Sex without protection is like playing Russian roulette – one day your luck might run out.

Miscarriage

Q: My wife is one-and-a-half months pregnant, but the doctor says it is a case of abnormal genes. An ultrasound scan shows no evidence of a heart in the baby. What is wrong?

A: Sometimes the baby dies in the uterus, but doesn’t come out. It just rema-ins inside without growing. After pregnancy is ascertai-ned, a scan is done, specially if the size of the uterus does not correspond to the dates you have given. The baby’s heart can then be seen. In cases of doubt, a second scan is done two weeks later. If there is still no heartbeat, it means the baby is not alive. About 5-10 per cent of expecting couples lose their first baby spontaneously as an early abortion. Before the advent of urine pregnancy tests and high tech scans, women sometimes did not even realise they were pregnant. They just presumed it was a normal “delayed period”. If your doctor advises you to terminate the pregnancy, please do so. Finish your wife's immunisations against measles, mumps and rubella and hepatitis B before planning her next pregnancy. She must also start taking folic acid supplements. This way, hopefully, there will be no problem next time.

Secret desire

Q: I am a 16-year-old boy. At night when nobody is around, I like to rub my private parts on a blanket for few minutes until a white sticky fluid comes out. Why is this happening with me? What precautions can I take? Will I become sterile? Will I die?

A: What you are describing is masturbation. It is normal and not unusual. Since the activity is undertaken in solitude and has a social stigma attached, people tend to be secretive and reclusive. The truth and statistics are hard to elicit. As the volume of sperms builds up in the testes, release is required, by masturbation, intercourse, spontaneous ejaculation at night (nocturnal emissions) or retrograde ejaculation into the urinary bladder. Don’t worry, masturbation will not cause illness, weakness, sterility or death.

Speech disorder

Q: I suffer from increased salivation. This causes an embarrassing situation while speaking because the saliva tends to come out as a spray. I also have bad breath and stammering problems. I do not drink, smoke or chew paan. I have a job interview to attend but am scared I will be rejected. Please advise.

A: Increased salivation can be caused by dental diseases such as caries teeth. It can also occur as a result of recurrent mouth ulcers. Both these may cause bad breath. You need to have your mouth and throat carefully evaluated. If there is a problem in swallowing or if you feel something is “stuck”, it may be an obstruction or abnormality in the oesophagus. Sometimes the problem may be “water brash”, that is, recurrent regurgitation of fluid from the stomach. This may be due to “hyper acidity” and ulcers and may cause bad breath. If the precipitating factor is treated, the problem will disappear. If there is no abnormality, the increased salivation may be a normal variant. Eating simple, smaller and frequent meals, or sucking on candies can help. Some anti cholinergic medications also help cause dryness of the mouth. Stammering occurs in intelligent people whose thought process works faster than the coordination required to speak. You need to practice formulating your thought and then enunciating, slowly and clearly. Anxiety and excitement will make it worse. Speech therapy is a specia- lity available in many hospitals. They have training techniques which will definitely help.

Missed period

Q: My boyfriend and I have regular sex. Sometimes he uses a condom. I missed my last period and am worried. What should I do?

A: First of all, you need to figure out if you are pregnant. Purchase a pregnancy test strip from the pharmacy and do as instructed. If the result is positive, you have to decide whether you want to keep the baby, get married or terminate the pregnancy. Both medical and surgical methods are available for termination, but please consult a qualified gynaecologist. Abortion is legal in India. If you are not pregnant and it is just a delayed period, you have got a second chance. Sex without contraception is like playing Russian roulette – one day your luck will run out. Condom use makes you dependent on your male partner but it also prevents sexually transmitted disease (STD), including AIDS. The other option is oral contraceptive pills. In this, control is in your hands, and pregnancy is reliably prevented. But unfortunately, not STD and AIDS. You have to choose what is best for you.

Prickly problem

Q: I am a 76-year-old diabetic with a terrible itching problem. It is uncontrollable and keeps me awake at night. I wanted a lotion and so went to the doctor, but he has prescribed a battery of expensive tests.

A: Itching is a very common symptom. If no skin lesion responsible for the itching is visible, the doctor will want to rule out internal causes. The diabetes or lipids may be uncontrolled. You may have a thyroid problem. More serious, it may be a non-specific manifestation of some of the blood or lymph node cancers. That is why he has asked for all these tests.