Dr. ABBAS 

Female Sterilization
Q. I am 36 years old and my husband is 40 years old. Recently, I made the decision to have myself sterilized. I was told to abstain from sex for seven weeks after the operation. Unfortunately, I only lasted for five weeks and now every time we make love I suffer muscles spasms, which really hurt. Have I damaged myself internally by having sex too soon?
Concerned Reader, Lindi.
A: Female sterilization is more complicated than the snip for men, but even so, complications are rare. Before sterilization you should be counselled to make sure you know what you are letting yourself into. Few obstetricians will perform sterilization of a young woman without a very good reason. Unlike vasectomy in men, the operation is now usually done under general anaesthesia. A small opening is made just near the navel so the scar is less noticeable.
After inflating the abdomen with carbon dioxide, to give some elbowroom as it were, a small telescope is used to guide the surgeon to the fallopian tubes. These are cut and clipped off at each end. The cut end is checked in laboratories to confirm that it really was the fallopian tubes that were cut and not pieces of garden hose, which just happened to be lying around at the time.
Many women experience discomfort immediately after the operation but this disappears. A fair proportion of women also complain of pain at the right shoulder tip. You are advised to avoid sex for a further four weeks or so after the operation because there may still be an egg sitting in the fallopian tubes or womb, which could be fertilized by sperm even though the tubes have been cut and sealed off.
There is little if any danger of harming yourself inside by jumping the guns. It is more likely that you are simply anxious and this has set up a vicious circle of expecting pain during intercourse. Try some foreplay and relaxation.

Sexual Partners
Q. I am a 29 year old lady and have a permanent sexual partner. My problem is that I have lied about my sexual history to my partner. I have actually had more partners and a far more colourful sex life than I admitted to. I now want to be open about this but I am afraid of the consequences. What should I do?
Concerned Reader, Singida.
A. Whether or not you decide to tell your partner partly depends on how seriously you take your relationship. If for example you plan to spend the rest of your life with this person, then it might be advisable to come clean so that you do not have to face a lifetime of feeling guilty. Your decision may also be based on how likely your partner is to find out about your sexual history. Are you still friendly with any of your ex lovers, for example?
Total honestly will allow you to relax in the knowledge that your partner judges you critically. Do you want to be with someone who holds a different set of sexual standards to you? If you do opt for honestly, bear in mind that people rarely responds well to revelations of past lies. Explain why you wanted to cover up your past and be prepared for anger or upset.

Sex and HIV Transmission
Q. I am 33 years old and my girlfriend is 23 years. I really would like to know what different risks, different sexual acts involve. Kindly, can you give me a brief explanation especially regarding HIV transmission?
Concerned Reader, DSM.
A: Different sexual acts involve different degrees of risk. To be completely safe you need to avoid any exchange of body fluids. Practices that involve risk are as follow: Vaginal sexual intercourse without a condom; anal intercourse with or without a suitable condom; any sexual activity that draws blood, whether accidentally or deliberately has high risk of transmission; sharing penetrative sex aids such as vibrators; unprotected fellatio, especially to climax and anal licking or kissing are also high risk; inserting fingers in the sexual organs; and mouth to mouth kissing if either partner has bleeding gums or cold sores are risk factors.
Less risky practices are: Vaginal intercourse with a condom; sexual activities that include urination; cunnilingus using a latex barrier and fellatio using a condom.
No risk practices are: Dry kissing; semen or vaginal fluids coming in contact with intact skin; self masturbating; cuddling and caressing.