Saturday, 8 July 2017

Know More About Fibroids

More than two million women worldwide are operated for hysterectomy every year and approximately one third, that is, 6,00,000 are performed because of fibroids. So what are fibroids? Fibroids are noncancerous growth of the muscle wall of the uterus. Fibroids behave differently depending on their size, location, number and associated disorders and hence have a unique behavioural personality. 30 per cent of women have fibroids and a large proportion of these will become symptomatic later on.

Know More About Fibroids 

FIBROIDS THAT CAUSE BLEEDING
PROBLEMS 

Large fibroids in the wall of the uterus, multiple fibroids and fibroids near the inner lining are responsible for heavy bleeding. The normal uterus has two basic ways to stop this bleeding.The first is the blood clotting mechanism that works throughout the body by forming plugs in the blood vessels. The second is unique to the uterus, which has an ability to contract and squeeze the bleeding vessels in the muscular walls. The presence of fibroids possibly does not allow the uterus to squeeze down properly, and so it can’t stop the flow of blood from the vessels and thus it is common for fibroids to cause an increase in the amount of menstrual bleeding.


FIBROIDS THAT CAUSE PAIN 

Fibroids grow because they receive blood flow from the arteries supplying the uterus. They grow at different rates. Some slowly and others quickly. When they grow at a very fast rate, the blood vessels feeding the fibroids may not be able to supply enough blood, resulting in cell death in some parts of the fibroid. This is called degeneration. Due to this degeneration, chemical substances are released that cause pain. This pain can be severe and incapacitating but usually not associated with any other serious problem. An extremely large fibroid can cause pelvic discomfort and a dragging pain continuously. Such fibroids need to be removed. Medicines like anti-inflammatory agents can take away the pain and provide temporary relief.


FIBROIDS THAT CAUSE URINARY PROBLEMS 

The uterus lies directly beneath the urinary bladder and they are partially attached at one point. If a fibroid begins to grow forward, it may push the bladder so that it cannot fill properly, this increases the urge to pass urine frequently. Very large fibroids may obstruct the ureters (which is the tube that carries urine from kidneys to bladder), thereby resulting in back pressure changes in the kidney. Such large fibroids definitely need to be removed.


FIBROIDS AND INFERTILITY 

A small group of fibroids may not allow pregnancy. Fibroids that are located close to the inner endometrial lining and those, which distort the uterine cavity can be responsible for infertility. Also very large fibroids can interfere with pregnancy. These fibroids can be easily treated with hysteroscopy (telescope inserted inside the womb). Larger fibroids are removed laparoscopically.

(telescope inserted inside the womb)


FIBROIDS THAT CAUSE MISCARRIAGE 

Some fibroids, especially the inner lining ones, can interfere with the growth of the developing embryo. These change the internal milieu resulting in a miscarriage. Such fibroids warrant removal hysteroscopically. During pregnancy, fibroids also grow faster.


FIBROIDS AND CANCER 

Fibroids by definition, are benign (non-cancerous) growths. However, very rarely, fibroids can undergo cancerous changes. The incidence is 1:750. Out of all women who have surgery for fibroids one out of approximately 750 would have leiomyosarcoma (fibroid cancer). The treatment in such cases is removal of the uterus and the ovaries if the patient is over 50 years and if her fibroids are growing rapidly.


FIBROIDS THAT RECUR 

Once a fibroid has been removed, it doesn’t come back. However, new ones can grow from other muscle fibres. Clinical recurrence occurs in 15-20 per cent of women within 10 years. The recurrence of fibroids does not depend on the technique with which it was removed the first time, but it is solely dependent on genetic tendencies. Women with only one fibroid in the past have a lower recurrence rate, while those with multiple fibroids have a higher recurrence rate. Fibroids that come back can also be treated laparoscopically.


FIBROIDS THAT CAN BE OBSERVED

If the fibroids are not very large and without bothersome symptoms a patient can wait. She must get an annual pelvic examination and sonography. If the fibroids are growing rapidly and symptoms appear, laparoscopic removal is advised. Fibroids must be dealt with judiciously and if surgical treatment is necessary, endoscopy is the answer.

Saturday, 3 June 2017

ASK THE DOCTOR - Helping Relieve Sexual Tension

A friend of mine — a single mother — has a physically challenged son suffering from cerebral palsy. She wants to know if it is OK for her to masturbate her son as he is unable to do so himself. Is it OK for relatives/siblings to help relieve sexual tension by masturbation? If not, what is the correct solution?
- ABC

ASK THE DOCTOR - Helping Relieve Sexual Tension


It is absolutely not advisable for relatives to masturbate the physically challenged person suffering from cerebral palsy. Only he can know his sexual needs, their nature and their intensity, if at all. His ability to understand his sexual needs and the necessity to relive his sexual needs cannot be assessed or guessed by anyone from outside. He may or may not be experiencing any such need physiologically. If an erection is noticed in such an individual, it need not always be a sign of sexual arousal. An erection can happen periodically in men irrespective of sexual urges. You may confuse and even torment the physically challenged person by attempting to masturbate him.

This situation can also be taken advantage of by a ‘sick’ relative who may be carrying a fetish similar to pedophilia and may sexually abuse the child under the garb of relieving the child’s sexual tension. The sexual tension built in a person does get relieved naturally through periodic nocturnal emissions.

Friday, 2 June 2017

ASK THE DOCTOR - Unable to sustain an Erection for Long

I am a 51-year-old married man. My erection does not sustain for long. What can I do?
- Kothari

ASK THE DOCTOR - Unable to sustain an Erection for Long


This is a form of Erectile Dysfunction (ED). There are many organic (physical) as well as psychogenic causes for this problem. It is necessary to find out the cause of this problem first, through history taking, examination and investigations. Once the cause (diagnosis) is found, treatment can be advised. Very effective drugs, Sildenafil citrate and Tadalafil, are now available in India for the complaint of inability to ‘sustain’ the erection. Remember, these drugs cannot bring about erection in a flaccid penis. They only help to ‘sustain’ the existing erection longer.

These drugs are useless in those who have difficulty in getting an erection. It helps only those who get an erection ‘on their own’ but cannot sustain it long enough to perform satisfactory sexual intercourse. You could be benefited with these drugs. However, neither can you get these drugs without a proper prescription by a qualified specialist, nor should you take it on your own. There are risks involved in taking them; and unless you are guided by a qualified expert, kindly avoid selfmedication.

Thursday, 1 June 2017

ASK THE DOCTOR - Is Discharge in Adolescent Girls Normal?

Is vaginal discharge in adolescent girls a normal phenomenon? Does it happen due to fungus or infection?
- D M

ASK THE DOCTOR - Is Discharge in Adolescent Girls Normal?



Most adolescent girls get a sticky, white discharge from their vagina. This is a perfectly normal and healthy sign that the pubertal changes have begun in you. Sometimes, this discharge can get on a girl’s underwear. It is good to pay close attention to your normal discharge and how it changes during your monthly cycle so that you can recognise any unusual signs or changes. If you closely pay attention, you will notice that the discharge is not always the same. Sometimes it may be clear while at other times it may be a bit whitish. When you are ovulating, it may become clear and slippery.

A female’s vaginal fluids/discharge also alter when she gets sexually aroused. If the discharge becomes thicker or heavier, changes colour to yellow, green, rusty or brown, or causes burning or itching in the private parts, it is suggestive of an infection. Foulsmelling discharge, and pain or bleeding in the vagina when you are not in your menstrual period, are also signs of infection. If you experience any of these changes, you will need to see a doctor.

Wednesday, 31 May 2017

ASK THE DOCTOR - Sex During the Menses

Is it true that if a virgin is suffering from severe pain during her menses for a long time and she has sexual intercourse, it cures her problem? Is sex during the menses responsible for developing sexually transmitted infection?
- P.K.

ASK THE DOCTOR - Sex During the Menses


There is absolutely no truth to the rumour that sex cures menstrual pains. In fact, sex during menstruation can increase the risks of getting sexually transmitted diseases (STDs), including HIV. Menstrual blood is a rich medium/environment in which bacteria and viruses can grow very quickly. If a menstruating female has sexual intercourse with a male who has an STD, she is more likely to get infected than during other times of her monthly cycle. In addition, she is likely to get a more ‘serious’ infection when she is menstruating.

This is because the opening of the cervix (mouth of the uterus) is wider than usual so that the menstrual blood can flow out. The STD germs can travel up into the uterus and fallopian tubes and can cause an infection high up in the female reproductive system. This can result in ‘infertility’. For the male, having sex with a menstruating female is also risky. If she is infected with HIV, her menstrual blood will be rich in HIV viruses.

Tuesday, 30 May 2017

ASK THE DOCTOR - Fantasy of Rape

I am a 25-year-old married woman. Very often I indulge in a fantasy of being raped by someone. I read somewhere that all women carry this fantasy in their mind. Is it normal to have such thoughts?
- R.Shah

ASK THE DOCTOR - Fantasy of Rape


It is true that there are some women (not all) who at some point or the other in their lives carry the fantasy of being taken sexually or being swept off their feet. These fantasies are common but not universal. This idea is played up a lot by some western fiction, pornographic literature and even the mass media. It is important to note that there is a great difference between a self-projected fantasy and an actual rape. Fantasies are our own creation, and thus we have control over it. It can be a great ‘turn on’ for some, but it is not the reality. In reality, rape is a violent act, forced and unwarned, over which a victim has no control at all.

Very often it is seen that a fantasy is necessary when there is a lack of emotional intimacy between partners and sex is merely a physical activity. Therefore, both you and your husband need to deeply examine your relationship, either on your own individually, or with the help of a good counsellor, to determine what can be done to enhance the emotional intimacy so that such fantasies are not required.

Monday, 29 May 2017

ASK THE DOCTOR - Does size Matter?

I am 22 and my fiancé is 27. We will be getting married in November. Recently my fiancé made a confession to me that his penis is small in size; that worries him as to whether he will be able to satisfy me through intercourse. I would like to know whether it is true that satisfaction of a woman depends on the size of the male penis?
- Savita

ASK THE DOCTOR - Does size Matter?


A large number of men carry the complex of small penile size. The size is invariably thought to be the parameter for one’s manliness and one’s ability to satisfy his partner. First of all, the woman’s satisfaction does not depend on the size of the penis. On the contrary, too big a penis can be a problem, as it could hurt the partner. The fact is, that only the outer 1/3rd of the woman’s vagina (approximately 2 inches) is sensitive to sexual stimuli. So, it doesn’t matter to a woman how deep one reaches during the intercourse. If an erect penis is even 2 inches, which is usually the case with most men, it is enough to satisfy his woman. It is not the size, but what you do with what you have, that truly counts.

In men too, only the ‘Glans-penis’ (the front portion) is sensitive to erotic sensations. The shaft behind the glans is incapable of feeling erotic sensations. So the pleasure of the male partner too, does not depend of the entire length of the penis, but depends only on the sensitivity (and not the size) of the glans-penis. A common mistaken belief that a flaccid penis gains in size on erection, in proportion to its flaccid size, causes this fear. The fact is that, though all the penises are different in their flaccid state, they become much more similar in size, when they get erect. Also, one tends to find his penis small as it is always seen from above, as against that of others, which is observed from the side or from the front. The different angles from which the penis is viewed also makes the penis ‘appear’ small or big, as the case may be.

Sunday, 28 May 2017

ASK THE DOCTOR - How do I know if my wife is satisfied?

I will be getting married this year. I wish to know wether women experience orgasm and ejaculate during sex? How can I know whether my wife has reached her orgasm and is satisfied?
- Navjyot




Girls/women lubricate at the vagina on arousal. On either sides of the vaginal opening, women have the Bartholin’s glands, in four o’clock and eight o’clock positions. These glands secrete a mucus-like fluid during sexual arousal, providing vaginal lubrication. Women too experience orgasm/climax, however they do not ejaculate like men during orgasm.

The only way to know about her orgasm/satisfaction is to ask her verbally and then believe her answer. What feels good to her is best assessed by her and known only after experimenting and experiencing. Let her be equally active during sex and she will guide you to her satisfaction.

Thursday, 18 May 2017

ASK THE DOCTOR - Treatment for Premature Ejaculation

I am a 45-year-old man. I have been married for 14 years with two kids.I want to know what is the treatment for premature ejaculation? I am suffering from it. Kindly reply.
- Vettikunnel

ASK THE DOCTOR - Treatment for Premature Ejaculation


Premature Ejaculation is not a physical problem, but a ‘learning disability’. There are no medical causes for premature ejaculation. It is essentially of a psycho-behavioural and relational origin. Modern medicine does not offer any drug treatment for this problem. Ejaculating early is a learned reflex response that can be effectively re-conditioned when a man and a woman actively learn ejaculation control together. You need to increase your awareness of the sensations of arousal building so that you can identify the level of your arousal. Secondly, awareness of sensations of arousal and ejaculatory control can be learned by following a step-by-step process. We teach couples the use of the ‘squeeze technique’ or the ‘stop-start technique’. Besides techniques, certain ‘exercises for sphincter control’ and ‘use of condom’ may help in some cases.

Wednesday, 17 May 2017

ASK THE DOCTOR - Is Watching Porn Normal for a Married Man?

My husband who is a pharmacist has great faith in your words and your knowledge. He watches a lot of porn. I hate it. He says it helps him to stay interested in sex. We argue often over this matter. He calls me abnormal. Kindly answer who is abnormal — him or me?
- H K B

 ASK THE DOCTOR - Is Watching Porn Normal for a Married Man?


It will not be correct to call either of you normal or abnormal. You are simply different from each other. Both of you have a right to choose what you like. Give that freedom to each other.

It is definitely a sign of sexual immaturity when one looks for excitement in pornographic films or literature. For such a person, sex is only skin deep. He is not adequately sensitive to the psychological and emotional components of sex. Counselling could help him to mature sexually and even otherwise.

 Let me add that outside inputs are necessary when there is a lack of love between partners… when sex is merely a physical activity. This lack of love cannot be blamed on only one partner. Love happens between two sensitive human beings. Both of you need to deeply examine your relationship, either on your own individually, or with the help of a good counsellor. Meanwhile, at least stop looking down upon your husband. Change your focus from him to yourself. Ask yourself what you can do to bring more depth into your relationship and make it more than sex — a sharing of intimacy.

Tuesday, 16 May 2017

ASK THE DOCTOR - Involuntary Ingestion of Fluids

During cunnilingus, there is involuntary ingestion of vaginal fluid. Is it harmful? If so, what preliminary preparations do you suggest before the act?
- Sunita

 ASK THE DOCTOR - Involuntary Ingestion of Fluids


If vaginal fluids are contaminated with infective agents (bacteria, virus, fungus) it can transmit infectious diseases during cunnilingus. Certain fungal, viral infections and parasitic infestations are commonly present on the genitals and may not be visible to the naked eye. A person may be harbouring these infections without manifesting any signs or symptoms, and oral sex could cause transmission of such infections to the partner. HIV/AIDS can also get transmitted through cunnilingus if either of the partners is infected. If the person is truly not infected with any STD, in that case swallowing vaginal fluids involuntarily may not be harmful.

Monday, 15 May 2017

ASK THE DOCTOR - Painful Intercourse

I am an 17-year-old girl. I have tried for the first time to have sexual intercourse with my boyfriend but just as he tries to insert his penis in my vagina, I get an extremely severe pain — so I ask him to stop. Please tell me, is it normal to have so much pain during penetration? Is it safe to let him continue the act anyway, irrespective of my pain?
- Kajal K

ASK THE DOCTOR - Painful Intercourse


Many girls unconsciously carry an apprehension about penetrative sexual intercourse and therefore are unable to comfortably respond during the first few experiences of intercourse. This may also happen because her emotional involvement in this relationship is not yet ‘ripe’. If there is unbearable pain, do not force yourself into the act. You may cause harm/injury to yourself. A tight hymen also can cause this problem. For this, you require an examination by a gynecologist.

Also remember that there is always the possibility of an unwanted pregnancy and STD once you go all the way, even if you are using contraception.

You are just 17. Don’t rush things. Grow and relax in this relationship. Know each other better. Sex will be more comfortable and pleasurable as you and your relationship matures.

Sunday, 14 May 2017

ASK THE DOCTOR - If the Blood Groups of Both Husband and Wife are the Same, can they Both have Children?

If the blood groups of both husband and wife are the same, can they both have children?
- Lakdawalla

 ASK THE DOCTOR -  If the Blood Groups of Both Husband and Wife are the Same, can they Both have Children? 


It is a myth that people with the same blood group cannot conceive. Having the same blood group is perfectly fine. Fertility does not depend on blood groups or matching of blood groups. Blood group matching in a couple is given undue importance by some illinformed people. It carries importance only to the point, that if ‘Rh factors’ of both the partners are not matching, it can be harmful for the second child of the couple. However if such incompatibility is known beforehand, precaution may be taken to avoid any harm to the second child. An injection of “Anti D Immunoglobulin” to the mother immediately after the birth of her first child (or first abortion) is all that is required to prevent any harm to the subsequent pregnancy.

Saturday, 13 May 2017

ASK THE DOCTOR - What are the Advantages and Disadvantages of a Vasectomy?

I am a 45-year-old man with two children. My wife and I do not want to have any more children. I am planning to go in for a vasectomy operation soon. I want to know the advantages and disadvantages of a vasectomy.
- J Gonsalves

  ASK THE DOCTOR  - What are the Advantages and Disadvantages of a Vasectomy?



During a vasectomy (male sterilisation surgery), the tube that carries sperms (vas deferens) from each testicle is clamped, cut or sealed. This prevents sperms from mixing with the semen that is ejaculated from the penis. An ovum (egg) cannot be fertilised when there are no sperms in the semen. The testicles continue to produce sperms, but the sperms are re-absorbed by the body. Because the tubes are blocked before the seminal vesicles and prostate, one still ejaculates about the same amount of semen. Sexual desire and erectile function remain unaffected after this surgery.

Advantages: Vasectomy is a ‘permanent’ method of contraception (birth control method). Once your semen does not contain sperms, you need not worry about using any other contraceptive. It is a shorter, safer and cheaper procedure that causes lesser complications than ‘tubal ligation’ surgery in women.

Disadvantages: The procedure MAY cause bleeding or infection under the skin, which may cause swelling or bruising. In extremely rare cases, the vas deferens grows back together (recanalisation), and the man becomes fertile again.

Friday, 12 May 2017

ASK THE DOCTOR - First Time Anxiety

I am frightened of having sex with a man. I fear that I will freeze up and freak out and not perform on my part. When having sex for the first time, does it hurt when the man breaks the hymen?
- Nisha

ASK THE DOCTOR - First Time Anxiety 


Sex is not about performance. Sex is a continuation of the communication you have with your partner. Yes it may hurt the first time, however this is transient. Moreover, it can be greatly minimised by helping each other relax, and if adequate foreplay is done to prepare each other for intercourse. A good foreplay in a relaxed atmosphere produces good amount of lubrication at the vagina, and that minimises the pain. Do choose a partner who you trust, feel comfortable with, and with whom you can communicate. Sex is really more about intimacy. Sex just for the sake of sex is somewhat empty. If you love him it is easier.

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