Fri | Oct 19, 2018

Dear Doc | I have two boyfriends what should I do?

Published:Sunday | December 17, 2017 | 12:00 AM

Q Dear Doc, I have this problem. I have two boyfriends - one here in Jamaica, and one in the United States. I love my Jamaican man very much, but the one in the States provides for me financially. He makes me know what it is to have money and a good life, so I do not want to give him up.

Before I met him, I used to sell my body in the tourist area to make ends meet. Now I do not have to do that anymore. My Jamaican man suspects what is going on, but he does not complain about it. I always use condoms with the one from the States, but now he wants to go without. He is now single and wants to marry me. What should I do?

A Situations like this are always dangerous, and can lead to violence. It is in your best interest to protect yourself by practising safe sex. Prolonging this scenario puts you at risk for violence and emotional stress which may develop into depression. Take some time alone this holiday season to find out what you really want. Weigh the pros and cons of each decision as well as the effect it will have on you and the people in your life. If necessary, seek guidance from a certified counsellor.


Does ganja make sex better?


Q Dear doc, does smoking weed make sex better? I have heard many men say they are able to last longer after they smoke it. Is there any truth to this?

A Thank you for this question. The jury is still out on this one. There are international surveys and research which contradict this local belief.

The effects of ganja on one's sexual performance is related to the strain, concentration (strength), and duration of use. People also differ in their sensitivity to it. Please note that all forms of smoking are dangerous to your health and can cause cancer. Some people use filters and vapourisers, and these reduce the odour, smoke, and debris, but do not remove all the cancer-causing agents.

Some men and women report that they have better sex after smoking ganja, others say the opposite.

Ganja, when used acutely in low concentration, lowers inhibitions and stimulates arousal and sexual desire. It also distorts one's sense of time and perception making sex/orgasm appear to last longer.

But chronic smoking of marijuana has been shown to be associated with erectile dysfunction, premature ejaculation, reduced sperm count, and difficulty achieving an orgasm (in the population studied).

A word of caution: the use of ganja in any form with Viagra, increases the chance of heart-related side effects associated with Viagra.


Bleeding for three years


Q Dear Doc, I am writing to you with tears in my eyes. For about three years now, I have been bleeding. I went to the doctor and I have done an ultrasound and Pap smear. I take medication, but I am still having the problem. What more can I do to make it stop? I tried everything.

A This is a fairly common problem experienced by women in Jamaica. You did not state your age, however, be aware that the main causes of abnormal vaginal bleeding differ according to age group.

Women below the age of 40, experience abnormal vaginal bleeding for the duration you described due to the following:

- Withdrawal bleeding due to hormonal contraceptives.

- Uterine fibroids/polyps.

The condition in women over 40, is mostly caused by a hormone imbalance in perimenopause, and thickening of the lining of the womb. Vaginal bleeding due to cancer of the womb is more likely to occur in this age group, so a thorough investigation is warranted.

Uncommon causes include thyroid problems and bleeding disorders.

The best solution is to visit a gynaecologist who will run the necessary tests which will reveal the cause of the problem. Currently, there are many treatment options available, so your problem can be solved.


Not interested in sex anymore


Q Dear Doc, seasons greetings, keep up the good work. My problem is, I have been married for almost 30 years now, but lately I have no sexual feelings for my husband. He is in his mid 50s like me, but he still wants to have sex once or twice a week. I am not interested. He has been very patient, but I can see he is getting frustrated. I worry he may start seeing other people, what can I do?

A Good day to you. A decrease in sex drive is common in women as they approach/reach menopause (around age 45 to 55). This is due to an decrease in the hormones oestrogen and testosterone (yes, women have this too). The severity of this varies, although there are a few women who experience no changes and others report an increase in their desire.

Depression, chronic medical conditions such as diabetes, and certain types of medication can decrease your sexual desire, so these factors need to be addressed by your healthcare provider.

Visit a counsellor/sex therapist with your husband, so that you can discuss the changes that occur in women and men during these years. Communication with your husband readjustments of sexual expectations can be helpful.

Hormone replacement therapy may be able to help you, but its use is controversial, and there are certain criteria that need to be met before one qualifies for this form of treatment, so discuss these with your healthcare provider.


Itchy scalp causing embarrassment


Q Dear Doc, I am a 19-year-old male, and I have a problem that has been bugging me for many years. My scalp is itchy all the time, especially when I sweat. It also has some dry white, scaly material on it that does not go away no matter how hard I scrub it, or how often I wash. I tried numerous shampoos and creams, but none seems to help. Now I am ashamed to go to the barber because they may see it and treat me with scorn thinking I am nasty. Please tell me how to get rid of it. I feel very uncomfortable.

A A pleasant day to you. The condition you describe appears to be a severe form of dandruff known as seborrhoeic dermatitis. Basically, it is an imbalance in the rate of turnover of scalp cells which is usually triggered by the following conditions:

• Elevated levels of male hormone (testosterone) such as during puberty, which promotes secretion of the oil glands in the scalp. The excess oil causes irritation, itching, and flaking of the scalp.

• Overgrowth of fungus due to excessive oiling of the scalp, poor hygiene and immunocompromised states (diabetes, HIV )

• Vitamin D deficiency due to lack of sunlight.

• Excessive washing/scrubbing of the scalp strips away the natural oils which also disturbs the balance, stimulating the scalp oil glands to hypersecrete. Excess oil is a breeding ground for more fungus, and so the vicious cycle continues.

What can you do? First of all, get tested to rule out the above medical conditions. Visit a dermatologist, who will examine your scalp under a high-powered microscope and, therefore, be able to provide a definitive diagnosis which will guide appropriate treatment. The itching may be uncomfortable, but scratching the scalp makes matters worse as this may cause cuts and bleeding, introducing bacteria into the scalp. Your dermatologist can recommend an appropriate anti-itch creams/solution. Regular washing of combs/brushes with diluted bleach and sun drying them will prevent bacteria/fungus from growing on these items.

Restoring the balance of the scalp takes time, and after initial treatment, use of a mild conditioning shampoo should keep things in check. Experimentation may be required to determine how often you should wash your hair in order to maintain this balance. Best of luck.

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