DOCTOR'S ADVICE - My husband's breasts

Q. Doctor, my husband is 55, and last week while he and I were 'horsing around' in bed, I realised that his left nipple felt different. In fact, it felt rather like my female breast. I asked him if it hurt, and he said 'no'. However, when I squeezed, some clear fluid came out. At that point, I became alarmed. He wants to disregard the problem, and so far has not been to the doctor. I have done some research on the Internet and I am worried that it might be something serious, like cancer.

A.Your concern is justified. Although breast cancer is rare in males, it can occur, and when it does it can be very serious.

The main symptom is swelling in or around the nipple, and sometimes there is a discharge. So although there could certainly be other causes for your spouse's breast enlargement, the fact is that he needs to see a surgeon-specialist as soon as possible. Please be firm with him about this. Delay could have serious consequences.

Q. I have two lovers and they do not know about each other. One of them is an Englishman and has had a vasectomy. So I do not need to use any contraception when I sleep with him. However, I do need some protection when I have sex with the other man who is Jamaican. I am planning to have a coil fitted, Doctor, and I want to know is if my English lover will be able to detect that I have a coil in? If he does, he will, of course, realise that I have another boyfriend. I am aware that coils have 'threads' which hang down into the vagina. But would a man be able to detect these threads?

A. A good question. I remember a case in which a man who was sterile detected that his wife had had a coil fitted and, therefore, deduced that she had another lover.

The coil is also known as the intrauterine device or IUD. As you say, it has either one or two threads, which come down a short distance into the vagina. Usually, the threads are no more than a half-inch long. But quite often, men do feel them with the tip of the penis, where they produce a fairly pleasant tickling sensation. Occasionally, they can give the man a slightly painful jab during intercourse.

So they are sometimes detectable during sex. Furthermore, if your English lover puts his fingers inside of you, there is a high chance that he might notice that there is something 'thread-like' touching his fingertips. So you might perhaps do better to pick another method of contraception. Or maybe you could choose to confine yourself to just one lover.

Q. I am a man who is depressed, and my doctor has put me on an anti-depressant called sertraline. Since then, I have had no libido and few erections. What could I use to counteract these side effects, Doctor?

A. Sertraline is a widely used anti-depressant. But like a lot of drugs for depression, its side effects can affect your sex life. Most commonly, it causes difficulty in reaching an orgasm. However, you should bear in mind that it could also be your depression that is causing your sex problems. Nevertheless, I feel that your best course would be to ask your doctor to switch your medication to another anti-depressant. I hope that will improve matters.

Q. I have met a wonderful new man, and he is a great lover. But whenever I spend the night with him, I find that next morning I have a very sore clitoris. Is this ok, Doctor?

A. Yes. Intensive lovemaking does tend to make the clitoral area sore the next day. Occasionally, the clitoris swells up into a tender lump, which does not go down, and if that happens, it is a good idea to have a doctor check it out. My advice to you is to use a lot of lubricant when you are spending the night with this man. Good lubricants can be bought from pharmacies, and on the Internet.

Q. Doctor I am a 33-year old woman. I have just found out that I have herpes! Will it stay with me for life?

A.Well, the herpes virus will almost certainly stay in your body for life. But that is not as bad as it sounds, because there is a tendency for attacks to get milder as the years go by. And it is possible to have a satisfactory sex life with your partner despite having herpes. You can get some good information by looking at the article titled 'Herpes genitalis' on Wikipedia. Good luck.

Q. What are the exercises that can help a woman get rid of a protruding belly?

A Well, the basic one is like this. You lie flat on your back, with your knees bent so that the soles of your feet are on the floor. Then you sit up without using your arms. Stay sitting up for a moment, and then lie back on the floor again. Do this 10 times, then have a little rest and do it 10 more times.

Ideally, that exercise should be carried out four times a day for six months. It is very good for firming up the muscles of the stomach. But if you don't get rapid improvement, it is worth seeking further advice from a physical therapist, a sports therapist or some other well-qualified expert.

Q. I visited my doctor recently for a check-up and he informed me that my uterus is turned to the right. Is this the same as a tilted womb? And would it cause difficulty with conception?

A No, this is not the same thing as a tilted womb. About one in 10 women have a tilted womb, which just means that the womb (uterus) points backwards instead of forwards. In your case, the womb apparently points to the right. I cannot say why it is doing this, but the odds are that it will not affect your ability to have children.

Q. I have fallen in love with a much younger man, and we hope to get married and have children. Problem is, Doctor, that whenever we have sex, his sperm seem to run right out of me. Is this because he produces so much? Or does it mean that I have something wrong with me, and so will be unable to conceive?

A. Well, it is certainly possible that because he is a younger man, he produces a lot of seminal fluid. But like a lot of people who write to me, you have not realised that, in fact, the fluid is supposed to run out after sex. This is simply because there is nowhere else for it to go. The female body does not absorb a man's ejaculate. Although some of the sperm make their way up into the womb, the rest of the liquid simply has to come out. So don't worry.

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