Dr. ABBAS 

Big Vagina
Q. I am 21 years old and my boyfriend is 25 years. We have been together for two years. My partner keeps telling me that my vagina is too big. I am really upset about it. Is there anything I can do about it?
Concerned reader, Nairobi.
A. If you have never had a baby, it is extremely unlikely that your vagina is particularly big. The reverse is usually true, especially for women who have only recently started having sex. Try putting a finger inside your vagina and gently try to grasp it by contracting your vagina muscles (imagining that you are trying to stop urinating in mid flow). Even if the movement that you can feel with your finger is only little that is fine. You do not need to worry about having a large vagina (after all, compare the girth of your finger with the girth of the penis). If you want to improve the strength of the vagina and pelvic floor muscles, there are special exercises known as Kegel exercises that you can practise. Kegel exercises are exercises that are often recommended to women before and after childbirth, in order to improve the muscles tone of the pelvic floor and vagina. However, any women can practice them. Kegel exercises improve vaginal muscles tone anytime in life. They also improve sex life by enhancing sensation during intercourse. You should also be aware that men who are finding it hard to get or to sustain an erection might complain about vaginal size. If you help your boyfriend to a stronger erection by giving him some sensual genital messages he will stop complaining.

No Climax
Q. I am 23 years old and my boyfriend is 24 years old. I have one problem. I cannot reach climax during sex, even when my partner uses his hands. What is wrong with me? Can I use a vibrator?
Concerned reader, DSM.
A. There could be several reasons for your difficulties in reaching orgasm. It may be that you need faster stimulation than the hand can provide. Most women do not reach orgasm from thrusting movements of intercourse because of the way that clitoris is positioned in relation to the vagina. Whereas the clitoris is positioned on the upper part or the front of the female genitals, the vagina is situated at the lower part or back. This means that the movement of the penis during intercourse only indirectly stimulates the clitoris. Only 30 per cent of women experience orgasm regularly through penis thrusting. The other 70 per cent need a little extra help and some 55 per cent of these use vibrators. A vibrator has the advantage of not only being able to target accurately the area on or around the clitoris, but it also runs a high speed of oscillation which, research has shown, helps many women to tip over into climax.

Fungal Infection
Q. I am 16 years old and have problem of soggy skin in between my toes and discolouration of my big toe nail. I also have fingernails changing colour. My right hand is scaling lots of powder-like substance. What is it and what should be done? I have also noticed that there are other students in the school with similar problems.
Concerned reader, DSM
A. You are suffering from fungal infection. It looks different depending on the site and on the strain of fungus involved. Tinea pedis (athlete’s foot) is the most common type of fungal infection for a man. The sharing of wash places, for example in the school, swimming pools, predisposes to infection. Occlusive footwear encourages relapses. There are three common pattern of presentation. Soggy inter-digital scaling is very common fungal infection particularly in the fourth and fifth interspaces of your toes. Another presentation is diffuse dry scaling of the sole and recurrent episodes of small blisters. Toenail infection is usually associated with tinea pedis. The initial changes occur at the free edge of the nail, which becomes yellow and crumbly. Separation of the nails from its bed and thickening may then follow. Usually only a few toenails are infected, but on rare occasions all toenails are involved. On fingernails lesions are similar, but less common and are seldom seen without a chronic infection of the skin of the hands. Tinea of the hands is usually asymmetrical as you mentioned. It usually involves one hand and is associated with your foot infection that is tinea pedis. It presents one palm with a characteristic powdery scale in the crease of your hands. You need to see your doctor first to confirm the lesion by undergoing microscopic examination of skin scraping, nail clipping, which is a simple procedure and not painful at all. Once it is confirmed there are several preparations that can be used. It all depends on the extent of your lesion.