Is it safe to use a coil and tampon at the same time?

Dear Doctor: I plan to use a coil as a contraceptive method. But I also use tampons for my periods. Is this safe? Farida

Dear Farida: An Intra Uterine Contraceptive Device (IUCD) is a small plastic and copper wound device that is inserted in the womb to prevent pregnancy. It has one or two threads on the end, to make it easy to be removed. An IUCD has thin threads that hang out through the opening of the cervix into the top part of the vagina.

Being a foreign body and having a string hanging out of the vagina where the tampon is inserted, using the IUCD raises fears of infection to the womb and fallopian tubes, and leading to problems such as pain and infertility. Fortunately, the feared infections are not as common as they used to be in the past because the IUCDs used today have a single or two strings instead of the many braided ones which increased the risk of infection. However, even though the infections have become rare, it is advised that women in stable, monogamous relationships should use IUCDs.

Tampons of a specific brand, which are not currently on the market today, were associated with a dangerous infection called toxic shock syndrome (TSS) once left in the vagina for more than eight hours. This, together with the said risks of infection in IUCDs has made people fear to use tampons when they have inserted a coil.

However, what is true is that one can use a tampon when they have an IUCD inserted without problems, provided they wash their hands before inserting it and following the guidelines on the packs.

These days TSS following use of the newer tampons is rare that even if one forgets the tampon in the vagina for longer than eight hours, she is unlikely to get infections and TSS. That said, all tampons still carry the same warnings about TSS. That said, all tampons still carry the same warnings about TSS. As long as you wash your hands before inserting your tampon and follow the directions on the pack, you should not have any problems with using a tampon with an IUCD.

Dear Doctor: Recently, I was diagnosed with a uterine tract infection (UTI) and the doctor prescribed ciprofloxacin and brutasol. I completed the dose but the signs and symptoms have not gone away. I have also developed a fishy smelly discharge which usually happens after sex. Please advise me.
SH

Dear SH: Even without any medical problems, many women develop vaginal odour, which is usually slight and musky and a turn-on for men. This odour may vary throughout the menstrual cycle, and may be especially noticeable right after having sex.

Normal sweating, seminal fluids, an overgrowth of normally occurring vaginal bacteria, poor hygiene, forgotten tampon, cervical cancer and a sexually transmitted disease (STDs) called trichomoniasis are the common causes of vaginal odour. However, STDs such as chlamydia and gonorrhoea usually do not cause vaginal odours.

Unfortunately, many women with vaginal odour over wash, or use a vaginal deodorant to decrease the smell, causing more bacterial imbalance worsening the odour apart from used products increasing irritation and other vaginal symptoms.

An imbalance of vaginal small organisms due to overgrowth of normally occurring vaginal bacteria (bacterial vaginosis) causes a fishy vaginal smell.
Some activities or behaviours including having a new or multiple sexual partners can also upset the normal balance of bacteria in the vagina. In most cases, bacterial vaginosis, save for the odour, causes no serious problems but it can increase a woman’s susceptibility to HIV and other STDs if she is exposed to them, and may also increase the risk of passing HIV to her sexual partner. Having this condition in pregnancy may lead to complications including premature delivery.

Although bacterial vaginosis will sometimes heal without treatment, all women with symptoms, especially when pregnant, should seek medical care to avoid complications. Prevention requires one to abstain, or avoid having multiple sex partners, apart from avoiding practices such as washing with soaps or perfuming the private parts. Though what was causing a urinary tract infection could also have caused a fishy smell, ciprofloxacin could have also decimated some of the normal bacteria creating a bacterial vaginal imbalance, worsening the smell.

Dear Doctor: At 43, I do not have a child of my own. I think I have a problem of fathering children. When I used a condom and poured the semen out, it was watery. Could this explain why I cannot father children?

Sam Akiiki

Dear Sam: Semen is a thick gel at the time of ejaculation, and normally becomes liquid 30 minutes thereafter. Being a thick gel at ejaculation helps protect sperms from the acidity of the vaginal canal apart from theoretically helping propel semen further up nearer to the cervix thereby enhancing fertilisation. When semen turns liquid, it releases sperms to swim and reach the fallopian tubes where they find the eggs (ova) to cause fertilisation.

Semen checked out after 10 minutes of production may therefore be watery but normal enough to cause fertilisation and pregnancy.

A man may however ejaculate properly even when he has few or no sperms in the ejaculate. Less than 20 million sperms per millilitre of semen or absence of sperms can lead to failure of a man to make a woman pregnant.
Semen is mainly made up of sperms and liquids from the prostate gland and seminal vesicles. If one cannot produce sperm or if thetubes that carry sperms to join the fluids from the prostate glands and the seminal vesicles are completely blocked, then one will ejaculate fluids which have no sperms to cause pregnancy.

Pregnancy does not occur by the man alone. Therefore in cases where a woman fails to get pregnant, tests should be done on both the man and the woman. In your case, semen analysis, in addition to checking out your sex partner’s fertility may be necessary. Being a ladies’ man without engaging in protected sex carries a high risk of sexually transmitted diseases, which may have blocked your semen tubes leading to failure to make any of your several women pregnant.