Sexual queries: 'Don't risk sex without a condom'

Last month, we invited Get Ahead readers to mail in their questions. Here is the second set of responses:

Hello Sir,

Is sex with prostitute girls and known women safe or not? What are the rules or medicines should be taken after had sex with them even though wearing condom? Please consider this as priority question and post your comments.

No sex is really 100 percent safe because most people are notorious liars about their sexual practices -- even spouses. With prostitutes, the risk increases several-fold. In fact, the default mode is one of contracting an STD (sexually transmitted disease/s). Known women can (and do) have many facets that may be unknown to you. This might include being positive for STDs, including HIV. Celibacy and masturbation are the only 100 percent safe practices! Engaging in high risk sex and then taking 'umbrella' medication is not a good or always effective idea.

Dear Dr Sudhakar Krishnamurti,

Physical lesions on the penis should not be diagnosed and treated without clinical examination, or at least clinical photographs. You need to see an andrologist.

Dear Dr Sudhakar Krishnamurti,

I am a 42 years old male. I am married for the last 12 years. For the last about 2 years am observing that at the time of sex my penis does not get aduquate stiffness, hence making it very difficult to have sex with the partner. I usually do it once in a week or 10 days and even after this gap, this is the issue. Please advice some remedies for this otherwise sexual life is dying in no time.

What you've got is known nowadays as erectile dysfunction (or ED). The older term for this was `impotence'. If ED makes its first appearance at 42, after many years of normal sex, the cause is most likely physical (organic) rather than psychological (functional); especially if you are in the same relationship. ED in middle age is often a forerunner or consequence of diabetes, high blood pressure, cardiovascular disease, etc. The causes of ED are listed on http://www.andrology.com. You need a professional andrology check-up and treatment.

Dear Sir,

I am suffering from delayed ejeculation, please help me. IT IS SECRET DO NOT DISCLOSE. Bye.

Delayed ejaculation, also known as retarded ejaculation, can have a variety of causes, many of them psychological. Chapter 19, Late Comers and Marathon Men in my book Sexx is Not a Four-Letter Word addresses this issue in detail. Treatment may include multiple modalities, including counselling.

Dear Sir,

I am 28 year old male, Mumbai. I am married and have a child. I have a peculiar problem. I am attracted towards good looking guys and even have sex with some. What should do? I am totally frustated.

You surely don't expect me to believe that you don't know what your condition is called?! There's nothing peculiar about your problem. You are a homosexual. Admit it and cope. There is no treatment for this. But be sensible enough to take precautions if you have a wife (and child). You could pass on infections. Use protection if you can't keep it in your pants. You may have heard of AIDS?

Good Evening Sir,

I am 36 years male. I am married for last 14 years. I have a son (12 years) and a daughter (6 years). When physically okay and mentally normal, I love going for sex, even everyday...sometimes it does not happen for a week also. My problem is that since last 2-3 years, after having sex, I feel my organ burning. I used to go to toilet, pour a lot of cold water over it continuously for 20-30 minutes. Drink little water. I get relief after half an hour or so.

I would like to know, if it due to age, or due to drinking less water or it a sexual problem? I have not consulted anyone till date on this topic. Also, please suggest me what shall I do when it happens?

You seem to be suffering from a genito-urinary infection. It's possible that your partner may be too. See your family physician first.

Dear doctor

I am 45 years old, don't get ejaculation in intercourse using condom, without condom there is no problem. Please advise.

Are you using a condom to prevent infection prophylaxis or for contraception ? If for protection against infection, it is better not to ejaculate than to risk sex without a condom. Or your partner (if a woman) can use a female condom. If you are using a condom for contraception, you can change your method of contraception.

Dear Sir,

I am suffering fever till 2 months. Blood test report also okay but esr 60 m/h. It is psychologically scary, I am fearing by doctor's advice it is very dangerous for me. But I now feel I am okay, no problems I have. My age 36 year -- sex also down only four times in 2 months I do it. I think what I do?

For your fever, consult your family physician. Regarding your sexual frequency, if your partner and you are content with it (you have to be both honest), then ignore all the media hype about frequency and multiple orgasms and get on with your life. It is the quality of sex that really matters. Are you both orgasmic and content? Does sex reinforce and strengthen your love and relationship? These aspects are more important than mere frequency. Also remember, newlyweds have more frequent sex than much married couples. So if you are observing that your frequency is less than what it used to be, this is normal. And don't try to keep up with the Jones' either. They are most likely fibbing anyway!

Sir

I think I suffer from ED. When erection occurs, its not full. Plus I find it difficult to maintain one, till there is constant physical touch/attention. And moreover it is does not remain turgid enough for dry/hard/anal penetration. Though this has been a phenomenon since youth, high energy levels somehow saw me through. Now it gets difficult to carry on. I am 37 years old now with normal habits. I smoke 2 cigarettes a day, I don't drink and I try to hit the gym when free. I am 5' 8", weighing 75 kgs, married, and losing interest in sex -- a deadly combination in short. Otherwise, I am fit enough to offer youngsters a few tips on fitness n lifestyle. Help me if you can, and please keep my id anonymous.

The best advice I can offer you is to visit http://www.andrology.com. It will answer all your aforelisted questions.

Sir,

First of all I thank REDIFFMAIL for creating such a facility. Though we are flooded with information relating to sex, one will be really confused reading all the things on the Internet. Hence the expert view is necessary. In my opinion, sexual education must be started from plus-two level. Coming to my question, should males go for intercourse on the very first night itself? I read in one of the books that eating country chicken, turkey and meat of kada will develop the sexual desires of men. Is it true? There is confusion regarding insertion of penis in to the vagina, which area appears to be vague. I know that the above questions will be really embrassing. But, I feel, that majority of youth do not know about these things.

If I have asked something wrong, please forgive me sir, taking into account my age.

(a) Whether a couple should compulsorily engage in sex on the proverbial wedding night, or not, is a very good question. If you are getting married to an unknown woman chosen by your parents, it might not be a bad idea to develop some acquaintanceship, friendship and intimacy in a phased manner. But many sexually repressed desperados can't wait.

(b) There is no scientific evidence that the aforementioned foods possess aphrodisiacal properties.

(c) If you are ignorant about the female genital anatomy, just use a search engine like Google and enter the word 'vagina'. You'll find many informative links. Also, search for images -- you'll find useful anatomy diagrams.

Do you have a question for Dr Krishnamurti? Simply e-mail him at sexualqueries@rediffmail.com; responses will be published each week and names will be withheld upon request.

Dr Sudhakar Krishnamurti is an international award-winning andrologist and microsurgeon. He is the only Indian on the world's first-ever batch of sexual medicine fellows (Oxford, 2007). Best known for the Krishnamurti Operation for Peyronie's Disease, he is also the founder of Andromeda, India's first andrology center, and author of the bookSexx is Not a Four-Letter Word.

Disclaimer: Please note that Dr Krishnamurti will be answering the most relevant queries at his discretion each week. His advice may not necessarily reflect the opinions of rediff.com and while it is in the capacity of professional medical counselling, it in no way should be considered an alternative to visiting a medical specialist for sex-related ailments.