Category Archives: Ask the Sexpert

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.

Fun Friday: Top 10 Signs You Might Be a Sex Educator

Top 10 Signs You Might Be a Sex Educator:

10. You know how to spell Chlamydia.photo-41

9. Your old yearbooks are stored in this box in your garage.

8. You can tell what a condom is made out of without even touching it.

7. You can’t wait until your kid asks, “where do babies come from?”

6. You know all the latest slang for sex, vagina, penis, etc.

5. Everyone thinks you have the coolest job ever . . . because you do.

4. There’s no sexual behavior that surprises you.

3. Your computer’s search history would make others blush.

2. Teenagers actually listen to you.

1. Your friends and family will send articles like “HPV and Oral Cancers” to you and say, “I saw this and thought of you.”

Oops, I Forgot My Pill!

pillsThe pill is the most popular birth control method used in America to prevent pregnancy, but it is also the most forgotten. Many women choose the pill because they think it will be easy to take, but life happens and they forget. The pill is 99.7% effective (this means that of 333 women taking the pill for a year, one will become pregnant). “Perfect use” assumes that the user will take the pill every day at the same time and not miss any pills. When it comes to real life, many women fall into the “typical user” category which puts the effectiveness around 91% (That means that of 11 women taking the pill for a year, one will become pregnant.)

Here are a few helpful tips to ensure you remember. It is important to find a time that can work for you every day of the week, not just the weekdays. Put it next to your toothbrush, night stand, or in your purse. You can also set the alarm on your phone, create a calendar reminder, or have Bedsider send you a text message reminder. It is super easy to set up and they will send you a fun fact with a reminder at the same time every day. They can also send a reminder message to individuals who use the shot, the patch, and the ring. Remember, birth control pills can help prevent pregnancy but do nothing to prevent STD’s. If you and your partner have not been tested, get tested and make sure that you have had a conversation about safer sex and pregnancy prevention. Using both condoms and birth control at the same time (dual protection) helps to prevent STD’s and ensures that on those days when you forget to take the pill on time or at all, you have a back-up method to fall back on.

Hook Ups vs Relationships: Equal Satisfaction for Males and Females?

sexboxI’ve often wondered if males and females experience casual sex in the same way. Like most things, I guess it depends on the male or female. But general belief is that males can orgasm pretty easily and females do not. Men are like switches, easy to turn on and off, while females are like ovens, slow to heat up and slow to cool down or so the saying goes. So how would this translate to sexual satisfaction for both sexes? Not surprisingly, males come out on top, so to speak.

What makes a sexual experience positive? For many males it’s all about the orgasm. When having casual sex, there may be no attachment to the partner and no concern for her pleasure. Hence the phrase, “wham, bam, thank you mam.” According to Kinsey, males take about 2 minutes to orgasm. Females, on the other hand may take 4 minutes during masturbation but 10 – 20 minutes during intercourse. A male has to be patient and focused on pleasuring her first if there is to be even a chance she will orgasm. Throw in a few drinks and this may not be in the picture.

Several studies show that significantly fewer females orgasm during casual sex, although they may be just as willing to experience a hookup. They may go into the encounter with no expectation of having an orgasm. A recent NY Times article reported that only 40% of women had an orgasm during their last hookup involving intercourse, while 80% of males did. Women appear to be less concerned with achieving an orgasm as they are in experiencing the feelings of closeness, power or connection. The number of female orgasms equaled men’s in committed relationships.

For many women it takes time, trust, communication, and being able to read each other’s signals to have a successful sexual encounter, if your definition always includes an orgasm. A little to the left, not so hard, go faster NOW, are not conversations most females have with a partner they just met. Woman also have an element of potential danger in putting themselves in the position of being alone with someone they don’t know well or even someone they think of as a friend. Date rape is still extremely common.

More research is being done on the topic. Here are two more recent articles on the subject you may find interesting:

  1. Can Women Enjoy Casual Sex? Should They?
  2. Casual Sex: Are Men and Women So Different?

Did You Know May was National Masturbation Month?

Masturbation_EECard_WideWho knew masturbation had its own month! I would have been thrilled if it just had a day. I thought I knew nearly everything there is to know about masturbation, but two recent articles (this one and this one) even taught me a few things. Masturbation is a way for everyone to increase their understand of their own bodies and consequently allows them to guide a partner to increase the chances of a favorable “outcome.” Many couples have discordant sexual needs, schedules or medical situations where one partner is not willing or able to have sex on a specific day. If a couple is open and honest about their sexual desires and needs, and don’t feel threatened by a partner masturbating, it can be an enhancement, not a detraction to their sex lives.

First, the male:

  • Apparently, male masturbation does not have the same health benefits as sex with a partner. Multiple studies demonstrate that intercourse benefits a male’s blood pressure, heart and prostate health, and helps manages pain. Even the makeup of semen is different.
  • It’s not entirely risk free. Frequent or rough masturbation can cause minor skin irritation and forcefully bending an erect penis can rupture the chambers. Surgery may be required.
  • How much is too much? There is never too much masturbation unless it starts to disrupt your work, social obligations, or you stop having sex with a partner because of it.
  • Most guys masturbate. They masturbate if they are single, in a good relationship, or in a bad relationship. It’s more about relieving stress, clearing their head or helping them sleep than a reflection of how attractive they find their partner.

Next, the female:

  • Even though most females don’t chat about masturbation with their friends like males tend to do, that doesn’t mean it’s not happening. Women tend to feel more shame, but most women have masturbated at least once. Since way fewer women than males fail to orgasm, masturbation can be very helpful to having her understand what she needs to do.
  • Women have a greater variation of methods and props than men. Most women need direct stimulation of the clitoris, so a vibrating ANYTHING may do the trick. Women who masturbate using a vibrator tend to have more orgasms with a partner.
  • Women tend to focus on pleasing their partner, be thinking about the kids, going through a mental “to do” list during sex with a partner. While masturbating, she may concentrate just on herself.
  • Masturbation can improve her mood, help her relax, and ease menstrual pain.

So, let’s be honest with what we need, what we do, and what we want to find pleasure and reap all the benefits of self-pleasuring.

To Pull Out or Not to Pull Out? That is the Question.

I am noticing that more of my friends are using the pull-out method when they are in a monogamous relationship versus a hormonal or barrier method. Several of them have asked me how effective the method is at preventing pregnancy so I thought I would share with you what I told them.

If someone used this method their chances of becoming pregnant would be:

  • Perfect Use: 4 out of 100 women will become pregnant within a year if they always use it correctly.
  • Typical Use: 27 out of every 100 women will become pregnant within a year if they don’t always use it correctly.

You may be asking yourself, “Well how hard is it to pull-out before ejaculation?” It can be very difficult to control when someone is going to ejaculate because a male ejaculates at 15-28 miles per hour. Even if he releases a few drops of semen it can contain millions of sperm. The average ejaculation contains 200-500 million sperm! It only takes one ‘Michael Phelps’ out of the group to make it to the egg. The other concern is even if he pulls out in time, there is the possibility of sperm being in the pre-cum/pre-ejaculate. FYI – pre-ejaculate and semen can contain any infection (ex. Chlamydia or HIV) he has in his body and be spread to his partner. There are a lot of people who have gone back and forth on whether there is sperm in the fluid from the Cowper’s gland. The fluid itself doesn’t contain sperm, but because the fluid is going through the same tube (urethra) it may pick up sperm on its way out that was left from a previous ejaculation.

leaking_tapIt is also possible that some men “leak” sperm. According to a small study administered by the NIH, some men repeatedly leak sperm in their pre-ejaculatory fluid while others do not. The study goes on to say that even urinating after ejaculation may not clear the tube and a male could still leak sperm. The study inferred that the use of this method might be more successful for some men because they are less likely to be leakers. In conclusion, if you want to help prevent an unplanned pregnancy or STD, a condom should be worn EVERY time.

Sex and Disability

We talk about sex a lot as a society. But we don’t talk about a lot of types of sex. The vast majority of the discussions follow a pretty predictable formula – take a young-ish, attractive guy and a young-ish, attractive girl, add chemistry, flirting and some amount of time, then you get to sex. There are lots of variations (as Netflix’s seemingly infinite number of Romantic Comedy subgenres will show), but the broad strokes don’t tend to vary all that much.

Now, obviously, a lot of us who don’t fit that mold are still having sex – norms aren’t rules, after all. But one area that doesn’t get talked about often at all is sex with disabilities. Part of this is because you’re not just changing the casting of the expected narrative – substituting in two queer women, someone older, someone heavier, etc. You often have to change up the story entirely.

When you’re in a wheelchair, the idea of just letting things progress from making out to making love can’t be done without some kind of discussion. Getting undressed and moving to the bed can be sexy and part of foreplay, but it’s not going to be something that can happen without talking about it. And for someone with a condition like Fibromyalgia, spontaneous sex at the end of the day can be amazing and fun, or something that’s physically off the table because of pain.

wheelchair-sex-positions-1

And this is all once you’re at the point of having sex – our society can resurrect its Puritannical roots with a vengeance when it comes to thinking about people with disabilities as sexual beings. Dating is hard enough – doing it when a lot of the dating pool thinks that you’re non-sexual is far trickier. (It’s particularly ironic since most of us will, at some point in our lives, experience disability in some capacity.)

Thankfully, there are some good discussions going on, even if they’re not yet part of the mainstream approach to sexuality. This piece from a couple of months ago has some great points about how sex with a disability (and sex with people with disabilities) can be way more amazing than “standard” sex. In a nutshell, communication and being in touch with your body are both things that make sex better, and they’re both elements that are a lot more present when one (or more) people who are having sex also have a disability.

And as complicated as all of this can be, there are still a ton of other areas that will come up depending on your situation. This is a great first-person account from Autostraddle about exploring kink with Cerebral Palsy, and this piece talks about a lot of the intersections between s/m and disability.

Here’s to more, better sex for all of us, and to making our stories about sex as diverse as we all are.