Dr. ABBAS 

Ruptured Eardrum
Q. Recently my 6 year old son was diagnosed with ruptured eardrum. The cause of rupture was not known. Would you kindly briefly let us know about the ruptured eardrum?
Concerned Reader, Mbeya.

A ruptured eardrum can result from an accidental direct blow with a sharp object or by indirect means such as a very loud bang or an explosion, or by sudden increased pressure resulting from a slap on the ear. Children can perforate their eardrum by accidentally sticking an object into their ears.
The fact that the eardrum has been ruptured is usually apparent from a diminished sense of hearing. It is essential to examine the ear in order to establish whether the auditory ossicle, or even the inner ear itself, is damaged. A small tear in the eardrum generally heals naturally. If this does not occur within a few weeks it may be necessary to close it by means of operation.
Spontaneous perforation of the eardrum occurs in acute untreated ear infection. This perforation heals naturally. If the opening persists and if there is a constant discharge of pus from the ear, it may be an indication of chronic infection.
Baro-trauma is special form of force applied to the eardrum. It occurs when there are large pressure variations in the surrounding air, such as in an aircraft. The pressure in the middle ear is normally kept equally to that in the surroundings by the Eustachian tube being opened during swallowing and chewing movements. When the tube is closed by a swelling of the mucous membrane caused by coldness in the head, a significant partial vacuum can develop in the middle ear when the pressure increases against as the aircraft descends.
This leads to intense earache and a loss of hearing. In rare cases, the eardrum can be perforated when the pressure suddenly increases. A partial vacuum of this kind can be prevented and remedied by ensuring that the Eustachian tube is opening regularly. This can be achieved by swallowing.
If there is still a partial vacuum in the ear, a doctor can remedy this by blowing into the nose with a special balloon while the patient at the same moment says a word with a nasal sounds. If the tube still does not open, the eardrum must be pierced.

Cannot Penetrate
Q. My boyfriend and I have tried to have sex for nearly a month now but he cannot manage to penetrate me. How will I ever lose my virginity?
Concerned Readers, DMS.

A. Take a close look at your genitals. Use a mirror so that you can see whether the entrance to your vagina is open or obscured by a thin membrane. If you can see a membrane this is your hymen and it needs to be broken to make intercourse possible. When hymen proves too tough to break during normal intercourse medical help is needed. Ask your doctor for advice.
If on the other hand your hymen has been broken, then you may be suffering from vaginismus. This involves involuntary spasm of the vagina, which are triggered by the unconscious mind as a result of some physical or emotional traumatic event that happened in the past.
For example, some women may have experienced an unpleasant gynecological examination when they were younger, others may have had a frightening sexual encounter - both can instill a profound fear of penetration. Your doctor can help you with this problem by teaching you how to insert safe cylindrical objects known as vaginal trainers into vagina.
You start with small sized trainers and gradually move on to bigger ones, so that you and your vaginal slowly but surely get used to degrees of penetration. It sometimes, but not always, helps to talk about your anxieties about sex and penetration.

Sex Peak
Q. I am 18 years and would like to know when does men’s sex drive peak? Secondly, is it normal to want to have sex every day?
Concerned Reader, Singida.

A. The sex drive can peak throughout life depending on the nature of the relationship you are in and your state of mind. In terms of age, a man’s sex drive tends to be highest in his late teens and late twenties. However, there is a great deal of variation between men.
Everyone’s sex drive is different. Some women desire sex several times a day and others are content with sex once a month or even no sex at all. The important thing is to settle into a sexual pattern that meets your needs - do not worry about comparing yourself with other people. Many things determine the sex drive. Hormones play a major role in libido, but also thoughts and feelings.