Dear Doc | Help, I have 'man boobs'

Q Hello, Doc. I'm a man in my 20s and suffering from 'gynaecomastia' - man boobs, or 'moobs'.

I started noticing this problem as a teenager. I don't have a big belly, so I suppose the 'moobs' are more noticeable. I really, really need your help!

A Sorry to hear about this. Although a lot of people laugh (somewhat unkindly) at the idea of 'man boobs,' they can be the cause of much distress to men.

Unfortunately, these swellings can make activities such as going to the beach and swimming quite embarrassing.

What causes them? Well, most doctors will tell you that they are fat deposits - mostly caused by being overweight. But in addition, it appears that in some men, the male hormone (testosterone) is for some reason partly converted to the female hormone (oestrogen) - and oestrogen is well known for increasing the size of breasts.

Rarely, other factors may be involved. For instance, a few medically prescribed drugs can encourage formation of man boobs. These include medications for prostate problems, some anti-ulcer drugs, and some major tranquillisers.

Also, recreational drugs such as marijuana (weed) and heroin can occasionally cause male breast enlargement.

Now, what are you going to do about your 'man boobs? Like many doctors, I would advise you to lose weight. Admittedly, you say that you do not have a big belly. But I guess you should check your body weight against standard 'height-weight' tables. If you do weigh appreciably more than average, it would help if you slim down!

Are there any medications which would assist? Occasionally, doctors prescribe drugs which are normally used to treat female breast cancer, in order to try and shrink the swellings. These are agents such as Soltamox (tamoxifen) and Evista (raloxifene). But this is controversial territory, and you might have difficulty in finding a medic who would give you that therapy.

Finally, we come to surgery. One form of this is liposuction - in which the fat is sucked out of the man boob. An alternate is mini-masectomy, in which a surgeon cuts the breast tissue away completely.

So, there we are. It is up to you to choose what to do. I wish you luck in defeating this embarrassing problem.

Q Doc, I am a 30-year-old woman and I have trouble with my boyfriend of three years. A few months ago, something happened between him and me, causing me to get fired from my job. So I lost trust in him.

Now I keep seeing his posts on Facebook, giving out his number to other women. Also, he is telling me about his female friend from church who he goes out with, and who he is thinking of having sex with.

Should I cheat on him, before he cheats on me?

A Please stop and think carefully. What good would cheating on him do? It might briefly make you feel better, but that is about it!

It most certainly would not improve the situation with your boyfriend. Also, by involving another man, you might end up with a lot more problems with him (and maybe with his current girlfriend too, if he has one).

To me, it seems like this bitter relationship with your boyfriend is almost over. I do not see how continuing it can bring either of you any happiness. Why not just 'cut your losses,' move out and move on?

Q I am a man, and my left hand shakes badly at times. What do you think, Doc?

A This is a little outside my usual field, but if you are over 50, you should certainly go and see a doctor. He will examine you to see if you have Parkinsonism (Parkinson's disease).

But in people who are young or middle-age, the most common cause of a shaking hand is just nerves. However, I still feel you should see a doctor and have them look at your tremor, and see if they can help.

Other, less common causes of a shaking hand include:

- Alcoholism;

- Certain drugs, notably some antidepressants;

- Thyroid disease;

- A condition called 'familial essential tremor.'

The sooner a doctor sorts this out for you, the better.

Q I am puzzled by the fact that when men have sex with me, I don't feel the 'jet' of sperm hitting my cervix.

Yet I have read books where the woman feels that powerful surge, Doc. Is there something wrong with me?

A There are certainly books (mostly written by men) which suggest that a woman should be able to feel the actual 'spurt' against her cervix when her partner discharges.

I am doubtful whether this is true. The cervix is not a very sensitive region of the female body. For instance, if a doctor or a nurse prods it with an instrument, she will often feel little if anything at all.

So I really don't think that anything is wrong with you.

Q Recently, I have had very poor erections, even when I am having sex with a very exciting woman.

For some reason, my own doctor will not give me Viagra and things like that.

But he does want me to try something called 'Muse'. What is that?

A Well, Viagra is not safe for everybody. Muse is often quite a good treatment for men who have erectile dysfunction (ED), but can't take Viagra.

Muse is manufactured in the form of a tiny pellet, which you drop into your penis just before you are going to have sex. It widens the blood vessels, and so causes an erection.

If your doctor thinks it might work for you, do give it a try. It is very important that you urinate before you put it in.

Q Dear Doc, I am a 45-year-old female and my periods are coming every other month. Is this healthy?

A Yes, this sounds OK. In a lot of women, the menses just get farther and farther apart during their 40s.

But if you ever get irregular or heavy or continuous bleeding, you should have yourself examined by a doctor.

Q How much fluid should a 31-year-old man produce at the end of sex, Doc?

A The average is about 5cc (5 ml), which is only a teaspoonful.

Q I am a woman who has a huge problem. My current partner and I had unprotected sex; he withdrew when he was about to discharge, then re-entered a few minutes later.

Four days before that, I had unprotected sex with my ex. He says he discharged inside of me. That was the week that I was ovulating.

Now I am pregnant! But I have no clue who the father is.

A This story is an illustration of the well-known principle - never have sex with your ex!

I am sorry to tell you that either of these two men could easily be the baby's father. You will just have to wait until the baby is born, and then try to arrange DNA tests. Sorry.

deardoc@gleanerjm.com