Fun Friday: It’s Giveaway Time! How Sex Works

How Sex Works, by Dr. Sharon MoalemHappy Friday, kittens! Today, we’re having a giveaway for the great readers of the Feronia Project!

Ever interested in how sex actually works or why we like the things we like? Why certain things are attractive to us and others aren’t? How Sex Works is awesome for answering all those questions.

And today, we’re giving away five copies to our fabulous readers. Just leave a comment telling us what you love about Feronia and you’ll be entered into a drawing to win the book! The contest ends at midnight Sunday EST, so get your name entered now!

(The books are supplied by Planned Parenthood of Southwest and Central Florida. Five winners will be drawn via random.org.)

To Lube or Not to Lube

It can be difficult to decide whether you should use lubrication and which type and brand is right for you and your partner. Here are a few simple tips to hopefully help you find the right one. Remember, it can be like Goldilocks at first and it may take experimenting with a few different lubes to find the one that is just right.

Reasons to consider using lubricants:

  • It may make sex feel better
  • It makes condoms less likely to break
  • Helps women who have vaginal dryness
  • Should be used for anal sex to help prevent tearing

Water-based lubricants with glycerin (Astroglide, KY Jelly, Pink) & water-based without glycerin (Good Clean Love, Blossom Organics, Please)

Silicone-based lubricants (Eros Pjur, Sliquid, Wet Lubricant, Liquid Silk)

Pros:

  • Rinses out of the body easily and easy to clean up
  • Can be used on sex toys
  • Sweeter tasting
Pros:

  • Lasts longer than water-based lube
  • Never gets sticky
  • Can be used for massage
Cons:

  • Can feel sticky on the skin
  • Are not as long-lasting as silicone
  • Are not good for use in water
  • May stain linens and towels
  • Lubrication with glycerin is not recommended for women with diabetes, immune deficiencies, and chronic yeast or vaginal infections.
Cons:

  • Can damage some silicone toys
  • Are more difficult to rinse off/out of body (especially out of the vagina)
  • More expensive

FYI: People have come up with some very strange things to use for
lubricants. The best way to explain what to use and not to use is as lube is to simply remember: anything you put in your hair, anything you cook with or eat, and anything you can find in your bathroom should not be used as a lubricant. People should know that if it is not designed to be used with condoms they should not use it. Furthermore, anything with oil in it can trap bacteria in the body and cause a condom to break.

By the way, there are also lubes that are organic, vegan, phylate-free, and paraben-free. For a list of a variety of lubes, you can visit Goodvibes.

The Final Frontier: Birth Control…for Men?

The Male Birth Control PillEvery once in a while, a news story pops up about some new male birth control that’s in the works, and I always think the same thing: “I’ll believe it when I see it.” Although we get an occasional tease in the media, birth control has always largely been the domain of women.  Sure, vasectomies have been around for a long time now, but when it comes to reversible birth control men have condoms, withdrawal, and…what else? Let’s do a quick run down of male birth control options, the current and the (allegedly) upcoming.

Condoms. You know how these work; if you don’t, we’ve covered it here on the Feronia Project.

  • Pros: Up to 98% effective when used correctly every time. Easily available and simple to use, and you can get them for free at the Health Department and Planned Parenthood.  Try using them with some water-based lubricant (not nonoxynol-9, which can cause irritation which may increase the chance of getting an STI) and spermicide.
  • Cons: feels unnatural to some people, may decrease sensation or cause allergies in the latex-sensitive (try polyurethane condoms!), and you have to interrupt foreplay to put them on.
  • Biggest bonus: Condoms are the only method on this list which protect both partners from sexually transmitted infections.

Withdrawal. Also known as the pull out method. I’m super biased against this method for three reasons which we’ll discuss.

  • Pros: It’s available to everyone with a willing partner, free, and doesn’t require health insurance or seeing a doctor.
  • Cons: It’s only 73-94 % effective, and here’s the catch: you have to do it right (that’s what she said! Sorry). Men have to have a lot of self-control and knowledge about their bodies, which takes experience and practice. Pre-seminal fluid, the fluid that comes out of the penis before the man ejaculates, can still contain sperm so pregnancy can still happen. Also, if the man ejaculates on the vulva (outside the vagina), pregnancy can still occur – sperm really can swim.

Here are my thoughts:

  1. 73% effective with typical use? When there are methods out there that are up to 99% effective? No thanks.
  2. Trust no one, that’s my motto.  Even the most well-meaning man can forget, or get caught up and lose control, and hey, pre-seminal fluid is beyond their control anyway. Too risky.
  3. The plural of anecdote isn’t data, but I swear that I’ve seen so many positive pregnancy tests in my day by women who checked the “withdrawal” box on their birth control questionnaire. Scary.  Still, I know it’s not easy for everyone to obtain other birth control methods for financial, time, or other personal reasons, so withdrawal may be your best option at times.

Vasectomy. Story time! I was on a first date with this guy, and he mentioned that he wanted to get a vasectomy soon and was just waiting for an appointment with his doctor. Instantly, music swelled and cartoon birds started flying through the air, and my eyes turned into hearts and sprung out of my head. (That really happened. We broke up, though.)

Vasectomies deserve their own post (which is coming soon!) because there are a lot of myths and misinformation surrounding them. I think the biggest barrier to a vasectomy is getting the man to agree because a lot of men think you’re cutting off their testicles or forcibly removing their manly essence or something. In reality, vasectomies are safe, quick, and easy. Ejaculation still occurs, but the vas deferens (the tube that carries sperm) is blocked so that there is no sperm in the seminal fluid. Sex still looks and feels totally normal. No organs are removed, hormones and sperm production continues; sexual pleasure and sexuality are not effected.

  • Pros: Birth control that doesn’t interrupt sex and is nearly 100% effective and I don’t have to do anything – and it’s permanent? Sold. As you can tell, I love vasectomies.
  • Cons:  It’s permanent. Reversal surgery is expensive, complicated, and there’s no guarantee, so you need to be sure that it’s what you want.

(PS: Our local Planned Parenthood offers vasectomies; if you’re in Florida and interested in a vasectomy, check out our man Dr. Stein at his site).
RISUG. The most exciting up-and-comer. The hard-to-pronounce acronym stands for Reversible Inhibition of Sperm Under Guidance and in the US is called Vasalgel.  I’m not a fan of the names, but otherwise it sounds amazing.

The vas deferens is numbed with an anesthetic and then a polymer gel is injected into it and kills sperm – for up to 10 years. Then, when the man decides he’s ready to have kids, there’s another injection to get rid of the polymer and welcome back sperm. It’s been in trials for about 15 years in India, and starting trials this year in the US with hopes that it will be available in the United States by 2015.  I’m really hoping this becomes available and catches on, because it sounds like it could be a revolutionary new family planning tool for men and women both.

What else?
Apparently there are other things potentially on the horizon, creams, implants, and pills, which I can’t find a lot of information on, individually. However, you can read this article on male birth control options on MSNBC and the men who are trying them out.

Here’s my question, though. Say we finally get reversible male birth control on the market – will men use it? Would women want them to?

For a lot of people, the answer is an obvious yes. Many men will be delighted at the chance to have more control over the decision of when to get pregnant. Women who have experienced bad side effects on hormonal birth control will be happy to let their men try it out so they can have a break. I think a lot of men may be suspicious and hesitant; men aren’t used to their sexuality being medicalized like women’s sexuality has. Plus, for some men, there may be psycho-social factors to take into account, given the cultural links between masculinity, power, the penis, testicles, virility, etc.  For women, giving up control may feel too risky – if a guy misses his pill or his birth control otherwise fails, he’s not the one getting pregnant.

What do you all think? Would any of you try RISUG? Have you had experiences with condoms or vasectomies, good or bad? Dudes, would you take a birth control pill? Ladies, would you feel comfortable with your man being the one on the pill? Tell me about it.

Pregnancy Prevention: What to Do If You Miss One, Two, or Three Pills

Birth Control PillsBirth control pills are more than 99% effective in preventing pregnancy as long as they are taken as directed. Having said that, birth control pills are a hormonal contraceptive method that must be taken orally every day at roughly the same time. (Progestin-only pills that do not include estrogen must be taken at exactly the same time every day in order to be effective and missing even one can lead to pregnancy; therefore the rules below do not apply to them.)

For many pill users, there will be at least once in your life when you miss taking your pill at the correct time. Don’t beat yourself up about it, but be prepared in advance for what to do in that scenario to continue keeping yourself protected from an unintended pregnancy.

The following are some general rules to follow in regard to combined hormonal contraceptive pills (estrogen and progestin, which are the vast majority of pills prescribed). As a reminder, in these pills the first three weeks are considered “active pills,” meaning that they include the active hormones needed to prevent pregnancy; the fourth week in a pack are considered “placebo pills” which do not include active hormones, and are taken during the menstrual flow portion of your cycle. If you are taking progestin-only pills, every pill in the back is considered active, and you must take them all!

If you miss one of the active pills: take it as soon as you remember and continue as normal with your pack.

If you miss two active pills: take them as soon as you remember but also use a back-up method like a condom (or abstinence) for one week.

If you miss three active pills: abandon the pack and use a different method for protection from pregnancy (like condoms or abstinence) until you have your next period. Begin a new pack the Sunday after your period starts, but continue your back-up method for one week, as you’re not yet protected from pregnancy.

If you mess up on your pills and had intercourse you believe wasn’t protected, you can take emergency contraception up to 72 hours afterward, most effective as soon as possible after the unprotected sex act. Again, if you’re 17 or older you do not need a prescription, but the medication is typically held behind pharmacy counters or at Planned Parenthood. If you’re under 17, you will need a prescription. (By the way, teens get discounted pricing at our affiliate.)

Also, if you find yourself forgetting two or more pills regularly, you might want to consider changing to a contraceptive method that does not require daily use, like the patch (weekly), the ring (monthly), the shot (every 3-4 months), the arm implant (three years), or an IUD (up to 5 years or up to 12 years).

As always, we recommend you use condoms in addition to your birth control method as a way of protecting against sexually transmitted infections, including H.I.V.

Need a text reminder to remember your pills/patch/ring or shot? Check out the free text-reminder service offered through Bedsider!

How Do You Have “The Sex Talk” with a New Partner?

Let's Talk About SexSo, you meet someone you think you want to have sex with and you are trying to be a responsible adult when it comes to sex. You’ve heard all the scary talk about HIV, chlamydia, herpes, HPV, etc., and you are definitely not ready to bring a baby into your life. How do you bring up the topic with your potential new partner?

Well, the best time is not when the hormones are peaking, bodies are sweating, hearts are pumping and sex is about to happen. The blood flow is not pulsing in an upward direction towards your brain, so the conversation might not be most effective at this time. Pick a time when you are fully clothed but in a private place. Starbucks is great for a first date, but probably not the best place to do some sexual negotiating.

There has hopefully been some indication that this person is interested in you as more than a friend. A longing look, a kiss or grope before you say good night, a bit of steamy sexting are always good indications that someone is looking to take it to a physical level. If you read the signals wrong and start a conversation about safer sex with someone not interested in you that way, this could be one of the most embarrassing moments of your life. But, better to be embarrassed now than having to explain to all future partners about these little bumps, periodic blisters or need for daily meds.

First, you need to be clear in your own mind: what do you want from your partner? Always use a barrier like a male or female condom? Does your definition of sex include oral and anal sex as well? (Remember health class? Sex includes oral, anal and vaginal intercourse.)  A full battery of testing for sexually transmitted infections before you go any further? And that just covers infections. What if the possibility of pregnancy is in the picture? Is this someone you would want to parent with? What if a pregnancy should occur? Do you agree on what the outcome should be: parenting, adoption, abortion?

So you’ve figured out your requirements for sex. You’ve got your list and checked it twice. What do you say? How do you start the conversation? You need to be yourself. Does humor work for you? Do you sort of slide into a topic or just blurt things out? No matter how you start the conversation, it will most likely feel awkward, unless you’ve done it before. Practice may not make perfect, but it can help. A few ideas:

“I’m really enjoying our time together.”
“I feel like we’re getting closer and things are heating up.”
“I think we need to talk before we go any farther.”
“I’m really into you, but before you get into me we need to talk.”

(If these sound totally lame, you come up with something better!)

How your potential partner reacts should tell you a lot about whether or not you want things to progress to a physical level. Do they appear angry, shocked, offended, or clueless as to what you are talking about? If so, you may want to slow down and reconsider your next move. Hopefully, they will be relieved that you were brave enough to start the conversation and were just trying to figure out how they could bring up the topic.

You are a responsible adult now, so act like one. Make a date to go get tested together. Do some research on ways to make safer sex more fun.

(Hmm – sounds like a good idea for another blog!)

We’re Here For You.

A couple of days ago, I had the humbling experience of supporting the Planned Parenthood patient services staff for GYT day (Get Yourself Tested – free Chlamydia, Gonorrhea and HIV testing). Without violating the confidentiality of our patients, I want to share a story with you – a story that illustrates that Planned Parenthood is here for you … no matter what.

During this crazy GYT day, we also saw many of our regular GYN patients. One of them reported a host of symptoms that alarmed the physician’s assistant. Immediately, diagnostic tests were ordered and performed. On the spot, her issue (a non-reproductive system issue) was discovered. The PA educated her, consoled her, and sent her straight to the hospital. As you would suspect, the patient was overwhelmed. She was confronted by a major health issue but at least she had an explanation for the symptoms that had been nagging her for too long. Because her concerns were taken seriously by a highly-trained and compassionate team of health care providers, she will soon have her health and her life back to normal.

You see? Planned Parenthood is a lot more than place where you get your pap smear. Or breast exam. Or vasectomy. Planned Parenthood is a trusted provider of basic health care, too. And even on our busiest days, we will be here for a patient in need.

The Self-Cleaning Vagina – Discharging the Myths of Discharge

Recently, I asked the staff at one of our health centers for a story that highlighted a myth about vaginas. They cited a recent story in which a patient came in complaining of vaginal discharge and, once diagnosed with a yeast infection, was convinced it was because she worked in a bakery. Yeast … around you … yes, we get the idea. But no, unless one places a baked good into the vagina, the chances the infection came from a yeasty treat are null and void.

We might chuckle a little at the sticker shock of such seemingly silly logic, but we realize the societal truth that vaginal discharge, along with many other reproductive health issues, is not usually a hot topic in people’s everyday lives. There is a lot of shame and embarrassment surrounding vaginal care, so let me clear a few things up.

Having worked for Planned Parenthood for close to four years, here are a few things I wish I could scream from the rooftops for every vagina-carrying human to hear:

1. Douching is bad for you and can cause the symptoms you’re trying to avoid!

We’ve all seen the boxes of Summer’s Eve tucked between the maxi-pads and pregnancy tests on our local pharmacy shelves. I’ve even seen advertisements that suggest vaginal douching will give a woman the confidence she needs to ask for a raise at work (what the hell?) I’ve heard women say their mothers douched, so they do it themselves. They’ve heard it makes them clean, or that it makes them smell good (with blatant implication that the natural odor is foul). Some do it every so often, while others integrate it into their sexual health routine more frequently. Regardless of the frequency of douching, please do yourself a favor and STOP! Douching, specifically with any agents that contain a fragrance, can drastically alter the natural balance of vaginal flora and acidity needed to self-regulate. Women who douche frequently are more susceptible to vaginal irritation, bacterial vaginosis, STIs, yeast infection or Pelvic Inflammatory Disease (PID). Same can be true for scented soaps and tampons … your temple smells fine the way it is, keep the perfumes outta there!

(**In some rare instances a medical professional may advise douching with water or other banal substance, in which case err on the side of your trusted health care advisor).

2. Healthy vaginas do not smell like fish or any other aquatic sea life!

There is a cultural myth that vaginas smell bad, specifically “fishy.” This myth has been further circulated within our society by some pretty off-color jokes (a blind man and a fish market…) which, while funny to those telling it, can often lead to reinforcing insecurities within women about their bodies. In a culture as dually sexually repressed and exploited as ours, it’s no wonder that this notion reigns “true” in the public arena. I can’t think of anyone else beside my P.P. family who would go toe to toe to argue the damaging ramifications of such a sexist joke as the punch line is delivered, so how else do we stop these dangerous lies from spreading? My thought is: education.

3. Vaginas are independent: When left alone they can clean and manage themselves just fine! 

The Vagina, as stated, is a self-sustaining organ that naturally produces bacteria and acids that cleans itself. It also produces a clear or whitish, generally odorless (sometimes acidic), itchless discharge that can increase and decrease in quantity as the menstrual cycle (28 days) changes. If you’re on a hormonal birth control method, your discharge may differ when on it from your non-hormonal cycles, as ovulation (releasing of the egg from the ovary) may increase discharge for a few days. Sexual arousal can also increase vaginal discharge, as your vagina naturally lubricates (though adding a fragrance-free water-based lubricant can help prevent tearing of condoms).

4. At the end of 6-8 hours, take out your tampon!

Too often a woman will come into our health centers complaining about a terrible vaginal odor, only to have the clinician remove days, weeks, or even months old tampon remnants. We call these “impacted tampons,” and they have the potential for some serious consequences, such as incredible odor (we sometimes have to close down the exam room for the day afterward), infection (bacterial vaginosis or pelvic inflammatory disease), toxic shock, or even death! It is so critical to take your tampons out within the time suggested for use on the package label, but also easy to ignore. Here’s a tip: confirm all tampons are out at the end of your period by placing your finger inside your canal and checking!

5. If your vagina smells abnormal, has colored or thick discharge, itches, or is generally out of the norm, head into Planned Parenthood!

So many times we see clients who incorrectly self-diagnose vaginal symptoms, and end up further irritating their condition, or wasting time and money on incorrect treatments. If I had a dollar for every time over-the-counter yeast medication was used on bacterial vaginosis, I’d create a P.S.A. about this topic and launch it during the Super Bowl. Delaying proper treatment of vaginal infections or sexually transmitted infections does not improve your health or save you money. Contrary, it can worsen temporary symptoms or cause irreversible damage to reproductive organs. Often clinicians can write a prescription that has multiple refills, if you are a person with chronic susceptibility to a specific infection, so you don’t have to pay for every visit to the health center (this rule is very specific to your condition, your health history, and the medical discretion of the clinician).

Here are some helpful links to some info about common vaginal infections, and as always, WE’RE HERE FOR YOU!

The Sound of Your Orgasm – Female Copulatory Vocalization

Sound of orgasmMost heterosexual couples recognize the many differences in the way males and females process emotions, communicate, solve problems, and generally view the world. We tend to think of males as more aggressive, physical and loud. Think of a group of male sports fans revved up over the final moments of a very close game. Few demure gestures, whispered comments or shy responses in this group. So where is the one area where women vastly out-vocalize men? During sex, particularly while having an orgasm.

While men typically orgasm with a bit of heavy breathing, a few grunts and the deed is done, women tend to vocalize with increasing volume, often climaxing with operatic proportions. The ancient Indian text of how to make love, The Kama Sutra, gives this advice, “As a major part of moaning, she may use, according to her imagination, the cries of the dove, cuckoo, green pigeon, parrot, bee, nightingale, goose, duck and partridge.”

Human females are not alone in the primate world when it comes to expressing their pleasure in a vocal cascade of sounds. Female non-human primates make sounds that they reserve only for mating. It is believed that this behavior is a call to males to come take advantage of her willingness to mate during the time she is ovulating. The closer she is to ovulation, the more complicated and intense the sounds.

To view one of the most well known, very vocal, fake orgasms, visit this YouTube video to view Meg Ryan giving it her all in When Harry Met Sally.

When You Are Trying To Conceive: Baby-Making Tips

Many of us have spent most of our adult life trying not to become pregnant, so when the day come that we decide we are ready it can’t come fast enough. I am at the age where everyone is getting married or having babies and for those of us creeping up on the 35 mark, it is difficult to ignore the very loud sound of our biological clocks. I want to first start out by acknowledging that not all families are made in the “traditional” manner and many families use surrogates, artificial insemination, adoption, etc. However, I will be focusing on the ways a women can boost her chances of conceiving through the “old school” method.

Hopefully, if you are planning a pregnancy you have looked into preconception health advice. These tips usually include taking a good prenatal vitamin approximately 3-12 months before you try to conceive. Women are also encouraged to cut back on their consumption of alcohol, quit smoking and use of harmful substances, check with their doctors if they are taking a prescription medication, lose weight if they are overweight or obese, make sure they are checked for STI’s, have vaccines updated, have any current medical problems under control, and finally stopping their BC method about a month to three months before ready to conceive to have a better gauge on when they ovulate.

Now that all of the basics are covered you are ready for the fun part. I want to reiterate: the fun part. Please do not make sex into a chore or get frustrated if you don’t get pregnant right away. If you are trying to have a little help in speeding up the process, here are a few tips that may increase your chances.

Tip #1 - Have a lot of sex and make it hot sex! According to Dr. Joanna Ellington, an American expert in reproductive physiology, the better the sex, the better the chances of conception. She states that the more excited they are, the further back in the testicles they are going to draw on their reserve sperm. This would then produce more sperm and increase the likelihood of the male releasing healthier sperm that are of a higher quality. For women, more orgasms not only make sex a more pleasurable experience but also increase the chances of conception. Many studies have documented the muscular contractions women have during orgasm and believe that their bodies helps suck the sperm through the cervix and then into her uterus. Check out a short clip on how this occurs from the Discovery Channel’s documentary on Why Sex Is Fun.

Tip #2 - The Pillow Method. After sex, you should put a pillow underneath you to elevate your hips and give his swimmers some extra help with the beginning of their journey. Some say a few minutes and others up to 45 minutes. I have been told by a few friends that the pillow thing has sealed the deal.

Tip #3 - Avoid lubricants. If you can, do not use lubricants during sex because they can affect the sperm’s motility.

Tip #4 - Track your ovulation. You can use a calendar, an application on your phone, an ovulation kit, or the Fertility Awareness Method.

Tip#5 - Improve partner’s sperm quality. Your partner can do his part to increase your chances of conceiving by: taking a multivitamin, reducing stress, maintaining a healthy weight, reducing alcohol consumption, avoiding tobacco or illegal drugs, increasing consumption of fruits and vegetables, regular exercise, avoiding masturbation around the time of ovulation, avoiding hot tubs and steam baths, and let “the boys” breathe by wearing boxers instead of briefs and placing something between himself and his laptop.

Remember, these are just tips, not a sure-fire way to get pregnant. It is a good idea to make an appointment with your doctor before you try to conceive just to make sure your health is where it should be. If you are having trouble conceiving after a year or more of diligent trying, you may want to consult an infertility specialist. Best of luck in your baby-making endeavors! Plan those Parenthoods!