Doctor's advice: Does she have chlamydia?

Q Doc, I read where you warned people about a sex infection called chlamydia. What is this and could you describe the symptoms? You made mention that it can damage one's Fallopian tubes. I am wondering whether I am affected. My boyfriend and I have been together for four years, and I have not been able to become pregnant during that time. I often have belly cramps - really bad ones - during my period, and also at other times. I am 26 and my boyfriend is 42. He is seldom here. Could that be part of the problem?

A Sorry to hear about your troubles. I will deal first with the question of chlamydia and then explain what I think you should do.

Chlamydia is a germ that is passed on during sexual intercourse and sometimes during other types of sexually activity, such as oral love play. It has become quite common nowadays, even though a generation ago it was almost unknown. This reflects the fact that it is so easily passed from one person to another during sex.

It is very important to realise that many people have got this infection, but do not know that they have it!

Now, what symptoms does it produce? In females, there may be no symptoms, so women do not know that the germs are breeding inside them.

But where there are symptoms, these can include:

Vaginal discharge;

Pain in the lower part of the belly;

Pain in passing urine;

Slight bleeding between periods.

What about men? Well, in guys, there may also be no symptoms, even though chlamydia might be living and breeding in the region of the man's testicles. However, where a guy does get symptoms, these could include:

Discharge from the penis;

Pain on passing urine;

Soreness and irritation at the tip of the penis.

The big problem with chlamydia is the long-term damage it can cause. In women, long-term effects can include:

Pelvic inflammatory disease;

Blocked Fallopian tubes;

Salpingitis, which is a painful inflammation of the tubes.

In men, the long-term effects may include:

Painful inflammation of the testicles;

Inflammation of the sperm-carrying tubes;

Infertility;

Inflammation of the joints.

So, summing up, chlamydia is not a nice thing to have lurking in your body, whether you are male or female. Anyone who thinks they might have caught it should get a chlamydia test. This can be done on a urine specimen or by means of a swab which is sent to the lab.

Now, let's turn to your particular case. You say that you and your man have been together for four years but still have not conceived.

This strongly suggests that at least one of you has a fertility problem.

However, at present, there is no evidence to indicate that you have chlamydia, or that your tubes are blocked. The symptoms which you mention in your email (belly cramps, especially at period times) are not clear indicators of chlamydia.

The other thing you asked me is whether your partner's frequent absence from home could be a factor. This is possible, particularly if the two of you don't often manage to have sex on your ovulation day. That day is usually around 14 days before a period is due, though it may vary a lot. If you can manage to get hold of an ovulation kit, that would help you to identify the day in question. That is when you should try to have sex.

Apart from that, your best course of action would be to consult a doctor who is interested in fertility problems. Both of you should see that doc because - as I have indicated above - there is always a strong possibility that the problem may lie with the male, and not the female.

Q Is it possible for a guy to get circumcised at age 22? And would the circumcision help me to maintain an erection longer and perform well in bed?

A It is certainly possible to get circumcised at 22, but I really would not recommend it.

Why do I say that? Because there is not the slightest evidence that circumcision makes anyone perform better in bed.

Also, it sounds as if you may have a tendency for premature ejaculation - circumcision will certainly not help that. Sorry.

Q I suspect that I have two clitorises. Please advise. I am 18.

A Well, I have never in my life seen a patient who had two clitorises. Such things can happen, but they are one-in-a-million cases.

I suspect that one of these objects you can see is not a clitoris at all, but some other lump or, perhaps, a piece of one of your labia.

Your best course is to go and get your body checked out by a doc. I am sure that she will be able to reassure you that you only have one clitoris.

Q From I was a child growing up through school, I was always being picked on because I had spots on my skin. I am now 24, and they are still there! I thought I would have grown out of them by now, but they haven't gone. I have tried bleaching creams, but they don't work. Please help because I'll be getting married soon.

A From the details you have given me in your email, I feel fairly sure that you have acne. A lot of young people do grow out of this, but you clearly haven't.

Please do not use any more bleaching creams because they won't help. I feel that you may well need a two-month course of an antibiotic, taken as a tablet every day. See a doctor about that.

Q I am a woman, and I have recently found out that I have genital herpes. I know that I have to live with it for the rest of my life. But will I be able to have children?

A Yes, you will. Herpes does not cause infertility.

It does, however, cause a lot of health problems, and I will deal with that subject next week. Although it must be real distressing for you to have herpes, bear in mind that sometimes it does burn itself out and becomes less severe as you grow older. I wish you well.

Email questions and feedback to Doc at saturdaylife@gleanerjm.com or post responses to Doctor's Advice, c/o The Gleaner Company, 7 North Street, Kingston.