Dr Ann Robinson on bigger, better erections

Problem patches

Q I am bombarded by unsolicited emails and pop-ups promising bigger, better erections. The latest advertises a skin patch that you can change every three days. Is there any harm in trying one?

A Is there anything wrong with your erections? If you do have a problem, there are far more effective ways of dealing with it than patches that claim to deliver extracts of herbs such as ginseng and saw palmetto into your bloodstream. Are you unsure of a relationship, depressed or preoccupied with work, rather than worried about the size or shape of your penis? Sexual function can also be affected by drugs, especially alcohol and those for high blood pressure, conditions such as diabetes and operations on the prostate gland. If you do fancy trying the patches, they are unlikely to cause any harm.

Iron shortage

Q I first suffered from iron deficiency throughout my pregnancy. Nine months after giving birth, I am still taking two iron tablets a day to treat my anaemia, yet oversleep on a daily basis. My GP sent me for a blood test, which indicated that I was one decimal point away from being anaemic. I eat a normal diet and fit in exercise time around my son. However, is there anything I can do to boost my iron levels? I don't want to have to give up work.

A No one should keep taking iron tablets indefinitely without being sure of needing the extra iron, and why. A blood test to measure the stores of iron in your body (ferritin) is important. If your iron stores are still low and your full blood count suggests a persistent iron-deficiency anaemia, either you are losing blood at a rapid rate and need to find the source of blood loss, or you are not absorbing all the oral iron you are swallowing. Common sources of blood loss are heavy periods or blood in the stool from piles, stomach ulcers, hiatus hernia or other bowel disease. A normal diet should provide enough iron for daily needs. But tea and antacids (such as Rennie) can bind to oral iron and make it harder to absorb, whereas vitamin C speeds up its absorption. Some individuals just don't absorb oral iron efficiently and need iron injections to top up their levels. Take a haematologist's advice before opting for this option.

Painful pudenda

Q I am a 28-year-old woman and for the past year or so have been suffering from vaginal discomfort, especially in the vulva. At one point I also had a rash in the perineum, which has not returned. I have had tests performed by the Well Woman Centre for herpes, gonorrhoea, thrush and chlamydia as well as physical examinations and all were clear. One doctor suggested that it might be stress related. I don't use perfumed soaps, just aqueous cream, and wear cotton underwear.

A A surprising number of women have long-standing and debilitating vulval pain, usually after the menopause. The discomfort may extend to the perineum, buttocks and rectum. The fancy name is "vulvodynia" and many doctors don't even know about it. Some women also find touching the entrance of the vagina so painful that using tampons and having sex become impossible. Stress can't be the sole cause but may be a contributory factor. An antidepressant drug that can block nerve pain, amitryptyline, is often prescribed. The pudendal nerve that carries pain messages from the vulva to the brain can be decompressed by a specialist to numb the pain; acupuncture and reflexology are less invasive approaches. I would request referral to a health professional who knows about the condition.

· These answers should never be used as a substitute for seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.

Thanks to guardian.co.uk who have provided this article. View the original here.


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