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Your Q&As
HerpesQ Dear Dr Anna: Although the doctor has put me on antibiotics, the sores around my vagina are still getting worse. Even walking is difficult; sex is impossible. What can I do? A Please see a sexual health doctor as soon as you can. Whatever waiting list there is, a sexual health clinic will see you urgently if you let them know your symptoms. What you are describing suggests that you have primary genital herpes and antibiotics won’t help, as they work on bacteria, not viruses like herpes. You need an antiviral, such as acyclovir, as quickly as possible. This will stop you getting new sores and allow the existing sores to heal. An attack like this is not common, happening only when you have never come across the virus before. With no prior immunity to the virus the first attack can be as bad as this. Much more commonly, the herpes virus causes the everyday cold sore. You’ll mostly see them around the mouth but they are pretty ordinary around the genital skin too. Some people get such small attacks that they have no idea it’s happening. In terms of evolution this is a great way for the virus to pass on to someone else. Reassurance that you will never get an attack like this again is vital and will really boost you confidence. Once you are better you may get a sore like an ordinary cold sore in the future but that’s about it. Debunking all the common myths about herpes
is an important part of your consultation about what is happening to you and should quickly be able to lift a whole weight of guilt and shame off your shoulders. See someone, now! VaginismusQ Dear Dr Anna: I have been living with a wonderful boyfriend for 11/2 yrs and we want to get married. Whenever we try to have penetrative sex it hurts and I tighten up so much that we have to stop. Years of treatment for ‘thrush’ has not helped at all. There must be someone or something that can help. What should I do next? A You probably have vaginismus, where the muscles in the pelvis contact involuntarily as soon as penetration is attempted. Commoner than you may think, this is an eminently treatable condition, especially with such a supportive partner. Success rates are over 50%. Treatment can take time, though, ranging from one to two sessions, to one to two years. A sexual health clinic can match your individual needs with the right health professional. Real progress is more than just a possibility. Taking this forward will help you feel back in control as well as on track in your relationship with your partner. SexualityQ Dear Dr Anna: I want to go to a sexual health clinic for a check-up. Will I be asked about my sexuality? I have never disclosed this to a doctor before? A Yes! To a sexual health doctor this really is as routine as whether you eat white or brown bread. The straightforward and only reason, for asking if a partner is male or female, is to get the right tests and treatment for you. ChlamydiaQ Dear Dr Anna: My GP has told me that I have Chlamydia and has suggested that I tell my partner to go and get treatment too. If I tell him I’m sure he’ll think that I’ve had sex with someone else and I’m frightened that he’ll leave me. A I agree, however common these days, situations like this are very sensitive to handle. You’re right to stop and think how best to handle this and minimise any negative effect on your relationship. It can be an enormous help to talk this sort of thing through with a sexual health professional, who will have the experience of different options that have worked for other couples. Even though Chlamydia doesn’t necessarily mean that either of you have had another partner, with this kind of support you don’t even have to say that you have tested positive. A sexual health clinic is used to handling these situations skilfully and can easily arrange for him to get the right antibiotics. As this can take time remember not to have unprotected sex until you’ve both been treated. You may prefer to wait and take your treatment at the same time, which is fine. Many couples also find that they end up with a relationship that is stronger than ever. HIV testingQ Dear Dr Anna: Although I want to have an HIV test I don’t think I can bear waiting for the result. How long will I have to wait? A Most sexual health clinics can get your result back to you in just a few hours, including the p24 antigen test, which becomes positive much sooner than HIV antibodies. If you have your test sometime in the morning this means that you won’t have to wait until the next day, which will be much better for you. Sexual health clinics understand that it is common to feel very anxious whilst waiting for your result and will do everything they can to make you feel comfortable and ensure that you get your result as soon as you can. The boost in confidence on getting a negative test can be enormous. ‘Point of care’ test, which are done in 15 minutes on a ‘while you wait’ basis went out of fashion as they weren’t accurate enough. The technology for better, accurate rapid tests are now available but they need rigorous quality assurance and are not yet widely available. Thrush/Lichen sclerosusQ Dear Dr Anna: Despite many years of thrush creams and tablets from the chemist the skin around the outside of my vagina is more itchy and sore than ever. Our sex-life has all but disappeared – is there another sort of treatment I can try? A This must be really uncomfortable and very frustrating. Firstly, a thorough examination by a doctor will confidently begin to find out what the underlying problem is. And there may be more than one. Understanding this is the key to getting the right treatment. A doctor will examine you in a very calm, straightforward way, as well as understanding how self-conscious you may feel yourself. Don’t hesitate to say if you would like a chaperone for this; it is now routine to choose to have one or not. Secondly, I can understand the difficulties this is causing for your sex-life. Once the right treatment has been established, my usual experience is that this will return to normal too. See a doctor you feel comfortable with as soon as you can. Anonymous testingQ Dear Dr Anna: My partner and I both want to have HIV test. Do we have to use our real names? A No. Sexual health clinics won’t bat an eyelid if you don’t want to use your real name. Even if you did use your real name there is an Act of Law to stop anyone finding out that you have ever had a test; this includes insurance companies. So your identity is safer than in Fort Knox – relax! Pregnancy related concernsQ Dear Dr Anna: A friend has told me that I should have a swab for Group B streptococci (GBS), as I'm 7 months pregnant. A You're right to check this out, as advice on this sort of thing can change, as and when we get new information. The experts, who carefully review our UK guidelines each year, do not advise routine screening for now. A quarter of pregnant women will test positive on a swab, as it can be found as one of the normal bacteria in our bodies. If all these women were treated, some women would get serious allergic reactions and the germ could get more resistant A very few babies can become dangerously ill with GBS and pregnant women more at risk of this are treated. This is with intravenous antibiotics and throughout labour. So, your midwife will not routinely do a test for this during pregnancy. But, if you do decide you want a test, it can be arranged, usually at around 36 weeks. If the result were positive the pros and cons of treatment would be discussed with you, by your midwife or a doctor. OdoursQ Dear Dr Anna: I am just so embarrassed; my nether regions really smell, especially after sex. I don’t have any other symptoms and feel fine. I’m too embarrassed to go to my GP. Sex has lost its spontaneity, as I feel I have to wash beforehand. A Fear not; this is a very, very common problem and probably one of the simplest to remedy. The key here is a gentle swab of your vaginal fluid, to check if it is in a natural balance. If the balance has changed, a chemical reaction can occur when it mixes with semen, resulting in the release of ammonia and the unpleasant smell. A swab is quick and easy to do - any imbalance may be treated with minimum fuss at your GP, family planning or genitourinary medicine clinic. Don’t suffer in silence and get your sex life back! Skin changesQ Dear Dr Anna: I am desperately worried. Dark, reddy-purple spots started to appear on my scrotum about a year ago and I seem to be getting more of them. Although they’re scary to look at they don’t hurt or itch at all. Have I got a serious infection? A These spots are almost certainly angiokeratomas, which are nothing to worry about. As each year goes by, the look of our skin can change, over any part of your body. Our skin is a dynamic living organ. Spots like this are usually made up of a tiny ball of blood vessels, so small that all you see is a dark reddish-purple spot. Up to 15% of men have them by the age of 60. No treatment is needed medically. What’s so important is that you don’t let them define your body image. So get back your confidence about this part of your body as soon as you can. It’s easy and quick for your local GP or GUM doctor to confirm what they are for you. They were first described in 1896, by Dr John Fordyce, who said that, ‘These varicules should be known so that we can allay the fears of men, many of whom have worries enough already’. Vaginal pHQ Dear Dr Anna: Is an acid vagina healthy? A Don’t believe the script writers of Green Wing! When Joanna Claw complains about having an acid vagina nothing could be further from the truth. The healthy fluid in the vagina has a natural pH balance, which is normally acid. This is delicately maintained by our healthy bacteria, and helps to keep harmful germs away. Comfort during sexQ Dear Dr Anna: I have a new partner who is fantastically interested in pleasing me. I have never climaxed from vaginal intercourse and it is his mission to make it happen (good thing). My question is this...I felt aroused by sensation/contact on my anterior vaginal wall, but was intimidated by the fact that I also felt like I would lose control of my bladder and since I was uncertain, I think I held back. Is this a common sensation? Should I move right through it or was I truly going to lose control of my bladder.... not sexy. A These sensations are fantastic proof of just how aroused you are with your partner. Only true sexual arousal gets the front of the vagina enlarging and contracting. Present day MRI scans show exactly how the anterior vaginal wall changes during arousal. The inner 2/3 lengthens and the outer 1/3 has regular contractions. It is also proven to be relatively sensitive to electrical stimuli. The bladder and the tube for urine to the outside of the body, the urethra, sit just in front of the anterior vaginal wall. An expert (and he certainly sounds it!) knows that these specific parts form an integral part of our orgasmic reflex. Surrounded by erectile tissue, they're sensitive and become engorged during arousal. So much for the upside. This all means, though, that your fear is well founded; it is possible that you will lose control and leak some urine, if you let yourself go. Let's concentrate on how you can separate out or dispel some of your individual fears and keep your mind on enjoying yourself. For instance, how would it be to go on a solo test drive, maybe with the right tools? Or, confidentially, empty your bladder before sex, assuring yourself that any slight leak would be too small to notice amongst all the other juices. Talking about your fears with your partner might make it a shared (lack) of concern, rather than let it build up in you. Hope you get past Go! Genital wartsQ Dear Dr Anna: I am a 18 year old female and I had went to the doctor and I had a skin tag on my vagina but he said that it was an ingrown hair and I was like anything to be concerned about he said no but now I have a couple more and I think its warts but I'm not sure what should I do and what do u think it is do you think what I had is spreadable please try an answer my question I have been driving myself crazy. A You can easily get more ingrown hairs, especially in summer, when we're all shaving away for our bikinis and so on. There's no short cut, though, to showing the new bumps to a doctor again. It takes seconds to have a quick look and put your mind at ease. Sexual health doctors are some of the friendliest and most approachable too. Spare a thought for the many people who do have genital warts. Our biggest problem, as doctors, is getting their body image and sex-life back to normal. They are important and a nuisance but warts are nothing to be ashamed of! Natural dischargeQ Dear Dr Anna: Where does the ejaculate go after intercourse? I have to wear a panty liner for 1-2 days after having sex due to vaginal discharge. Is it the ejaculate being discharged? A Great sex stimulates innumerable glands in and around our sexual organs, so take joint credit for all those juices. Of the 6ml down to him, the rarest fraction can get as far as the tubes leading to the ovaries, the oviducts. Bacterial vaginosis, where the natural pH balance in the vagina is altered, can also give you more discharge after sex, in which case you'd probably notice an unusual smell too. A sexual health doctor can simply check for this with results the same day. If the sex was that good – the memory could even be keeping your juices flowing!
References 2. eMedicine: April 14th 2005; Angiokeratoma of the scrotum; |
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