Questions about sex and health

Reader questions about sex, relationships, and health answered by experts: case analyses, anatomy, potency, contraception.

Why do doctors take so long to figure out the cause of my intimate pain, and sometimes even say I'm imagining it?

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Answer

This is indeed a common situation. Vulvovaginal pain is not a single disease but a group of conditions, and often a single symptom can have various underlying causes: inflammation, neuralgia, or muscle tension. Moreover, there may be no visible changes—tests are normal, but pain persists, so a doctor unfamiliar with such cases might mistakenly say it's all in your head. But it's not: it's important to find a specialist in pelvic pain and not give up, asking about treatment options, physical the...

I live far from doctors and fear judgment. Can I buy PrEP online myself and how not to harm myself?

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Answer

Unofficial PrEP means obtaining HIV prevention drugs without a doctor, for example, via the internet. This is risky, as an incorrect dosing schedule can make the virus resistant to the medication. Research shows that for many, this is the only accessible way to protect themselves, but the best option is to try to find an official path: talk to a doctor or learn about support programs. If the system fails you, it is at least important to study information and be cautious. Only a doctor can provi...

Why are STIs increasingly found in people over 50 if they are not sexually active?

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Answer

In fact, many people over 50 feel great and full of energy, so their sex life can be active. Additionally, with age, mucous membranes become thinner and the immune system weaker, which facilitates the entry of infections. Even if it seems that 'this is not about me,' protection is needed at any age. If you have doubts, it is worth discussing this with a doctor — a general practitioner can also help and provide guidance.

Why do I have erection problems despite normal total testosterone?

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Answer

It could be due to free testosterone — its inactive form that is bound to proteins, and it is the free fraction that affects erections and libido. In a study, men with low free testosterone were more likely to have problems, even when total testosterone was normal. Ask your doctor to check free testosterone using a direct method rather than a calculated one, as formulas may underestimate the real picture. However, note that this study showed an association but not causation, and only a speciali...

Я начал принимать тестостерон, но уже несколько месяцев не вижу изменений. Это нормально или что-то не так?

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Answer

This is completely normal, as changes occur gradually rather than all at once. Each person has their own timeline, and comparing yourself to others' schedules found online is not advisable. If you are concerned about the pace, you can discuss with your doctor the possibility of adjusting the dose or switching to a different form of the medication, as the protagonist of the article did. It can also be helpful to shift your focus from anticipating results to what you can control, such as taking u...

I'm afraid that hormone therapy after menopause will cause breast cancer. How justified is this fear?

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Answer

This fear is often based on old data, but modern therapy using natural hormones and proper selection is associated with a much lower risk of breast cancer than commonly thought. Exact numbers depend on the type of treatment and its duration, but for many women the benefits of therapy outweigh the risks. It's important to understand that the decision must be made individually with a doctor who will assess your medical history and risks, and that self-medication is not acceptable. If you are conc...

Как выбрать человека, которому можно рассказать об абьюзе, и как подготовиться к разговору, чтобы не стало хуже?

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Answer

Идеальный первый собеседник — тот, кто уже проявлял беспокойство о вас или ваших отношениях, например, друг, говоривший, что что-то не так, или человек, сам переживший подобное. Если такого нет, обратитесь к психологу или консультанту на горячей линии. Главное, чтобы человек не был тесно связан с обидчиком, иначе он может защищать его или сомневаться в ваших словах. Перед разговором установите правила: попросите не сомневаться в вашей правде, не оправдывать абьюзера и сохранять всё в секрете. Н...

I heard that microplastics were found in the penis. Could this be a cause of erectile dysfunction?

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Yes, in one study, microplastics were found in the penises of men with severe erectile dysfunction. Scientists suggest that microplastics may disrupt hormonal balance (lowering testosterone) and impair vascular function, which can affect erections. However, these are still preliminary findings, and most research has been conducted on animals. If you are concerned about erectile dysfunction, it is important to see a doctor rather than self-diagnose.

Правда, что сквирт — это просто моча?

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Answer

По составу сквирт отличается от мочи: в нем меньше мочевины, мочевой кислоты и креатинина, зато есть простатспецифический антиген и глюкоза. Поэтому это не моча, а отдельная жидкость. Однако из-за похожего запаха многие ошибочно думают иначе.

Is it true that men who watch porn more often suffer from erectile dysfunction, while women, on the contrary, do not?

Editorial

Answer

Yes, that's correct. Research shows that in men, frequent porn viewing is associated with a higher risk of erectile dysfunction and reduced sexual satisfaction, whereas in women, no such association is found—in fact, they more often report better sexual functioning. Scientists explain this by noting that men tend to perceive porn as instructions, which can cause anxiety when reality does not match, while women more often use it to expand boundaries. If you notice that porn is negatively affecti...