What con­tra­cep­tive method should we use?

Jamaica Gleaner - - NEWS - Email ques­tions to Doc at sat­ur­daylife@glean­erjm.com and read more in the ‘Out­look Mag­a­zine’ to­mor­row.

Q Doc, I am a girl of 19 and I don’t know much about sex. My boyfriend and I have fi­nally de­cided that we are go­ing to ‘do it’ be­fore Christ­mas. We don’t want our par­ents to know this, so please do not pub­lish any­thing that will iden­tify us.

So can you please ad­vise us? What kind of con­tra­cep­tion is avail­able to us?

A Well, if you re­ally have made up your minds to go ahead, then you should def­i­nitely use some highly re­li­able birth con­trol (i.e. con­tra­cep­tion).

The main meth­ods which are eas­ily avail­able to young cou­ples these days are as fol­lows:

The male con­dom: Avail­able cheaply in many places. I strongly ad­vise that you two buy a few pack­ets now, so that you will have some with you if you get car­ried away by de­sire. The fe­male con­dom: On sale in quite a few phar­ma­cies. Helps make a young wo­man feel in charge of her own body.

The Pill: The over­whelm­ing choice of a vast num­ber of younger fe­males. Has the added ben­e­fit that it makes the menses much eas­ier to bear. But ask your doc­tor about pos­si­ble side ef­fects. The mini Pill: A milder prepa­ra­tion, with less risk of side-ef­fects. You have to take it ev­ery sin­gle day with­out fail.

The coil (or IUD): Can be a lit­tle dif­fi­cult to insert in a young wo­man who has never had chil­dren, but a good method.

The med­i­cated coil: Very ef­fec­tive and may give you lighter menses.

The shot: Al­most 100 per cent ef­fec­tive, but can some­times lead to chaotic pe­ri­ods. Get ad­vice from a doc­tor about side ef­fects be­fore you go ahead.

Ex­cel­lent brochures about sex and con­tra­cep­tion for young peo­ple are avail­able from the Ja­maica Na­tional Fam­ily Plan­ning Board.

Q Hi, Doc. I am a guy of 18. I am not gay be­cause I like girls. How­ever, an older male friend has sug­gested that we ‘fool around’ a lit­tle to­gether, just for fun.

When I said to him that this sounded a lit­tle bit gay, he just said: ‘No, no, it is only fin­ger play’.

What do you think, Doc?

A My guess is that this older guy is ho­mo­sex­ual. Clearly, he wants to go in for some sort of gay love play with you, and maybe he hopes that it will even­tu­ally lead to oral sex, or even gay in­ter­course. You say that you are het­ero­sex­ual, and if that is true, I feel you would do bet­ter to steer clear of this older man’s games.

Q I am 20 and have al­ways en­joyed a happy sex life with my fiancé, but for the last month, I have ex­pe­ri­enced pain deep in­side me when­ever he thrusts deeply.

A friend of mine says this is prob­a­bly psy­cho­log­i­cal. What do you think, Doc?

A There is no way that this deepseated pain is psy­cho­log­i­cal. The odds are that some­thing is phys­i­cally wrong in the re­gion of your cervix. You re­ally must see a doc­tor and un­dergo a good in­ves­ti­ga­tion. She will be able to look in­side you with a spe­cial in­stru­ment called a specu­lum in or­der to see what sort of shape your cervix is in. What­ever the prob­lem, I am sure it can be cured.

I am em­bar­rassed to ad­mit this, but last week I caught my pe­nis in the zip of my pants. It bled quite a bit, Doc. How­ever, it has now stopped, but it is very far from healed up!

Do you think ev­ery­thing will be OK?

A Most lit­tle cuts to the pe­nis do heal up even­tu­ally, and ev­ery­thing works out al­right. Nev­er­the­less, you can­not take chances with this del­i­cate or­gan.

I strongly sug­gest that you let a doc­tor take a look at this in­jury right away. Don’t be afraid. It is most un­likely that he will need to do any­thing dras­tic to it, but he can give you an ex­pert as­sess­ment of the sit­u­a­tion.

Un­til you can get to see the doc­tor, gen­tly bathe the wound twice a day with any an­ti­sep­tic in­tended for the skin. It would be best if you didn’t at­tempt any sex­ual ac­tiv­ity un­til the in­jury has com­pletely healed.

Q I am 18, and one of my breasts is quite big, while the other is al­most non-ex­is­tent, Doc.

I am to­tally flat on that side, and my bra-cup is com­pletely empty. Do you think that my flat breast will even­tu­ally grow to a nor­mal size?

A I am sorry to say that I think that is a lit­tle un­likely, es­pe­cially as you are al­ready 18.

Your best move now would be to con­sult a plas­tic sur­geon for spe­cialised ad­vice. It may well be that you will need to take an op­er­a­tion to place an im­plant un­der the skin on the left side of your chest, so as to give you a nor­mal-look­ing and nor­mal-feel­ing breast. Good luck.

I was hit by a car two years ago and had to have one of my tes­ti­cles re­moved. I am grate­ful to say that I still get good erec­tions and I can mas­tur­bate and or­gasm, pro­duc­ing about a tea­spoon­ful or two of man-fluid.

Doc, do you think I will be able to have chil­dren?

A I would say that it is highly likely that you are fer­tile. For­tu­nately, when this kind of in­jury oc­curs, the re­main­ing tes­ti­cle is ca­pa­ble of tak­ing on the work of two.

If you want to be more cer­tain, you could go to a doc­tor and ask for a sperm test, but I think you will be OK.

Q Doc, where on earth is my cli­toris, please? I am fe­male, age 20, and I just can­not work out where it can be.

I sup­pose that one day I will get mar­ried and have sex. But at the mo­ment, I can’t see how I can do it be­cause I am sure I don’t have one of those cli­toris things.

Can you ad­vise me, please?

A Well, a sur­pris­ing num­ber of younger women are not very sure where the cli­toris is, but I am quite cer­tain that you do have one. In my en­tire med­i­cal ca­reer, I have never seen a fe­male who re­ally did not have a cli­toris.

Your best move is to look at a re­li­able anatom­i­cal draw­ing, which shows the po­si­tion of this lit­tle or­gan. Un­for­tu­nately, on the In­ter­net; there are many di­a­grams that don’t show it clearly, or which are just plain wrong; how­ever, if you look at the Wikipedia en­try on ‘cli­toris’, you will find that low down on the right hand side of the screen there is a real clear colour pho­to­graph (with la­bels) that shows ex­actly where it is.

If af­ter that you are still un­cer­tain, I sug­gest you con­sult a sym­pa­thetic fe­male doc­tor who can re­as­sure that you do have one and show you pre­cisely where it is lo­cated.

I am a guy of 18 and have never had erec­tions or an or­gasm, so I sup­pose I am im­ma­ture. What should I do, Doc?

A Ask a doc­tor to ex­am­ine you and then send you to a gland spe­cial­ist (an en­docri­nol­o­gist) at the Univer­sity Hospi­tal. There, they will do hor­mone tests and give you treat­ment to try and help you to ma­ture.

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