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Doctor's advice: How should she start the Pill?

Published:Saturday | February 27, 2010 | 12:00 AM

How should she start the Pill?

Q Doc, how long after starting to take the Pill could a woman assume that the medication has become active? In other words, how soon would I be protected? I know it is not 100 per cent safe.

A Well, the Pill is virtually 100 per cent safe, as long as you don't forget to take any!

Now, there is a lot of misunderstanding about this business of the Pill. These days, most doctors and nurses will advise you that when you are about to take the Pill for the very first time, you should begin on the first day of your menses.

If you do that, you will be protected from pregnancy immediately! Then, just make sure that you take one Pill every day for three weeks out of every four.

I think the confusion about how to start taking the Pill has arisen because docs once used to advise women to start on the fifth day of the period. This worked fine, but it did not give you protection until you had been on the Pill for two weeks.

The more modern method is better. Just make sure that with that very first pack, you begin taking them on Day One of your menses. After that, it is a straightforward question of three weeks on the Pill, and one week off the Pill.

During the week off the Pill, you will have your period. However, it is a different and easier form of menses. With luck, the period will be shorter, lighter and less painful.

So your menses should be much more bearable on the Pill! But if by any chance you don't see an improvement in your menses, talk to your doc about switching you to another brand of Pill.

These days, no young woman should have to suffer painful, heavy or prolonged periods.

Q Good day, Doc. I have been masturbating since I was in my teens. I am now in my 30s and I still release my sexual tension this way. I find that when I am in a relationship with a girl, as I am at the moment, I still want to masturbate. I am now in a relationship that has been going on for more than a year. I love my partner very much and I know she loves me. But when I am with her in the bedroom, I find it very difficult to get and maintain an erection in order to have sex with her. My mind wants to, but my body will not respond. Yet, when I am alone, I have no problem. Everything works fine!

What can I do to be able to have sex with her and not lose my erection?

A Masturbation has nothing to do with your problem, except that you might be making yourself exhausted.

Really, your problem is erectile dysfunction (ED). In other words, you cannot get and keep an erection when your girlfriend is there.

I have seen this situation often. It is caused from the fact that the guy is anxious about having sex with a woman. If she left the room, he would be fine.

There is no question that you need some skilled therapy. You need to find yourself a good counsellor or psychotherapist who understands sex problems. I imagine that he or she will wish to see you and your girlfriend at the same time.

It is excellent news that your partner loves you, and that you love her, so I expect that she will be willing to help you by going to see the therapist with you.

I cannot forecast exactly what the therapist will do. But in these cases, it is quite common to suggest that the couple begins sex sessions in adjoining rooms. They talk to each other through the open door, and the guy is allowed to masturbate over a period of around half an hour.

During the course of the next few weeks, the therapist encourages the couple to gradually move closer together, until eventually they are in the same bed. When he is totally happy about having an erection in her presence, they can attempt sexual intercourse.

It is usual for them to begin intercourse with the man lying on his back, and the woman straddling him. Researchers in the United States have found that this is a non-demanding position for the male. And if he thinks that he is about to lose his erection, it is usually quite easy for him to regain it through manual stimulation.

Solving your problem right will take time and determination but you can do it! I wish you well.

Q I am sure that I do not have a clitoris. Please advise.

A It is almost impossible that you do not have a clitoris. Consult a doctor or nurse who can show you where it is located.

Bear in mind that it is very tiny, and probably much smaller than you had thought.

Q I am a 14-year-old boy. Am I correct in thinking I am not yet fertile?

A I don't know where you could have got this idea. Unfortunately, most boys of 14 are perfectly capable of fathering a child.

If you are fooling around with a girl, I advise you to stop right now.

Q I am a young woman who has a vaginal infection. This has existed for 15 months. When I was about five months into it, I saw a doctor who diagnosed it as candidiasis, or yeast infection. She prescribed vaginal tablets, but at the time I could not afford to buy them. Eventually, I did get some, but they were not as effective as I had hoped. Now the infection is worsening. It is characterised by a thick yellow discharge with a strong odour. At times, it is tinged with red. What can I do to rid myself of it once and for all?

A Sorry to hear about this. Candidiasis (infection with the candida fungus) is quite common. It usually produces a white discharge, so I am doubtful that it is candidiasis that you now have.

Therefore, you should visit a doctor. Likely possibilities include infection with trichomoniasis, or an anaerobic infection.

Once the diagnosis has been made, you will need an immediate course of an appropriate antibiotic. If you have a partner, he will need treatment too. Do not have sex until you have been completely cured. Good luck.

Email questions and comments for Doc to You may also read the Doctor's Advice column in 'Outlook' magazine in Sunday's 'Gleaner'.