Impotence or erectile dysfunction (ED) is the inability to obtain or maintain an erection sufficient for his sexual needs or the needs of his spouse. In order to understand impotence, one should know the conditions that must be present for erection to take place. These are:

• The male sexual organs, including testes and penis must be healthy
• Circulating hormones (substances traveling through blood and acting on specific organs) including male sex hormone and milk-producing hormone must be normal
• Nerve supply and blood flow to the sex organs must be intact
• There must be healthy psychological response to sexual arousal and relaxed state of mind

Many men with ED, like you, suffer in silence. They are too embarrassed to tell their doctors. Yet ED is a fairly common condition in Singapore, affecting about 50% of men aged 30 years and above. For more details, please see separate page on impotence.

About 70% of pregnant women experience urine leakage called stress incontinence. To reduce the leakage, you can:

Practice pelvic floor exercises several times a day to strengthen the pelvic muscles.

Reduce high-impact activities.

Drink plenty of water.

Do not hold urine.

Avoid caffeine and alcohol.

Keep the private parts dry and reasonably comfortable during the day.

Please see web page Stress Incontinence Pregnancy for further details.

The white jelly-like substance that you find on your husband's penis after sex is the discharge from your vagina (birth canal). Glands from your vagina and cervix (neck of the womb) produce small amount of secretion every day. This discharge may flow out of the vagina when you pass motion. It is acidic in nature and discourages infection from occurring. A healthy vagina produces secretion to cleanse and regulate its own environment.

Women of reproductive age have some vaginal discharge. Normal discharge may appear clear, cloudy white, and/or yellowish when dry on clothing.

Changes in vaginal discharge occur during different phases of menstrual cycle. There is increased discharge which is transparent like raw egg-white at the time of ovulation. The cyclical nature of the normal discharge is noticeable in most women and can be used as biomarker in managing fertility.

Before and after menstruation, the vagina is least acidic. Infections, therefore, are most common at this time. The itchiness and discharge that you experienced is most probably due to yeast or fungus This is a very common vaginal infection and the discharge is cheesy white with redness and itching around the genital area. It may be related to antibiotics, birth control pills, pregnancy, diabetes, or a weakened immune system.

Other common infections include:

• Bacterial vaginosis in which bacteria that normally live in the vagina overgrow, causing a grey discharge with fishy odor.
• Trichomonas infection from a sexually-transmitted parasite that causes yellowish-grey or green discharge and intense itching.
• Other sexually transmitted diseases like chlamydia or gonorrhea.
• Tips for reduicng vaginal infection:
• Bathe daily and keep the genital area dry by wearing cotton underpants. Avoid wearing tight pants, pantyhose, swimming suits, biking shorts or leotards for long periods.
• After using the toilet, always wipe from front to back. This may prevent getting bacteria from the anal area into the vagina.
• Avoid douching or use feminine hygiene sprays, perfumed toilet paper, deodorant pads or tampons, and bubble bath. These items disturb the balance of healthy germs in the vagina thus reducing the natural, protective acidity of the vagina.
• Change the detergent or fabric softener if it irritates the genital area. Latex in condoms and diaphragms and the sperm-killing gels may also cause irritation for some women.
• Reduce stress.
• Eat yogurt or take Lactobacillus acidophilus tablets when you are on antibiotics.
• If the discharge is caused by sexually transmitted diseases,the sexual partner must be treated as well, even if he has no symptoms. Failure of partners to accept treatment can cause continual reinfection which may lead to problem like infertility

An IUCD, or intrauterine contraceptive device or IUD, is a small, plastic, flexible, T-shaped device that is placed into the uterus (womb) and prevents pregnancy. It has to be inserted by trained doctor.
There are basically two types of IUCD. One type of IUCD contains copper, which is slowly released into the uterine cavity. Another type releases the hormone progesterone, which causes the cervical mucus to become thicker so the sperm cannot reach the egg.
Please see IUCD for further details.

Please see our web page on Intrauterine Insemination (IUI) for answers.

Please see our web page on In Vitro Fertilisation (IVF) for answers.