Category Archives: Health Concerns

Our shame over sexual health makes us avoid the doctor. These apps might help.

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We’re taught to feel shame around our sexuality from a young age, as our bodies develop and start to function in ways we’re unfamiliar with, as we begin to realize our body’s potential for pleasure. Later on, women especially are taught to feel ashamed if we want “too much” sex, or if we want it “too early,” or if we’re intimate with “too many” people. Conversely, women and men are shamed if we don’t want nearly as much sex as our partner, or if we’re inexperienced in bed. We worry that we won’t orgasm, or that we’ll do so too soon. We’re afraid the things we want to do in bed will elicit disgust.

This shame can also keep people from getting the health care they need. For example, a 2016 study of college students found that, while women feel more embarrassed about buying condoms than men do, the whiff of mortification exists for both genders. Another 2016 study found many women hide their use of health-care services from family and friends so as to prevent speculation about their sexual activity and the possibility that they have a sexually transmitted infection (STI).

While doctors should be considered crucial, impartial resources for those struggling with their sexual health, many find the questions asked of them during checkups to be intrusive. Not only that but, in some cases, doctors themselves are uncomfortable talking about sexual health. They may carry conservative sexual beliefs, or have been raised with certain cultural biases around sexuality. It doesn’t help that gaps in medical school curriculums often leave general practitioners inadequately prepared for issues of sexual health.

So how do people who feel ashamed of their sexuality take care of their sexual health? In many cases, they don’t. In a study on women struggling with urinary incontinence, for example, many women avoided seeking out treatment — maintaining a grin-and-bear-it attitude — until the problem became “unbearable and distressing to their daily lives.”

Which may be why smartphone apps, at-home testing kits and other online resources have seen such growth in recent years. Now that we rely on our smartphones for just about everything — from choosing stock options to tracking daily steps to building a daily meditation practice — it makes sense people would turn to their phones, laptops and tablets to take care of their sexual health, too. Websites such as HealthTap, LiveHealth Online and JustDoc, for example, allow you to video chat with medical specialists from your computer. Companies such as L and Nurk allow you to order contraceptives from your cellphone, without ever going to the doctor for a prescription. And there are a slew of at-home STI testing kits from companies like Biem, MyLAB Box and uBiome that let you swab yourself at home, mail in your samples and receive the results on your phone.

Bryan Stacy, chief executive of Biem, says he created the company because of his own experience with avoiding the doctor. About five years ago, he was experiencing pain in his genital region. “I did what a lot of guys do, and did nothing,” he says, explaining that, while women visit their gynecologist regularly, men generally don’t see a doctor for their sexual health until something has gone wrong. “I tried to rationalize away the pain, but it didn’t go away.” Stacy says he didn’t want to talk to a doctor for fear of what he would learn, and didn’t know who he would go to anyway. He didn’t have a primary care physician or a urologist at the time. But after three months of pain, a friend of his — who happened to be a urologist — convinced him to see someone. He was diagnosed with chlamydia and testicular cancer. After that, he learned he wasn’t the only one who’d avoided the doctor only to end up with an upsetting diagnosis. “What I found is that I wasn’t strange,” Stacy says. “Everyone has this sense of sexual-health anxiety that can be avoided, but it’s that first step that’s so hard. People are willing to talk about their sexual health, but only if they feel like it’s a safe environment.”

So Stacy set out to create that environment. With Biem, users can video chat with a doctor online to describe what they’re experiencing, at which point the doctor can recommend tests. The user can then go to a lab for local testing, or Biem will send someone to their house. The patient will eventually receive their results right on their phone. Many of the above-mentioned resources work similarly.

Research shows there’s excitement for tools like these. One study built around a similar service that was still in development showed people 16 to 24 years old would get tested more often if the service was made available to them. They were intrigued by the ability to conceal STI testing from friends and family, and to avoid “embarrassing face-to-face consultations.”

But something can get lost when people avoid going in to the doctor’s office. Kristie Overstreet, a clinical sexologist and psychotherapist, worries these tools — no matter their good intentions — will end up being disempowering in the long run, especially for women. “Many women assume they will be viewed by their doctor as sexually promiscuous or ‘easy,’ so they avoid going in for an appointment,” she says. “They fear they will be seen as dirty or less than if they have an STI or symptoms of one. There is an endless cycle of negative self-talk, such as ‘What will they think about me?’ or ‘Will they think that I’m a slut because of this?’ If people can be tested in the privacy of their own home without having to see a doctor, they can keep their symptoms and diagnosis a secret,” Overstreet says, which only increases the shame.

As for the efficacy of these tools, Mark Payson, a physician and co-founder of CCRM Northern Virginia, emphasizes the importance of education and resources for those who do test positive. These screening tests can have limits, he says, noting that there can be false negatives or false positives, necessitating follow-up care. “This type of testing, if integrated into an existing physician relationship, would be a great resource,” Payson says. “But for patients with more complex medical histories, the interactions of other conditions and medications may not be taken into account.”

Michael Nochomovitz, a New York Presbyterian physician, shows a similar level of restrained excitement. “The doctor-patient interaction has taken a beating,” Nochomovitz says. “Physicians don’t have an opportunity to really engage with patients and look them in the eye and talk to them like you’d want to be spoken to. The idea is that tech should make that easier, but in many cases, it makes it more difficult and more impersonal.” Still, he sees the advantages in allowing patients to attend to their health care on their own terms, rather than having to visit a doctor’s office.

Those who have created these tools insist they’re not trying to replace that doctor-patient relationship, but are trying to build upon and strengthen it. “We want people to be partnering with their doctor,” says Sarah Gupta, the medical liaison for uBiome, which owns SmartJane, a service that allows women to monitor their vaginal health with at-home tests. “But the thing is, these topics are often so embarrassing or uncomfortable for people to bring up. Going in and having an exam can put people in a vulnerable position. [SmartJane] has the potential to help women feel they’re on a more equal footing when talking to their doctor about their sexual health.”

“If you come in with a positive test result,” says Jessica Richman, co-founder and chief executive of uBiome, “it’s not about sexual behavior anymore. It’s a matter of medical treatment. It’s a really good way for women to shift the conversation.”

This can be the case for men and women. While many will use these options as a means to replace those office visits entirely, their potential lies in the ability to improve the health care people receive.

Complete Article HERE!

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STI symptom checker: Do I have gonorrhoea, chlamydia or syphilis? Signs of sex infections

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STIs – or sexually transmitted infections – can be passed on via unprotected sex. These are the symptoms of gonorrhoea – commonly misspelt gonorrhea – chlamydia and syphilis to look out for.

STI symptom checker: Unprotected sex risks sexually transmitted infections

By Lauren Clark

STIs – the common abbreviation for sexually transmitted infections – can be passed on via unprotected sex.

Common STIs include chlamydia, syphilis and gonorrhoea, and they are on the rise, according to recent figures.

In 2016 there were 420,000 diagnoses of sexually transmitted infections in England, including a 12 per cent increase nationwide in cases of syphilis.

Rates of gonorrhoea are also soaring particularly in London, which earlier this year was revealed to be the city with the highest STI levels in the UK.

Failing to get a diagnosis and treatment for an STI can cause pelvic inflammatory disease in women, and infertility in both men and women.

But do you know the symptoms of gonorrhoea, chlamydia and syphilis? The NHS has revealed the signs to look out for.

Gonorrhoea

They usually develop within two weeks of an infection, but can sometimes take months to appear. The signs vary between men and women.

Women:
– an unusual vaginal discharge, which may be thin or watery and green or yellow in colour

– pain or a burning sensation when passing urine

– pain or tenderness in the lower abdominal area (this is less common)

– bleeding between periods, heavier periods and bleeding after sex (this is less common)

Men:
– an unusual discharge from the tip of the penis, which may be white, yellow or green

– pain or a burning sensation when urinating

– inflammation (swelling) of the foreskin

– pain or tenderness in the testicles (this is rare)

Syphilis

The first signs usually develop within two to three weeks of infection, and can be split into early symptoms and later symptoms.

Early symptoms:

– the main symptom is a small, painless sore or ulcer called a chancre that you might not notice

– the sore will typically be on the penis, vagina, or around the anus, although they can sometimes appear in the mouth or on the lips, fingers or buttocks

– most people only have one sore, but some people have several

– you may also have swollen glands in your neck, groin or armpits

Later symptoms:

– a blotchy red rash that can appear anywhere on the body, but often develops on the palms of the hands or soles of the feet

– small skin growths (similar to genital warts) – on women these often appear on the vulva and for both men and women they may appear around the anus

– white patches in the mouth

– flu-like symptoms, such as tiredness, headaches, joint pains and a high temperature (fever)

– swollen glands

– occasionally, patchy hair loss

Chlamydia

This is one of the most common STIs in the UK, and, worryingly, it often doesn’t trigger any symptoms. If signs do appear, however, they may include the following.

– pain when urinating

– unusual discharge from the vagina, penis or rectum (back passage)

– in women, pain in the tummy, bleeding during or after sex, and bleeding between periods

– in men, pain and swelling in the testicles

If you think you may have an STI, you should visit your GP or local sexual health clinic. Find out more information here.

Complete Article HERE!

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10 Safe Sex Tips to Protect You From STIs

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Great sex exists in many forms, but the best sex of all is when you don’t have to worry afterwards. Practicing safe sex is as simple as sticking to some main principles.

Follow these 10 tips below and you’ll be able to sleep at night without fear of STD’s or STI’s.

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Cancer diagnosis affects person’s sexual functioning

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Cancer can put a patient’s life on hold, especially among young adults who are just starting their careers or families.

 

A cancer diagnosis affects a person’s sexual functioning, according to a research.

The study, led by the University of Houston, found that more than half of young cancer patients reported problems with sexual function, with the probability of reporting sexual dysfunction increasing over time.

The study discovered that two years after their initial cancer diagnosis, nearly 53 percent of young adults 18 to 39 years old still reported some degree of affected sexual function.

“We wanted to increase our understanding of what it’s like to adjust to cancer as a young adult but also the complexity of it over time,” said Chiara Acquati, lead author and assistant professor at the UH Graduate College of Social Work.

“Cancer can put a patient’s life on hold, especially among young adults who are just starting their careers or families.”

The study also found that for women, being in a relationship increased the probability of reporting sexual problems over time; for men, the probability of reporting sexual problems increased regardless of their relationship status.

“We concluded that sexual functioning is experienced differently among males and females. For a young woman, especially, a cancer diagnosis can disrupt her body image, the intimacy with the partner and the ability to engage in sex,” Acquati said.

At the beginning of the two-year study, almost 58 percent of the participants were involved in a romantic relationship. Two years after diagnosis, only 43 percent had a partner. In addition, psychological distress increased over time.

She says it’s important to research how psychological and emotional developments are effected so tailored interventions and strategies can be created. Detecting changes in the rate of sexual dysfunction over time may help to identify the appropriate timing to deliver interventions.

Failure to address sexual health, the study concludes, could put young adults at risk for long-term consequences related to sexual functioning and identity development, interpersonal relationships and quality of life.

Acquati said health care providers might find it challenging to discuss intimacy and sex because of embarrassment or lack of training, but she believes addressing sexual functioning is vital soon after diagnosis and throughout the continuum of care.

“Results from this study emphasize the need to monitor sexual functioning over time and to train health care providers serving young adults with cancer in sexual health,” said Acquati.

“Furthermore, patients should be connected to psychosocial interventions to alleviate the multiple life disruptions caused by the illness and its treatment.”

The findings have been published in the American Cancer Society journal Cancer.

Complete Article HERE!

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New treatments restoring sexual pleasure for older women

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By Tara Bahrampour

When the FDA approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding decades to their vitality. Meanwhile, older women with sexual problems brought on by aging were left out in the cold with few places to turn besides hormone therapy, which isn’t suitable for many or always recommended as a long-term treatment.

Now, propelled by a growing market of women demanding solutions, new treatments are helping women who suffer from one of the most pervasive age-related sexual problems.

Genitourinary syndrome, brought on by a decrease in sex hormones and a change in vaginal pH after menopause, is characterized by vaginal dryness, shrinking of tissues, itching and burning, which can make intercourse painful. GSM affects up to half of post-menopausal women and can also contribute to bladder and urinary tract infections and incontinence. Yet only 7 percent of post-menopausal women use a prescription treatment for it, according to a recent study.

The new remedies range from pills to inserts to a five-minute laser treatment that some doctors and patients are hailing as a miracle cure.

The lag inaddressing GSM has been due in part to a longstanding reluctance among doctors to see post-menopausal women as sexual beings, said Leah Millheiser, director of the Female Sexual Medicine Program at Stanford University.

“Unfortunately, many clinicians have their own biases and they assume these women are not sexually active, and that couldn’t be farther from the truth, because research shows that women continue to be sexually active throughout their lifetime,” she said.

With today’s increased life expectancy, that can be a long stretch – another 30 or 40 years, for a typical woman who begins menopause in her early 50s. “It’s time for clinicians to understand that they have to bring up sexual function with their patients whether they’re in their 50s or they’re in their 80s or 90s,” Dr. Millheiser said.

By contrast, doctors routinely ask middle-aged men about their sexual function and are quick to offer prescriptions for Viagra, said Lauren Streicher, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause.

“If every guy, on his 50th birthday, his penis shriveled up and he was told he could never have sex again, he would not be told, ‘That’s just part of aging,’” Dr. Streicher said.

Iona Harding of Princeton, New Jersey, had come to regard GSM, also known as vulvovaginal atrophy, as just that.

For much of their marriage, she and her husband had a “normal, active sex life.” But after menopause sex became so painful that they eventually stopped trying.

“I talked openly about this with my gynecologist every year,” said Mrs. Harding, 66, a human resources consultant. “There was never any discussion of any solution other than using estrogen cream, which wasn’t enough. So we had resigned ourselves to this is how it’s going to be.”

It is perhaps no coincidence that the same generation who first benefited widely from the birth control pill in the 1960s are now demanding fresh solutions to keep enjoying sex.

“The Pill was the first acknowlegement that you can have sex for pleasure and not just for reproduction, so it really is an extension of what we saw with the Pill,” Dr. Streicher said. “These are the women who have the entitlement, who are saying ‘Wait a minute, sex is supposed to be for pleasure and don’t tell me that I don’t get to have pleasure.’”

The push for a “pink Viagra” to increase desire highlighted women’s growing demand for sexual equality. But the drug flibanserin, approved by the FDA in 2015, proved minimally effective.

For years, the array of medical remedies has been limited. Over-the-counter lubricants ease friction but don’t replenish vaginal tissue. Long-acting mosturizers help plump up tissue and increase lubrication, but sometimes not enough. Women are advised to “use it or lose it” – regular intercourse can keep the tissues more elastic – but not if it is too painful.

Systemic hormone therapy that increases the estrogen, progesterone, and testosterone throughout the body can be effective, but if used over many years it carries health risks, and it is not always safe for cancer survivors.

Local estrogen creams, suppositories or rings are safer since the hormone stays in the vaginal area. But they can be messy, and despite recent studies showing such therapy is not associated with cancer, some women are uncomfortable with its long-term use.

In recent years, two prescription drugs have expanded the array of options. Ospemifene, a daily oral tablet approved by the FDA in 2013,activates specific estrogen receptors in the vagina. Side effects include mild hot flashes in a small percentage of women.

Prasterone DHEA, a naturally occurring steroid that the FDA approved last year, is a daily vaginal insert that prompts a woman’s body to produce its own estrogen and testosterone. However, it is not clear how safe it is to use longterm.

And then there is fractional carbon dioxide laser therapy, developed in Italy and approved by the FDA in 2014 for use in the U.S. Similar to treatments long performed on the face, it uses lasers to make micro-abrasions in the vaginal wall, which stimulate growth of new blood vessels and collagen.

The treatment is nearly painless and takes about five minutes; it is repeated two more times at 6-week intervals. For many patients, the vaginal tissues almost immediately become thicker, more elastic, and more lubricated.

Mrs. Harding began using it in 2016, and after three treatments with MonaLisa Touch, the fractional CO2 laser device that has been most extensively studied, she and her husband were able to have intercourse for the first time in years.

Cheryl Edwards, 61, a teacher and writer in Pennington, New Jersey, started using estrogen in her early 50s, but sex with her husband was painful and she was plagued by urinary tract infections requiring antibiotics, along with severe dryness.

After her first treatment with MonaLisa Touch a year and a half ago, the difference was stark.

“I couldn’t believe it… and with each treatment it got better,” she said. “It was like I was in my 20s or 30s.”

While studies on MonaLisa Touch have so far been small, doctors who use it range from cautiously optimistic to heartily enthusiastic.

“I’ve been kind of blown away by it,” said Dr. Streicher, who, along with Dr. Millheiser, is participating in a larger study comparing it to topical estrogen. Using MonaLisa Touch alone or in combination with other therapies, she said, “I have not had anyone who’s come in and I’ve not had them able to have sex.”

Cheryl Iglesia, director of Female Pelvic Medicine & Reconstructive Surgery at MedStar Washington Hospital Center in Washington D.C., was more guarded. While she has treated hundreds of women with MonaLisa Touch and is also participating in the larger study, she noted that studies so far have looked only at short-term effects, and less is known about using it for years or decades.

“What we don’t know is is there a point at which the tissue is so thin that the treatment could be damaging it?” she said. “Is there priming needed?”

Dr. Millheiser echoed those concerns, saying she supports trying local vaginal estrogen first.

So far the main drawback seems to be price. An initial round of treatments can cost between $1,500 and $2,700, plus another $500 a year for the recommended annual touch-up. Unlike hormone therapy or Viagra, the treatment is not covered by insurance.

Some women continue to use local estrogen or lubricants to complement the laser. But unlike hormones, which are less effective if begun many years after menopause, the laser seems to do the trick at any age. Dr. Streicher described a patient in her 80s who had been widowed since her 60s and had recently begun seeing a man.

It had been twenty years since she was intimate with a man, Dr. Streicher said. “She came in and said, ‘I want to have sex.’” After combining MonaLisa Touch with dilators to gradually re-enlarge her vagina, the woman reported successful intercourse. “Not everything is reversible after a long time,” Dr. Streicher said. “This is.”

But Dr. Iglesia said she has seen a range of responses, from patients who report vast improvement to others who see little effect.

“I’m confident that in the next few years we will have better guidelines (but) at this point I’m afraid there is more marketing than there is science for us to guide patients,” she said. “Nobody wants sandpaper sex; it hurts. But at the same time, is this going to help?”

The laser therapy can also help younger women who have undergone early menopause due to cancer treatment, including the 250,000 a year diagnosed with breast cancer. Many cannot safely use hormones, and often they feel uncomfortable bringing up sexual concerns with doctors who are trying to save their lives.

“If you’re a 40-year-old and you get cancer, your vagina might look like it’s 70 and feel like it’s 70,” said Maria Sophocles, founding medical director of Women’s Healthcare of Princeton, who treated Mrs. Edwards and Mrs. Harding.

After performing the procedure on cancer survivors, she said, “Tears are rolling down from their eyes because they haven’t had sex in eight years and you’re restoring their femininity to them.”

The procedure also alleviates menopause-related symptoms in other parts of the pelvic floor, including the bladder, urinary tract, and urethra, reducing infections and incontinence.

Ardella House, a 67-year-old homemaker outside Denver, suffered from incontinence and recurring bladder infections as well as painful sex. After getting the MonaLisa Touch treatment last year, she became a proslyter.

“It was so successful that I started telling all my friends, and sure enough, it was something that was a problem for all of them but they didn’t talk about it either,” she said.

“I always used to think, you reach a certain age and you’re not as into sex as you were in your younger years. But that’s not the case, because if it’s enjoyable, you like to do it just as much as when you were younger.”

Complete Article HERE!

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