Epidural anesthesia is probably the best choice for you to take away the pain of labour. Please visit our web page on epidural anesthesia for details.

I would strongly recommend that your wife see her gynecologist.
There are few possibilities for pain during sexual intercourse.

1. Endometriosis.
2. Pelvic Inflammatory Disease (PID).
3. Ovarian cyst or tumor.

It is important that your wife be evaluated by the gynecologist as this subtle symptom may suggest that something is wrong.
It is difficult to imagine other explanations for the pain if your wife is adequately aroused before and during intercourse. Her uterus should elevate out of the way and not cause her pain, even with deep intercourse thrusting. And she should not feel pain in her vagina from friction if she is well lubricated from either her own arousal or the use of a sexual lubricant.
Further details are available in web page Pain during sex.

Pain is a subjective experience involving a complex interaction of physiological, psychosocial, cultural and environmental influences. The pain feels much worse if you are tense. Continuous support of the husband in the labour room will reduce anxiety, fear and the pain. Self-help techniques such as relaxation and breathing may help. If you breathe steadily and evenly during contractions and relax between them, it will reduce the pain. Click here for information about ways to reduce labour pain.

You probably have what we call primary dysmenorrhea which affects about 80% of young girls like you. The period pains can be severe enough to interfere with daily activities. Period pain or dysmenorrhea is characterized by severe cramps in the lower abdomen. There are two types: primary or secondary.
Please refer to Painful Period for further details.

You and your wife should visit a gynecologist who could explain to both of you the normal anatomy and physiology of female reproductive system. This is to allay the fear that both of you might have. She may not bleed during the first intercourse as rupture of hymen may occur well before the first intercourse. Participation in sports, swimming, cycling, use of tampons during menses, and insertion of fingers or objects into vagina during sexual self-pleasure may lead to hymenal tear. Some women are born with only a rudimentary hymen or none at all.
Your wife should be mentally well prepared for the first intercourse and will have lubricated enough by the time of penetration to permit a relatively painless entry of penis into vagina. However, should she experienced discomfort or pain and bleeding during the first penetration it is advisable to go slow, taking time to settle down.
Sex should take place in a very relaxed atmosphere, which frequently is absent on the wedding day. Usually both of you may be tired, under stress or preoccupied by non-sexual thoughts on this day. Thus it is a good idea for sexually inexperienced couples and newly wedded to just kiss, cuddle and wait to have intercourse until they are relaxed. This by itself is the first step in having a less painful first intercourse. Take this opportunity to explore each other¡¯s genitals. Awareness of female genital anatomy is important. You can apply some water-soluble lubricant such as K-Y Jelly to the tip of your penis and her vaginal opening to make the penetration easier.
You and your wife should also spend time on communication about sexual matters, showing love and affection to each other, understanding each other's concerns and fears, understanding one¡¯s own and each other's bodily responses to sexual stimulation. This will go a long way in building a strong, affectionate and enjoyable sex life.

Please see web page Pain During Sex for answers.

Please see our page on Abnormal Pap Smear and Colposcopy for answer.

Please see our page on Abnormal Pap Smear and Colposcopy for answer.

There are no such pills. These are bogus products that do not work. The safest way to enlarge a penis without erection is to take a hot shower. However the effect is only temporary as the increase in body temperature will make the penis as full as it could.

Morning after pill (MAP) is a hormonal method of emergency contraception which aims to prevent pregnancy after unprotected sexual intercourse. It is usually used when a condom breaks or after a sexual assault.
Timing is a critical factor in effective use of MAP. Depending on the time during the menstrual cycle that they are taken, MAP may stop or delay the egg from ovulation, interfere with fertilization, or change the lining of the womb thereby preventing implantation of a fertilized egg. If the baby has already attached to the womb, studies have shown that MAP will have no effect. The pregnancy will continue normally.
The common and unpleasant side-effects are nausea and vomiting. About 50% of women develop nausea; 20% vomit according to some studies. Some women may experience headache, dizziness, cramping, tender breasts, and/or irregular bleeding. Because of the side effects, MAP should not be used repeatedly.
MAP is not as effective as other hormonal contraceptive methods such as pills or skin patches. Their effectiveness in preventing pregnancy varies between 74% to 89%.

PCOS is a complex hormonal disorder usually associated with infertility. It is characterised by the presence of many small cysts (sacs of fluid) in the ovary due to failure of ovulation. Menses are usually irregular or absent due to long-term lack of ovulation. Other symptoms include excessive weight gain (obesity), acne (pimples) and excessive body and facial hair.
Long-term effects include diabetes, high blood pressure, heart disease and womb cancer. Therefore treatment is critical.
Treatment depends on symptoms and whether you want to become pregnant. It is important that you work with your doctor to address the issues relevant to you.

You are suffering from postnatal blues or baby blues. It is fairly common for mother to feel anxious, weepy, angry, depressed, restless or guilty within the first few weeks after birth. This is because of big fluctuations of pregnancy hormones after the birth. Fortunately, with good emotional and physical support from the husband and family, most women recover within a week or two. You should talk to your husband and your obstetrician about your feeling. Reassurance and support will help you though this transient period.
If your mood swing lasts longer than few weeks or if your husband notices that you are depressed, you should seek medical help as you may be suffering from post-partum depression. You may be overly anxious about how to look after your baby, or obsessively worried about your baby getting hurt. As a result, you will be so exhausted that you do not know or cannot bear to look after your child. Insomnia (unable to sleep) becomes very common and you may have a nervous breakdown.
A more severe form of behavioral and mood changes is called postpartum psychosis. Hallucinations, suicidal thoughts and fears of being a threat to the newborn are the symptoms. Urgent medical help is needed.

Preconception examination or pre-pregnancy care is important in helping couples to have a healthy pregnancy and a healthy baby. It involves assessments of a woman's overall health and identifications of risks factors that may complicate pregnancy. For details, please visit our page on Pre-conception Examination.

You can still get pregnant with only one fallopian tube as long as your ovaries still ovulate.
Normally, the ovary releases a single egg each month. The egg meets the sperm in the fallopian tube, where it is fertilized. The fertilized egg then continues its journey to the uterus and gets implanted. Only one fallopian tube is required for this to happen.
The egg released from the ovary usually enters the fallopian tube adjacent to that ovary. Although medical evidence suggests that an egg released from one ovary can be transported through the fallopian tube of the opposite side, this is not common.
As you have only one fallopian tube left and it may be partially blocked, your fertility may be reduced. There is also increased risk of tubal pregnancy.

Premature ejaculation is one of the common sexual problems. It is defined as ejaculation before the man wishes it (American Psychiatric Association). How long a man is able to last before orgasm is rather subjective. The important issue is the inability to delay ejaculation to the satisfaction of both partners. The exact cause is not well understood. It can occur temporarily in teenagers, sexually inexperienced men, and people who have abstained from sex for a longtime. Occasionally, it may be a symptom of some nervous disorders.
Please see page on premature ejaculation for details.

A. From your description, the sexual responses appear normal. Sometimes you reach orgasm quickly while at other times you take longer. If you have sex the second time within a day, the ejaculation would occur later. If the time between sexual encounters is longer, you get aroused and released more quickly.

According to medical studies, it takes a man 2-3 minutes on an average to ejaculate on vaginal penetration. However, this is based on research where couples are asked to use stopwatch to time the length of sexual intercourse. It is rather artificial and does not necessarily happen in a “natural setting”. Therefore, it would be difficult to define what is the “normal” time for ejaculation to occur.

One thing worth mentioning is that you should not view sex as a performance test. It is not about achieving or scoring. There is no chart that tells you how long a man should last when he is sexually stimulated during intercourse Your belief of “ standards” (around 30 - 45min) is presumably based on commercially produced sexually explicit videos which rely heavily on many hours of filming and editing. This does not usually happen in real life situation.

Stories of people having sex “all night long” do not mean that the couples have penetrative intercourse all the time. Usually sex that lasts for hours at a time contains breaks, and lots of different kinds of sex play, not just intercourse.

The following tips may help:

• Be aware of your body. This permits you to adjust the speed, depth, angle of intercourse or any stimulation that you can modulate for your own arousal.
• Reduction of sexual anxiety may help. Many things can contribute to sexual anxiety. Lack of positive sexual experiences is top of the list.
• Pelvic muscle exercises (Kegel’s exercises) will help you to have a better voluntary control over the timing of ejaculations. These exercises involve pulling and squeezing the muscles you use to stop passing urine. Squeeze hard and slowly release the muscles until you can count up to ten. Do this few times a day.
• Changes in attitudes. Keep in mind that sex is not "performing" .Try to create shared sexual pleasure with your spouse with good and effective communication. Intercourse is only one way and not necessarily the most pleasurable way of communication with your partner.

Usually, our body breaks down much of the food we eat into a type of sugar, called glucose. Our body makes a hormone called insulin that moves glucose out of the blood and into the cells of the body. In diabetes, the glucose cannot get into the cells, so the amount of glucose in the blood gets higher and higher. This is called high blood sugar or diabetes. During pregnancy, because of hormonal changes, some women cannot utilize the sugar (glucose) in the blood as well as it should. The level of blood sugar becomes higher than normal. We call it gestational diabetes as it happens during pregnancy. Most of the time, the blood sugar returns to normal and the diabetes go away after delivery. High sugar levels in the blood can be harmful to the mother and the baby. If the diabetes is not treated, miscarriage, stillbirth (baby dies in the womb) and premature birth can occur. A more complete description of Diabetic Pregnancy can be found in a separate page in our web site.

Ectopic pregnancy is a dangerous medical condition where the baby instead of embeding in the womb is implanted outside. The most common site is within a Fallopian tube (tubal pregnancy). Very rarely, it can occur in the ovary, the abdomen, and the neck of the womb.
About 85% of the women who have experienced one ectopic pregnancy are later able to achieve a normal pregnancy. A subsequent ectopic pregnancy may occur in 10 to 20% of cases. Some women fail to become pregnant again, while others become pregnant and spontaneously abort during the first trimester. Click here to read more about ectopic pregnancy.

Most exercises are safe during pregnancy provided one exercises with caution and does not overdo it. Swimming, brisk walking, stationary cycling and low-impact aerobics carry little risk of injury and can be done in moderation. One should choose exercises that do not require too much balance or coordination. Exercise may not be advisable if there are medical problems, such as asthma, heart disease or diabetes.
Please visit Exercises during Pregnancy for more details.

There is not enough information to state with certainty that using hair dyes during pregnancy is completely safe as there are no extensive human studies available. There is also no information on having hair treatments during breastfeeding. However, The Food and Drug Administration of America recommends that until conclusive evidence is available, pregnant women may want to proceed with caution in using hair dyes.
For more details, please see our web page on Hair Treatment During Pregnancy.

Over-the-counter (OTC) medications mean medicines without prescription. These are now readily available in the pharmacies. However, it is wise to ask your obstetrician about the safety of taking these medications including prenatal vitamins. Most herbal preparations and supplement have not been proven to be safe during the pregnancy. Therefore, do not take any OTC medication unless it is necessary.
You may like to visit our web page on medication during pregnancy for more details.

There is no hard and fast rule on sexual intercourse during pregnancy.
Scientifically, there is no evidence to suggest that it causes problems such as miscarriage or premature birth.
Theoretically seminal fluid contains substances called prostaglandins which might stimulate uterine activity. Orgasm has been shown to cause prolonged and sustained contractions of the womb. Some bacteria may be transmitted during intercourse causing infection of the birth canal and the womb. Thus sexual intercourse may have potential harmful effects on the mother and the baby.
More information available in Sexual Intercourse during Pregnancy.

Please see the section on Sexual Desire in Pregnancy in the "Sexual Intercourse during Pregnancy" web page.

Prenatal vitamins are specially formulated multivitamins that are taken during pregnancy. These will make up for any nutritional deficiencies in the mother's diet during pregnancy.
Folic acid, iron and calcium are especially important for the development of the child in the womb. Please visit our web page on prenatal vitamins for more details.

You have probably what we call Osteitis Pubis, an inflammation of the pubic bones.
The pelvic girdle is made up of bones which form a ring like structure. The bones meet in front and form a fused joint called symphysis pubis. During pregnancy, hormones relax the ligaments and soften the joint. As a result, the pubic bones rub against each other causing sever pain when the patient walk,climbing stairs, rising from a seated position or turning over in bed. The pain may affect the groin or the inner side of the thigh. There may be weakness and difficulty in moving about. The patient ususally walk with a waddling gait.
A special support belt may be required to relieve pressure from the weight of the growing baby. The pain usually subsides weeks after the delivery.

Hemorrhoids or piles are swollen veins (blood vessel) in the lining of the back passage (anus and lower intestine). These veins are swollen when pressure in and around them is increased. They then form one or more swellings which may protrude through the anus.

Piles are fairly common during pregnancy because of pressure effects of pregnant womb on the veins, and the effects of the progesterone hormone which relaxes the walls of the veins. They are made worse by constipation and straining at the toilet.

To prevent hemorrhoids from getting worse the following measures would help:

• Eat high fiber diet such as fruit and vegetables. If the diet is not helpful, try to eat bran or other fiber supplements.
• Drink at least two liters of water or fluid a day. You will pass out most of the fluid as urine, but some remains in the gut to soften the stools.
• Do not drink too much coffee and tea. Caffeine in tea and coffee can sometimes make constipation worse.
• Avoid constipation and straining at the toilet. Go to toilet daily. As soon as you feel the urge to pass motions, do not suppress the feeling and go to the toilet later. This may result in bigger and harder faeces which are then more difficult to pass.
• Hemorrhoids may cause a feeling of 'fullness' in the lower intestine (rectum) and an urge to bear down. Try not to strain.
• Take a sitz bath for ten to twenty minutes 2-3 times a day. Soaking the buttock area in warm salt water can be very soothing. Ice pack or cold compresses may also reduce the swelling and pain.
• Kegel exercises increase blood circulation in the anus thereby decreasing the chances of hemorrhoids getting worse
• Avoid sitting or standing for long stretches of time.
• Various preparations of ointments, creams, and suppositories are commonly used to treat piles. They may ease symptoms such as discomfort and itchiness. Creams containing local anesthetic provide short-term relief.

It is unlikely that hemorrhoids will cause any problem during labor and they will not impede the passage of the baby through the birth canal. However, they may bleed during delivery. Your obstetrician may minimize damage to the anal region by doing an episiotomy carefully to reduce the risk of perineal tears during delivery.

Surgery is rarely necessary during pregnancy since piles usually resolve after delivery.