Dear Dr G,

I am emailing you about a strange problem that is happening to me as I turn 50.

I am a healthy chap who exercises and watches my diet regularly.

Thankfully, my wife and I still have strong libido, and I guess mine must be derived from high levels of testosterone from a healthy lifestyle.

I recently started waking up at night to urinate and struggled with the stream.

In addition to waking my wife, the inaccuracy of my nighttime relief that sometimes ends up on the toilet seat also annoys her.

As a result, I was dragged to see a urologist, who reckoned I had the age-associated benign prostatic hyperplasia (BPH).

I was put on some medicine, which gradually helped with my urination issue. However, I am sad to say I am now struggling with my libido.

My wife and I used to have sex twice a week, but now we struggle with doing it once a month. Even my erection is weaker than before.

I am really curious and would like to put Dr G on the spot for advice on why I am trading stronger urinary flow for weaker libido.

Firstly, what exactly is BPH, and how does it affect the urinary flow?

I read somewhere that prostate size is affected by high levels of testosterone. Is there a direct correlation between levels of testosterone and prostate enlargement?

Shouldn’t high testosterone induce a better erection?

The doctor said the medicines are to shrink the prostate. Does that mean my testosterone is lowered, too?

Please help.

Yours truly,

Weak William

The prostate is a walnut-size organ in the pelvis that starts small at birth (1.5g) and remains so throughout childhood. During early puberty, it becomes active in producing ejaculates and increases in size via an androgen-dependent pubescent growth phase. It grows from 10g to an average of 20g in young adults.

The second selective growth phase of the inner zones occurs in approximately 50% of men by age 50 and 90% of men older than 80. The causes of this growth are unknown, and pathologically recognised as benign prostatic hyperplasia (BPH), clinically noted as benign prostatic enlargement (BPE) that induces bladder outlet obstruction.

A fun fact is that the prostate will continue to grow despite the rest of the body shrinking with age. BPH commonly affects men with advancing age. The gradual overgrowth results in the compression of the urethra, causing obstruction and leading to various urinary symptoms. These include poor urinary flow and hesitancy in initiation, as well as dribbling and straining at the end of the void.

In addition, the post-void residual urine also results in urination frequency during the day and night. When the symptoms become worse, it can even result in urgency and urge incontinence. Urinary troubles are generally a good barometer of age in men. Scientists have known of the importance of testosterone in prostate pathology, but the exact correlation is largely unknown.

It is often cited that men who are castrated do not experience problems associated with BPH. However, serum testosterone has also been shown to decrease in men with age by approximately 2% to 3% annually. The process of BPH, however, continues as men age despite the fact that their serum testosterone decreases.

On the other hand, some men also do not encounter problems with BPH despite undergoing testosterone replacement therapy. In fact, many studies have demonstrated there was no significant correlation between serum testosterone levels and BPH in many individuals. The real hormonal change responsible for BPH is the active component of dihydrotestosterone (DHT). This active form of testosterone induces the proliferation of the prostate gland cells.

Several other factors have also been identified as potential contributors to BPH, including hormonal imbalance, particularly the ratio between oestrogen and testosterone, which is considered more significant in the development of BPH. Genetic factors also play a role in predisposing certain individuals to BPH.

Lastly, lifestyle choices, such as a sedentary lifestyle, obesity, smoking and excessive alcohol consumption have been associated with an increased risk of BPH.

Various treatment options are available to address prostate enlargement. Lifestyle modifications, medication, or surgical procedures may be recommended depending on the severity of symptoms. Oral medications such as finasteride and dutasteride, known as 5-alpha reductase inhibitors, are used to reduce the active form of testosterone.

Sadly, the reduction of the active form of testosterone will also have an impact on the libido in men. Therefore, many men who are taking this treatment face the issue of weakening libido. Some even describe worsening erection. Another fun fact about the prostate is that the active form of testosterone is also responsible for male pattern baldness. Therefore, the medicine can also have a positive impact on hair growth.

BPH is a complex condition influenced by multiple factors, rather than testosterone level itself. While the connection between testosterone and BPH remains somewhat elusive, research continues to shed light on the mechanisms at play. Having knowledge of the pathogenesis and effective treatment strategies allows men to take proactive steps to maintain overall health and enjoy a fulfilling sex life despite the ageing prostate.

Celine Dion once said: “There is no such thing as ageing, but maturing and knowledge.”

So when men experiencing problems with enlarging prostate and dwindling testosterone due to its treatment put Dr G on the spot for a solution, his view is: “When it comes to the ageing prostate, maturing and knowledge will allow men to trade off certain troubling urinary symptoms with some sexual function, though sometimes the medicine may also yield an unexpected surprise in your crowning glory”.

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Dear Dr G,

Thank you for answering my email. I am a big fan of your articles.

I am 34 years old and engage in a healthy sexual relationship with my girlfriend.

Both of us have a strong appetite for sex and are adventurous at times.

Apart from dressing up in sexy undergarments to excite each other, we also read many articles about different sexual positions.

We truly believe in making every sexual encounter magical and memorable.

As we progress in our relationship, my girlfriend and I are getting increasingly more adventurous in bed.

We openly talk about our likes and dislikes between the sheets, and something my girlfriend brought up several times is using adult toys.

As I am toying with the idea of getting my girlfriend some birthday surprises and have no idea about sex toys, I hope to put Dr G on the spot for some clarification.

What exactly are sex toys? How long have they been around?

Are they predominantly for men or women?

Has any research been done about the benefits and risks of using them?

Lastly, in the 21 st century, what are the adaptations of sex toys keeping up with technology?

Looking forward to your toy advice.

Warmest regards,

Toying Thomas

SEX toys are objects or devices with the sole purpose of enhancing sexual pleasure. Erotic stimulation with the aid of devices has been documented for many centuries, across different civilisations.

Their use has been seen from Egyptian artefacts to paintings from the Emperor’s Court in China.

In the Sexual Revolution of the 1960s, the adult toy industry expanded its range.

Most are designed to resemble human genitals. Perhaps they also gained mainstream attention through erotic novels such as Fifty Shades of Grey.

These devices may not be acceptable in conservative societies and are masked by toned-down euphemisms like “marital aids” or “bedroom enhancers”.

Technically, substituting “sex toys” with the term “marital aid” is inaccurate.

A marital aid in the broader sense should include medication and supplements that help couples enhance their sexual experience.

The global sex toy industry is estimated at US$35.1bil (RM156bil) annually and projected to grow to US$54.6bil (RM242.7bil) by 2026 (source: Yahoo! Finance, January 2022).

TV series such as Real Housewives of Atlanta, showing Kandi Burruss frequently displaying and giving out sex toys as presents, help fuel the industry. Although such programmes are helping to diminish the taboo, the embarrassment of buying and using adult toys still prohibits open acceptance among couples.

These days, sex toys are easily available on the Internet, from adult shops and even pharmacies. However, their sale and use are still illegal in conservative countries such as India and South Africa, where they are considered obscene and “Intended to be used to perform an unnatural sexual act”.

Hence, buying them in such jurisdictions may land unsuspecting customers in hot water.

Sex toys can broadly be divided into several categories: gender-specific or gender-neutral, penetrative or non-penetrative, and electrical or non-electrical, for example.

There are also many crossover versions that may not easily fall into one category, but their usage and effectiveness is still dependent on the user’s objectives and imagination.

The most widely known and recognised sex toy is perhaps the female-oriented dildo. These are made from various materials and come in various shapes and sizes to cater for all needs. They may be static or vibratory in nature.

On the other hand, male-oriented sex toys are also available but perhaps less publicised.

These aids may be in the shape of female sexual organs. Again, there are variations to simulate other bodily orifices and such toys may also be powered or non-powered, to suit the user’s fancy.

Sex toys are usually sold as novelty items and need not adhere to regulatory restrictions. Although most devices are made of inert materials, some quarters may argue that they should be regulated as medical devices, as certain toys may contain phthalates that can be harmful when inserted in the body.

Devices that are electrical in nature should at least come with an assurance that they do not short-circuit or malfunction while in use.

The evolution of the sex toy has also been transformed in the 21st century. Technology allows virtual reality to be incorporated into sex dolls and other devices.

Clearly, the line separating them from being socially acceptable is also blurring, raising many ethical questions as they evolve.

As taboos about the devices subside, mature discussions about the morality of their usage can begin.

The Ethiopian-born, Swedish-raised chef and restaurateur Marcus Samuelsson once said: “Even just a few spices or ethnic condiments that you can keep in your pantry can turn your mundane dishes into a culinary masterpiece.”

There are certainly many similarities between bedroom and culinary arts. Adventurous couples toying with the idea of some devices to spice up magical moments between the sheets want to put Dr G on the spot over his views.

His response is: “The constant thought of adding spices or condiments to the ingredients of sexual health is the first step for couples to make all experiences between the sheets a bedroom masterpiece!”

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Dear Dr G,

I am a novice when it comes to sex. I often hear about the risk of HIV transmissions and that is enough to send chills down my spine and put me off sex!

Perhaps I am being overly cautious, as I have not engaged in penetrative sex, even though I am well into my late 20s.

You can imagine I have missed out numerous opportunities in universities with girlfriends, and now even at work.

My friends all think I am weird, as I am constantly trying to work out the risk of sexually transmitted infections.

I guess being an accountant, you would think it is in my character to work out the calculations before engaging in any form of risky behaviour.

I am hoping to put Dr G on the spot today for the exact risk and possible protective measures against the contraction of HIV.

Firstly, can you please tell me the exact risk of HIV transmission?

What sort of sexual act would be the most risky?

And what are exact risks of transmission for oral, vaginal and anal sex?

Finally, can you tell me what measures I can take to prevent HIV transmission?

Yours truly,

Cautious Caleb

THE highest risks of transmission of the HIV virus are unprotected anal sex, unprotected vaginal intercourse, needle sharing and vertical transmission from mother to baby.

It is difficult to put an exact risk of HIV transmission to different modes of sexual behaviour, as the viral load of the infected person is not always known.

The likelihood of HIV transmission from a person with HIV to a HIV-negative individual depends on the mode of sexual activity.

The state of immunity of the HIV-negative partner is also difficult to quantify in scientific studies.

However, clinical data is available to help individuals to work out exactly how risky each encounter can be during sexual contact.

Fellatio and cunnilingus (better known as oral sex) are sexual acts that involves one person kissing and licking the other person’s genitals. All the scientific data agrees the risk of HIV infection from oral sex is low, but it is not risk-free.

In fact, a study actually quoted risks as high as 3%. HIV is not transmissible through saliva alone. The risk of transmission during oral sex depends on bodily fluid containing the virus (semen and vaginal secretions) entering the bloodstream of the HIV-negative person if there are inflammation, cuts or sores in the oral cavity.

The risk of contracting HIV through cunnilingus is near impossible, and there is no documented case of such transmission.

Globally, the most frequent route of transmission is unprotected vaginal intercourse. There are differences in biological risks of viral acquisition for men and women, also in high- and low-income nations.

A woman is twice as likely to contract HIV from a virus-positive male partner, and in low-income countries, transmission rates are higher and seem to be similar among both sexes.

The calculated risk of viral transmission to women having sex with HIV-positive men is 0.08% (which translates to 1 in 1,250) and risk to men from infected women is 0.04% (1 in 2,500).

In low-income nations, the risk is 1 in 300 for both sexes.

Unprotected anal intercourse carries the highest risk of HIV transmission. The virus is more likely to pass from a HIV-positive partner to the receptive partner.

In a recent study in Australia, the accurate calculation of per-act risk of receptive anal intercourse to both men and women was estimated to be 1.4%.

This translates to a 1 in 70 risk of contracting HIV.

The prevention of HIV can be as straightforward as ABCD.

A stands for Abstinence; without the sexual act, the risk of sexually transmitted infection is clearly negligible. However, if Abstinence also involves some degree of oral sex, then the risk would clearly increase accordingly.

B stands for the Barrier technique. Analysis found that couples using condoms all the time can prevent HIV transmission by up to 90%, even with one partner diagnosed positive.

C stands for Circumcision. Although technically this is not a preventive measure, the recent meta-analysis of observational studies in Sub-Saharan Africa reveals the protection against HIV can be as high as 60% in men after circumcision.

Finally, D stands for Drugs. The introduction of antiviral medications has turned out to be an absolute game-changer in the prevention of HIV.

A recent study that observed 888 couples, with one HIV partner with antiviral drugs inducing zero viral load, having unprotected intercourse for over three years.

The risk of HIV transmission was reduced to zero. This clearly is the scientific breakthrough many have hoped for!

When it comes to sexually transmitted infections, taking risks and going too far may mean visits to the doctor when faced with infections such as chlamydia or gonorrhea.

The risk of transmission when engaging in high-risk sexual activity is often the subject of discussion.

Many men (and occasionally women) ask me to outline the exact risk of transmission with each mode of sexual contact, sadly this is also with reference to the ultimate price to pay for serious infection such as HIV.

One of my favourite authors and the 20th century’s major poets, TS Eliot, once said: “Only those who will risk going too far can possibly find out how far one can go.”

When Dr G is put on the spot for his opinion of risk reduction to prevent HIV transmission, his view is: “Not risking going too far by taking the steps of ABCD, one can slowly explore how far one can go!”

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Dear Dr. G,

I am hoping to get some help from you about my hormonal complaint.

My husband and I have been happily married for three years.

Like most couples, our initial sex life was active.

However, the passion seems to have dwindled a bit in recent months.

Strangely enough this also coincided with me putting on weight and having issues with irregular periods.

As we are reaching certain stages of our lives to start a family, we are trying hard to conceive a baby.

Sadly, it is simply impossible to catch the fertile window, as the menstrual cycles are really chaotic.

We went to the fertility specialist for help. To our surprise, I was diagnosed with Polycystic Ovarian Syndrome (PCOS).

The doctor also explained this is related to problems of excessive acne and facial hair.

Perhaps, that explains why I am growing hair on my face, and yet losing hair on my head.

I understand the theme this month is sexual health and testosterone.

I am hoping to put Dr. G on the spot about PCOS.

Firstly, what is PCOS and why is PCOS happening to me?

Is the elevated testosterone responsible for all my hairy and skin complaints?

Is the testosterone also causing me to have deranged menstrual cycles?

I hear testosterone is responsible for enhanced sexual desires in women, which does not seem to happen to me?

With all the hormone chaos, am I really turning into a man?

Regards,
Chaotic Cathy

Polycystic Ovarian Syndrome or PCOS is a common hormonal disorder in women, which was documented in Italian medical literature as early as 1721. The disorder is characterised by multiple cystic formations in the ovaries or unknown trigger. Around three-quarters of PCOS sufferers have elevated levels of male hormones (hyperandrogenism) resulting in the derangement menstrual cycle. The prevalence ranges from 2%-26% of the adult female population, with varying prevalence across countries. The World Health Organization (WHO) estimates 116 million women worldwide suffer from PCOS with the manifestation of symptoms in women of reproductive years between the ages of 18 and 44.

The exact cause of PCOS is largely unknown, however the etiology is generally associated with the combination of genetic and environmental factors. Obesity and lack of exercise are well recognised to induce the onset of PCOS, especially in individuals with such family history. The manifestation of the disorder can range from mild symptoms of irregular periods to excessive bodily and facial hair, acne, male pattern baldness, mood disorder, diabetes and obstructive sleep apnea. In severe cases, elevated testosterone in PCOS sufferers can even result in heart diseases and endometrial cancer.

PCOS is generally considered to be a chronic disease that has no cure. Lifestyle changes, such as weight loss and regular exercise are known to minimize the overall symptoms. As hormonal derangement can affect women in various forms and different degree of severity, targeted measures aiming to treat specific symptoms suffered by the patients, plus disciplined healthy life, are key for a successful outcome.

Oral contraceptive pills and diabetic medications such as metformin are utilized to improve the regularity of period. On the other hand, issues of hirsutism can be treated with laser esthetic hair removal technology. Apart from hair removal treatment, many patients would also accept medications such as anti-androgen to reduce acne, facial hair growth and the progression of male pattern baldness.

Not all women with PCOS encounter the problem of infertility. Weight loss and dietary adjustment, especially the reduction of carbohydrate, are known to be associated with the resumption of natural ovulation. For women not responsive to such lifestyle changes, medications such as clomiphene and assisted reproductive technology can often overcome PCOS-induced infertility.

The correlation between circulating testosterone and sexual desire in women is often a subject of debate but remains inconclusive. On one hand, testosterone supplementation at physiological levels in menopausal women or age-related decline in androgen is known to improve sexual desires. On the other hand, the excessive levels of testosterone in women in PCOS has no significant impact on enhancing libido. On the contrary, sexual dysfunction is documented in up to 50% of women suffering from PCOS. Most studies demonstrated the impact of adverse bodily image of obesity and hirsutism, resulting in poor rates of sexual arousal, lubrication and orgasm.

The intricate set-up of the female hormonal system is the fine balance of estrogen and testosterone, which is crucial for the bodily order of sexual functions, reproduction health and secondary female characteristics. Although the onset and progression of PCOS are largely unknown, unhealthy lifestyle and obesity are well-recognised triggers that tip the balance.

Clearly, the excessive supply of androgen is associated with adverse outcomes of irregular period, skin complaint and overall health chaos in women. The American Historian, Henry Adams once said: “Chaos was the law of nature; Order was the dream of a man”. When women with the chaotic hormonal issues of PCOS is putting Dr. G on the spot. His view is “keeping a healthy lifestyle can restore the law of nature, without the nightmare disorderly chaos of turning into a man!”

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Dear Dr G,

I am a 24-year-old guy who is always curious, especially when the subject matter is about sex.

I recently read an article about genital piercing and upon further research, came across what is known as a “Prince Albert”.

I have no knowledge about genital piercing and am rather hooked on the idea of having some jewellery hanging from my manhood.

I am sure this can be painful, but I guess this is where the phrase “no pain, no gain” applies.

Before curiosity kills the cat and I commit to being the “Lord of the Ring” in the pants, could Dr G enlighten me about the curious practice of the Prince Albert?

Is it purely for cosmetic purposes or are there any benefits to sexual performance?

If enhanced sexual pleasure can be achieved, who does it primarily benefit – the man or the woman? Is the piercing very painful? Can it be removed and put on again, just like a earring?

I have also heard many urban legends about the Prince Albert; can you please confirm or debunk these?

Finally, I am also curious if the Prince Albert will also set off metal detectors at the airport?

Regards
Curious Chris

The Prince Albert specifically refers to a form of genital piercing that is “a ring-style insertion that extends along the underside of the glans penis, from the urethral opening to where the glans meets the shaft of the penis”.

Various variations of the Prince Albert exist, including the reverse Prince Albert is when the “piercing traversing the urethra and exits through a hole in the top of the glans”. Although many piercings are done for circumcised men through the frenulum in the midline, an off-centre genital piercing in uncircumcised men to allow the surrounding skin to reposition itself is also common.

The initial piercing usually has a small diameter (about 2.5mm), followed by gradual stretching to accommodate the insertion of a ring up to 9mm in diameter. Some piercers may choose to fit wider rings at first instance, but this is at risk of delayed wound healing or even a “cheese-cutter” effect.

Generally, the healing time for genital piercing can range from one to six months, and mild complications such as bleeding, swelling and local inflammation may be expected.

The prince whose name is associated with such genital piercing is the 19th-century prince consort of Queen Victoria – not the current one of Monaco. Why such an unconventional sexual practice is linked to the 19th-century Prince Albert is unknown. He was noted to be uptight about sex and unlikely to go for such a practice.

The contemporary resurgence of genital piercing in modern times is sometimes attributed to an American body piercer, Jim Ward and businessman Doug Malloy in the early 70s. Malloy published a pamphlet concocting fanciful tales of Prince Albert who did the piercing to “tame” his large asset in tight trousers – especially while riding horses. Another claimed the prince suffered from Peyronie’s Disease, where his bent penis needed to be straightened with a ring and a chain. Although wonderful subjects for naughty dinner conversations, these stories remain urban legends and can never be verified.

There is no robust medical evidence to support that the sexual performance in men (or women) with genital piercings is enhanced.

However, some anecdotal reports suggest that piercings such as the apadravya and ampallang (which pass through the head of the penis vertically or horizontally) can heighten sensations for female partners. On the contrary, many reports also say it can bring discomfort when the piercing object comes in contact with the cervix. On a more serious note, vaginal trauma caused by genital piercing has also been reported.

Materials used range from stainless steel, implant-grade titanium to even solid gold!

One of the worries faced by body piercers is when your travel companions – unaware of your penchant for piercing – are shocked by the unplanned disclosure during airport security screening. Especially when hand-held detector wands are used, which are often very sensitive and set off an alarm directly over the private parts!

Albert Einstein is well known for saying: “I have no special talent. I am only passionately curious”. In the journey of exploration for better sex, there is often no need to have exceptional talent in bed, but being passionately curious is the key to find pleasure in the most unexpected, including genital piercings. Although the idea of getting a Prince Albert may seem completely bonkers to some, it is also known to bring pleasure to couples when sharing the journey of curiosity.

While staying passionately curious is the key for better lovemaking, it is also crucial to weigh out the risks of pain, infection and the potential irreversible aspect of adding jewels on the crown jewels.

For those who still passionately yearn for a Prince Albert, I wish you good luck – at both the piercing parlour and of course, airport detectors!

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Dear Dr. G,

I am a 32-year-old man who has been married for three years. My wife and I enjoy an active healthy appetite and great intimacy.

In recent months, we have been trying for a baby and it has been very disappointing.

As my wife is slightly older than me, it is natural for the extended family (and myself too) to point the finger at her.

My wife went to see her gynaecologist, who assured her nothing was wrong with her reproductive organs. She has been asking me to go and see a urologist, but I am rather apprehensive and scared.

I recently built up my courage to get a sperm test and was completely shocked to be told I have no sperm.

How can that be? I have a strong sexual desire and no erectile dysfunction. I don’t think I suffer from premature ejaculation either. I am worried and confused.

I would like to put Dr. G on the spot for clarification of my “seedless” sex.

Can you explain why am I producing copious semen, but firing blanks?

What exactly is “Azoospermia”? Why do I suffer from this condition?

Is it curable? Will I be able to father a child?

I am so shock and really eager to get the answers.

Yours truly,
(In)Fertile Fred

The World Health Organisation defines infertility as a “disease of the reproductive system characterised by the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse”.

It is estimated between 3% and 7% of couples have infertility. This sad fact renders many couples being involuntarily childless, ranging from 12% to 28%.

Although it is a well-known fact that women gets less fertile with advancing age, the causes of infertility are not exclusively female in origin.

It is frustrating when the assumption of the causes of infertility seem to be exclusively female in origin.

Many would be surprised to learn that scientific data revealed 30% of infertility issues are due to male factors and another 50% due to women. The remaining 20% are result from complications with both partners.

As a result of such naivety, the delay in the seeking treatment would compromise the success of conception as couples are working on a tight “timeline” due to the female “fertile biological clock”.

Azoopsermia is a medical condition of a man not having any measurable sperm in his semen. This affects about 1% of the male population and around 20% of all men presented with issues of infertility.

As the vast majority of the semen derives from the prostate and seminal vesicles, men who have azoospermia would have normal sex drives, erectile ability, producing copious amount of semen, but all amount to literally a “seedless” reproductive exercise. In fact, just like in men after a vasectomy, they would be oblivious to the fact their semen contains no sperm.

The causes of Azoospermia can be broadly divided into obstructive or non-obstructive in nature. Obstruction of the sperm ducts can occur after previous trauma or vasectomy.

In some cases, the “naughty past” of a man that he is not so proud of (such as previous infections of chlamydia or gonorrhea) would come back to haunt them in obstructive azoospermia.

Obstruction of the sperm ducts can also be associated with genetic conditions such as Congenital Bilateral Aplasia of Vas deferens (CBAVD) that is closely linked with Cystic Fibrosis.

Non-obstructed causes of Azoospermia can also occur. These are generally conditions that render the cessation of spermatogenesis such as previous chemotherapy, mumps, or radiation.

The increase of temperature in the scrotum caused by dilated veins, as varicocele, can also severely impair spermatogenesis.

Lastly, some reports demonstrated radiation derived from mobile phones in the trouser pockets may not be too “sperm-friendly”. So, keep the “crown jewels” away from those hand sets, boys!

It is not uncommon for men to make the assumption that while the “machinery” of sexual health is optimal, the reproductive apparatus should also be at its best.

In reality, the sexual libido in a man is controlled by his circulating testosterone and his erection is exerted by the integrity of the blood vessels and nerves to the penis.

In other words, the reproductive system is an independent entity. Therefore, many years of “trying” may just be sheer “pleasure” with no outcome for men who are suffering from Azoospermia.

In the space age of the 21st century, ART (Artificial Reproductive Technology) has brought optimism to many. Procedures such as PESA (Percutaneous Epididymal Sperm Aspiration); MESA (Microscopic Epididymal Sperm Aspiration) or TESE (Testicular Exploration Sperm Extraction) will be carried out with the intention to search for those healthy sperms in hiding.

Though, such pursuit for the sperms will mean a small operation on the scrotum, most men would agree to this small price to pay for parenthood!

In many instances, this has brought hope to millions, who were deemed impossible in that quest for parenthood.

Martin Luther King once said: “We must accept finite disappointment, but never lose infinite hope!”

Societal and cultural attitudes have always placed the burden of fertility on women, based on the principles of a finite biological clock.

Increasing numbers of men who are building up the courage to admit the possibility of deficiency in fertility is a sign of a paradigm shift.

This may be a symbol of hope for “mankind” and definitely infinite hope for couples living in the “darkness” of childlessness.

When assumedly fertile men possibly firing blanks with seedless efforts put Dr G on the spot, his response is that the only way to find out is to get the specimen bottle out and get tested. After all, how difficult can it be?

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Dr George Lee returns to discuss the latest medical news. Expect deep insights delivered with generous humour. In conjunction with Deepavali, which falls on Sunday 27 October, we find out from a dietitian how she celebrates Deepavali, as well as what we can eat, and how to stay healthy during the Festival of Lights.

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