DOCTOR'S ADVICE - Has my husband lost interest in sex?

Q. Doc, I have been married for four years now and it has been great! My husband is kind and loving. Our sex life has been very good too. We are also in the church. But things are suddenly going wrong. After I got pregnant, he has not been performing the way he used to. He has an erection that only lasts five minutes, and then he ejaculates. Sometimes it's even less than that. He never used to be like this. So what's the problem, Doc? I told him to go to a doctor, but he is afraid to. He is still quite young - in his early 30s. Would the doctor give him Viagra? Please help a concerned wife.

A: Sorry to hear that things seem to have gone wrong in your previously happy marriage. Let me deal first with your question about Viagra. No, a doctor would probably not give your man this drug. It is a very effective medication for erectile dysfunction. In other words, it helps men get a good, firm erection. But it is not for the kind of problem that you are talking about.

So what is your husband's difficulty? Seems like he has recently developed premature ejaculation, also known as PE. This makes a man climax very quickly, after which he is unable to continue. But your husband's case is unusual. From what you have said, he was ok when you first got married. But then everything went wrong after you got pregnant.  It sounds as though your pregnancy has had a profound psychological effect on him and caused him to orgasm far too soon.

In fact, it is quite common for pregnancy to have an adverse emotional effect on men. A lot of men grow up thinking that motherhood and sex are two entirely separate things. Deep down, they believe that a woman who is a mother cannot be a sexually active person.

Some of these men simply lose all sexual interest in their wives. Others find that they cannot get an erection. And some, like your husband, develop premature ejaculation.

It is possible to get medical treatment for PE. For instance, some doctors prescribe an antidepressant drug that is taken orally a few hours before sex. The most commonly used one is called Anafranil (also known as clomipramine).

But I am sure that your husband needs some emotional help from a counsellor or therapist. The aim of this treatment would be to explore his feelings about pregnancy and to look into the reasons why he has suddenly started climaxing so quickly.  The next few months are not going to be easy for you and your husband, but the best chances of 'weathering the storm' is to undertake a course of therapy. I wish you both well.

Q. Doctor, if I have sex with my wife without a condom, but without ejaculating inside her, is it possible that I could still get her pregnant?

A: Yes, it is. Many couples try to avoid conception by having intercourse without the man going all the way to a climax. If the man doesn't orgasm at all, that is called coitus reservatus. But if he pulls out before orgasm and ejaculates outside her body, that is known as coitus interruptus.

Both these methods do reduce the risk of pregnancy. But unfortunately, they often fail. Experts say that if a couple practises coitus reservatus or coitus interruptus, there is roughly a 20 to 30 per cent chance that the woman will become pregnant in the course of a year.  The main cause is that men do tend to 'leak out' some sperm during intercourse. Also, sometimes a man fails to control himself and accidentally climaxes while he is inside the woman. Therefore, I would not advise you to rely on these methods.

Q. If I took my husband's Viagra, would it make me a very sexy woman?

A: No. Unfortunately, research has shown that Viagra and similar drugs don't work on women. All they seem to do is to increase vaginal lubrication.

Q. Doc, I am a 30-year-old woman and I don't have any feelings for sex. There is no urge at all. Yet, I love my partner very much. How could this happen? Would it be a good idea for me to see a gynaecologist?

A:It is unlikely that a gynaecologist could help you very much, because it is unlikely that your lack of desire the result of any physical illness.  However, there would be no harm in seeing one for an internal examination and maybe some hormone tests.

But when a woman at your age says that she feels absolutely no sexual desire, then usually the best thing is to look at how she was raised and the way she learned about sex.  A psychologist would want to ask you whether you were taught to believe that sex was dirty or dangerous. She would also like to know whether you were ever molested or even raped. I am sorry to hear about your situation, but with the help of your loving partner, you may well be able to defeat this problem. Good luck.

Q. Doc, my 14-year-old son has complained to me that there are some palish, pink bumps on the head of his penis. Is this serious? Please help me.

A: Try not to worry. Young men do often have small pink, brown or white spots in that region. These are rarely of any significance.

Nevertheless, I do think that you should take your son to a doctor, who can take a quick look at these bumps and make sure that everything is all right. The main thing that the doctor will want to do is to make sure that they are not genital warts. But if he has never had sex, it is unlikely that they are warts.

Q. I have passed through menopause a year ago, but last Monday I had sex with a young and very virile man who seemed to produce a great deal of sperm. Do you think there is any chance I could be pregnant?

A: Very little chance, though occasionally women who are past menopause do conceive. If you intend to continue this relationship, you would be wise to use some form of contraception for the next year.

Q. If I took the morning-after pill and somehow it failed. Could this affect the baby?

A:The 'Emergency Contraceptive' does contain a powerful dose of hormone. Generally, it is not good for a foetus to be exposed to such medication. But not enough research has been done regarding the effects of this tablet on the unborn child.