Dr. ABBAS 

Blood Pressure

Q. I am 42 years old and have been diagnosed to have high blood pressure. I wonder
if the blood pressure remains constant all the time? Secondly, does blood pressure
rise with the age?
Concerned Reader, Nairobi.

A. No, blood pressure is constantly changing within a range of pressures, which
depends entirely upon what the person is doing. During physical work the muscles
needs a greater supply of food and to meet this extra demand the blood flow has to
be increased. To achieve this, the heart must beat faster and the blood pressure rises.
Blood pressure is lowest at night when we are asleep, but even then there are
fluctuations, which are presumably due to the influence of dreams. During the day the
fluctuations are greater and more frequent and reflect the sort of work the person is
doing. Mental as well as physical stress can increase the blood pressure.
To your second question, yes as a natural part of growing old the arteries tend to lose
their elastic properties to some degree. The walls of the arteries tend to thicken after
the middle age and consequently the internal diameter of the vessels is slightly
reduced. All these changes mean a very slight increase in blood pressure, which is
perfectly normal and age related.

Husband Feels Rejected

Q. I have been masturbating for 30 years as sex with my wife is limited to once or
twice a month but I need it once a week. I have explained my desire and
unhappiness several times, and have even bought her sex books. I have tried to be
more romantic and have even suggested seeing a doctor, but she refuses. Our
relationship outside the bedroom is great. We share similar interests and have four
children. I would love for this marriage to work out, but after all these years of feeling
rejected I am getting concerned.
Concerned Reader, DSM.

A. I see that you really are trying to do as much as you can do from your end and I
would guess that maybe there are other reasons for her actions that I cannot know
just from your letter. Since you have such a good relationship outside the bedroom,
for the sake of this marriage you should convince her to see your family doctor. You
should ask her to choose another doctor, perhaps a female doctor in case she is not
comfortable with the family doctor. If she refuses to do that, I would talk to your family
physician because it would be a pity, especially as you have four children, if this
could not be worked out. Talk to your family physician to see if he or she has any
suggestions of how to convince your wife to see a doctor.
Perhaps her not wanting to make love has something to do with her not being able to
have an orgasm when you do make love. Maybe she does not know how to lose
herself in the sexual experience. Since you have tried everything else, maybe you
will have to be a little insistent, saying that you really would like to change this one
aspect of your relationship. Continue to tell her that you are very happy with her, that
you are happy with your four children.

Hysterectomy Steals Sex Drive

Q. Last year my wife had to undergo a hysterectomy and since then her sexual drive
has reduced tremendously. The doctor says there is nothing wrong with her. This is
causing a serious problem, because I am still active. Prior to operation our sex life
was fantastic.
Concerned Reader, Rukwa.

A. Hysterectomy means the removal of womb. After hysterectomy many women are
surprised to find that they feel spoiled and less valuable and withdraw from sexual
activity as a precaution against being discarded by the partner. Many women after
having the operation are left with fatal complaints such as headache, depression,
backache, lack of sexual desires, painful sex, marital disharmony, etc. A majority of
the women gets emotionally affected. Often they are fussy, continuously demanding
attention and sympathy from a husband who is perhaps too considerate.
The very idea of having the womb removed surrounds them with an aura of mystery
and fragility to the unknowing and unsuspecting male. She must be encouraged that
there is nothing wrong with her and should take an active responsible part. Many
women then experience a change in their feelings when they find that being actively
involved removes their anxiety about how to respond. Try to have intercourse a
couple of times in a week. Women are referred to psychiatrist much more commonly
after hysterectomy than after any other operation.