Dr. ABBAS 

Not Reaching Orgasm
Q. I am 21 years and have the habit of faking orgasm. I know it is not correct but I cannot seem to stop myself. How can I break this instinctive habit? I am really worried and do not know how and what to do?
Concerned Reader, Bukoba.

A. You probably fear that your lover will reject you if you cannot respond by having an orgasm. It is very important that you examine this fear carefully and if your partner would reject you then he is not the right guy for you. Improving your relationship will inevitably mean taking a risk. Try experimenting yourself with your fingers. If you can climax on your own, ask your partner to incorporate some finger skills into lovemaking. If he wants to know why, tell him that you know you will have enjoyable experience as a result.
Alternately, you could try using your own fingers during intercourse. Tell your partner that recently your response has felt muted and you want to heighten it. Incidentally, a small proportion of women find it extremely difficult to climax and the use of stimulator gel can help to improve their sexual responses. Most women need direct and ongoing stimulation of the area around the clitoris to reach orgasm. Stimulation can come from a vibrator, your own hand or your lover’s hand. If you go on to a new relationship in the future, do your best to be honest about your sexual needs and responses from the outset.

No Enjoyment In Masturbating
Q. I have been with my boyfriend for a year and we are close. I just recently moved to another city for six months, and he was not able to come with me. At first I could not handle it. I had to have sex! It was driving me crazy, and then I started to masturbate. After a while I became depressed and emotional because I could not be with my man, and now masturbating does not seem to work for me. I am still craving sex even more than before, but nothing is helping me. I cannot even get an orgasm anymore. What can I do to feel satisfied?
Concerned Reader, Nairobi.

A. While it is common to think of the genitals as the most important sex organ, it is actually the brain that counts the most. For some women it is even possible for the body to have an orgasm — but because the brain does not perceive it, they do not know it. In your case, your body is craving the sensations and sexual satisfaction that come with having an orgasm, but your brain is preventing you from reaching that goal. You clearly stated the reason why your brain is acting this way: You are depressed and emotional. Those feelings are overpowering your level of sexual arousal when you are trying to masturbate, and so you cannot achieve sexual satisfaction.
Since you said this period of separation is going to last for six months, you could try just being patient. No one ever died from being sexually frustrated. By not putting so much pressure on yourself, you will actually be able to reduce your suffering.
However, I can give you one tip that might help you start having orgasms again when you masturbate.
As I said, what is happening is that you feel aroused and you start to masturbate, but then you begin to feel depressed, and those emotions overwhelm your arousal so you cannot have an orgasm. What you have to do is focus on yourself as a sexual being not on how much you miss your boyfriend.

Hoarseness
Q. I am 42, smoker and have developed hoarseness of the voice. What could be the cause of change in my voice? What should I do about it?
Concerned Reader, Arusha.

A. Hoarseness is failure of the voice box to close properly when speaking. There can be various causes, such as pharyngitis in the case of a cold or influenza. Factors other than infection are important, such as a smoky stuffy environment. Inhalation of stream, resting the voice and a ban on smoking are usually sufficient treatment. If the condition is chronic, abuse of voice is a much more important factor, as in singers, market traders and teachers. Resting the voice and a ban on smoking are also the treatment, possibly combined with voice lessons. Any underlying condition should be treated. Abuse of the voice can also cause nodes on the vocal cords, small benign lumps opposite each other on both vocal cords, preventing them from closing. Resting the voice and voice lessons can usually eliminate them; surgery is rarely necessary. Malignant tumours of the vocal cords occur particularly in middle-aged men, possible encouraged by smoking and alcohol abuse. Paralysis of the vocal cords caused by nerve failure can also cause hoarseness. You need to undergo a proper check-up.