Dr. ABBAS 

Want a Child
Q. I am 36 years old and we have been married for five years. We have been trying for a child for the past two and half years, but without success. Can you tell us what can be the cause for me not getting pregnant?
Concerned Reader, Shiyanga.

A. Sterility means failure of a wished for pregnancy to occur for a period of more than a year during which sexual intercourse has occurred during ovulation. The use of the terms sterility and infertility is justified only after an examination from which it is established that abnormalities are present which make impossible for pregnancy to come about in the normal fashion. There are many causes of fertility disorders, both in men and women.
The man’s production of healthy sperm cells can be disturbed because the testicles have not descended to its place; the higher temperature then hinders good production of sperms. An attack of mumps after puberty can sometimes affect the sperm production tissue. Before puberty the patient recovers from mumps without any harmful consequences where fertility is concerned.
The production of sperms can also suffer through poisoning by heavy metals, smoking and exposure to radiation. Abnormalities in the passage from the testicles hinder the transport of sperm cells. Such abnormalities may be congenital or may result from an operation or inflammation.
In women, hormonal disturbances are often the cause of faulty ovulation. This is usually accompanied by an abnormal menstrual cycle. The number of occasions on which ovulation is possible is there but much reduced. Stress also influences ovulation.
The passage of sperm through the cervix can be rendered difficult by an abnormality in the vaginal mucus. Moreover, congenital abnormalities in the ovaries or ducts or constriction arising from scars from infection can impair the ovum fertilization to uterus.
The causes of infertility can be of many kinds. The investigation of the causes and their possible treatment can take a long time; both the woman and man should be involved. Both of you need to go to your doctor.

Erection & Orgasms
Q. I am 29 years old and have mainly two problems. How long should I be able to keep an erection? Why can’t I keep my erection during sex?
Concerned Reader, Shiyanga.

A. Some people would say for as long as it takes to satisfy your partner. The truth is that you do not strictly need an erection to do this as you can give your partner an orgasm with your hands or your mouth. If you are one of those people who adore spending a long time on sex, keeping a continuous erection is not really necessary as you can allow your erection to wax and wane before you finally ejaculate.
For example if you stop full body contact in order to concentrate on giving your partner oral sex, you are likely to lose your erection until the sexual focus returns to you. You just need to trust that your erection can be revived and it can. If you are concerned that you ejaculate too quickly during sex try the squeeze technique. Remember that sustaining intercourse for a long period is not always desirable, both you and your partner may find that sensation becomes blunted and your genitals can feel as though they have been anaesthetized.
Loosing your erection is an upsetting problem particularly when it happens frequently. Young men often lose their erection for psychological reasons; older men are more likely to suffer from physical problems. The following are all possible reasons for erectile dysfunction. You are stressed or depressed.
You are nervous or suffering from performance anxiety. You have lost your erection on previous occasions and this is making you nervous. You are not sufficiently aroused. You have physical problem such as diabetes, etc. You are taking medication that influences erection. You suffer from long term alcohol abuse. You have low levels of the male sex hormone testosterone.

Genital & Sex
Q. I am 23 years old and my boyfriend is 29 years. My boyfriend has a huge penis. I have not had intercourse with him yet and I am worried in case he hurts me. Are there any special positions that we should use?
Concerned Reader, DSM

A. It might be sensible to avoid positions that allow deep thrusting and this includes the missionary position and doggy position. One method of creating more room for him is to lie on your back with your legs out straight and clamped together quite tightly. This means that he is trusting between your thighs as well as into your vagina. A side by side facing position would also allow extra room. Alternatively, if you go on top of your boyfriend, you will be in control of the depth of penetration.