Ask the Doctor: Causes and treatment of genital warts

I have developed pain-free swellings on the foreskin of my penis. What is the cause and how can they be treated? John

Dear John,
What you call pain-free swellings on your foreskin are growths due to certain types of Human Papilloma Virus (HPV). Medically, the growths are known as venereal or genital warts. Much as genital warts may be annoying or ugly to look at, they usually disappear without treatment and if they do not, then treatment can be effected.

One can get genital warts from skin-to-skin contact with an infected person, often during vaginal, anal or oral sex. Much as warts are sexually transmitted, it may be difficult to pinpoint the person who transmitted them because they can appear in a person who was infected before the person who infected them shows any signs.
Warts can be prevented by vaccination, especially in virgins or those tested and found not to have them. That said, even babies may get them from their infected mothers during vaginal delivery.

Also, minimising sexual partners can help. Condoms are not 100 per cent effective in preventing warts since the skin of the pubis or testicles could be infected and get in contact with the sexual partner’s other body parts.
Please visit your doctor for help and while there, get checked for other sexually transmitted diseases as well.

What determines a person’s gender?

Can what is happening to Kester Semenya be explained medically? Winnie

Dear Winnie,
The type of genitals, physical build, one’s chromosomal compositions, sex hormone concentrations and gender orientation all combine to determine one’s gender. Although it is usually easy to decide whether a person is male or female by looking at the external genitals, in some, the genitals may not easily indicate whether one is male or female hence being called intersex.
Intersex people are born with variations in sex characteristics including chromosomes, gonads (ovaries/testes), sex hormones, or genitals that do not fit the real definitions for male or female bodies hence creating confusion about whether they are male or female.

The athlete you are referring to is said to have neither a womb nor ovaries, but instead has internal testes because of a chromosomal abnormality and should therefore be labelled an intersex. She also has been said to have testosterone levels three times higher than is expected in women due to a condition referred to as hyperandrogenism.
Male hormones (Androgens) are also present in females where they are produced in the ovaries, adrenal glands and fat cells. Excess amounts of androgens (hyperandrogenism) can result in symptoms such as acne, beards, and balding but can also give a woman athlete an unfair advantage because of being linked to lean body mass and increased strength, speed and power. In order to compete fairly then one has to take medications to reduce the male hormone.

Although most hyperandrogenism is caused by presence of small water-filled sacs in the ovaries (polycystic ovary syndrome) adrenal hyperplasia, Cushing’s disease, certain types of cancers, and certain medications, certain genetic syndromes can also cause the problem.
Medications such as anabolic steroids, occasionally abused by body builders and athletes for performance enhancement, can also give an unfair advantage to female athletes.

What causes hiccups?
There is a belief that when one gets a hiccup then someone else is probably gossiping about them. Is this true?
Ben

Dear Ben
A hiccup is caused by a sudden contraction (spasm) of a big flat muscle that separates the chest from the abdomen (diaphragm) resulting in a rush of air into the airway only to be stopped by a sudden closure of the vocal cords which then makes the characteristic “hiccup” sound.
Athough in many cases the hiccup comes without a known cause and goes away after a short time, a full stomach due to eating or drinking too quickly, swallowing lots of air, smoking, emotional stress or excitement may cause it. Drugs called steroids can also send one hiccupping.

Ugandans have a false belief that short-lasting hiccups are due to being talked about. The belief could have been strengthened by the fact that most hiccups are short lived, requiring no treatment and go when one coincidentally mentions certain names. Breathing into a bag to increase the amount of carbondioxide in the body is a good first aid for hiccups.

Can sex during pregnancy cause a miscarriage?

In March 2018, I suffered a miscarriage when I was four months pregnant and suspected the cause as sex with my husband. Can one suffer a miscarriage through sexual intercourse? Tina

Dear Tina,
Spontaneous miscarriages are so common that more than 25 per cent of all diagnosed pregnancies may be spontaneously lost with the commonest cause being abnormal inheritance material (chromosomes). This happens by bad chance much as many mothers worry that they may never bear live children is usually not repeated.
In a few cases, a mother’s health condition that may include uncontrolled diabetes, thyroid disease, malaria or other infections, fibroids or an open cervix may lead to spontaneous miscarriages. Here, the pregnancies might keep being lost until the cause is properly addressed. There is no evidence that sexual intercourse causes miscarriages.
It is, however, advised that if a woman is bleeding on and off during pregnancy, she may require to avoid sex until the bleeding stops. Sex during pregnancy should therefore only be avoided at the advice of the antenatal clinic since sexual intercourse during pregnancy has its benefits including staying connected to the husband as well as it being a good physical and mental exercise, among others.