Trust Women

Today is the 37th anniversary of Roe v. Wade and the 5th annual Blog for Choice event. For the Past 5 years NARAL has been asking bloggers questions related to the right to choose in order to raise awareness for reproductive rights and ask what they mean to us. This year's question is:

In honor of Dr. George Tiller, who often wore a button that simply read, "Trust Women," this year's Blog for Choice question is:
What does Trust Women mean to you?

To me, trusting women is about understanding that we can make our own informed decisions. We do not need to be coddled. We do not need to be told misinformation in order to make the "right decision." We do not need to be forced to look at ultrasounds of the fetus to make a decision that we've already thought long and hard about. We do not need to be ordered by a court to do what is best for us and our families. If kids are given comprehensive sex education they will be given the tools with which to make informed decisions about sex and family planning. Women will have the ability to prevent unwanted pregnancies and to plan families if and when they want to. We need to help women to be able to make the right decisions for them by helping everyone to be educated about sex and sexuality.

I also think that part of trusting women is listening to their stories and having more women coming forward with them (if they so choose) to show that they make hard decisions that are right for them. Abortion especially is so demonized and we normally only talk about it in terms of rape or incest cases, but what about the rest of the women out there who get them? So many women feel like they can't come out and share their stories because they do not want to be demonized or judged for making a decision that was right for them. That was why I shared my story back in August soon after Dr. Tiller's murder. Read it here.

Related reading:
1. STIs and Sexual Responsibility
2. Contraception
3. Can you Get Pregnant from the Withdrawal Method?

Herpes Saves Lives?

The fabulous and talented Midori wrote a great article for Carnal Nation entitled 'How Herpes Saved My Life'. She talks about how contracting herpes led her to safer sex. She gives the usual downtrodden dirty slut story a spin into a wonderful sex-positive message and normalizes STIs. Its a seriously nice change. Because we've all heard the statistics about how many people have STIs and yet we still associate them with only dirty sneaky evil folks. How is that possible?

One thing to keep in mind though is that Midori does tell a very rosey tale and that won't be everyone's experience. So far she's had a couple of comments that have addressed that. I think it is important to note that there are many people living with STIs who have a harder time finding a mate. But I think its also nice to see someone who tells a story about how she doesn't give a crap about the people who turn her down.

My Story

In light of recent events – specifically Dr. Tiller’s murder, federal marshals being removed from the aide of Dr. Carhart, and the ongoing violence focused on reproductive health clinics – I’ve decided to tell my own story. I believe that it is extremely important for women (and men) to come out and talk about how their reproductive health clinics have helped them and why they are a positive necessity in our society. We should all tell our own stories.

My story isn’t a pretty packaged story about how I was a victim of incest or rape. Not that these stories are ever pretty, but they are the ones that so often come to view when we are talking about women who need to be able to have abortions. The stories of innocence lost. The women who “deserve” to have a pregnancy terminated. What about the rest of us? We all need control over our own bodies.

I expect that a lot of people won’t agree with my decisions. And I also expect that there may be some backlash because of it. But I refuse to hide when the people who are trying to help women are being murdered.

I tell this story from a sex positive viewpoint; the idea that there is nothing inherently evil about sex. In fact there is a lot of good in it, but there are risks as well.

When I was 18 I was a typical teenager. I thought I was invincible. I thought that nothing bad could happen. And so, even though I knew full well what the consequences were, I had unprotected sex with my boyfriend. I was not a victim of abstinence-only education, I had comprehensive sex ed starting in 5th grade. I was also raised in a sex positive household where information about sex and condoms were always available. I did know better. But I was in love and the sex was fantastic.

What I didn’t know was that I was with a young man who was also extremely fertile, as many 18 year olds are. He hadn’t told me that he had gotten two other women pregnant before me. And he definitely should have known better. But we’re both to blame for what happened. A couple of months before my 19th birthday I got pregnant.

I had always thought that if I got pregnant before I was ready that I would have an abortion. It would be an easy decision. When it actually happened I was struck by how difficult the decision actually was. After all, this life had been created out of love.

After thinking about it for a few weeks though I knew that it was the right decision. I had not been planning on bringing a baby into the world and was smoking at the time. Not a great way to start a pregnancy. My mom, a very supportive woman in general, refused to support me emotionally or financially if I chose to have the child. My boyfriend whom I loved dearly, all of a sudden disappeared when I became pregnant. I had my whole life ahead of me. And even dedicating 9 months to pregnancy was a burden my body could not handle. The first couple months that I did go through were awful and I knew it would only get worse. My body has always had issues with health and pain.

I did not know how to go about seeking an abortion. I am so incredibly lucky that it all turned out as well as it did considering I was doing my research via the yellow pages and, being a broke teenager, cost was my main concern. Had I lived in the Bible Belt instead of a suburb of Chicago I’m sure I would have ended up talking to a crisis center that would’ve misinformed me about pregnancy and abortion. And in my relatively fragile state, that would have been very difficult to deal with.

Ten days after my 19th birthday my best friend took me to a women’s reproductive health clinic. There were lots of women with boyfriends in the waiting room. I was the only one with my best friend.

I don’t really remember much of that day except for having a difficult time peeing in the cup, accidentally stepping on a button on the floor in the operating room that made a loud noise, waking up in another room with my underwear back on, and my best friend taking care of me that evening (mmm Blue’s Clues macaroni and cheese). But it all went pretty well.

As the years went on I became pretty loyal to Planned Parenthood. I really wish I had gotten the procedure there, but I’m happy that it went well. Planned Parenthood has been there for me through thick and thin. They’ve helped me through condom breakage, STI testing, genital warts, pap smears, putting me on the pill to prevent pregnancy, and then keeping me on it to prevent ovarian cysts. They’ve been there when I’ve cried, they’ve laughed at my jokes, and they’ve been non-judgmental of my lifestyle choices. They’ve been like a really good friend to me. And as a good friend I’ve tried my best to give back as well. I’ve donated time and money to them. I ran the local college campus chapter of VOX (Planned Parenthood’s student outreach) and I’ve worked as an escort keeping myself between women entering and leaving the clinic and those who did not agree with why they thought those women were there. I will always support Planned Parenthood and I hope that they are always able to support me.

The Answer to UTIs?

Several months ago a woman wrote to me about her problems with getting Urinary Tract Infections (UTIs) after sex and I answered to the best of my ability in this blog entry. This is actually a relatively common problem that is often asked of sex educators and doctors. One woman who experiences this problem recently wrote in to Betty Dodson and Carlin Ross saying that she's found the solution. She highly recommends Waterfall D-Mannose. So for those of you out there who are still having a difficult time with UTIs, this might be your answer. Check it out, do the research, and maybe give it a try. I'd love to hear from anyone who has tried this stuff. Does it really work?

Hormonal Birth Control

What do you know about the long term effects of hormones? (ie birth control pills, the ring) I've been on the pill for 10 years (switching to different ones throughout) and am on my 2nd month of the ring now. I feel like I don't know what my body wants/needs anymore, because its been without normalcy for so long now--how do I know? I know a doctor wouldn't test me hormonally normally at my age (27) but I feel like it might be a huge contributor to my long time (at least 10 years) migraines. How do I know if I need the hormones anymore?? Is there even a test?

Thanks Garnet

Let me preface this with saying I am not a doctor. Your best bet is to talk to someone who is. That being said however, I do have to say that there is a very good chance that your migraines are caused by the pill. There are a lot of side effects to hormonal birth control that a lot of us don't think about since its a pill that is taken every day. Afterall how are you supposed to know the difference if you're never off of it?

Now, I don't know what you mean exactly by asking if you need the hormones anymore. If you're talking specifically about birth control then there are non-hormonal methods on the market. The IUD is even as reliable as the pill if not more so since you don't have to remember to take it. But I would only recommend an IUD if you're in a longterm monogamous relationship as there can be severe complications if you contract an STI.

If you're talking about needing hormones for other things like regulating your cycle or relieving severe menstrual cramps then the only way to know is by going off hormones to see if your cycle is still really haywire or if your cramps are as bad as they used to be.

If you're talking about needing hormones to prevent anything like ovarian cysts or endometriosis then you should consult a doctor. They may decide to take you off the hormones for a period of time and watch you carefully to see if you do in fact need them. But only a doctor will have the tools to do so.

While hormonal birth control can have many benefits there can also be health risks especially as you get older. At 27 you don't have to worry too much, but once you start nearing 35 the risks go up. So that's something you should keep in mind as you start this process.

Female Viagra

Dear Garnet,

I was wondering what your opinion is of the so-called "pink Viagra." Do you think that female sexual dysfunction and related disorders are best treated pharmaceutically?

Sincerely,
Curious in Indianapolis

Oh yay, rant time!

I think that in general our society is too quick to take pills in order to "fix" whatever they perceive to be wrong with them. Everyone is always searching for the little magic bullet that will somehow make them happy, thin, beautiful, ageless, healthy, and a tiger in the sack. It's just not going to happen. While medication has definitely done wonders for us, there are some issues that may be better solved with trying to figure out what the problem is and how to fix it without the help of pills. And sometimes it may be healthier to just take things on head on. For example, I'm amazed at how quickly antidepressants are prescribed for people mourning the death of a loved one. Mourning is necessary and taking pills to stop that process is not healthy in my opinion.

Anyways, back to the topic, Viagra and "pink Viagra." Viagra has done good for older men who physically are unable to get erections. But I feel that Viagra has also done a lot of harm as well in relationships. The book, The Viagra Myth by Dr. Abraham Morgentaler, talks a lot about this. Viagra is seen as this wonder drug that is somehow going to fix a relationship that isn't going so well. As if a hard dick is the solution to all intimacy issues. Sex stops being about connecting and starts centering only on the erection. The erection can even be a source of frustration when the man wants sex and his partner does not. Foreplay becomes less important. I'm not saying that this is the case for all men on Viagra and their partners, but it happens often. In fact, according to Dr. Morgentaler, 50% of men prescribed Viagra don't get refills. Viagra use can sometimes result in the end of a relationship. This can especially be true when it comes to men who don't even need Viagra in order to get an erection. What needs to happen is for these couples to talk about their problems with each other. Communication is very important. And if that isn't working then relationship counseling may be the next step.

Now pink viagra is a little different. Women have been being diagnosed with sexual dysfunctions for a really long time, but I don't believe that a lot of these dysfunctions are real. Our society is so phallic centered that many women who can't orgasm from vaginal intercourse alone often think of themselves as dysfunctional. Freud called them frigid. Women often need more stimulation, specifically clitoral stimulation. Not only that, but they need time to warm up. While quickies can be fun, many women really need to be wooed before intercourse can start. This wooing can even include chores taken on by her partner so that she has less to worry about and is more relaxed. I fear that if a Viagra-type pill for women comes out the average woman who needs to be wooed in order to be in the mood for sex will be considered even more dysfunctional even though in reality she is actually quite normal.

So in other words, what I'm basically saying is that instead of resorting to pharmaceutical solutions, couples should figure out what is missing from their lives and their relationship. They should communicate with one another to figure out why maybe she doesn't have as high of a libido as she once did or why she has difficulty orgasming and how these things can be overcome. Communication and experimentation are going to work a lot better than any kind of pill. And if you're having a difficult time communicating with each other then it is probably best to see a relationship counselor so that you can get help with communication. A lot of people rather skip this because its hard, but a pill is not the easy way out of a tough spot.

UTIs from Sex

Have you ever heard of anyone having UTI symptoms after sex? This has happened with my husband, plus the last 2 guys I dated. I've been to doctors, and they can't think of any reason this would be happening, especially since we seem to be doing everything right (pee before and after, wipe front to back, plenty of lube, etc.). Pretty much any time I have sex now I know that I'm going to have to take Azo or Uristat immediately after.

My husband was thinking it might be the lube-- I'm uber sensitive to like, everything. When we used to use condoms, I'd get really irritated, and even at work I have to use Nitrile gloves. So, we don't use them, obviously. A few years ago, I used to use Wet Original, before they took out the nonoxynol-9, and that was like, the best shit ever. Now I feel like I can't use it, and I feel like everything else makes it burn (though I haven't tried everything else). What's out there for uber-sensitive skin? Please don't tell me I can't have sex anymore.

The only thing my ob/gyne told me was that she didn't see anything there, and that if I'd be willing to give it a shot, she could prescribe a numbing gel for me. Apparently some people use it during sex, but why the hell would I want to do that? At least just right after. It becomes painful pretty much immediately after I orgasm, but not during sex. Ugh.. any thoughts? Should I give the numbing gel a shot? It just sounds so un-sexy, but I also hate feeling like this.

I want to preface this with the fact that I am not a doctor or trained in the medical field at all. So really all I can do is offer you some options to try to see if they help, but I can't really suggest anything medically. You've definitely done the right thing by going to doctors and have hopefully gotten a second opinion on this matter as well.

I have definitely heard of women getting UTIs from vaginal intercourse. A very good friend of mine had a lot of problems with it. She fixed her issue by doing a lot of the things you're doing now like peeing right before and after sex. She also takes cranberry supplement pills every day. Another thing I would suggest is to try different positions. If your husband's penis curves then try to get into positions where the curve won't be directed towards the front of your body. So for example, if his penis curves upwards try doggy style instead of missionary position.

It seems odd that you have hyper sensitive skin and yet you don't have a problem with nonoxynol-9. That stuff can wreak havoc if you're sensitive. But since you say you're sensitive I would suggest lubes which don't have a lot of ingredients in them. You will not be able to find these kinds of lube at your local Walgreens so you'll probably have to order them online unless you live near a high quality sex toy shop. I would suggest Sliquid H2O or Astroglide that is paraben and glycerine free. And if you haven't tried silicone-based lubes you should as they are hypo-allergenic. They can't be used with silicone sex toys, but they can be great for intercourse. There are a lot of different types out there, but I'd recommend any of the Pjur silicone lubes which come in both liquid and gel.

You could also try using polyurethane condoms to see if those help at all. There are two brands on the market currently: Trojan Supras and Durex Avanti.

I don't really like the idea of you having to use a numbing gel if you don't have to. Especially since it's not going to keep you from getting UTIs. If none of the things I suggested above help I'd think about seeing a urologist. They may know something that your doctor doesn't.

Contraception

I have a question from a female friend; she and her boyfriend are in a long term relationship. They're both serious about it and there's not really any risk of STD (since it's a single partner situation) so she was looking for an alternative contraceptive that would allow her and her boyfriend to have sex without a condom. What would your recommendation be, how reliable are the various options, and how safe are they?

As a biologist I know a fair amount, but I'm sure you have more specific knowledge of this than I do, so I thought I'd ask the expert.

Before they decide to go on an alternative form of birth control they should both get tested to find out if they are both disease free and keep in mind that 1. Sometimes certain STIs won't show up on a test for 6 months after it has been contracted and 2. There are some STIs that may not have tests like HPV in men and some STIs that aren't automatically tested for like herpes. When they go in to get tested they need to specifically tell the doctor/nurse that they want to be tested for HIV and Herpes as well.

If they are both clean then they can start thinking about what kind of birth control she wants to be on. There are several on the market, some are more effective than others and some have more side effects than others. Any hormonal forms of birth control are going to have more side effects than non-hormonal forms, but they will also be more effective. If a woman is over 35 or smokes she should not use hormonal forms of birth control as they increase the risk of blood clots and stroke.

First, the hormonal forms:
The most used form of birth control in the US is The Pill. There are many many different brands of pills out there with different hormone dosages. Finding the right one can be difficult, but worth it to find one that works well with a woman's body chemistry. The goal is to find the pill with the least amount of side effects that actually makes life easier, not more difficult. A woman's doctor or nurse should work with her to find the right dosage. Some possible side effects include: nausea, weight gain, fatigue, moodyness, loss of sexual desire, depression. The Pill is about 99% effective when used correctly. If you cannot remember to take your pills at the same time every day then they will not be anywhere near as effective. They are also less effective if you take St John's Wart or are on antibiotics.

If you cannot remember to take your pills every day at the same time there are a few other options. The NuvaRing is a small plastic ring that a woman inserts into her vagina that emits a low dosage of hormones. The ring is kept in place for 3 weeks and then on the fourth week the woman must take it out to allow for her period. After that week is over she puts in a new ring. The NuvaRing is just as effective as The Pill if used correctly and also has the same side effects. This option should not be used if a woman is at all squeamish about touching her genitals or feeling around inside of her vagina. It may also be more expensive than The Pill and is not covered under a lot of insurance plans.

Another option is The Patch, Ortho Evra. This is a patch that is placed on the body for a week at a time for 3 weeks, with a week off for your period. The patch sends hormones through your skin and into your blood system. The patch has more estrogen in it than The Pill and may cause more side effects because of that. It is as effective as The Pill if used correctly. There is risk of The Patch falling off if a woman leads an active (read: sweaty) lifestyle and if this is not noticed right away it can increase risk of pregnancy. The Patch can also cause irritation to the skin where it is applied.

Another option is Depo Provera. This is a shot that the woman gets once every three months. If a woman has a difficult time remembering to do the above three options then depo may be a good option. However, depo is in your bloodstream for 3 months, which means that you are stuck with any bad side effects that you may have for three whole months. This can be unbearable for some women. Depo is, however, very effective since there is very little risk of human error. It is about 99% effective.

There are two types of IUD (Intrauterine Device), hormonal and non-hormonal. The hormonal type is in the shape of a small T, is made out of plastic, and releases progesterone into the body, which thickens the cervical mucus making it difficult for sperm to reach the egg and also by changing the lining of the uterus so that a fertilized egg cannot implant. The device is inserted by a doctor and can be used up to a year. It is 98% effective, but should only be used by women in longterm monogamous relationships as the IUD can cause severe complications if the woman contracts an STI. This caution should also be noted for the non-hormonal IUD as well as the IUS, which follows.

The Intrauterine System (IUS) is very similar to an IUD but the big difference is that it releases a small amount of the hormone levonorgestrel into the body that thickens the cervical mucus which makes it difficult for the sperm to reach the egg. It has to be placed into the uterus by a doctor and stays in for up to 5 years. The IUS is 99% effective.

Non-hormonal options:
The diaphragm, like the condom, is a barrier method, which means that it blocks the sperm. Unlike a condom though, the diaphragm is put into the vagina, covering the cervix so sperm can get into the vagina, but not into the uterus or fallopian tubes. Diaphragms need to be fitted by a doctor and they are a lot less effective than hormonal methods. The chance for human error is also greater. Diaphragms should be used with a spermicide, which makes them more effective, but spermicides can also be harmful to the delicate tissues of a woman's vagina. Diaphragms with spermicide are about 86-94% effective. If a woman chooses this method she should not feel squeamish about touching her genitals or reaching inside of her vagina.

The cervical cap is a lot like the diaphragm, but instead of simply covering the cervix, it is fitted to snuggly cap the end of the cervix. The cervical cap should also be used with a spermicide and is about 84-91% effective, but that effectiveness goes down if the woman has previously given birth.

The sponge is a soft disk shaped device made out of polyurethane foam and contains the spermicide, nonoxynol-9. As stated above, spermicide can cause harm to the tissues inside of the vagina. It doesn't effect all women, but if a woman has had problems in the past she should not use this method or any of the non-hormonal methods mentioned above. The sponge is a bit easier to remove than the cervical cap, diaphragm, and NuvaRing because it does have a small loop attached for ease of pulling it out. But if a woman is at all squeamish about touching her genitals, she should still not use this method. The sponge is about 84-91% effective depending on correct usage, but that effectiveness goes down if the woman has previously given birth.

The IUD, or intrauterine device, is a small t-shaped copper device that is placed into the uterus by a doctor and left for up to 12 years. This device is very effective and there are a few theories as to why exactly. Some include the device's material and some include the shape of it. But basically what any woman needs to know is that it prevents pregnancy by making it practically impossible for a fertilized egg to implant itself in the lining of the uterus. It is about 99% effective. This device should only be used by women in longterm monogamous relationships for the same reason as described above for the hormonal IUD and the IUS.

The last 2 non-hormonal methods are the Rhythm Method and the Withdrawal Method and I really advise against both unless you are a couple who doesn't particularly want to get pregnant, but wouldn't mind it if it happened. These are methods that should never be used by young people as they do not have enough self control. The rhythm method is when a couple only has sex when a woman is least likely to get pregnant. The withdrawal method is when the man withdraws his penis from the woman's vagina right before he ejaculates so that he does not get any sperm into her vagina. Neither of these methods are very effective, but can increase the effectiveness of any of the methods listed above.

Spontaneous Orgasm

How and more importantly why do men sometimes ejaculate without having an erection?

Further information was provided after I asked some more questions, specifically:

Without erection at all, arousal being anything from nothing to an unusually stunning person. Right before, my testicles get very ticklish and there's a euphoric tingling sensation. This usually happens while sitting down.

This question took me a really long time to get around to answering. The reason for this is because I'd actually never heard of this before and when I talked to the medical professionals that I know (and also someone at Planned Parenthood) they were all pretty puzzled. In researching I have found some information that may help you though.

An erection is not required to have an orgasm or to ejaculate. While they are all often tied together in our minds because they all usually happen together, there are different things going on in each and none are required to make the other one happen. However, this is mostly talked about with men who cannot get an erection.

When it comes to spontaneous orgasm it looks like the most likely culprit is antidepressants. There have been studies done that show that spontaneous orgasm is actually a side effect to antidepressants including: Wellbutrin, Paxil, Prozac, and Celexa. Most of the studies have been done on women and some report having as many as 15 spontaneous orgasms per day with very little or no stimulation whatsoever. So if you're on an antidepressant that may be what is causing it. Either way though you should probably go to a doctor and get yourself checked out. Spontaneous orgasms, especially ones where you ejaculate, can become pretty embarrassing in public situations.

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STIs and Sexual Responsibility

We talk about safer sex, we talk about the risks associated with sex, we talk about the types of STIs, but what a lot of people don't talk about is what happens when you have an STI and the responsibilities you have towards your partner(s). This is where I start to get a little preachy.

Having sex is an enormous responsibility; one that most people take too lightly. There are a lot of risks: physical, emotional, and financial. Sex is a lot of fun, but we have to be adults about it. We have to take responsibility for our actions.

This means getting tested regularly and informing your partner(s) of your STI status before the clothes ever come off.

Lets keep in mind though that not all STIs are tested for and some (HPV in men) don't even have tests. So testing is not enough. Inspecting one's genitals and anus regularly is also a must. This doesn't have to be a downer. It is easy enough to inspect yourself when you masturbate and also when you clean yourself in the shower. You should know exactly how your genitals and anus feel so you know if there are any new bumps or sores. It is very important to know your body and to be aware of changes in it. Does it burn when you pee? Well for heaven's sake go to the doctor!

So what if you catch an STI?

If it is something curable like chlamydia, syphilis, or gonorrhea then it is important that you stop having sex. Why would you want to give anything that uncomfortable to someone who is giving you a lot of pleasure? Get treated and talk to anyone you've slept with recently to let them know that you have it and that they should go get tested. Before you start having sex again make sure that both you and your partner are cured.

If you contract herpes which will stay with you for the rest of your life or HPV which will be around for a couple years you need to tell anyone you are considering becoming sexually intimate with. Both of these are contagious even if you do not have warts or sores. Let the other person decide whether or not they want to take the risk. There is a good chance that many may reject you because of your STI, but that is something that you will just have to deal with. It isn't easy, but that does not mean it is ever ok for you to not tell someone you have it. I don't care if you've had sex with someone else and they never contracted it from you. This does not mean that you are not contagious. Be careful and honest and use protection. Keep in mind that even if both you and your partner have herpes or HPV you can continue to pass it to each other and make it worse.

If you contract HIV/AIDS I highly discourage any sort of casual sex. If you do choose to be sexually active that is a big decision that will have to be the responsibility of both you and your partner. Keeping in mind that even if you both have HIV you can continue to pass the virus to each other and put each other at further risk. Always use protection and I recommend being in a long term trusting relationship.

The Golden Rule is applicable to all of life including sex. Treat others the way you would want to be treated and the world will be a much happier, healthier place.

Yeast Infection Remedies

For yeast infections, what remedies other than the uber chemical-y suppositories from pharmacies are out there?

One option is Diflucan which is a prescription pill which is still a drug, but not a suppository.

A home remedy which can be used for mild yeast infections involves yogurt. The bacteria in yogurt is the same type of bacteria that is naturally in the vagina that needs to be replaced when a yeast infection occurs. Plain, sugarless yogurt that has active bacteria cultures in it can actually be inserted into the vagina to help combat yeast infections. Getting the yogurt in there is the hard part. You can soak a tampon in it, fill a needleless syringe (the same kind used to inject the chemicaly yeast infection creams), or experiment with different methods yourself to find one that works for you.

There are other home remedies that are suggested elsewhere, but yogurt is really the only one that I'm willing to endorse.

You should always consult a physician before trying any home remedies and if it is your first yeast infection you should get diagnosed by a physician as well. If symptoms persist it is important to seek medical assistance.

In order to help prevent yeast infections women can wear underwear with a cotton crotch, avoid tight pants, eat yogurt with live bacteria cultures on a regular basis or take acidophilus supplements, practice safer sex, clean sex toys before and after use, and practice good hygiene which does not include douching.

Of course it is impossible to prevent all yeast infections especially at times when body chemistry is changing like during pregnancy, after pregnancy, or when on antibiotics.

The Pill

I started Yasmin and noticed that my emotional stability went totally haywire, is this common for all birth control pills or no?

Different birth control pills have different amounts and kinds of hormones in them. This means that different kinds will have different effects on different people. It is best to experiment with different pills to see what works best with your body and natural hormone levels. You and your doctor need to figure out what is best for you. It really can be a life changing effect.

If you experience some moodiness, fatigue, spotting, or nausea don't discount the pills right away though. Give your body some time to adjust to the new pills. However, if your reactions are severe or the minor annoyances won't go away then consider talking to your doctor about changing your prescription. If your doctor won't listen to you, as I've heard of many who won't, try going to a reproductive health or women's clinic like Planned Parenthood. The goal is to find a pill that will make your life better and easier, not harder.

Unfortunately, not all women will find a pill that works for them. There are other options for contraception. Here is a pretty good chart outlining birth control options. It is slightly out of date on emergency contraception, but other than that it is pretty good.

Latex Allergies

Here is an article I wrote a few years ago for a website that no longer exists (a few changes have been made):

If you experience itching, burning, rashes, or irritation of any kind right after or during sex you could very well have an allergy to the condoms being used. There are several possibilities of what you could be allergic to: the spermicidal lubricant known as Nonoxynol-9, fragrances, or latex. Experiment with different condoms to see what you are allergic to. The first two are easy enough to avoid; just don’t buy condoms with Nonoxynol-9 or those banana or orange flavored condoms, both very easy to find. All of these condoms will have about the same rate of efficacy. Latex, on the other hand, is a bigger issue.

What happens when you have an allergy to latex is that your immune system thinks that the latex is a dangerous substance and attempts to remove it from your body by giving you rashes or itching. Latex allergies develop over time so you might not have any issues at all for years and then one day it starts to itch and burn. About 7% of people develop a latex allergy.

There are two other materials that condoms are made of besides latex: lambskin and polyurethane. Lambskin is made from the intestines of a lamb. Yeah, I know gross, right? Well, don’t worry you shouldn’t use these. They are effective in preventing pregnancy, but because they have small pores in them they still let fluids pass through which carry HIV and other scary diseases.

Polyurethane, on the other hand, is made from plastic and has a slightly lower efficacy rate than latex. The problem is that polyurethane isn't as stretchy as latex so the condoms are made a bit bigger than the average latex condom. The reason this is an issue is because 1. they slip off more easily, which as long as you’re aware of this is easily preventable and 2. if your partner or dildo is on the larger side the condom is more likely to break, which is not as preventable unfortunately.

There are actually many people who are not allergic to latex who use polyurethane condoms because they actually have a lot of advantages. Polyurethane is thinner, transfers heat better, stronger, can be used with oil based lubricants, and doesn’t have an odor or taste. There are disadvantages as well; polyurethane is not as stretchy as mentioned earlier, they are more expensive, and they are harder to find.

The only two polyurethane condoms on the market in the US currently are Trojan Supra and Durex Avanti. There are a couple differences between these two brands. The Trojans are slightly smaller in size than the Durex, which is especially helpful if you are trying to avoid slippage. Trojans have Nonoxynol-9 and Durex do not, which is important if you’re also allergic to spermicide. Experiment with both and find out which works best for you.

HPV

Recently, someone I slept with 7 years ago contacted me to tell me they have HPV and had no idea when she got it so was contacting everyone she slept with to let them know. I thought it was a bit silly for her to go through such lengths to contact people because from what I understand it is incredibly common, and relatively harmless except with some kinds that can cause cancer.

My question is.. Since HPV is also not normally included in the regular battery of STD testing people get, is it something people should test for regularly even if they don't notice any warts? And if you do have it, is it really serious enough to contact all your previous partners to let them know?

Human Papilloma Virus or HPV is a very common Sexually Transmitted Infection (STI). The CDC estimated in 2005 that 20 million people in the US had the virus. The reason that it is spread so easily is because most people do not know they have it because they don't show any symptoms. In fact, there are very few symptoms even associated with HPV. The known symptoms are genital warts and changes in the cells of the genitals; only one of which is visible to the naked eye. There are many different strains of HPV. The scary thing is that only the low risk strains show up as genital warts and therefore are easily detected. High risk strains, on the other hand, can go unnoticed for years because the only difference is in the change of cells.

Another reason that HPV spreads so easily is that there is no HPV test for men. Unless a man gets genital warts he does not know for sure if he has the virus or not and this only shows if he has a low risk strain.

When women get a pap smear the cells that are collected are tested to see if they are abnormal. If it turns out they are abnormal then further testing will be done to see if it is HPV. Women get abnormal pap results all the time though and it doesn't necessarily mean anything. They should always follow up with their doctors though to see if they need further testing.

HPV for the most part goes away on its own. If someone has genital warts though it is advised to have them removed so as to help prevent spreading. There are a number of different ways to remove the warts including prescription creams, burning with acid, and freezing with liquid nitrogen. High risk strains that do not go away on their own can cause cervical cancer and in lesser cases, cancer of the penis or anus. It has recently been found that HPV also has a low risk of causing throat and oral cancer.

There is no way to prevent all forms of HPV. Condoms can help, but are not perfect especially if the infected partner has genital warts in places that are not covered by the condom. HPV can also be transmitted through oral sex as well as manual stimulation.

Guardasil is an HPV vaccine offered to girls and women aged 9-26 and it has been shown to help protect against 8 strains of the virus, several of which are high risk strains, but it is not easily accessible to many females. Some people think that if girls get the vaccine they will be more likely to be promiscuous, which is just plain faulty logic in my opinion. It is also one of the most expensive vaccines on the market today, costing in the neighborhood of $400. To my knowledge, no insurance companies currently cover the cost of Guardasil.

Is it necessary for a person to contact their past sex partners to let them know that they have HPV? Yes, it is necessary to contact past sex partners for any STI that is contracted. It is the responsible, adult thing to do. However, I would say that seven years may be a bit of a stretch. It is nice to see people being responsible, but I would say that, unless you know around what time you contracted it (HPV can lay dormant for a long time), contacting your sex partners over the last 2 years would be a sufficient. 91% of new HPV infections disappear within 2 years of contracting it. However, if you feel it is your duty to contact beyond that, I say go for it.

I would ask your ex-partner what type of HPV they have. This can give you a better grasp on what the risks are and what you're looking for.

NEVER Douche!!

Because I am surprised by the amount of people who do not seem to know this ....

Women should NEVER douche!!

The idea that a woman's vagina is dirty/gross/smelly in its natural state is extremely hurtful to women. There is nothing wrong with asking a woman to bathe before sex but douching is harmful to a woman's vagina. It can cause/put women at risk for all kinds of problems including but not limited to yeast infections, pelvic inflammatory disease, infertility, ectopic pregnancy, and cancer. When bathing, a woman or her helpful partner should only clean the outside of her genitals.

Only two parts of the body have natural cleaning mechanisms and those are the eyes and the vagina. When a woman douches she washes away those natural cleaning mechanisms. Let the body do what it is designed to do!

However, if you do notice a change in your/your lover's smell or discharge make sure that you/she sees a doctor.

Tell a woman you care about not to douche. It is harmful to her body. This needs to be spread around because too many women still think it is ok (many poor and uneducated) and many men require it of their lovers because they think that it is healthy to clean the vagina. It is not.

Also, douching after sex can actually increase the likelihood of getting pregnant because it can push sperm up into the uterus and fallopian tubes. Use protection! This does not mean that one should use douching as a means to help get pregnant. It can also cause infertility.