Dr. ABBAS 

Physical Activity & BP
Q. I am 49 years old and have high blood pressure. I was wondering if it is true that physical exercise helps reduce high blood pressure, instead of increasing it. There is a common belief that any physical stress increases pressure. How does physical activity help if I have high blood pressure? How much and how often?
Concerned reader, Morogoro.

A. You must be aware of that your blood pressure measurement is made up of two numbers: systolic and diastolic. The first number is the pressure during heartbeats and the second pressure is in between heartbeats. Regular physical activity can lower systolic as well as diastolic blood pressure. People usually get the biggest reduction in blood pressure within the first 10 weeks of activity, but you need to remain active to maintain the benefits. Increasing your level of activity helps speed up your metabolism. This helps you burn more calories and as long as you do not eat more to compensate for this you will lose weight.
Physical activity helps reduce other factors for heart disease such as high blood cholesterol levels, obesity, diabetes and stroke. Physical activity together with a healthy diet, help reduces stress and improves your overall feeling of well-being and quality of life, and helps you to sleep well. Aim at building up slowly; maybe you can start exercise initially three times a week for ten minutes followed by 30 minutes of moderate exercise five or more days over the time period. Moderate intensity activity means breathing harder and getting warmer than normal. It does not need to be hard. You should be able to talk and be active at the same time. Try to avoid sitting still for more than 20 minutes.

Overactive Bladder
Q. I am 30 years old and have a problem of not holding my urine. If I feel like going to the toilet suddenly, I have to rush, other wise I will leak. What is this problem and what should be done about it?
Concerned Reader, DSM.

A. An overactive bladder is a common problem that often causes distressing and embarrassing situations. It can make you rush to the toilet many times a day. If you cannot get there in time, you may accidentally leak some urine. Many people with an overactive bladder find way to cope instead of seeking medical advice.
Some people who have an overactive bladder do not notice that anything is wrong because their symptoms have come gradually.
You could have an overactive bladder if you regularly get any of these symptoms: Suddenly having a desperate need to pass urine, leaking urine if you do not get to the toilet in time, passing urine many times a day even when you have not drunk much liquid, getting up to urinate more than once or twice in night and wetting bed.
There are ranges of treatment that can help if you have an overactive bladder. Your doctor or nurse can help you decide which ones are suitable for you.
Bladder training trains your bladder to hold more urine and gives you more control over when you go for urination. Bladder training with the help of your doctor has shown to reduce symptoms of overactive bladder.
Firstly, your advisor will need to know how often you go. Then a target rate of going to the toilet is set; for example no more than once an hour. Aim is not to go between these times even if you have occasional leaks.
Once you have managed to keep to the target rate, and stayed dry, the set time period is increased step by step. Pelvic floor exercise is another thing to strength the pelvic floor muscles to help prevent urine from leaking out. These exercises involve repeatedly tensing and relaxing the muscles around the genital areas.

Never Reaching Orgasm
Q. I am 18 years old and my boyfriend is 22 years old. I have problem with orgasm. Why is it very hard for me to reach orgasm during intercourse with my boyfriend?
Concerned reader, Zanzibar.

A. Most women do not reach orgasms from thrusting movements of intercourse because of the way the clitoris is positioned in relation to the vagina.
The clitoris is positioned on the upper part of the female genitals; the vagina is situated at the lower part. This means that the movements of the penis during intercourse only directly stimulate the clitoris. 20 per cent of women experience orgasm regularly through penile thrusting.
The other 80 per cent need a little extra help.
Around 50 per cent of them use fingers or vibrators to reach orgasm. A vibrator, which is not used as much as in the west, has the advantage of targeting accurately the area on or around the clitoris.