Jamaica Gleaner
Published: Saturday | November 21, 2009
Home : Let's Talk Life
Doctor's advice: Sex and ectopic pregnancy
Q Doctor, my girlfriend and I have a fabulous sex life and we hope eventually to get married and have children.

However, she recently had an ectopic pregnancy. Neither of us has any idea of what that is.

She had to take an operation, and the docs told us not to have sex for the next two months. They said they had had to take the tube away.

What exactly is an ectopic pregnancy, Doc? Is it my fault? Did I do something wrong during sex?

Also, why have they said we must not have sex? And will we be able to have babies one day?

A Sorry to hear about all this. Ectopic pregnancies are common. It is important that all young women be aware that this is a very frequent cause of stomach pain.

Well, now, let me explain it to you. She must have become pregnant without either of you realising it. Now, what normally happens in a pregnancy is that the sperm fertilises the egg in the fallopian tube.

The fallopian tube is one of a pair of narrow tubes which connect the upper part of the womb to the two ovaries. One tube is on the right of the belly, and the other on the left.

You can get a good idea of the layout by holding your arms up above your ears, with a cricket ball in each hand! The cricket balls then represent the two ovaries. Your two arms represent the two fallopian tubes and your body represents the womb.

The fertilised egg should than gradually move into the womb, where it will spend the next nine months.

However, quite often this arrangement goes terribly wrong! Often, the fertilised egg gets 'stuck' in the fallopian tube, or maybe just outside it. That is an ectopic (meaning 'out of place') pregnancy.

Sadly, there is almost no way that a pregnancy can progress when it is outside the womb. Very occasionally, a child does survive ectopic pregnancy.

In practice, what often happens is that the pregnancy tries to develop in the narrow fallopian tube, but cannot do so, because there is no space. The woman may feel terrible pain.

The typical storyline of a patient undergoing an ectopic pregnancy goes like this: The woman is around three weeks overdue when she bleeds a little through the vagina. And she gets intense pain in the belly, low down and on one side. Sometimes the pain may travel to the shoulder.

At this stage, hospital admission is vital, and may be life-saving. What frequently happens is what seems to have occurred in your partner's case. The surgeon has to operate in order to remove the ectopic pregnancy. Usually, that means that the fallopian tube on that side has to be removed too.

Happily, there is sometimes a less dramatic chain of events. If the ectopic pregnancy occurs in the fallopian tube, but at the end which is nearer to the womb, the tube may actually push it right out into the womb, usually with some blood. If that happens, the patient may just think she has had a miscarriage, and might not realise she had an ectopic pregnancy. In some cases, giving a drug called methotrexate may encourage this to happen.

This phenomenon where an ectopic pregnancy is pushed out into the womb is called a tubal abortion.

It is clear that in your girlfriend's case, the gynaecological surgeon had to operate to save her life - and they had to take one of her tubes away.

However, she has another fallopian tube, so it is very likely she can become pregnant in the future.

You ask if YOU 'did anything wrong'. No, you didn't, and you didn't cause the pregnancy to be ectopic. However, I do feel that you should take care to use a good contraceptive method, such as the condom, until you both are ready to try for babies.

The reasojn the gynaecologists have advised no sex for a couple of months is because your girlfriend's body needs time to recover from what has been quite an ordeal.

QDoc, a girl performed oral sex on me at a party recently.

Could that give me VD?

A Sexually transmitted infections (STIs), often termed venereal disease, are occasionally passed on this way. I don't think it's very likely that you have caught anything.

But if you get any discharge or pain, please consult a doc.

Q I am a 29-year-old woman and my doc has put me on hormones.

Can I safely assume that they would prevent me from getting pregnant?

A No, you can't. Unless she has put you on some form of the Pill, you must assume that you are liable to get pregnant.

QI am getting attacks of numbness in both hands. Why?

A You may have the famous carpal tunnel syndrome, which you can look up on the Net or check your doc. But numbness in both arms is often caused from a problem in the neck, where something is pressing on the nerves.

Please get a good medical check-up.

QMy wife, aged 28, has just astounded me by telling me that she sometimes gets what she calls 'warm sexual feelings' about other females.

Does this indicate that she is really a lesbian?

A No, it does not. Studies have indicated that a lot of women sometimes feel a certain amount of attraction towards their own sex. This doesn't mean they have any intention of doing anything about it, or of leaping into bed with ladies.

However, what interests me is why your wife told you this. Was she perhaps just trying to turn you on? Or is there some problem with your marriage?

If in doubt, you should see a marriage counsellor together.

QI am an 18-year-old man and have only just started to get interested in sex.

What concerns me, Doc, is that it now appears that my organ is splitting apart when I get erect!

Help me, please.

A I am not sure what you mean by 'splitting apart'. However, it often happens that when a young man first starts to masturbate, or indeed to fool around with girls, little bands of protective tissue called adhesions break up.

These adhesions attached the skin to the head of the penis during childhood. They are no longer required, so it does not matter that they split away.

Maybe that's what's happening to you. Nevertheless, I would like you to have a doc examine you to make sure all is well. Please do not fret.

Email questions to Doc at saturdaylife@gleanerjm.com.

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