DR FLO: What are the implications of having high levels of cholesterol?

Dr Flo, in a recent visit to a doctor, he disclosed from blood tests carried out that my cholesterol levels, both good and bad, were high. What are the implications of this? What precautions should I take? Walji

Dear Walji,

Cholesterol is a fatty substance that is used by the body. It is made by the liver and also gets into our body through what we eat.

Cholesterol is carried through the body, attached to protein, in a combination called lipoprotein. “Good cholesterol” or high density lipoprotein (HDL) carries excess cholesterol back to the liver.

“Bad” cholesterol or low density lipoprotein (LDL) carries cholesterol to the cells, and the extra is deposited on the walls of blood vessels, making them hard and narrow.

In most cases, high cholesterol levels are due to unhealthy diet, lack of exercise, being obese, diabetes and smoking. In a few people, it is due to a genetic abnormality in how they process cholesterol.

High cholesterol levels increase the risk of heart attack, stroke and peripheral arterial disease (which causes reduced blood flow to the feet and hands).

To manage it, take lots of vegetables, fruits and whole grains, limit the amount of fat in your diet, exercise, maintain a healthy weight, quit smoking and limit alcohol intake.

There is medication that can lower the cholesterol levels, in addition to the lifestyle changes.

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Dr Flo, my son is nine months old and he has refused to suckle his mother’s right breast. It’s been three months since he stopped suckling that breast, and the said breast has stopped producing milk completely. Could there be a problem? Joseph

Dear Joseph,

A baby may prefer one breast over the other because difficulty with latching or a difference in the nipple; an older baby may avoid one breast because of low milk supply or slower milk flow.

It may also be because the baby prefers to be held on one side, maybe because something hurts e.g. an ear infection or something else.

When the baby does not breastfeed from one breast, milk supply on that side reduces. The only concern is that the breasts may start to look like they are of different sizes.

To manage this, the mother can continue to encourage the baby to feed from that side or use a breast pump to encourage milk production, and store this for the baby to use when she is not there. She should also go for a breast check-up.

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Dr Flo, when I was in high school, I was very strong sexually, but after masturbation throughout that time, something changed and I have premature ejaculations, which I can’t manage. Please advise on what to do and not seeing a doctor. Paul

Dear Paul,

The normal male sexual response cycle involves desire, arousal, plateau, ejaculation, and resolution.

The average time from beginning of intercourse to ejaculation is five minutes. If ejaculation happens sooner than you or your partner would like, it is called premature ejaculation. If it happens once in a while, it is not a cause for concern. If it is frequent and is causing frustration, then it needs to be addressed.

It can occur due to psychological and physical factors. Psychological issues include early sexual experiences, worry about sexual performance, anxiety, depression, guilt, poor self image or relationship problems.

Physical factors include abnormal levels of hormones or brain messengers (neurotransmitters), or inflammation of the urethra or prostate.

To manage it, you need a supportive partner, and any psychological issues need to be addressed by a mental health professional. There are medications that can be prescribed and topical creams with a numbing agent that can be used.

Other ways of managing it:

1. Avoid sexual intercourse for some time and focus on other forms of touch to reduce pressure to perform.
2. Strengthen pelvic muscles using Kegel exercises – Tighten the muscles that you would use to stop urine flow. Contract these muscles 10 times and repeat at least three times a day.
3. Stop-start technique – During intercourse, when you feel the urge to ejaculate, stop all activity until the urge passes, then start again. By repeating as necessary and with practice, holding off ejaculation can become a habit.
4. Pause and squeeze technique - During intercourse, when you are about to ejaculate, have your partner squeeze the penis where the head joins the shaft for several seconds, until the urge passes, then continue.
5. Use a condom to reduce sensitivity.

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