Dear Doc: Should I tell my husband about my fantasy?

Q. Doc, please help me. I am a fairly happily married woman and my husband and I have always had a pretty active sex life. He has always said he is satisfied with my performance in bed, and I don't think he has ever cheated on me.

I was not a very sexual person when we first got married, but now I have grown to really like sex a lot.

But I have one problem. Over the years, I have learned that it is a lot easier for me to orgasm if I fantasise during the last few minutes of sex. When I realise that my husband is approaching his climax, I start dreaming about all kinds of other sexual activity that I might be involved in. This helps me 'get there' - usually at the same time he does, which is nice.

But in the last few years, I have found myself tending to fantasise about other women. For a while, I imagined female film stars, and that was enough.

But in the last six months, things have changed. Just as my husband approaches his orgasm, I suddenly find myself thinking about being in bed with a beautiful younger woman who works at my office. That idea is always enough to make me climax.

What do you think about this, Doc? My worry is that I am getting hooked on these fantasies. Should I tell my husband about them? Or do you think that the idea might make him mad?

A.  Research has shown that during sexual intercourse, between 50 and 60 per cent of women do sometimes fantasise about having sex with other people. And in some cases, they fantasise about sexual activity with other women.

Whole books have been written about female fantasies. There are some experts who think that it is OK since it helps the woman to reach an orgasm. And sometimes, as in your case, the fantasy helps her to climax simultaneously with her partner.

But there is one big disadvantage associated with these types of fantasies. Psychologists have found that if people do this constantly, then the fantasy eventually becomes imprinted upon the mind. This means that, eventually, the woman (or man) cannot orgasm unless she (or he) thinks about the sex fantasy.

Now it seems to me that you are getting perilously close to that stage. If you don't do something about this, you are probably going to find that you cannot climax with your husband unless you think about this woman.

Therefore, you should immediately make every effort to stop thinking about her. You may have to try concentrating on other fantasies in order to help you to orgasm. But you should try and get this woman out of your mind.

Should you tell your husband about your fantasies? Some men are very turned on by that kind of thing, and even like the idea that their wives think about lesbian activity. But a lot of men do not. There is the possibility that your husband might become angry or upset. So, in my view, it would probably be better not to tell him about your fantasy.

Q. Doc, my wife gave birth two months ago and, during the last week, her left breast has become engorged below the nipple. It has started leaking blood-stained milk.

It is very uncomfortable and she needs your help.

A. I am sorry to hear about this. To see blood in breast milk is very alarming for a woman, but usually, the cause is not serious.

There are several possible causes for bleeding and discomfort. For instance, your wife may have a blocked milk duct (that is milk channel), or she may have an infection or inflammation in the breast. But if she is not already seeing a doctor, she must do so right away. If she was delivered at a hospital, it would be a good idea to try to go back and consult the doctors there.

If she continues to have problems, please email me again.

Q. I'm a very worried woman. I gave birth to three children through C-section, then had my tubes tied to prevent further pregnancies.

Now I am thinking of untying my tubes to give my future husband a child. He does not have any children yet.

He is coming from the United States in the spring for us to get married, and he is excited about the idea of us having a child. I have not told him that my tubes are tied.

Is it possible to untie them and then get pregnant? Are there any risks? I would not mind travelling to the United States to get the best medical care.

I'm worried, Doc. Please help me.

A. Sorry to hear about your predicament. What is surprising is that you have not told your fiancé that your tubes are tied.

It is not fair to keep that from him. A lawyer has informed me that your prospective husband might have cause for legal action if he marries you without knowing that you have been sterilised. So please tell him right away.

The reversal operation is very difficult, but there is no great risk to your health. The plain fact is that very often these operations do not succeed, so the woman does not get the child she wants.

All in all, I think your best move now would be to consult a good gynaecologist here in Jamaica to find out what the prospects are for reconnecting your tubes. Good luck.

Q. Would taking a circumcision improve my chances of getting my wife pregnant?

A. No. Not unless your foreskin is so tight that the sperm cannot get out properly.

Q. I have a problem with my throat. I have to be clearing it constantly, like almost all day. Could it be because I had rheumatic fever in 2011?

A. I don't think this throat-clearing problem is linked to rheumatic fever. I suggest you get some throat medication from a pharmacy. This could be lozenges to cut down on throat and nose secretions.

If that doesn't work, please have a doctor check out your throat.