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Why is everything so dry?

Published:Sunday | January 10, 2010 | 12:00 AM

Q Doctor, I need your advice about my sex life. I just celebrated my 40th birthday!

I really love my boyfriend, and he loves me. But there is a problem. In the last year or two, I have noticed that I am a little 'dryer' than I used to be, and this is affecting him. Sometimes, after sex, he complains that he is sore because he is being painfully rubbed by my dry parts.

Intercourse has also become very painful for me because there is too much friction. It burns me.

So what is going on, Doctor? Is this early menopause, or is something seriously wrong with me?

A I am sorry to hear about this. Even though the average age for menopause is around 49-50, it is a very common problem for women to start experiencing pre-menopausal symptoms around 10 years earlier.

My guess is that this is what is happening to you. If, as I suspect, the levels of female hormones in the blood are starting to drop, then a probable result of that would be vaginal dryness.

The natural lubrication of the vagina during sexual excitement is very dependent on female hormones. So too is the soft, 'cushiony' quality of the vaginal walls.

I do think you should go and see a doctor very soon to make sure there is no other cause for this recent dryness and soreness. Your doctor will want to rule out any infection.

Your doctor will be able to advise you on what to do. But the treatment can be summed up in two words: lubricants and hormones.

In terms of lubrication, I think you should get a tube or bottle of a very good vaginal lubricant as soon as possible. These can be bought in a pharmacy or online.

Some very popular brands which can be bought on line include: Senselle, K-Y Jelly, Pjur Woman, Astroglide and Liquid Sylk.

You should put a fairly large amount inside and around the outside of your vagina before you start foreplay. Sometimes, its a good idea for your partner to help you apply it; this could make for very stimulating 'love play'.

It is also very important that you put some on him before he attempts entry.

Following these steps should make intercourse more enjoyable and easier.

However, there is the possibility that the mere use of lubricants will not be enough. If they do not 'cure' the problem, then you will need to get female hormone treatment prescribed by a doctor.

Female hormones can be taken orally or through the skin via a patch. But I would recommend taking them via a vaginal cream or pessary. (A pessary is a little vaginal tablet.)

When you use vaginal hormone cream for a few weeks, the walls of your vagina become healthier, and you start producing more natural lubrication. So sexual intercourse becomes easier and pain-free.

The downside to this is that you do absorb some of the hormone into your body, so there is a small risk that you might experience some side effects. You should speak to your doctor about this.

It is possible for the man to absorb some of the female hormone during intercourse. So occasionally, the man will develop little breasts!

For that reason, you should not insert the hormone just before having sex. Putting it in a day before will work perfectly well, and expose your partner to less risk.

I must add that it is OK to use a lubricant as well as a hormone preparation. Many women do this, and the combination seems to work very well.

Q My new boyfriend wants me to tie him up before we have sex, Doctor. Is he sick or what?

And could I get him cured?

A This man is into 'bondage' which is fairly common. It is widely believed that some men get 'hooked' on this practice because when they were young, they somehow got 'turned on' when they were strapped up, or otherwise restrained, by their parents.

Although psychological therapy is possible, most persons who are into bondage, simply do not want treatment. So it is unlikely that this man is going to change.

Should you continue this relationship? Only if you are willing to accept that whenever you want to have sex you are going to have to tie him up.

Q I am 21-year-old male and I am scared to sleep with my girlfriend because I am sure that she will laugh at the small size of my organ.

What can I do?

A Please go and see a doctor and get an examination. He may tell you that there is nothing wrong with your penis, and that it is normal size. Very often, young men are convinced that they are too small when, in fact, it is not so.

In the unlikely event that your organ is seriously small, the doctor will be able to advise you on any kind of operation or stretching technique that could help you.

Q The only time I will get to see my fiancé this month, will be when I am having my period. This is a pity because I would really like to make love to him.

When I was living in England, last year, I was given a 'contraceptive cap', and I still have it, and know how to fix it.

Could I safely use this for a couple hours so that there is no bleeding and we can have sex?

A Yes, that would be safe. It is often used in countries where the diaphragm or 'cap' is popular. But, please, do not forget to remove it after.

Q Three months ago, a bullet passed through my scrotum, and the wound has just healed. Fortunately, I am in good health now and feel fine.

But how can I tell whether this wound has made me impotent or infertile?

A Are you able to have erections? If so, you are not impotent.

If you are very nervous following the injury, this might cause you a little erectile difficulty when you resume having sex. But that can be treated.

If you are still producing seminal fluid when you have an orgasm, the odds are that you will be ok. But you could check with a doctor, and ask him to arrange a sperm test for you. Good luck.