ASK THE DOCTOR - ‘Will an IUD Hamper Sex?’

I delivered my first child four months ago. My family doctor has advised me to use an IUD as a contraceptive. Kindly give more information about IUDs. Will an IUD come in the way of enjoying sex?
- Nilima

An IUD (Intra-uterine device) is a small object made of plastic, copper or stainless steel. Copper T is one such IUD that is shaped in the form of a ‘T’. Your doctor places it inside the uterus. The arms of the Copper T contain some copper, which stops fertilisation by preventing sperms from making their way up through the uterus into the fallopian tubes. If fertilisation does occur, the IUD would prevent the fertilised egg from implanting in the lining of the uterus. The IUD can stay in your uterus for up to 3 to 10 years. The IUD is 90-99 per cent effective at preventing pregnancy. It requires visits with your doctor to have it inserted and to make sure you are not having any problems. The upside is that once a doctor places it inside your uterus, you cannot feel it and can forget about it for 3 to 10 years. Moreover, they are cost-effective. The downside of IUDs is chances of pelvic infections, excessive menstrual bleeding and a higher risk of contracting STDs. An IUD does not interfere in any manner in enjoying sexual intercourse as it is within the uterus and not in the vagina. 

ASK THE DOCTOR - It is normal for children to play ‘doctor’ with each other?

QUESTION:
I was disturbed when I noticed that my five and half year old nephew was playing “doctor” with my 4-year-old daughter and another friend. The ‘game’ involved the showing private parts to each other. What should I do if I catch them playing “doctor” again? Is it normal? I am afraid that my daughter might be a victim of sexual abuse if I do not take action now.
- R Chopra

ANSWER:
Children from three to six years of age are most likely to play “doctor.” Many parents overreact when they witness or hear of such behaviour. Heavy-handed scolding is NOT the way to deal with the situation. Nor should parents feel this is promiscuous behaviour or will lead to promiscuity. Often, the presence of a parent is enough to interrupt the play. You may wish to direct your child’s attention to another activity without making a lot of fuss. Later, sit down with your child for a talk.

Explain that although you understand her interest in her friend’s body, she is getting  to be a big girl and people are generally expected to keep their bodies covered in public. This way you have set limits without having made the child feel guilty. This is also an appropriate age to begin to talk about good and bad touch. Tell your child that her body is her own and that she has the right to privacy. No one should touch her if she doesn’t like it or want it. Tell her that if anyone ever touches her in a way that feels strange or odd, she should tell that person to stop it and then tell you about it. Explain that you want to know about anything that makes her feel odd or uncomfortable. 

ASK THE DOCTOR - What is circumcision?

QUESTION:
I am a 32-year-old man deeply in love with a muslim girl. I am going to marry her soon. Her family members have insisted that I should get myself ‘circumcised’ before marriage. I want to know what exactly is circumcision and how many days will it take to heal the wound?
- A Mhatre

ANSWER:
Circumcision is a small surgery. It takes only 20-30 minutes and is done under local anaesthesia. The patient is sent home on the same day after a couple of hours. One can have it done by any general surgeon in a hospital or a nursing home. The wound heals within seven to ten days, however, sexual intercourse in not advised for about four to six weeks after the surgery.

ASK THE DOCTOR - What is ‘Surgical Menopause’?

QUESTION:
I am a 48-year-old woman. Three years ago I had undergone a hysterectomy operation. My ovaries were removed. The doctor advised me to take hormone tablets (Premarin). But after almost one and half years, my family doctor advised me to stop taking the tablets as they may have some side effects. After that I have totally lost interest in sex and there is a guilty feeling in me as I am unable to satisfy my husband. In spite of taking medicine, my BP is always high. I also experience mood swings. Is there any connection between the removal of ovaries and my other problem?
- Shaila

ANSWER:
Ovaries produce female hormones (Estrogen and Progesterone). If the ovaries are surgically removed, it causes a rather abrupt “surgical menopause” as the female hormones are now not produced in your body. It is due to this reason that your gynaecologist advised you to take hormone supplements. On the advise of your family doctor when you stopped taking the hormone tablets, you started producing menopausal symptoms which are inevitable for every menopausal woman due to withdrawal of female hormones. The loss of interest in sex, mood swings, fluctuating BP are the symptoms of menopause. Menopausal symptoms can be managed successfully with treatment. I advise you to consult a gynaecologist for the management of your menopausal symptoms.

ASK THE DOCTOR - What is Peyronie’s disease?

QUESTION:
I am a practicing doctor. I wish to know, what is Peyronie’s disease? What are the various options for treating this disease? Kindly explain in detail.
- Dr Mahadevan

ANSWER:
Peyronie’s disease (also known as fibrous cavernositis or plastic induration of the penis), first described by French doctor Francois de la Peyronie in 1743, is characterised by the formation of a plaque or hardened scar tissue (fibrosis) beneath the skin of the penis that causes pain, curvature, and distortion, usually during erection. The treatment choices for patients with Peyronie’s disease are very limited. The objective of treatment is mainly to maintain normal sexual function and relieve pain. Invariably, surgery is the only effectual treatment, and as Peyronie’s disease may simply resolve by itself, doctors often suggest waiting for one or two years before going for this option. The non-surgical treatment should be implemented within six months of the onset of the symptoms and before the plaque has calcified. Para-aminobenzoate tablets (B complex substance) and Vitamin E capsules can be taken for few months. A calcium channel blocker such as verapamil, an enzyme (collagenase) that breaks down connective tissue, and steroids such as cortisonecan be injected into the plaque or delivered by ‘iontophoresis’. Iontophoresis is a painless method of delivering medication to localised tissue using an electrical current.


Source:

Peyronie Disease Treatment in India

ASK THE DOCTOR - Sex and hysterectomy?

QUESTION:
I am a 44-year-old married woman. Two years ago I had my hysterectomy done. Even my ovaries were taken out. The gynaecologist told me to take Premarin pills after the operation. Six months ago a doctor friend told me to stop these tablets immediately as they can cause harm. Since I stopped the tablets, my sex desire has gone down drastically. My BP has been going high too. I get crazy mood swings. Why is all this happening?
- Mathur

ANSWER:
Ovaries produce female hormones (estrogen and progesterone). If the ovaries are surgically removed, it causes a rather abrupt ‘surgical menopause’ as the female hormones are now not produced in your body. It is due to this reason that your gynaecologist advised you to take hormone

supplements. On the advice of your doctor friend, when you stopped taking the hormone tablets, you started producing menopausal symptoms which are inevitable for every menopausal woman due to withdrawal of female hormones. The loss of interest in sex, mood swings, fluctuating BP are the symptoms of menopause. Menopausal symptoms can be managed successfully with treatment. I advise you to consult a gynaecologist for the management of your menopausal symptoms. 

ASK THE DOCTOR - My wife lacks an interest in sex?

QUESTION:
I am a 55-year-old man in good physical health and married happily for the last 30 years. I have a good sex drive and desire to have sex as often as I can with my wife of fifty years. However since the last few years, I find that my wife is not taking an interest in sex. After her menopause, she complains of dryness in her vagina which makes it difficult to enjoy sex. Apart from this physical issue, I find that she doesn’t take any initiative in sex and avoids the same on some or the other pretext. As a result, we have sex only once in a fortnight, whereas I desire sex at least twice a week.
- XYZ

ANSWER:
Menopause is invariably wrongly blamed for declining interest in sex in women. The cause for lack of matching interest in sex in partners could be physical, psychological, situational or even out of a so-called religious belief. It is necessary to find out the cause of such sudden loss of interest in sex. Only after knowing the cause, therapy can be planned.

For your information, a woman’s interest in sex depends on the following factors:

Integration of Love and Sex:
A woman operates through her heart. Her sex-life is not separate from the rest of her life. She sees everything in her life as inter-related. As against this, man tends to compartmentalise. He can mentally put aside stressful aspects of his life and separate it from sex. A woman needs good feelings and experiences during the day to have satisfying sex. How her husband treats her out of bed, greatly influences her response in bed. Inattentiveness, harsh language, a rude tone, hurting words, and criticism can make it difficult for a woman to get involved, to feel enthusiastic and to be passionate during sex. It is important for a couple to be loving even when they are not in the sex act. Sexuality and affection cannot be compartmentalised. Good sex is a continuum of affection and closeness during the day.

Lack of Love: 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 or with the help of a good counsellor. Ask yourself what you can do to bring more depth into your relationship and make it more than sex — a sharing of intimacy.

Satisfaction: The level and frequency of satisfaction that she has experienced in her sexual life. If sex has been a one-sided activity by the man without bothering much about the needs of the woman, then over a period of time, she may lose interest in sex.

Foreplay: If foreplay is not done correctly and adequately, female partners do not feel aroused enough to have intercourse. Many husbands are impatient and want to go for intercourse after a short and hurried foreplay. Such repeated experiences of unsatisfactory sex gradually make the woman lose interest.
It will be better if both of you speak freely on this subject with each other and try to understand each other.

PLEASURE... THE NATURAL WAY

Erectile Dysfunction (ED) is a big issue among modern-day couples. But the solution is easy.

To put it simply, ED is the repeated inability of a man to achieve an erection sufficient for sexual intercourse. The causes could be many, from old age, diabetes and stress to prostate cancer, hypertension, vascular diseases, neurological diseases, pelvic surgery and some other medical conditions. Vacurect is the only non-invasive and safe device to treat the problem. This internationally patented vacuum therapy system is compact, comes in a pleasing design and is easy to use. It gives you complete natural erection every time in less than 60 seconds and can be maintained for 30 minutes without any harmful side effects. The device uses a unique double-sealing tension ring that ensures maximum efficiency, which means that it works much faster, resulting in minimal interference with intimacy. Vacurect is highly recommended to men with erectile dysfunction and premature ejaculation. What’s more, it’s safe and needs no maintenance cost. The complete Vacurect system includes the device, nine pure silicon tension rings, silicon oil for device servicing, lubricating jelly, travel pouch and a manual. 

Tiny Balloons Solve Prostate Problem?

Tiny Balloons Solve Prostate Problem

Two implants have been developed which could cure a distressing side-effect of prostate cancer surgery — incontinence. A study shows seven out of ten men implanted with one of the new devices no longer had the problem.

Incontinence is a complication of radical prostatectomy surgery, one of the main forms of surgery to treat the disease. Research suggests as many as 21% of those who have it are incontinent three months later. It is estimated one in ten do not respond to conventional incontinence treatments. But it is hoped the new implants will change that. The implant by Uromedica use fluid-filled balloons to boost muscles around the bladder to prevent leakage. It takes just 30 minutes to implant and is held in place naturally.

The second implant, from Uroplasty, involves injection of tiny silicon particles into the same area which cause the bladder-neck to close to relieve Urinary Incontinence. The Uromedica technology has 2 balloons connected to a titanium port by tubing. A balloon is placed either side of the bladder neck. They are then inflated with a liquid so they are firm enough.

Source:

• Radical Prostatectomy Surgery in India
• TUR-Bladder Tumour Surgery in India
• Urethral Stricture Surgery in India
• Inguinal Hernia Surgery in India

Erectile Dysfunction after surgery

QUESTION:
I am 62-years-old. I got myself operated for prostate last year. After the operation I have almost lost the ability to get an erection. My erection was satisfactory before this operation. Will I ever get my ability to get erection back? What can be done to get my erectile function as it was before the operation.
- A Shah 

ANSWER:
A prostate removal surgery such as ‘Radical Prostatectomy’ can cause injury to the pelvic nerves resulting into neurogenic erectile dysfunction. The incidence of erectile dysfunction after Radical Prostatectomy depends on whether a ‘nerve-sparing’ surgical procedure was performed. Reported rates of Erectile Dysfunction after bilateral nervesparing radical prostatectomy range from 18 to 82 per cent. Other factors related to disease or surgery can also affect erectile function. It will be worthwhile discussing your post-operative erectile dysfunction status with the surgeon who operated on your prostate. I think your surgeon is the best person to guide you through your present dilemma.