Category Archives: Health Concerns

Don’t Be Afraid of Your Vagina

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By Nell Frizzel

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Lying across a turquoise rubber plinth, my legs in stirrups, a large blue sheet of paper draped across my pubes (for “modesty”), a doctor slowly pushes a clear plastic duck puppet up my vagina and, precisely at that moment, Total Eclipse of the Heart comes on over the radio and it’s hard not to love the genitourinary medicine, or GUM, clinic.

I mean that most sincerely: I love the GUM clinic. It is wonderful beyond orgasm that in the UK anyone can walk into a sexual health clinic—without registering with a doctor, without an appointment, without any money, without a chaperone—and get seen within a few hours at most. It brings me to the point of climax just thinking about the doctors and health professionals who dedicate their life to the nation’s ovaries, cervixes, vaginas, and wombs.

And yet, not all women are apparently so comfortable discussing their clitoral hall of fame with a doctor. According to a recent report commissioned by Ovarian Cancer Action, almost half of the women surveyed between the ages of 18 and 24 said they feared “intimate examinations,” while 44 percent are too embarrassed to talk about sexual health issues with a GP. What’s more, two thirds of those women said they would be afraid to say the word “vagina” in front of their doctor. Their doctor. That is desperately, disappointingly, dangerously sad.

In 2001, I went to see a sexual health nurse called Ms. Cuthbert who kindly, patiently and sympathetically explained to me that I wasn’t pregnant—in fact could not be pregnant—I was just doing my A-Levels. The reason I was feeling sick, light-headed, and had vaginal discharge that looked like a smear of cream cheese was because I was stressed about my simultaneous equations and whether I could remember the order of British prime ministers between 1902 to 1924. My body was simply doing its best to deal with an overload of adrenaline.

Back then, my GUM clinic was in a small health center opposite a deli that would sell Czechoslovakian beer to anyone old enough to stand unaided, and a nail bar that smelled of fast food. I have never felt more grown up than when I first walked out of that building, holding a striped paper bag of free condoms and enough packets of Microgynon to give a fish tits. My blood pressure, cervix, heartrate, and emotional landscape had all been gently and unobtrusively checked over by my new friend Ms. Cuthbert. I had been given the time and space to discuss my hopes and anxieties and was ready to launch myself, legs akimbo, into a world of love and lust—all without handing over a penny, having to tell my parents, pretending that I was married or worry that I was being judged.

My local sexual health clinic today is, if anything, even more wonderful. In a neighborhood as scratched, scored, and ripped apart by the twin fiends of poverty and gentrification as Hackney, the GUM clinic is the last great social leveler. It is one of our last few collective spaces. Sitting in reception, staring at the enormous pictures of sand dunes and tree canopies it is clear that, for once, we’re all in this together. The man in a blue plastic moulded chair wishing his mum a happy birthday on the phone, the two girls in perfect parallel torn jeans scrolling through WhatsApp, the guy with the Nike logo tattoo on his neck getting a glass of water for his girlfriend, the red-headed hipster in Birkenstocks reading about witchcraft in the waiting room, the mother and daughter with matching vacuum-sized plastic handbags talking about sofas, the fake flowers, Magic FM playing on the wall-mounted TV, the little kids running around trying to say hello to everyone while the rest of us desperately avoided eye contact—the whole gang was there. And that’s the point: you may be a working mum, you may be a teenager, you may be a social media intern at a digital startup, you may be a primary school teacher, you may be married, single, a sex worker, unemployed, wealthy, religious, terrified, or defiant but whatever your background, wherever you’ve come from and whoever you slept with last night, you’ll end up down at the GUM clinic.

Which is why it seems such a vulvic shame that so many women feel scared to discuss their own bodies with the person most dedicated to making sure that body is OK. “No doctor will judge you when you say you have had multiple sexual partners, or for anything that comes up in your sexual history,” Dr. Tracie Miles, the President of the National Forum of Gynecological Oncology Nurses tells me on the phone. “We don’t judge—we’re real human beings ourselves. If we hadn’t done it we probably wish we had and if we have done it then we will probably be celebrating that you have too.”

Doctors are not horrified by women who have sex. Doctors are not grossed out by vaginas. So to shy away from discussing discharge, pain after sex, bloating, a change in color, odor, itching, and bleeding not only renders the doctor patient conversation unhelpful, it also puts doctors at a disadvantage, hinders them from being able to do their job properly, saves nobody’s blushes and could result in putting you and your body at risk.

According to The Eve Appeal—a women’s cancer charity that is campaigning this September to fight the stigma around women’s health, one in five women associate gynecological cancer with promiscuity. That means one in five, somewhere in a damp and dusty corner of their minds, are worried that a doctor will open up her legs, look up at her cervix and think “well you deserve this, you slut.” Which is awful, because they won’t. They never, ever would. Not just because they’re doctors and therefore have spent several years training to view the human body with a mix of human sympathy and professional dispassion, but more importantly, because being promiscuous doesn’t give you cancer.

“There is no causal link between promiscuity and cancer,” says Dr. Miles. “The only sexually transmitted disease is the fear and embarrassment of talking about sex; that’s what can stop us going. If you go to your GP and get checked out, then you’re fine. And you don’t have to know all the anatomical words—if you talk about a wee hole, a bum hole, the hole where you put your Tampax, then that is absolutely fine too.”

Although there is some evidence of a causal link between certain gynecological cancers and High Risk Human Papilloma Virus (HRHPV), that particular virus is so common that, ‘it can be considered a normal consequence of sexual activity’ according to The Eve Appeal. Eighty percent of us will pick up some form of the HPV virus in our lifetime, even if we stick with a single, trustworthy, matching-socks-and-vest-takes-out-the-garbage-talks-to-your-mother-on-the-phone-can’t-find-your-clitoris partner your entire life. In short, HRHPV may lead to cancer, but having different sexual partners doesn’t. Of course, unprotected sex can lead to an orgy of other sexually transmitted infections, not to mention the occasional baby, but promiscuity and safe sex are not mutually exclusive. And medical professionals are unlikely to be shocked by either.

We are incredibly lucky in the UK that any woman can stroll into a sexual health clinic, throw her legs open like a cowboy and receive some of the best medical care the world has ever known. We can Wikipedia diagrams of our vaginas to learn the difference between our frenulum and prepuce (look it up, gals). We can receive free condoms any day of the (working week) from our doctor or friendly neighborhood GUM clinic. We can YouTube how to perform a self-examination, learn to spot the symptoms of STIs, read online accounts by women with various health conditions, and choose from a military-grade arsenal of different contraception methods, entirely free.

A third of women surveyed by The Eve Appeal said that they would feel more comfortable discussing their vaginas and wombs if the stigma around gynecological health and sex was reduced. But a large part of removing that stigma is up to us. We have to own that conversation and use it to our advantage. We need to bite the bullet and start talking about our pudenda. We have to learn to value and accept our genitals as much as any other part of our miraculous, hilarious bodies.

So come on, don’t be a cunt. Open up about your vagina.

Complete Article HERE!

Sexuality and Illness – Breaking the Silence

(This is a Companion piece to yesterday’s posting. You’ll find yesterday’s posting HERE!)

By: Anne Katz PhD

Sexuality is much more than having sex even though many people think only about sexual intercourse when they hear the word. Sexuality is sometimes equated with intimacy, but in reality, sexuality is just one way that we connect with a spouse or partner we love (the true meaning of intimacy). Our sexuality encompasses how we see ourselves as men and women, who we are attracted to emotionally and physically, what turns us on (eroticism), our thoughts and fantasies, and yes, also what we do when we are sexually active, either alone or with a partner. Our sexuality is connected to our image of ourselves and it changes over the years as we age and face threats from illness and disability and, eventually, the end of life.seniors_men

Am I still a sexual being?

Illness can affect our sexuality in many different ways. The side effects of treatments for many diseases, including cancer, can cause fatigue. This is often identified as the number one obstacle to sexual activity. Other symptoms of illness such as pain can also affect our interest in being sexually active. But there are other perhaps more subtle issues that impact how we feel about ourselves and, in turn, our desire to be sexual with a partner or alone, or if we even see ourselves as sexual beings. Think about surgery that removes a part of the body that identifies us as female or male. Many women state that after breast cancer and removal of a breast (mastectomy), they no longer feel like a woman; this affects their willingness to appear naked in front of a partner. Medications taken to control advanced prostate cancer can decrease a man’s sexual desire. Men in this situation often forget to express their love for their partner in a physical way, no longer touching them, kissing them, or even holding hands. This loss of physical contact often results in two lonely people.  Humans have a basic need for touch; without that connection, we can end up feeling very lonely.

Just talk about it!

seniors_in_bedCommunication lies at the heart of sexuality. Talk to your partner about what you are feeling, how you feel about your body, and what you want in terms of touch. Ask how you can meet your partner’s needs for touch and affection. The most important thing you can do is to express yourself in words. Non-verbal communication and not talking are open to misinterpretation and can lead to hurt feelings. Our sexuality changes with age and time and illness; we may not feel the same way about our bodies or our partner’s body that we did 20, 30 or more years ago. That does not mean we feel worse – with age comes acceptance for many of us – but we do need to let go of what was, and look at what is and what is possible.

The role of health care providers

Health care providers should be asking about changes to sexuality because of illness or treatment, but they often don’t. They may be reluctant to bring up what they see as a sensitive topic and think that if it’s important to the patient, then he or she will ask about it. This is not good. Patients often wait to see if their health care provider asks about something and if they don’t, they think that it’s not important. This results in a silence and leaves the impression that sexuality is a taboo topic.senior intimacy02

Some health care providers are afraid that they won’t know the answer to a question about sexuality because nursing and medical schools don’t provide much in the way of education on this topic. And some health care providers appear to be too busy to talk about the more emotional aspects of living with illness. This is a great pity as sexuality is important to all of us – patients, partners, health care providers. It’s an important aspect of quality of life from adolescence to old age, in health and at the end of life when touch and love are so important.

Ask for a referral

If you want to talk about this, just do it! Tell your health care provider that you want to talk about changes in your body or your relationship or your sex life! Ask for a referral to a counselor or sexuality counselor or therapist or social worker. It may take a bit of work to get the help you need, but there is help.

Complete Article HERE!

Sexuality at the End of Life

By Anne Katz RN, PhD

In the terminal stages of the cancer trajectory, sexuality is often regarded as not important by health care providers. The need or ability to participate in sexual activity may wane in the terminal stages of illness, but the need for touch, intimacy, and how one views oneself don’t necessarily wane in tandem. Individuals may in fact suffer from the absence of loving and intimate touch in the final months, weeks, or days of life.head:heart

It is often assumed that when life nears its end, individuals and couples are not concerned about sexual issues and so this is not talked about. This attitude is borne out by the paucity of information about this topic.

Communicating About Sexuality with the Terminally Ill

Attitudes of health care professionals may act as a barrier to the discussion and assessment of sexuality at the end of life.

  • We bring to our practice a set of attitudes, beliefs and knowledge that we assume applies equally to our patients.
  • We may also be uncomfortable with talking about sexuality with patients or with the idea that very ill patients and/or their partners may have sexual needs at this time.
  • Our experience during our training and practice may lead us to believe that patients at the end of life are not interested in what we commonly perceive as sexual. How often do we see a patient and their partner in bed together or in an intimate embrace?
  • We may never have seen this because the circumstances of hospitals and even hospice may be such that privacy for the couple can never be assured and so couples do not attempt to lie together.

intimacy-320x320For the patient who remains at home during the final stages of illness the scenario is not that different. Often the patient is moved to a central location, such as a family or living room in the house and no longer has privacy.

  • While this may be more convenient for providing care, it precludes the expression of sexuality, as the patient is always in view.
  • Professional and volunteer helpers are frequently in the house and there may never be a time when the patient is alone or alone with his/her partner, and so is not afforded an opportunity for sexual expression.

Health care providers may not ever talk about sexual functioning at the end of life, assuming that this does not matter at this stage of the illness trajectory.

  • This sends a very clear message to the patient and his/her partner that this is something that is either taboo or of no importance. This in turn makes it more difficult for the patient and/or partner to ask questions or bring up the topic if they think that the subject is not to be talked about.

Sexual Functioning At The End Of Life

Factors affecting sexual functioning at the end of life are essentially the same as those affecting the individual with cancer at any stage of the disease trajectory. These include:go deeper

  • Psychosocial issues such as change in roles, changes in body- and self-image, depression, anxiety, and poor communication.
  • Side effects of treatment may also alter sexual functioning; fatigue, nausea, pain, edema and scarring all play a role in how the patient feels and sees him/herself and how the partner views the patient.
  • Fear of pain may be a major factor in the cessation of sexual activity; the partner may be equally fearful of hurting the patient.

The needs of the couple

Couples may find that in the final stages of illness, emotional connection to the loved one becomes an important part of sexual expression. Verbal communication and physical touching that is non-genital may take the place of previous sexual activity.

  • Many people note that the cessation of sexual activity is one of the many losses that result from the illness, and this has a negative impact on quality of life.
  • Some partners may find it difficult to be sexual when they have taken on much of the day-to-day care of the patient and see their role as caregiver rather than lover.
  • The physical and emotional toll of providing care may be exhausting and may impact on the desire for sexual contact.
  • In addition, some partners find that as the end nears for the ill partner, they need to begin to distance themselves. Part of this may be to avoid intimate touch. This is not wrong but can make the partner feel guilty and more liable to avoid physical interactions.

Addressing sexual needs

senior intimacyCouples may need to be given permission to touch each other at this stage of the illness and health care providers may need to consciously address the physical and attitudinal barriers that prevent this from happening.

  • Privacy issues need to be dealt with. This includes encouraging patients to close their door when private time is desired and having all levels of staff respect this. A sign on the door indicating that the patient is not to be disturbed should be enough to prevent staff from walking in and all staff and visitors should abide by this.
  • Partners should be given explicit permission to lie with the patient in the bed. In an ideal world, double beds could be provided but there are obvious challenges to this in terms of moving beds into and out of rooms, and challenges also for staff who may need to move or turn patients. Kissing, stroking, massaging, and holding the patient is unlikely to cause physical harm and may actually facilitate relaxation and decrease pain.
  • The partner may also be encouraged to participate in the routine care of the patient. Assisting in bathing and applying body lotion may be a non-threatening way of encouraging touch when there is fear of hurting the patient.

Specific strategies for couples who want to continue their usual sexual activities can be suggested depending on what physical or emotional barriers exist. Giving a patient permission to think about their self as sexual in the face of terminal illness is the first step. Offering the patient/couple the opportunity to discuss sexual concerns or needs validates their feelings and may normalize their experience, which in itself may bring comfort.

More specific strategies for symptoms include the following suggestions. senior lesbians

  • Timing of analgesia may need to altered to maximize pain relief and avoid sedation when the couple wants to be sexual. Narcotics, however, can interfere with arousal which may be counterproductive.
  • Fatigue is a common experience in the end stages of cancer and couples/individuals can be encouraged to set realistic goals for what is possible, and to try to use the time of day when they are most rested to be sexual either alone or with their partner.
  • Using a bronchodilator or inhaler before sexual activity may be helpful for patients who are short of breath. Using additional pillows or wedges will allow the patient to be more upright and make breathing easier.
  • Couples may find information about alternative positions for sexual activity very useful.
  • Incontinence or the presence of an indwelling catheter may represent a loss of control and dignity and may be seen as an insurmountable barrier to genital touching.

footprints-leftIt is important to emphasize that there is no right or wrong way of being sexual in the face of terminal illness; whatever the couple or individual chooses to do is appropriate and right for them. It is also not uncommon for couples to find that impending death draws them much closer and they are able to express themselves in ways that they had not for many years.

Complete Article HERE!

One Of The Willie Worrisome

Name: lup92
Gender: Male
Age: 15
Location: England
I’m 15 and masturbate often but have had no form of sex although my girlfriend wants to start. However my penis and scrotum have extremely small lumps all over. I also have a purple red large lump on the rim of my bellend. What do I do? Should I start? Or do I risk giving something to my girlfriend?

A quick note before we begin. I’m a Ph.D. kind of doctor. not MD type of doctor. You know that, right? While I know my way around the human body, I never offer medical advice of any sort. And, just so you know, no self-respecting physician, MD kind of doctor, is gonna offer you medical advice online either without seeing you in person first. Which, if you ask me, is a real good thing.

teen intimacy

Here’s the thing about lumps and bumps and discolorations of the skin anywhere on your body, especially on your precious willie, pup. They are signs that all is not well. Do us all a big favor and have your johnson looked at by a physician. Your health is nothing to fool around with. Everything you describe could be completely harmless, but you don’t want to take the chance that it isn’t, right? And here’s a tip: don’t do it for your girlfriend. DO IT FOR YOU! It’s your dick, you gotta lean how to take care of it. And there’s no time like the present to start properly lookin’ after it.

willy_worryJust so you know, I’m not suggesting that your have a STI (Sexually Transmitted Infection). I mean, how could you? You’ve only been wanking, right? Still, if you’re concerned enough to write to me about it, you should take yourself in for a look-see. Since you are underage, you’ll probably need one of your parents to arrange the appointment. But if you are typical teenager, you’ll probably be embarrassed to discuss this with your parents. Still, there’s no getting around this. I think your parents will be proud of you for being proactive about your health and wellbeing. Besides, there’s nothing to be ashamed about.

Another option is to contact a sex-positive resource near you. Check out the folks at FPA. Surely they’ll have a resource for you.

Please take care of this ASAP.

There is one more thing. And I’m gonna be as blunt as I know how. If you think you’re old enough to fuck, you’re old enough to know all about condoms and how to use them. If ya don’t, you’re just a dumb kid who may function like a grown-up, but doesn’t know how to behave like one. And I don’t want to believe that about you.

What it is with young people (old people too) who are still fuckin’ clueless about unprotected sex in this day and age? I have nothing against younger people being sexual. That pretty much is to be expected. But I am totally opposed to kids having kids! Like I said, if you’re old enough to swing it around, you’re old enough to know how to swing it responsibly.

Good luck

What a pain in the ass!

Name: Garth
Gender: Male
Age: 44
Location: South Africa
Hi, I fissured my butt sometime ago and I think it has healed. I have undergone a Lateral Sphincterotomy twice – inner and outer. Unfortunately the area is now VERY sensitive and when I defecate the area ‘screams’ in pain. The softer my stool the worse the pain. When my stool is firm, the pain is less. Will this go away? Is there any medication that I can use?

Everyone in my audience please listen up! I am not a medical doctor, nor do I play one on the internet. The Dr Dick moniker I use refers to my Ph.D. I am a clinical sexologist or a sex therapist if you prefer, not a physician. Get it? Got it? Good!

That being said, anal fissures are a common proctological problem, especially for the heavy ass play crowd. An anal fissure is a tear at the anal tissue. The most common complaint is pain in the anal region during and after taking a dump, itching and possibly some bleeding. Pain and irritation result in spasm of the internal anal sphincter muscle, which then fails to relax during defecation further aggravating the condition.ass-pain

The lateral sphincterotomy you mention is a surgical procedure that removes the fissure. This operation remains the primary form of treatment for chronic anal fissure.

From all that I could learn from my medical consultants, if your surgeries healed properly you shouldn’t be experiencing pain, let alone “screaming pain” when you shit. We all understand that the area will continue to be sensitive, but the pain you describe is not a good sign. You may very well have an infection. You need to have that looked at ASAP. This is nothing to roll around with.

Here’s a tip for all everyone in my audience: pain, of any sort, is one way our body talks to us. Its message is: things are not as they should be; get it fixed NOW. Sometimes the pain will subside when we stop doing something…like holding our hand too close to a flame, or being flogged senseless by Christian Grey. Some pain will only subside when a condition is fixed…like getting a cavity in one’s tooth filled. Other pain, like the emotional pain that come with depression is harder to soothe, but it is important to try. Finally, pain like Garth is experiencing means something is very wrong. And if not attended to immediately, things will only get worse.

Good luck

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