Doctor's advice: The secret her cousin told her

Q I am female, and recently my cousin and I were having a little 'girls' talk'.

She decided to share with me an experience that happened between her and her boyfriend. She said they were having sexual intercourse, which was unprotected. Apparently, he was forcing his penis into her, and it was some time before it finally went through.

Five minutes later, they both discovered blood on the bed. They weren't sure whose blood it was. She said it was "not much, but a good amount". It made her panic.

I asked her if she had contacted a doctor, but she said "no". This was because they were both too scared.

So it is a mystery what happened that time. And I am puzzled.

A Well, thank you for emailing me about your cousin. Are you sure that this story isn't about yourself?

Anyway, the first thing that I must say is that it is very unwise to have unprotected sex. Doing that will very often lead to pregnancy, or to serious infection. Also, unprotected sex at a young age raises your chances of getting cancer of the cervix when you are somewhat older.

Now, what happened here? If it was the young lady's first time, then the answer is real simple. The boyfriend's 'big push' broke through her hymen (the membrane called the 'virgin's veil'). When that happens, it is common to lose several big spoonfuls of blood - though, in fact, not everybody bleeds.

But if it was not the young woman's first time, then what has occurred is that by pushing hard, the boy has made a little tear in the delicate tissue of her vagina, or possibly in the outer, visible part, which is called the vulva.

These areas of the female body often bleed if they are treated roughly.

Slight bleeding does not matter very much because most of these little cuts heal up pretty quickly. However, if there is any further bleeding in the future, then the girl should definitely have a check-up from a doc.

Please wish 'your cousin' all the best from me, and tell her to practise only safe sex in future.

Q Doctor, I think that Jamaica has a problem with obesity. For some, obesity still signifies wealth, prosperity and the ability to afford good food.

In reality, obesity is mainly due to poor dietary habits and lack of exercise. It contributes to illness, and burdens our overstressed health system.

But I am a voice crying in the wilderness. Most people seem to think that to be obese is OK. And they rename it 'fluffy' !

I believe that in order to fight obesity, we have to start recognising it as a disease.

A Well, 'voice in the wilderness', I have to agree with most of what you say.

Young people should be made aware that being fat or overweight really is bad for you, and is likely to give you all sorts of diseases, including 'sugar'.

The ideal shape to aim for is, alas, not that of the late, lamented 'Miss Lou'. In fact, young people should be aiming to grow up looking like Usain Bolt, Asafa Powell, or Veronica Campbell-Brown.

In other words: slim and fit!

Q I have been conversing via email with women from the Philippines and Thailand. Someone warned me that in those countries, it is common for men to take a 'sex change' operation and to pose as women.

Apparently, they do this in order to get to countries like Canada and the USA.

I was wondering if it is easy or difficult to tell if a person has had such an operation?

A Well, I am not quite sure why you are interested in the details of this operation. Are you perhaps thinking of having a physical relationship with one of the (apparent) females with whom you have been corresponding?

Anyway, what you have heard is partly true. In certain oriental countries, and particularly Thailand (aka Siam), it is quite common for young men to dress up as women, and make themselves look like women, with the aid of skilled make-up and exotic hairstyles.

These guys are often called 'the Lady-Boys'. A lot of them go into show business, and the touring 'Lady-Boys of Bangkok' are a famous theatrical company.

Some young men go as far as having surgery in order to make them look more like women. Any reader who is squeamish had better skip the next paragraph because I am going to describe what the operation usually involves!

Generally speaking, the surgeon cuts off the young male's penis and testicles. Next, he 'fashions' the scrotum into something that looks like a girl's labia (vaginal lips), and makes a little cavity behind it. The cavity is supposed to be the person's vagina.

In addition, the young man may be given breast implants by the surgeon. And he could be advised to take female hormones, to increase his resemblance to a woman.

To be frank, in the dark it could be real difficult to tell the difference between a 'Lady-Boy' and a genuine woman. So if you ever get to meet one of the ladies with whom you are corresponding, you might like to think carefully before deciding to take the person to bed.

Q As far back as I can remember, I have had irregular periods. I went to the doctor, and found out that I have 'polycystic ovaries'.

I know this means that it will be more difficult for me to get pregnant. I am trying so hard to conceive, and have been taking the drug 'metformin' for six months. But up to date, I have not succeeded. Please help.

A I have previously dealt with the problem of polycystic ovary syndrome in this column. It is real common. The anti-diabetic drug metformin is helpful.

But in order to get pregnant, you really need some assistance from a gynaecologist or an endocrinologist (a gland specialist). It is important to pinpoint the rare days on which you are ovulating, and to have sex at least once on that day. I wish you good luck.

Q Can herpes give you blocked tubes?

A No. Herpes gives you painful blisters on the genitals, whether you are male or female. But it does not usually block the Fallopian tubes.

Tubal blockage is common, but it is mostly caused from other sexually transmitted germs, such as chlamydia or neisseria, which is the gonorrhoea 'bug'.

Q I seem to exist in three mental states. These are:

1. Depressed and crying for little or no reason;

2. Totally devoid of emotions;

3. Extreme happiness or anger.

I have done research, and have come to the conclusion that I may be bipolar. However, I have a friend that is diagnosed as bipolar, and my episodes are not as severe or as often as hers.

So could there be another possible diagnosis for me?

A Bipolar illness, which used to be known as manic depression, is common, and is characterised by bouts of deep depression, alternating with wild emotions or wild activities.

Your description of yourself does sound like that of a young person with a bipolar problem - and not very like anything else. But to get an accurate diagnosis, you need to have at least an hour's session with an expert, such as a psychiatrist. I wish you well.

Email questions for Doc to saturdaylife@gleanerjm.com. You may also read Doctor's Advice every Sunday in The Outlook Magazine.