Q I am a 25-year-old man. I have had many girlfriends during my life. I have never used any contraception because I do not like the idea of the condom.
The other day, it suddenly struck me that I have never got a young woman pregnant. This seems quite surprising in light of the fact that I have been such a sexually active guy since I was 17.
Is it possible that I might be infertile? I am really fretting about this because I would like to have children one day.
If I went to a doc, what would he do? Would he examine my sexual organs? I dread that because I feel it would embarrass me. Also, would he do a sperm test if I asked him?
A I am rather alarmed by the fact that you have had unprotected sex with all these young women since you were 17. Frankly, I feel rather relieved that all this unsafe sex has not so far caused any pregnancies.
However, I can understand why you are worried. It certainly does seem a little odd that you have never fathered a child. Indeed, it sounds as though none of your girlfriends has ever even had a scare.
On the other hand, maybe all these women were very sensibly using contraception themselves!
Male infertility
It is possible that you are infertile. Male infertility is much commoner than many people imagine. There are lots of fit, healthy guys who are leading very active sex lives, but who are actually 'firing blanks'. That could be the case with you. But why would this happen?
Well, did you by any chance have mumps as a child? That quite often makes the testicles inflamed and painful, and might result in infertility. Also, when you were small - did you undergo any operations on your genitals? Quite a number of male babies have testicle problems.
Finally, when you grew up and became sexually active, did you ever catch any sexually transmitted infection (STI)? Regrettably, STIs are a common cause of male infertility. This is due to the viruses attacking the testicles and adjacent structures.
Really, I do not suppose you will be happy until you have found out whether you are infertile. To do this, you will have to go to a doctor.
Please try to overcome your embarrassment about being examined. The doc will need to look at and palpate (that is, feel) your genitals to see if there is any structural abnormality present.
After that, he might suggest that you have a 'sperm count' done. This involves sending a fresh specimen of your sex fluid to the lab to be examined.
Q I am thinking about going on the Pill. Could you explain to me what its effect will be on my menses, and also on my sex life?
A The Pill almost always has a good effect on a woman's menses. Scientific studies have shown that as a rule, the oral contraceptive makes periods lighter, shorter, less painful and more regular.
The fact that menses are shorter and lighter makes women less likely to become anaemic. (As you probably realise, anaemia is really common in younger women, mainly because so many of them have prolonged, heavy menstruation.)
In addition, while you are on the Pill, premenstrual tension tends to be reduced, though this is not always the case.
Pill good for the menses
So really, the Pill is a very good thing for the menses. However, I should add that today's very low-dose Pills do not always control the periods quite as well as the 'traditional' brands of Pill do. Therefore, if you find that our periods are not responding very well to the Pill, there is a good case for asking your doc to prescribe you a slightly higher-dose brand.
Turning now to the question of sex, it is a fact that a small number of females report that their libido is reduced when they go on the Pill. In these cases, it is usually a good idea to switch to another brand.
However, studies have shown that most women enjoy their sex lives a lot more after they start taking the Pill. This is believed to be simply due to the fact that they feel much safer, knowing that they do not have to keep fretting about unwanted pregnancy.
There is no doubt that since the Pill was invented, many more women are experiencing very active and enjoyable sex lives. Not everyone thinks that that is a good thing, but that is how it is.
Q. I am 20, and do not have much experience with girls. I have fallen in love with an older woman, who is around 28. Unfortunately, whenever I try to have sex with her, I lose my erection. I was OK with previous girlfriends.
Do you think this is a hormone problem, Doc?
A I really do not. When a guy of 20 suddenly starts having trouble with erections, the usual reason is anxiety.
You see, if a male is a little nervous, the immediate result is that 'anxiety chemicals' suddenly start circulating in his bloodstream. These hormones are really the enemies of erection, since they make it difficult for the tubes which supply blood to the penis to 'open up' properly.
Also, as soon as a guy realises that he is losing his stiffness, this creates more worry. The result is a further outpouring of 'anxiety chemicals', so it is a kind of vicious circle.
I would like you to go and see a doc to have a check-up. However, I must tell you that the odds are he will say nothing is physically wrong with you.
One good tip for young guys who are affected by coital nervousness is this: Tell your partner that you would like to lie flat on your back, letting her lower herself on to you.
In many men, this position creates a lot less anxiety than the traditional guy-on-top situation does.
Q I do not seem to have reached puberty yet. What is the normal age for doing this?
A For both males and females, the average age of puberty is around 12 to 14. Your letter seems to suggest that you are now 17, so you should see a doc as soon as possible for an examination. She will also do blood tests. Good luck.
Q Is masturbation bad for the eyes, as I have heard?
A No, this is an old myth from the Victorian times. There is no way in which masturbation, or any other sexual activity, can harm the eyes or make you need glasses.
Email questions about your medical problems to saturdaylife@gleanerjm.com and look out for Doc's responses in Saturday Life in coming weeks.