Jamaica Gleaner

I have sagging breasts from breastfeed­ing

- Deardoc@gleanerjm.com

There are many different brands of ‘firming’ creams available in most pharmacies and beauty shops. Technicall­y, they cannot repair the stretched ligaments and reduced skin elasticity which causes sagging breasts – the only solution for this is surgery.

However, these creams do provide moisture to the skin which makes the breasts appear firmer. Many of them also contain vitamin E and other antioxidan­ts which improves skin tone and texture, so there is some benefits in using them.

Be careful of products that contain steroids and retinue, as they are not meant for long-term use, and should only be prescribed by a physician.

Homemade pastes such as cucumber blended with an egg yolk, or some aloe vera applied to the breasts for half-hour, also provides moisture and improves skin tone and texture. These have the advantage of not containing any artificial ingredient­s, so they can be used on a daily basis.

Exercises that strengthen the chest muscles also improve breast support. Invest in high-quality, well fitting bras, and take care of your overall health and this will, over time, improve the appearance of your breasts.

Worried about constant bleeding

QDoc, I have a problem — I have been bleeding for about three months non-stop with heavy clotting in between. I did a Pap smear and it came back normal. My gynaecolog­ist put me on birth control to stop the bleeding, but it just helps a little for a few days, then the bleeding is back again. I don’t know what to do! Do you know what is wrong with me? I am getting very depressed. So sorry to hear about what you have been going through. There are numerous factors that could be causing this. The most common encountere­d locally

Ainclude: Withdrawal bleeding from incorrect use of oral contracept­ives/emergency contracept­ive. Uterine fibroids. Hormone problems such as polycystic ovarian syndrome. Ovarian pathology. Retained products from incomplete abortion. There are other possibilit­ies, such as liver disease, blood disorders and thyroid problems. As you can see, the list is exhaustive, and these are just a few. You need to go back to your gynaecolog­ist, who will do the necessary blood and imaging studies which should give more clarity as to the cause of your problem.

INever had an orgasm

QI’m 23 years old and my boyfriend is 27. I’ve been having sex since I was 17, but I’ve never had an orgasm. We have been together for two years now, and my boyfriend and I are worried that I may never climax when he makes love to me.

What can I do to get myself relaxed and empty my mind of other thoughts when having sex? He always tries clitoral stimulatio­n, but I just can’t seem to have an orgasm. Maybe I could orgasm if I had more time with intercours­e, but my boyfriend doesn’t last more than 10 minutes. I am beginning to think that I won’t ever get to experience that ‘good feeling’ that others describe. How can I get relaxed completely, and what else can my boyfriend and I try? This is an issue which is very common and has been addressed several times in this column. The factors which play a role in female orgasm are multiple, complex and poorly understood. For many women, psychologi­cal factors are significan­t, and the comfort level with the partner as well as with their own bodies are also very important.

Providing there are no medical conditions, many women require about half an hour of foreplay (kissing, cuddling, caressing, etc) before they are fully excited and ready for vaginal penetratio­n.

AThe clitoris has a lot of nerve endings, so sometimes direct stimulatio­n may defeat the purpose. The best advice is to communicat­e with your partner – be honest about your sexual needs, and take the time to get comfortabl­e with each other before direct intercours­e. Examine your own attitudes towards sex. If nothing changes, then visit your doctor who will give you a checkup and, if necessary, refer you to a sex therapist for counsellin­g.

My friend is worried about being pregnant

QDear Doc, my friend thinks she is pregnant because recently her boyfriend ejaculated on her dress. I try to tell her that it is not possible, but she does not believe me. She is talking about abortion. What should I tell her? Sperms do not survive long outside of the body. They die once the semen has dried out. They can survive up to an hour if the ejaculate is not dry. Theoretica­lly, the dress would have to be resting firmly against her vulva for even a

Aslight chance of pregnancy to occur. It is highly unlikely but not impossible, so get a pregnancy test done instead of making assumption­s, and have her consider using condoms when having sex if she is not ready to become pregnant. She should visit her doctor if she misses her next period.

Boyfriend says he can’t get me pregnant at 20

QDear Doc, I have been dating a young man whom I have recently begun to have sexual intercours­e with. I am very concerned about getting pregnant, however, he insist that he cannot get me pregnant in his 20s and doesn’t want to wear a condom. He is 25, and he says his father and brothers either have children in their teens or 30s. I find this unbelievab­le and, therefore, have taken my own precaution­ary measures. Tell me if what he is saying makes sense. Is it possible for him to be sterile/infertile in his 20s only? It is good that you have taken precaution­s to prevent unwanted pregnancy, but bear in mind that condoms are the only contracept­ive method which also reduces the risk of contractin­g a sexually transmitte­d infection. I am sorry to tell you that what he is saying is absolute nonsense. There is no medical condition which makes a man fertile in his teens, then infertile once he hits his 20s and then fertile again at 30!

For sure, there are genetic conditions which interfere with sperm developmen­t, but this causes infertilit­y throughout the reproducti­ve years and not selectivel­y to a particular decade.

Many men use this ploy because they do not want to wear a condom, because it reduces the sensitivit­y of the penis, to an extent, in different individual­s, and many men (and women) derive more pleasure from going ‘bareback’. Have an open and honest discussion with your partner. Tell him your concerns about getting pregnant, and I am sure you can reach a reasonable compromise.

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