Jamaica Gleaner News - Doctor's advice - Saturday

Q. Doctor, I am a 19-year-old guy and I am really worried because one day I had sex twice for the evening. On the second occasion, I produced nothing. Nothing! No fluid at all.

I began to be concerned that there was something seriously wrong with me, so I quickly did some research on the Net. There, I found that a dry orgasm is likely to be due to the seminal fluid going back into the urinary bladder. This does not sound good, Doc. Will I be OK? And will I be able to have children?

A. Sorry to hear you have been fretting, but you have no need to. Among males, there is a lot of anxiety about the matter of dry orgasms. Indeed, if one Googles those two words, it rapidly emerges that there are 2.7 million entries on the subject.

Now it is quite true that a dry climax can be caused by seminal fluid going back into the bladder rather than coming out. This is called retrograde ejaculation.

But what you have not realised is that retrograde ejaculation occurs mainly among much older males who have had surgery (or other treatment) on their prostate gland. Obviously, that does not apply to you. So what has been happening here?

Well, the answer is quite simple. When a young guy has two or three orgasms in an evening, quite often he simply 'runs short' of fluid for a few hours. He will not be able to produce any more until his testicles, and other glands, have manufactured some. Therefore, any further orgasm that night might be a dry one.

In some countries and cultures, it is well-known among men that second or third orgasms may be dry ones. So guys take a chance and do not use a condom when they make love for the second or third time of the night. That is a pretty risky practice because there is always a possibility that some sperm might be produced. I would not recommend it as a method of birth control.

I am sure you have absolutely nothing to worry about. When you next have sex, your testicles will have recovered somewhat, and there should be plenty of fluid available. What I am not clear about is who you are having sex with! Maybe it's just masturbation, or maybe it's with a girl. Anyway, if you have a partner, practise safe sex to avoid sexually transmitted infections, pregnancy and other serious problems.

Q. Doctor, I am 22 and engaged to be married. Last week, my fianc� persuaded me that we could have full sex with a tampon inside me as protection against pregnancy. So I did what he suggested. Is this OK?

A. No, it isn't. Quite a few younger couples decide to try this do-it-yourself method of contraception but it is very risky. For a start, the tampon will become soaked in seminal fluid. And sperm may try to ascend from the damp tampon into the womb and cause conception.

Second, the tampon may become jammed right up into the top of the vagina and be difficult to remove. That could cause infection and an odorous discharge. Have you actually managed to get this tampon out? If not, you should remove it as soon as possible. If you find the removal difficult, ask a doc or nurse to help you.

Q. I am having a serious problem with premature ejaculation (PE). Can you give me some advice as what I can do to solve this problem?

A. Certainly. Research suggests that around 10 per cent of males suffer from PE, though it depends on how one defines it.

But if you are what Tell Me Pastor has rightly called 'a one-minute man', or if you can't even last a single minute, clearly you have it. However, it can be cured, so be of good cheer!

So, what are the options for treatment?

Let me list them:

Distraction techniques or 'sliding': This means trying to think of something else during intercourse. But it only works for really mild cases.

Local anaesthetics: These 'numb' the penis somewhat, but they can cause painful sensitivity reactions. Also, they can numb the lady as well! A way around that is to use the 'Long Love' condoms, which have local anaesthetic inside, so that it only touches the man, not the woman. However, local anaesthetics are of very limited value.

The Masters-Johnson 'squeeze' technique: This gives great results, but you really need a professional (like a therapist or counsellor) to teach you and your partner how to use it. The basic idea is that a special 'squeeze grip', applied by the lady, diminishes the desire to climax. Over a spell of months, this retrains the man to last far, far longer. This is the best method.

Antidepressant drugs: Some of these have the side effect of delaying orgasm. Please do not buy the ones that people offer you in bars! Instead, get a doc's advice and prescription.

Dapoxetine: This is an American drug which has a similar effect to antidepressants. As with the antidepressants, you would need to take it a few hours before sex.

Anti-PE devices: Really no good at all, at present. I would not advise you to buy any of the many expensive devices which are advertised on the Net. I wish you well.

Q. I have had no menses for two months, but the only sex I have had this year was an occasion when I let my boyfriend ejaculate on my thigh. Am I pregnant, Doc?

A. I really think that is most unlikely. However, it does occasionally happen that a woman conceives as a result of a guy climaxing just outside her vagina. So, what you must do now is to take a pregnancy test. I hope that will be negative, and put your mind at rest. You could then discuss with a doc why your periods have stopped. Common causes include anaemia, weight loss and worry.

Q. I have become very anaemic as a result of a miscarriage and then a number of very heavy periods. What is the best treatment for that, Doc?

A. Anaemia is common in women because they lose so much iron in periods, childbirth and miscarriages.

I'm sorry to hear about your problems, but it is likely that they can be put right by some iron tablets from any pharmacy. However, I would like you to see a doc for a good check-up which should help make the menses lighter.

Q. I have been buying tablets for bad, spotty skin, but they don't seem to help me, Doc.

A. My guess is that you probably have acne, though your skin needs examination by a dermatologist. If I'm right, I would strongly suggest that you now go on a mild antibiotic, prescribed by a doc, for several months. Good luck.

Want advice from Doc? Email questions and feedback to saturdaylife@gleanerjm.com.