Dr. ABBAS 

Inhibition Of Ejaculation
Q. I am 19 years old and I am in my first relationship. I cannot ejaculate during intercourse and can go on and on for hours but I just wear my girlfriend out. I can climax okay when I masturbate. What has gone wrong? Secondly, how can I have powerful orgasms? I am not feeling satisfied by sex with my girlfriend but I do not want to start sleeping with other women.
Concerned reader, Shiyanga.

A. There could be several reasons. Either you are not getting enough friction from intercourse or more likely you are feeling inhibited and this is preventing you from letting go. This is your first sexual relationship and your reticence may be caused by nervousness or a lack of confidence in your sexual ability. Take heart from the fact that these feelings are very common in first lovers.
Spend more time talking intimately with your girlfriend so that you can learn to trust her.
If possible try to masturbate together so that she can understand what you like and what stimulates you. Then try a combination of masturbation and intercourse. The more open you are with your girlfriend, the more accepted you will feel and the easier it will be for you to ejaculate.
Perhaps you are not getting enough physical and mental stimulation before orgasm. Extending foreplay and spending time teasing and tantalizing every possible part of each other’s body might make sex more satisfying.
Plan on spending much longer in the bedroom, but do not rely only on the physical aspects of sex. Great eroticism includes a mental exchange between lovers. Talk to her and seduce her to talk back.

Premature Ejaculation
Q. I come so quickly that sexual intercourse is impossible. Ejaculating before I have even penetrated my partner can be extremely frustrating for both of us. Would you kindly help us what to do? Can I practice squeeze techniques?
Concerned Reader, Moshi.

A. Premature ejaculation is a common problem among men but there are several reliable ways of treatment. The squeeze technique is one of the most straightforward. It involves grasping the tip of the penis (just below the glans) between your thumb and fingers. Simple apply firm pressure when you feel that you are close to ejaculating. Do not worry if this causes your erection to wilt slightly - it will come back again. You can also apply this squeeze technique to the base of your penis. This can be useful during intercourse when you do not want to withdraw from your partner. Another way to overcome premature ejaculating is the self-help program. This program uses tried and tested techniques. You learn greater ejaculatory control and increase your sexual staying power. Take it slowly and you should start to see result in several weeks. If all fails then you have to see your doctor for further evaluation.

Pleurisy
Q. I am 55 years old and recently developed cough with sputum. I was diagnosed to have pleurisy. Kindly, can you briefly explain me what pleurisy means?
Concerned Reader, Dodoma.

A. Pleurisy is inflammation of the mucous membrane surrounding the outer lung membranes (pleura), which consists of two layers separated from each other by a thin film of fluid. The inner layer is in contact with the lungs, the outer layer is in contact with the lung, the outer layer with the wall of the chest; the film of fluid allows them to slide freely against each other. The space between the layers of membrane, the plural cavity, is a vacuum, so they cannot drag on each other because of the formation of fine threads of protein; this is almost always caused by a process in the lung directly under the plural. This can be inflammation as in tuberculosis, or lung cancer. The adhesion occurs only at the site of the disorder.
The condition can also occur in association with a general disease such as rheumatoid arthritis. The adhesion prevents the pleura from sliding smoothly against one another, causing pain on breathing and coughing. Breathing is more shallow than usual. A small quantity of inflammation fluid causes little discomfort large quantities causes shortness of breath through pressure on lung tissue. A patient with pleurisy commonly complaints of having cough, fever, expectoration of sputum, loss of weight, general malaise, etc. The pain disappears with the fluid. The condition is most usually caused by pneumonia or lung tumour. There are three possibilities usually fluid is formed, so that the dry pleurisy changes to the wet form; the threads can disappears spontaneously; or they can develop into a definitive adhesion of the pleural layers. In wet pleurisy an abnormal quantity of fluid accumulates in the pleural cavity; the condition tends to be preceded by dry pleurisy. Treatment is directed at the underlying disease; very large quantities of fluid can be removed.