Weight loss and diet plan for a healthy lifestyle.

The male tubes. A man’s tubes, the vas deferens, may have developed abnormally (congenital blockage), or they may have become blocked by infection or trauma, or surgery.

The veins. The veins in the scrotum can become swollen, like varicose veins on the leg. This is called a varicocoele, and it can interfere with the temperature maintenance of the scrotum, and the temperature of the testes can become too high. This leads to poor quality sperm, and can impair fertility.

Other male factors. Infection in the system can affect sperm production and quality. Faulty plumbing, which forces the ejaculate (semen) to go backwards instead of forwards, and anatomical defects in the male genitalia are also cited as causes of infertility.

Chromosomes. If a woman or man has a chromosome abnormality it may affect their ability to reproduce. Chromosomes are the bits of genetic material we inherit from the egg and the sperm we developed from, which came from our parents.

Chromosomes determine many things about us, like what sex we are, the colour of our eyes, and other genetically inherited characteristics. Usually women and men have forty-six chromosomes, and two of those determine what sex a person is. The chromosomal pattern for most women is 46 XX, and for men it is 46 XY, the X and Y chromosomes being the sex-determining ones. If the combination of the chromosomes from the egg and the sperm is incorrect at the time of fertilisation the resulting conceptus will have an abnormal chromosome pattern. Many abnormal patterns are not consistent with survival, and the pregnancy may spontaneously miscarry. If the chromosomal mismatch is not life-threatening, a baby may be born and have some degree of abnormality with whatever systems relate to the abnormal chromosomes.

Some women (about one in 2,500 female babies) may have what is known as Turner’s syndrome, because their chromosomal make-up is different. They are definitely women, but they are missing one of the X chromosomes (45 XO). There are typical characteristics, including lack of sexual development at puberty, when the condition usually becomes obvious. Women with Turner’s syndrome have very poorly developed ovaries, and are infertile. Some forms of Turner’s syndrome are incomplete (called ‘mosaic’), and may not be discovered until later in life, after normal sexual development. The ovaries, however, do not tend to work well, and the women are generally infertile.

Men can have chromosomal abnormalities similar to those in women. Men can have Klinefelter’s syndrome (chromosome complement 47 XXY). They have one too many sex chromosomes, and this results in their testes not producing sperm.

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Feeling tired. This is a fairly common thing doctor hear from women in early pregnancy, particularly from about eight to fifteen weeks; after then it seems to decrease. It might have something to do with the blood-flow changes associated with pregnancy. There is also a lot happening in your body (creating a baby is a pretty energy-utilising process). We tend to think of strenuous physical exertion as the only type of activity which should wear us out, but in fact mental and biological work use our resources, too. It also makes biological sense for our bodies to aim to conserve energy early in the pregnancy to ensure that things get off to a good start.

Feeling hungry. Don’t fall into the old ‘eating for two’ trap. Yes, your requirements will be greater, and that, plus the morning sickness thing, may change your appetite. However, don’t go overboard. The increased intake you need is not that great, if you have an adequate diet to begin with. If you feel you need extra food, try to make it useful food. Legend has it that pregnant women typically have food cravings, often for bizarre foods or combinations. There may be some biological reason for this, such as we crave foods which contain nutrients we are lacking, but it would be difficult to prove. (It may also be difficult to believe that pregnant women could be suffering from Tim Tarn deficiency.)

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Like all viruses, the wart virus is tiny, and is spread without anyone knowing. It may be that the person who gives you the wart virus has no visible warts at all. Within one to six months, the virus may have caused some warts to grow. These can be anywhere, but if they are sexually transmitted they will often be on or near the vagina, anus or penis. They may be flat and rough, or like a little cauliflower-shaped thing. They come in different shapes and sizes. They do not usually hurt, unless they have some other problem or infection with them, and can sometimes be associated with some excess vaginal discharge or, more commonly in women, itching. Sometimes the virus may be passed, and no obvious warts ever appear, but the infection has still taken place (called a sub-clinical infection). Actual warts may not appear until months or years after the initial transfer of the virus.

Diagnosis. Apart from the microscopic diagnosis on pap smears, it is usually up to someone to look at the thing, and say ‘it’s a wart’.

Syphilis can cause warty lesions, which usually look quite different from the average genital warts. However if there is doubt about the diagnosis, a test for syphilis may be suggested.

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The actual incidence of serious side-effects of the pill is very small. These can be divided into groups: common and pleasant, less common and a nuisance, very rare and nasty, very rare and potentially disastrous.

Less common and a nuisance—some women may notice a slight pigmentation change in their facial skin. This is called chloasma, and looks a bit like a blotchy conglomeration of freckles. It is more noticeable when suntanned, and will occur in susceptible women when they become pregnant, or are on the pill. It is related to increased levels of oestrogen. It is also perfectly harmless, does not go on to become skin cancer, and can be avoided by keeping your face protected from the sun (which is what you should be doing anyway, unless you want a crinkle-cut leather-look face by the rime you are 35), and is also easily camouflaged by make-up.

If the pill tends to make your acne worse, as it does in some people, a more oestrogenic pill may improve the problem, or one of the pills with a different progesterone.

Nausea, similar to typical morning sickness experienced in early pregnancy, may affect some women taking the pill, particularly soon after starting it. In most cases it will settle after a few weeks. If it doesn’t, a change of pill or the addition of vitamin B6 may be worth trying.

There are some women who experience mood changes on the pill. These can vary from the level of minor annoyance, to marked depressive symptoms, and may in fact mean that some women should not take the pill, although this is rare. Sometimes a change to a lower dose or different type of pill will suffice.

Light vaginal bleeding at times other than when it is due can be a real drag. This ‘spotting’ or ‘breakthrough bleeding’ can happen while taking the pill. As long as it is not associated with an infection, like chlamydia, or an abnormality of the cervix, it is of little significance (except of course to the person who is getting it). It is important that infections and abnormal pap smears are excluded by an examination. If it is persistent, often a change of pill will eliminate the problem. It may be due to inadequate levels of hormone at times in the cycle. Theoretically then, it might be wise to use another form of contraception as well (like condoms) until the problem is sorted out, if you are really keen to avoid pregnancy. Often breakthrough bleeding happens for the first couple of cycles of the pill and stops spontaneously.

Spotting may also occur because of an ‘ectropion’ or ‘erosion’ on the cervix. This is a natural phenomenon in response to increased oestrogens in pregnancy, or when on the pill. It is not serious, and regular pap smears will help to pick up any abnormalities. If persistent bleeding is a problem the cervix can be treated by a gynaecologist with diathermy.

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The workings of the human body are extremely complex. Consequently, they are not that easy to explain. The word ‘anatomy’ relates to the study of the structure of the body. What goes where, like muscles and bones and skin, etc. ‘Physiology’ refers to the way the body actually functions. Medical science is about trying to understand what the bits are, and how they work. Unlike a manufactured machine, the body was not designed by humans, so we cannot just refer to the plans.

Medicine has given names to things, and proposed how things work, in the hope of understanding the body better, and perhaps fixing it if it goes wrong. It is also helpful for the owners of all this high-tech machinery to know as much as they can about it. It can help us to monitor our bodies and pick up problems earlier. Probably more importantly it can help us to look after our bodies, so they are less likely to break down. Prevention is better than cure.

The penis is made up of sensitive skin covering ‘erectile’ tissue. This specialised tissue becomes harder when there is more blood flow to the area, such as at times of sexual arousal. The penis lengthens and hardens when a man is sexually aroused, which allows for insertion into a woman’s vagina.

The penis has a ‘shaft’, and a smooth rounded, more sensitive tip, which is called ‘the glans’. Covering the glans is a sheath of skin, called the foreskin. The foreskin retracts when the penis is erect. The foreskin is removed in circumcision, which is a surgical procedure performed in some cultures around the world for social reasons, and sometimes performed for medical reasons.

In the middle of the penis is the urethra, which not only acts as a tube to empty the bladder, but is also the duct through which ejaculate passes.

Ejaculate is the secretion containing seminal fluid and sperm, released at the moment of orgasm.

Testes (balls) are situated in the scrotum, a skin sac which hangs below the penis. Testes make sperm, by the squillion. The sperm travel from each testis through a network of ducts which become the epididymis, attached to the upper part of each testis. From the epididymis on each side the sperm travel through tubes, the vas deferens. They mix with seminal fluid, which is made in the prostate gland and stored in the seminal vesicles. This mixture is expelled from the penis, via the urethra, during ejaculation.

Sperm are constantly being made, and unlike females, fertile males are potentially able to reproduce at any time. Testes continue making sperm irrespective of a man’s age.

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