowly as he gets older. The research of the late Dr Alfred Kinsey showed clearly that very few men in their 40s can manage to have sex three times in one night. Not many can manage it twice for the night.
So there is nothing wrong with you. You are just expecting a little too much of yourself, and there is really no point in having a hormone test.
Do I have to abstain from sex before having a Pap smear?
Q I have to have a Pap test next week. Should I abstain from sex before?
A It is usual to refrain from sexual intercourse for around three days before a cervical screening test.
Can antidepressants help with premature ejaculation?
Q I cannot really satisfy my wife because I ejaculate much too quickly. Is it true that there is some kind of anti-depression medication that can help with this?
A Yes. You clearly have some degree of premature ejaculation (PE). This is extremely common among men.
I don't think that this medication is always the best way of treating PE.
There are actually various antidepressant pills which can be used, but your doctor might prescribe clomipramine 25mg, to be taken an hour before sex. Please bear in mind that these drugs can often have side-effects - notably dry mouth, blurred vision, and ringing in the ears.
Taking the mini-Pill
Q I would like to take the mini-Pill, but I don't know how.
A It's simple. You just take it every night, at about the same time. Do not miss any!
The big difference between the ordinary Pill and the mini-Pill is that you do not have a week's break at any point. You should take the mini-Pill every day of the year, without fail.