Q. Ever since October 12, I cannot be close to my partner
sexually. I have had several counseling sessions as a friend
of ours was killed in the blast. This does not seem to have
helped with my problem. I am concerned that if I cannot resume
a normal relationship with my husband soon that our family
will suffer.
A. This is a very trying time for many people, and you can
rest assured that you are not the only one suffering in this
respect. Loss of libido is common if not normal in any grieving
process. Your relationship will be tested, and it is imperative
that you both have patience and a caring attitude through
this challenge. I suggest that you continue counseling as
a couple, so that your partner can also understand that what
you are experiencing is a reaction to a situation rather than
a reaction (or non-reaction) to him. Try to have close times
when it is mutually agreed that sexual intercourse will not
be the finale (hard for men to do this!). By expressing affection
and trust you can re-build the foundations that have been
so badly shaken, and eventually return to your relationship
the way it was in better times.
Q. I had a casual relationship with a young lady from Surabaya
about 3 months ago. She is now claiming that she is pregnant
and that the child is mine. We were only together for a weekend,
and I do remember that she began to menstruate on the Sunday
before we parted. As I understand it women cannot fall pregnant
when they are close menstruating. Could I be the father of
this child?
A. Oooops! This is the oldest trick in the book. While it
is highly unlikely that you are the father of this child,
you are the “chosen” one, and remain guilty until
proven innocent. The menstrual cycle in most women is 28 –
30 days long. Ovulation occurs on about day 14 (counting the
first day of the menses as day one), and an ovum remains receptive
for 3 – 5 days following. As the menses occur on day
28, the ripe ovum is well and truly gone just before the menses
begin. Proving or disproving that you are the father is a
tricky process. Blood grouping is a process of elimination,
and will only get you off the hook if you, and the baby have
completely unrelated blood groups. You may, by coincidence,
have the same blood group as the baby even if you are not
the father. DNA matching is the only surefire way to prove
paternity, and you will of course have to wait until the baby
is born to do this test (This test is so far unavailable in
Bali for these purposes). You may find that if you inform
this young lady of your intentions to confirm her accusation
that she will re-think her position. Meanwhile I am sure that
you will agree that “Mr Durex” is the way to go
next time. It will save a lot of heartaches, headaches, and
any nasty little diseases as well.
Q. I have a small but very painful blister on my genital
area that looks and feels a lot like a cigarette burn, and
yet I am sure that I have not burned myself. What else could
this be?
A. It sounds like you have picked up genital herpes. A simple
blood test (Anti-HSV II) will confirm this. This is not an
uncommon and approximately 20% of sexually active adults carry
the disease. Herpes is a virus and there is no cure. Once
you become HSV II positive, you will always be HSV II positive.
This does not mean that you will always have the lesion, but
you will always carry the disease. The lesion may re-occur,
especially if you are stressed or run down, just as cold sores
can re-occur around the mouth. (A cold sore is HSV I, also
a form of viral Herpes). Unfortunately herpes lesions have
a habit of popping up at the most inconvenient times …….like
on your honey-moon! Your GP may prescribe an anti-viral agent
(i.e Acyclovir), as a cream or tablets; supplements of Vitamin
C and Zinc at the onset might help shorten the course of the
lesion. Herpes is contagious and you should avoid sexual contact
while you have an active lesion.
Q. I recently had an I.U.D. fitted as I cannot take oral
(hormonal) contraceptives. Since this device has been inserted
my periods have become very heavy and painful with a lot of
cramping and sometimes clots. I was not warned of this as
a side effect. Is what I am experiencing normal?
A. It is important to know how the IUD works and I am surprised
that your doctor did not explain this to you before you had
it inserted. Strictly speaking the IUD is not actually a contraceptive
agent (pregnancy prevention), but rather causes a very early
abortion if conception (pregnancy) should take place. The
IUD is a small metal or plastic device that is positioned
inside the uterus where it acts as an irritant to the uterine
wall. Should conception occur, the fertilized ovum that would
normally implant into the uterine wall, is expelled due to
the irritation caused by the IUD. This would explain why you
are having heavy, cramping periods. I suggest that if these
menstrual pains trouble you that the IUD be removed and another
form of contraception be considered. If you are unable to
take hormonal medications, your only other options are barrier
methods (condoms), and fertility date calculation (the Billings
method).
Q. My 13 y.o. daughter recently had a urinary tract infection
which I hear is also termed “honeymoon cystitis”.
Does this mean that my daughter is sexually active?
A. Urinary tract infections frequently occur in women that
have recently become sexually active, hence the name “Honeymoon
cystitis”, however it is by no means a disease that
is limited to this group of women. Even very young children
and celebate females can suffer from the disease. I suggest
that you have a woman to woman chat with you daughter, and
she may be willing to volunteer information as to where she
is at in her sexual development. There are other (more serious)
sexual awareness issues that teenagers of today need to know.
It is difficult sometimes to talk about these issues with
our children and give them an objective overview of the challenges
that they will face during the adolescent years. If you do
not have an honest and open relationship with her, or if communication
on these issues is difficult I suggest that perhaps you enlist
the services of another trusted female relative (an older
sister or Aunt), or speak to the school counselor. Best of
luck to you, this is a really difficult time to be a Mom.
Q. My baby is 3 months old and I am breast-feeding. My doctor
has told me that I do need contraception as breast-feeding
will prevent pregnancy for the time being but my mother says
that this is not so. Who do I believe?
A. Your mother is correct. While breast feeding certainly
decreases the risk of falling pregnant it is by no means 100%
protection. A progesterone oral contraceptive pill (not available
in Bali) is one option, barrier methods (condoms) are another.
The rhythm (Billings) method is not an option as you will
generally not menstruate while you are breast feeding, and
therefore cannot calculate or predict when you will next ovulate.
Kim Patra is a qualified Registered Nurse / Midwife, and
mother of three, who has been living and working in Bali for
past 15 years. She has assisted many traveller (... and others)
either as a flying medical escort or just a voice on the end
of the phone! Kim is happy to discuss any health concerns
that your may have. Her e-mail contact is info@chcbali.com
