Tag Archives: sexual health

Lesbian and Bisexual Women’s Sexual Health Issues

TwoWomenPocketsLesbian and bisexual women face unique problems when it comes to sexual health care. Many healthcare professionals have had little or no training on health issues specific to women who have sex with women or have sex with both males and females. They may make assumptions about the patient’s need for birth control, ask about a boyfriend instead of a partner, educate on safer sex practices that may not apply or not be aware of sexual health issues unique to this population.

According to the Department of Health and Human Services there are several factors that can prevent lesbian and bisexual women from getting good health care.

  • Being afraid to reveal your sexual orientation or sexual history
  • Having a health care provider who does not know your disease risks or issues that may be unique to you
  • Not having health insurance or not being able to qualify for your partner’s insurance
  • Not realizing the risk of STDs and cancer of the female reproductive organs

In general, women who are lesbian or bisexual have a higher rate of obesity, smoking, alcohol and drug abuse and stress. These are primary factors in heart disease, cancer and diabetes. In addition, sexually transmitted diseases can be spread from woman to woman sexual contact through:

  • Skin-to-skin contact
  • Mucosa contact (Oral sex)
  • Vaginal fluids
  • Menstrual blood
  • Sharing sex toys

Some STDs are more common among lesbians and bisexual women than the general populaton. The STDS that are most likely to be passed are:

  • Bacterial vaginosis – BV often occurs in both members of the couple. The vagina has a natural balance of mostly helpful bacteria to lesser amounts of harmful bacteria. BV develops when the balance is reversed. Sometimes there are no symptoms but there may be vaginal itching or fishy smelling discharge. BV is cured with antibiotics.
  • Chlamydia – Chlamydia is caused by a bacteria being passed during vaginal, oral or anal sex. It often has no symptoms. It can be cured with antibiotics.
  • Genital herpes – Genital herpes is caused by herpes simplex types 1 and 2. Type 1 usually causes painful blister on the mouth or lips while type 2 typically is spread by genital skin-to-skin contact. However, oral sex can spread either type between two partners. Medications can lessen the symptoms, but there is no cure.
  • Human Papillomavirus – HPV can cause warts which may be removed and cancer of the cervix, which can be detected by a Pap test. Here is a vaccine to help prevent several strains of the virus.
  • Trichomoniasis – Trich is caused by a parasite that can be spread during sex. You can also get it from contact with damp moist objects such as towels or wet clothes. It can be treated with antibiotics.

For more information on lesbian and bisexual health issues contact:

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Why Young People Should Still See a Gynecologist Before Their First Pap Smear

Nurse Meeting With Teenage Girl And Mother In Hospital

Nurse Meeting With Teenage Girl And Mother In Hospital

Many people now know the new guidelines from the American College of Obstetricians and Gynecologists (ACOG) do not recommend pap smears until the age of 21. This can be a bit confusing and frustrating for parents and teens that still have sexual and reproductive health care needs and are unsure if they should visit a gynecologist or sexual and reproductive healthcare provider (SRHP) who specializes in this area.

Here are some of the most common reasons young people should go to a SRHP.

STDs – Many young people and their partners need to be tested or treated for STDs. They may also want to talk to their parent/guardian and their medical provider to determine if they should receive the Human Papilloma Vaccine. The Gardasil Vaccine is recommended for boys and girls ages 11 or 12. The vaccine is recommended for people ages 9 to 26. According to Merck pharmaceuticals, the Gardasil vaccine helps protect against 4 types of HPV that cause 70% of cervical cancer cases, 70% of vaginal cancer cases, and up to 50% of vulvar cancer cases. In males and females ages 9 to 26, GARDASIL helps protect against about 80% of anal cancer cases and 90% of genital warts cases.

Vaginal Infections – Infections can occur at any time during our lives and many times have nothing to do with whether we are sexually active (i.e. urinary tract infections, bacterial vaginosis, yeast infections, folliculitis).

Menstruation – Some teens have irregular periods, PMS, painful cramps or heavy bleeding that keeps them home from school or work, acne or other medical conditions like endometriosis or abnormally large ovarian cysts that may require medication, procedures, or an office visit.

Birth Control – A sexual and reproductive health care provider can discuss the benefits and potential side effects of each birth control method and help the patient determine which method is best for them.

Pregnancy – Young people can receive pregnancy tests, options counseling, and preconception health if someone is planning to become pregnant in the future.

Safer Sex – Education can empower people to make safer choices and know their risks if and when they decide to be sexually active.

LGBTQ Health Concerns – Specific information can be given on how to be safer with a partner, medical concerns that impact LGBTQ individuals and referrals to additional resources.

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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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Male Fertility: What Can You Do?

Image via Lady-Comp

Image via Lady-Comp

There has been so much attention paid to good prenatal care for females, but what about the males? It’s pretty much taken for granted that he’s good to go with little forethought to the health of his sperm. According to the Mayo Clinic, there are several things to consider.

If a male is able to ejaculate, he is most likely fertile. A single ejaculation contains about 15 million sperm per milliliter.

Normal sperm have oval heads containing the genetic material needed to reproduce and a long whiplike tail to propel it towards the egg. The more sperm produced with both parts in good order, the more likely he is to be fertile.

The sperm has a long way to go from the tip of the penis through the cervix and uterus and finally into the fallopian tube. If there are at least 40 percent of the sperm able to propel themselves, your motility is considered good and you are probably fertile.

Here are a few things recommended to increase your chances of producing healthy sperm.

Practice safer sex and get STD testing
Chlamydia and gonorrhea can cause sterility in both males and females. Before trying to conceive, both partners should be tested. Using condoms with new partners and checking their STD status can help prevent any unwanted surprises.

Protect your heart: protect your penis and testicles
Anything that is good for your heart is good for your fertility. Keep an eye on your weight. Overweight men have a 20 percent greater chance of being infertile as well as having an increased chance of heart disease and diabetes. If you smoke, stop. Just as smoking damages the blood vessels in your heart, it also damages the circulation to the penis and testicles. No news here, diet and exercise are an important key to a healthy heart, penis and testicles!

Manage stress
Stress can decrease sexual function and interfere with the hormones needed to produce sperm.

Keep cool
Sperm is sensitive to temperature and can be affected by things as simple as having a laptop on your lap for long periods of time, spending extended amounts of time on a bike or seated, or wearing tight underwear or athletic shorts. If these things are an essential part of your life, take frequent breaks.

For additional information, check out “Sex Matters”.

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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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Because Consent Always Matters

This year, we haven’t talked all that much about Sexual Assault Awareness Month. There are a lot of great resources already out there, as well as here on Feronia, and since we talk about consent throughout the year, we’re happy to let the spotlight fall on more local, in-person events in April. But our SOURCE team put together an absolutely fabulous PSA about consent last month, and I’m really excited to share it with you:


(There’s also a 15-second version for those of you who want even quicker ways to explain consent.)

Every year, I run into a fair number of people who ask me why there are so many events for Sexual Assault Awareness Month – doesn’t everybody already know about this stuff? While it’s always (sadly) easy to show that we still have a lot of work to do in addressing sexual assault, the news last month brought a really good story out that illustrates just how invisible sexual assault can still be.

Jon Krakauer’s new book “Missoula: Rape and the Justice System In A College Town” explores a series of assaults connected to the University of Montana, but the meta-story is about how Krakauer was largely unaware of the scope of sexual assault in the U.S. before 2012, when a friend of his shared her story of being raped. When he started looking into it, he discovered that many of the other women in his life had similar experiences that he just hadn’t known of, and he felt surprised by it.

The fact that he found more women in his life who have dealt with this is unfortunately what you’d expect when you look at things statistically: 1 in 6 American women will be victims of attempted or completed rape in our lifetimes. But the fact that he was surprised is one of the most interesting parts of this for me.

Humans are known to be pretty bad at estimating the actual risks that are involved in lots of areas of life – it’s something that people involved in public health, economics, sociology and a whole host of other fields have been looking into for ages. But Krakauer’s description of what he went through shows that this was something even more basic – he hadn’t been considering this issue and deciding that it wasn’t likely for himself and the people in his life, he just hadn’t been considering it at all at a personal level.

And that’s a big part of why these events, PSAs, and other types of outreach are so important – these issues affect all of our lives, even when we don’t know that they do. And the more we talk about them, the more openings there are for people to share their stories, and help move us all towards a future when the statistics won’t be so bleak.

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Who Has Better Sex: Males or Females?

Even though there are many obvious differences in males and females, our sexual responses are very similar. For both, orgasms have the same variety of intensities and degrees of pleasure. This shouldn’t be too surprising since both male and female sexual parts are derived from the same sources. Both males and females described orgasms as “waves of pleasure in my body” and descriptions could not distinguish if the respondent was male or female.

For the first two months of fetal development, male and female genitalia are indistinguishable. All the basic patterns of cells, nerves and blood vessels are created during this time. Somewhere between six and twelve weeks of fetal development things differentiate into male and female parts. Except for the development for the potential of the female ovaries to produce and release eggs, the female stays the same. If a Y chromosome fertilized the egg, testosterone will flood the body during this time frame and the clitoral tissue will begin the change into a penis. The testicles and scrotum evolve from tissue that formed the female’s labia and ovaries.

All this means that a male and female’s response to sexual stimulation is remarkably the same. One of the body’s first responses is the opening of arteries supplying blood to the penis, clitoris and to some extent the breasts causing swelling and increased sensitivity.  The rhythms of muscle contractions in the female and male during orgasm have exactly the same pattern and timing. A major difference between the sexes is that following ejaculation, males experience a latency period where they need to recover in order to have another erection and ejaculation. Females, luckily, can continue to have another orgasm and another and another!

Another difference in initial sexual response is that males are intensely visual. They have 25% more neurons in the visual cortex than females, so a large part of their brain is used to process visual information. This helps explain why males are so much more interested in watching porn. In fact, males make up two-thirds of users of sexually explicit internet sites. In addition, 29% of males prefer having sexual activity with the lights on compared with only 14% of females.

To read more about male sexuality, check out this fascinating book by Harry Fisch, M.D. and Kara Baskin.

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What to Say & How to Say It

We’ve talked about communication before on Feronia, and how it’s a key part of so many different things – consent, exploring new activities, embracing your own desire, not to mention the roles it plays in all of the rest of our lives. But while wanting to communicate well is a good (and necessary!) first step, it’s a bit vague as a roadmap.

Whenever I see advice that says “communicate with your partner” and doesn’t offer specifics, I’m reminded of the South Park Underpants Gnomes:

Thankfully (though somewhat sadly) this is a really common problem, so you don’t have to start from zero.

Often, we find ourselves tongue tied when we want to talk about trying something new. Writing things down can often be easier than talking about them in the moment, though. And when it comes to communicating around sex, silliness can sometimes help break the ice a bit. One way to bring up new possibilities is to fill two bowls with different slips of paper – put actions (kissing, touching, massaging, etc.) on one set, and body parts on the other. You’ll get a few odd combinations, and laughing about them can help make it easier to try new things and talk about what you like and aren’t so into.

That brings up another tricky set of conversations – talking about things that you don’t like. While it can feel really awkward to bring up, know that your partner wants to know this stuff! One way to bring it up gently is to pair a statement about what you don’t like with one about something you like better – you’re still being clear about your desires, but you’re making it easier to move forward to things you enjoy. (Note: this is advice for talking about specific activities within an otherwise good dynamic. If anything is seriously off-kilter, you don’t want to risk rushing past it by doing this.)

There are a lot more hurdles to clear when dealing with communication issues – judicious use of advice columns and the self-help aisle can provide a lot more for tips more specific to your particular situation. There are a lot of great advice sites out there – I can recommend Go Ask Alice, Ask a Queer Chick, and Autostraddle, and there are a lot of other places with good tips about communicating outside of romantic relationships, too.

With all advice, though, be sure to take it with at least a grain of salt. I like reading Dan Savage, but I know to be wary around his columns that talk about bisexuality and trans* issues (particularly for things in the archives). And there’s a lot of useful information in books like the 5 Love Languages, but you have to sift through a fair bit of dross to get to it. (In that example, the author only talks about opposite-sex relationships, is pretty proscriptive about monogamy, and has some other ideas that made me roll my eyes pretty often.)

Whatever you’re talking about, here’s to making it less intimidating, more fun, and connected to getting more of what you want, in your relationship and beyond.

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A Libido Pill for Women?

A company called Spout Pharmaceuticals is trying to receive FDA approval for a drug called Flibanserin. The company claims the pill can dramatically increase a women’s desire to have sex. In their study, the participants reported a distinct increase in sexual desire and in the number of satisfying sexual events, as well as a marked decrease in distress around having sex with their partner.

two pairs of feet in bed

image via Rodale News

Unlike Viagra that works to increase blood flow to the genitals, it works by increasing the chemicals in the brain. The drug works by increasing dopamine, norepinephrine and decreases serotonin. While this sounds like an easy fix, it isn’t. First, decreases in libido are not always linked to one cause. A person’s sexual desire can be changed by fatigue, children, emotional problems, menopause, hormonal changes, medications, etc. The reasons can vary so widely that it is unclear if changing brain chemistry will erase all of the other potential culprits of not wanting to get frisky with their partners. Second, the medication has not been approved by the FDA.

While I’m all for focusing more on female desire and sexual health, I don’t know how I feel about taking a mood altering drug that has unknown sides effects and potential risks for long term use. If someone is having trouble with a decrease in sexuality they may want to evaluate their personal and professional life.

Psychological Issues
-Poor body image or low self-esteem
-Prior sexual or physical abuse with previous partner

Relationship Issues
-Feeling disconnected
-Lack of communication
-Not feeling happy with your partner
-Constant fighting or arguing

-Medical problems
-Pain during sex
-Hormonal changes
-Lack of desire after surgery

If you are experiencing a decrease or lack of desire it’s important to realize that you’re not alone. By pinpointing the problem, you can find the resources you need to get your sexy back. Many people benefit from counseling or seeing their doctor if it’s a physical problem.

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What We’re Reading via The New York Times

If you don’t follow The New York Times, you should. One of the reasons we love it is because they publish excellent and timely articles on health, and we sex educators rely on it to stay up on the latest news. It is a reliable and sound resource for us. Here are a few of our recommendations from the last month or so…

Searching for Sex, by Seth Stephens-Davidowitz, January 25, 2015

If you’re fascinated by all things sex ed like I am, you MUST read this article. I’m not even going to prep you with a little introductory paragraph because I want you to be totally blown away. The article is a bit long so if you don’t have time now, bookmark it for later.

Medicating Women’s Feelings, by Julie Holland, February 28, 2015

There are lots of things our society doesn’t talk enough about and mental health tops the list, in my opinion. This article, written by an experienced psychiatrist, says enough is enough! She says, “The new, medicated normal is at odds with women’s dynamic biology; brain and body chemicals are meant to be in flux. By evolutionary design, we are hard-wired to be sensitive to our environments, empathic to our children’s needs and intuitive of our partners’ intentions. Women’s emotionality is a sign of health, not disease; it is a source of power. But we are under constant pressure to restrain our emotional lives.” I highy recommend this read…share the article, talk about it, reach out to a friend.

Two Strains of H.I.V. Cut Vastly Different Paths by Carl Zimmer, March 2, 2015

Two strains of HIV-2 have made it to gorillas from chimps, and it's created two rare strains, O and P.

Two strains of HIV-2 have made it to gorillas from chimps, and it’s created two rare strains, O and P, both of which have jumped to humans in Cameroon

We’ve posted many articles about HIV before, including this one the origin of HIV. What I like about Carl Zimmer’s article is that he retraces what we already knew about HIV’s origin, but helps us fill in the gaps by exposing us to new research. HIV-2 didn’t just take one giant leap from primate to human, IT TOOK NINE! HIV-1 was trickier to track down. Scientists have been sifting through chimpanzee and gorilla feces for years looking for answers and now they finally have definitive proof that they can use to reconstruct the path that HIV-1 took. It’s a very fascinating read so be sure to check it out!

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