chatwithketch

Q Hello Dr Ketch! I have an issue that’s troubling me and I just want to know if I should be worried. Before I became sexually active, I had a manhood I was proud of in terms of length and girth even without erection. But, I discovered that it has shrunk. It’s now the size of a 7-year-old if not erected. I sometimes can’t feel it down there if am not aroused. I’m somehow comfortable it the size only when I’m sexually aroused. Anything to worry about?

A: The issue of penile length has been a problem forever and people generally think that bigger is better. Is it? The average penile length is about 8 to 13cm when not erect and this can be pushed up to 13 to 18cm when erect, give or take a few. Does the penile size determine whether a man can father a child or not? Absolutely not…penile size does not affect fertility.

A woman’s vagina is about 7.5cm and would lengthen to about 10cm when aroused and so, generally, there should be no problems with sexual intercourse as the average length of a penis can adequately cover this gap.

Now the challenge…a lot of men who think they are small in this area are actually within the average measures but perception can make them think otherwise. For instance, the only way they can assess the size is by looking down at it and this automatically makes it look smaller. If you looked sideways in a mirror, you might just think, it looks longer. Men who are fat also appear to have smaller penises because the fat around the stomach may hide part of the base of the penis, making it look shorter.
It does appear that guys with small penises achieve about 100% increase in length during sexual excitement, probably nature’s way of compensating as opposed to men with longer ones who may achieve about 75% increase in length.

There are all sorts of touted treatments that help increase penile length including surgery, vacuum pumps, extenders, creams, pills etc. There is little evidence that people who go through this are satisfied with the result or that they work. Indeed, some can cause permanent damage.

So, what to do?

Take charge…lose weight if you’re overweight and have a heart-to-heart chat with your partner about this. You just may be surprised to hear that she doesn’t care. If you still feel bad about this, you may try talking with your doctor.

That’s it, guys 😀  Have a good night y’all 😀

Q: Can I be cured naturally if I have cervical lesion?

A: Hello! Thanks for writing in.

I assume you mean precancerous cervical lesions. As the name implies, this is not a cancer but indicates an abnormality in the cells of the cervix that could, ultimately, become a full-blown cancer.

Common types of precancerous cervical lesions are:

Atypical squamous cells: This refers to abnormalities in cells of the cervix, referred to as squamous cells. Squamous cells are thin, flat cells that resemble fish scales. They are found in the tissue that forms the surface of the skin, lining of hollow organs in the body, and lining of respiratory and digestive tracts. Atypical squamous cells could be due to Human Papilloma Virus (HPV), which is a common sexually transmitted infection that is spread through sexual, skin-to-skin contact. There is a vaccine to prevent this cancer now. Please ask your doctor where you can get it. Health conditions associated with HPV include genital warts, cervical pre-cancer and other cancers. A repeat pap smear is usually recommended after some months

Atypical glandular cells, which could be suggestive of a precancerous lesions in the uterus or upper cervix. Glandular cells are located in the inner part of the cervix or the lining of the uterus

Squamous intraepithelial lesion refer to changes in the cervix that could be precancerous. High grade squamous intraepithelial lesions are more likely to progress to cancer of the cervix.

Pap smears can detect cervical pre-cancers before they become actual cancers. If pap smear is suggestive of precancerous cervical lesions, further testing procedures will be indicated. Further tests that could be requested include repeat pap smear, cervical biopsy, HPV testing, colposcopy (using a magnifying device to get a better look at the cervix).

Now to the crux of your question, can you be cured naturally? I guess the question you really want to ask, if there are treatment procedures that exclude surgery. Yes. Available treatment procedures involve destroying the abnormal lesions in the cervix using a cold probe to freeze them (cryotherapy) or using an electrically charged wire or using laser.  The surgical option, conization, involves surgically removing the area with the abnormal cells.

You need to have a long chat with your doctor to find out what options are available to you. Remember that the fact that you have precancerous cervical lesion does not mean that you will end up The earlier you get treatment, the better your chances of avoiding cervical cancer.

All the best!

Have a good night y’all 

Every year, lots of people ring in the New Year with resolutions but then end the year hardly making a dent in that list of plans. Well, if you want this year to be different, you have to go about your resolutions differently. This time, with an actual action plan! Read what Harvard Health suggests: https://www.health.harvard.edu/healthbeat/seven-steps-for-making-your-new-years-resolutions-stick

Q: Please Doctor find time to give me a response. God bless you

I am 29 after an active sexual life I stopped having sex but just last year after 11 months the last time I had sex, resuming sex practice has been painful for me which after having sex I have pain and my vagina suffers inflammation on the body of the two inner closure of my private part and it is becoming disturbing to me and my partner. Please what could be the cause or prevention to it?

A: Pain during sexual intercourse is more common with women but can also happen in men. The first question above was sent in by a woman and the second one was sent in by a man. This condition is called dyspareunia in medicine.

Dyspareunia is a condition in which one experiences pain during or after sexual intercourse. In women, the cause may be due to:
• Vaginismus: a condition in which the vaginal muscles go into spasms when an attempt is made at penetration.
• Lack of adequate lubrication eg due to hasty foreplay etc. This will be discussed some more at the end of this post.
• Infections of the vagina (like candidiasis as mentioned in the question) or urinary tract can also cause pain during sexual intercourse.
• Injuries/wounds to the vagina
• Emotional issues like stress or emotional disconnect from partner.
• Fibroids around the vagina or cervix

In men, the cause of this problem could be due to:
• Infection of the urethra (the tube which conveys urine from the bladder out of the body and also conveys semen out during ejaculation)
• Infection of the prostate gland.
• Infections, some of which may be due to STI
• Emotional issues may also be involved eg feelings of guilt.

Treatment depends on cause. If due to infections, they have to be treated. If it’s due to lack of lubrication, that has to be handled. Some lubricating gels may be suggested. If no physical cause can be seen and the problem appears to be emotional, some counseling may be required. Understanding that when people get married, they are actually two ‘strangers’ trying to get to know each other, should form part of the incentive for slowing down and trying to find out what pleases each member of the union.

For related topics, please click on https://chatwithdrketch.com/2014/08/22/daily-health-tips-why-am-i-not-into-my-husband/

I will spend a little time on vaginal dryness or inadequate lubrication. Vaginal dryness can occur due to variety of reasons and at any age. Usually the vagina has a thin film of fluid that coats it. This fluid helps lubrication during sexual intercourse, maintains the normal environment of the vagina preventing the overgrowth of organisms like fungi, flushing out dead cells and menstrual blood. The level of this fluid/moisture varies with the level of estrogen released in the body. During sexual intercourse, there is increased blood flow to the vaginal area leading to an increase in the volume of moisture. During menopause, however, the level of estrogen is very low leading to vaginal dryness, loss of elasticity and thinning.

The main consequence of vaginal dryness is the fact that it affects sex life such that these women experience significant pain and sometimes, bleeding. Other problems that vaginal dryness could cause include soreness, itching and burning around the vaginal area, recurrent urinary tract infections and frequency of urinating etc.

There are other conditions, other than menopause that can lead to low estrogen and consequent vaginal dryness. They include childbirth, breast feeding, cigarette smoking, some medications (like anti-estrogen drugs used to treat cancer) and douching. Douching refers to the practice of cleaning the vagina with a ‘cleansing’ fluid. For more on this topic, please click on this link: https://chatwithdrketch.com/…/daily-health-tips-what-is-dou…/

Other very common causes of vaginal dryness include a lack of foreplay during sexual intercourse, feelings of guilt, relationship issues, allergy etc

Treatment depends on cause. If it’s due to low estrogen, the focus would be on replacing this either through Hormone Replacement therapy or through the insertion of estrogen pessaries (tablets, cream or ring) into the vagina) should help. If due to rushed foreplay, there should be a conscious effort to slow down allow enough time for foreplay and sometimes, discussion with the partner may be helpful. Avoid heavily perfumed products like sanitary towels, tissues etc which may lead to irritation of the vagina and subsequent dryness etc.

Use of vaginal moisturizers can also help. Vitamin E may be useful as a vaginal moisturizer with the gel rubbed on the vagina.

Please discuss these with your doctor and don’t be embarrassed to discuss your symptoms with him 😀

I hope this helps.

‘A study shows that, for many people, less is more when it comes to vitamin D.‘ Now what do you think about that?! Read!

https://www.health.harvard.edu/staying-healthy/too-much-vitamin-d-may-harm-bones-not-help

Dear all, it is the season for the sniffles again. it always boggles my mind how the hygiene practices that we take for granted are not really known and practiced by everyone. For instance, sneezing or coughing into ones hands and then going around touching doors, shaking hands and touching other surfaces is a quick way of sharing ones germs with others. Please don’t do that! A reminder class below on how not to share your germs with others:

Okay…so no one loves to have the sniffles; carrying tissues around and sneezing/blowing our noses into tissues and just feeling miserable! We hate even more when we are in the uncomfortable position of ‘rejecting’ a handshake because we want to avoid getting infected by someone who has the flu.
Here are top tips for escaping the cold and flu as it makes its rounds:

• Wash Your Hands: Wash your hands with anti-bacterial soap for at least 20 seconds…time taken to sing happy birthday twice. Use safeguard soap and this will not only remove millions of bacteria but stop their re-growth for at least 12 hours. Dry your hands thoroughly.

Get a flu shot: This may not be perfect and certainly does not protect everyone, but you do have more of a chance of beating the flu with it than without it

• Live healthy: A balanced diet, regular sleep and exercise work wonders for your immune system and helps you resist the flu.

• Cover your cough: Don’t sneeze into your hands…you’re more than likely to see someone you know and shake them soon enough…spreading your germs. Rather sneeze or cough into the crook of your arms. This limits significantly the spread of germs.

• Give that immune system of yours some extra boost by:Taking a break from stress. Stress messes with your ability to stay healthy, especially during cold and flu season. Try taking a mini meditation break during the day – just close your eyes and focus on breathing in and out for a few minutes.

Trying to stick with a bedtime. Consistently getting eight hours of sleep a night gives your body the chance to repair cells and build up your immune system.

Please spread this news and let’s stop the spread of these nasty viruses 😀

Happy New Year Fam.

I trust the year has started well and you are all set to impact your world this year and decade!

And now, our question for today which is the second part of a question I addressed last week, I believe.

Q: I have pains from my left shoulder to fingers most time and slurp (I assume this means drool) morning saliva. I am 65 years. Please can you give tips of stroke and signs?

A: Stroke as the name implies refers to an incident that happens suddenly…without warning. It usually occurs when the brain is deprived of some of its blood supply and consequently oxygen supply. This can happen when there is a blood clot in a vessel in the brain or due to a burst blood vessel leaking blood onto the substance of the brain or around the brain. This blood leakage can lead to undesired pressure on the brain.

Oftentimes, people refer to a Transient Ischaemic Attack (TIA), as a partial stroke. This condition occurs when a blood vessel is partially blocked. This would usually be resolved within 15 minutes and is a sign that a major event (a stroke, proper) may not be far off. This is a warning that should be taken seriously.
It is important to know the signs of a stroke because if action is taken immediately, it can prevent permanent damage from being done. If the brain is deprived of its blood supply for about 4 minutes, irreversible changes begin to occur in the brain. If this deprivation continues beyond this time, permanent changes would have occurred that may affect different facets of the individual’s functions.

The signs of stroke to look out for are known by the acronym FAST.
• F stands for drooping of a side of the face. Ask the patient to smile and you will observe that the smile looks lopsided.
• A stands for arms – weakness of one side of the body. Ask patient to lift both arms and it will be seen that one side is being ‘dragged’ or lagging. Symptoms like yours located on one side of the body are therefore suspicious. I suggest you get a doctor to check you out properly.
• S stands for speech difficulty like slurring. Patient cannot enunciate words properly again
• T stands for time. Once these symptoms are noticed, it’s time to call for help. In climes where there are emergency numbers like 911 or 999, please call these. Otherwise, efforts should be made to take the person involved to the hospital immediately.
Patients may also complain of sudden inability to move legs, feel confused, have blurred vision etc. Symptoms like yours located on one side of the body are also suspicious. I suggest you get a doctor to check you out properly.

There are risk factors for stroke and they include:
• Age: The older you are the more prone to stroke. People from age 55 years are more likely to have a stroke, though this can also happen in children eg those born with heart defects and those with Sickle Cell Anaemia etc
• Race: Africans and Asians are more at risk
• Sex: Females are more at risk…as if we don’t have enough problems
• Family history of stroke: The presence of this increases risk
• Previous history of a stroke.

Other risk factors:
• Hypertension
• Diabetes Mellitus
• Overweight
• Sedentary lifestyles
• Not eating healthy
• Smoking
• Drinking Alcohol

The rate at which one recovers from stroke and indeed the degree of symptoms experienced, depends on the area of the brain affected, how serious the damage to the brain is etc and so recovery will be different for different people.

Patience is key. Speech therapists may be needed to help the person re-learn the art of speaking. Physiotherapists will help improve motion on the affected side and indeed, mobility. Other therapists may help with eating…if swallowing is a problem, relearning the art of reading and reasoning etc

Usually, people who visit find it difficult to understand their speech during recovery and this can put even more pressure on the patients. Speak slowly and listen carefully so you can understand what they are saying.

Generally eating healthy with lots of fruits and vegetables, cutting out the white carbs (pastries etc), exercising (at least 150 minutes weekly), ensuring you are not overweight and quitting smoking help with reducing bad cholesterol and also preventing strokes.

The person recovering from a stroke may need to walk with a stick as s/he re-learns the art of walking. Recovery may be long and tedious but s/he’s got to keep at it.

I hope this is helpful

Have a good night, people 😀

Dear Family,
As we come to the end of the year and decade, I reflect on my journey.

Where I’ve been and what I’ve seen.

Where I succeeded and where I failed.

What I feared and the strengths I developed

If I had to say anything to my 10-year younger self, it would be: Go on! Dare to do it! Do it afraid! Whatever you do, just do it!

My journey could have been faster but who knows, i may not have learnt as much as I have. I may not have dared to dream the dreams I have dreamed and may not have achieved what I have.

And so, as I stand on the threshold of a new year and new decade, I urge you as I urge myself to dream dreams that are so big that they scare you and then get to work achieving them one at a time. There will be obstacles (expect and anticipate them) but when they come, understand that you will overcome them – spend time to understand the challenge, and then find a way to deal with them or work around them. Sometimes, you may fail, but that’s okay too – make sure you learn from them and ask yourself what you would do differently another time.

Happy New Year and bon voyage as we wait to take the first step into the new decade! If you have already taken that first step, Godspeed!

With Love,

Dr. Ketch

Q: My questions are what signs & causes of a low sperm count & watery sperm? Do they have any remedy? Can they fertilize egg?

A: Thanks for writing in.

One of the causes of ‘watery’ sperm is pre-ejaculate (a lubricating fluid) which may contain some sperm cells. It is believed that the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is thought that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations. Diets poor in protein, frequent ejaculation as occurs in people who masturbate and exposing the testicles to high temperatures like in saunas could lead to a watery consistency of semen.

Just to be sure you do know what normal semen should look like, below is a guide.

Using WHO reference values, a normal semen sample should fulfill the following:

• Volume amount of sperm produced in one ejaculation): Greater than or equal to 1.5 ml
• pH (whether acidic or alkaline. If less than 7, it’s acidic and greater than 7 is alkaline): Greater than equal to 7.2
• Viscosity (being semi-fluid):  viscous
• Transparency: opaque
• Motility (percentage of sperm that move forward normally):  This should be more than 40%
• Morphology (percentage of sperm that have normal shape): This should be greater than or equal to 15% normal, oval sperm heads
• Liquefaction (time taken for the semen to become ‘liquid’): This should be complete within one hour
• Pus cells should be less than 1 million/ml or less than 5/hpf
• Total sperm count: This should be greater than or equal to 15 million.

The causes of low sperm count, which is often considered a cause of watery sperm, could be medical, environmental or due to lifestyle issues. Sometimes, the cause(s) can, also not be identified.

Medical causes include infections like gonorrhea and chlamydia, certain drugs used for cancer and fungal infections, hormone imbalance, undescended testes, varicocele (swelling of veins that drain the testicle) and cancer.

Environmental causes include over-exposure to industrial chemicals, heavy metals and X-rays; over-heating the testicles by frequently using the sauna and hot tubs; prolonged bicycling

Lifestyle causes include alcohol use, tobacco smoking, illegal drug use, obesity and emotional stress.

To get a woman pregnant, a man has to have at least 40 million sperm per ejaculate. People with low sperm count usually have less than this.
If you have been diagnosed with low sperm count, then do something about it. Here are some tips that could help to improve your sperm count. Treatment is generally based on the cause:
Stress has been found to contribute to infertility problems such as hormonal issues. So, prevent excessive stress and perform relaxation exercises. Remember that infertility and life in general can be stressful. Learn to relax.

Stop smoking because smoking significantly reduces both sperm count and the movement of sperm cells.

Prevent overheating of the scrotum: When scrotal temperature rises (caused by tight underwear, long stays in a sauna or Jacuzzi, for example) sperm production can be impaired.

Maintain a healthy weight: Not too under or overweight since weight influences estrogen and testosterone levels.

Stop using drugs: Prolonged use of recreational drugs (for example, alcohol, marijuana, cocaine)

If you have infections like gonorrhea and chlamydia, these need to be treated.

Surgeries can be done for varicocele and cancers. Radio and chemotherapy are also treatment options for cancer.

Medications or hormone replacements can be used for hormonal problems.

The major challenge with low sperm count is infertility. Sometimes, the treatments listed above do not work, especially when the cause is not known. But IVF is an option that exists for this group of people.

So, first thing is to confirm from the doctor what exactly the cause of the low sperm count is (if known) and then review your options from there.

All the best.

‘Women at high risk for breast cancer might benefit from taking medication to prevent the disease, says a new recommendation from the U.S. Preventive Services Task Force (USPSTF), a national group of experts’

Want to know more? Read! https://www.health.harvard.edu/womens-health/high-risk-for-breast-cancer-you-might-benefit-from-preventive-medication