Dr. ABBAS 

Painful Erection
Q. I am 18 years old and my wife is 19 years old. I have noticed that occasionally I have an erection, which is very painful although I do not have any desire for it. It takes about an hour to get back to normal. What is it and what should be done?
Concerned Reader, DMS.

You have a male sexual dysfunction not commonly seen called priapism. It is the persistence of an erection that does not result from sexual desire. Pain and tenderness often accompany priapism, and the erection can persist despite orgasm and ejaculation. Causes, which have been reported, are sickle cell anemia, results of alcohol or drug abuse, perineal trauma, side effect of some medications, etc. It is important that the patient and the partner are made aware of this condition when using medications, which have this side effect. Medicines used for impotency can have this side effect.
Patients and their partners need to be specially cautions about drinking alcohol. From an emotional point of view, priapism can trigger fear regarding future erection and can decrease future interest in sexual activity. When severe, priapism can lead to depression and other affective changes that may require medication. You need to have a check-up followed by proper treatment. Priapism should be treated as soon as possible.

Sex at Middle Age
Q. I am 46 years old and have turned from being an active, affectionate human being into a snappy monster after the menopause. My husband is finding me hard to take and I am worried that I am driving him away. He does not approach me so often for sex any more. How can I control my moods?
Concerned Reader, Singida.

A. When you reach your mid 40s your ovaries stop manufacturing as much oestrogen and progesterone as before, with the result that you go through a variety of physical and emotional changes in the build up to menopause (the time of life during which a women finally cease to menstruate). This period is known as the peri-menopause and it may be characterized by hot flushes, night sweats, irritability, nervousness and insomnia. This marks the end of your fertility life.
It would be good to tell your husband what is happening inside your body. Explain that just as adolescents are hit by huge hormonal storms of feelings, so too are menopausal women. This might encourage him to sympathise with you. You can also help yourself: do your best to get enough sleep, take nutritional supplements and consult your doctor about taking hormone replacement therapy (HRT). Menopause can be prevented by the use of HRT. Counselling or therapy is also a very good idea at this stage of your life because it can help you to get a new perspective on old situations.
Above all, try not to lose touch with your husband. If you have not made love for more than a week, try to initiate sex even if you are feeling exhausted. It is important to maintain intimacy now because later on your energy will return and you will want to be sensual with your husband again.

Closed Eyes & Sex
Q. I am 27 years old and my boyfriend is 28 years old. I was talking to my friend and she says that she has amazing sex with her eyes closed. What difference could closed eyes make? Secondly, do differently shaped condoms make our sex-life different?
Concerned Reader, DSM.

Being blindfolded offers a sense of helplessness and allows you to feel vulnerable. Your mind is likely to start racing as your imagination fills the gaps created by sight deprivation. Your anxiety levels may also go up. An astute sexual partner will pick up on these swirling emotions and exploit them erotically. Another advantage of sex while being blindfolded is that you are forced to pay more attention to the physical sensations you are giving and receiving. From your partner’s point of view, the sight of you naked and blindfolded is likely to be extremely arousing because it confers dominance and power. The best turn on is the one that works on both partners and perhaps having sex with your eyes closed does the trick!
To your second question regarding condoms: shaped condoms are designed to provide extra sensation for women. Special rubbing or projections on the outside of the condoms are meant to stimulate the inside of the vagina. This sounds good in principal, but the trouble is that with the exception of the vaginal entrance the vagina is not richly supplied with nerve endings and most women do not have great deal of sensation inside the vagina. So, the truth is that shaped condoms make little difference to sensation during sex.