Category Archives: Ask the Sexpert

Why Do Humans Have Sex? (A Synopsis)

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.

*This post is a synopsis/simplification of the original paper, Why Humans Have Sex, by Cindy M. Meston and David M. Buss, which was published in The Archives of Sexual Behavior (2007) 36:477–507. If you find this topic fascinating, be sure to read their entire paper.

For a long time, the reasons people have sex have been thought to be few in number and easily discernible. The most commonly stated reasons are: to procreate, to experience pleasure, and to express love and affection.

whyHowever, research on this topic has shown that the reasons why people have sex go beyond just love, pleasure, and making babies, but not a lot of studies have been done to pinpoint these reasons. The studies which have been done have shown significant gender differences and individual differences, which were coherently linked with certain personality traits. These studies have documented more than 200 reasons why people are motivated to have sex. The reasons/motives can be categorized into groups since they can be very similar to each other but just worded or expressed in different ways.

The four groups which most of the reasons fall into are:

  1. The physical reasons: including stress reduction, pleasure, physical, desirability, and experience seeking.
  2. The goal based reasons: including resources, social status, revenge, procreation, and utilitarian.
  3. The emotional reasons: including love, commitment, and expression.
  4. The insecurity reasons: including self-esteem boost, duty/pressure, and mate guarding.

Looking at the gender differences, men generally seek sex because they like how it feels. Women, although they also derive pleasure from the act, are generally more interested in the emotional and relationship enhancement that sex offers. This difference has been named body-centered and person-centered sex.

Body-centered sex is when you have sex because you like the way it makes your body feel. You aren’t concerned with the emotions of your partner. Person-centered sex is when you have sex to connect with the other person. You care about the emotions involved and the relationship between you and your partner. Individuals can switch between body-centered and person-centered sex depending on a lot of factors which include stage in one’s life (which age and life experience is affected by), current situation in life and many more.

Despite these general observations, studies suggest that there has been a convergence in sexual attitudes among men and women in recent years. Instead of men and women being at opposite ends of the (traditional) sexual spectrum, they are now coming together. More women are having sex for physical reasons and more men say they have sex for emotional reasons (or maybe now they just feel safer reporting these feelings?).

Why are these reasons important to know? Well, why people have sex is often tied to the image of themselves and their social relationships, with changes continually happening over time. Understanding the differences in these motivations is very important. It helps us understand what’s going on in our sexual relationship(s). Finding out the reasons for wanting to have sex can aid in addressing certain problems with interpersonal relationships especially between couples and also be used to identify certain issues with sexual behaviors. Very often, you find the source of the problem can be traced to the particular motivation.

STD Mythbuster: Blue Waffle

Please enjoy the last contribution from our wonderful student intern…

A couple of weeks ago, I was facilitating a sexual health class with middle schoolers on viral STDs. I was asking the class to match the STD to its symptoms when a girl raised her hand.

blue-waffle9-290x200“What about blue waffle,” she asked.

“Blue waffle?” I thought I had heard her wrong.

“Yeah, it gives women discharge and makes it all blue and painful on the outside,” she responded.

Luckily for me, my supervisor was able to step in and explain to the class that “blue waffle” is an internet hoax. (READ: BLUE WAFFLE IS NOT REAL.) There are a number of graphic images circulating around the internet that accompany lists of bogus symptoms, and there are a whole host of bogus websites that appear to be real (but aren’t). The graphic images appear to be photoshopped.

Regardless of where the images come from, if you are perusing the internet for health information, always go to reliable websites and triple check your sources. Just because it’s on the internet doesn’t mean it’s real or true. If you are looking for sexual health information and don’t stop by a well-known, reliable website like The Centers for Disease Control and Prevention for verification, you’re doing your research the wrong way.

  • The majority of STD’s are asymptomatic (that means no symptoms).
  • If you are sexually active, or have multiple partners, always use protection and get tested for sexually transmitted diseases, and do it often.
  • Use lubricants to minimize tearing of the condom.
  • When in doubt, see a medical professional.

Sometimes we feel shy or embarrassed talking about sexual health issues with a doctor and the internet is a logical place to search for health information. This simply underscores what we aim to do at The Feronia Project, by providing you with medically accurate sexual health information.

Want more information about STD’s and safer sex? Check out the Centers for Disease Control (CDC) and Planned Parenthood to help you decide whether to get checked!

Or you can Ask the Sexperts! here at The Feronia Project.

SANE: Sexual Assault Nurse Examiner, and How They Can Help You

SANE programAfter experiencing a sexual assault a hospital is often the first place the victim goes for help and medical services. Unfortunately, a hospital is not always well-equipped to provide services for a rape victim. Often they experience long wait times in a busy and crowded place, their trauma is seen as less important than other patient’s trauma, the staff is not sufficiently trained in the type of examination needed for forensic evidence, and worse, the staff may be unsupportive and even judgmental of the victim (from a report by the US Department of Justice.)

The SANE program was created to combat this issue and provide a safe and competent way for the sexual assault victim to receive the care they need. “Sexual Assault Nurse Examiners (SANE) are registered nurses who have completed specialized education and clinical preparation in the medical forensic care of the patient who has experienced sexual assault or abuse.” Planned Parenthood of Southwest & Central Florida operates a SANE program in our private health center in Manatee County, allowing rape victims to receive their care in a quiet, private environment. Typically, the person is referred to the SANE program by police or paramedics, and brought to the center. There, the nurse examiner provides the exam, which in general consists of “the medical forensic history, a detailed physical and emotional assessment, written and photographic documentation of injuries, collection and management of forensic samples, and providing emotional and social support and resources.” After the exam, the nurse also ensures the integrity of the samples is maintained so that they are admissible in court, and may testify in legal proceedings related to the examination.

Overall, the SANE program provides many services: professional forensic evidence collection, documentation, and preservation of evidence, screen for and prophylactically treat for sexually transmitted infection, evaluate for pregnancy risk and offer prevention, document and care for injuries, refer for followup medical care and counseling, and aid law enforcement in prosecution. All of this is done in a private, supportive and nonjudgmental environment by a professional who is trained to provide specialized care.

It should be noted that the program is geared towards prosecution of the rapist, and if the victim is not interested in filing an official report she will be encouraged to discuss her reasons with the nurse examiner. SANE often encourages the victim to go through the criminal justice process. For a lot of victims, going through the process of reporting the rape and dealing with the legal process is stressful and potentially harmful (personally or professionally), and so many rapes are not reported. Still, the SANE program is a more private and emotionally supportive way to receive medical care, pregnancy prophylaxis, STI testing, and other resources after a sexual assault.

Sex and Pregnancy Myths

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.

There is a lot of information surrounding sexual intercourse and pregnancy, and a lot of it is incorrect. Easy access to the internet has made it so much easier to get information, but it is hard to know what’s true. This misinformation can lead to risky sexual behaviors especially among teens and young adults. Since the topic is also very sensitive, teens prefer to discuss about it among people they are comfortable with (friends, significant other) and they could be just as misinformed.

This 4 minute video discusses some myths about sexual intercourse and pregnancy, some of which I have heard as a teenager and some I have heard from the teens I teach sex education classes to.

Below are a few myths and the truths about them explained:

Can I get pregnant if I’m a virgin and it’s my first time having sex?
Yes. Your chances of becoming pregnant are always the same: 1 in 20.

Can someone be too young to get pregnant?
Once a woman is ovulating, she can become pregnant. Ovulation occurs before your first period (since ovulation begins 14 days before your period).

What if the guy “pulls out” before he finishes?
Once a guy is aroused, he releases pre-ejaculatory fluid. That’s at least 300,000 sperm swimming upstream. And guess what? It only takes 1 sperm to fertilize an egg. Pulling out should not be the only form of birth control that you and your partner use.

Can I get pregnant if I’m on my period?
Absolutely. For those that have shorter cycles (or are irregular), you can ovulate during your period. Sperm can also live in the body for up to 5 days, so if you ovulate within 7 days of having unprotected sex, you could become pregnant.

Can I get pregnant if I’m having dry sex (the act of sexual motions while still wearing clothing)?
Any time the penis and vagina come into contact, there is the slight chance of pregnancy or STI transmission. All it takes is for seminal fluid to get inside the vagina.

Is it possible to get pregnant by having sex in a pool?
You can get pregnant in any kind of water – bath, hot tub, etc. (you get the idea) – if actual intercourse takes place.

Does sperm die once it hits the air?
This is 110% FALSE. Sperm can live for 3-5 days if it’s in a warm, moist environment.

There are many more myths out there about sexual intercourse and pregnancy.

How is Syphilis Spread?

gytIf you thought that syphilis wasn’t an issue anymore, you’re wrong. Read on…

Primary Stage  
During this stage many people will notice a painless sore(s). The sores can appear on the penis, vagina, anus, rectum, and/or lips/mouth. The sore(s) usually take 3-6 weeks to heal and can go away on their own without treatment. It is important to note that an infected person should make sure they seek medical attention to ensure the infection does not go into the second stage. During this stage an infected person is contagious. The sore(s) spread from direct contact (aka: oral, anal, or vaginal sex).

Secondary Stage
During this stage someone may notice an unusual rash and/or sores in the mouth or genital area. The rash can also occur on other parts of the body. You could also develop a rash on the palms of the hands or bottom of the feet. Sometimes it is very noticeable and other times it can be so faint someone may not notice it. Other symptoms can include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue (feeling very tired). The symptoms from this stage will eventually go away, but if they are not treated the infection can develop into the latent and late stages.

Latent and Late Stages
During these stages the infection can hibernate for years and not show any signs or symptoms. If someone had the infection for a long time it could move to the late stage and cause damage to internal organs, blindness, brain damage and potentially lead to death.

Can syphilis harm a pregnancy?
Syphilis can lead to a low birth weight baby that is born early, stillborn or cause severe birth defects. Women should be tested for STD’s during pregnancy and at delivery.

How do you test for syphilis?
A quick blood draw will determine if you are positive.

Can syphilis be cured?
Yes, thankfully syphilis can be cured with antibiotics, but the medication cannot reverse any damage that the infection has caused.

How do you prevent syphilis?
The only way to prevent syphilis is to not have direct contact with a syphilis sore. In other words, abstinence from oral, anal and vaginal sex. You can reduce your risk by always using condoms and barriers.

For more information on syphilis or to find a Planned Parenthood in your area.

3 Things Everyone Can Do to Prevent HIV

December 1st was World AIDS Day so we are reposting this one from a couple of years ago to highlight that not much changes in terms of HIV prevention… 

Although HIV has been a part of our lives for over 25 years, people in this country are still getting infected at about the same rate they have been for several years. Many people still have misinformation about the virus or don’t feel they are at risk. Here are a few things everyone can do:

• Encourage people to get tested and get tested yourself
Planned Parenthood of Southwest & Central Florida offers 3 types of HIV testing: a rapid test (results in 20 minutes), blood draw sent to a local lab (results in 2-3 days) or the free state test (results in about 3 weeks).

• Learn the facts about HIV so you can educate yourself and others
There are still many myths about how HIV is spread, who’s at risk, and how it’s prevented.

• Promote condom use
Many people worry more about becoming pregnant than becoming infected with a STI. If they or their partner are using contraception, they may believe they have taken care of all their reproductive needs. If they have a same sex partner or are past childbearing years, they may figure they have nothing to worry about.

Out of all the STIs, HIV is the most difficult to acquire, and it has a dramatic impact on someone’s life as well as the lives of those who love them. Despite fears of many to the contrary, a positive HIV test isn’t a death sentence; with medical attention, proper medication, and taking control of their health, someone can live a long and healthy life with HIV.

The best medication for HIV, though? Not getting the virus at all. Let’s all do our part to reduce the spread of HIV.

For the most current information on the virus, check out the CDC website on HIV.

For living with HIV, read this CDC brochure on HIVas well as Avert, the international HIV & AIDS charity, to answer common questions about living with HIV.

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.

best-emergency-contraception

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.

Breathe

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.

bc

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?