It is a mystery why cells can sometimes detach from the endometrium, find their way to other body parts and attach there. Various theories exist. Perhaps they are bits of menstrual flow which back up through the fallopian tubes and enter the pelvic cavity. Douching may force some fragments out of place. Strong menstrual cramps might do the same. Love making during a period is suspect, as is scarring from previous surgery. They could be scraps of prenatal tissue which develop into endometriosis under the influence of estrogen.

A fibroid is a benign growth (non cancer lump) of gland tissue which develops inside the uterus wall. Average fibroid size is 2 to 21/2 inches in diameter. They are more common, and grow earlier and more quickly in black women; it is not known why. Usually, a fibroid is asymptomatic and is only found at a pelvic exam.

Avoid douching or making love before a Pap test and pelvic exam. Choose any non period time. A spatula is put into the os to collect a layer of cells. Another collects cells from the canal. The test is not normally painful. If it does hurt, ask the doctor to use a lighter touch. There can be mild spotting afterwards. It is rare to get cramps.

Cancer of the cervix is the second most common female cancer. Each year, about 45,000 non invasive and 16,000 invasive cases are diagnosed in the United States. The rate is 1 in 100,000 for women aged 20 to 24. It rises to 50 in 100,000 at ages 45 to 65. Cervical cancer used to be an older Women's disease. Today, it is showing up more frequently in young Women. In the 1960s, 9 percent of cervical cancers were found in women under age 35. In 1992, 25 percent of the cancers are found in women under age 35.

The cervix has a front door, the external os. The os is tiny, about 3 millimeters across. It is known as the "mouth of the little fish" (os tincae), because its function is to open at mid cycle and welcome in millions of sperm. After mid cycle, it closes firmly to keep out all other objects. It opens slightly at a period to allow the flow through. In rare cases, the os can be blocked, causing cervical stricture, and has to be opened surgically.

The uterus is held in place by ligaments and smooth muscle. It lies over the bladder and at a right angle to the vagina. This is called ante flexed, and occurs in 80 percent of women. The other 20 percent are retroflexed, bent backwards. It used to be thought a retroflexed uterus caused period cramps, backache, and urine leakage, but it is normal. Unfortunately, surgery to "correct" a "tipped" uterus was fairly common in those days.

Can a woman be a nymphomaniac? Who decides how much sex is excessive? Physicians? Sex therapists? John and Mary Doe? Nymphomania, like inhibited sexual desire, is a philosophical concept. Some women do have more sexual passion than others. Whether they become promiscuous or not often depends upon their moral choices. When a man regards female desire as excessive or insatiable, that is his subjective opinion only.

In 1991, a young man terrorized elderly women living in a certain Florida neighborhood. First, he scouted out their comings and goings. Then, when it was safe, he broke into their homes, gagged them, stripped off their clothing, and photographed their frail, cringing bodies.

Most sex therapists find that when couples finally summons the nerve to seek help, the problem is usually in an advanced stage, and can no longer be ignored, or endured. In nearly all cases, both partners need to be treated together.

The previous letter and answer highlighted the old controversy of women faking pleasure, pretending to have orgasms. Yes, women do this. Some older men do it too. The reason for faking orgasm might be to give the partner more pleasure. Can this be bad? Sometimes a woman will fake orgasm to get the tiresome business over with as quickly as possible. Again, is this of itself bad?