Tag Archives: safer sex

Self Love is Safe Love: A History of Masturbation

grab the Heart.retro photo image.

Today we are re-running an oldie, but so very goodie: Fosgood’s history of masturbation post. Enjoy!

Masturbation has a long and colorful history.  According to some ancient Egyptian myths, the god Apsu created the Milky Way when he copulated with his fist. (This certainly gives star gazing a new twist!) Greek men and women both were known to masturbate and saw it as a gift from the gods. They believed the god Hermes taught his son Pan how to masturbate to help heal his broken heart when he was rejected by the nymph, Echo.

Some took it a bit too far: the philosopher Diogenes masturbated in public stating that no human activity should be seen so shameful that it must be done in private; his fellow citizens disagreed. The physician Galen felt that the retention of semen is dangerous and leads to sickness while Hippocrates cautioned that loss of excessive amounts of semen could result in physical damage, such as spinal cord deterioration.

Women in ancient Athens commonly purchased dildos known as olisbos, made of padded leather or wood. Greek men saw masturbation as a sign of poverty and if you had the money, you would pay someone to do it for you. A few centuries later, Roman boys were encouraged to deplete their sexual energies through philosophy and gymnastics, the Roman equivalent of a cold shower.

Many of the negative attitudes about masturbation are attributed to the Bible, but no mention of masturbation is found; actually, what is referred to is the story of Onan, who  protested God’s commandment to impregnate his brother’s widow, whom he did have sex with but pulled out and “spilled his seed.”  From here, things went way downhill. An early Christian bishop taught that masturbation was a worse sin than adultery, rape and incest because it was “unnatural” and a form of contraception. On and on the debate went for many centuries. By 1729 the “post-masturbation disease” came with a long list of serious and debilitating symptoms and charlatans made a killing selling cures for this dreaded affliction.

Things became so extreme that be the turn of the 20th century parents were encouraged to have their sons circumcised so as not to be aroused when cleaning their foreskins and daughters to have clitoridectomies (removal of the clitoris).  Parents were encouraged to place their children in straightjackets, or wrap the child in cold wet sheets and apply leeches to remove blood and congestion, or burn genital tissue with hot irons to make sure their child had no access to their genitals at night where the evil deed was likely to happen.

There has been much improvement in the attitudes about masturbation, but there is still a long way to go. On a regular basis, health educators today still hear very negative responses about masturbation. (Female masturbation, in particular, is often greeted with something like, “Eww, that’s nasty!”) I’ve frequently asked parent groups concerned about masturbation if they would prefer their child masturbate or be out having sex, possibly causing a pregnancy or contracting a STI. That gets them thinking – though many would just prefer their child have no sexual feelings at all.

We know masturbation is an important way for people to discover their own sexuality, prevent infection (as long as their hands are clean), and prevent a pregnancy – and we would sincerely hope it’s sex with someone you love!

Edit: Historical facts come from the Planned Parenthood Federation of America’s white paper publication, Masturbation, From Stigma to Sexual Health.

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How to Shop for Condoms

Today we’re reposting an oldie, but goodie. Happy condom shopping!

When you’re standing in the condom aisle, seconds seem like hours. Your eyes dart nervously across the colorful packaging, waiting for some clear sign that you should grab one particular box and make a mad dash for the checkout line. Oh yeah, then there’s that pack of gum to grab.

Condom shopping doesn’t have to be difficult or awkward. If you use my three-point condom shopping system, you’ll be outta’ there and gettin’ busy before you know it.

Step #1 – Material

Condoms are made from three different materials – latex, polyurethane and lambskin.

  • Latex: helps prevent pregnancy and sexually transmitted infections; stretchy, yet durable; ring at base; reservoir tip for ejaculate; inexpensive (or free if you get them at the health department or Planned Parenthood)
  • Polyurethane (fancy word for plastic): helps prevent pregnancy and sexually transmitted infections, safe for those with a latex allergy; less stretchy than latex, but still durable, ring at base; reservoir tip for ejaculate; transfers heat better than latex; female condoms come in this material
  • Lambskin: helps prevent pregnancy ONLY (because it is made from animal intestinal lining, it has small pores that bacteria and viruses can fit through, but sperm are bigger, therefore contained by the condom); a bit more eco-friendly than latex or polyurethane; safe for those whose culture or religion dictates the use of a “natural” method of birth control or for those not worried about sexually transmitted infections; no ring at base (more like a drawstring); no reservoir tip for ejaculate; distinct odor; fairly expensive

So, decide which material is right for you and, when you’re shopping, let your eyes wander to the bottom right side of the boxes – that’s where the material type is usually printed. I recommend latex or polyurethane.

Step #2 – Expiration Date

Condoms are manufactured about 5 years before they expire so if your condoms expire next month, they’re already 5 years old. Age degrades the material, making condoms more likely to break. The expiration date is usually printed on the back or side flap of the box and on each individual condom, as seen below:

condom

Step #3 – “The Extras”

By “extras” I mean lubricant, spermicide, size, texture, flavoring, etc. Here’s the skinny on the “extras”:

  • Lubricant: unless you have a bottle of safe lubricant (water-based, because oil-based breaks condoms) handy, opt for lubricated condoms for vaginal and/or anal sex. For oral sex, either get a dental dam or cut an unlubricated condom up the side.
  • Spermicide: this is often called nonoxynol-9 and is a chemical that helps to kill sperm. The use of spermicides is debatable on several fronts. Do your research before you decide on this one.
  • Size: condoms are basically one-size-fits-all. There are, however, “slim fit” and “extra large” versions. Just remember, condoms are SUPPOSED TO BE SNUG.
  • Texture: ribbed or studded – truth is, it doesn’t matter much, particulary for penis-in-vagina sex. Why? Because the vaginal walls have very few nerve endings, making it hard to feel tiny ribs or studs. Think about it – women can wear tampons for hours and not feel a thing! Really, ribs and studs and such are just marketing tools.
  • Flavoring: If it tastes like strawberries, that means it has some sugar and flavoring to make it taste like strawberries. These condoms are meant for oral sex only. Sugar can cause a yeast infection because it throws off the pH balance in the vagina.

But what about the brand name!!!??? I get this question a lot. Just pick a trusted brand. You might need to try various types of condoms before you find one that you really like.

If going to the store to purchase condoms or going to the health department or Planned Parenthood to get free ones is just too intimidating for you, do your shopping online.

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Condom Use Among Young African American Men

Today’s guest post was written a sex educator who specializes in peer-to-peer pregnancy prevention programs. He understands the cultural nuances that influence the decisions young people make and works to help youth realize their potential. 

Condom use can be a taboo topic, especially within certain cultures and ethnic communities, including the African American community. When you dissect the African American community into subsets (by age, for example) you see trends in attitudes about condom use. According to the Black Aids Institute, young African American men report a 20.5 percent condom usage rate. It’s alarming to consider that 4 out of 5 young black men are not using condoms during sexual intercourse. Lack of condom use among African-American men can be seen as a direct correlation to higher rates of unplanned pregnancies, HIV, and other STI’s within the African American community.

couple

Research done by the Pacific Institute for Research and Evaluation conducted a qualitative study on condom use behaviors among urban African-American men ages 18-24. That research revealed various reasons for non-condom use:

  • Lack of interest in condom use
  • Lack of immediate access to condoms
  • Inconvenience
  • The mood-killing length of time it takes to put on a condom
  • Partner’s disinterest in condom use

The most commonly expressed rationale for not using condoms among the research participants was their general disinterest in using condoms. It is evident that there may be some cultural perceptions among young African-American men that promote the non-use of condoms during sexual intercourse. Education is a critical component to refute many of the misconceptions that this population has in regards to condom use and it may be highly beneficial for Sexual Health Educators to consider the use of peer-to-peer education.

Some of the perceptions of condom use among young African-American men are driven by peer influence. A literature review of peer-to-peer programs done by Advocates for Youth revealed the following results:

  • Improved reproductive and sexual health outcomes, including reduced incidence of pregnancy, births and STIs
  • Reduced sexual risk behaviors, including delayed initiation of sex, increased contraceptive use and condom use, reduced number of new sexual partners as well as increased abstinence among sexually experienced youth, reduced incidence of unprotected sex, reduced frequency of sex, and increased partner communication
  • Increased incidence of testing and sharing test results, including testing for HIV, for STIs, and sharing positive test results with a partner

Lack of condom use among African-American men has far-reaching public health consequences and effective strategies must be implemented to mitigate the cultural behavioral norms that promote non condom use. Peer education appears to be a promising model to educate young African-American men about the benefits of consistent and appropriate condom use.

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Fun Friday: The Guy’s Guide

Bedsider produced a fun, yet educational series of PSA’s aimed at guys, and today we’re sharing the one about emergency contraception. Enjoy!

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Why Don’t More People Use Condoms?

Most of us know that condoms are great at preventing pregnancy and sexually transmitted infections, so why aren’t more people using them? The most common reasons why people state they don’t use condoms are:

  • It takes away from the moment
  • It smells or tastes bad
  • Some men lose their erection
  • Reduces pleasure for both men and women
  • They don’t have one when they decide to have sex
  • Their partner will think they don’t trust them if they ask to use a condom
  • Their partner will think they sleep around if they ask them to use a condom
  • Fear of being identified as “high risk”

Man unwrapping condom, woman lying on bed in background, close-up of hands, close-up

All of these are valid reasons, but there is more to it. Most people know at least a little bit about the risks of unprotected sex and the consequences, but someone’s “Perceived risk” is a bigger factor in whether they choose to protect themselves. Education by itself is not enough to change behavior. Our personal beliefs on how likely we are to become infected with STI’s or pregnant play a much bigger role in whether someone uses a condom use. The components of these beliefs are part of the Health Belief Model listed below which can help an individual or medical provider address sexual risk and behavior.

Perceived Susceptibility People will not change their health behaviors unless they believe that they are at risk. Ex: 
If someone doesn’t think they are risk for STI’s they won’t use a condom.

Perceived Severity 
The likelihood that someone will change their behavior depends on the severity of the potential consequences. Ex: I had a pregnancy scare and now I always use a condom.

Perceived Benefits 
People won’t change their behavior if there isn’t something in it for them.
 Ex: I really like the way it feels without a condom and partner doesn’t make me use one.

Perceived Barriers People won’t change their behavior if they think it will be hard. Ex: My partner and I have already had unprotected sex and I can’t start using condoms now.

Self-Efficacy The extent or strength of one’s belief in one’s own ability to complete tasks and/or reach goals. For many individuals something has to change or connect with them to make them step back and decide that their current choices are not working for them or place them in danger. Ex: If a person truly believes they can avoid chlamydia by negotiating condom use, they are apt to be more successful in reaching their goal.

Things to consider:

  • Get tested if you don’t know your status or your partners status.
  • Think about your risk factors and what safer sex strategies you could implement.
  • Go to a reliable website to learn more about safer sex or make an appointment and learn how to protect yourself and make safer sex fun.

Sources: here and here

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What’s the Best Birth Control for Teens?

Well, the obvious answer is abstinence: 100% effective when used correctly. But what method is second best? Third best?

If you’re a teen reading this, here’s what to expect from your pediatrician, per the guidelines from the American Academy of Pediatrics: they will conduct a developmentally-targeted sexual history, assess risk for sexually transmitted infections, and provide appropriate screening and/or education about safe and effective contraceptive methods. Basically, they will ask you a choiceslot of personal questions that may make you uncomfortable, but it is really important to be honest with them. The information you give them is confidential, meaning they can’t share it with your partners, parents, friends, etc. They can’t match you to the best birth control method for you unless they have all of your behavioral and medical information in front of them. And sometimes it takes a few tweaks to get it right. Your doctor will advise you to spend 3-6 months getting used to your birth control, as it takes time for your body to adjust. Pay attention to any side effects you might be having and report back to your doctor the next time you see them.

implantNow back to what’s best for adolescents. Often, what’s considered the best is heavily influenced by what’s the most effective. Please look at this table so you can see the difference between “perfect use” and “typical use” of each contraceptive method. Take a look at “single-rod contraceptive implant.” This method is considered the best for teens who are or plan to be sexually active because it’s perfect and typical use rates are the same, and after a year’s use, 84% of women choose to stick with it. Unlike pills, patches, rings, and condoms, this type of contraception, also known by its brand names, Implanon and Nexplanon, is hard to mess up. Why? Because it is implanted into the upper arm, where it can stay for up to 3 years, preventing pregnancy. It can even be inserted immediately after birth.

Next in line are IUDs (intrauterine devices) in terms of effectiveness. There are two types of IUDs, hormonal and copper, lasting between 3 and 10 years. The copper IUD can be used as emergency contraception. What single-rod implants and IUDs have in common are their effectiveness in preventing pregnancy, ease of use, and their long-term coverage. They are often referred to as LARC’s, or long-acting reversible contraception. LARCs are as effective as birth control methods (aside from abstinence) can get without being permanent (like sterilization).

ALL birth control comes with side effects. You must weight the benefits and risks with your doctor. And remember, only abstinence and condoms will give you protection from sexually transmitted infections. It is a good idea to use your hormonal birth control WITH condoms.

If you are a parent reading this, there are a plethora of resources out there for you. Start with the American Academy of Pediatrics to read the most current guidelines. Visit Advocates for Youth to learn what to say and when to say it. Call your local Planned Parenthood affiliate as most have educators that you can talk to, learn from, ask questions, and even practice with.

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My Pap Came Back Abnormal…Now What?

Pap tests come back abnormal all the time so this re-post from E.G. Hanna still applies…
Pap test

So you got your annual screening and a few weeks later you get a phone call stating your pap test came back “abnormal.” Don’t freak out! This can mean a couple different things. To be clear, infections like chlamydia or yeast do not count as an abnormal pap! An abnormal pap means atypical cells on your cervix, that is, that the cells have begun to change in such a way that may be or become cancerous. This is called dysplasia.

After a pap smear comes back abnormal, what happens next depends upon a couple of factors, including your age and the severity of the dysplasia.

You may only need to repeat your pap smear in a few months, as often a health immune system can fight off the changes itself. Or you and your provider may opt for a colposcopy, which is a better way of looking at the cervix. A speculum is inserted into the vagina, solution is applied to the cervix with a cotton swab to highlight abnormal areas of tissue, and then a special microscope is used to look at the cervix. This allows the provider to see the dysplasia and, if deemed necessary, take one or more small tissue samples. This biopsy may feel like a small pinch and, while slightly uncomfortable for most women, it is usually tolerated very well. This biopsy allows the pathologist (the person who examines the tissue sample at the lab) to get a more detailed and accurate reading of the cervical cellular changes.

Depending on the colposcopy results, you may need to go back to pap smears every 3-6 months or, if the dysplasia is severe, you may need further treatment to fully remove the abnormal tissue. This treatment may consist of cryotherapy or a LEEP (Loop Electricosurgical Excision Procedure). Cryotherapy uses a freezing chemical to remove abnormal cells, allowing healthy cells to grow back in their place. A LEEP cuts away abnormal cells with a thin wire carrying an electrical current. Though both procedures may sound intimidating, in truth they are not very painful (many patients tell me their LEEP was more comfortable than their colposcopy, because of the numbing solution applied).

Cervical dysplasia is most often caused by HPV, a very common virus transmitted through sexual contact. Here are a few tips on how to avoid HPV and cervical changes:

Don’t smoke! Smoking is not good for your immune system, and you need a healthy immune system to fight the virus.

Consider the Gardasil vaccine, which protects you from 4 strands of HPV, 2 of which cause 75% of cervical cancers.

Use condoms. Though they may not fully protect you from HPV, as HPV is passed through skin to skin contact, because condoms cover parts of sexual anatomy they reduce the chance of transmission. Try female condoms too, which cover more skin.

Practicing abstinence or limiting sexual partners is also helpful, but isn’t foolproof. The CDC sums it up really well: “People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That’s why the only sure way to prevent HPV is to avoid all sexual activity.”

Most of all, if you have a pap come back abnormal, keep these two things in mind: 1) Don’t panic. 2) Don’t ignore it. Cervical dysplasia is treatable and it does not necessarily mean you have or will get cancer. The keyword there is “treatable,” meaning you must see your provider for treatment to avoid detrimental effects to your health!

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The Challenges with a Cure for HIV

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.

Since the discovery of Human immunodeficiency virus (HIV) as the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1983, it continues to pose a huge threat worldwide to the health of millions of people. Data from the World Health Organization (in 2013) revealed that worldwide 35 million people were living with HIV, there were 2.1 million new cases and 1.5 million deaths.

hivThe development of multi-drug combination therapy known as Highly Active Antiretroviral Therapy (HAART) for treatment of HIV/AIDS in 1996 was one of the major successes of modern medicine leading to a dramatic drop in the death rate by 50 to 80% between 1996 and 2006. This period is known as “the decade of HAART.” This changed the view of HIV/AIDS from a fatal and catastrophic disease to what is now a manageable chronic illness.

After this initial success, the next step was to find a cure and/or an effective preventive method. Currently the best way to avoid HIV/AIDS is to take conscious steps to avoid contracting the virus in the first place. This has been the aim of a lot of efforts all around the world teaching safe sexual health practices and healthy lifestyle behaviors. However, changing human behavior is quite difficult.

Due to the rapid and constant mutation of HIV, the human immune system finds it very difficult to defend against it and scientists have found developing an effective vaccine very problematic. Also, HIV is able to create reservoirs in its hosts leading to latency of the disease, which is the main reason HAART can’t eliminate the virus but only reduce its load in the human body to very low levels. For this reason HIV positive patients are unable to stop HAART therapy to avoid dramatic increase in their viral load.

Despite all these issues, promising advances in therapy are being made. Drugs like Prostratin, which are able to reactivate latent HIV and therefore increase the effectiveness of HAART therapy, are being developed. There are also a small group of people who are known to be immune to HIV due to the absence of the cell receptor necessary for HIV to infect cells known CCR5. This knowledge was used in the case of Timothy Ray Brown, the first case of a cured HIV positive patient. Although the therapy used on Timothy is very risky and expensive and therefore can’t be applied on a large scale, it has given researchers ideas on how to modify a patient’s immune system to resist HIV.

Continuing research in this field, including various promising results from numerous clinical trials show that there is hope for an effective cure for HIV. Tests in the lab have shown promise at a cellular level and the aim is to replicate these results at the macro level. This process may take years but with each passing year we get a better understanding of the virus and the disease mechanisms which would bring us closer to developing a cure and possibly a vaccine. Until then, maintaining a healthy lifestyle approach and engaging in healthy sexual behaviors (using condoms) will be the mainstay of HIV prevention.

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Getting it up to 5 Stars – where to find good condom reviews

I’m a sucker for online reviews. I love them for restaurants, hotels, and all the random things on Amazon that I find myself searching for. And they’re especially great for  things that are a little farther off the beaten path, like menstrual cups. I don’t have the patience – or the budget – to go through a lot of options using trial-and-error, so narrowing down the field is wonderful.

But until a few weeks ago, I hadn’t thought about reviews for condoms. I’ve been lucky to work in places that offer free condoms for ages (you can pick them up at any of our health centers!), and I hadn’t explored very far beyond that.

Now, anyone who’s spent time reading online reviews knows that not all reviews are created equal. Some information is useful across the board – Consumer Reports has a very analytical approach to things that’s helpful in determining what ‘ultrathin’ and other terms actually mean when you’re comparing across different brands. (And their reliability testing is very reassuring, too – none of the samples they tested in their ‘smart picks’ category had any holes or tears.) And size charts are very helpful in figuring out what to try, and what to avoid. Finally, no matter how awesome reviews are for flavored condoms, make sure that you’re not using them for vaginal or anal intercourse. A yeast infection caused by a 5-star condom is still a yeast infection.

Once you’re looking at more specific details, though, you can feel adrift in a sea of information. I can recommend Condom MonologuesBabeland and Good Vibrations’ reviews as sex-positive spaces. Additionally, the staff at Babeland and Good Vibes will always be willing to help you out if you have any specific questions on fit. Amazon is pretty comprehensive when it comes to what they carry, but the reviews can be a bit more hit-and-miss in their approach.

Once you’ve gathered the information you want, some pieces do come down to personal preference and experimentation – finding out what feels good will depend on the bodies in question. You’ll learn very quickly if you’ve got to take a latex allergy into account, but you might also have reactions to the lubricants included in condoms. Some condoms include nonoxynol-9 as a spermicide, which can cause skin irritation on your genitals. Aside from not feeling great, that irritation can make it easier to contract STIs such as HIV; if you’re wanting to add another layer of protection against pregnancy, you can consider some other forms of birth control.

Have a great time taking your new brands out for a test drive!

 

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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.

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