Which infection is affecting my fertility?

Dr Flo,

I have been trying to conceive and I have not been successful. I have visited a gynaecologist and a scan was done but no disease was found. There was a time I was treated for a sexually transmitted infection and the following month I conceived, but I later miscarried. I suspect an STI is standing between me and pregnancy. Which STI can block conception and which drugs should I use to conceive? Kindly help. Briannah

Dear Briannah,
Medically, concerns about fertility arise after one year of having regular unprotected sexual intercourse without getting pregnant.

In women, infertility can be caused by problems with how the ovaries function, hormonal disorders, fallopian tube obstruction and abnormalities of the uterus.

Some factors can increase the risk of infertility e.g. alcoholism, smoking, obesity, severe weight loss, extreme physical or emotional stress, being over 35 years, use of bhang, some hormonal medication, exposure to radiation, and environmental toxins like lead, mercury, pesticides, etc.

Sometimes, there are multiple causes, or there may be a problem present in the other partner or in both partners. In some cases, however, an exact cause is never found.

Sexually transmitted infections can cause scarring and damage to the fallopian tubes, uterus and other surrounding organs, leading to infertility. The most common STIs that cause this are chlamydia and gonorrhoea. Unfortunately, most women with gonorrhoea or chlamydia do not have symptoms.

A few people have symptoms like abnormal, foul-smelling vaginal discharge, painful or abnormal periods, abdominal pain, and pain when passing urine or during sex, or an itching or burning sensation in or around the vagina.

You need to have a thorough STI screen, including urine and blood tests and testing of the vaginal fluid. If you have an STI, you will be treated with the appropriate antibiotics. You can be tested again later to check if the infection has cleared. In addition, your partner would need to be tested and treated to avoid re-infection.

There are other checks that can be done. These include a hysterosalpingogram (HSG) to check the fallopian tubes and a hormone profile. Your partner may also need to have a seminalysis and a hormone profile.

Treatment is prescribed, depending on what is found. For example, you may be given medication to help with ovulation or to control hormones; you may need surgery if the fallopian tubes are blocked or scarred or if you have endometriosis. Your partner may also be put on medication. You may also benefit from assisted reproduction through intra-uterine insemination or in vitro fertilisation.

***

Dr Flo, I have had a fungal skin infection for some years now. I have used different medication but none has been effective – the infection disappears for a while, then it recurs. What can I do? Musyoka

Dear Musyoka,
Recurring fungal infections could be due to misdiagnosis, not completing treatment, or a poor immune system. It could also be due to a genetic condition where the skin does not recognise the fungus as foreign matter and therefore the body does not try to get rid of it.

Often, the fungi that cause infection usually live naturally on or in our bodies and only cause a problem when they multiply too much. This also means it is easy to get a fungal infection from another person, since they are also carrying fungi, and from clothing, towels, lanyards, floors, etc. Fungi like warm and wet environments, which is why it is easy to get fungal infections between the toes, or on the groin.

Fungi also shed spores, which are like tiny seeds that collect on our clothes or in our shoes, waiting for the right conditions to grow again. This means that if there are spores present, you can have proper treatment and then the infection comes back when the spores start growing.

This condition can be managed, though it may not be possible to get rid of it permanently. You need to visit a dermatologist to get a proper diagnosis. It would also be beneficial to check for any conditions that could lower your immunity like diabetes, HIV, etc. When you are put on medication, take it for the prescribed duration, even if the skin rash has disappeared.

You can also take tablets or use a cream or anti-fungal shampoo occasionally after treatment to prevent re-growth. You can also apply antifungal powder to your shoes daily. Clothes should be washed and sun-dried in an airy place, and if possible, ironed inside-out.

Also clean shoes regularly and get rid of old shoes. Any family members or other contacts that have the skin infection should also be treated. Also avoid sharing clothes, shoes, towels, etc. Avoid wearing tight clothes, wear cotton clothes and leather shoes.

***

Dr Flo, I am 25 years old and my penis is too small. Is there a way to enlarge it? Maina

Dear Maina,
The average penis size is seven to 10 cm in length and nine to 10 cm in circumference when flaccid, and 12 to 16 cm in length and 12 cm in circumference when erect.

Men who think that they have a small penis usually have a size that is within the normal range. Increasing the size is only recommended for those with a flaccid penis of less than four centimetres in length or an erect penis of less than 7.5 cm in length.

This decision should be made after consultation with a psychologist and a urologist. The only medical ways of enlarging penis size are through surgery, use of a prosthetic or liposuction, which should be done by a urologist.

You should be careful with medications, pills and other treatment methods that are usually advertised for penis enlargement as they may not have proper scientific backing.

Send your medical questions to [email protected] for absolutely free expert advice