Doc, is my husband’s pain due to lack of sex and what can we do?
Dr Flo,
I am concerned about my husband's health. When he fails to have sex for three to four weeks, he experiences a lot of pain in the lower abdomen and when passing urine. Sometimes he passes a very little amount of urine. What could be the problem?
Bridgit
Dear Bridgit,
Your husband may be suffering from chronic prostatitis/chronic pelvic pain syndrome (cp/cpps) which causes pain in the pelvis (lower abdomen), the penis, the scrotum or the perineum, and inflammation of the prostate. This causes pain when passing urine, painful ejaculation, weak urine stream, frequently passing urine, inability to hold urine and passing little amounts of urine at a time. It may be triggered by stress, nerve problems, or a physical injury. An urinary infection in the past or chemicals in the urine might also have contributed to the development of the condition.
The symptoms may also have been caused by benign prostatic enlargement (BPE), which is enlargement of the prostrate with age.
He should visit a doctor, preferably a urologist for examination and tests that may include urine analysis and culture, prostate ultrasound and examination of prostrate fluids. Treatment may include antibiotics, pain management and alpha blockers (medicine that relax the muscles in the bladder and prostrate, making it easier to urinate). Some people benefit from release of fluid from the prostrate, like from ejaculation from a prostrate massage, which may explain why his symptoms worsen if he stays for long without having sex.
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Dr Flo,
I am 26 years old. I have had a problem for more than five years now. During sex I have a colourless, odourless fluid before ejaculation. I do not feel any pain. This has affected my relationship with my partner. What could be the cause and remedy? What does it mean for my sexual health?
Andrew
Dear Andrew,
This is pre-ejaculator fluid or pre-ejaculate, which is fluid that is produced by the cowper’s glands (and other accessory sexual glands) to help with lubrication during intercourse. It also neutralises acidity in the urethra, therefore protecting the sperms that will pass through during ejaculation. This fluid may have sperms occasionally, and it can also transmit HIV and other sexually transmitted diseases. It is normal to have pre-ejaculate, and the amount ranges from a few drops to more than five millilitres. Some men produce large amounts of the fluid, which is problematic. Some have benefited from using 5-alpha-reductase inhibitors like finasteride and dutasteride.
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Dr Flo,
Are there people who cannot get infected with HIV? That is, in terms of T-lymphocytes or killer cells. I have had sex with an HIV-positive partner who was not on treatment at that time and had the virus for a long time, so the viral load must have been high (had not been tested at that time).
Aldi
Dear Aldi,
There are people whose immune system (CD8+ T lymphocytes and natural killer cells) protects them from acquiring HIV. If they do get infected, the immune system prevents the virus from staying in their body, or if the virus remains in the body, it takes a much longer time to cause problems within the body (slow progressors). This happens through killing of virus-infected cells and by production of chemicals (chemokines) that prevent multiplication of the virus. There may also be a mismatch of the receptors on the killer cells and the proteins on the surface of the HIV-infected cells of the partner, which theoretically would prevent infection in a monogamous relationship. However, this immune protection does not work as well if the amount of the virus in the body is high or if your immune system becomes weak due to other reasons, other than HIV infection. There are several theories for HIV discordancy (one positive partner and one negative partner) but they are mostly difficult to prove in real life and they may be affected by route of infection, presence of other infections, use of anti-retrovirals among other factors.
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Dr Flo,
What causes pimples on one’s private parts? The pimples come and go.
B
Dear B,
Recurrent painful swellings in the groin occur when the hair follicles (where the hair comes out of the skin) are blocked by bacteria and other substances. Some people overreact to the blocked follicle, either because their immunity system is overly sensitive, or because of hormonal changes, such as those that come with the menstrual cycle. It is also more common in overweight people. It is not contagious and it does not occur due to poor hygiene. Sometimes the swellings clear on their own, and may leave a scar. You may also develop the swellings when hair is growing after shaving. The simplest treatment is to let the hair grow, or only trim it, and not shave completely. You can use a shaving cream or go for permanent hair removal using laser or electrolysis. The ingrown hair in the bumps can be removed gently with tweezers. Some creams can help reduce the inflammation like steroid creams, acne medication, antibiotic creams in case of infection and antibiotic tablets, when necessary.
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