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Heart To Heart

Monday, September 12, 2016

Phimosis & circumcision
I am a 24 yr old guy working in a firm. My problem is that while having sex with my girlfriend I have to always use a condom because without it my penis pains a lot because I have lot of skin on my penis so it’s impossible to have sex without a condom. The last time I tried without a condom and I was bleeding badly. And I am planning to get married to my girlfriend in a year or two. Will I have a good sexual life and can I have kids. Plz help me doctor!

You seem to be suffering from ‘Phimosis’. Normally, a man should be able to pull back his foreskin to expose his "glans penis". If he is unable to do so, then he has a medical condition known as Phimosis. This condition may require a small surgery known as "Circumcision" which takes 20-30 minutes and is done under local anaesthesia. Circumcision is done when the foreskin cannot be retracted to expose the glans-penis on erection. It is a small surgery in which the foreskin covering the glans-penis is removed.

Common problem in men
I am 49 years old and suffering from what may be a common problem these days in men of my age & seek your help. My wife is an extremely loving, caring & understanding person. Problem of PE began in 1998/99 but I could manage to satisfy her. But this recent problem has had me stumped and do not know what to do. I do not get proper erection and get PE while trying to penetrate. This has been happening since the last few months. I feel confused & frustrated. These days I ejaculate sometimes during foreplay only.  I have a highly sensitive penis tip & get extremely worked up during the process. I walk 6 KM a day very regularly & some time twice a day if I get time. I am very careful about what I eat & avoid spicy, fried & oily food with very regular eating habits & time. Do not suffer from Diabetes or BP, or any other problem. I seek your advice.

You seem to be experiencing Erectile Dysfunction (ED) as well as Premature Ejaculation (PE).  As far as erectile dysfunction is concerned, there are many organic (physical) as well as psychogenic causes for this problem. If it is due to psychogenic or situational causes, the treatment will be “sex counselling” and “supportive therapy”. If the cause is organic or constitutional, then appropriate medical or surgical measures will have to be undertaken. It is necessary to find out the cause (diagnosis) of this problem first, through history taking, examination and investigations. Once the cause is found, only then can the treatment be advised.

Your other problem is premature ejaculation. There are no medical causes for premature ejaculation. It is essentially of a psycho-behavioral and relational origin. Ejaculating early is a learned reflex response that can be effectively reconditioned when a man and a woman actively pursue learning ejaculation control together.

You need to increase your awareness of the sensations of arousal building so that you can identify the level of your arousal. Secondly, awareness of sensations of arousal and ejaculatory control can be learned by following a step-by-step process. Couples are taught to use the ‘squeeze technique’ or the ‘stop-start technique’. Besides techniques, certain exercises for sphincter control and using a condom may help in some cases.

Why she needs to evade sex?
I have been married for approx 4y yrs with a Kid of 2yrs. Mine is a love marriage (7 yr courtship). Earlier we did enjoy great sex. 4-5 times in a week. It’s just that she just does not feel interested towards sex anymore. We have had a fair talk (on many occasions about our sexual frequency, obviously initiated by me) but the fallout is that we have sex (& that too if I take the initiative) once & then again fall in the same routine. Last month we had sex only once in the entire month. This is getting somewhat annoying; as a result I don’t like interacting with her much. Otherwise she is a very loving person I have no complaints apart from this. Request you to kindly advise. She is in teaching line.

It is important to understand why she needs to evade sex. Is it because she has been left unsatisfied or has had some painful experiences of the sexual act with you? Is it because of fear of pregnancy? Is it because she disapproves of some sexual behavior you demand? Is it because she considers the sexual act as sinful, dirty etc. due to religious reasons? Is it because she has unresolved emotional issues with you and so cannot give in to intimacy without resolving them? Is she unwell? Is she overworked and too busy with the home and child? Is she involved with someone else? All this needs to be explored with your wife. I suggest that both of you have a session with a good sex counsellor to reach to the bottom of the matter.

Is it OK to remove those hair?
My boyfriend says thatI need to remove hair from my private part. Is it OK and hygienic enough to remove it as i have never done it before and he also says that we may have more pleasure while making love. Is that true? Also if the removing of hair is ok how should I do it? I mean by waxing, or by razor. Please Advise.

Pubic hair provides a cushion and a natural cover to the genitals. Medically, it is not advisable to remove pubic hair completely; unless the area is infected with skin infection or infested with lice. The pubic area is also shaved off before any surgery in that area. In normal conditions, pubic hair need not be removed completely. You only need to trim them regularly and not shave. Scissors are good enough to trim pubic hair. Avoid using a razor, electric shaver or any depilatory cream to remove pubic hair from their base.

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I am a 24 yr old guy working in a firm. My proble
Dr. Rajan B. Bhonsle, M.D. (Bom)
Consulting Sex Therapist & Counsellor
Dr. (Mrs.) Minnu R. Bhonsle, Ph.D.
Consulting Psychotherapist & Counsellor
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