Category Archives: Ask the Sexpert

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!

Long Acting Reversible Contraception…FOR MEN!

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

Over the past decades the tedious, but important job of using contraception has mostly been the woman’s – from daily pills to injections to invasive surgical procedures – the burden is uneven. I come with good news!

A relatively new long acting reversible contraceptive (in the biz we call them LARCs) is currently being tested on men in India with a likely release to the general public by 2017. It was created by Professor Sujoy K. Guha from the Indian Institute of Technology with the name Reversible Inhibition of Sperm Under Guidance (RISUG). It is being spearheaded by Parsemus Foundation. Like a vasectomy, it is an outpatient procedure and needs a tiny incision in the male genital area but unlike vasectomy, it’s more easily reversed.

Here’s a brief description of how RISUG/Vasalgel works:

  • a pin hole-sized incision is made at the base of the scrotum
  • the physician locates and gains access to the vas deferens
  • Vasalgel is injected into the vas deferens and then carefelly placed back into the scrotum

vasalgelThat’s it! Vasalgel is made up of two chemicals which mix when injected and thickens to make a polymer lining the vas deferens. Its specific mechanism of action is that it lines the wall of the vas deferens and lets sperm flow through it but ruptures the sperm cell membrane as they pass by. Fantastic, right?!

Vasalgel can be effective for up to ten years. When the male wants his fertility back, a solution of dimethyl sulfoxie or sodium bicarbonate (baking soda) and water is injected into the vas deferens, which flushes it out. The procedure has been proven in clinical trials to be very effective and there are some side effects like scrotal swelling and pain but those were very limited. As you know, female contraceptives also have side effects (good and bad) so you can expect the same from a male contraceptive. It is important to note that Vasalgel will NOT prevent the spread of sexually transmitted diseases.

Have you heard of this simple, yet innovative LARC procedure for men? What do you think?

To read a similiar article, see The Daily Beast.

Panorama: A Groundbreaking Prenatal Test for Women Over 35

In case you didn’t know, once you turn 35, your pregnancies will be deemed “high risk” by the medical community. It isn’t necessarily because you are an unhealthy person, but the egg from which your child will become, is also 35+ years old. And with age, comes more genetic abnormalities and complicated pregnancies.

Women under 35 will most likely experience the “old way” of testing, which includes a series of blood tests and the “anatomy ultrasound,” which typically occurs around 20 weeks. But if you’re over 35 (or have other risk factors) imagine learning the sex of your baby as early as nine weeks into your pregnancy (optional, of course)! Imagine that that very same blood test could also test for the following:preggo

  • Trisomy 21 (Down syndrome)
  • Trisomy 18 (Edwards syndrome)
  • Trisomy 13 (Patau syndrome)
  • Turner syndrome (Monosomy X)
  • Sex chromosome trisomies
  • Triploidy
  • 22q11.2 deletion (DiGeorge)
  • Angelman
  • Prader-Willi
  • Cri-du-chat
  • 1p36 deletion

This simple blood draw, performed at your OB’s office, tests for the aforementioned conditions by separating the fetus’s DNA from the mother’s. Here’s the science…

how it works

Within 7-10 days, your OB will go over your results. If the test reveals that you fall in the “high risk” category, more specialized tests such as Chorionic villus sampling (CVS) or Amniocentesis may be recommended.

Panorama is not intended for women carrying multiples or who have received a bone marrow transplant or for women who have become pregnant using donor eggs. If your insurance doesn’t cover Panorama, there are other tests available to you.

Watch the company’s video and visit their website for more information. Here’s a great graphic that compiles the clinical data. So what do you think? Would you be willing to give a vial of blood to know very early in your pregnancy if there was a genetic abnormality?

*As with all medical issues, remember that we are educators, so be sure to ASK YOUR DOCTOR about this and other concerns.

Fun Friday: By the Numbers

percentI’m always reading articles, blogs, books about health, especially sexual health. I’m not sure why, but it seems that more people pay attention to percentages or statistics than to words explaining the same thing. SO I’ll keep it sweet and simple and see if this is true for you!

  • 60% of women have had unprotected sex during their period (a bad idea if you really don’t want to take a chance on getting pregnant)
  • 47% of women have called in sick to work because of cramps (see a gynecologist about hormonal relief)
  • 67% of women have been too embarrassed to talk to a health care provider about a concern (honestly, they have heard and see it all before)
  • 60% of women have worried about one breast looking different from another (perfectly normal to have different shapes and sizes)
  • 43% of women have had a condom come off during sex (you have 72 hours to get emergency contraception)
  • 65% of women say they don’t need to have an orgasm to be satisfied
  • 87% of women have looked at their genitals with a mirror

*Stats above from What the Yuck?: The Freaky and Truth About Your Body

Positive Sex Ed Parenting

As a long time sexuality educator, I’ve come across many people who have done a really inadequate job of talking to their children about basic sexuality. I often ask the teens in my classes if they have any trusted adult they can talk to about sex or what messages they have gotten from home. When doing workshops with parents I learned that it’s a rarity to find an adult that is informed and comfortable enough to give accurate, sex-positive messages to their kids. Here are a few things I’ve learned that might be helpful.

Most parents are terrified of their children’s sexuality

Adults have a really difficult time admitting that sexual feelings are part of being human. All the parts that are pleasurable to be touched as an adult were there from birth. Hormones released during puberty certainly increase sexual feelings but even young children masturbate, have crushes, and crave physical (not sexual) contact. Children are curious about bodies and often have questions from a young age. I ask parents to think about what they want for their children when they are in a healthy, committed adult relationship. Don’t you want them to enjoy sex and be able to communicate openly with their partner? How can they help their child become this adult?

A simple first step is when teaching the names of their body parts use the actual names. This is your nose, these are your toes, this is your penis. It’s your body and you have the right to say no to unwanted touch. As the child grows older and more questions come to mind, you should be the one to answer these questions. If you start giving simple, factual answers to these questions when they are a young child, they are much more likely to come to you as a teen when the consequences are so much greater. If they don’t ask questions, use “teachable moments “to give basic information. “Did you see Aunt Sally’s big tummy? She’s going to have a baby! Here’s a book we can look at together that explains how this happened.”

Most parents are even more terrified that their child will be gay

A child’s sexual orientation is determined before they are born. Hormone levels released during the first trimester form much of a child’s basic sexual preferences, gender identity, and brain patterns. Many parents know from a very early age that their child would probably be attracted to same sex partners. How they support their children throughout their formative years is critical in them negotiating the cruelty of peers that is still a huge fact of life for gay youth. We don’t get to create the child we want. We do get to love and support the child we have.

Many parents feel their child is too young for sexual information

I was so horrified when my daughters came home from elementary school and told me some of the things they heard from their peers. THEY WERE TOO YOUNG AND INNOCENT TO HEAR THIS! But hear it they did. They read words written on the bathroom walls, on the back of the bus seats, in books. They were propositioned by boys. They were told about things kids watched at home. Luckily, they felt comfortable enough to tell me, so I could answer their questions with accurate information, explain what words meant so they understood why we don’t use them and give them responses to name calling and bullying. Try as we might to shelter our kids from sexual information, it will find them at a very tender age. It is critical that we educate them with age appropriate information and create an atmosphere where they feel safe talking to us.

Here at Planned Parenthood resources for parents are available to help navigate this critical, often confusing part of parenthood. A recent blog gives an excellent and entertaining example of positive sex ed parenting.



How to Get Your Sexy Back

sexyAs we get older sex is further down on our priority list. With all the responsibilities that come with being an adult it becomes more difficult to find the time or desire to have sex. Here are 5 ways to help get your sexy back.

Tip #1 – Exercise. It is one of the most important things you can do to maintain or increase your libido. Physical activity helps to increase circulation, blood pressure, and maintain a healthy weight and hormone levels. Exercise can also help you look and feel better about your appearance, which for a lot of people can hold them back from wanting to be sexual with their partner if they are insecure about their body.

Tip #2 – Reduce Stress! If you are stressed you won’t be able to enjoy or want sex. Some people find meditation or breathing exercises helpful. Others find that making a to do list is helpful to quiet the noise in their heads or just taking a 10 minute walk to find some quiet time. Our brain is our biggest sex organ and if we are worried about chores, bills, work, the kids, etc., we can’t give our undivided attention to our partner or the pleasure we should be experiencing. Sex on average for most couples is 12-18 minutes from start to finish. As busy as we all are, we can find 12-18 minutes to connect with our partners, but we have to make it a priority not a chore.

Tip #3 – Spice Things Up. If sex has become a little boring try to wear something that makes you feel sexy or turns your partner on. Buy a sexuality book that gives you new ideas or suggestions and talk to your partner about trying them out. You can also go away for a few days to just focus on each other. Exploring activities that take you out of your element like snorkeling, hiking, skydiving, etc. can help you reconnect and enjoy each other’s company.

Tip #4 – Try aphrodisiacs. Many people claim that foods like oysters, chocolate, and spicy foods can increase your libido. It is hard to know if they actually increase the libido or whether there is a placebo effect from thinking they make a difference. Either way, if it works then by all means eat them.

Tip #5 – Ditch the cigarettes! We all know that cigarettes are bad for us, but did you know they can actually decrease your libido? This is just another reason to find a way to quit cigarettes. Your sex life and partner will thank you.

The Vaccine That Prevents Cancer

cancerIt is time to discuss the Human Papilloma Virus (HPV) and the vaccine that helps prevent it (again). I recently took my son to the pediatrician and noticed several Gardasil pamphlets on the rack. When the doctor entered the room I asked how many parents have had their children vaccinated. He stated that it is a mix and many parents still have misinformation on vaccinations of any kind. Some parents are also concerned about giving their child something that protects against an STD. They have a hard time wrapping their head around the idea of giving a (sexuality-related) vaccine to their 11-14 year old (it is recommended at 11-12 for both boys and girls) and feel like they have to go into detail on why they are receiving the shots. The vaccine is intended for children in order to prevent infection and possible cancer later in life.

Parents can give as little or as much information as they want on the details of HPV. Human papillomavirus (or HPV) is a sexually transmitted infection that can lead to cancer of the cervix, throat, vulva, vagina, penis, and/or anus. The HPV vaccine was introduced in the US in 2006 and has helped to decrease the HPV rate among teenage girls by 56 percent. However, we can’t celebrate yet. Nationally, 33 percent of girls ages 13 to 17 and only 7 percent of boys in the same age range have received all 3 of the recommended doses. HPV is now the most common STD in the U.S. and the major cause of cervical cancer.

Facts about HPV:

  • Nearly all sexually active people will contract a form of HPV at some point in their lives.
  • There are over 100 types of HPV, but the 4 strains that the vaccine protect against (are responsible for 70 percent of the cervical cancer cases and 90 percent of the genital warts cases
  • Approximately 360,000 people in the United States get genital warts each year.
  • More than 10,000 women in the United States get cervical cancer each year.

How to help prevent HPV:

  • Get vaccinated if your under 26.
  • Use condoms.
  • Limit your number of sexual partners.
  • Get a regular pap test (starting at age 21).

Need to schedule an appointment for the vaccine or for a pap test? You can get both at Planned Parenthood!

Birth Control Sabotage

Many people find themselves in relationships that are not what they anticipated. No one starts out being a bully or abusive, but it’s all too common for coercion, manipulation, control to slowly creep into what appeared to be a healthy, romantic, loving partnership. You would hope if people realized someone was trying to control them or signs of abuse started showing up they would end the relationship before it progressed to physical or emotional abuse or before children came into the picture, but often excuses are made, emotional ties are too strong, or fear of retaliation comes into play. It’s complicated.

imagesOne of the ways most people don’t realize abuse can manifest itself involves birth control. While this usually happens with males trying to control a woman’s birth control, females sometimes try and sabotage his as well by poking holes in condoms or saying she is using contraception when she isn’t. In cultures where the expectation is that the male makes all the decisions, some women acquiesce to his desire to have a child or more children. I’ve heard so many times, “He doesn’t want to use a condom or for me to be on birth control.” He may throw out her birth control, poke holes in a condom, pretend to wear a condom, refuse to pay for birth control or take her to an appointment.

In cases where the female does want to use birth control without a partner’s knowledge, there are a few options.

Depo Provera – A shot every three months. However, she still needs to be able to get to an appointment and her period will most likely stop.

The Implant – Once inserted into the upper arm, bruising may appear for a few weeks. After that has disappeared, unless someone goes looking for it, it should be invisible. It provides protection for 3 years.

IUD – There are 3 types of IUDs that are effective from 3 to 12 years. Occasionally a partner may feel the strings at the top of the vagina.

Emergency Contraception – Available at health departments, Planned Parenthoods or over-the-counter, this may be a temporary fix but not a long term solution.

For more information on birth control methods, visit Planned Parenthood. To read another great article on birth control sabotage, visit this website. If you’re in an abusive relationship, please reach out to The National Domestic Violence Hotline.

Female Circumcision: Plight of the Girl Child

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

nigeriaIt is often very surprising the degree to which certain practices take place in the world today but thanks to global communication, we are able to bring these issues to light and attend to them accordingly. I would like to discuss a topic which I have personally had some experience with in my home country of Nigeria as a medical practitioner. I will talk about female circumcision, extent of this practice, where, how and why it is practiced, which will help create more understanding about the social dynamics that perpetuate it. Increasing awareness is also important tool on the road to abandonment of this practice, which is a violation of the fundamental rights of girls and women.

Female circumcision, also known as ‘female genital cutting’ or ‘female genital mutilation,’ refers to all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons.

Female circumcision is practiced in about 29 countries mostly concentrated in Africa and the Middle East. According to UNICEF, over 125 million girls and women alive today have been circumcised. Countries with the highest prevalence of this practice are Egypt, Ethiopia, Nigeria, Sudan, Kenya and Burkina Faso.

The majority of the girls are usually ‘cut’ before the age of 5 years with most of the remaining girls being cut by the age of 14. This practice is conducted by traditional practitioners (which include traditional birth attendants, traditional circumcisers, or generally older women) or health personnel (which include doctors, nurses, trained midwives or other health workers).

There are four main types of female genital mutilation:

  • Type 1: This involves removal of the hood of the clitoris and all or part of the clitoris (also known as a clitoridectomy)
  • Type 2: A more severe form in which there is removal of the clitoris including all or part of the labia minora
  • Type 3: This is the most severe form; it involves the removal of the clitoris, the labia minora and adjacent medial part of the labia majora and the stitching of the vaginal orifice, leaving an opening of the size of a pin head to allow for menstrual flow or urine
  • Type 4 (Unclassified): This involves mild cuts, pricking, incision of clitoris or labia, stretching the clitoris or labia, cauterization, introduction of corrosive substances and herbs into the vagina and many other forms

Unlike complications from male circumcision such as bleeding and infection, which are minor and tend to be easily treated, girls and women who are circumcised suffer both short and long term consequences. These include damage to the urethra or anus, chronic pelvic infections, sexual dysfunction, difficulty with childbearing, and many other complications. The mental and psychological agony attached with female circumcision is deemed the most serious complication because the problem does not manifest outwardly for help to be offered. The young girl is in constant fear of the procedure and after the ritual she dreads sex because of anticipated pain and dreads childbirth because of complications caused by circumcision.

Multiple reasons have been given to justify female circumcision and it varies between different cultures. Some of the reasons include: traditional practice for preservation of chastity and purification, cleanliness and hygiene, aesthetic reasons, social acceptance, protection of virginity and prevention of promiscuity, increasing sexual pleasure of husband, enhancing fertility and many more. Most of these reasons are founded in beliefs and traditions centuries-old making its origin and significance uncertain and very confusing.

Although traditions, cultures, and beliefs are an important aspect of any society, certain harmful practices should be abolished. The uphill task of changing attitudes towards female circumcision needs a multidisciplinary approach involving legislation, health care professional organizations, empowerment of women in the society, and education and activism of the general public with emphasis on the dangers and undesirability of female genital mutilation.

To learn more about female genital mutilation, please visit Unicef.