My Cervical Cancer Diagnosis Changed the Way I Think About Sex

— I’ll never approach sexual risk the same way again

By Andrea Karr

I’ve long been a fan of condom use and STI testing. I’m the woman who carries a rubber in her wallet *just in case* and heads to the lab a couple times a year to have my blood and urine screened for gonorrhea, syphilis and other sexually transmitted infections.

Occasionally, I’ve foregone the condom. I’d like a guy and we’d sleep together a few times. One night, he’d suggest that it would feel way better if we skipped protection. He’d keep the conversation light but would make it clear that we’d both have more fun if I’d loosen up. I wouldn’t want to come off as a killjoy or prude, so sometimes I’d give in. Each time it happened and I received a clear STI test afterward, I’d sigh with relief and go on with my life.

But then I was diagnosed with cervical cancer after a routine Pap test when I was 35. The fastest increasing cancer in females in Canada and third most common cancer in Canadian women ages 25 to 44, cervical cancer is almost always caused by human papillomavirus (HPV), an STI with more than 200 strains that can also cause vaginal, vulvar, penile, anal and oropharyngeal (a.k.a. throat, tonsils, soft palate and back of the tongue) cancer. HPV often has no symptoms, and cervical cancer can take one or two decades to develop after infection. Though condoms don’t guarantee protection, they reduce the risk of transmission.

Cervical cancer is no joke for a woman’s wellbeing and fertility. I was very lucky that my cancer was caught at the earliest stage: 1a1. I required two small surgical procedures (called LEEPs) to remove the cancerous cells, and now I get checkups every three months. If it was caught later, I might have needed a hysterectomy, radiation and/or chemotherapy, which could have harmed my eggs or put me into early menopause.

The phrase “it’s cancer” is something we hope to never hear in our lifetime. Those little words changed my life. As a result, I spent a lot of time looking back on my sexual relationships. I regretted ever having sex at all at first. Sex is what gave me cancer! But then I realized that just being alive carries risk, and I don’t want to avoid intimate relationships, which can be so crucial to physical, emotional and mental wellbeing, just because I could get hurt.

Instead of abstaining from sex, I decided I wanted to get educated about my risk, then develop clear boundaries that I can confidently communicate to a partner. I also want to break down the guilt or shame I feel about being a “killjoy” or “prude.” I have a great justification: a history of gynecological cancer. But no one should need a life-altering event to justify having sexual boundaries.

Still, it’s not easy. “As a woman, you’ve been told your whole life that if you stand up for yourself, if you don’t go with the flow, you are difficult, and that it’s not feminine to be difficult,” says Frederique Chabot, sexual health educator and acting executive director at national organization Action Canada for Sexual Health and Rights. She’s referring to the way most girls and women are socialized growing up. “In romantic or sexual scenarios, there are many things that can put you at risk of retaliation, of reputational damage, of harassment. There is the pressure put on women to say ‘yes,’ people asking, asking, asking, asking. That’s not consent. That is getting pressured into doing something you’re not willing to do.”

A woman's legs and a man's legs intertwined in bed

I’m now comfortable with having a detailed chat about sexual history, STI testing, HPV vaccination and condom use before I get into bed with someone. Of course, it’s not only on me. Men are at risk for HPV and other STIs too.

So far, I’ve had this conversation with two guys. One responded badly; now he has no place in my life. The second agreed to have a fresh STI test before we had sex. He also looked into the HPV vaccine, which he ended up getting, and he is okay with consistent condom use. We’ve been dating for almost a year.

I know that every woman in the world won’t share the same boundaries as me. That’s okay. But there are potential risks to sexual contact, even though our hook-up culture likes to pretend otherwise. It’s about deciding how much risk you can live with and then feeling empowered to communicate that. I won’t let my desire for acceptance compromise my sexual health going forward. I hope, after hearing my story, no one else will either.

“Instead of abstaining from sex, I decided I wanted to get educated about my risk, then develop clear boundaries that I can confidently communicate to a partner.”

Ways to be proactive

HPV vaccination

In Canada, Gardasil 9 is the go-to HPV vaccine and it protects against nine high-risk strains of HPV that cause cancer and genital warts. Health Canada currently recommends it for everyone aged 9 to 26, and it’s offered for free in schools sometime between grades 4 and 7, depending on the province or territory. Though it’s most effective when administered before becoming sexually active, it can still have benefits later in life. I wasn’t vaccinated at the time I was diagnosed with cervical cancer, and all my healthcare practitioners told me to get vaccinated immediately. The Canadian Cancer Society recommends the HPV vaccine for all girls and women ages 9 to 45Regular Pap tests

In Canada, most provinces and territories rely on Pap tests to check for cellular changes that, if left untreated, may lead to cervical cancer. Generally, the recommendation is to go to your doctor or a free sexual health clinic every three years (if everything looks normal) starting at age 21 or 25. I had no symptoms for cervical cancer; it was caught early thanks to a routine Pap test. You still need to go for regular Pap tests even if you’ve been vaccinated, you’ve only had sex one time or you’re postmenopausal.

HPV testing

Free STI tests that you can get through your family doctor or a sexual health clinic do not check for HPV. They usually test for chlamydia and gonorrhea (and maybe also syphilis, HIV and hepatitis C). If a sexual partner tells you they’ve had a clear STI panel, they’re probably not talking about HPV since it’s a test that comes with a fee.

P.E.I. and B.C. are transitioning from Pap testing every three years to HPV testing every five years. HPV testing is more accurate than Pap testing. It can detect certain strains of high-risk HPV with about 95 per cent accuracy, while Pap tests are only about 55 per cent accurate at detecting cellular changes on the cervix, which is why they need to be done more frequently.

The shift to provincially covered HPV screening in other provinces is slow. Ontario, for example, may be years away from the transition.

DIY testing

Canadian company Switch Health has launched a self-collection HPV test that can be ordered online for $99. You do your own internal swab, mail your results to the lab and get your results from an online portal—it can take as little as a week. It screens for 14 high-risk strains of HPV, including types 16 and 18, which cause 70 per cent of cervical cancers and precancerous cervical lesions. If you test positive for one of the strains, you should see your family doctor, and if you don’t have one, Switch “will work to set you up with one of our partners for a virtual or in-person appointment,” says co-founder Mary Langley.

The cost may be a barrier, plus privately purchased DIY tests aren’t supported by the infrastructure that there is for Pap testing. “There are quality control checks in place. There’s evidence review on a regular basis. Many people will receive letters from [their provincial health agency] telling them they’re due for their Pap,” says Dr. Aisha Lofters, a scientist and family physician at Women’s College Hospital in Toronto. But if you aren’t getting regular Paps because you don’t have easy access to a doctor or you’re uncomfortable going in for the test, it’s a lot better than nothing.

Complete Article HERE!

6 Questions to Ask Your Doctor About Sex after 50

— Vaginal dryness, erection challenges, safe sex and more

By Ellen Uzelac

With most physicians ill prepared to talk about sexual health and many patients too embarrassed or ashamed to broach the subject, sex has become this thing we don’t discuss in the examining room.

“So many doctors talk about the benefits of nutrition, sleep, exercise — but they don’t talk about this one really essential thing we all share: our sexuality,” says Evelin Dacker, a family physician in Salem, Oregon, who is dedicated to normalizing sexual health in routine care. “We need to start having this conversation.”

Starting the conversation about sexual health

Sexual wellness experts suggest first talking about a physical problem such as a dry vagina or erectile challenges and then segueing into concerns about desire, low libido and intimacy.

As Joshua Gonzalez, a urologist and sexual medicine physician in Los Angeles, observes: “Patients sometimes need to be their own advocates. If you feel something in your sex life is not happening the way you would like it to, or if you are not able to perform sexually as you would like, never assume that this is somehow normal or inevitable.”

Often, there are physiological issues at play or medications that can alter your sexual experience. “If you’re interested in having sex,” Gonzalez says, “there are often real solutions for whatever the problem may be.”

Here are six questions to help steer the conversation in the right direction.

1. What can I do about unreliable erections?

Erectile dysfunction is common in older men — 50 percent of men in their 50s will experience erectile challenges, Gonzalez says, and 60 percent of men in their 60s, 70 percent of men in their 70s, and on up the ladder.

The good news: There are fixes. “This doesn’t mean giving up on having pleasurable sex at a certain age,” Gonzalez says. The two primary things he evaluates are hormone balance and blood flow to the penis. A treatment plan is then designed based on those results.

Some older men also find it often takes time and effort to ejaculate. Gonzalez suggests decoupling the idea of ejaculation and orgasm. What many men don’t realize: You can have an orgasm with a soft penis and without releasing any fluid at all. “Your orgasm — the pleasure component — is not going to change.”

Also good to know: Sexual health is a marker of overall health. As an example, erectile dysfunction can be a predictor of undiagnosed health issues such as heart disease and diabetes years before any other symptoms arise, says Gonzalez.

2. Sex is different now. My body is no longer young but I still have sexual urges. How do I accommodate this new normal?

Dacker often asks her older patients: How is the quality of your intimacy? Is it what you want it to be? Have you noticed a shift as you’ve gotten older and what does that mean to you?

“Naturally, as we age our bodies start working differently,” she says. “I like to reframe what it means to be sexual by expanding our intimate life, doing things that maybe you haven’t thought of doing before.”

Dacker, who teaches courses on how to be a sex-positive health care provider, suggests exploring each other in new ways: dancing, eye gazing, washing one another while bathing, giving hands-free coconut oil massages using your stomach, arms and chest. She’s also a fan of self-pleasure.

“There’s so much pleasure that doesn’t involve penetration, orgasm and erections,” she adds. “It’s not about performance, it’s about pleasure.”

3. My vagina hurts when I have penetrative sex to the point that I’m now avoiding it. What can I do?

A lack of estrogen in older women can cause the vaginal wall to get really thin, resulting in dryness, irritation and bleeding when there is friction.

“It can be uncomfortable with or without sex,” says Katharine O’Connell White, associate professor of OB/GYN at Boston University and vice chair of academics and the associate director of the Complex Family Planning Fellowship at Boston Medical Center. “What people don’t realize is that what they’re feeling is so incredibly common. A majority of postmenopausal women will experience this.”

White offers a three-part solution for vaginal dryness: If you’re sexually active — and even if you’ve never used a lubricant before — add a water-based lube during sex play. Also, consider using an estrogen-free vaginal moisturizer, sold in stores and online, to help restore the vaginal lining. Finally, think about adding back the estrogen that the body is craving through medically prescribed tablets, rings or creams that are inserted into the vagina.

White also advises patients to engage in 20 to 30 minutes of foreplay before penis-in-vagina sex. “The whole body changes and the vagina gets wet, wider and longer, which can go a long way to alleviating any discomfort,” she says.

4. Urinary incontinence is interfering with my sex life. How can I control it?

Because the bladder is seated on top of the vagina, the thinning of the vaginal wall can also impact the bladder. When you urinate, it can burn or you will want to pee more often, symptoms typical of a urinary tract infection, according to White.

Some women feel like they need to urinate during sex, which, as White says, “can pull you out of the mood.” Her advice? “Pee before sex and pee after sex.” She also suggests using vaginal estrogen to plump up the walls of the vagina and, by extension, the bladder.

5. I’m interested in dating again. What screenings for sexual wellness should I get — and require of a new partner?

Fully understanding the importance of reducing your risk for sexually transmitted infections (STIs) should be front and center as you reenter the dating scene, according to nurse practitioner Jeffrey Kwong, a professor at the School of Nursing at Rutgers University and clinical ambassador for the Centers for Disease Control and Prevention’s “Let’s Stop HIV Together” campaign. 

“Individuals should be screened if they’re engaging in any sort of sexual activity — oral, vaginal, anal — because many times, some of these conditions can be asymptomatic,” he says. “You can transmit without symptoms and vice versa.”

Screening may involve a urine or blood test or swabs of the vagina, throat or rectum. With STIs soaring in older adults, Kwong suggests testing for HIV, hepatitis C, hepatitis B, chlamydia, gonorrhea and syphilis. In early 2024, the CDC reported that syphilis cases had reached their highest level since the 1950s.

6. My doctor was dismissive when I brought up sex, basically saying, At your age, what do you expect? What should I do now?

Sex is a special part of life no matter how old you are. “If you’re with a doctor who brushes aside any of your concerns, it’s time to find a new doctor,” White says.

Finding a good doctor, she adds, is no different from looking for an accomplished hair stylist or a reliable mechanic: Ask your friends.

“I’m horrified when I hear about things like this,” she adds. “Any good doctor really wants you to bring up the things that concern you.“

Complete Article HERE!

6 things we learned about sexual health this year

By Kaitlin Reilly

Sexual health is health — and, boy, did we learn a lot about it this year. After spending 2023 diving into studies, surveys and even pop culture moments that focused on all things sex, I’ve concluded that there’s always more to know about the more intimate side of our lives. Sometimes the things we learned may have felt a little TMI — like, say, the role Christmas ornaments have as potential sex toys. Most of the time, however, the stuff we learned about sex was pretty groundbreaking, such as how there are two types of desire, and neither is wrong.

Here’s a wrap-up of the top six things we learned about sex this year — and here’s to many more fun, sexy facts in the new year.

1. Many women keep a ‘sexual toolbox’

You may not find it at Home Depot, but more than half of menopausal women ages 50 and over who were asked about their sex lives in a September Kindra-Harris poll said that they kept a “sexual toolbox” to make intercourse more pleasurable. These products include lubricants, as well as vibrators, both of which can make sex more fun and comfortable, especially as many menopausal women experience vaginal dryness and other pain during sex, medically known as dyspareunia.

And speaking of lubricant — you may want to be careful about what you put in your own toolbox. If you are using condoms, whether that’s with a sex toy or partner, you should never use oil-based lube, as it can “destroy the integrity of latex condoms,” women’s health expert Dr. Jennifer Wider tells Yahoo Life.

You don’t have to be menopausal to benefit from lube either. “A myth surrounding lube is that people only use lube when something is not quite working correctly,” says Dr. Laura Purdy, chief medical officer at Wisp. “This couldn’t be further from the truth. Many people use lube to make things feel more natural, and lube can be your best friend during sex.”

2. There are 2 types of desire — and neither is wrong

In movies (and, of course, porn) all it takes is someone looking at their partner for Marvin Gaye’s “Let’s Get It On” to start playing. In real life, sexual psychologist Laurie Mintz says that’s not exactly how things work — at least, not most of the time, and especially not for people in long-term relationships. That’s because there are two types of desire: “spontaneous desire,” which is when you feel aroused pretty much immediately, and “responsive desire,” which means you need some kind of stimulation in order to put yourself in a sexy mood.

“With this type of desire, one doesn’t wait to be horny to have sex, but has sex to get horny,” Mintz says, which means that “the desire follows the arousal, versus the reverse.”

Obviously, there are times when sex is completely off the table between two consenting adults — headaches and new episodes of The Golden Bachelor do exist, after all. However, these two kinds of desire may take some of the pressure off people who may feel like they have a lower libido simply because they don’t feel spontaneously sexual.

Instead of making yourself feel bad because you can’t go zero to 60, try engaging in things that make you feel in the mood before you get to your sexual main event, whether that’s masturbating, kissing your partner or even just relaxing and thinking about sex in the hours leading up to a planned encounter.

3. Young people are having less sex than their parents did at their age

Teen rates of sexual intercourse are declining, according to a 2023 published survey from the Centers for Disease Control and Prevention. The survey found that only 30% of teens in 2021 said they ever had sexual intercourse, down from 38% in 2019. While, yes, the COVID-19 pandemic did likely have something to do with the declining rates (it’s a little hard to socially distance during sex), some experts think there may be other reasons for the decline, such as more teens identifying as LGBTQ and engaging in sex acts that don’t necessarily involve intercourse.

It’s also possible that young people just aren’t growing up as fast as they once did. Jean Twenge, a San Diego State University psychology professor who reviewed the data for her book Generations, told the Los Angeles Times that more young people are living at home longer and delaying things like getting their driver’s license and going to college — which may also affect their sex life.

“In times and places where people live longer and education takes longer, the whole developmental trajectory slows down,” she said. “And so for teens and young adults, one place that you’re going to notice that is in terms of dating and romantic relationships and sexuality.”

4. People are using strange seasonal things as sex toys

TikTokers love to review the holiday items at Target each year, but Dr. Adam Gaston, an internal medicine physician since 2021, went viral on the platform for a different reason: by reminding his followers not to put said Christmas decor any place it “doesn’t belong.” Sure, that Christmas tree ornament may not be shaped all that differently from a dildo, but spending the holidays in an emergency room because glass broke inside your rectum or vagina is ho-ho-horrific.

Of course, it’s not just the holiday season that gets people hot, bothered and making bad decisions about what to use for sexual gratification: A 2013 case study revealed that things like ballpoint pens, a tea glass and even an eggplant were found in the rectum of different men, so really, why wouldn’t a Christmas ornament be on deck too?

Place those ornaments on your tree and add a silicone-based sex toy on your holiday wish list.

5. Libido gummies (probably) don’t work — at least not how you think

Popping a supplement or chewing on a gummy won’t make you instantly hot and bothered, even as more and more companies are selling libido gummies that claim to put women in the mood for love.

The jury is out on these products, says Dr. Tiffany Pham, an ob-gyn and a medical adviser for female health app Flo Health, as there is “a lack of robust research into the claims behind these supplements,” even as some individual ingredients show promise.

But that’s not the only reason they’re unlikely to be the sole solution for low libido for women: Libido involves more than just physical function and can be affected by everything from stress to past trauma to the connection one has with a partner. If you’re really struggling with a lack of desire, talking with a sex therapist will likely do way more than an over-the-counter supplement. And if you are curious about taking something to boost your libido, make sure to talk to your doctor, who can tell you if it’s safe to explore.

6. Dry orgasms are a thing for men

And Just Like That may be lacking the sex part of its predecessor’s name, but there’s still plenty of sex in the city for Carrie Bradshaw and her friends. In a 2023 episode, Charlotte and her husband, Harry, are having sex when Harry orgasms — only for no semen to come out. After consulting with a doctor, the couple learns he experienced a retrograde orgasm, or a dry orgasm, which occurs when semen enters the bladder instead of exiting through the penis, leading to little to no ejaculation. While Harry is instructed to do kegels — leading to Charlotte training him in the famed pelvic floor exercise — urologist Dr. Fenwa Milhouse told Insider that advice won’t help. Dry orgasms are typically a nerve issue and often caused by certain medications, like ones taken for diabetes, as well as pelvic injuries.

“It’s not dangerous. It’s not detrimental to the person’s body, but it can interfere with fertility because the semen isn’t getting where it needs to be, which is being deposited into the partner’s vagina,” Milhouse told Insider.

Bonus: Here’s how you find your G-spot (which may not be a ‘spot,’ after all)

Ah, the G-spot. If you’re a person with a vagina and have always found this famed alleged center of pleasure elusive, Martha Kempner’s breakdown of the G-spot includes where to find it. The G-spot is on the front wall of the vagina, nearly two inches in. Also worth noting? The G-spot may not be a spot at all but more of a zone, as, according to a 2022 article, there are actually “five separate erotogenic tissues that function in a similar way to the G-spot.”

One theory why stimulating the G-spot feels so good is that people are stimulating the clitorourethrovaginal (CUV) complex, which includes interactions between the clitoris, urethra and uterus, says Debby Herbenick, director of the Center for Sexual Health Promotion at Indiana University and author of Read My Lips. A come-hither motion with two (well-lubed!) fingers should do the trick.

Complete Article HERE!

The future of treating sexual dysfunction in 2024

By

Sexual dysfunction, a concern affecting millions worldwide, has long been shrouded in silence and stigma. However, new developments in 2024 are transforming how we approach and treat this sensitive issue. This change isn’t just about enhancing sexual pleasure; it’s deeply tied to self-esteem, mental health, and the quality of relationships.

Open Communication: The first significant trend is the shift towards open communication about sexual dysfunction. This growing openness is largely fueled by mainstream acceptance and the increasing awareness among healthcare providers of the interconnection between sexual and overall health. Online counseling and specialized sexual wellness apps are playing a crucial role in this transformation, offering accessible resources for those hesitant to discuss these issues in person.

Advancements in Technology: Sound wave technology, particularly the development of Cliovana, is a breakthrough in treating sexual dysfunction, especially in women experiencing menopause-related symptoms. This pain-free, non-invasive technology stimulates natural healing processes, leading to enhanced blood flow, sensitivity, and sexual responsiveness. The simplicity and effectiveness of treatments like Cliovana’s soundwave therapy are key drivers in changing the landscape of sexual health solutions.

Menopause Education: The destigmatization of menopause and its associated sexual dysfunctions is gaining momentum. With the global menopause market projected to reach $22.7 billion by 2028, there’s an increasing focus on educating and providing solutions for women. This includes hormone and testosterone replacement therapies, which are tailored to individual symptoms, offering rejuvenation and improved sexual experiences.

Normalization of Sex Toys and Lubricants: Once considered taboo, sex toys and lubricants are now recognized as essential elements of sexual wellness. The market for these products is expanding rapidly, reflecting a societal shift towards accepting these products as tools for enhancing sexual experiences. Retail accessibility, both online and in physical stores, underscores this trend.

Lifestyle Choices and Sexual Health: Finally, there’s a growing understanding of how lifestyle choices impact sexual health. Research linking low-grade inflammation to erectile dysfunction (ED) has encouraged a broader distribution of information from doctors and researchers. Lifestyle modifications like reducing smoking, increasing physical activity, maintaining a healthy weight, and moderating alcohol consumption are recognized as effective strategies for minimizing the risk of ED.

One promising treatment is Cliovana, a unique, patented procedure specifically designed to enhance women’s orgasm intensity and frequency. This innovation is particularly noteworthy considering the widespread issue of sexual dissatisfaction among women. Studies indicate that 60% of women are not satisfied with their sex life, highlighting a significant disparity in sexual fulfillment between genders.

What sets Cliovana apart is its use of sound wave technology. This non-invasive approach, steering clear of lasers or scalpels, significantly reduces the risk of side effects, making it a safer alternative for sexual wellness. The technology is focused on increasing arousal levels, orgasm frequency, and intensity, aiming at a core aspect of sexual satisfaction: the clitoral responsiveness.

The efficacy of Cliovana is backed by clinical trials, which consistently show heightened sensation and stronger orgasms among women who undergo the treatment. The results are not just immediate but also long-lasting. Women report a sustained enhancement in their sexual experience, which can last for over a year, with the option of annual revitalization sessions to maintain these benefits.

2024 is setting a new tone in the realm of sexual health and wellness. With advancements in technology, increased openness, and a holistic approach to treatment and education, the future looks promising for individuals struggling with sexual dysfunction. This year symbolizes a breakthrough in not only treating the physical symptoms but also in supporting the emotional and relational aspects of sexual well-being.

Complete Article HERE!

Taking Antibiotic After Sex Could Slash Your Risk for an STI.

— Here’s What to Know

By Ernie Mundell

  • If you’re sexually active, taking the antibiotic doxycycline within 72 hours of sex might help prevent an STI
  • Syphilis cases are surging in the United States, making ‘Doxy on Demand’ a welcome weapon against the disease
  • Taking doxycycline shouldn’t be a substitute for condom use, experts say

Data showing that the antibiotic doxycycline might prevent a sexually transmitted infection (STI) if taken soon after sex made headlines earlier this year.

As surging numbers of cases of syphilis and gonorrhea affect more Americans, here’s what you need to know about using the drug.

“If you’re actively having sex and not using condoms 100% of the time, which is the reality out there, this strategy could be appropriate for you,” said Dr. Christopher Foltz, an infectious disease specialist at Cedars-Sinai in Los Angeles. “It comes down to each person’s individual risk level, something that you should discuss with your physician.”

He noted that syphilis, especially, has reemerged with a vengeance in recent years as a health threat.

“Syphilis has been climbing at the highest rate with a significant increase among pregnant women and men who have sex with men,” Foltz said in a hospital news release.

According to the U.S. Centers for Disease Control and Prevention, syphilis cases among gay and bisexual men in the United States rose by 7% between 2020-2021.

Rates of new cases of the disease rose even more steeply among women: a 55.3% jump between 2020 and 2021, and 217.4% rise between 2017 and 2021 overall. That means more babies potentially being born with syphilis, as well.

You may not even realize you are infected with syphilis, Foltz noted, since in many cases it can lurk symptom-free for years. But left undiagnosed, long-term syphilis can cause blindness and neurological issues.

“That’s what we’re trying to prevent — these kinds of catastrophic long-term complications from undiagnosed STIs,” Foltz said. “If we can prevent infections with a relatively safe and easy-to-take antibiotic, the overall number of new infections will ultimately decrease.”

That’s why the new data on doxcycycline is so promising. A trial found that one 200 milligram (mg) dose of the drug — which has been used to treat other ailments for years — could prevent infection with syphilis and chlamydia if taken within 72 hours of a sexual encounter.

The strategy has even gained a nickname: “Doxy on Demand” or “Doxy PEP” (post-exposure prophylaxis).

The method isn’t foolproof however, and it’s no reason to forgo the use of condoms, Foltz warned.

“We absolutely encourage condom use to prevent against other STDs and HIV as an added barrier of protection for prevention,” he stressed.

Doxycycline is not advised for certain groups: Pregnant women and anyone known to be allergic to a class of antibiotics known as tetracyclines. Always consult with your doctor before taking any antibiotic.

Complete Article HERE!

How Late Can Your Period Be After Taking Plan B One-Step?

By Patricia Weiser, PharmD

Plan B One-Step is a single-dose emergency contraceptive (EC) pill. It contains the active ingredient levonorgestrel, a synthetic hormone belonging to the progestin class. Plan B One-Step and its generic alternatives are available over the counter (OTC).

The Food and Drug Administration (FDA) has approved the use of Plan B One-Step to reduce the chance of pregnancy if taken within three days (72 hours) after unprotected sex.1

Plan B One-Step is intended for use if another contraceptive method fails (such as a condom breaking during sex) or isn’t used.2

Taking Plan B One-Step may affect your period. Some females get their period about a week early or a week late after taking Plan B One-Step, and their bleeding may be lighter or heavier than usual. However, if your period is more than a week late, you could be pregnant.3

Keep reading to learn more about the link between taking Plan B One-Step and your period’s timing, along with basic safety and dosage information regarding its use.

Understanding the Morning-After Pill

Emergency birth control such as the morning-after pill, can help decrease your chance of becoming pregnant after unprotected sex. EC pills, like Plan B One-Step, work by preventing ovulation, the release of an egg from the ovaries.

By stopping this process, the sperm cannot fertilize the egg, thus avoiding a pregnancy.

It is important to note that EC will not have any impact if ovulation has already taken place. As a result, EC does not affect fertilized eggs or pregnancies already implanted.4

EC, including Plan B One-Step, differs from Mifeprex (mifepristone). Mifeprex is a medication given in combination with the drug misoprostol for medical termination of a pregnancy up to 70 days into the pregnancy.5

EC, on the other hand, only works as a preventive measure against pregnancy, with no effect after pregnancy begins.2

Some states restrict access or completely disallow the use of Mifeprex. Fourteen states have banned access to Mifeprex for medical termination of pregnancy, while another 15 states limit its use to certain situations.

In contrast, Plan B One-Step is legal and available in all 50 states.6

What Is Plan B One-Step?

The FDA approves Plan B One-Step for use in females to reduce the likelihood of pregnancy following unprotected sex. It comes as a single-dose oral tablet that you swallow. It is intended for use in females of reproductive age.

Plan B One-Step works up to 72 hours after unprotected sex to prevent pregnancy. Taking it as soon as possible increases its effectiveness and reduces the chances of getting pregnant.1

The sooner you take it after sex, the more effectively it works, though some research suggests that it may still work up to four days (96 hours) afterward.4

Levonorgestrel, the active ingredient in Plan B One-Step, is also available OTC as several other emergency contraceptive products, such as Her Style, Opcicon One-Step, and Fallback Solo.2

Levonorgestrel is also an active ingredient found in other contraceptives, such as certain types of birth control pills, transdermal patches, and intrauterine devices (IUDs).7

How Does Plan B One-Step Work?

Plan B One-Step prevents or delays ovulation when the ovary releases an egg. As a result, sperm cells cannot reach or fertilize the egg, which helps prevent pregnancy.3

Plan B One-Step works by preventing or delaying ovulation. If you take it after ovulation has already occurred, it may be less effective.

However, since you may not know when you ovulated, you can still take Plan B One-Step at any time during your menstrual cycle to help prevent pregnancy within three days after having unprotected sex.8

Note that it offers no protection against HIV (human immunodeficiency virus) or other sexually transmitted infections (STIs). Therefore, it should not be considered a preventative measure against STDs.1

Taking Plan B One-Step may result in changes to the menstrual cycle. After taking Plan B One-Step, your period may be earlier or later than expected. In most cases, individuals taking it will get their period within a week when expected.

However, if your period is more than a week late, this could be a sign of pregnancy; take a pregnancy test or talk to a healthcare provider for guidance.

Period flow and duration may be similarly affected by Plan B One-Step. Some individuals experience heavier or lighter bleeding than usual, and their period may be longer or shorter than usual.

Some people may notice spotting or light bleeding after taking Plan B One-Step, but this side effect may not be your actual period. You should still anticipate your period within a week before or after the expected time.

After taking Plan B, you may feel anxious while waiting to see if it was successful at preventing pregnancy. The most typical indication of its effectiveness is the arrival of your period. You can also take a pregnancy test if your period is late.

There is no other method to determine the effectiveness of Plan B One-Step if signs such as a negative pregnancy test do not occur.3

Why Does Plan B Affect Your Period?

Levonorgestrel, the active ingredient in Plan B One-Step, results in possible changes to the menstrual cycle. Levonorgestrel is a synthetic progestin hormone.

It is a lab-made version of a naturally occurring progesterone hormone and acts similarly.1 

Because Plan B One-Step contains a more significant amount of hormone than the body naturally produces at various stages of the menstrual cycle, the medication can alter the flow, duration, and timing of the next period.

In general:9

  • Taking Plan B One-Step after the midpoint of the menstrual cycle (the time of expected ovulation) may result in extended periods and/or delays in period onset.
  • Taking Plan B One-Step before the midpoint of the menstrual cycle is more frequently associated with spotting and earlier period onset.

Dosing Guidelines

The table below shows the strength and dosage of Plan B One-Step:1

Plan B One-Step can be taken with or without food as long as you take it within 72 hours of unprotected sex. If you vomit within three hours of taking it, you may need to repeat the dose.2

Consult a pharmacist or healthcare provider for advice if you have questions about taking Plan B One-Step.

Precautions & Safety

The FDA advises pregnant individuals against using Plan B One-Step. However, the drug is not known to cause harmful effects if taken during pregnancy, and it does not affect an established pregnancy. Plan B One-Step will not terminate an existing pregnancy.

In addition, individuals should not rely on the morning-after pill as their primary form of contraception.

Other options, such as birth control pills or vaginal rings, are more effective when used as prescribed compared to Plan B One-Step or other emergency contraceptive pills.

Certain medications interact with Plan B One-Step and may lead to less effective results for Plan B One-Step when taken simultaneously.

These medications include:1

Side Effects

Generally, Plan B One-Step provides safe emergency contraception. However, some individuals may experience side effects from the medication.

The most common side effects are:10

In most cases, these side effects are mild. Notably, abdominal pain could be a sign of ectopic pregnancy.

If you’re experiencing severe abdominal pain after taking Plan B One-Step, contact a healthcare provider for evaluation and observation.

How Effective Is Plan B One-Step?

Plan B One-Step provides a practical option for preventing pregnancy. In a major clinical study, Plan B One-Step prevented 84% of expected pregnancies.

This was a drop from 8% to 1% in the expected pregnancy rate following unprotected sex without EC.1

However, other factors can alter the effectiveness of Plan B One-Step. Studies show that taking the medication as soon as possible after the time of unprotected sex increases the chances of effectively preventing pregnancy.

Furthermore, the point in the menstrual cycle when you take Plan B can affect how it works.11

An independent study of Plan B One-Step showed that while the medication may still be effective after ovulation, it is more effective if taken before ovulation.8

Summary

Plan B One-Step (levonorgestrel 1.5 mg oral tablet) is an OTC EC pill.1 It is taken to reduce the chance of pregnancy if taken up to 72 hours after unprotected sex.

After taking Plan B One-Step, it’s common for individuals to experience some changes to their normal menstrual cycle.2

Your period can come one week earlier or later than expected. Plan B One-Step may cause spotting and/or periods that are heavier, longer, or lighter than usual.

If more than a week has passed since you expected your period after taking Plan B One-Step, you may be pregnant. Take a pregnancy test; if the result is negative and another week passes without a period, take another test or reach out to a healthcare provider for medical advice.

Frequently Asked Questions

  • How can I safely store Plan B One-Step?

    Store Plan B One-Step at room temperature (68-77 degrees F) and keep it away from any area susceptible to high levels of heat or moisture, such as the bathroom.

    Keep Plan B out of the reach of children and pets.10

  • Will Plan B One-Step affect future fertility?

    No. Plan B One-Step does not impact future fertility. The medication works quickly and only stays in your system for a few hours without making any lasting changes to hormones or fertility.12

  • What is the shelf-life of Plan B One-Step?

    Plan B One-Step comes with an expiration date on the product packaging. It is usually four years after the date of manufacturing.

    Once expired, the medication may be less effective, so dispose of any unused Plan B One-Step and replace it with a fresh supply if desired.13

  • How commonly used is EC?

    EC has gained popularity over the last two decades.

    According to a 2019 survey, more than 25% of females of reproductive age reported taking EC at least once; a similar survey from 2002 found that only 4% of females reported using EC.

    This increase is likely because EC is now an easily accessible OTC product that had previously required a prescription.7

    Complete Article HERE!

5 Ways to Have Healthy Sex When You Have Diabetes

— Here’s how to continue enjoying intimacy

By Mauricio González

Age and the passage of time usher in many changes. But in all my years practicing medicine, one thing remains a constant: My patients want to continue having a fulfilling and pleasurable sex life, even if they’re dealing with health problems or chronic illness. One disease that can take a heavy toll on a couple’s sex life is diabetes. Fortunately, there are ways to manage it and reignite your sex drive. Don’t despair! Here’s how you can do it.

The role of glucose in your sex life

People with diabetes are more prone to sexual dysfunction than the rest of the population, according to the American Diabetes Association (ADA). Both men and women may experience little or no sex drive due to poor management of their diabetes. But only 47 percent of men and 19 percent of women with diabetes discuss this issue with their doctors, according to a study published by Diabetes Care. Controlling blood sugar levels with medication and regularly monitoring these levels is essential to maintaining a healthy sex life.

But even if blood sugar is kept under control, men and women with diabetes may feel sexual desire but have difficulty becoming physically aroused.

And a failure to control blood sugar will eventually lead to blood vessel and nerve damage, which can prevent arousal.

How does diabetes affect your sex life?

There are many reasons why people with diabetes lose their sex drive or their ability to orgasm. Obesity, high blood pressure, sleep apnea and depression are conditions that often accompany diabetes and can compromise your libido. Some of the medications used to treat these conditions can also adversely affect your sex life. Some treatments for high blood pressure, for instance, can cause erectile dysfunction.

According to a study published in the International Journal of Environmental Research and Public Health, the sexual disorders of patients with type 1 diabetes are directly linked to depression and are less severe in those who accept their diabetes. These disorders also affect men more than women, and they take a greater toll on patients with blood glucose levels above 6.5 percent.

Erectile dysfunction in men with diabetes

If a man’s blood vessels don’t function properly or he has a blocked artery, his penis will not receive enough blood flow to get an erection. Men over 50 with type 2 diabetes are 11 times more likely to experience erectile dysfunction than younger men, according to a study published in the Caspian Journal of Internal Medicine.

Men with diabetes-related erectile dysfunction are also at greater risk of developing Peyronie’s disease, where a type of scar tissue known as plaque forms under the skin of the penis. This causes a curvature that can make erections painful, difficult or impossible.

Sexual problems in women with diabetes

Nerve damage in women can cause vaginal dryness, a condition that is not unique to people with diabetes but, according to the ADA, is twice as common in this population. The neurovascular system plays a necessary role in arousal and orgasm. If the small nerves aren’t working properly due to damage from poorly controlled blood sugar, a woman can have sensation problems. The clitoris needs optimal blood flow and sensation to become engorged enough to achieve orgasm.

Women with diabetes are also at greater risk of urinary tract and vaginal infections, which can make sexual intercourse painful and unpleasurable. Middle-aged women with diabetes who take insulin are 80 percent more likely to have difficulty reaching orgasm than women without diabetes, according to a study published in Obstetrics & Gynecology.

How can you maintain a healthy sex life?

Here are some practical suggestions that anyone can follow:

1. Eat right

Eating healthy can make all the difference. Non-starchy vegetables, such as broccoli and carrots, and whole grains can help stabilize your blood sugar and give you the energy you need to have sex. These foods are also rich in fiber and nourish your gut microbiome — the bacteria and other organisms that keep your gut healthy. A snack before sex will help boost your stamina and keep your blood sugar under control.

2. Exercise

Sex, like any other form of exercise, requires energy. So how can you be prepared? Activities such as weightlifting and Zumba classes can help you build stamina and have more energy in bed. I recommend at least 150 minutes of exercise per week, which can include walking, swimming or even gardening. Exercise also makes the body more sensitive to insulin, which helps it control insulin levels more efficiently.

3. Take your medications

Strictly follow your doctor’s instructions and make sure you take your medications. If you have diabetes, controlling your blood sugar starts with taking your prescriptions. Talk with your doctor if you suspect that a medication prescribed to treat other conditions may be interfering with your sex life, so that you can work together to look for alternatives. I also recommend buying a weekly pill organizer, which has been shown to help increase compliance with medical treatment.

4. Manage stress

Learning that you have diabetes can be upsetting and can affect your mental health. Learn how to calm your mind and body in stressful moments, such as during a sexual encounter. Brush away negative thoughts. Be grateful for — and focus on — enjoyable moments. Meditation can be very helpful. Research shows that meditation may strengthen the parts of the brain that help you remain calmer in stressful situations. But my favorite tool for reducing stress and anxiety is cognitive behavioral therapy; check with your doctor to see if this is a good option for you.

5. Be consistent

Consistency is a bridge between dreams and reality. Follow these suggestions daily. Take it gradually at first. Don’t reach for gimmicky or drastic solutions; just stick to the basics and you’ll get results, especially over time. Remember that the key is consistency, not perfection.

Complete Article HERE!

Alcohol Might Be Ruining Your Orgasm

— How much and how often you drink can affect your ability to climax during sexual activity.

By Catherine Pearson

Emma Schmidt, a clinical sexologist in Cincinnati, has lost track of the number of clients she’s seen for low libido and problems orgasming after they’ve first visited a doctor who advised them to “Just relax and have a glass of wine.

That type of suggestion is not just dismissive, Dr. Schmidt said, but it highlights the gaps in our collective understanding about the interplay between alcohol and sex.

After years of contradictory findings, recent research has made it clear that even moderate drinking poses risks to your overall health. But the question of how alcohol affects sexual health — specifically, orgasms — can be a bit fuzzier.

“Society has long depicted alcohol as a crucial ingredient for romantic encounters,” said Catalina Lawsin, a clinical psychologist who specializes in sexuality. She added that people often mix sex and alcohol because it relaxes them and offers a sense of escapism — and because of a widely held belief that alcohol “elevates sexual prowess and pleasure.”

But the reality, she said, is much more complex.

What happens when you mix alcohol and sex?

“Essentially, there’s no research,” said Dr. Lauren Streicher, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine whose work focuses on sexual dysfunction in women.

The data that does exist — much of it from rat studies or small, qualitative investigations — suggests a pattern: Small amounts of alcohol seem to enhance arousal and decrease sexual inhibitions, Dr. Streicher said, but large amounts can suppress arousal and delay or prevent orgasm.

To understand why, it helps to look at the specific processes happening in your brain when you drink.

Alcohol releases dopamine, said Dr. Regina Krel, an assistant professor of neurology with Hackensack Meridian School of Medicine, who described it as “the feel good neurotransmitter.” Researchers believe it helps control desire.

At the same time, alcohol enhances the effects of gamma-aminobutyric acid, or GABA, a chemical messenger that inhibits impulses between nerve cells, essentially slowing the brain down and making a person feel more relaxed.

“It does make you think, ‘Oh, I feel hornier!’” because it lowers inhibitions, said Laurie Mintz, an emeritus professor of psychology at the University of Florida who focuses on human sexuality. “But the irony is that, in fact, it’s a central nervous system depressant.”

That means that alcohol has a dampening effect throughout the brain, Dr. Krel said, including in the prefrontal cortex (which is responsible for things like weighing consequences), the cerebellum (which controls coordination) and the autonomic nervous system (which regulates functions like heart rate and breathing).

Alcohol can hinder the brain’s ability to process sexual stimuli and coordinate muscle contractions, which are central to the orgasmic response, Dr. Lawsin added. “While it may contribute to relaxation and inhibition reduction initially, excessive consumption can interfere with the intricate processes that lead to the intense pleasure and satisfaction of orgasm.”

How much you drink matters.

The experts said that moderate drinking before having sex is usually OK. However, they also stressed that knowing whether alcohol will help lead to orgasm by reducing stress and inhibitions, or get in the way of orgasm by suppressing basic functions, has a lot to do with how often you drink and how much you drink on any given occasion.

Moderate drinking is usually defined in the United States as no more than two drinks a day for men or one drink a day for women. But the way alcohol affects you is determined by a host of factors, including genes, body size and composition, and your history with drinking.

Chronic, heavy use of alcohol has been linked to erectile dysfunction and premature ejaculation in men, Dr. Mintz said. Research has also connected alcohol consumption to sexual dysfunction (persistent problems with sexual response, desire and orgasm) in women.

“There isn’t a magic number of drinks that applies to everyone,” Dr. Lawsin said, adding that excessive alcohol use can hamper the connection between partners, as well as impair decision making and the ability to consent to sex.

How to find help with orgasm issues.

If you are experiencing anorgasmia (which is delayed or infrequent orgasms, or no orgasms at all), your first step should be to reach out to a primary care physician or sex therapist who can help determine the root cause or causes and connect you to the right type of specialist or treatment, Dr. Schmidt said.

There could be one or a number of underlying issues affecting your ability to orgasm, including certain health conditions or medications, relationship problems and trauma, as well as your alcohol consumption.

Many primary care doctors, and even some gynecologists and urologists, do not have a specific background in sex medicine, so it can help to ask if they do, she said, and if they have any experience working with patients with anorgasmia.

If alcohol seems to be hampering your orgasms, ask yourself how and why you use alcohol around sex, Dr. Schmidt said, noting that mental health professionals and sex therapists can be a valuable resource.

Do you often or always drink beforehand?

“If someone is using alcohol as a way to be able to have sex,” she said, “or if they feel scared, ashamed or vulnerable having sex without alcohol, then we might want to explore more.”

Complete Article HERE!

A New Way to Prevent S.T.I.s

— A Pill After Sex

By Apoorva Mandavilli

In a bid to stem the resurgence of sexually transmitted infections, the Centers for Disease Control and Prevention plans to recommend doxycycline, a widely used antibiotic, for use after an unprotected sexual encounter.

The antibiotic would be taken only by gay and bisexual men and transgender women who have had an S.T.I. within the previous year or who may be at risk for one. The scientific evidence is too limited to recommend the strategy, called doxy-PEP, to all people who might be exposed to infection-causing bacteria during sex.

The agency released draft guidelines on Monday and plans to finalize them after a 45-day public comment period.

A close-up view of a bottle of the antibiotic doxycycline, held by a hand in a pharmacy.
“We need game-changing innovations to turn the S.T.I. epidemic around, and this is a major step in the right direction,” an official with the Centers for Disease Control and Prevention said.

Why It Matters: Rates of S.T.I.s are skyrocketing.

In 2021, there were 1.6 million cases of chlamydia, more than 700,000 cases of gonorrhea and nearly 177,000 cases of syphilis in the United States, together tallying up to $1.1 billion in direct medical costs. (Rates of babies born with syphilis also soared that year, with nearly 3,000 affected.)

All three S.T.I.s are caused by bacteria and are easily treated with antibiotics. But the closure of sexual health clinics across the country and a drop in public awareness has contributed to a sharp rise in infections.

Gonorrhea cases have increased 118 percent since a historical low in 2009, according to the C.D.C. Syphilis was nearly eliminated in the United States about 20 years ago, but cases have risen 74 percent since 2017.

On any given day in 2018, about one in five Americans had an S.T.I., the C.D.C. has estimated.

“We need game-changing innovations to turn the S.T.I. epidemic around, and this is a major step in the right direction,” Dr. Jonathan Mermin, director of the agency’s National Center for H.I.V., Viral Hepatitis, S.T.D. and TB Prevention, said in an emailed statement.

The C.D.C.’s guidelines are based on studies that show that a single dose of doxycycline taken within 72 hours of unprotected sex dramatically cuts the risk of the infections.

Evidence from emerging research was compelling enough that clinics in some cities, such as San Francisco, have been offering doxy-PEP to those at high risk of infection for months. Generally, patients are given a supply of pills and told to take one within three days of an encounter during which they might have become infected.

But rates of S.T.I.s are highest among Black people and Native Americans, who are often those with the least access to health care. “No prevention tool — no matter how powerful — will change the S.T.I. epidemic if it doesn’t reach the people who need it most,” Dr. Mermin said.

Doxycycline has been in use for decades, and there are few indications that bacteria have become resistant to it. Syphilis and chlamydia do not often develop resistance, but gonorrhea is another question: Those bacteria have become resistant to multiple classes of antibiotics.

Still, the picture may change depending on how many people take doxy-PEP and how often, some experts cautioned.

“At the population level, that does worry me,” said Antón Castellanos Usigli, a sexual health expert who is an adjunct lecturer at the Columbia Mailman School of Health.

In places like his native Mexico, Dr. Castellanos Usigli said, indiscriminate use of antibiotics has fueled the rise of drug-resistant bacteria, which can alter a person’s gut microbiome.

What Happens Next: The C.D.C. will finalize new guidelines.

Evidence so far supports doxy-PEP’s use only in men who have sex with men and in transgender women. In those groups, the antibiotic cut rates of syphilis and chlamydia by about 90 percent and gonorrhea by about 55 percent.

Men who have sex with men account for nearly half of reported syphilis cases, according to the C.D.C. If studies show the approach to be effective in heterosexual cisgender men and cisgender women, the guidelines may be expanded.

The agency said doctors should prescribe doxy-PEP as part of a comprehensive sexual health program that includes counseling, screening and treatment for the infections and for H.I.V.

“Doxy-PEP will be a good option for some patients,” Dr. Castellanos Usigli said. “But we will have to do a lot of education with medical providers and patients so that we target the best candidates and prevent misuse and overuse.”

Complete Article HERE!

Sex after prostate cancer

— Prostate cancer treatments can have side effects that may result in changes that affect intimacy, desire and function. While these symptoms are often temporary, they can be distressing and it’s important to talk to your physician about what to expect and the steps you can take to improve them.

Why this happens

As men become sexually aroused, the brain sends messages through the nervous system to the muscular walls of the blood vessels in the penis. The vessels enlarge, allowing more blood to flow into the penis. The incoming blood makes the penis bigger and harder, causing an erection.

Even if your libido is normal, your hormones, nervous system, muscles and blood vessels need to work properly to get an erection. Cancer treatments may affect your hormones, which in turn can affect your libido as well as the nerves, muscles or blood vessels that play important roles in causing an erection.

Prostate cancer treatment and erectile dysfunction

Erectile dysfunction (ED) is one of the most common side effects of prostate cancer treatment. Nearly all men will have trouble getting an erection for a period of time after undergoing different types of treatment, such as:

  • Surgery. The nerves responsible for an erection (the cavernous nerves) travel very close to the prostate gland and may be injured during the removal of the prostate. Nearly all men who have their prostate removed will have trouble getting an erection for some time, even if they have a “nerve-sparing” operation. However, most men recover with time.
  • Radiation therapy. Damage to the delicate tissues involved in getting an erection, such as nerves, blood vessels or blood flow, can occur with radiation therapy. These side effects appear more slowly during the year after treatment. Men may have softer erections, lose their erection before climax (orgasm) or not be able to get an erection at all.
  • Chemotherapy. The drugs used in chemotherapy treatment of prostate cancer may affect your libido and erections if it affects testosterone production, but most men still have normal erections. Chemotherapy can also cause fatigue or distress, which can affect your sexual desire and ability to have an erection, but normal desire usually returns when treatment ends.
  • Hormone therapy. The prostate depends on androgens, such as testosterone, to do its work. Unfortunately, testosterone may help some prostate cancers to grow. The hormone treatment used in prostate cancer, called androgen deprivation therapy (ADT) blocks androgens to slow the growth of prostate cancer, but it can also decrease libido and sexual function. (ADT does not cure prostate cancer.)

Recovery after prostate cancer treatment

Time is the most important factor in recovery. The healing process for men who have had nerve-sparing radical prostatectomy (removal of the prostate) is often 18 to 24 months or more, because nerve tissue requires a longer time to heal. How much erectile function returns depends on several things:

  • The type of operation you had (one, both, or no nerves spared). Most men with intact nerves will see a substantial improvement within a year of treatment.
  • Your age: Men under 50 or 60 are more likely to recover their erections than older men.
  • Your erectile function before the operation. Men who had good erections before surgery are more likely to recover their ability to get an erection than those who had previous erection problems.

It is also common to need medications to assist with erectile function, even if you did not need them before your operation.

Rehabilitation and aids

Studies suggest that starting a program to promote erections about six weeks after surgery can help some men recover sexual function. Different methods are available, depending on your case, your level of motivation and the judgment of your surgeon. These penile rehabilitation programs focus on increasing blood flow to the area to encourage healing and help men have regular erections that are hard enough for penetration. Having two to three erections a week, even if there is no sexual activity, helps keep the tissues in the penis healthy.

Several options are available to treat ED, and they may or may not be part of a rehabilitation program:

  • Medication: sildenafil/Viagra®, tadalafil/Cialis® or vardenafil/Levitra MUSE™(a prostaglandin suppository that you insert into your urethra)
  • Vacuum erection devices
  • Penile implant
  • Penile self-injection with a prostaglandin: alprostadil/Caverjet™/Edex™

Complete Article HERE!

A new morning-after pill to stop STDs could also make the problem worse

The CDC is considering recommending the antibiotic doxycycline to be used after sex to prevent syphilis, gonorrhea and chlamydia.

By

Public health officials are deploying a powerful new weapon in the war against rising sexually transmitted infections: a common antibiotic that works as a morning-after pill.

It is the latest advancement as the sexual health field shifts to preventive medicine — not just condoms, abstinence and tests — as the best hope for quashing the pathogens that can spread during sex.

For the past decade, people have been able to have unprotected sex with a low risk of contracting HIV thanks to daily pills known as PrEP, or pre-exposure prophylaxis. But they were still susceptible to bacterial bugs, including the recent spike in syphilis, gonorrhea and chlamydia — until now.

Recent studies show the antibiotic doxycycline taken after sexual encounters works as a post-exposure prophylaxis to prevent those infections. But experts are also worried about unintended consequences. The Centers for Disease Control and Prevention plans to release guidelines later this summer for deploying the treatment, known as DoxyPEP, in hopes of addressing fears among medical professionals that preventive use would fuel antibiotic resistance — and the rise of drug-resistant superbugs.

“It’s the first major intervention we’ve had for STIs since the vaccine for human papillomavirus,” nearly two decades ago, said Jonathan Mermin, who leads STI prevention for the CDC. “But it is a new intervention, and because of that, there are potential benefits and potential risks.”

Doctors, public health officials and sexual health clinics have embraced preventive pills as a realistic way to curb STIs because they preserve pleasure while protecting partners. Some doctors have started prescribing it to a narrow segment of the gay community considered at elevated risk for STIs.

“Just like PrEP was a game changer, this empowers individuals to make choices about their sexual health,” said Jorge Roman, senior director of clinical services at the San Francisco AIDS Foundation, one of the first to widely distribute DoxyPEP. “It doesn’t always have to be about condoms.”

Doxycycline is already used as a front line antibiotic treatment for chlamydia and occasionally for syphilis and gonorrhea. But its use for prevention has drawn concerns that it would no longer be effective in patients who use it regularly and that it may facilitate the evolution of antibiotic resistant strains of the pathogens.

The drug’s proponents say these concerns are overblown because the criteria for eligibility are often narrow: Transgender women and men who have sex with men — and only if they have condomless sex and contracted an STI in the preceding year.

Those were the demographics recruited for a study of 500 patients in San Francisco and Seattle that found DoxyPEP effective. The study found a roughly 65 percent reduction in syphilis, gonorrhea and chlamydia cases in those who used the antibiotic between 2019 and 2022, mirroring similar results from European studies.

Another study of DoxyPEP use by cisgender women in Kenya between 2020 and 2022 did not find the treatment effective, a result that surprised and stumped researchers. Anatomical differences could play a role, but health officials say other studies suggest doxycycline becomes concentrated enough in vaginal fluid to confer protection against STIs.

Experts say it’s too early to conclude that DoxyPEP won’t work for women and more research is needed. Another possible explanation is women enrolled in the Kenyan study may not have consistently used doxycycline after sex. Researchers note early studies that found PrEP ineffective in protecting African women from HIV were eventually explained by poor adherence to the drug regimen rather than biological differences.

Researchers studying DoxyPEP are scrutinizing whether it could also render antibiotic treatments less effective. The U.S. study found a slight increase in antibacterial resistance, which the study’s authors said merits long-term attention. But they also said the finding should be tempered by the fact doctors would also be administering fewer antibiotics if people avoid catching and spreading STIs.

David Hyun, director of the Antibiotic Resistance Project at The Pew Charitable Trusts, said he was concerned by patients in the study using DoxyPEP as frequently as 20 times a month. More data is needed to understand the long-term effects — for individuals as well as broader communities, he said.

“If you keep exposing a patient to antibiotics like doxycycline, you are raising the risk of that patient being colonized or infected with a resistant strain sometime in the future,” Hyun said.

Some LGBTQ+ health providers suspect doctors may be using antibiotic resistance concerns to mask discomfort with condomless gay sex. They note that syphilis has yet to become resistant to penicillin since the antibiotic became the front-line treatment for the STI in the 1940s. And they point out doxycycline is widely used for other reasons, including long-term acne treatment and malaria prevention.

“We have used doxycycline for multiple other things,” Shira Heisler, medical director of the Detroit Public Health STD Clinic, said during a May conference of the National Coalition of STD Directors. “And I think specifically now being like, ‘We are not going to do it because of antimicrobial resistance’ when it’s specifically related to STIs is a good time to call out, ‘This is what stigma is. This is what bias is.’”

Proponents of DoxyPEP said it offers a long-needed solution to a spike in STIs. The CDC recorded more than 2.5 million cases of syphilis, gonorrhea and chlamydia in 2021, up from 1.8 million in 2011.

In 2021, 36 percent of syphilis and gonorrhea cases were in men who have sex with men, according to the CDC. The CDC says these disparities cannot be explained by differences in sexual behavior alone. When people have a smaller pool of potential sexual partners with higher rates of STIs, they are more likely to have sex with someone with an infection. Cases in cisgender women and heterosexual men have also been rising.

Experts say everyone would benefit from DoxyPEP being limited to those most at risk because that would break chains of transmission early and reduce the likelihood of infections spreading more broadly.

Some physicians say allowing people to have worry-free sex is a worthy goal on its own.

“My goal as a physician is to make sure my patients are able to have whatever type of sex they want and however much sex they want as safely as possible,” said Boghuma Kabisen Titanji, an infectious diseases specialist in Atlanta. “And if DoxyPEP would allow them to do it, then I have no problem offering it.”

Nick, a 35-year-old resident of Lafayette, Ind., said he recently started taking DoxyPEP for peace of mind, knowing he would be less likely to get an infection as he has frequent condomless sex.

HIV was no longer a concern because he has been taking PrEP for a decade, said Nick, who spoke on the condition that his last name not be used to candidly discuss his sex life. But he has endured uncomfortable bouts of syphilis and chlamydia.

“If you are taking HIV PrEP, why not take another extra kind of safeguard too?” he said. “It’s like a security blanket.”

As the country considers how widely to distribute DoxyPEP, public health officials and activists are worried it will be the latest medical advancement to roll out in an inequitable way, following similar racial gaps seen with PrEP and mpox vaccinations. Federal officials say PrEP users are disproportionately White even though most new HIV cases are in Black and Latino people. The CDC estimates that most mpox cases have been in Black and Latino men, but only a third of vaccine doses have gone to them.

LGBTQ+ health providers are already reporting disparities, with White patients more likely to ask about DoxyPEP and Black and Latino patients less likely to be familiar with it.

During a discussion about DoxyPEP at the STD conference, one state health official noted that those who can afford to travel to Puerto Vallarta, a popular vacation destination among some gay Americans, can buy doxycycline to stockpile for themselves and their friends because the antibiotic is available over the counter in Mexico. But experts say concerns about antibiotic resistance would make it difficult for over-the-counter sales to occur in the United States.

Mermin, the CDC official, said equity is a top concern as the agency crafts its guidance for the use of DoxyPEP. It would be essential to ensure the medication is available in clinics serving people at the highest risk for STIs, he said, and to raise awareness outside of medical settings, such as on dating apps.

In London, Joey Knock said he started buying DoxyPEP outside of official channels, a common practice among some gay Europeans, last winter after regular bouts of gonorrhea.

But he limits his use to higher-risk nights, such as when he has unprotected sex in dark rooms with strangers.

“I’m someone who was averaging an STI a month,” said Knock, 33. “I’ve done the risk analysis for me, but it also benefits other people if me taking DoxyPEP means I don’t get chlamydia, then I don’t pass chlamydia around.”

In San Francisco, the first major jurisdiction where public health officials recommended DoxyPEP, providers noticed patients taking a similar approach: Using it after higher-risk sexual encounters rather than every encounter.

“We need to do more analysis to see if that could be making DoxyPEP less effective or if perhaps people are making really good decisions about when to use it,” said Stephanie Cohen, who leads STI prevention for the San Francisco Department of Public Health.

The San Francisco AIDS Foundation, which says it has connected more than 1,800 people to DoxyPEP, does not limit the antibiotic to people who have recently contracted a sexually transmitted infection, but counsels patients on the unknown risks of antibiotic resistance.

Anu Hazra, co-medical director of the Howard Brown Health, an LGBTQ+ health provider in Chicago, said antimicrobial resistance is “probably the largest public health threat we have” but doxycycline for a small group of people pales in comparison to the rampant use of antibiotics in the meat industry and other sectors.

He and other experts say vaccines to prevent STIs could be another game changer that does not carry the same baggage as antibiotics. A recent study showing that a vaccine for meningitis can also reduce the likelihood of contracting gonorrhea offers promise on that front. But DoxyPEP offers an immediate solution to an ongoing problem and could be pared back if antibiotic resistance emerges, Hazra said.

“We are seeing rising rates of STIs across the board for nearly a decade now. What we are doing now is not working,” Hazra said. “We need to try something new.”

Complete Article HERE!

How First US Over-the-Counter Birth Control Pill Could Revolutionize Reproductive Health

— “After a year during which there has been very little good news about people’s reproductive health, this is the first solid win in a long time,” says BU gynecologist

The FDA’s approval of Opill for over-the-counter use makes it the first hormonal contraceptive available without a prescription in the United States.

By Molly Callahan

The FDA’s approval of the first over-the-counter birth control pill in the United States could be a revolutionary change in birth control and reproductive health, says Katharine O’Connell White, an associate professor of obstetrics and gynecology at the Boston University Chobanian & Avedisian School of Medicine.

White, who is also vice chair of academics and associate director of the complex family planning fellowship at Boston Medical Center, says she felt “jubilation and glee” at hearing news of the Food and Drug Administration’s approval of Opill, a hormonal birth control pill, on Thursday.

“After a year during which there has been very little good news about people’s reproductive health, this is the first solid win in a long time,” she says. “And it finally puts the United States on par with most other countries in the world, where people have always had access to pills without a prescription.”

The news was received with support from almost every major reproductive health organization in the country, including the American Medical Association, the American College of Obstetricians and Gynecologists, the North American Society of Pediatric and Adolescent Gynecology, and the American Academy of Family Physicians.

The FDA’s approval comes amid myriad legal battles over reproductive rights—and almost exactly a year after the Supreme Court overturned Roe v. Wade, rescinding the right to abortion nationally.

Perrigo Company, which manufactures the pill, says it will likely be available in stores and from online retailers in the United States in early 2024.

BU Today spoke with White about the safety and effectiveness of Opill, as well as questions that still remain about its rollout and accessibility.

Q&A

with Katharine O’Connell White

BU Today: Based on what you’ve seen or read about Opill, how effective is it compared to other, prescription or nonprescription, birth control options?

White: The pill that got approved for over-the-counter use is a progestin-only pill. There are two types of birth control pills: the vast majority of pills—the ones you think about when you hear “The pill”—have estrogen and progesterone in them. But a few varieties are progestin only, for people who can’t or don’t want to take estrogen. So, this pill looks to be like other progestin pills. And all pills have roughly the same effectiveness rate—that they’re about 97 percent effective when taken perfectly, and about 93 percent effective when taken like a typical human being.

So, it’s a very effective method of contraception. And it’s now the most effective birth control that you can buy at the drugstore without a prescription. When you compare it to condoms and spermicides, or Plan B and other emergency contraception, all of those are effective, but they’re not as effective as a daily birth control pill.

BU Today: It sounds like in terms of effectiveness, it’s not necessarily better to get a prescription birth control pill vs this over-the-counter version. Is that correct?

White: So much of it is about access, which sounds like an advocacy talking point. But access has a real impact on people’s lives.

From the medical perspective, there’s no difference between a pill you take by prescription or a pill that you would then get over the counter. But the best birth control method for any given person is the one they’re most likely to take. And to take consistently. And now, we have a method that is not behind the walls of a doctor’s office. You don’t have to go in for a visit or a pap smear or even just get through on a telephone line in order to access this birth control. You can just walk into a place and get it and take it. That, for a lot of people, is going to be the key to feeling in control of their birth control.

BU Today: Do you see this as a step toward equalizing access to birth control or reproductive healthcare?

White: Hopefully—although I’m hesitant.

What’s really great about this is that it’s finally a highly effective method—a hormonal method—of birth control for which you don’t need medical insurance and you don’t need access to a doctor. This is great news for people who work weekdays and can’t get to a doctor’s office because they can’t take the time off of work. It’s great news for people who don’t have health insurance, or who are underinsured, meaning their insurance doesn’t cover a lot, or any, contraceptive methods. If you are new to this country and don’t have health insurance or if you are in a new job and in a new state and don’t yet have access to your insurance, this is going to help.

I’ll also add that this is birth control that you do not need to persuade [a healthcare provider] that you should take or want to take. It is a completely independent decision that you get to make, and that’s important.

The reason I’m hopeful that this will equalize access, but not certain, is because we don’t know how much it’s going to cost. And so it’s only an equity issue if everyone can actually access it. The company says that it’s committed to widespread access for the pill and that it’s going to have some kind of voucher or savings program for people who don’t have insurance coverage. Along with advocacy groups, it is going to push for coverage by insurance companies so that even though it’s over-the-counter, you can still use your insurance card, like you can in many places for emergency contraception, or until recently, COVID tests. But we need to see what the sticker price is.

BU Today: Besides the price, are there other things that you, or your colleagues in the medical community, are waiting to learn?

White: The implementation of something is always important. For example, when emergency contraception first went over-the-counter, it was actually, in a lot of cases, behind-the-counter. You had to ask a pharmacist for it, which meant that not only did you have to have a conversation, and possibly justify why you wanted something, there was a chance they would say no.

I want to see this product on the shelf, next to Plan B, next to KY jelly. I want it to be as easy as just taking it off the shelf, putting it in your cart, and checking out.

I also wonder: is it going to be behind in a clamshell? Are you going to have to get an employee to unlock it for you? Are you still going to have to deal with people’s judgment? Will mom-and-pop pharmacies refuse to stock it? Will Amazon stock it? Will national pharmacy chains make it available online? Because in that case, I can get it with my ibuprofen when I do an Amazon run. All of this remains to be seen. But I’m hopeful.

BU Today: Are there certain populations who might find an over-the-counter hormonal birth control option especially helpful?

White: Adolescents—you might not want to ask your pediatrician, who’s been seeing you since you were a baby, about the fact that maybe you need birth control. Adolescents are also people who maybe haven’t yet figured out how to get to the doctor on their own. Maybe they don’t have a car or don’t have access or even know how to navigate the system to try to get their own gynecologist. Now, they can just take matters into their own hands and get it.

I also think anyone who is on someone else’s insurance, where an explanation of benefits goes home whenever you have a visit with a provider or get a prescription filled. An over-the-counter option leaves less of a record. So if you are in a situation where you are not wanting your parents to know or not wanting your partner to know, this provides another layer of protection.

For people who have medical problems, whose doctors just tell them not to have sex so you don’t get pregnant—which is actually a thing—and don’t know who to turn to for advice, they can now do their own reading, decide this might be right for them, and then access it on their own. People who just changed jobs and whose new insurance hasn’t kicked in, or who have not yet found a new doctor. People who’ve just moved to a new state.

There are also all these situations during which there can be gaps in birth-control use. Let’s say you are a prescription-pill user or a patch or a ring user, but you find yourself in this position where you’re between insurance providers, between doctors, between homes, you then can just go get a pack [of birth control pills] to bridge that gap.

Or people who travel and forget their pack. You’re crazily packing for the airport, and you realize you’ve forgotten your pills. No worries, you can just go get a pack and take those pills for a week and then resume your birth control back at home.

This means that birth control doesn’t have to be this precious, Hope Diamond–like resource. Now, your birth control pills can be available to you whenever you need them, wherever you are. That is revolutionary. No one should have to fight for birth control. And now you have an option where you can just go get it.

BU Today: What about from a safety viewpoint? Is it safe to take these over-the-counter pills?

White: I think there’s a natural hesitancy to embrace something as safe, especially when, for so long, people have been telling you that it’s not. There’s this idea that, ‘Well, we’ve had birth control pills for 50 years, why hasn’t it been available over the counter until now? Is it actually safe?’

It’s so important for people to know that we have reams of good evidence about how safe the pill is. There are very few people who cannot use this pill, and it is very well labeled for who shouldn’t use it.

There’s a very small group of people who can’t, and everybody else can use it safely. People who have breast cancer or certain kinds of liver disease or certain kinds of benign liver tumors, and some people with lupus, should not use this. But people who have the kinds of conditions on this list are people who are already plugged into a healthcare system where they can get access. The vast majority of healthy people who don’t need to see doctors can all take this.

BU Today: What should people who might use this as their first hormonal birth control know?

White: One of the common side effects of a progesterone-only pill is irregular bleeding. This might be occasional spotting, it might be bleeding more days than not, though not usually as heavy as a period. If people are not prepared for that, it can be very surprising. I’ve had more than one patient who stopped their birth control pills when they were spotting, because they thought that meant either it was making their body sick or that it wasn’t working. My message is that you may have weird bleeding for three months, possibly even a little longer. And that is normal. Weird is normal when it comes to bleeding on this pill. So don’t be alarmed.

Complete Article HERE!

Sex After 60?

— You Need to Know About STD Prevention

By

Coming this fall to your TV screen: “The Golden Bachelor.” That’s right, reality television fans, seniors are finally getting their shot at this (somewhat unscripted) love connection. The suspenseful rose ceremonies and extravagant date nights are likely. But will there be an overnight in the fantasy suite?

If this is, in fact, reality, then there should be. Physical intimacy important — sex even has health benefits. Yes, even for those in their twilight years. Shining a light on sex after 60 may be just what the doctor ordered. But seniors also need to know how to protect themselves from sexually transmitted diseases (STDs).

STD Rates Rise Along with Sex After 60

Sexual health may not be a topic older adults are keen on discussing — even with their care providers. “Unfortunately, this reluctance to talk about sex is putting newly single seniors at risk for sexually transmitted infections,” says Laurie Archbald-Pannone, MD, a geriatrician with UVA Health. As a geriatrician, she specializes in primary care for older adults.

One analysis showed that in adults over age 60, diagnosis rates for STDs (also known as sexually transmitted infections or STIs) increased 23% in 3 years.

That’s more than double the increase seen in the rest of the population, which saw a rise of just 11% in diagnoses of STDs. The main STDS are gonorrhea, chlamydia, and herpes simplex.

Why the STD Boom Among Boomers?

The rise is likely due to “a lack of awareness among this age group about STI prevalence and prevention,” says Archbald-Pannone.

“A common scenario is when someone older in life suddenly rejoins the dating scene after a decades-long monogamous relationship. This person may not have a history of STI education, so may not be aware of appropriate prevention or STI signs and symptoms,” she says.

With increased availability of medications for menopausal symptoms and erectile dysfunction, sex after 60 is more common. But older adults are also more susceptible to infections due to age-related changes in immune function. For women, postmenopausal vaginal dryness can increase the risk for tears in the vaginal wall, which can accelerate the spread of infection.

Let’s Talk About Sex After 60

Unfortunately, says Archbald-Pannone, many clinicians are missing an opportunity to educate this population about STD prevention, including the use of condoms and the importance of screening.

“In terms of sexual health, we as providers readily talk about STI prevention with younger patients,” she says. “Among older adults, however, studies show clinicians are not having the same conversations. Often it’s because the provider is uncomfortable bringing up the topic. At any age, it’s difficult to discuss sensitive topics. But, as providers, we can have a big impact by talking to our patients about sexual practices, sexual health and STI prevention.

“We have to make sure that, as clinicians, we’re well educated on these topics so we can be a resource for our patients,” adds Archbald-Pannone. “We also have to create a judgment-free, open environment so patients feel comfortable having those conversations.”

4 Tips for STD Prevention

For anyone entering a sexual relationship, Archbald-Pannone has the following advice:

Talk to Your Partner

Be aware of your partner’s sexual history and STD risk factors before being intimate.

Use Protection

Condoms or other barrier methods used during intercourse prevent infections.

Looking for Senior Healthcare?

UVA Health geriatricians are experts in senior care.

Get Screened & Encourage Partners to Do the Same

If you are sexually active — either with a new partner, with several partners, or if your partner has recently had sex with others — you should have an annual STD screening. There is no age cutoff for screening.

Know STD Symptoms

If you’re having sex after 60 or any age, educate yourself on the signs and symptoms of gonorrhea, chlamydia, and herpes simplex. Some of the most common include:

  • Bumps, sores, or lesions around the genitals
  • Discharge from the penis or vagina
  • Painful urination

Get Treated

If you experience any unusual symptoms after engaging in sexual intercourse, don’t delay treatment. The condition can get worse.

Be sure to discuss your diagnosis with your partner so that they can get treatment as well.

Talk to Your Doctor

Your sexual health is an important part of your overall well-being. So don’t hesitate to discuss your questions and concerns with a clinician. Make your doctor aware of changes in your sexual practices to ensure you’re making safe choices when having sex after 60 or any age.

Complete Article HERE!

How a bad night’s sleep affects your sex life

— Another reason to go to bed

By Penelope Clifton

Turns out a poor night’s sleep can not only be detrimental to your mood and energy levels but also to your libido.

We might need to rethink the term ‘beauty sleep’ because missing out on the recommended eight hours is hard on more than just your looks.

According to the 2023 ResMed Global Sleep Survey, one in five Australians says their sex life is lacking, the highest of any participating country.

Sex has so many benefits; it can lower your blood pressure, boost your immune system, and even act as pain relief. It’s also great for self-esteem and can help promote a better night’s sleep. The problem is, not many of us are that keen when we’re sleep deprived.

The survey found millennials are most affected, with one in four from that age bracket vocalising a link between their sleep quality and decreased sex drive.

Just 8.7 per cent of Australians said they woke up feeling happy or energetic in the AM, so that’s not many of us adults getting hot and heavy under the covers.

“Embracing our sexuality and focusing on intimacy, especially in these cold months, is a beacon of warmth and connection,” sexologist Chantelle Otten says.

“It’s an overlooked fact that our sleep quality and libido are intricately linked. A poor night’s sleep doesn’t just leave you feeling drained and foggy; it can also dampen your desire.”

Embracing our sexuality and intimacy can lead to sex, which in turn can result in a good night’s sleep. The following day you’re more likely to be well-rested, leading to an increase in libido – and the cycle can continue.

This is undoubtedly a tough ask for new parents, those dealing with mental health issues or those of us who are simply overworked, however, it doesn’t have to involve the full month. A cuddle can also do the trick.

According to Christine Rafe, a sex and relationship therapist and director at the Good Vibes Clinic, it’s important for people to be aware of the correlation between sex and sleep.

“Partner intimacy whether sexual or non-sexual is a form of co-regulation, and even hugging and soft slow touch with a partner can activate a relaxed or regulated state which is essential for falling and staying asleep.”

She suggests creating space for physical connection with your partner in the lead-up to bedtime and then trying to carry it through to the bedroom to really reap the benefits of co-regulation.

“The hormones released during sexual pleasure and orgasm combat stress and help to regulate our nervous system, meaning orgasms can support falling asleep as well as the quality of our sleep,” she says, supporting Otten’s advice.

An added bonus is it will bring you and your partner closer as a couple.

“Decreased libido or discrepancies in libido can be distressing for both people within the partnership and can have relational, emotional and psychological impacts,” Rafe says.

One thing Australians do well is supporting their partner, says ResMed sleep physiologist Tim Stephensen. He claims we’re pretty encouraging of our partners to seek help regarding poor sleep and vice versa.

“One of the primary reasons Australians seek support for their sleep is due to their partner’s encouragement once their sleep becomes impacted, such as through loud snoring,” he explains.

“The relationships people take into the bedroom are highly influential on sleep health. A good night’s sleep is vital for a person’s sexual, physical and mental health.”

Complete Article HERE!

5 Ways You Can Vet Advice About Sexual Health Online

— Misinformation can be dangerous wherever you find it. Here’s how to stay safe.

By Kate Daniel

“Is this syphilis? PLEASE HELP,” user Difficult-Parsnip508 posted to r/STD, a page on Reddit that’s devoted to everything and anything related to sexually transmitted diseases (STDs).

“I’m female; my last exposure was approximately three weeks ago. I don’t have any rashes on my hands/palms or my foot/soles. It’s this rash on the top of my right shoulder. It’s been here for the past 3 days and hasn’t gotten better or worse. For complicated reasons, I can’t go to the doctor. I’m freaking out and I will be grateful for any help.”

A photo depicting her back and the small, brownish-red bumps accompanied the text.

Within hours, the root vegetable-loving (or hating?) original poster had received several replies. Most suggested it looked like acne or maybe an insect bite. Several encouraged her to see a doctor or get an at-home test.

One, luckychatms130, railed against the dangers of sex outside of marriage, advising never to trust a partner who is “already fornicating.” They also suggested getting tested.

Difficult-Parsnip508’s is one of the countless similar posts to the r/STD forum that seek advice on everything from suspicious bumps to confusing test results and anxiety-inducing one-night-stands.

Research into online health advice

A 2019 study published in the Journal of American Medicine (JAMA) collated data from thousands of these posts published between 2010—the year r/STD was created—and 2018. Of those, about 58 percent of all posts on the page explicitly sought crowd diagnoses, the study authors reported, with about 38 percent sharing (often graphic) photos of their symptoms. Like Difficult-Parsnip508, nearly 90 percent received replies and advice, usually within hours.

Some of those responses were medically sound. Most, however, were “wildly inaccurate,” the study authors explained in a press release. They specifically cited the “crowd’s” astonishing degree of faith in apple cider vinegar, which is not, for the record, a cure-all.

Perhaps more concerning, many respondents gave advice that directly contradicted doctors’ recommendations, sometimes with potentially dangerous implications and outcomes.

The World Wide Web is a powerful tool for education and empowerment—but it’s also home to content such as ‘how to make a DIY condom’

Of course, it’s not just Reddit users doling out dubious advice. A 2021 systematic review published in the Journal of Medical Internet Research examined 69 studies on a variety of health topics, from smoking to the HPV vaccine. Researchers found the prevalence of health misinformation was high across multiple platforms and subject areas.

A 2022 systematic review of 31 previous studies published by the World Health Organization (WHO) yielded similar results. The WHO report indicated such false information negatively affected people’s health behaviors.

Amid a nationwide epidemic of sexually transmitted infections (STIs) and ever-changing reproductive healthcare laws, medically accurate information and competent services may be more important than ever. Yet, due to various barriers, from shame and stigma to a lack of transportation, tens of thousands of people are turning to their fellow internet users instead of licensed primary care doctors or health services.

If you’ve ever been online, you know why that might be a problem. The World Wide Web is a powerful tool for education and empowerment. But it’s also home to content such as “how to make a DIY condom” or “tighten your vagina with ice.” Neither of those things works, in case you were curious.

It’s not always easy to determine what’s legit.

We spoke with experts to get their take on what’s behind the crowd-diagnosis phenomenon and how to sort fact from fiction when researching health topics online.

Why are people seeking crowd diagnoses?

It’s understandable why people might be motivated to look online for sexual health answers and diagnoses from strangers, said Ceara Corry, M.S.W., L.C.S.W., a sex educator, sex and relationship therapist, and owner of The Naked Truth in Raleigh, North Carolina.

“Adequate and supportive healthcare is not always accessible, especially for marginalized groups like people of color, queer and trans folks, or people with disabilities,” she said. “I’ve even experienced this personally.”

In 2016, Corry told her gynecologist she suspected she had polycystic ovary syndrome (PCOS). She had researched the condition online and had characteristic symptoms and a personal and family medical history that made her more susceptible.

Instead of taking her concerns seriously, the doctor minimized her symptoms and blamed them on her weight, Corry said. It took her nearly two years to receive a diagnosis. Research, including a 2019 review, indicates Corry’s experience is not an uncommon one.

The stigma around topics such as sexual health can make people feel embarrassed or ashamed to talk face-to-face with a professional, Corry noted, whereas online forums provide a shield of distance and anonymity.

Logistical hurdles such as cost and lack of transportation may also prevent some people from seeking in-person care, said Rosalyn Plotzker, M.D., M.P.H., an assistant professor in the University of California, San Francisco department of epidemiology and biostatistics.

“From the perspective of someone who is worried about an STI, asking something online can be easy, free and anonymous, and multiple replies could be used to get a ‘consensus.’ I can see the appeal,” Plotzker said. “The only problem is that the information isn’t necessarily reliable. There’s no opportunity for a physical exam or lab tests, and the responders are not accountable since there isn’t a provider-patient relationship. So there is a major risk for misinformation.”

That misinformation can lead to various harms, from ineffective treatments to unintended pregnancy and STI transmission, noted Sarah Melancon, Ph.D., a Fullerton, California-based sociologist and clinical psychologist at Sex Toy Collective. Study authors agreed, noting that misdiagnosis can have a ripple effect, impacting not just the poster, but millions of viewers who believe they may have a similar condition.

The ramifications can be substantial and potentially life-threatening.

“STI infections may worsen with the wrong treatment. For instance, untreated chlamydia can cause pelvic inflammatory disease,” she said. “Syphilis or HIV may progress to an advanced stage, which has greater negative effects and is harder to treat and in the long term can lead to death.”

As for why approximately 20 percent of the posts included in the study were seeking a second opinion, people might doubt a clinician’s capability or feel their provider didn’t listen or take them seriously. That’s according to experts such as Danae Maragouthakis, M.B.B.S., M.P.H., an emergency medical doctor in Oxford, England, and a co-founder and CEO of Yoxly, a provider of at-home STI and sperm testing kits.

They may also have felt embarrassed or anxious about revealing certain pertinent details and worried about the significance of omitting them. Receiving a diagnosis, particularly a serious one, can be devastating and some folks might seek solace in alternative answers, even those that are inaccurate.

“On one occasion, a patient had received an HIV diagnosis but turned to a crowd diagnosis to be convinced the doctor was wrong,” said John Ayers, Ph.D., one of the study’s co-authors and an epidemiologist and adjunct professor at the University of California, San Diego, in a statement. “People, when faced with life-altering information, often want to delude themselves and, in some cases, they are finding it on social media.”

5 tips for vetting advice about sexual health online

Experts stressed that while seeking health information online can be a gamble, it isn’t inherently a bad idea, especially because education and even self-diagnosis can be empowering.

Here are five strategies you can use to get the most out of the advice you find online.

1. Define your goals

First, determine what you’re hoping to gain from your search, Corry suggested.

Are you investigating whether a diagnosis matches your symptoms, or do you want to know how others with similar experiences have handled their situation? Both are valid but have different search criteria.

Being clear about what you’re seeking can help rule out unhelpful sources, she explained.

2. Check credentials

There are many ‘influencers’ who simply hold a certificate or bachelor’s degree in their area of focus, while others are just self-deemed ‘sexperts.’

“There’s nothing wrong with individuals who want to speak about sex on the web, but take their information with a big grain of salt,” Melancon said. “Certainly, not all M.D.s or Ph.D.s are going to agree on every topic—that is laughable, actually—but typically, their perspective will be supported by theory and data.”

If you’re not in the habit of reading the About Us sections on websites you visit, it’s time to start. These pages can provide valuable information such as who funds the site, where they’re getting their information and who’s fact-checking it (if anyone), Corry said.

If well-known, reputable organizations and people with nursing and medical degrees are involved, that’s a positive.

3. Take extra precautions with controversy

If a topic is controversial, don’t accept one perspective as truth, even from credentialed sources, Melancon said.

“Compare and contrast. Look at the content you think you won’t agree with to get a broader picture,” she added.

For example, if you’re uncomfortable with your pornography use, coming across the NoFap movement might seem like the answer, as it treats porn use and masturbation as addictions and leans heavily on self-control as treatment. However, research suggests it is ineffective.

“Participants experience strong negative emotions including shame, worthlessness and even suicidal ideation after ‘relapses,'” she added. “Is that the outcome you’re really wanting?”

Some principles and information are subject to debate within the medical community, Melancon pointed out. In that case, it isn’t a flaw but part of the scientific process. Examples include the potential safety risks of hormonal contraceptives or the effects of pornography on mental health.

4. Go directly to the source

When websites and content creators use terms like “research indicates” without citing their source, it’s a red flag. That said, experts pointed out that it’s important to note that not all research is equal.

“If you want to really geek out, dig deep,” Plotzker said. “If an article mentions a study, you can look up that study on Google Scholar and read the abstract. Some articles are also fully available online.”

When reading the abstract, experts recommend checking how many people were involved in the study and whether they represent your demographic. For example, information gleaned from a study conducted on 30 male-identifying people in their 20s may not directly translate to you if you are a postmenopausal woman.

5. Corroborate with expert sources

When in doubt, experts suggest corroborating information you find through influencers or other uncertain sources with more surefire resources, like the Centers for Disease Control and Prevention (CDC) or Mayo Clinic. You can also message, email or call your local health clinic to ask if a specific piece of information is correct or whether a certain treatment is one they’re familiar with and condone.

Many of those clinics have nurse helplines and telehealth options that enable you to speak with a licensed provider without an in-person appointment.

“If you find something online that impacts your health directly, ask your healthcare provider about it if you can. There are ways to communicate with your provider through online patient platforms,” Plotzker said. “Or go in and have an old-fashioned, in-person discussion with someone who is a healthcare provider. You can show them the webpage on your phone—it’s a great way to confirm what you have read.”

The bottom line

The internet and social media are both a blessing and a curse, experts agreed. On one hand, the ability to connect, organize, disseminate information and promote causes, such as HIV prevention and family planning, is incredibly valuable.

“But it’s a double-sided coin. With all of the benefits, there is the equal and opposite aspect of misinformation, the perpetuation of fear and stigma, and resources available online that have not been vetted,” Plotzker said. “That can be very difficult to navigate.”

Ultimately, Plotzker recommended viewing the internet as a complement—don’t consider it a substitute—to traditional medical care as the best strategy.

“I do think patients understand their own bodies better than anyone else. If someone has had a condition in the past and then they have very similar symptoms again, it’s reasonable for them to think that history could be repeating itself,” Plotzker said.

All assumptions, though, have limitations.

“A physical exam and medical tests that can confirm a self-diagnosis are important as an objective way to know for sure what is happening, especially since it might be something else,” she noted. “And only then determine the best treatment course.”

Complete Article HERE!