Q Dear Doc, I'm a 42-year-old female who has been having a constant discharge. It all started about seven years ago when I had sex with three different men in two days. I have been to the doctor every month since then. I have been tested for HIV, diabetes and they all came back negative. I have been treated for chlamydia, bacteria vaginosis, trichomonia, over and over again, but the discharge keeps coming back. I had a hysterectomy recently and I still have the problem. I have changed all my underwear, put them in the sun to dry, do not use soap, and I take a probiotic every day and I still have it. Doc, I don't know what to do anymore. Can you help me?

A Good day to you, unprotected sex with multiple partners is a health risk. The symptoms you describe can persist despite treatment if you continue this sexual behaviour as the chance of sexually transmitted infection and reinfection is great. Go back to your doctor and explain the problem, he/she will send some of this fluid for testing to find out exactly what is happening. If your cervix was not removed during the hysterectomy, a Pap smear will be useful.

Some women find that keeping an underwear on for long periods leads to a persistent vaginal discharge. This is due to elevated anaerobic bacteria caused by the high temperature and sweating in the area. Going without the underwear as often as is practical and wearing loose clothing made from cotton often alleviates this problem.

Is it cancer, Doc?

Q Dear Doc, I am a 26-year-old man and recently I found myself having tenderness to mild pain in the testicles. That however, has now subsided and it appears they're back to normal. Does this disappearance of discomfort qualify as a case of testicular cancer?

A Testicular cancer does not occur often, but is the commonest cancer in your age group (20 to 35). Testicular cancer is usually painless, but about 10 per cent of men develop pain due to decrease blood supply to the area as a tumour (felt as a lump) is 'feeding' on the supply to the testicles. During the late stages, other symptoms such as fever, night sweats, weakness, weight loss and loss of appetite may occur.

Did you feel a lump? Regular self-examination of the scrotum is a good practise for men to adopt as it can alert one when an abnormality develops in the area.

Transient pain in the testicles can be due to urinary tract stones, clots in the blood supply to the area, abdominal muscle strain from high-intensity exercises.

Sustained pain in the area can be due to infection, pressure symptoms caused by cysts/varicose veins and disruption of the blood supply as in torsion (twisting) of the testicle.

You say your symptoms have resolved, however, an ultrasound of the abdomen, pelvis and scrotum is advised.

I got my son circumcised will he enjoy sex?

Q Dear Doc, I desperately seek your advice. My son is almost a teenager he does his school work, has a few friends, and for the most part seems to be well-adjusted. His father and I talk to him about girls a lot, so he knows what is expected of him and he is OK with that.

The problem is this, when my son was an infant, I made the decision to have him circumcised, in keeping with biblical tradition. I now wish that I could undo that mistake because I am worried that (based on some online reading I have done) my son will grow up to not enjoy sex. This is one talk that his father and I have held off from discussing with him.

There is not a day that I don't worry about my boy hating me, because it was my decision. His father thinks I worry needlessly and that he will be fine. What do you think?

Can circumcision be corrected with plastic surgery, or is there a support group located in Jamaica?

A Dear worried mother, I understand your concern as it is a legitimate one. Studies have shown that circumcision decreases penile sensitivity to a varying degree in different individuals. However, research also shows that there is a decreased risk of penile cancer and HIV infection in some men who are circumcised. The fact is that men who are circumcised still have the ability to enjoy sex and achieve orgasm provided there are no medical or psychological conditions which would prevent this, so do not worry. There are many circumcised men in Jamaica and all over the world who are quite satisfied with their sex lives. Some men and many women also like the look of a circumcised penis, this factor also contributes to stimulation of sexual desire.

Since it is weighing on your mind having a frank discussion with your son and your husband may be helpful to you as a family. Avoiding the issue may only prolong your worry.

Currently, there are no support groups in Jamaica for men and families of boys who are considering foreskin restoration but there are many online communities where you can participate in the discussion.

Foreskin restoration surgery is a rather technical procedure and is not routinely done anywhere in the world. Most males resort to nonsurgical methods which use gadgets that apply light sustained tension to the skin on the shaft of the penis, which over time could stretch the skin enough to give some measure of cover to the head of the penis. There are, however, no studies which assess the effectiveness or outcome of the use of these gadgets.

There are plastic surgeons in Jamaica who will be willing to discuss the issue in more detail with you. Contact: Plastic Surgery and Family Medical Centre, Unit 1-2 Seymour Ave. Tel: 946 3895-7.

deardoc@gleanerjm.com