Dear Doctor

Dr Ann Robinson on reversing a vasectomy, daily headaches and body odour issues.
  
  


Can I still have a baby?

Q I'm 41 and recently married for the second time. My wife is 28. After the birth of my second child - during my first marriage - at the age of 32, I had a vasectomy. I was told then that it might be possible to reverse it, but that any attempt should be made within 10 years. My new wife says she might like to have children. What I'd like to know is, can sperm be surgically extracted from my testes and used for artificial insemination?

A Your GP can put you in touch with a urologist specialising in male fertility. Vasectomies can be reversed after any length of time, but success is not guaranteed. Failing that, advances in a male fertility technique known as ICSI mean that sperm can be extracted from the testes and used to fertilise an egg.

Rotten headaches

Q I suffer from daily headaches affecting both sides of my head at the temple. It feels like a tightening pressure band. I don't get flashing lights or vomit, so I've been told it's not migraine. I've no idea what makes it worse and nothing seems to make it better. I used to live on painkillers, but my GP told me to stop them as they can make it worse. I can't say I've noticed any difference. Have you any ideas? I'm getting desperate.

A Abour 4% of adults suffer daily headaches over long periods. At least half of them have a similar problem to you: chronic tension-type headache (CTTH). It often runs in families, gets better as you get older and can start in childhood. You're right to ditch painkillers. but if you don't mind drugs, the anti-depressant amitriptyline may be your best bet. It can make you sleepy, cause a dry mouth and occasionally weight gain.

Alternatively, relaxation therapy uses exercises, meditation and training. And in EMG biofeedback, you are wired up so that the clenching of your forehead and neck muscles emits a sound that is amplified and fed back to you via headphones or a loudspeaker. You learn to reduce the noise by relaxing the clenched muscles.

A vile smell

Q I have a distressing problem. After sex, I have a fishy smell from my vagina which I have been told is due to bacterial vaginosis. I also sometimes get a smelly discharge. A course of an antibiotic, Flagyl, does the trick for a few weeks, but the problem returns. It's putting me off sex - although my partner says he doesn't really notice the smell - and is making me lose my self-confidence.

A Bacterial vaginosis is caused by a mixed bunch of bacteria that can gain ascendancy in the vagina over useful bacteria (lactobacilli) which produce hydrogen peroxide. The lack of this disinfectant-like chemical means the vagina isn't as acidic as it should be and the smelly bacteria take hold.

Antibiotics wipe out the smelly germs but don't restore the vagina's acidity or replenish the lactobacilli. Eating live yoghurt containing lactobacillus, heaping it into the vagina or taking supplements of it help some women. But it's not the perfect panacea. Long courses of antibiotic tablets or vaginal creams may not work either. Research is centring on finding ways to restore lactobacilli to the vagina. Meanwhile, try to avoid vaginal douches, bubble baths and soap, which can cause irritation. Try aqueous cream instead of soap, and Aci-jel vaginal gel, for a few days after each period. Using condoms may lessen the smell after sex. If you are seriously turned off sex, consider a few sessions with Relate (tel: 01788 573241) who offer psycho-sexual counselling.

· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and 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.

 

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