Category Archives: Ask the Sexpert

Which Emergency Contraception is Right for You?

Emergency Contraception aka Plan B and the morning after pill is used to prevent pregnancy. It GD*5768580is not an abortion pill. This method works by preventing the ovaries from releasing an egg.

  • After unprotected sex
  • The condom slipped off or broke
  • A female was using a birth control method but not taking it correctly (ex: she was taking the pill but forgot to take it two days in a row)
  • A female was raped
  • A female was under the influence and unsure if her partner used a condom

There are 3 Emergency Contraception options for women to prevent pregnancy:

  • Next Choice One Dose and Plan B One-Step: works best when taken within the first 3 days after unprotected sex and is 89% effective at preventing pregnancy. This means that if 100 women take the medication, 11 could still become pregnant. The pill can be taken up to 5 days after unprotected sex, but it is less effective on the 4th and 5th day. This method of emergency contraception may not work as well for women who have a BMI (body mass index) over 25 and won’t work for women with a BMI over 30. If women are in the higher BMI category they will need to get a prescription for Ella or have an IUD inserted. Both brands are available over the counter and there are no age restrictions.
  • Ella: 85% effective if taken with 5 days after unprotected sex and works for women well for any BMI below 35. If a woman has a BMI greater than 35 it may still work but not as well. Ella is only available by prescription from a medical provider.
  • Paraguard (aka Copper IUD): 99.9% effective if inserted within 5 days after unprotected sex and can prevent pregnancy for up to 12 years. The IUD is inserted by a medical provider.

Please see the chart below for a side-by-side comparison of the 3 methods. If you still have questions you can chat with a Planned Parenthood educator online or text a question to 774636.


Why Do My Boobs Sag?

This is a question that many women of childbearing years ask their doctors and friends. Unfortunately gravity is not pleasant to all women. When we are in our 20’s they are perky and saying hello to you when you look in the mirror. As we reach our 30’s, 40’s, and 50’s they start the downward spiral of slowly drooping.

boobsWhen we are younger the breasts are made of mostly glandular tissue and as we age it gets replaced by fat. Then to make it worse, if you have given birth your breasts increase in size when the baby is born or during breastfeeding, but once you stop they look like two deflated balloons. This occurs because the breast tissue decreases after the milk producing mechanisms in our bodies shut off. For those of you that think you are in the clear because your breasts are still perky and round, Mother Nature may still play a trick on you when menopause comes around. During menopause our bodies tell our breasts that they can close up the milk factories and may start to sag or drop even further!

Some people claim that wearing a bra can help curb sagging, but most experts agree that it will not prevent the inevitable from happening. Ptosis (a fancy term for the degree of sagging) occurs because of our genes, diet, breast size, hormones and the stretchiness of our skin. There is no muscle in the breast tissue, so wearing a bra is not going to tone them. However, bras can help women who are less endowed or perky feel more confident when they have breast changes. Bras come in all sizes and can help some women feel sexier or more comfortable in their own skin. Whether you choose to wear a bra or go commando, know that you are not alone if you’re feeling self-conscious about your breasts. As I have gotten older I have realized that I will never have a perfect body, but at the end of the day life is pretty great and I have realized that aging means I’m still here.

Natural Pain Relief During Labor

N0019821 A foetus at full term ready for deliveryFor many women, the scariest part of pregnancy is labor. It certainly was for me. I knew I wanted as little medical intervention as possible and hoped to have a birth at home with the help of midwives. I saw my first birth while watching a video during childbirth preparation classes. I don’t know what I expected it to look like, but certainly not THAT! The video talked about “waves of increasingly intense cramping followed by periods of relaxation.” Intense cramping was sort of an understatement, but I did end up having two natural home births.

I recently found an article suggesting some techniques for pain relief during labor. Some of these I tried with varying degrees of success during my two births. These three were the most helpful.

Have a support person

Having someone throughout the labor who you trust completely and who knows what medical interventions you want is extremely helpful. With my first birth, my husband was right by my side throughout. The midwives coached him when necessary. With my second birth he was trying to get daughter number one to sleep so the midwives were there to talk me through. When labor became intense, having someone looking me in the eyes talking me through the contractions and helping me focus on what was happening made all the difference. I found myself spacing out, forgetting why I was going through this! A simple reminder that the baby is almost here, everything I was feeling was normal, I was doing great, helped me calm down and get perspective. I found touch and physical nearness comforting as well. Massaging my back, belly and feet felt wonderful and helped me relax. However, some people don’t want to be touched at all. I could not imagine going through the experience alone.

Move around

Movement is distracting to me when I’m dealing with any sort of pain. During labor being able to walk, sit in a rocking chair, and change positions in bed was very helpful. Sitting in a warm tub or taking a shower was comforting during early labor. I felt more in control and could follow what my body wanted to do if I wasn’t restrained to staying in a bed. I gave birth in the squatting position both times.


Since most labors last for hours and both of mine started at night, being able to breathe deeply and slowly between contractions helped me relax and rest a bit. As labor intensified, counting my inhalations and exhalations helped me feel more in control and helped distract me. My support person helped me focus on breathing as well.

Each of us has their own individual birth experiences and deals with pain uniquely, but I hope this encourages people to realize this is an amazing, doable, life changing experience. I never felt so empowered as after having brought my daughters into this life in a natural, peaceful way.

What Happens When You Give Teens FREE Birth Control?

New research from the New England Journal of Medicine suggests that giving teens FREE birth control decreases their pregnancy, abortion, and birth rates. Uh, duh.


Since 2007, a St. Louis program has been offering 15-19 year old females free access to FDA-approved birth control such as pills and shots, but encouraged LARC use (long-acting reversible contraception – aka – IUDs and implants). Of the 1404 participants, 72% chose to use LARCs. Enrollment in the program also included education, so I’m not surprised by the majority of the participants choosing the more effective, longer-lasting methods.

Here are the numbers that will knock your socks off:

During the 2008–2013 period, the mean annual rates of pregnancy, birth, and abortion among CHOICE participants were 34.0, 19.4, and 9.7 per 1000 teens, respectively. In comparison, rates of pregnancy, birth, and abortion among sexually experienced U.S. teens in 2008 were 158.5, 94.0, and 41.5 per 1000, respectively.

Did you see that? The girls enrolled in the study had a 9.7 (per 1,000) abortion rate, while their unenrolled U.S. peers endured a rate over 4 times that! Dig a little deeper into the study and you’ll read that HALF of the 14-17 year olds who enrolled in the study reported a previous unintended pregnancy!

The CHOICE Project isn’t the first of its kind, but it is obviously changing lives in the St. Louis area. Removing the barriers (cost, access, education) to birth control is a proven and effective way to reduce the pregnancy, abortion, and birth rates. Although the teen pregnancy rate continues to drop in recent years, we’re still one of the worst of the developed nations. The next step is getting the policies in place that support teens/women/families in their quest for planned pregnancies.

Studies like these are clear: increased use of effective birth control prevents unplanned pregnancies and abortions. While the nation continues to use women’s health and family planning as a political football, what more ammunition does one need to vote in favor of increased education and access to birth control?



Your Three Holes: Urethra, Vagina, and Anus (Part II)

You may remember our very popular post Your Three Holes: Urethra, Vagina, and Anus, in which I briefly described what those parts do and how to find them. The popularity of that post leads me to believe that there are a lot of people out there who need more information about the three holes.

As a recap, let’s review the important terms:

  1. Vulva – all of the external parts (labia majora, labia minora, clitoris, urethral opening)
  2. Vagina – internal canal; place of penis/vagina intercourse, where period exits body, where tampon can be worn
  3. Perineum – skin between vaginal opening and anus
  4. Anus – end of large intestine; where feces exits body

See all the parts on this diagram:

Let’s add a few more important terms:

  1. Labia majora – soft, fleshy skin covered in pubic hair; protects labia minora, clitoris, and vagina
  2. Labia minora – widely varied in shape and color; two folds of skin that separate to reveal the urethra and vagina; provides physical and bacterial protection
  3. Clitoris – small round organ found where the labia minora meet (at top); home to 8,000 nerve endings; protected by clitoral hood
  4. Urethra – the tube that connects the bladder to the outside of the body; carries urine out of the body

Much of the reason why people don’t know there are three holes is because they are hidden. In order to see the urethra and vagina, you have to open up the skin of the labia minora, and even then, the urethra can be difficult to spot, even with a mirror.

clitorisThe clitoris is an amazing little organ. Evolutionary design really got it right with the clitoris. Did you know that the only function of the clitoris is sexual pleasure? But how does such a tiny organ pack such a punch? The glans portion (the part you can see) is about the size of a small pea but it is home to about 8,000 nerve endings. To put that into perspective, the penis, the clitoris’ equivalent, only has about 4,000. What you may not know is that the clitoris isn’t just the part you can see – it actually extends back into the body. When stimulated, the nerves in the clitoris respond. These nerves start ‘firing’ together in a rhythmic pattern, which is how an orgasm occurs. Basically, the nerves go berserk all at once, creating intense pleasure.

While we’re talking about orgasms, it is important to note that the vagina has far fewer nerve endings than the clitoris. This means that most women need stimulation of the clitoris to achieve orgasm.

There you have it, your second installment of Your Three Holes. Questions?

What is the Purpose of Testicles?

Many people think males store semen in their testicles, but this belief is incorrect. The testicles are the male version of the female’s ovaries. They produce sperm and make testosterone. Unlike females who are born with all the eggs they’ll ever have, males are not born with sperm. They start producing sperm (and a lot of it) during puberty around the age of 10-16 years old, and never stop! Males are sperm factories. They make around 3,000 sperm per second with an average of several hundred million every day. Sperm are produced in the testes, mature in the epidydimis, and when ejaculation occurs, they combine with fluid from the Cowper’s Gland and seminal vesicle and leave through the spermatic cord/vas deferens/urethra.

testicleBecause the testicles are covered in nerves and on the outside of the body rather than the inside (very little protection), it can be very painful when they are hit, kicked, pinched, or twisted. The reason they are outside the body is because they have to be kept 3 degrees cooler than the rest of the body. His “testicle thermostat” (scrotum) brings them closer to the body when it is cold and farther away from the body when it is hot. Essentially, the skin that makes up the scrotum either shrinks, drawing the testicles closer to the heat of the man’s body, or it relaxes allowing the testicles to move away from the heat of the body. The ability to make sperm would shut down if the testicles reached the body’s normal core temperature of 98.6 for an extended period of time. This is why doctors recommend wearing boxers instead of briefs and not frequenting hot tubs when males are trying to conceive.

Now that we cleared that up, what is up with guys having different sized testicles? When it comes to penis size, bigger is not always better, but for testicles, size definitely matters. If someone has bigger testicles, he produces more sperm and probably more testosterone. A normal sized testicle should be about the size of a walnut. If they are smaller (the size of an olive or a cherry), have unusual hardness or lumpiness they should be checked by a medical provider. Males should also seek medical attention if they notice any sores or bumps on their scrotum. For more information visit Planned Parenthood.

Still So Much to Learn About Sex!

bookAfter 22 years as a sexuality educator, I’m still excited when I learn something new. I recently started reading a book called Sexy Origins and Intimate Things that expanded my knowledge on a variety of subjects. I thought I’d share a few tidbits with our dear readers in the hope that you would learn something too!

Promiscuity can be deadly for a female bedbug. The penis of the bedbug is curved, sharply pointed and large like a lance. Since his penis cannot reach his partners vagina, he mounts her and thrusts it through her back to deposit the sperm. It there lies dormant until her belly becomes engorged after sucking blood from her next human host. The sperm them becomes mobile and finds its way into her ovaries. If she mates with more than 6 males she may die from multiple stab wounds.

bad ducks 4Humans are not the only animal to rape. Male ducks become sex crazed in the spring. Although many ducks remain mated and monogamous for life, some males remain unattached and will seek out a mated female and force himself on her. Some females will do their best to hide from an aggressive male, but may be attacked by several males who take turns forcing themselves on her.

Females are always “in heat.” Most female animals are only receptive to male advances when they are likely to conceive. They have a brief period of frantic searching for a mate, mad coupling, and then no interest until the next fertile time. She may attack or even kill an unwanted suitor. A current theory on why human females evolved differently goes back to when humans began to walk upright. This caused a narrowing of the pelvis and resulted in many deaths during childbirth. Women who gave birth prematurely were more likely to live. They began having longer periods of dependency on males for protection so found the more sex they provided for their mates, the more likely they were to stick around.

The first two hours after sex are the riskiest. You are most likely to die from a heart attack during this time whether you have a weak heart, strong heart, or have had a previous heart attack. The risk of a healthy person having a heart attack during sex is one in a million, for a person with heart disease it’s two in a million. Sex is still safer than driving a car. The best thing you can do to prevent a heart attack during sex is participate in regular moderate exercise.

Interesting, huh?


Sex Education and Your Preschooler

October is Let’s Talk Month so… let’s talk!

I am a mother of two daughters, ages 2 and 4, I have a Master’s degree in Public Health Education, and I have over ten years experience as a sex educator. Yes, I’m that mom who can’t wait until her kids ask where babies come from.

The term “sex education” is widely misunderstood. What most people don’t understand is that sex education is built upon a foundation of anatomical and emotional vocabulary, self-respect, self-exploration, body image, family values, communication and negotiation skills – and that’s just in the toddler/preschool years!

Sex education begins when you look into your baby’s eyes, meet their basic needs, and start to build a safe and secure attachment. The baby will cry, communicating the only way it knows how, and you’ll meet its needs, which is how your child starts to trust you.

woman-changing-diaper-photo-450x400-ts-75677441Diapering is another of those early opportunities you have to create positive experiences and foster brain development. Use gentle touches. Use positive language. Don’t use words like gross, disgusting, and stinky because remember that you are applying those words to their genital area and they need to have a positive relationship with their private parts. If they reach for their genitals while you’re changing them, don’t swat their hand away because that gives them the sense that there’s something wrong with them, that somehow touching their own body is wrong. Instead, gently move their hand to the side.

Before you know it, your 12-18 month old seems to be picking up a new word every day. By this time, you’re asking her where her nose, elbows, ears, and toes are so why not include the rest of the anatomical parts? Your son doesn’t have a “birdie” or a “ding dong,” he has a penis, scrotum and testicles. Your daughter doesn’t have a “vajajay” or a “potty maker,” she has a vulva and a vaginavagina. Your daughters can’t see their vaginas so it is best to use the correct term for the part they can see and touch (vulva). You may feel weird saying these words especially if your parents didn’t raise you using these words, but practice makes perfect. An elbow is an elbow, a back is a back, and a penis is a penis. Send the message that you are comfortable talking about their bodies because after words come sentences. And questions. Oh, the questions.

Seize questions and teachable moments like they are winning lotto tickets floating from the sky. If you aren’t sure how to answer their questions, follow these tips.

Using that technique, here’s a conversation I had with my almost-three year old:

Daughter: “How did the baby get out?”

Me: “How do you think it happened?”

Daughter: “It boomed out of her mouth.”

Me: “Well, that’s interesting.”

And maybe you’re wondering why the sex educator mom didn’t tell her daughter the whole truth… well, I know my child best. I knew her body of knowledge and vocabulary about the topic and she was still 2 years old. I did not think it was age-appropriate to tell her the whole truth at that time. Lucky for me, she asked me again recently and I told her that a baby comes out either through the vagina or by surgery. Children ask more sexuality-related questions by 8 years old than they will the rest of their childhood and adolescence. Take advantage!

My two year old is starting to sit up on the changing table with legs spread apart to examine her vulva. I let her. I say, “that is your vulva.” She repeats after me. And just like that, a valuable teachable moment occurs.

When my oldest was three she had some questions about pregnancy. A well-intentioned friend told her that her baby was in the tummy, but she knew the tummy to be the stomach, where food goes. I clarified for her, “the baby actually grows inside of a very strong muscle called the uterus.” Teachable moment.

Messages about privacy and self-exploration are now working their way into conversations with my four year old. She has discovered that it “tickles” when she touches herself. I tell her it is ok as long as she does it in private. We also teach her that other people want privacy when they are in the bathroom and changing rooms.

My husband and I avoid using the f word. Not the swear word, the FAT word. We are both aware that early adoption of a healthy body image will directly influence her sexual decision making later in life. If she values and respects her body, she’ll hold her future partners to the same standard.

bodyimageA lot of the messaging about family values at this age is unspoken. Do you shower or get dressed in front of your little one? Do you show affection to your spouse and/or extended family members? Do you look at yourself in the mirror with appreciation or disdain? What role does your faith play? Do you and your spouse argue respectfully or not? And much of it is spoken, hopefully loud and clear. 

So the next time someone tells you that your child is too young to receive sex education, tell them they are wrong. In the beginning, sex education isn’t about sex at all. It’s about giving your child a solid foundation to stand on. Help them learn to love, respect, and trust during the early years because it’ll make a huge difference during their adolescence. Be open, be honest, and don’t fear THE BIG TALK. You know you’re doing it right if you’re having many little talks. You can do this!

Do You Have That Not-So-Fresh Feeling?

close up of a woman body with  white  rose on her pubesWomen have been taught for generations that our genitals are smelly or dirty and need to be constantly cleaned. These messages are passed on through the media, peers, and even family members. Just like any part of our bodies, we should clean our vulvas and vaginas, but our body is not supposed to smell like rose petals!

If you have just finished working out you might smell a musky odor. If you smell like baked bread or beer you may have a yeast infection. Our crotches and anal cleavage are full of sweat glands and some of us have more active sweat glands than others. If you smell “fishy,” you might have a bacterial infection. A healthy vagina has its own unique smell and varies depending on what you eat, if you wear tight clothing, how often you shower, how well you wipe, how much you sweat, and your pheromones. It is important to note that females should not douche unless you want to go to the gynecologist. The vagina is self-cleaning and does not need any help from an outside source. You wouldn’t squirt a harsh chemical in your eye, so leave the delicate tissue in your vagina alone. Douching can actually disrupt the healthy balance of good bacteria that grows in the vagina and cause an over-growth of bad bacteria. All you need to use is a mild soap to clean the vulva and anus. You can use your hand or a wash cloth to gently clean the area. Do not put soap in your urethra or vagina, just warm water. It is also a good idea to stay away from feminine sprays, washes, scented tampons and pads, and don’t stay in wet workout clothing or swimsuits for too long. If you follow these rules you will have nothing to worry about. If you suspect you might have an infection, call your doctor or local Planned Parenthood.


Chlamydia 101: A Refresher Course on a Common STI!

gytEveryone here at the Feronia project cares a great deal about sexual health. Why else would we spend time writing about it if we didn’t!? We try to give you as much information as possible about current issues, new findings, and exciting research. However, sometimes it’s important to get back to basics. Recently, I was talking with a friend of ours at the Feronia Project about Chlamydia, and she highlighted how important it was that we keep everyone informed about the infection! So today, we’re doing some Chlamydia 101, and giving you all the info you need to know about this sexually transmitted infection!

What is Chlamydia?

It’s a common STI that can infect anyone who is sexual active. It can be spread through sexual contact, and no ejaculation has to occur for it to be spread! Chlamydia can also be transmitted through childbirth. While chlamydia can be easily treated if it is detected early enough, there can be serious long lasting damage if an infection is left for too long without being treated. These long term consequences include pelvic inflammatory disease, infertility, and increased risk of ectopic pregnancy. Check out this CDC fact sheet to find out more.

What are the symptoms of Chlamydia?

When symptoms of chlamydia are present, they can include abdominal pain, abnormal vaginal bleeding, abnormal vaginal and penile discharge, low grade fever, swelling inside the vagina, swelling around the anus, painful or burning urination, and swollen testicles. However, it is important to note that MANY people are asymptomatic, or have symptoms so mild that they do not notice them. According to Planned Parenthood, three out of four women with chlamydia have no symptoms, while half of men have no symptoms.

What should you do?

The first thing you can do is get tested, and make sure you have a regular testing schedule. If at risk, people between the ages of 15 and 24 should get tested yearly, while those 25 and older should be screened with each new sexual partner that they have. Additionally, you need to use a barrier method (like condoms) to help prevent the spread of this infection. While abstinence is absolutely the best method to prevent any STI transmission, the next best thing that you can do is use a barrier method. Condoms are very effective at reducing the spread of chlamydia, but it is important to use them during ALL sexual acts where transmission is possible, such as anal, vaginal, and oral sex. Condoms which are effective against STD transmission include latex condoms (the most common kind), as well as polyisoprene and polyurethane condoms. Lambskin condoms are not as effective at preventing sexually transmitted diseases, and should only be relied upon for pregnancy prevention.

So that’s the 411 on chlamydia! It’s important to always use a barrier method and to get tested regularly, particularly because chlamydia can often leave people without symptoms despite causing damage later! If you have chlamydia, it’s important to not engage in ANY sexual contact until you have completed your treatment, even if you are using a condom! Additionally, if you have been diagnosed with chlamydia it is important that you tell any partners that you may have infected. It might be embarrassing or uncomfortable, but there is a good chance they won’t know otherwise!