During sex, where do the fluids come from? Is it urine? Why are some women perpetually dry?

Mike

Dear Mike,
Even when not sexually aroused or engaging in sexual intercourse, the cervix and vaginal canal produce fluids to keep the canal moist and lubricated at all times. The fluids also help keep the canal healthy by removing worn out lining cells, dead or excessive microorganisms that include bacteria and fungi.

During sexual intercourse, there is an increase in genital blood flow, which causes swelling of the genitals with fluid (transudate) being pushed out of the contained blood vessels to further lubricate the genitals.

A woman’s lubrication may, however, be affected by fluctuating levels of the female hormone oestrogen, so that towards or after menstruation when the levels of female hormone oestrogen are low, a woman may be less lubricated.

Lubrication may also be compromised during menopause, breastfeeding and when a woman is on hormonal contraception.
Also, lack of proper foreplay, use of certain drugs, and a woman’s emotional state such stress may make a woman dry during sexual intercourse. That said, naturally, some women may be more lubricated than others regardless of the above conditions that affect lubrication.

What you are calling water is a fluid produced by skene’s glands that lie around the urethra and open around the urethral opening. These are thought to be akin to the male’s prostate glands with some being more prominent and more efficient at producing water than those of others.

The skene’s glands water production can also be affected by the said factors so that a woman’s lubrication is affected by factors such as foreplay, hormones, drugs and emotional state. It is, therefore, true that a woman may be more lubricated at particular times.

This is also why some women are perpetually dry. Although a few women who have urinary incontinence may leak urine during vaginal penetration or orgasm, the urethral taps called urethral sphincters are normally tightened in both men and women during sex so that acidic urine does not accidentally escape and mix with semen killing the reproductive sperms.

Can a person who is not coughing be treated for TB?
Winnie

Dear Winnie,
Tuberculosis (TB) is an infectious disease that usually affects the lungs leading to chronic cough (sometimes coughing blood), weight loss, fever and night sweats, among many other symptoms.

TB can affect other parts of the body such as the kidneys or coverings of the brain without causing cough but the said or other symptoms depending on the affected area. This, despite occurring without cough, will require treatment to stem ill health and death.

TB that makes one sick with symptoms and signs (active TB) requires treatment without which it may not only be fatal but may spread to other people. Some people may have TB germs in the body which are neither active nor infectious (latent TB) but this under certain conditions may become active TB, making one sick thus spreading it to others.

Therefore, if one is found to have latent TB, even if they are not coughing, they should be treated. TB treatment helps save the victim’s life apart from preventing spreading it to other people.

Much as not everyone with latent TB will have it turn active, people with HIV, diabetes, or people with conditions that reduce the ability of the body to fight disease (immunosuppressed) may be at risk of the disease (TB) turning active and, therefore, requiring treatment the most. Also, people living with HIV infection, especially when their viral load is high and CD count low require TB preventive treatment even when they have no symptoms of TB as their doctor may see fit.

I am 22 but have two growing teeth from the jaw bone making it a total of 30 teeth. I know someone above 18 years of age should have 32 teeth. Am I normal? Lawrence

Dear Lawrence,
While most babies get their first teeth at around six months after birth, one out of every 2,000 new born babies may be born with one or more so-called natal teeth. Although tooth eruption occurs at different times for different people, generally humans have 20 primary (baby) teeth which at six years start falling out only to be replaced by 32 permanent teeth of which the last to erupt are the wisdom teeth.

Wisdom teeth, usually four in number, one in each half of the jaw come between the ages of 17 and 25. So, it is perfectly normal for you at around 18 years to grow two more teeth, making the total number of teeth 30. You are yet to grow two more wisdom teeth, which should arrive before you turn 25.

There are small pimples growing on the skin of my penis. How can they be treated?

Sam

Dear Sam,
Pimples result from blockage and inflammation of oil glands of the skin including skin that covers the penis. Pimples including those developing on the penis are usually harmless, may appear at the time of puberty and in many cases, disappear as one grows older, therefore requiring no treatment.

Tight-fitting clothes, excessive sweating, shaving, poor hygiene and oily skin risk one getting the pimples and therefore these may need to be addressed. Oil glands are usually associated with hairs and much as the hairs naturally lie at the base of the penis, removing too much skin during circumcision can pull up the hairs to the penile shaft taking the pimples up to the shaft as well.

A number of men with hair on the penile shaft try as much as possible to shave the hair, resulting in the hairs growing backwards towards the penile skin (ingrown hairs) piercing it and leading to pimples.

Another cause of penile pimples that is normal and is no cause for concern is pearly penile papules, which appear in rows of bumps lining the edge of the penile head (glans). These akin to other animals’ penile spikes are thought to increase sexual pleasure. Men with allergies may develop a rash on their bodies including on the penis and this may especially happen when one is allergic to vaginal fluids, condoms or scented soaps.

If the pimples are painful, you may have developed herpes simplex, an STD that requires treatment as it is likely to disappear and return much often. Another STD called Human Papilloma Virus can cause penile pimples both inside and outside the penile foreskin. Please do not press the pimples before seeing a doctor as they are likely to grow bad scars or if they are sexually transmitted, they are likely to spread the infection.