Doctor's advice - Could she do without menses?

• Q.  I am a 20-year-old woman, and have just started on the birth-control Pill. I was just wondering if it would harm my health if I were to take it continuously, without having a week's pause after the last tablet? In that way, I could avoid having the menses.  Alternatively, if you think that taking the Pill continuously would harm my health, is there any other form of medication that could prevent me from seeing my period at all? I would like that.

A.  This is a good question. An increasing number of today's women are fed up with having to cope with menses, and wonder if they could do without them.

Quite a few gynaecologists think that it is sometimes a good idea for younger females to take the Pill continuously, in the way that you suggest, so that there is no gap between packs of the Pill and, therefore, no period. This should not harm the health.

In the USA, that idea has become very popular. Some gynos advise what they call 'bi-cycling', which means taking two packets in succession without a break.

Others advocate what they call 'tri-cycling', which indicates taking three packs in a row without a break.

There are even some experts who suggest that a woman should go for a whole year with no breaks between packets. So in theory, there would be no menses for 12 months.

I must add that when this is done, sometimes nature overrides this intervention and triggers a period, whether you want it or not. For that reason, I would advise any woman who tries continuous Pill usage to keep a tampon in her purse, just in case some blood loss occurs.

Some females are not happy about taking the Pill continuously because they have heard that the menses consist of bad blood, and that this has to be got rid of every month. I assure you, this story is not true. There is no such thing as 'bad blood' in the womb.

Finally, it is clear from your email that you have only recently started on the Pill. For that reason, I would be happier if you would check with your own doctor before deciding to go on continuous Pill usage.

She might believe you should get settled on taking the Pill the usual way before moving on to taking it continuously.

Anyway, I wish you well, and I hope that before long you will be able to manage to free yourself from the 'tyranny' of monthly periods!

• Q. I am a young guy and have a problem. When my organ is erect, it is about seven and a half inches in length. I want to know if this is normal, and what I can do to get it larger?

A.  Have you measured this correctly, with a tape measure? The measurement should be taken from the base of your organ, on the side of it which is nearer to your belly when you are erect. In other words, place the end of the tape measure in your pubic hair, just where the penile shaft begins.

Then you use the tape measure to check the distance to the point of the organ, just where the little hole is. If you do that, you will get a pretty accurate figure.

I shall be slightly surprised if you really do measure 7.5 inches. There have been many surveys of penile length, carried out all around the world over the years. The various pieces of research give slightly different results.

The average size of the erect penis is between 5.1 and 5.9 inches. This is slightly less than older surveys have claimed.

So if you really do measure 7.5 inches, which I rather doubt, you definitely have no need whatever for any form of penis enlargement.

• Q. I am a 21-year-old woman, and I just can't seem to get pregnant. I had an abortion when I was 18. Do you think that is why I cannot become pregnant now?

A.  Well, it's possible. In fact, there are so many factors - both male and female - which can make conception difficult that it is impossible to say for certain.

The fact is that an abortion carried out by an unqualified practitioner is very likely to introduce germs into the lower part of the female body. A medical bug can fester for years, often producing no symptoms. But frequently, the germs end up blocking the Fallopian tubes.

Blocked tubes are common. When the tubes are blocked, the ovum (egg) cannot find its way from the ovary to the womb. Therefore, the egg cannot meet the sperm. So, pregnancy is pretty well impossible.

However, I must stress again that there are dozens of different causes of infertility. For instance, have you considered the idea that your male partner might be sterile!

Really, your best move now would be to consult a doctor who is experienced in these matters, preferably taking your partner with you. The doctor can examine you and try to establish whether any infection is present.

She cannot tell whether the tubes are blocked by simply examining you, but she can arrange special tests which will show whether an egg could get through them or not. I wish you luck in your attempts to conceive a baby.

• Q.  I am a young man, and my foreskin is very tight when my penis is erect. What can I do about that?

A.  Whatever you do, don't rush into having surgery because there is a high chance that that will not be necessary. Your first move should be to get some bland lubricant from a pharmacy and apply it to your foreskin daily. Try to stretch it so that it becomes less tight.

Warning: If you are having sex please don't use Vaseline (or any other petroleum-based product) as a lubricant, because those products can make holes in condoms!  If you aren't successful within a couple of months, get yourself checked out by a doc. Ask him whether he thinks that the new technique of applying hydrocortisone cream sparingly might help you.

• Q. I have the sickle-cell trait. But why do they call it sickle cell?

A. It is because of the fact that when the red blood cells are viewed under a microscope, some of them are shaped like a sickle or grass-cutting scythe, instead of having the normal round appearance.

Q. At what age can a girl become pregnant, Doc?

A.  There was one terrible incident in South America when a little girl became pregnant at age four. But in general, females tend to become fertile at around the age of 12.

For more information, please consult www.jamaicasicklecelltrust.com. Email questions and comments to saturdaylife@gleanerjm.com.