Q: I am a woman in my late 30s, and I would like some advice regarding the problem of lubrication.
To be honest with you, Doctor, I used to have a great sex life. I have been a little unwise in the past, but now I would like to settle down and marry the man I love.
But there is a problem. Whenever we try to make love, I seem to be too dry. He is complaining about this, and says that it pains him to have intercourse with me. His penis actually became quite sore, and at one point he went to his doctor, who said there was nothing wrong with him and that I must be the problem.
I am very distressed by this. It is clear that I am not producing enough lubrication and I would like to know why. I have been using Vaseline, and this helps a bit.
Doctor, do you think that I may have caught an STI in the past, and that it what is making me too dry?
A: I do not know of any sexually transmitted infection that makes a woman 'dry'.
Actually, it is extremely common for women to produce less lubrication in the years before menopause. I am not sure of your exact age, but if you are (say) 39, then it is probable that you have about another 10 years to go before menopause.
Nevertheless, it is quite likely that your output of female hormones is already starting to decrease a little, and that this is reducing the volume of vaginal secretions.
No reason for embarrassment
That is nothing to be embarrassed or ashamed of. It is just something that happens to many women.
Now you say that you have been using Vaseline (petroleum jelly) and that this helps a little. However, I would not recommend that you discontinue. This is because Vaseline and other petroleum products tend to make holes in condoms. They can also do the same thing to any rubber-based female contraceptive barrier which you might be using.
If you are not using rubber contraceptive products, then it is OK to use Vaseline, when you have nothing else available. But the fact remains that most couples don't find Vaseline a really pleasant thing to introduce into sexual intercourse. Many persons prefer to use products that feel better like baby oil (though this too can damage condoms).
What you really need is something which gives good lubrication, something that mimics the natural female secretions. It should be water-based rather than petroleum-based.
Fortunately, these days pharmacies do sell such products. Also, you can buy them online from various companies which will send them to you by mail. Just type the words 'lubricant' and 'vaginal' into Google, and you will find that there are over half a million entries, featuring numerous firms that offer water-based intimate lubrication products.
Good brands which you can purchase include Astro-Glide, Sylk, Replens and Senselle.
They do not 'attack' condoms, and also they do not often produce any side effects, such as skin irritation.
So I think you should try one of these lubricants for a few months. Use it on your self just before sex and also apply some to your partner before penetration. I hope it will prove to be very successful for you and the man you love.
But, if by any chance the intimate lubricants do not work too well for you, then it will be time to see a doctor. She will give you a good check-up, and then tell you whether you need any extra help in the form of female hormones.
If you do need these hormones, then she will probably prescribe them for you in the form of a vaginal hormone cream or gel - or perhaps as a vaginal pessary, which is a little tablet to put into the vagina. These products usually work extremely well.
However, these female hormone products can have side effects, so they must only be used under a doctor's guidance.
Q: I am a 52-year-old male and I find that my erections are not as hard as they used to be. This is very worrying.
I have heard that it is possible to take a pill called Cialis every day, so that you can have a firm erection whenever you want. Is this true, Doc?
A: It is usual for erections to become less hard as one gets older. But if you are having real problems, you should see a doctor who can give you a check-up for general health problems, including diabetes.
As for Cialis, it is a drug from the same family as Viagra. However, its effects last much longer than Viagra's - often for 24 hours.
Expensive choice
In the United States, there has been some support for the idea of giving men a Cialis tablet every day of the year. But to do this would cost you a lot of money. Also, please bear in mind that Cialis has numerous possible side-effects, including back pain and muscle pain.
Q: I am 26, and last week I had sex with a guy whom I met while on holidays.
What is the risk of getting pregnant from a single act of intercourse?
A: At your age, it is around one in 20.
Q: Doc, is it possible for a man to get breast cancer? I am a 32-year-old man and I have a strange swelling behind my right nipple.
A: Breast cancer does occur in men, but it is rare. Nevertheless, I suggest you get this swelling checked out by a doctor immediately.
Q: Doctor, I have been told that I have fibroid in my womb. Does this mean I will have to have a hysterectomy?
A: No, not necessarily. These days, it is possible to get rid of these fibrous swellings without taking the womb out.
Q: My wife has been very 'jumpy' and irritable recently. A friend has suggested that this might be due to thyroid trouble. Is that possible?
A: Certainly. An over-active thyroid (hyperthyroidism) is common in women. It makes them nervous, easily frightened, and often quick to take offence.
It also makes them lose weight, and unable to tolerate the heat. They tend to move around very quickly; one woman said to me that her over-active thyroid had made her "like a humming bird".
So your wife should see a doctor for a check-up and probably a blood test. If she is indeed hyperthyroid, it should be easy to treat her, with medication or other means.
Q: I am 25 years old and my period suddenly stopped. Is it possible that this may be due to the recent shock of my mother's passing?
A: Certainly. But if there is any risk at all of pregnancy, you should do a test.