DOCTOR'S ADVICE - An embarrassing question

• Q Doctor, I have an embarrassing question. My husband and I are expecting our first child. We would like to know how soon after having a child can a woman resume having oral sex? We heard that it is dangerous to do that after childbirth. But is that true?

A. Yes, it is. Sexual intercourse is unlikely to cause any problems after childbirth. However, you must avoid resuming it till your midwife or doctor says it is safe to go ahead. But in general, it should be safe for a couple to start having intercourse around eight weeks after birth.

However, oral sex is a different matter. It's perfectly all right for you to resume performing oral sex on your husband as soon as you like. However, him performing oral sex on you after giving birth can be dangerous. Many people do not realise this.

This is because for a few weeks after birth, the lining of the womb is quite raw, and has many exposed blood vessels. If the man performs oral sex on the woman, germs from his mouth and nose can get into her womb and cause an infection. That could be serious.

The other danger is that he may introduce air into the woman's genitals. This can get into the exposed blood vessels inside the womb and the results could be disastrous.

If air gets into the bloodstream, it can cause a stroke - which could be fatal. I recall a case, several years ago, where a woman died after her husband performed oral sex on her and blew air into her vagina.

So this can be very dangerous and I would strongly advise women to refrain from it for several months after childbirth. Once your monthly cycle has returned to normal, everything should be all right. However, blowing air inside the vagina should always be off limits - just in case.

• Q I am a happily married man, and I have received a disturbing letter from a woman with whom I had a very brief affair about 20 years ago. All I can remember about that relationship is that she was very happy when she had an orgasm, as she claimed that she could not.  Anyway, the letter says that in the last 20 years, she has never met anyone else whom she has fallen in love with. I am puzzled by that, because I did not know that she was ever in love with me. She wants to meet me for drinks or dinner the next time she comes to my parish. I do find that idea quite exciting, because I have seen a photograph of her, and she is still a very attractive woman. What should I do?

A. Unfortunately, some women do decide that it would be a great idea to reactivate an affair with someone they knew 20 or 30 years ago. This is particularly likely, especially with what happened in your case, where she was sexually fulfilled. So she may well have very strong feelings for you.

However, I think you would be absolutely crazy to accept her offer to meet for drink or dinner. What do you think would happen after that? I would be amazed if the two of you did not end up in bed!

You say that you are happily married. So presumably you love your wife. Therefore, I would urge you not to do anything that would hurt her. It could end your marriage. I urge you to respond to this woman and tell her that the past is the past, and that you just cannot meet with her. Also, it would be a good idea to discuss the matter with your wife.

• Q My husband and I will be 40 next year. Do you think that we can expect to have a rapid decline in sexual activity after that?

A. Where did you get such an idea? Most loving couples have excellent sex lives when they are in their 40s. There may be a very slow decline, but research shows that it is not very much. My bet is that you will both be enjoying each other physically when you hit 50!

• Q Is there any drug that would pep up my wife's libido? I really would like to give her something that would make her feel sexy. I have heard that there is a new drug called flibanserin. But is it any good?

A. Well, in general, when women complain of a lack of sexual desire, what they (and their partners) need is expert counselling, rather than medication. Very often, simple advice in consulting can make the entire situation much better.

As for this new drug flibanserin, it has been extensively promoted throughout the world, particularly in the United States where there has been a huge media campaign suggesting that a lot of women should be on this medication, and that it would do wonders for their sex lives!

In reality, the evidence for this new drug is not yet entirely convincing. In June, the American Food and Drug Administration (FDA), which is the authority on medicines in the United States, would not give a licence for flibanserin. This was because the FDA felt enough was not known about its effectiveness or its side effects.

So really, I think that at the moment the best thing would be for you and your wife to go to an experienced marriage counsellor or therapist. A few sessions will probably help your wife feel much more enthusiastic about sex.

• Q I have very heavy monthly periods. A doctor has suggested that I use a coil or IUD. But surely they make the periods heavier, don't they?

A. The ordinary coil does, indeed, make the menses heavier and longer in many cases. But I expect that this doctor is talking about the medicated type of IUD, also known as Mirena. This contains a female hormone which is released into the womb. That hormone makes the menses lighter and shorter, as well as working as a contraception. A gynaecologist recently told me that because so many women are using Mirena to 'cure' their heavy periods, there is much less need for hysterectomy (womb removal).

Send feedback/questions to editor@gleanerjm.com and read more in the Saturday Gleaner.