Q. Doc, my mother died of cancer of the cervix at age 43, and I would not like the same to happen to me. I am now 25.
I know this disease is connected with sex in some way, but I do not understand how. Can you please enlighten me, doctor?
I have only had four boyfriends in my life, and I have never had a sexually transmitted infection.
Also, I have no symptoms at all: no bleeding, no discharge from the vagina, no soreness or anything like that.
So, can I assume that I am safe from cancer of the cervix, and do not need to take the smear tests?
A.No, that is completely wrong. I must tell you that ALL women who have ever had sex need to take regular Pap smear tests in order to protect themselves against cancer of the cervix. Even a woman who has no symptoms at all should make sure she has these important tests because the whole point of them is to detect the real EARLY stages of cervical cancer - long before it can cause any symptoms.
Now let me explain what this disease is, and how it is connected with sex.
First of all, what is the cervix? It is the lowest part of the womb. It projects down into the vagina. If you put a couple of fingers into your own vagina, you can feel it at the far end. It is soft - as if you were touching the tip of someone's nose.
Unfortunately, the cervix gets hit repeatedly by the end of the penis during sexual intercourse.
I say 'unfortunately' because of the fact that many guys carry a germ on the penis. This 'bug' is called human papilloma virus or HPV.
During intercourse, this virus is often transferred to the woman's cervix, where it finds a kind of 'safe haven' or 'nest'. So it can stay there, inside the female body for quite a while.
This HPV is so common that around three-quarters of all adult woman get it at sometime or other.
Happily, the woman's bodily defences will often overcome the HPV, so that eventually it vanishes from her cervix.
But in some females, the virus gradually causes a cancer - that is a malignant growth - in the cervix. As your poor mother discovered, that cancer can sometimes be fatal.
I am glad to say that the great majority of women who get HPV do NOT go on to have cancer. But some do. Factors which make you more liable to develop cancer include:
Smoking
Being poor
Having a partner who has a manual job
Having given birth to four or more children
Having had a lot of sexual partners.
However, it is real important to appreciate that ANY woman who has ever had sex can get cancer of the cervix. Even a non-smoking rich woman who has no children, and only one sex partner, could get it.
Some experts say that you can even catch HPV and get the cancer if you have only gone in for 'heavy petting'. But I must say that I have NEVER seen this cancer in a woman who is still a virgin.
Cancer of the cervix usually takes around 15 to 20 years to develop. So the commonest age group in which it is first noticed is 30 to 45. But it can also affect women much later in life. I have seen a case in a lady of 75.
Common symptoms of this terrible disease are:
Bleeding after sex
Bleeding between the menses
An unexplained discharge - often brownish;
Unexplained pain near the top end of the vagina.
Younger women who have any of those symptoms should not fret too much because this cancer is rare in the under-25s. However, the occurrence of symptoms like the above does mean that you should have a check-up from a doc.
Now what about Pap smear tests? Well, the great thing about Pap smear tests is that they detect the beginnings of cervical cancer so very, very early that it is almost always CURABLE. And that is why every adult woman should try to make sure that she has these tests throughout her life.
Finally, you may have heard that scientists have now developed two VACCINES which help to protect against cervical cancer. These vaccines are designed to fight certain dangerous types of HPV.
The jabs are good, especially for young teenage girls. But they cannot protect against ALL types of HPV. Therefore, the fact is that despite the arrival of the vaccines, all women who have ever had sex do still need to have regular smear tests.
Q. I sometimes poke a little stick into my ears to clean it out. Is this OK, doc?
A. No! This could damage your eardrum, and seriously affect your hearing.
No one should ever stick anything into their ears.
Q. I am a 16-year-old girl who has a big problem. I have been sexually active for one year. My boyfriend and I have had sex around 10 times already.
But I don't know when I have reached my climax. I cannot tell whether I have 'come' or not. Please help me, doc.
A. If you don't know whether you have discharged or not, then the fact is that you HAVEN'T.
Orgasm is such a shattering experience that it is almost impossible to be unaware that it has happened.
On the basis of your short email, I would guess that you may never have orgasmed in your life. This is scarcely surprising at your age. Recent research has shown that many females do not learn to discharge till they are 20 or 21.
Incidentally, I do hope that you are practising 'safe sex' when you go with your boyfriend.
Q. I resent being told to clean my teeth. Is this really necessary, doc?
A.Yes. If you do not do it, then your teeth will probably get rotten and ugly.
Q. Last month, my boyfriend climaxed inside me, but I was not ready to have a child. So I went to the doctor, and he prescribed something for me.
After that, my menstruation came. So, am I OK now?
A.Yes, if you are sure it was a normal period. If you are NOT sure, take a pregnancy test.
The doc clearly gave you the so-called Morning After Pill. But it would be better to use a regular method of contraception, such as the Pill.
Q. I am a 23-year-old male, and I went to a doctor because I was worried about ejaculation in my sleep, that is, wet dreams.
He detected a mass in my left testicle, and so he fixed up an ultrasound scan for me.
The report said, 'Both testes normal, with NO focal lesion.'
However, the scan also showed some mild varicose veins in the groin. Another doctor told me that if I don't get these veins operated on, I will not be able to get anyone pregnant.
Is this true?
A.You raise a number of important issues here.
First, it is a pity that you were fretting about wet dreams. These are completely normal in young men. They are a natural thing, and there is no point in going to a doctor about them!
Second, you say you were told that you had 'a mass in the left testicle'. In fact, your ultrasound scan shows that this is not so, and therefore you have no need to worry about that.
Third, the scan showed that you have some varicose veins (that is, unusually wide veins) just above your left testicle. This condition is real common, and it is called a varicocele (pronounced varry-ko- seal).
Varicoceles do tend to reduce male fertility. But there is no real evidence that you are sterile. To find out if you can have babies, get yourself a sperm test.
Q. I get a great deal of back pain, and a friend in Miami has said she could bring me home a special machine that eases pain.
But would it work, doc?
A. I think your friend must be talking about a 'TENS machine'.
This is an electrical device which genuinely does reduce pain in a lot of people. And it has practically no side effects.
If your friend can get you a TENS machine, then I feel you should try it.
Q. I am a guy of 18, and I think I have gonorrhoea. This because I have burning pain while passing urine, and also joint pain.
I would like your advice about what treatment to use.
A.Gonorrhoea (or 'clap') usually causes burning pain, plus a discharge on the pants. But urethritis produces similar symptoms, so you may have that.
Also, it really isn't your job to decide what treatment you need. Please, see a doc or go to a clinic IMMEDIATELY. Meantime, no sex.
