Q & A’s Sex & the City…….Island Style

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

Copyright © 2002 Kim Patra