Q Doctor, what effect would a sterilisation operation have on my sex life?

I am 37 and I have had five children and two miscarriages. I feel that enough is enough, but my husband and I have a very active sex life. I also have a boyfriend in Black River.

The doctor told me I can't have the Pill anymore. He suggested that I be sterilised and then I won't have to worry about getting pregnant.

But I do not really understand what sterilisation is, Doctor. What do they do?

Would it ruin my sex life as one of my friends told me? To be honest, sex is very important to me.

Will it affect my monthly period? Someone told me being sterilised will cause me to have very heavy periods.

A Clearly you need some totally reliable form of contraception, especially if you are going to continue this rather dangerous-sounding relationship with the boyfriend. There are various choices that are available to you, including:

The mini-Pill

The coil

Mirena

The jab (the shot)

Possibly the skin patch

Maybe the vaginal ring

The under-skin implant.

Also, I suppose it is just possible that you might be able to persuade one or both of the men in your life to have a vasectomy. But I appreciate that that is not a very likely solution.

So, let us assume that you might choose a sterilisation operation. It is a fairly straightforward procedure, in which the surgeon 'blocks' both falopian tubes, so that eggs can no longer get into the womb.

You see, your ovaries continue to releasing eggs, which pass down the tubes and into the womb. The surgeon's objective is to cut through those two tubes (or block them in some other way), so that the eggs can no longer reach the womb.

However, there is a SMALL 'failure rate' with sterilisation.

There are various ways in which the operation can be done.

There is an older operation, in which the surgeon makes quite a big cut in the lower part of the abdomen, then finds the tubes and 'ties them off' or perhaps cuts a section out of them.

There is the more modern 'laparoscopy' operation, in which the entire thing is done by pushing a special 'telescope' through a small nick near your navel, and operating an instrument through another small cut lower down. This is often called 'the Band-Aid op' - because you only need small sticking plasters on the skin after.

The tubes can also be approached through the vagina, so that there is no cut in the skin at all.

I should add that there are some newer types of sterilisation, in which the surgeon pushes a telescope up the vagina and into the womb, and then tries to block the tubes from the inside with some type of 'plug'. That procedure is not yet widespread.

So sterilisation is really not a very big operation, and most women recover from it pretty quickly. Sex is usually possible within a month, and your partner should take things easy to start with.

Please bear in mind that there is a tiny 'failure rate' with sterilisation - usually reckoned to be around one in 200. So the chance of a pregnancy occurring is not very great.

This operation will not affect your sex life? No. I have never seen a patient whose sex life was affected by a sterilisation 'op'.

Many women have a much better time in bed after the surgery, because they are no longer fearful about getting pregnant.

Some medical textbooks still say that periods are 'heavier' after sterilisation, but recent research in Denmark has shown that this is not true. Your menstrual cycle should NOT be affected by the operation.

However, do bear in mind that coming off the Pill is likely to make your periods heavier and less regular than they were when you were taking it.

Q I am guy who simply cannot discharge, except when I am by myself. I have been like this all my life, Doctor.

I would like to marry my girlfriend and have children, but what can I do? I am a successful businessman, and can afford to pay.

A You have a male condition called 'delayed ejaculation' or Delayed Ejaculation. You can look it up on the net by typing in the words 'delayed' and 'ejaculation'.

It can be treated, but you need some help from a therapist or counsellor. What they usually do is to 'train' you to have an orgasm closer and closer to your partner - until eventually you can have an orgasm inside her.

This may take many months, but good luck !

Q Recently I have been passing blood in my urine. This terrifies me, Doc! Is it serious?

A Well, the most likely reason is an infection in the 'waterworks'. Admittedly, there is a chance that it could be something more serious.

What you must do now is to see a doctor this week, taking with you a specimen of urine in a very clean container.

Q: I have to have a general anaesthetic next month. I am very afraid that the gas will make me talk about certain secret things, which I know I must not tell anyone. Help!

Ans: Relax. This really does not happen when people are given gas. They simply don't 'blab' their secrets.

Q: Doc, I am 29, and my wife is 28. I am convinced that she does not have a clitoris.

Could she be given one by means of surgery?

Ans: It is almost impossible that your wife does not have a clitoris. I do not think I have seen such a case in my entire professional life.

I would strongly recommend that you both consult a doctor, preferably at a Family Planning Clinic, where they know a lot about such matters. The doctor will show you and your wife where the clitoris is.