ASK THE DOCTOR - Sexual Intercourse After a Long Gap

We are married for eight months. Whenever we have sexual intercourse after a long gap, my wife suffers from urine infection. We both keep good health and are quite particular about cleanliness. Why is this happening?
- Palat

Mechanical rubbing during intercourse can cause urethral inflammation in females. In spite of all the so-called hygienic precautions, infection can enter the inflamed urethra and bladder causing urinary infection. This is a common complaint known as ‘honeymoon urethritis’. Whenever there is a ‘gap’, excitement levels are high. This causes aggressive movements and harder rubbing of organs. An aggressive mechanical rubbing during intercourse causes this problem. Try to be gentle during intercourse. Women enjoy it better that way. Also engage in prolonged (20-25 minutes) and mutually satisfying foreplay. This will produce adequate lubrication in her vagina for an enjoyable intercourse. Lack of lubrication (which is likely to be either due to a lack of interest, lack of relaxation during the act or lack of adequate foreplay) can also be the cause of urethral (or even vaginal) injury and inflammation.

ASK THE DOCTOR - What is ‘Criptorchidism’? How Does it Affect Sex or Fertility in Man?

What is ‘Criptorchidism’? How does it affect sex or fertility in man?
- Dr Kothaari

Criptorchidism i.e. Congenital bilateral undescended testes is a birth defect in men where both the testicles fail to descend into the scrotum and remain stuck either in the inguinal canal or even in the abdomen. In a human foetus, testicles are formed in the abdominal cavity. Just before birth (or shortly after) the testicles slither down into the scrotum through a canal (inguinal canal) in the abdominal cavity. When this fails to happen with both the testicles, it results into Criptorchidism. This can prove destructive to the sperm producing tissue of the testicle, and thus it is important that parents consult a surgeon urgently, if their newborn son’s testicles have not descended into the scrotum. When both testicles fail to descend the condition is invariably due to a pituitary or hypothalamic disorder. By the time a boy becomes an adult, the undescended testicles are mostly nonfunctional, resulting in a deficiency of the hormone testosterone, causing a lack of sexual desire and even impotence. If a man has only one testicle, he is still able to have children; but if both the testicles are undescended (as in criptorchidism), it causes infertility as well as impotence. The undescended testis can turn malignant, if left unattended. Thus, surgery is invariably the only choice of treatment followed by hormonal replacement. Criptorchidism is also often linked with other birth defects in a person.

ASK THE DOCTOR - Sexual Intercourse Cures Menstrual Pains

I have heard that sex cures menstrual pains. Is it true? Does sex during menses have any relation to developing or contracting Sexually transmitted diseases (STD)?
- A. Nakti

There is no truth what so ever to the rumour that sexual intercourse cures menstrual pains. On the contrary, intercourse during menstruation can heighten the risks of contracting sexually transmitted diseases (STDs), including HIV/AIDS. Menstrual blood is a very rich medium in which micro-organisms can grow very rapidly. If a menstruating female has sexual intercourse with a male who is infected with 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 severe infection when she is menstruating. This is because the mouth of the uterus (cervix) is wider than usual at this time so that the menstrual blood can flow out easily. The micro-organisms of STD 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 sexual intercourse with a menstruating female is also very risky. If she is infected with HIV, her menstrual blood will be very rich in viruses (HIV).

ASK THE DOCTOR - Postponing Sexual Intercourse in Teenagers

QUESTION:
As parents, what kind of messages can you give your teenager about postponing sexual intercourse that won’t sound preachy, or like you are living in the dark ages?
- H Pawar

ANSWER:
Most parents hope their teenagers will wait to have sex till they are psychologically mature and are able to have emotional resources to manage relationships. It is important for parents to be able to convey this hope while communicating accurate information about sexual health and consequences. While we may encourage teenagers to postpone intercourse, the present reality is that, most young people become sexually active when they are in the clutches of their hormones. Because of this, they must be prepared to protect themselves when they decide to engage in sexual activity. Information about preventing pregnancy and sexually transmitted diseases is vital to help young people make informed decisions. And parents can help their kids understand the value of selfrespect, assertiveness, and responsible decision-making in postponing sexual activity.

‘Everybody is doing it’ is an age-old pressure tactic that applies to experimenting with drugs and alcohol as much as it does to experimenting with sex. Encourage your children not to be taken in by it. Teenagers often say they have intercourse the first time because they are curious. Open family communication about sexuality can satisfy your teenager’s curiosity, and help him/her behave more responsibly while exploring his/her sexuality.

You can communicate to your teenager that anyone can have good intentions of abstaining from intercourse. However, to translate this intent into responsible behaviour may not be as easy because of the high levels of arousal experienced due to raging hormones. And yet one needs to remember at the right time the consequences of irresponsible sexual behaviour in order to practice responsible sexual behaviour.

ASK THE DOCTOR - Unsuccessful Attempt at Sex

QUESTION:
I have been married for the last two years after a passionate-but-no-sex six month affair. In these two years, my husband and I have attempted sex exactly six to seven times, but because it was so painful and unsuccessful, it was a total turn-off. Now my husband feels so repulsed at the very mention of sex, also he says he that has to force himself to feel attracted towards me. I still feel attracted and turned on by him. His private area is a ‘prohibited zone’ when it comes to me. He is addicted to masturbation and he says he’s quite comfortable relieving himself this way. I’ve totally lost interest in relieving myself on my own. He doesn’t help either. He has also begun calling me a child-wife although I’m nearing 30. Please help.
- Manju

ANSWER:
It is sad that your sexual relationship is in a mess today. It seems that it all started with painful and unsuccessful attempts at the initial stage of your relationship. That has put your husband totally off towards you, as far as a sexual relationship with you is concerned. You seem to have carried the fear of penetration, which resulted in a clenching up of your body during intimacy, and when one is tense, the lubrication is insufficient, and thus the pain, which merely serves to reinforce the fear of penetration. This becomes a vicious cycle. Your husband on the other hand was afraid of causing you pain when you might have resisted, and his fear due to your apprehension kept him away resulting in his seeking sexual release through masturbation which he now finds as a comfortable outlet as he does not want to have to encounter your apprehensions and be responsible for causing you any pain. Neither of you can be blamed for this situation completely. It happened due to a lack of proper knowledge (sex education) on the part of both of you. Both of you were either uninformed or ill-informed about the physical as well as psychological (emotional) aspects of a healthy sexual relationship. That made both of you commit major mistakes during your early attempts at intercourse. This situation can now be rectified through a series of ‘sex counselling’ sessions for both of you. This requires a willingness on the part of both of you to attend such counselling sessions together. Do consult a senior sex counsellor as a couple for professional help. Strictly avoid more attempts and self-help. That may worsen the situation.

ASK THE DOCTOR - ‘I’m Unable to Achieve Orgasm’

QUESTION:
I am a 31-year-old married woman. I am unable to experience orgasm during intercourse. We have tried ‘everything’ but have not succeeded. Even a senior sexologist was of no help. Can you help us? - Ashwini

ANSWER:
Inability to reach orgasm is quite common amongst women. Probably, it is the result of age-old sexual repression of women, forced by religious and cultural beliefs. It either stems from your own deep rejection of your sexuality, or as a result of a moralistic upbringing. A woman is as capable of experiencing an orgasm as a man. All it needs is her true and complete acceptance of her sexuality, love for the partner, a relaxed atmosphere, complete privacy and an uninhibited passion. In such circumstances, one simply discovers the technique to reach to one’s orgasm.

You say that you have tried everything. In that case you need to look into your own inhibiting factors. If you find it difficult to see them all by yourself, you may take the help of a professional sex counsellor.

ASK THE DOCTOR - What are VSDs?

QUESTION:
I have heard a lot about Vacuum Suction Devices (VSDs) that is used to achieve good erection. Kindly give me some information about VSDs. What are they? Are there any side effects and do they really help?
- N. Reddy

ANSWER:
A Vacuum Suction Device (VSD) was designed to help men whose erections are not strong, or not as strong as they used to be, to enable them to engage in intercourse. This is a satisfactory solution for some men. However, if the pump is not used correctly, there can be loss of sensation, loss of penile skin, and even gangrene. If you are having trouble with erection, and this is a problem for you, I recommend that you see a qualified sexologist who can check, among other things, your blood flow. The VSD is only a temporary solution to erectile dysfunction. Erectile dysfunction is a treatable condition in a majority of cases, and you should approach a sexologist for help.

Source:
Radical Prostatectomy Surgery in India

ASK THE DOCTOR - ‘How does a vacuum suction device work?’

QUESTION:

For erectile dysfunction (ED), some sexologists advise a ‘vacuum suction device’. How do they work? Are there any side effects of using such a device? 

- Jayant 

ANSWER:

A vacuum suction device (VSD) is also called a ‘penile pump’. It was designed to help those men whose erections are not firm, or not as firm as it used to be earlier, to make it possible for them to penetrate the vagina and perform sexual intercourse. A vacuum suction device is a good option for men in this situation. However, if the device is not used properly, it can cause serious loss of sensations, loss of penile skin, and even gangrene. If you are having difficulty with an erection — and this is a problem for you, I suggest that you consult a qualified sexologist who can assess, among other things, your penile blood flow. The VSD is only a temporary solution to erectile dysfunction. Erectile Dysfunction is a treatable condition in a majority of cases, and you should approach a sexologist for help.

LET’S TALK ABOUT SEX

An unhealthy level of interest in bed can soon land you in rehab. AT tells you how to deal with sex addiction

When Tiger Woods entered rehab after his ‘transgressions’ became public, detractors were quick to pipe ‘sex addiction’ as the reason. Years ago, Michael Douglas took treatment to get over his unhealthy interest in sex. And later, so did Xfiles star David Duchovny. And just recently, it is disgraced footballer, John Terry who’s facing the music for his innumerable flings, even as his wife,
Toni is contemplating leaving him.

Interestingly, the American Psychiatric Association does not list sex addiction as a diagnosable mental disorder with no real statistics to show the magnitude of its prevalence. However, its existence cannot be refuted. Like any other addiction, sexual addiction, too, can be treated.


ADDICTED TO SEX? 
As the term suggests, a person can be called an addict when he/she can’t control his/her sexual behaviour — even with strangers, or in public situations. The need for sex becomes so compulsive that it starts affecting the person’s functioning. Addiction to masturbation or even porn are aspects of sex addiction. In extreme cases, the addict goes against societal norms, engages in unsafe sex and can repeatedly cheat despite being in a committed relationship.


WHY IT HAPPENS 
Personality type 
Often, kids can be seen holding on obsessively to their toys. This may indicate an obsessive personality type. Combined with a dysfunctional family, lack of love from parents makes the child excessively dependent on material factors to compensate for the lack of intimacy. While that doesn’t mean the child, later, might turn out to be a sex addict, it increases the risk.

Genes 
Some times the genetic makeup makes them more susceptible to addictions.

Stress 
If under severe stress, a person may look towards sex for temporary relief — not for intimacy but for the momentary ‘high’.


SIGNS TO WATCH OUT 

• Spending excessive amount of time chasing sex and preparing for the same. 
• Continuously compromising on social activities to make way for sex. 
• Feeling extremely dissatisfied, depressed, even angry citing lack of sex (despite having an active sex life). 
• Dwindling sense of intimacy and satisfaction despite engaging in sex. 
• Engaging in sex with multiple partners. 
• Dependency on pornography. 

THE WAY OUT 

• Set a time-frame challenge of not engaging in the sexual act for a particular number of days, or say only once in X number of days. This exercise will accurately tell you about the degree to which you are hooked. 
• Find an activity that can replace the craving, and channelise your energy towards it. Let it be something you enjoy or sticking to it will be difficult. 
• If you feel the cause of addiction is stress, figure out the source and deal with it. 
• Seek professional help. 

NOTE FOR PARTNER 
Most addicts are known to live in a sense of denial. Hence, if your partner suffers from the syndrome, do not confront with harsh words and most importantly, do not address the problem as an ‘addiction’. This will only backfire and strengthen the sense of ‘denial’. Instead, seek professional help citing lack of intimacy and a relationship problem ‘shared’ by both. Use the ‘our’ problem approach rather than mentioning it as ‘your’ problem. 

ASK THE DOCTOR - Unsuccessful Attempt at Sex

I have been married for the last two years after a passionate-but-no-sex six month affair. In these two years, my husband and I have attempted sex exactly six to seven times, but because it was so painful and unsuccessful, it was a total turn-off. Now my husband feels so repulsed at the very mention of sex, also he says he that has to force himself to feel attracted towards me. I still feel attracted and turned on by him. His private area is a ‘prohibited zone’ when it comes to me. He is addicted to masturbation and he says he’s quite comfortable relieving himself this way. I’ve totally lost interest in relieving myself on my own. He doesn’t help either. He has also begun calling me a child-wife although I’m nearing 30. Please help.
- Manju

It is sad that your sexual relationship is in a mess today. It seems that it all started with painful and unsuccessful attempts at the initial stage of your relationship. That has put your husband totally off towards you, as far as a sexual relationship with you is concerned. You seem to have carried the fear of penetration, which resulted in a clenching up of your body during intimacy, and when one is tense, the lubrication is insufficient, and thus the pain, which merely serves to reinforce the fear of penetration. This becomes a vicious cycle. Your husband on the other hand was afraid of causing you pain when you might have resisted, and his fear due to your apprehension kept him away resulting in his seeking sexual release through masturbation which he now finds as a comfortable outlet as he does not want to have to encounter your apprehensions and be responsible for causing you any pain. Neither of you can be blamed for this situation completely.

It happened due to a lack of proper knowledge (sex education) on the part of both of you. Both of you were either uninformed or ill-informed about the physical as well as psychological (emotional) aspects of a healthy sexual relationship. That made both of you commit major mistakes during your early attempts at intercourse. This situation can now be rectified through a series of ‘sex counselling’ sessions for both of you. This requires a willingness on the part of both of you to attend such counselling sessions together. Do consult a senior sex counsellor as a couple for professional help. Strictly avoid more attempts and self-help. That may worsen the situation.