Wake Up, Philippines!

All your sex questions answered medically (Part II)

Posted in Sex, What/How/Why/Where/When by Erineus on March 4, 2009

MIND YOUR BODY By Willie T. Ong, MD Updated March 03, 2009 12:00 AM

Sexually-transmitted diseases

Q. My lady friends say that you can tell if your husband is fooling around by the color of the semen. Is this true?

A. The normal semen is transparent or whitish in color. It is gel-like in consistency when released and it should liquefy in about 30 minutes, so it can swim up the vagina and into the fallopian tube for possible fertilization.

According to surgeon Dr. Anthony Ang, semen which is yellowish and foul-smelling indicates gonorrhea infection, a common sexually transmitted disease. Usual treatment is the superdrug Ceftriaxone given intramuscularly plus a few days of doxycycline tablets. See your doctor ASAP!

Q. I have smelly yellowish vaginal discharge. Is this bad?

A. The normal vaginal discharge is whitish and not foul- smelling. If it is yellowish and foul-smelling, it could be a yeast infection (not sexually transmitted). If you are sexually active and have multiple partners, it could be trichomonas, which is a sexually transmitted disease. It is best to see your gynecologist and have a checkup.

Q. What is HPV?

A. Human papillomavirus or HPV is a virus that causes genital warts. Some strains of the virus can increase your risk for cervical cancer, if your cervix becomes infected.

Unusual Sex Questions

Q. Is there a problem with anal sex or gay sex?

A. Yes, according to urologist Dr. Eduardo Gatchalian. Anal sex is not advisable because the anus, including the rectum inside, is a “dirty” organ meant for the body’s waste. It’s like putting feces on the male organ. Studies show that those who engage in anal sex are prone to serious infections like HIV-AIDS, genital warts, anal warts, and HPV virus. These diseases are very easily transmitted because of the breaks in the skin of the anus. The anus is tight and wasn’t meant for sex. However, if you can’t avoid anal sex, use a condom for protection.

Q. Is oral sex bad?

A. Oral sex is not bad as long as you and your regular partner are healthy. But don’t alternate oral sex and vaginal sex because this can transfer bacteria, especially sexually transmitted diseases, from the vagina to the mouth.

Q. Are there sexual positions that should be avoided?

A. Yes, contortionist and acrobatic positions are best left for real contortionists and acrobats. Normal people, like you and me, especially those with aching backs, should stick to the usual less strenuous positions. Go to a gym, work out, and perform better in bed.

Q. What is the G-spot?

A. The G-spot is the area where the back of the clitoris touches the top wall of the vagina. This area is very sensitive and crucial for a woman’s sexual arousal and orgasm. Sometimes, rubbing the G-spot can stimulate female ejaculation, which releases a clear fluid from the urethra. By the way, the G stands for Grafenberg, the last name of the German doctor who first described this area.

Sex, Pregnancy & Contraception

Q. When is it safe for women to have sex and not get pregnant?

A. Our good friend, OB-gynecologist Dr. Angela Du, says that women with regular menses are safe for seven days before menstruation and seven days after the first day of menstruation. So, for a lady with a 28-day cycle, this is from Day 1 to Day 7 (including the menstrual period) and Day 21 to 28.

The female egg cell can live for 24 hours only, while the sperm cell lives for 72 hours (3 days). The mathematical computation of safe days is based on the long life of the sperm. What about the other days? In those times, you would need artificial contraception (like a condom) or practice self control.

Q. Is it safe to have sex during menstruation?

A. Yes, our experts agree that it’s safe for both the guy and the girl, but it’s messy. Did you know that some men prefer to have sex during the menstrual period because they are confident their partner will not get pregnant?

Q. Is it safe to smoke when taking birth control pills?

A. Smoking (as you probably know) increases your risk for all kinds of illnesses, including heart attacks and strokes. Smoking as few as four cigarettes a day makes you seven times more likely to develop heart disease. Birth control pills that contain estrogen can also increase your risk for blood clots. Doctors usually advise smokers not to take these pills.

Talk to your obstetrician about taking birth control pills that contain only progestin (and not estrogen). Better yet, talk to your doctor about how you can quit smoking.

Female Sex Concerns

Q. I am 45 years old and have just undergone a hysterectomy (removal of the uterus) because of stage I uterus cancer. How can I increase my husband’s sexual pleasure?

A. According to Dr. Angela Du, there is a misconception that women who have undergone a hysterectomy cannot have pleasurable sex. This is simply not true. The woman’s vagina is still intact and the nerve endings are still connected in the vagina. You don’t need the uterus for sex.

The problem really is more psychological because the woman might feel less of a woman. After hysterectomy, there could be some dryness in the vagina, which can be treated by using lubricants like KY jelly.

Q. I am 31 years old. After my regular periods, I notice some white discharge. Should I take it seriously?

A. Normal vaginal discharge is clear or milky white with no unpleasant odor. Signs of possible infection include an increase in the amount of vaginal discharge, an abnormal odor or consistency of the fluid, the presence of pain, itching or burning sensation in the vagina.

Candidiasis or vaginal yeast infection causes a thick, white, cottage cheese-like, non-odorous discharge, and may also be associated with itching. Other causes of vaginal discharge, like sexually-transmitted diseases, should be ruled out. See your OB-gynecologist.

The Importance Of Circumcision

Q. Is it better to be circumcised or not? What are the medical benefits of circumcision?

A. There is some controversy on this topic. Dr. Rey Joson, a surgeon from the Philippine College of Surgeons, has long been an advocate of avoiding routine circumcision. Dr. Joson states that routine circumcision can cause undue pain and stress for the males.

However, Dr. Eduardo Gatchalian prefers that males undergo circumcision for reasons of cleanliness and reduction in cancer risk. Dr. Gatchalian cites that it has been proven scientifically that circumcised males have less risk for HIV-AIDS and other diseases.

Given a choice, I believe it is more advantageous to be circumcised. Aside from reducing cancer risk, circumcision avoids the problem of smegma production. Smegma is a foul-smelling discharge from the foreskin of the penis. Also, the foreskin of the penis has to be retracted during the sex act and is frequently injured during sex. But the choice is really up to you.

Q. When is the best time to get circumcised?

A. The best time for boys to get circumcised is around 10 to 11 years old, before the onset of puberty. The problem with circumcising infants with very small penises is that you may accidentally injure the head of the penis. And psychologically, boys are ready and willing to accept the pain.

Infertility Questions

Q. I have been married for five years already and yet we still have no children. My sperm count is low and my sperms are slow in moving. Are there vitamins for the sperm?

A. Actually, yes. Some doctors give testosterone injections to increase the sperm count. Vitamin E at 200 to 400 IU and zinc supplements are necessary for normal male sexual function. It’s not a guarantee, but it may help.

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For your sex concerns, see a urologist or gynecologist. E-mail comments to drwillieong@gmail.com.
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Fighting HPV cancers and diseases through vaccination

Posted in Uncategorized by Erineus on March 4, 2009

Dr. Ricardo Manalastas Jr., chief, UP-PGH Department of Obstetrics and Gynecology, Section of Infectious Diseases (OB-IDS), and his IDS group conduct lay forums for members of socio-civic organizations, private schools, and corporations to explain the benefits and cost of HPV Vaccination.

MANILA, Philippines – The number of Filipino women diagnosed with cervical cancer remains high. Every year, an estimated 6,000 Filipinas are diagnosed with cervical cancer and 4,349 die of the disease. Approximately, 12 Filipino women die each day due to cervical cancer. Five out of 10 Filipino women with cervical cancer will die within five years.

“The human papillomavirus (HPV) vaccine can significantly reduce the risk of developing cervical cancer, genital warts, and other genital cancers. Through our advocacy program, we aim to give more Filipinos access to this important vaccine by offering it at the lowest possible cost,” says Dr. Ricardo Manalastas, Jr., chief, UP-PGH

Department of Obstetrics and Gynecology, Section of Infectious Diseases (UP-PGH OB-IDS).

Vaccine That Can Prevent Genital Cancers

Over 100 types of HPV have been identified, about 40 of which infect the anal and genital areas with approximately 15 to 20 types proven to cause cancer. HPV has been implicated in cancer of the cervix, vulva, vagina, anus, penis, oropharynx (tongue and tonsils), low-grade dysplasia (abnormal changes in cells lining the cervix), genital warts, and recurrent respiratory papillomatosis (warty growths in the larynx of children and young adults).

One hundred percent of cervical cancer cases worldwide (with almost 500,000 new cases and 270,000 deaths each year); 40 percent of vulvar and vaginal cases; 90 percent of anal cancer cases; 40 percent of penile cancer cases; 12 percent of oropharynx cancer cases; and three percent of mouth cancer cases can be attributed to cancer-causing HPV types.

HPV infection is transmitted mainly through sexual contact. Note that sexual contact is not limited to penetrative sex alone but also includes any direct skin-to-skin contact such as oral sex, anal sex, or any other contact involving the genital area, including hand-to-genital contact.

Starting Small But Aiming High

“Our advocacy program was launched only in December 2008 and we are initially focusing on socio-civic organizations, private schools, and corporations,” explains Dr. Manalastas. The OB-IDS group conducts lay forums for members of these groups to explain the benefits and cost of the HPV vaccine.

To date, the OB-IDS advocacy program has vaccinated members of the Rotary Club of Quezon City and employees of the Makati branch of a major commercial bank. Dr. Manalastas and his group are currently working with schools to provide immunization against HPV and other vaccine-preventable diseases to the school’s teachers and office staff. They plan to vaccinate teachers and employees in other schools in Manila, Quezon City, Pasig City, etc. by the end of the year.

“Who knows? Maybe we can also vaccinate students in the future,” adds Dr. Manalastas.

Dr. Manalastas is negotiating with the PGH management to make discounted HPV vaccines available to hospital patients as well. “We hope our advocacy serves as an example to other government hospitals.”

Reducing cost, increasing coverage

“We hope that through our advocacy, my colleagues and the government will realize the public health value of our advocacy and eventually support it,” Dr. Manalastas reveals. He points out that his group does not make any profit from their advocacy and they sometimes even spend their own money on syringes and other vaccination paraphernalia.

Vaccination can help prevent HPV-caused cervical cancer, genital warts, vaginal cancer, and vulvar cancer. Ask your doctor about the different ways to help prevent these HPV-related diseases.

More information is available from the UP-PGH Obstetrics and Gynecology Infectious Disease Section website at http://www.hpv.com.ph. For inquiries about the HPV vaccine advocacy program, call 524-3518 or e-mail rmmanalastasmd@yahoo.com.

Updated March 03, 2009 12:00 AM