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'I am 44 and recently developed a problem with my penis'

Q. I am 44 and recently developed a problem with my penis. When it becomes erect, it is not straight but quite tilted to the right. And the penetration is also quite painful. What is my problem?
— Tilted
A. Please remember that little curvature of the penis is a normal phenomenon and does not affect the vaginal penetration. In your case, there is definitely some constitutional pathology responsible for the curvature. The most common cause for this type of curvature at this age is Pyronie’s disease. However one needs to rule out the evidence of plaque in the penis by colour Doppler examination by a radiologist. There are oral medications available but are of doubtful value. You may need a surgical intervention.

Q. My husband never uses a condom. He always takes his organ out just before he ejaculates. But is this safe enough to avoid pregnancy? Which is the safest contraception?
— Safe Method
A. This is known as “coitus interruptus” where the man pulls out his penis from vagina prior to reaching orgasm. This is not a very safe method for contraception. Sometimes, a drop or two of semen may ooze out without a man’s knowledge which may contain sperms and may lead to conception. The best contraceptive method would be to use a condom. Though your husband does not like it, you can explain to him that in reality the pleasure component of sexual response is hardly hampered by wearing a condom. The real pleasure at the time of orgasm is experienced between the two ears and not between the two legs! The next choice for contraception would be using a low dose oral contraceptive pills (for women) which you can start as per your doctor’s advice. Please note that when you start oral contraceptive pills; in the first cycle you need to use an additional protection like condom for the initial 10 days. In the subsequent cycles, additional protection is not needed.

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