DOCTOR'S ADVICE - Could I be pregnant?

Q Doctor, I hope you can help me with an urgent problem. I'm a 33-year-old career woman. Although I enjoy sex, all my adult life I have taken the attitude that work is first. Therefore, I have taken great care not to get pregnant.  So I very rarely allow men to have full intercourse with me. However, I have become very good at oral sex over the years, and they seem to appreciate that.

A week ago, I had a date with a handsome and charming new man. We enjoyed a pleasant dinner together, and afterwards I invited him back to my home. He wanted to have intercourse with me, but I explained that that was not on the agenda.  Nevertheless, he was highly delighted when I gave him fellatio, at which I would say that I am an expert. After about 20 minutes of this, I let him ejaculate in my mouth because I have learned over the years that men really appreciate that.

What happened next is a bit of a blur, but my recollection is that soon afterwards, he French kissed me on the lips, while putting his tongue into my mouth. A minute or two later, he switched to giving me oral sex, and brought me to a highly satisfactory climax.

It was not until the next morning that I suddenly realised the implications of all this. It suddenly struck me that when he kissed me on the lips, some of his sperms could have passed into his own mouth. Then, when he went down on me some of those sperms could presumably have entered my vagina. This is a horrifying thought for me, but I suppose that I could now be pregnant. My period is not due for three weeks.  What do you think, Doctor? Is it possible that I have conceived in this way?

A. I have occasionally been consulted by women who thought that they could be pregnant as a result of some variation of oral sex. In every case, it turned out that conception had not occurred.

That is not surprising because sperms are fairly fragile. I think that it would be a little difficult for them to survive contact with the enzymes which are present in the saliva in someone's mouth. Also, there is the question of what date this occurred on. It sounds like you were in the very early part of your menstrual cycle, and that you were not yet near your ovulation day.

So I think that you are going to be OK although I cannot guarantee it. You will just have to wait and see if your period appear on time. The odds are it will.

You do seem to really like this new man, and I just wonder whether you should give some consideration to the possibility of settling down with him in a monogamous relationship. It might be possible to do that without affecting your career.

But if you do not want to do that, then in the future I think you should bear in mind that oral sex does carry a small but definite risk of transmitting sexual infections, notably gonorrhoea. It is possible to reduce that risk by using barriers that are intended to prevent the spread of infection.

There are two types of barrier:

• Condoms, which can be used while giving a man fellatio;
  
• Dams which are specially designed sheets of rubber or other material, intended for use during cunnilingus.

Finally, in case you ever get carried away' and allow a man to have intercourse with you, it might be worthwhile buying yourself some post-coital pill, often known as the morning-after pill.

Q I am getting married to a wonderful woman in July. We have not had sex together and we intend our wedding night to be the first time. But what she does not know is that I have a problem, Doctor. My foreskin does not roll back when I am erect, so I have a rather odd appearance. What can I do? The wedding date is drawing near.

A.  Frankly, it is not very hygienic to have a foreskin (prepuce) that does not roll back. Germs tend to breed under it, and that is not good for you or your partner.

Therefore, I urge you to see a urologist (that is, a urological surgeon-specialist) right away. He will examine you and tell you whether you need to have a circumcision or maybe some milder surgical procedure. It is just possible that he may be able to help you fix the problem with the use of some special cream.

Please do not delay. If you need to take an operation, it will take some time before it heals. And clearly, it has to be completely healed by the time you get married.

Q I am a 44-year-old woman and my period has suddenly stopped. Surely this couldn't be menopause already, could it?

A. Yes, it could, although most women don't experience menopause until around 48 to 50 years of age. I feel you should see a doctor who can give you a check-up, and if necessary do hormone tests. Please bear in mind that sudden absence of menses in a woman of 44 can occasionally mean pregnancy.

Q I'm a 29-year-old married man with two children. I am extremely worried by the fact that last night I had a sexual dream which involved another man! I actually orgasmed at the end of it. Does this mean that I am subconsciously gay, Doctor?

A. No, it doesn't. As I am sure you know most virile men have sexual dreams from time to time, and these dreams frequently end in an orgasm. In sex dreams, crazy things sometimes happen, just as they do in non-sexual dreams. For instance, I recently saw a patient who dreamt that he was having sex with a female whale. When wacky things like that occur in your dreams, the best thing to do is to ignore them.

Q I am a happily married 32-year-old woman, but I am wondering whether my husband has been unfaithful to me.You see, Doctor, in the last few weeks I have developed a slight vaginal discharge, which is something I have never had before. Does this mean that he has brought some germ home?

A. Not necessarily. There are many possible causes of this symptom. Not all discharges are caused from germs.

For instance, in a woman who is in her early 30s, like yourself, a discharge is commonly due to factors such as:

• A forgotten tampon;
  
• A raw place (an ectropion) on the cervix;
  
• A polyp, which is a small harmless growth on the cervix.

So really, you need to see a gynaecologist and ask her to examine you and do some tests. Unless she finds some sexually transmitted infection, there is really no cause to think that your husband has been unfaithful.

Send feedback/questions to:editor@gleanerjm.com and read more Doctor's Advice in the Saturday Gleaner.