Doctor's Advice - HIV scare!

Q. Doctor, I am very worried. Last night, I let a girl in Negril give me oral sex. Could she have infected me with HIV/AIDS? Help me, please.

A.  Researchers say that oral sex can pass on HIV, which is the virus that causes AIDS. However, they add that the risk is relatively low, compared with the danger posed by vaginal sex or rectal sex. So unless you have some evidence that this young lady in Negril is HIV-positive, I feel you have no cause to fret.

Q. Hi Doc, can having an abortion prevent a girl from getting pregnant later on? It was at an early stage of pregnancy when I had it done.

A. Well, a lot depends on what sort of abortion this was, and who it was performed by. You do not say whether it was in Jamaica.

Sadly, illegal abortions do often lead to serious medical complications. Occasionally, the woman loses her life. Much more often, she develops long term ill health. And the damage to her internal reproductive organs may indeed lead to infertility - usually because the tubes get blocked. But that certainly doesn't occur in all cases.

When I say illegal abortions, I mean terminations performed by women on themselves, or else performed by persons who do 'back street abortions' outside the Law.

It is a different matter when a termination is carried out by a qualified surgeon in a clean operating theatre, as happens in quite a few parts of the world. In such instances, the chance of subsequent infertility is very low.

Q. Doc, I am a young woman, and I am still a virgin. My boyfriend and I have been together seven years, and we haven't had sex yet. He is still waiting till I am ready to 'go all the way'. Also, it's my culture to postpone it until we get married. But now we have finally decided to live together. Doctor, I am really scared about the prospect of sex. We have tried a lot, but I am still full of nerves, and I couldn't let him do it. Whenever he has tried, it has always been very painful, and I couldn't handle the situation. So can I ask you three questions:1. Is there any way to make sex easy and painless?2. Is there any medicine to get rid of this pain?3. When we last tried, he used a condom. Is there any possibility that I could be pregnant? I am really scared, and worried about losing my virginity.

A. Poor you! You have all my sympathy. I have seen many young women who were in a similar situation to yourself. And I am sure that everything will work out OK in the long run.

Let me try and sum up your story. For perfectly understandable moral reasons, you decided at an early age that you did not want to have sex before marriage. But recently, you seem to have relented somewhat - so you and your boyfriend have been trying to have intercourse. But you have not succeeded.

Based on many similar cases, which I have dealt with, I feel it is likely that you have the well-known conditions called vaginismus. If you look that word up on the Internet, you will see that it is a psychological disorder in which the vaginal area goes into a sort of muscle contract whenever any approach is made to it. That makes intercourse extremely painful or even impossible.

It seems to me that your psychological problem is clearly related to the fact that you don't believe in sex before marriage. That is a perfectly sensible viewpoint. So maybe it would be better if you and your fiancée stopped trying to have sex for the moment, and agree that you will just leave it alone until you have married him.

However, there is one drawback. If you do have vaginismus, getting married is not going to cure your problem. So you would probably find your wedding night very painful indeed.

Therefore, I think you should do something now about starting to get this problem treated. You should begin by consulting a helpful and sympathetic doctor. Research has shown that young women with this condition do best if they consult a female doctor. This is because of the fact that the woman doctor is often regarded by the patient as a sort of 'mother-substitute', who gives her permission to enjoy her own vagina.

Quite a few female doctors, particularly those who work in the field of contraception, have had training is how to teach young women to relax the vaginal muscles. They get very good results.

In answer to your three questions:

1. Seeing such a doctor would be the best way to learn how to enjoy easy and painless sex;

2. Medicine would not help;

3. I think it is very unlikely that your recent attempt at intercourse has made you pregnant.

I wish you both well.

Q. I am very worried about myself, because I have noticed that my morning erections are not as common as they once were. I am sure that when I was 14, I always woke with such an erection. But now I am 21, and this is not happening each morning, Doc. I would say that it occurs only about twice per week. Am I losing my nature? Or do I have some disease?

A. There is nothing for you to fret about. You have not realised that it is normal for the frequency of morning erections to lessen as a guy progresses through his teens and into adulthood. In fact, two morning erections per week is about average for a male of your age. So please quit fretting.

Email questions to Doc at saturdaylife@gleanerjm.com and read more in the Outlook Magazine tomorrow.