Dear Dr. Eva,

Which has more nutritional value, fellatio or cunnilingus?

Nutrition Major

Dear Nutrition Major,

If you have been reading your assignments, you should know that, if you do it correctly, you won’t get any calories from oral sex, because you are using condoms or dental dams and are not taking any of your partner’s body fluids into your mouth. To answer the question as an academic exercise: the higher protein content in male ejaculate makes it a better nutritional source than vaginal fluid, although the amount of calories is minimal. If you are having sex with energy and enthusiasm, you will be burning calories at about the same rate as fast walking.

 

Dear Dr. Eva,

Does having larger testicles mean a man makes more sperm?

LR

Dear Dr. Eva,

If a man doesn’t release much fluid when he comes, does that mean he’s​ sterile?

Dry

Dear LR, Dear Dry,

Reproductive potency can’t be predicted either from testicular size or by the amount of ejaculate (cum). The Leydig cells that produce sperm make up less than 10% of the testicle. Most of it consists of fibrous structural tissue, so larger testicles don’t necessarily make more sperm. On the other hand, testicles that are small, soft and spongy rather than firm may not be producing sperm. Don’t rely on the size or shape of the testicles for family planning, though. The only way to find out how much sperm is in a man’s semen is to get a sperm count, a lab test in which the sperm in ejaculate are counted through a microscope.

Dear Dr. Eva,

My girlfriend, who is 45, has very different sized breasts. She says they​ have always been different, but I am concerned she might have a tumor.

Concerned

Dear Concerned,

Asymmetrical breasts are not unusual. If a woman’s breasts have been different sizes since puberty, she is not at any more risk of cancer than women with same-sized breasts. If the asymmetry developed in adulthood or is increasing over time, it would be good idea to get a clinical breast exam and a mammogram. Clinical breast exam is part of the routine well woman exam and can be done by most primary care doctors and nurse practitioners as well as by gynecologists. By age 50, all women should get these screening tests even if there is no particular reason for concern. The rule is different for women who have a sister or mother with breast cancer. In that case, annual mammograms should be started when the woman is five years younger than her relative was when she was diagnosed with breast cancer.

Dear Dr. Eva,

Is it cleaner to shave your pubies? Is the skin more sensitive when your genital​ area is shaved?

JD

Dear JD,

As far as sensitivity, that’s an individual perception. However, if you think about it, the most sensitive parts of the genitals are the parts that are naturally hairless, that is the inner labia, clitoris and penis, so if you are seeking sensitivity it makes more sense to focus on those naturally hairless areas than it does to shave. Shaving doesn’t make a person cleaner: men who shave their beards aren’t any cleaner than men who grow them. Shaving tends to irritate the skin and cause small injuries, increasing the risks of skin infections like folliculitis and MRSA and opening pathways for blood-borne infections like hepatitis and HIV. Depilatory creams (hair removers) don’t break the skin, but they are not meant to be used on this sensitive area and often cause irritation. Overall, there are more arguments against shaving the genital area than there are for shaving it.

Eva Hersh is a family physician. Send your comments and questions to her by email at publisher@ baltimoreoutloud.com.

 

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