Choosing the right contraceptives (1)

It might come as a shock to you if I tell you that in Modern India almost 50 per cent of the pregnancies still come as unplanned and unwanted. A recent health survey concluded that it happens even in the most educated families. With increasing number of women concentrating on their careers and delaying their marriages and pregnancy, the practice of contraception assumes even more importance. One of the secrets to lead a healthy, happy and balanced family life is to have proper knowledge and usage of contraception.

Here’s a list of some popular contraceptive methods along with their risks and benefits:

1. Oral Contraceptive Pills

• More than 100 million women worldwide use the contraceptive pill. The Pill is a tablet containing two female hormones – an oestrogen and a progestogen. These two hormones stop you from ovulating (producing an egg) each month. And if you don’t ovulate, you won’t get pregnant.
• Risk: Weight gain and high blood pressure
• Benefits: One of the safest methods of contraception; reduced risk of ovarian cancer - Pill-users have a 12% reduction in their risk of developing cancer
• Medical advice: Women on pills should go for pill-checks every six months to their gynecologist
• Warning: Do not forget to take it daily or as advised by your doctor
  

2. Female Sterilisation

• Sterilisation means preventing the woman from becoming pregnant by means of a fairly straightforward operation in which her Fallopian tubes are blocked or cut through – which makes it very difficult for her eggs to reach her womb.
• Risk: There is a small ‘failure rate’ for this operation generally estimated at around 1 in 200.
• Benefits: A permanent method; a woman who has been sterilised, but then really wants to have a baby, does nowadays have the opportunity of ‘in vitro fertilisation’ (IVF treatment).
• Medical Advice: If you are seriously overweight, it can be quite tricky for the surgeon to get at your tubes. Also, if your general health is poor, then you might not be an ideal candidate for surgery.
• Warning: If you ever miss a period after the surgery, you should get a pregnancy test done. Pain is often a warning sign of an ectopic pregnancy. If in doubt, call your doctor.

CLICK HERE for Part 2 of the series >>

Is abortion in Week 6 risky?

Q: I got married recently. My wife is pregnant. We aren't emotionally and financially ready for the added responsibility. Hence, we are contemplating abortion. My wife is 27 years old. She is about six to seven weeks into pregnancy. Can abortion create complications in the future? Is it safe? We don't want to regret later on. Kindly advise.

A: If done under strict surgical conditions, the abortion process will not affect the future. However, I strongly suggest you rethink your decision. Your wife is already 27 years old. Once accepted, the pregnancy will pass by happily. She can continue working till the eighth month of her pregnancy. Both of you will not regret the decision. Sex can also continue, but follow the instructions of her doctor.

Small testicles, Semen quality & Sex

Q1: I am a 15-year-old boy. My testicles are smaller than my friends’. When I masturbate the sacks get empty. The semen is also thin and watery. Also, I look like a girl. Is this because of my small testicles? Am I infertile? Please help.

A1: The size of the testicles varies with people. If you are passing semen, sperms will be there. Thin or thick, does not affect the sperms. When you masturbate, the testicles are pulled up. So, don't be worried.

Q2: I am 24 years old. What is the safest period in a woman's monthly cycle to indulge in unprotected sex?

A2: There's always a risk of pregnancy, even during the safe period. The risk can be taken by married couples.

Orgasms boost woman's career and health

Women who get thrills from regular orgasms are more likely to be successful at work and healthy, according to a leading expert.

Psychologist Dr Lisa Turner said that while men lose energy through orgasm, women are empowered by them and gain clarity of thought. According to Turner, the right type of orgasm will massively increase your energy.

Previous studies have suggested that 28 per cent of women rarely, or never, achieve full orgasm, and many resort to faking it. Now, Turner has said that good orgasms boost health and concentration and help women perform better at work.

Broken condoms & risk of pregnancy

Q1: I am a 26-year-old man. Next month, I will be getting married to a 22-year-old woman. We do not want children for at least three years. How do we prevent pregnancy? Will it affect our sex life?

A1: You can reconsider using a condom or visit a family planning centre. Ensure that you use only branded, good quality condoms. You can choose from Special Thick Condoms or Flavored Condoms.

Q2: I am 24 years old. I indulged in protected sex with my girlfriend. Later, we realised that the condom was torn. To avoid pregnancy, my girlfriend took an I-pill after an hour. Her periods are due next week. Will she get pregnant? We are extremely concerned. Please help.

A2: Since precaution was taken, it is unlikely for her to get pregnant. However, the pill doesn't succeed every time. So sweat it out till she gets her periods. Also use a urine pregnancy kit and check for pregnancy.

Masturbation, Night fall & Penis infection

Q1: I am a 15-year-old boy. I have been masturbating for the last five years; now I am experiencing night fall. I think I will become weak, if this continues. Please help.

A1: If you are masturbating it is unlikely you will get night emissions. Sleep well, neither your brain nor your body will wither away.

Q2: I am a 21-year-old man. Three months back a few red spots and some wax like substance appeared on the head of my penis. Since then I am unable to pull the foreskin back. My skin cracks and bleeds. Please help.

A2: Consult a doctor. An antibiotic can be prescribed after the diagnosis. The wax substance is smegma, a natural secretion under the foreskin.

How to consummate marriage?

Q1: I got married a month ago, but we are not able to consummate our marriage. I feel scared when my husband tries to penetrate me. He tried inserting his finger, but I didn’t bleed. My husband is supportive but I feel guilty of pushing him away. How we can have a normal sex life?

A1: Use Xylocaine gel 2% and apply it for 15 minutes before bedtime in and around the vagina. You will not experience pain. Ask him to insert a finger deep inside the vagina before the intercourse.

Less of ejaculation & Ringworm infection

Q1: I am a 26-year-old man and I’ve been married for the past six months. Till date I have not been able to ejaculate into my wife’s vagina directly. I need to use my hands to do so and as a result we are both left unsatisfied. Please help.

A1: Engage in more foreplay as this will help satisfy the both of you. If you are having a delayed ejaculation, then start intercourse after your wife orgasms. Then, you can withdraw and masturbate.

Q2: I’m 26 years old. I’ve had an unbearable irritation near my pelvic area for the last a few days. I used Itchguard, but it didn’t help.

A2: Visit a skin specialist. You probably have ringworm infection. With proper medication it will be cured.

Semen quantity & better Sex life

Q: I am a 34-year-old man and I have been married for the past 12 years. My wife and I have intercourse twice to thrice a week. My problem is that since the last one year, I have noticed a reduction in my discharge. If we have sex twice a day, hardly two or three drops of semen get discharged the second time around. Does this have anything to do with age? I am worried and embarrassed especially when we can't enjoy sex for the second time in the day. Please help.

A: Think of a tank of water. When it is almost empty, hardly any water will flow out. In any case, semen has nothing to do with your sexual energy - it is only necessary when you want a pregnancy to occur. Even if you had no semen you can have a normal sex life. Just be sure to check your blood sugar levels.

Satisfying sexual urge by masturbating

Q: I am a 19-year-old woman. Whenever I watch sexually-charged scenes in movies I start stimulating my private parts. Though I can only touch myself for a maximum of three seconds, a white discharge flows out of my vagina. I am really worried about this. Will indulging in such behaviour affect my future sex life or my ability to conceive a child? Also, I've noticed my periods get delayed by as much as a month whenever I do this.

A: You are satisfying your sexual urge by masturbating. This is perfectly normal and will not affect your married life or future conceptions.

Unable to consummate marriage? Know most common reasons (2)

----- Continued from Part 1 of the series -----

Dr Rajan Bhonsle gives ten most common reasons that stop couples from consummating their marriage...

6. Psychogenic Erectile Dysfunction
Erectile Dysfunction is the inability to achieve or maintain an erection. In majority of cases, the cause is psychogenic, such as stress, anxiety, guilt, anger, mood disorders, relationship difficulties and past traumatic events. The treatment depends on the cause. Sex counselling and therapy is needed for psychogenic causes.

7. Organic Erectile Dysfunction
Whenever a man is unable to attain or maintain erection of penis (and thus unable to consummate his marriage) due to biological causes, it is called as organic erectile dysfunction. Organic causes may include endocrine conditions such as diabetes (50% of diabetic men suffer from ED), disorders of pituitary, thyroid or adrenal glands, diminished testosterone levels, reactions to certain medications especially hypertension medications, and many more.

8. Performance Anxiety
Fear of failure or anxiety about impotence ranks first in order of prevalence, in all the sexual fears that men bear. Ironically, the fear itself is the greatest cause of impotence and thus non-consummation of marriage. If a man is more focused on how well he is performing with a partner, rather than on enjoying the sensations in the sexual act, it may be difficult to attain or maintain an erection. This can become a vicious cycle. The remedy is to learn to relax. A couple needs to know that there is no possible way that a man can have an erection at will. When a man is involved in foreplay, without 'examining' the organ, erection happens on its own. The wife's cooperation plays a very important role in getting over such psychogenic impotence.

9. Premature Ejaculation (pe)
PE is the most common complaint amongst men. It is not a physical problem, but a 'learning disability' found very commonly in newlyweds. Ejaculating early is a 'learned reflex response' that can be effectively re-conditioned when a man and a woman actively learn ejaculation control together. The 'squeeze technique' or the 'stop-start technique' can benefit in this case.

10. Fsad
FSAD stands for Female Sexual Arousal Disorder. Female arousal is as much necessary as male erection for a couple to engage into intercourse. The physical causes of the same include many hormonal, and other organic causes that cause erectile dysfunction in men. Psychological issues that contribute to FSAD are physical or psychological abuse, low self-esteem or distorted body image. Unrealistic expectations from the partner and unresolved emotional and relational issues in the couple also can cause FSAD. Certain medications can also impair female sexual arousal.

Surgery for tight foreskin

Q: My foreskin is very tight. I want to go in for surgery. Is the surgery painful? Will I experience pain after surgery? What is the recovery time? Please suggest a good hospital for the same.

A: The surgery is a simple procedure and is usually done under local anesthesia. You can walk home after a few hours of rest and get back to work after two days. You will heal completely within 10 to 14 days. Opt for a hospital near your home. Visit a private hospital such as Jaslok, Bhatia, Hinduja (all in Mumbai) or a general hospital if you don't wish to spend much.

Sex with girlfriend & after pregnancy

Q1: I indulged in anal sex with my girlfriend. However, during the act, my penis just touched her vagina. Does she need to take any contraceptives?

A1: The act may cause infection to both of you, and particularly cause injury to her anal region. The anal membrane is much thinner. She still risks pregnancy so I will advice you to buy a urine pregnancy kit and check for pregnancy.

Q2: My wife is two months pregnant. Can we indulge in intercourse? If yes, till what month of pregnancy can we continue? What are the precautions to be taken?

A2: Ask her obstetrician for permission. If everything is okay, you can continue till the eighth month. However, you must keep her mood in mind. The first three months might be difficult but she may show a good desire to get physical during the next six months. Ensure that you approach the vagina from the rear or when she is in a sitting position. Avoid the missionary position.

Unable to consummate marriage? Know most common reasons...

Dr Rajan Bhonsle gives ten most common reasons that stop couples from consummating their marriage...

1. Lack of Emotional Involvement

Many women carry an apprehension regarding sex and hence, are unable to respond comfortably during the first few attempts of intercourse. This may also happen due to lack of emotional involvement in the relationship, especially if it's an arranged marriage. A woman's sexuality is usually 'heart-oriented'. It is best to wait a little and do not rush things.

2. Penetration Phobia

Irrational fear or phobia associated with penetration is often a cause of non-consummation of marriage, even in educated couples. The cause is a deep rooted psychological fear related to the genitals, mostly due to physical and/or psychological trauma in the earlier years. It may also be a learned fear caused by listening to myths about painful penetration during the impressionable years. Due to this, the woman rejects all attempts of penetration made by her partner.

3. Dyspareunia

There are several possible causes for dyspareunia, better understood as pain during intercourse. The problem arises because the woman's pelvic muscles may be too tight, or her vagina may not be adequately lubricated. Also, her hymen may still be partially intact which may be causing pain. It is strongly recommended that couples avoid having intercourse until the cause of this pain is found, or else things may only get worse. In later stages, a physical problem may become a psychological one.

4. A Tight Hymen

The hymen is a thin membrane that covers the vagina. It may or may not be present at birth. In some women the hymen is extra thick and tight. This makes it either impossible to penetrate during intercourse. Also, it may cause severe pain and bleeding if penetration is forcibly attempted. If a gynaecologist finds the hymen to be unusually tight on examination, a small surgery - hymenectomy - may be necessary before the couple attempts intercourse.

5. Vaginismus

Vaginismus is an 'involuntary spasm' of the muscle controlling the entrance to the vagina during attempts of penetration that invariably causes pain and discomfort. The cause is a deep rooted psychological fear related to the genitals. The woman involuntarily tightens the muscles of her vagina, making penetration painful and impossible. A woman may or may not be consciously aware of the root cause. No medication can help in such a situation. A sex therapist trained in counselling and psychotherapy is better equipped to deal with it.

----- To be concluded -----

Foreskin & Pains of Masturbation

Q1: I am a 21-year-old man. I lose my erection if I try to pull my foreskin down. It seems that the tip of my foreskin is attached to the head of my penis. Please tell me what to do. Do I need to consult anyone? Will this cause a problem while having sex?

A1: The foreskin is naturally attached to the under-surface of the head of the penis. Do not try to push it further, otherwise it will pain. See a surgeon or your family doctor.

Q2: I am a 23-year-old man. After masturbation, I experience severe pain in both my legs for at least six to seven hours. Though the pain subsides later without any medication, I am extremely worried about this. Please advise what I should do. Please reply.

A2: This should not happen. You should see vascular specialist who may advise a Doppler study. If you are having a good erection it is unlikely that anything is wrong.

Is it true that all Indians have big sex organs?

Q: I am a 34-year-old virgin of Malaysian Chinese origin. My fiancé is a 32-year-old Malaysian Indian. He has tried to have intercourse with me many times after our engagement, but without any success. His penis is long and big. I am afraid my vagina will not be able to accommodate it. We have tried KY jelly. I am very worried and am thinking of calling off our marriage, though I love him. What should I do? Is it true that all Indians have big sex organs?

A: The vagina in any culture is able to expand enough to deliver a baby and has the ability to lengthen to accommodate the length of the penis. You are probably not using the right position. Try the woman on top position. I suggest you do not have sex till after marriage to avoid complications.

How to control wife demanding sex too often?

Q: I am 36 years old and my wife is 42. She demands sex at least every alternate day. It is affecting my health. Is there any way I can control her sexual desire?

A: Why control her? Rather buck up and build your stamina. Arouse your desires and instead of thinking of sex as a duty, try to enjoy it. Please be more positive. Of course you could ask her to give you a holiday sometime.

Large penis & unprotected Sex

Q1: I am 21 years old. My penis is very large in size and it is slightly tilted towards the left. Will it harm my sex life? Or will my child be born handicap due to this?

A1: Neither your sexual activity nor your progeny will be affected in any way. In case you're facing trouble with erections, you should try the proven techniques to prolong erection.

Q2: I had unprotected sex with my girlfriend on the seventh day of her periods. However, her next periods lasted only for two days. We are worried that she might be pregnant. We regret our mistake. Please help.

A2: Buy a urine pregnancy kit and check for pregnancy. Most probably, it will be negative. If tested positive, consult a gynaecologist. If your girlfriend experienced a good flow during the supposed periods, then that was her menstruation.

Monotonous Sex life and drugs

Q1: I have been using a capsule called spasmo proxyvon for the past two years. I feel my penis size is reducing because of this. It measures about four inches when erect. Will this capsule affect my sex life? Also, I want to get rid of this drug addiction. Please help.

A1: I am sorry to say, you have become a drug addict. It is wise that you try to get out of it before your normal and sexual life is disturbed. Instead of drugs, you should use proven techniques to prolong erection. You should also contact a drug addiction centre such as SANKALP. Tel: 24901302.

Q2: I am 40 years old and my wife is 35. Our sex life has become monotonous over the last two years. We want to experiment with oral and anal sex. Is it harmful? Please suggest.

A2: Why not break the monotony by going back to your early naughty days. Have a bath or a massage together. Oral sex is not harmful but please avoid anal sex, and if you must, then only with a special thick condom.