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Ask Your Doctor 174 (15.12.2014)
 

To know more about Dr. Edward Nazareth - Click Here

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Please read this before you ask your question.....!

We are pleased that this column has become popular among our visitors. This column is purely of educative and informative type. We do not intend to suggest any definite treatment or give name of any specific drug or doctor either in India or abroad.

We are receiving questions from many of our visitors from different parts of the world. Though we have the desire to give the reply at the earliest, we are unable to do so. At present we are updating the column once in two weeks, but at times there is inadvertent delay. This results in lot of back log. We answer the questions in first come first serve basis. Even then to answer a particular question, it may take more than a month. We request our visitors to bear with us.
We regret, we are not able to help when reply is sought urgently. It is absolutely not possible to help in emergency situations. There is no facility to give personal reply through e-mail.

Please fill up all the relevant details in the columns when you send the question. Please give your correct name, e-mail address etc. While answering we are editing the name and try to conceal the identity of the person who sends the question whenever it is required. We will not attend the question when the details are not sent. This is just to see that the person is serious of his question.
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Even when a person consults the doctor in person, there can be error in diagnosis and treatment! Please remember the answers here are based on the perception of the problem sent in the questions. There can be an error in perception by us and the answer may not be suitable. It is always advisable to consult the appropriate doctor before taking any treatment.
Dr. Edward Nazareth

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1. U.F., KSA


*I am 28 years. I am working in oil and gas projects here.  I have the problem of losing hair for the  past two years. What may be done to prevent hair loss. What about hair transplantation and hair permanent fixing?


** The average adult head has about 100,000 to 150,000 hairs and loses up to 100 of them a day. At any one time, about 90% of the hair on a person's scalp is growing. Each follicle has its own life cycle that can be influenced by age, disease, and a wide variety of other factors. This life cycle is divided into three phases:

An active hair growth that lasts between two to six years

The transitional hair growth that lasts two to three weeks

The resting phase that lasts about two to three months; at the end of the resting phase the hair is shed and a new hair replaces it and the growing cycle starts again.

As people age, their rate of hair growth slows.


There are many types of  hair loss, also called alopecia. Involutional alopecia and androgenic alopecia are common.

Involutional alopecia is a natural condition in which the hair gradually thins with age. More hair follicles go into the resting phase, and the remaining hairs become shorter and fewer in number. This is commonly seen in people as the age.

Androgenic alopecia is a genetic condition that can affect both men and women. Men with this condition, called male pattern baldness, can begin suffering hair loss as early as their teens or early 20s. It is characterized by a receding hairline and gradual disappearance of hair from the crown and frontal scalp. Women with this condition, called female pattern baldness, do not experience noticeable thinning until their 40s or later. Women experience a general thinning over the entire scalp, with the most extensive hair loss at the crown.

In some people the hair follicles are programmed to have a shorter growth period than others. Several factors may influence hair loss:

Hormones, such as abnormal levels of androgens (male hormones normally produced by both men and women). Androgen has profound effect on hair loss.

Genes, from both male and female parents, may influence a person's predisposition to male or female pattern baldness.

Stress, illness, and childbirth can cause temporary hair loss. Ringworm caused by a fungal infection can also cause hair loss.

Drugs, including chemotherapy drugs used in cancer treatment, blood thinners, beta-adrenergic blockers used to control blood pressure, and birth control pills, can cause temporary hair loss.

Cosmetic procedures, such as shampooing too often, perms, bleaching, and dyeing hair can contribute to overall hair thinning by making hair weak and brittle. Tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also damage and break hair. However, these procedures don't cause baldness. In most instances hair grows back normally if the source of the problem is removed. Still, severe damage to the hair or scalp sometimes causes permanent bald patches.

Medical conditions. Thyroid disease, lupus, diabetes, iron deficiency, eating disorders, and anemia can cause hair loss, but when the underlying condition is treated the hair will return.

Diet. A low-protein diet or severely calorie-restricted diet can also cause temporary hair loss.

For assessing the cause and treatment you may consult a skin preferably a cosmetologist. Male-pattern baldness is not usually treated, as the treatments available are expensive and do not work for everyone. There are certain medicines, prescribed to be used locally which  may be effective in treating male-pattern baldness .

Most men and women  are now considering ‘hair loss surgery’  for male-pattern or female-pattern baldness. Surgery for hair loss should only be considered after trying less invasive treatments, as they are expensive. The success of hair loss surgery depends on the skill of the surgeon, as complications can arise. It is better to discuss in detail with the cosmetologist performing the procedure before going for it.


2. R.F. Mangalore

*My age is 25 years. I am suffering from infection of the penis. I get redness, itching, white discharge with unpleasant smell, pain while moving the skin,unconfortable. What is the treatment to this? What can I do now?

**It appears that you have balanitis. Balanitis is an inflammation of the glans. Often the foreskin is also inflamed at the same time as the glans. Balanitis is common, and it can occur at any age. It is very uncommon in men who are circumcised. Various germs (bacteria) that live on the skin in small numbers may multiply and cause infection. A common cause of infection is with a yeast called Candida. Candida is the same germ that causes vaginal thrush in women. Small numbers of Candida commonly live on the skin and can sometimes cause infection.

You may consult a skin specialist for proper evaluation and treatment. The local application medicines depending on the cause of inflammation will help you to get rid off the problem.

There are few points to be remembered to prevent balanitis:

Wash the glans each day. Pull the foreskin back gently whilst in the bath or shower. Then gently clean the glans using just water, or water and a bland soap. Make sure the penis including the glans is dry before you put on underpants.

Wash the hands before going to the toilet if you work with chemicals which can irritate delicate skin.

Use a condom each and every time you have sex with a new sexual partner. If symptoms are related to condom use, try using a condom which is designed for sensitive skin


3.V.D, Dubai

* My son is 10 year old. His health, height and weight is normal. However his penis size is very small compared to other boys of his age and it seems that it is not growing in length. We have shown it to doctors and according to them there is no problem and no need to worry. I am bit anxious. I would like to know whether there is any treatment / method make the penis big.

** In boys, the penis start out small, and stay fairly small until puberty. The hormones at puberty influence physical as well as sexual growth; puberty generally start around the age 13-15. 

At birth, an average penis is 1.5 inches long, and anything over ¾ of an inch is considered normal. An average 8 year old (and, really, an average any-year-old prior to puberty) has a penis size of about 2 inches—that is gently stretched, while pushing back the pubic fat pad that can sometimes “bury” the base of the penis. A penis that appears much smaller than expected is sometimes the result of obesity or a thick body type that makes the penis look “pushed in.” This is called a “hidden penis.” If the penis can not be pushed back out (by pressing back on the fat pad), it may be a truly “buried penis,” which may require surgery. Sometimes, the scrotal skin is attached up high on a “webbed penis,” which can also be corrected surgically.

Parents who have concerns about penis size should bring this up with their doctor. The pediatrician will examine for other signs of unusual genital development. As you have already consulted and the doctor has found no abnormality, it may be wise to wait till your son approaches puberty. During puberty his organ will grow and attain the required size.

4.C.N., Mangalore

*I am 42 years. I feel too much cold in my hands and legs. When I shake my hands with others, they say my hands are very cold. Even light AC also makes my body too cold. Am I anemic? Please suggest some medicine. My son is also having same symptoms

**Sweating is necessary to control body temperature during times of exercise and in warm/hot surroundings, and is a normal response to a rise in temperature or anxiety. Sweating is regulated by the sympathetic nervous system. In about 1% of the population, this system is revived-up and works at a very high level, causing sweating to occur at inappropriate times, far in excess of the amount necessary to maintain normal body temperature. It can occur in many different areas of the body, and the condition is known as hyperhidrosis, which means 'excessive sweating'. It affects both sexes equally, and all races.

Hyperhidrosis is not a temporary condition. It can affect the people of all the ages. Hot or cold, the sweating is constant, and the impact of hyperhidrosis can be severe. Wetness and staining of clothes, clammy hands and sodden smelly shoes, inability to grip objects such as pens, cold and wet handshake, damage to keyboards and difficulty dealing with paper and metals, can make a miserable existence. 

Primary (or focal) hyperhidrosis most commonly affects hands (palmar hyperhidrosis, feet (plantar hyperhidrosis) and underarms (axillae), but can also affect or other areas - face and scalp, back, neck, groin, legs and buttocks. It affects both sides of the body equally, and often starts in adolescence or even childhood.

There are no effective treatment for the condition in modern medicine. Rarely there can be some endocrine disorders causing the problem. You may consult an endocrinologist for further assessment.


5.P.D, Oman

*I am 40 years old working in Gulf for the last 13 years. I have a serious problem of Social Anxiety Phobia. I cannot face the small group or bigger group. I cannot talk in front of small group or bigger group. I don't have confidence. I think that other person or people are observing me & thinking bad about me. I tried many medicines like allopathic, ayurvedic & homeopathy but no positive result. I am working in hotel industry and this is hampering my career. When I want to face people, my hands are trembling, sweating and I get nervous. This has been observed by people and I am really worried about this. Please suggest me to overcome this problem. Recently I am diagnosed having diabetes but its under control.

** It is normal to feel nervous in some social situations. But in social anxiety disorder, also called social phobia, everyday interactions cause significant anxiety, fear, self-consciousness and embarrassment because of  fear of being scrutinized or judged by others.

Signs and symptoms of social anxiety disorder can include persistent fear of situations in which one may be judged, worrying about embarrassing or humiliating oneself, concern that others may be offended by oneself, intense fear of interacting or talking with strangers etc.

There can be associated physical signs and symptoms  like fast heartbeat, upset in the stomach or feeling nausea, dizziness or lightheadedness, confusion or feeling "out of body" etc.

Social anxiety disorder symptoms can change over time. They may flare up if  the affected person is  facing a lot of stress or demands. Although avoiding anxiety-producing situations may make the person  feel better in the short term, the anxiety is likely to persist over the long term if not treated.

The two most common types of treatment for social anxiety disorder are medications and psychotherapy. These two approaches may be used in combination. You may consult a psychiatrist who will assess your problem and might refer you for psychotherapy or counseling.

You may not get miraculous improvement when the therapy is started. You should not give up if treatment doesn't work quickly. You can continue to make strides in psychotherapy over several weeks or months. And finding the right medication for your situation can take some trial and error.

For some people, the symptoms of social anxiety disorder may fade over time, and medication can be discontinued. Others may need to take medication for years to prevent a relapse.

To make the most of treatment, keep your medical or therapy appointments, take medications as directed, and talk to your doctor about any changes in your condition.

There are certain life style changes which might be of use. First, consider your fears to identify what situations cause the most anxiety. Then gradually practice these activities until they cause you less anxiety. Begin with small steps in situations that are not overwhelming.

Consider practicing these situations:

Eat with a close relative, friend or acquaintance in a public setting.

Make eye contact and return greetings from others, or be the first to say hello.

Give someone a compliment.

Ask a retail clerk to help you find an item.

Get directions from a stranger.

Show an interest in others — ask about their homes, children, grandchildren, hobbies or travels, for instance.

Prepare for conversation, for example, by reading the newspaper to identify an interesting story you can talk about.

Practice relaxation exercises.

Adopt stress management techniques.

Set realistic goals. Pay attention to how often the embarrassing situations you're afraid of actually take place. You may notice that the scenarios you fear usually don't come to pass.


6.F.Z. Pakistan


*I am 27 years of age. I was VDRL positive then my doctor advised me penicillin G 2.4lakh injection, I took for 3 weeks  and after a month  VDRL was non reactive but after 3 months again VDRL became positive. I want to go to Dubai.

** The VDRL test is a screening test for syphilis. It measures the antibodies, that the body may produce if one has come in contact with the bacteria Trpeonemas palladium that causes syphilis. Either you are re-infected or you are not effectively treated in the earlier occasion. The VDRL test becomes negative if you are treated. There is one more test tpha done for  Gulf immigrants, which may remain positive even if VDRL is negative. You may consult the physician and take proper treatment.


7. D.P., Kundapura


*I am 35 years and I am pregnant of 5 months. Recent ultra sound report shows that baby has not fully developed in brain and back head skull. Can you suggest me how this has happened and can we solve this with medication? or better to terminate pregnancy? The doctor told it is safe and good to terminate pregnancy.

** The condition is known as anencephaly. It is a serious birth defect in which a baby is formed without parts of the brain and skull. It is a type of neural tube defect (NTD). These are birth defects that happen during the first month of pregnancy, usually before a woman knows she is pregnant. As the neural tube forms and closes, it helps form the baby’s brain and skull (upper part of the neural tube), spinal cord, and back bones (lower part of the neural tube).

Anencephaly happens if the upper part of the neural tube does not close all the way. This often results in a baby being born without the front part of the brain (forebrain) and the thinking and coordinating part of the brain (cerebrum). The remaining parts of the brain are often not covered by bone or skin.

Almost all babies born with anencephaly will die shortly after birth. This can happen in one out of 5000 births.

You may have ultrasound scanning from another trained radiologist and follow the advice of your doctor. If the baby has enencephaly, it will die within few days of birth.


8.D.L.D., Dubai


*I am 31 years of age and got married 2 years ago. We are planning for a baby now. But my organ becomes bit small, so my wife is not fully satisfied. also, semen comes out within 1-2 minutes during intercourse, so am just worried. Is it common or should I consult the doctor? Should I undergo the semen analysis

** The size of the organ has nothing to do with pregnancy and satisfaction during physical union. It may be better to consult an urologist who can guide you regarding infertility and premature ejaculation. Both these problems can be treated.


9. A.P. Dubai

* I am 33 years of age. For the past 2 to 3 months the top skin of my organ is becoming stiff and when I pull back I get cracks on the skin and also fungus kind like paste is accumulating under the skin. I used to clean it everyday but I don't know why this is happening. I never had relationship with any one and as my wife is pregnant of 5 months and we did not have sex recently.

** Please refer the answer to the second question of this update. You may be having infection of the  glans and foreskin of your organ. It may not be related to sexual activity. Consult a skin specialist for proper assessment and medication.


10. J.P., Mangalore

*I am 39 years and am having 3rd degree, thrombosed piles. What is the best treatment?

** Thrombosed external hemorrhoid is a common problem. Although conservative nonsurgical treatment (stool softeners, increased dietary fiber, increased fluid intake, warm baths, analgesia) ultimately results in improvement of symptoms for most patients, surgical excision of the thrombosed external hemorrhoid often precipitates complete resolution. Surgical excision of the acutely thrombosed external hemorrhoid is safe procedure offers low recurrence and complication rates. 

11.D.N., Mangalore


*I am 35 years of age. I have both neck and back ache problem. For the past three years it has become severe. Due to neck pain I have regular pain in hands and fingers especially thumb and small finger. My hand writing has become worse and I cannot write quickly. Some times I get severe head aches after which I sweat a lot and go for urine many times. I had consulted doctors and taken physiotherapy about two years ago. The pain is recurring.

** It appears that the nerve roots of your hand and fingers are irritated in the neck due to spondylosis. It is better to see a spine surgeon for proper assessment and treatment.

 

12. J. P. Kuwait


*I am a 30 years of age and I am married.  When I sleep in the night, I get lot of dreams.  Some are wild, some are funny, some are romantic and some are as if I am repeating what happened during the days. Right from the time I close my eyes my dreams start till I get up in the morning.  I consume alcohol in moderation. I dream whether I drink or not, whether I do physical exercise or not, whether I pray before going to bed or not.  Can you please advise a remedy to get rid of these dreams?.  Because of these dreams, I feel tired during the day.  

** Dreaming is a hallucinatory experience that occurs during sleep. Dreaming, a common and distinctive phenomenon of sleep has since the dawn of human history given rise to many beliefs, fears, and conjectures, both imaginative and experimental. There are volumes of books written about the meanings, importance and interpretations of dreams.  Sigmund Freud, the famous psychiatrist had written “The Interpretation of Dreams” (1899). His insistence that dreams were "the royal road to the unconscious".  

But modern psychiatrists believe that dreams have no significance. There are no methods or medications to alter the pattern of dreams or dreaming altogether. Though there is no need to give any importance to dreaming, here are a few suggestions which might help you to a certain extent:

Make sure you get plenty of sleep every night; someone who is sleep deprived is more likely to sleep talk. 

Reduce the stress and anxiety levels 

Keep to a regular schedule of going to bed and getting up at the same time 

Don't eat a heavy meal right before bedtime 

Read some smoothening reading before you go to bed may be a few versus from the Bible.

If you wish, you may consult a psychiatrist to rule out any other associated problem. However, dreaming is not an illness and does not require treatment.


13.  B. R. Mangalore

*I have a 7 year old daughter who has head aches all the time and she is on medication but these do not help. She has allergies, which are really bad; and she takes medication for that too. What should I do? What would cause her head aches? 

** Repeated nose and throat allergies are likely to be associated with allergic response in the para nasal sinuses. The para nasal sinuses are around the nose. These are small air filled empty spaces in the skeleton of the face and skull. In normal conditions they produce little amount of secretions which are drained into the nasal cavity. In allergic conditions there will be swelling of the inner lining of the sinuses which leads to increased secretions in the sinuses. Due to the swelling, the natural passage from the sinuses to nose may be blocked. This leads to increased pressure in the sinuses which is the main cause of headaches.

If the allergen is found, the allergic response can be minimized by avoiding the allergen. {For example if a child is allergic to chocolates, they can be avoided} However it is not easy to locate the allergen in every case. In such situations, the drugs that minimize the allergic phenomenon, or that reduces the swelling of the mucus lining (decongestants) are usually advised. These formulations are to be used as per the advice of the doctor. 

Some of these children who had allergic response during childhood get dramatic relief at maturity. Till then it may have to be tolerated. You may show your daughter to an ENT surgeon for opinion. Some of the children with allergic disorders respond well to homeopathy medicines.


14. S. D, Mangalore


*I am 29 years old lady. In 3 months time I will be getting married. When I think of the time that I will be having sex with my husband for the first time, I am scared. The reason being I have heard that it is painful for a girl for the first time to have sex. Is this true?  Basically this has created a kind of fear in me towards sex. I had read and heard about it. 

** Pain at the first physical union is not rare but it is not universal.  Though the initial sexual acts may cause mild discomfort in few of the women, usually the pain is minimal and negligible. Even if there is pain at the first instance, it can be avoided at subsequent acts. 

There is a myth that the female genital tract is narrow and it gets torn during initial sex acts. But in reality, if properly performed, sexual act should not cause any tear in either of the partners. The female tract of physical union has the capacity to expand. During child birth it can expand to allow the head of the child to pass through, the average diameter of the head of the new born is around 10 cms. During physical union the diameter of the male organ is around 3 to 4  centimeters. As a result in normal sex act, there should not be any tear or injury. Most of the time pain is due to forcible penetration done in a hurry! 

Other than this the causes of pain during any sexual acts can be due to following reasons:

Most often it is due to lack of required lubrication. To facilitate lubrication, the couple should spend as much time as possible in foreplay. In women, not being wet enough for comfortable intercourse can sometimes be a signal that her body is not yet fully aroused. 

Fear of pain itself can cause pain! Anxiety may interfere with the relaxation that facilitates arousal and lubrication, i.e. anxiety about sexual performance, prohibitions to being sexually active, fear of pregnancy, concern about being interrupted or any other source of anxiety in the person's life can inhibit arousal and can cause pain. 

Sometimes this is because it is not the right time/place/partner/activity for her. If the woman is on birth control pills, pills too may reduce lubrication.

Rarely the pain can be due to some underlying infection or diseases of the genital tract. Vaginal or vulvar conditions such as HPV, yeast, chlamydia can cause discomfort as with other gynecological problems, i.e. pelvic infections, ovarian cysts, endometriosis. 

Sometimes people will experience discomfort because of physical reactions to relationship problems or to previous negative sexual experiences


Here are few hints that might help if the pain is a persistent botheration:

Taking more time before intercourse or trying different activities during "foreplay" can be helpful in increasing arousal and lubrication. 

Using water based lubricant such as "KY" jelly may help to increase lubrication for intercourse (oil based products should not be used if condoms are being used preventatively, as oils weaken the latex). 

If the pain persists or is of recent origin, then a gynecologist may be consulted as the pain can be due to  specific cause. 

If there is continuous pain, the couple may discuss this with each other and try to resolve factors related to anxiety, relationship problems or previous negative experiences.

If the problem has definite psychological influence it may require counseling. 


15. A. S. Mangalore

*I am 31 years. I am writing this to you because I feel shy to consult my family doctor as he is also our family friend. I am married for 2 years and we were having good married life. Lately I lose erection soon after insertion and I come out fast. I cannot last for more than 2 minutes. My wife also does not feel happy. These days she is not talking to me as before. She used to actively take part in fore-play, but lately she stopped doing that. I am upset. 


** You seem to be having some stress in your relationship with your wife. This must be the cause of loss of erection early and associated premature ejaculation. Normally men do not develop this type of problems in the early age due to any specific organic cause. In middle age and above, long standing diabetes mellitus, certain neurological disorders can precipitate erectile problems.  Your problem appears to be psychological.

Improve the emotional relationship with your wife. Have a free talk with her. If possible go on holidays to some place away from the house and spend as much time as possible together.

Be confident. You have no physical problem. The worries and tension has lead to the current problem. You alone can solve it.

Give up smoking and reduce alcohol intake, if you have these habits.

Reduce your body weight if you are obese. Do regular exercises like walking. Exercises  help to reduce the anxiety.

If these are not applicable, increase the frequency of union, try for various positions than having a monotonous type of sex. Variety is also required in sex life. 

Encourage your wife to take part in foreplay as before. You too will have to indulge in active foreplay. It can help you to a greater extent to solve the problem.

Check your blood sugar. Diabetes Mellitus can cause sexual weakness.

If problem persists consult an urologist. Do not use any medicines unless you are examined and the drugs/medicines are prescribed. If he finds you normal and advises you to see any other specialist, do that.


16. I. M., Mumbai

*I am 28 years, married and having 3 children. I am basically from Mangalore and at present I am in Mumbai. These days my full body is itching. It is so bad that I cannot bear. I do not know the reason. Some people are telling me that after the delivery one should not eat pork meat and other ‘nanji’ things. I do not know what to do. Itching is more in the morning and evening. I get small red rashes and itching.


** You must be having some type of allergy. It is better to consult a skin specialist. 

The belief that foods like pork, crabs, brinjal  etc. are infectious during post-operative period or after delivery is not true. Your present problem is not related to your diet after the delivery. However, certain foodstuffs that you consume now can be allergic and can cause itching. It can be even in the environment or in the air you are breathing. Your doctor might be able to help you to identify the allergen. But in most of the time, it is not possible to locate a single allergen. In such situations symptomatic medicines may help you to overcome the problem.


17. K. G., Mangalore

*I am 19 years. My sexual organ when erect is not straight in shape. It is bent from middle, which gives it a curved shape. Is it going to cause me problems later in my sexual life? What could be the reason for it? Could this be because of wearing tight underwear? 


** The direction of the erect organ varies from man to man. It can be straight upwards, downwards or may be bent to right or left side. It never stands straight and is bent to a curved shape. This is normal and is perfect. It will not have any adverse effect on sex life. It is not because of the under wear.


18. E.P., Mumbai

*I am 26 years of age, married for 8 months. I was using birth control pills (the name of the pill is Novelon) recommended by a gynecologist but this was giving me pain and there was discharge. The pain started after a week or so from the time I took the pill and gradually the pain increased as long as I was taking the pill. The pain was lasting for few seconds and was increasing day by day. The discharge was dark yellow. So I stopped taking the pill and the pain vanished immediately. My gynecologist suggested another pill (the name is Yasmin) but the problem still exists. My husband has a smaller organ due to which we cannot try condoms.


**Generally estrogen progesterone combination pills eliminate pre- existing pelvic pain or ovulation pain due to its mechanism of action by anovulation. However some people get minor side effects such as pelvic pain or vaginal discharge due relative excess of estrogen in the combination. This is because of wide variation of metabolism and the bio-availability of steroids in individual women. You could try a different combination with relative progesterone excess preparation (Ethinyl estradiol 30 microgram+levonorgesterl 150 microgram. If your symptoms still persist, then you should see a gynecologist to exclude any underlying organic cause for your symptoms. 

 Normally the sexual organ of men at full erection attains the required length as well as thickness (circumference) irrespective of its size at normal state; therefore condoms can be used by any man if required. Proper use of condom is to be known. The condom has to be worn when the man attains full erection. 


19. G. K. Calicut

*I am 32 years old working woman (software professional), married for 7 years and have a daughter of 5 years old.  I have put on some weight after my daughter's birth.  I am 5 feet and 2 inches and I am 68 kgs weight (before her birth I was 55 kgs).  I had a caesarean during her birth and complaints of back pain after that.  At present I have pain on my right leg, above the foot approximately 7 to 8 inches above the ankle.  I feel as if one nerve is being pulled inside. I could not do anything, but just sit.  After sometime (not even a minute) it becomes fine.  Few months back this kind of pain used to come once a week or may be once a month etc., but nowadays it is there at least 3 to 4 times a day.  I feel, I may be having deficiency of calcium in my body and started taking calcium tablets.  

** The problem is most likely due to repeated strain at the lower back, which is known as chronic lumbo-sacral strain. Bad posture at work, lack of exercises, weak back muscles, excess body weight are some of the factors that cause this problem. The pain which you feel in the leg may be due to irritation of a particular nerve root at the back. Such type of pain is normally the referred pain from the back. This may be associated with the back pain or may be an additional problem. 

You may consult an orthopaedic surgeon for proper assessment. There is no surgical treatment for lumbar strain. Most of the backaches and radiating pain in the limbs due to the problems in the vertebral column can be effectively treated without surgical intervention. Even if there is some other cause for the pain, physiotherapy and exercises normally relieve the symptoms. 

You are also required to reduce the body weight. Diet and exercises like walking may help you to reduce the excess weight which you have gained recently.  Your problem is not related to deficiency of Calcium in the body

20. A. S. Mangalore

*I am 29 years old and my husband 31. We have married for 4 years and having a baby boy of 2 years. Ours is love /arranged marriage, we both love each other. We are staying in Dubai, with joint family (with mother-in-law, bothers-in-law). I am too busy working lady. Since one year I have not much interest in sex. But my husband would like to have everyday. I cannot co-operate because of so many problems at home and my baby does not sleep till late in the night.  I am very busy from morning to evening, so I feel very tired in the night. Because of all this, I have no interest in sex. But my husband is very understandable person. He does not say anything. But I feel sorry. I get angry on myself.

**It is not unusual for women, working or otherwise to have low desire for sex at certain time of their married life. There are many causes and majority of them are psychological. 

Somewhat negative attitude towards the role of sex in married life is not unusual. One has to cultivate a positive attitude towards sexual life; in marriage it is the best method of expressing mutual love. In married sex it is not the union exclusively for physical gratification, there is more psychological satisfaction. Though your husband may not express his dissatisfaction, he must be feeling dejected. If you continue in the same situation, he may not remain as he is now. You can solve the whole matter by just changing your attitude.

In marriage some give and take policy for sex is desirable. Even if the wife has little or no desire for sex, she may have to submit herself for the marital act when her husband wants it; similarly the husband may have to suppress his desire when his wife is not ready for physical union. But this should not be a regular affair. If the refusal persists it may lead to some serious consequences and even affect the relationships badly.

Stress is an enormous factor. The body naturally puts survival ahead of pleasure. Your over-burdened adrenal glands can rob your body of the building blocks it uses to make certain hormones, which are vital to desire and sexual response. Changes in your routines, a new form of creative self-expression, help from your partner, working on unresolved problems, time you devote to yourself – the positive effects can be profound

Open communication is so important in a relationship and this is especially true during this confusing time. Don’t let your partner wonder and speculate about why the relationship with you has become one without intimacy and passion. Be open and share your feelings that seem beyond your control. Help your partner be part of the solution by asking for patience and encouragement while you work toward becoming healthy and balanced.  Be sure to show your love in other ways that have been meaningful to both of you. Remind your partner that you need time and space to feel warm and comfortable without the pressure for sex. Facing this issue with openness and respect for each other will foster a mutual understanding and bring you closer.

Many a times the woman gets ready only when she is prepared by her man for the act. The man may get excited without any external stimuli, where as the woman may require lot of foreplay to get excited. Foreplay is an integral part of the marital act and is very much required for mutual fulfillment. Encourage your husband to initiate it and try to take part.


Do you seriously believe that the baby’s sleeping habit is the cause of the problem? Sex need not be performed just before going to bed. It can be also done before getting up in the morning! Mean time, the baby’s sleeping habit has to be changed. It should be woken up early in the morning and during day the sleep may be reduced. 


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Editor-in-chief : Walter Nandalike


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