Gay, Straight, Or Bisexual – Which Group Of Men Are More At Risk Of Heart Failure?

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Can your sexuality increase or decrease your risk of heart failure?  A new study released by the NYU Rory Meyers College of Nursing states that Bisexual men have a higher risk for heart disease compared with heterosexual men.

Now, of course it is not because you’re sleeping with men, but it’s because of everything else that may come with it.

In a new study published online in the journal LGBT Health, Billy Caceres, the study’s lead author, states:

Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men.

More than 30 percent of men in the US have some form of heart disease making it a leading cause of death for American men. Not many studies have been done to understand the impact of sexual orientation on heart disease risk for men.

In this study, NYU researchers examined differences in modifiable risk factors for heart disease and heart disease diagnoses in men of different sexual orientations. Risk factors measured included:

mental distress
health behaviors such as

  •       tobacco use
  •       binge drinking
  •       diet
  •       exercise

biological risk factors such as

  •       obesity
  •       hypertension
  •       diabetes
  •       cholesterol.

Responses from 7,731 men ages 20 to 59 were part of the National Health and Nutrition Examination Survey (2001-2012). Differences were analyzed across four groups based on their sexual identities: gay men, bisexual men, heterosexual men who have sex with men, and heterosexual men.

The researchers found no differences in heart disease diagnoses based on sexual orientation, but risk for heart disease was more complicated.

  • Gay men, heterosexual men, and heterosexual men who have sex with men had similar heart disease risk.
  • Gay men reported lower binge drinking compared with heterosexual men, but otherwise few differences in health behaviors were noted.
  • Bisexual men, however, had higher rates of several risk factors for heart disease relative to heterosexual men: mental distress, obesity, elevated blood pressure, and three different measures of diabetes (medication use, medical history, and average glycosylated hemoglobin level).

“Poor mental health is a recognized risk factor for the development of heart disease,” said Caceres. “Clinicians should be educated about sexual minority health and should routinely screen bisexual men for mental distress as a risk factor for heart disease. This is particularly important as healthcare organizations increasingly include sexual orientation as part of demographic questionnaires in electronic health records.”

Complete Article HERE!

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Do You Have Sexual Side Effects From Antidepressants You Stopped Taking?

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From low libido to erectile dysfunction, some people report suffering from enduring sexual problems.

From low libido to erectile dysfunction, some people report suffering from enduring sexual problems.

By Michael O. Schroeder

Antidepressants are widely prescribed, commonly used for depression and recommended to treat a range of other issues, from anxiety disorders to pain. But the medications aren’t without risk – and some potentially serious side effects start, or continue, after a person has stopped taking them.

These effects vary by the individual and the drug, but for the most commonly prescribed antidepressants – selective serotonin reuptake inhibitors, or SSRIs, and serotonin-norepinephrine reuptake inhibitors, or SSNIs – side effects, or adverse events reported by patients, range from headache, nausea and fatigue to paresthesia, or an abnormal sensation that can feel, to some, like electrical shocks, to insomnia to seizures. And though less widely recognized, some patients also report another enduring effect of SSRIs and SSNIs: sexual dysfunction.

To be sure, sexual side effects ranging from lower libido to erectile dysfunction are known and detailed in drug labeling information. But though online support groups have cropped up for people who experience persistent sexual dysfunction after going off antidepressants – post-SSRI sexual dysfunction, or PSSD – it’s not clear how common the concern is.

However, one recent paper co-authored by researchers linked with an independent drug safety website RxISK.org that collects reports of side effects – including after people stop medications – recently reported on 300 cases of enduring sexual dysfunction. These were reported by people from around the world who were taking SSRIs, SSNIs and tricyclic antidepressants, as well as drugs called 5α-reductase inhibitors and isotretinoin. which are used to treat male hair loss (baldness) and benign (non-cancerous) prostate enlargement, and acne respectively. Reports by patients who’d taken 5α-reductase inhibitors and isotretinoin to RxISK of enduring problems with sexual function after stopping these medications appeared to have similar characteristics to those related to antidepressants, notes co-author Dr. Dee Mangin, the David Braley and Nancy Gordon Chair in Family Medicine at McMaster University in Hamilton, Ontario, and chief medical officer for RxISK.org.

“We were really looking at sexual dysfunction both on and after taking medication, because some of the reports we were getting were suggesting that sexual dysfunction, which is a known side effect of a number of drugs, seemed to be persisting once the drugs were stopped,” Mangin says.

As noted in the paper published in the International Journal of Risk & Safety in Medicine, there have been limited references to the potential for such issues to occur after patients stopped antidepressants. In the U.S., the product information for Prozac (fluoxetine) – the oldest of the SSRIs – was updated in 2011 to warn, “Symptoms of sexual dysfunction occasionally persist after discontinuation of fluoxetine treatment.” What’s more, the authors noted, “The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published in 2013, states that ‘In some cases, serotonin reuptake inhibitor-induced sexual dysfunction may persist after the agent is discontinued.'”

But the authors go further in detailing reports of enduring sexual dysfunction such as the onset of premature ejaculation and persistent genital arousal disorder (whereby a person becomes aroused without any stimulation) as well as losing genital sensation, or genital anaesthesia, pleasureless or weak orgasm, loss of libido and impotence. “Secondary consequences included relationship breakdown and impaired quality of life,” the authors note.

The individuals weren’t independently evaluated before, during or after taking the medication, and more study is needed. Still, Mangin asserts, “The study provides the strong signal that there is a group of people who seem to experience enduring side effects that affect their sexual function after they’ve stopped taking the drug.”

Experts say just as patients should never stop antidepressants abruptly, or without consulting with their provider – since doing so is known to increase side effect risk and worsen those effects – patient and provider should discuss any adverse effects that start or continue after stopping a medication.

Dr. Eliza Menninger, who directs a behavioral health program at McLean Hospital in Boston, says she hasn’t heard from patients voicing serious concerns about sexual side effects after stopping their medication. For the most part, sexual side effects seem to go away after patients stop taking the medication, Menninger says. “Some will indicate it’s still an issue, but they don’t seem as bothered by it – and I don’t know if it’s as bad an issue as when they were on the SSRI,” she says.

However, clinicians say, it would be helpful to have more clarity on the issue – including how likely it may be that patients could experience enduring sexual side effects. In part due to the sensitive nature of sexual complaints, experts point out, these effects often go unacknowledged in patient-provider conversations.

One problem is that sexual side effects aren’t tracked in a systematic way like other drug side effects – even though they can be severely damaging to intimate relationships and undermine a person’s overall quality of life and well-being. “There’s no requirement, for example, for drug companies to track sexual side effects. They’re not considered serious adverse events, although the potential for them to continue post-medication I would consider extremely serious – even a disability,” says Audrey Bahrick, staff psychologist at the University of Iowa’s counseling service.

Bahrick recently signed onto a petition, along with Mangin and others who’ve researched enduring sexual side effects, asking the U.S. Food and Drug Administration and other regulatory bodies to require makers of SSRIs and SSNIs to update drug labeling to warn that such legacy effects can occur and continue for years or even indefinitely.

Sandy Walsh, a spokesperson for the FDA, said it would review the petition and respond to the petitioner, but declined to comment further regarding the petition. Drugmakers who responded to a request for comment say they work closely with regulatory agencies to keep information updated.

Mads Kronborg, a spokesman for pharmaceutical firm Lundbeck, notes that summary production information for its SSRIs, citalopram (Celexa) and escitalopram (Lexapro), “already states that side effects can occur upon discontinuation, and that such side effects may be severe and prolonged.” Specifically, it’s stated that “generally these events are mild to moderate and are self-limiting, however, in some patients they may be severe and/or prolonged.” The side effects listed for citalopram and escitalopram “include sexual side effects,” he says, though he adds that sexual side effects are not among the most commonly reported reactions to discontinuation. “So information about potential enduring side effects is actually already included.”

But the petition asserts drug companies aren’t going far enough to acknowledge these concerns.

Bahrick says though the prevalence of enduring sexual side effects remains unknown, “My own impression clinically is that it’s not at all uncommon, and that it can range from subtle – not returning to sexual baseline – to really a complete sexual anesthesia, where a person who has been without any significant sexual problems prior to taking the medication might be rendered unable to experience sexual pleasure, unable to have sensation in the genitals, having orgasms that are not associated with pleasure,” she says. “These are clearly, I think, drug effects. [Issues] like genital anaesthesia and pleasureless orgasm – these are not symptoms that are associated with any sexual problems, say, that are commonly associated with depression. We can see these as legacy effects of the SSRIs.”

In the absence of prevalence data, clinicians continue to debate the potential extent of enduring sexual side effects for those who have stopped antidepressants. Some worry about unnecessarily scaring patients away from antidepressants who may benefit from taking the drugs.

“These medications are used to treat symptoms of illnesses that are potentially quite debilitating and can be lethal, so while I want to encourage a discussion of side effects, the intent is to use medications to help improve significant symptoms,” Menninger says. She points out, as the petition notes, that to date no prospective studies have been done assessing sexual dysfunction prior to SSRI and then during and after SSRI use. Though certainly side effects are real and concerning, she says, “there is clinical evidence the medications make a significant difference in helping [and/or] saving a life.” That’s something some clinicians emphasize shouldn’t get lost in the discussion.

But Bahrick says for patients, not having information that these effects may occur undermines their ability to make a fully informed decision when deciding to go on antidepressants, and deciding whether to try alternative treatment options first. “It’s so important to get this information out there on the front end. Because these injuries are very real and can be lifelong and seriously limit intimacy and create a lot of shame and isolation and despair,” she says. While for some the side effects go away on their own, for others they persist – and Bahrick says there’s no known cure for PSSD. “So this is in service of informed consent that is quite lacking at this time.”

Complete Article HERE!

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The End of Safe Gay Sex?

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By Patrick William Kelly

June is Pride Month, a ripe time to reflect on one of the most startling facts about our sexual culture today: Condom use is all but disappearing among large numbers of gay men.

Many rightly attribute the condom’s decline to the rise of PrEP — an acronym for pre-exposure prophylaxis, a two-drug cocktail that inoculates a person from contracting H.I.V. But another crucial component is the fading memory of the AIDS crisis that once defined what it meant to be gay.

After tracking the sexual practices of 17,000 gay and bisexual Australian men from 2014 to 2017, a team of researchers this month unveiled the most convincing evidence to date. While the number of H.I.V.-negative men who are on PrEP increased to 24 percent from 2 percent, the rate of condom use decreased to 31 percent from 46 percent. More troubling, condom use among non-gay men is also down significantly</a

Although public health advocates have been sounding the alarm on condom use for the last decade, their calls have gone largely unheeded. Part of that is because of a shift in how we talk about risky sex: The Centers for Disease Control and Prevention has replaced “unprotected” with “condomless” sex.

The dangerous implication is that PrEP alone may ward off all sexually transmitted infections. Indeed, studies have shown a strong correlation between PrEP use and the contraction of S.T.I.s. PrEP enthusiasts counter that PrEP mandates testing for S.T.I.s every three months, a practice that promotes rather than discourages a culture of sexual health.

But a 2016 study by the University of California, Los Angeles illustrated that PrEP users were 25.3 times more likely to acquire gonorrhea and a shocking 44.6 times more likely to develop a syphilis infection (other studies have found no significant uptick in S.T.I. rates, however).

More than the specific public-health risks of declining condom use among gay men is the shocking speed with which a sort of historical amnesia has set in.

The very idea of “safe sex” emerged from the gay community in the early 1980s, in response to the AIDS crisis. Drag queens once ended performances with catchy one-liners like, “If you’re going to tap it, wrap it.”

AIDS indelibly shaped what it meant to be gay in the 1980s and 1990s. When I came out at the tender age of 14 in 1998, I recall my mother’s reaction. As tears welled up in her eyes, she buried her face in her hands and said, “I just don’t want you to get H.I.V.” No stranger to controversial allusions, the AIDS activist and author Larry Kramer famously called it a homosexual “holocaust.” Condom use, therefore, was never a negotiating chip.

Until it was. PrEP, which the Food and Drug Administration approved in 2012, replaces the condom’s comforting shield. Liberated from the stigma of AIDS, gay men, many people think, are now free to revert to their carnivorous sexual selves. In this rendering, the condom is kryptonite, a relic that saps the virile homosexual of his primordial sexual power.

AIDS is no longer a crisis, at least in the United States, and that is a phenomenal public-health success story. But it also means that an entire generation of gay men has no memory or interest in the devastation it wrought. AIDS catalyzed a culture of sexual health that has begun to disintegrate before our eyes. What is there to be done to bring it back?

One answer is to recall the gay culture of the 1970s that gave rise to the AIDS crisis in the first place. The myth of a world of sex without harm is not new. The 1970s were a time of unprecedented sexual freedom for gay men, during which diseases were traded rampantly, fueled by a libertine culture that saw penicillin as the panacea for all ills.

The nonchalant dismissal of the condom today flies in the face of the very culture of sexual health that gay men and lesbians constructed in the 1980s. If a hyper-resistant strand of another life-threatening S.T.I. develops, we will rue the day that we forgot the searing legacies of our past. We might also recognize that PrEP has not proved nearly as effective a prevention strategy for women as it has for men, and that some strains of H.I.V. have developed resistance to the drug.

While we debate the utility of latex, what are we to think about the millions of sex workers, injecting-drug users and marginalized populations (in particular, black men who have sex with men) without adequate access to costly and coveted drugs like PrEP? If they develop AIDS, they also struggle to acquire the triple drug therapies that have since 1996 turned AIDS into a manageable if chronic condition. Millions have died from lack of access while pharmaceutical companies rake in billions every year.

We might also pivot away from the individualistic and privileged approach of our dominant L.G.B.T. organizations — what one scholar called the “price of gay marriage.” We might, then, regain a radical sense of queer community that we lost in the wake of AIDS.

Complete Article HERE!

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Sex and gender both shape your health, in different ways

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When you think about gender, what comes to mind? Is it anatomy or the way someone dresses or acts? Do you think of gender as binary — male or female? Do you think it predicts sexual orientation?

Gender is often equated with sex — by researchers as well as those they research, especially in the health arena. Recently I searched a database for health-related research articles with “gender” in the title. Of the 10 articles that came up first in the list, every single one used “gender” as a synonym for sex.

Although gender can be related to sex, it is a very different concept. Gender is generally understood to be socially constructed, and can differ depending on society and culture. Sex, on the other hand, is defined by chromosomes and anatomy — labelled male or female. It also includes intersex people whose bodies are not typically male or female, often with characteristics of both sexes.

Researchers often assume that all biologically female people will be more similar to each other than to those who are biologically male, and group them together in their studies. They do not consider the various sex- and gender-linked social roles and constraints that can also affect their health. This results in policies and treatment plans that are homogenous.

‘Masculine?’ ‘Cisgender?’ ‘Gender fluid?’

The term “gender” was originally developed to describe people who did not identify with their biological sex. John Money, a pioneering gender researcher, explained: “Gender identity is your own sense or conviction of maleness or femaleness; and gender role is the cultural stereotype of what is masculine and feminine.”

There are now many terms used to describe gender — some of the earliest ones in use are “feminine,” “masculine” and “androgynous” (a combination of masculine and feminine characteristics).

Research shows that gender, as well as sex, can influence vulnerability to disease.

More recent gender definitions include: “Bigender” (expressing two distinct gender identities), “gender fluid” (moving between gendered behaviour that is feminine and masculine depending on the situation) and “agender” or “undifferentiated” (someone who does not identify with a particular gender or is genderless).

If a person’s gender is consistent with their sex (e.g. a biologically female person is feminine) they are referred to as “cisgender.”

Gender does not tell us about sexual orientation. For example, a feminine (her gender) woman (her sex) may define herself as straight or anywhere in the LGBTQIA (lesbian, gay, bisexual, transgender, queer or questioning, intersex and asexual or allied) spectrum. The same goes for a feminine man.

Femininity can affect your heart

When gender has actually been measured in health-related research, the labels “masculine,” “feminine” and “androgynous” have traditionally been used.

Research shows that health outcomes are not homogeneous for the sexes, meaning all biological females do not have the same vulnerabilities to illnesses and diseases and nor do all biological males.

Gender is one of the things that can influence these differences. For example, when the gender of participants is considered, “higher femininity scores among men, for example, are associated with lower incidence of coronary artery disease…(and) female well-being may suffer when women adopt workplace behaviours traditionally seen as masculine.”

In another study, quality of life was better for androgynous men and women with Parkinson’s disease. In cardiovascular research, more masculine people have a greater risk of cardiovascular disease than those who are more feminine. And research with cancer patients found that both patients and their caregivers who were feminine or androgynous were at lower risk of depression-related symptoms as compared to those who were masculine and undifferentiated.

However, as mentioned earlier, many health researchers do not measure gender, despite the existence of tools and strategies for doing so. They may try to guess gender based on sex and/or what someone looks like. But it is rare that they ask people.

A tool for researchers

The self-report gender measure (SR-Gender) I developed, and first used in a study of aging, is one simple tool that was developed specifically for health research.

The SR-Gender asks a simple question: “Most of the time would you say you are…?” and offers the following answer choices: “Very feminine,” “mostly feminine,” “a mix of masculine and feminine,” “neither masculine or feminine,” “mostly masculine,” “very masculine” or “other.”

The option to answer “other” is important and reflects the constant evolution of gender. As “other” genders are shared, the self-report gender measure can be adapted to reflect these different categorizations.

It’s also important to note that the SR-Gender is not meant for in-depth gender research, but for health and/or medical studies, where it can be used in addition to, or instead of, sex.

Using gender when describing sex just muddies the waters. Including the actual gender of research participants, as well as their sex, in health-related studies will enrich our understanding of illness.

By asking people to tell us their sex and gender, health researchers may be able to understand why people experience illness and disease differently.

Complete Article HERE!

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6 Things Every Transgender Person Should Know About Going to the Doctor

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You deserve sensitive, comprehensive care.

By Nathan Levitt, FNP-BC

[T]ransgender patients often experience tremendous barriers to health care, including discrimination and an unfortunate lack of providers who are knowledgeable about and sensitive to this population. As a result, many transgender and nonbinary people avoid seeking care for preventive and life-threatening conditions out of fear.

According to a report from the National Transgender Discrimination Survey of more than 6,450 transgender and gender nonconforming people, nearly one in five (19 percent) reported being refused care because they were transgender or gender nonconforming. Survey participants also reported very high levels of postponing medical care when sick or injured due to discrimination and disrespect (28 percent). Half of the sample reported having to teach their medical providers about transgender care.

As a transgender person myself, I know how difficult it can be to access sensitive care.

That’s why it’s essential for trans and gender nonconforming people to be empowered with the knowledge and information that will help them find the best providers they possibly can, who are knowledgeable and sensitive, and will advocate for their gender nonconforming patients.

It can be hard to know where to start, so I’d recommend looking into the following resources online to help you find trans-friendly medical care near you:

And here are a few questions you might want to consider when looking for a doctor or health care provider who is accessible, inclusive, and who can responsibly and knowledgably care for you:

  • Do they have signs or brochures representing the transgender community?
  • Have the care providers been trained on issues specific to transgender health?
  • Does the organization have a nondiscrimination policy that covers sexual orientation and gender identity?
  • Do they have experience caring for transgender patients? Specifically, are they able to provide medical advice on how to manage hormones, after-surgery care, and health screenings in the trans population?
  • Are they able to provide the necessary accommodations you need to feel comfortable (For instance: a gender-neutral bathroom, a safe and comfortable waiting room environment, willingness to use your requested name and pronoun, etc.)?
  • Has their staff (including the office staff) received training on transgender sensitivity?

Even after you’ve found a medical provider, the reality is that transgender patients often still have to teach them about transgender care.

It’s your responsibility to communicate your medical history and needs so that you can get the best, most appropriate care. That can be intimidating and overwhelming, so I’ve outlined a few of the most important things you should go over with your doctor or medical provider.

1. Make sure your provider has a baseline medical history for you.

Once you find a transgender-sensitive health provider, think of this person as your medical ally—someone who can help you with any changes your body is experiencing. In that vein, you’ll want to tell them about your family and personal health history so they can better manage your health care screenings, such as cardiovascular, bone health, diabetes, and cancer screenings.

Cancer screening for transgender people can require a modified approach to current mainstream guidelines. If your provider isn’t sure what that looks like, you can point them towards UCSF Center of Excellence for Transgender Health.

Unfortunately, I know from professional experience that transgender people are often less likely to have routine screenings and cancer screenings due to discomfort with health care providers’ use of gendered language, providers’ lack of knowledge about surgery and hormones, gender-segregated systems, and insensitive care.

2. Discuss your goals and expectations around medical transition, whether it’s something you have done, are in the process of doing, or are interested in pursuing.

Of course, not all transgender and gender nonbinary individuals are interested in medical transition—including surgery and/or hormones—but for those who are considering these options, it’s important to select health care providers who understand how to administer and monitor hormones and who are knowledgeable about what is needed for pre- and post-operative care.

So it’s a good idea to ask your provider about their experiences with transition-related medical care or if they can refer you to someone who is experienced in that field. You’ll want to talk with your provider about your goals of hormone therapy, any lab work needed, and any relevant information from your and your family’s medical history.

There are many different surgeries that transgender individuals may undergo to align their body with their gender identity. Share with your medical provider any gender affirming surgeries you have had or are interested in. You deserve to feel comfortable with your surgeon and feel that your health care team is working together.

As your body changes, stay informed about what additional screenings may be needed. For instance, although the data linking hormone therapy to cancer is inconclusive (when taken correctly and monitored by a medical provider), it is still important to discuss risks with your provider.

For patients who currently have hormone-dependent cancers, it is imperative that you discuss with your oncologist and your primary care provider any past history or current use of hormones.

I know that some cancer screenings such as Pap smears and prostate screenings can be incredibly uncomfortable for some transgender and gender nonbinary people. Finding sensitive providers is essential to not delay important screenings.

3. As awkward as it may be, discuss your sexual history and activity in a way that allows your medical provider to accurately assess your sexual health needs.

It’s unfortunately not uncommon for transgender men to skip pelvic exams (whether they fear discrimination, think they don’t need them, or avoid them for dysphoria-related reasons). It’s also not uncommon to forego preventive health care, such as STI screenings, out of fear of discrimination or disrespect. This can hurt the transgender population’s health.

Of course it can be awkward, but your sexual health is an important topic to discuss with your provider, so they shouldn’t make you feel too uncomfortable to talk about it. If you feel your provider is not conducting transgender-sensitive sexual histories, you should feel empowered to give them this feedback. You can even ask your provider to use the language you feel most comfortable with to describe your and your partner’s bodies. This is important because they can help you to understand how to have sex that is safe, affirming, and specific to your body and identity.

It’s also important to tell your provider the nitty gritty details about your sex life and history (like: how many sexual partners you have had, whether you’re using condoms or dental dams during sex, what kind of sex you are having, and if and when you were last tested for STIs and HIV).

Unfortunately, surveys tell us that transgender people are less likely to get tested for STIs because of the discrimination and fear they face when talking about their bodies and identity. According to the CDC, in 2015, the percent of transgender people who were newly diagnosed with HIV was more than three times the national average. Trans women are at an especially high risk for HIV; in particular, African American trans women have the highest newly diagnosed HIV rates within the transgender community.

Be proactive and ask what you should be doing to reduce your risk of STIs and HIV. One option your physician may discuss with you is pre-exposure prophylaxis (PrEP), which is a daily pill that can greatly reduce your risk of HIV infection, and may be appropriate for some patients

I know it can be uncomfortable to have these conversations with a medical provider, and it can be just as difficult to have them with your partner. To help get you started, here are some helpful resources on sexual health for trans women and trans men.

4. If you’re using substances, ask your medical provider for trans-sensitive resources and referrals for substance support services.

Substance and tobacco use can often be the result of depression and anxiety associated with discrimination by the community. In fact, the National Transgender Discrimination Survey showed that 26 percent of transgender individuals use or have used alcohol and drugs frequently, compared with 7.3 percent of the general population according to a National Institute of Health’s report. In addition, 30 percent of the transgender participants reported smoking regularly compared with 20.6 percent of U.S. adults.

There are many risks associated with substance and tobacco use, especially in combination with hormone therapy. Smoking can cause an increased risk of some cancers, blood clots, and heart disease, and it may negatively impact the outcome of hormone therapy, among other complications. Talk to your provider about resources to help decrease substance dependency.

5. If you’re experiencing anxiety, depression, or any other mental health symptoms, bring it up to your health care provider.

When it comes to getting help or making that first call, you don’t have to wait until things get “bad enough.” Unfortunately, mental health issues can be prevalent in the transgender community as a result of isolation, rejection, lack of resources, and discrimination. Share with your provider any feelings of depression or anxiety you may be having. They can help manage your care and recommend a trans-sensitive mental health professional, which can be challenging to navigate on your own.

If you are in crisis, contact Trans Lifeline at 877-565-8860.

6. Tell your physician if you’re interested in potentially having children someday.

Transgender populations have fertility concerns that are often unaddressed by providers. If you are interested in potentially starting a family someday, make sure to talk to your provider about your reproductive health and fertility options early on, especially if you’re considering medical transition or have transitioned.

Transgender men may need to discuss cessation of testosterone if they are interested in becoming pregnant. And if transgender women are interested in having children using their own sperm, they may need to use sperm banking services because of estrogen’s potential effect on sperm production.

Finding trans-sensitive ob/gyn care, birth control resources specific to the trans population, and trans-sensitive fertility support can be difficult, but there are resources that can make it easier, like the ones listed at the beginning of this article.

Finally, remember that you are deserving of a responsible, knowledgeable health care team.

While patients often initially come into a medical office nervous, when they find a healthcare team they trust, they are able to open up more—sharing more information and asking more questions.

As a healthcare provider, I’ve witnessed that those patients who become increasingly empowered to take control of their own health have lasting positive effects, including better overall wellness and greater confidence and self-esteem. Everyone deserves that level of care.

Complete Article HERE!

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Doctors Are Failing Their Gay Patients

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by Liz Posner

[Y]ou’re supposed to be able to tell your doctor anything. But how are patients supposed to know what to tell their doctors if the doctors don’t ask the necessary questions in the first place? When it comes to sexual health screening, many doctors either missed the class in medical school that was supposed to teach them to ask patients about sexual health questions, or their lack of attention to sexual health is a conscious choice. Bespoke Surgical recently conducted a study of 1,000 Americans of various ages and sexual identities to hear what they’ve been asked by their doctor on the topic. The results suggest few doctors are asking questions about sexual health at all, and that LGBTQ patients, in particular, are being neglected.

The survey asked participants what kinds of questions their primary care physician focused on when they brought up sexual health during physical exams. The results varied based on the sexual orientation of the patient, as the graph below shows.

There are some outliers here that should be noted, but first, take a second to note how low these numbers are overall. Over half of heterosexual respondents said they were never asked about basic sexual health questions like HPV and STD exposure—a number that’s surprising, especially since 79 million Americans have HPV, a condition that can lead to cancer in both men and women. In general, it seems like doctors aren’t asking patients the right questions about sexual health.

But consider the shocking numbers revealed in the chart above. Of the physicians who saw homosexual patients last year, only 13 percent asked their patients if they had received the PrEP HIV prevention drug. Nearly half of all gay and lesbian respondents said their doctor had not asked them about HPV/Gardasil, anal pap smears, PreP/Truvada, or prior STD exposure. Only 40 percent of patients gay, straight and bi said they were asked if they used any kind of protection during sex.

When they do ask the right questions, the survey suggests doctors are asking them of the wrong people. In all but one of the above sexual health categories, bisexual patients were more likely to be asked about sexual health conditions. This could be because, as the Advocate explains, there’s a myth that bisexual people are more promiscuous than other people. The survey authors affirm this: “the ‘B’ in LGBTQ+ is often misrepresented in a variety of settings, including sexual promiscuity.”

Undoubtedly, doctors aren’t asking their patients a full range of questions because they aren’t able to spend enough time with them in the first place. People of all sexual orientations have experienced the rotating door model of doctor visits. Some primary care doctors say they treat 19 patients a day. With a full roster of 2,500 patients total, the Annals of Family Medicine says each doctor would have to “spend 21.7 hours per day to provide all recommended acute, chronic and preventive care” for that many patients. A 2016 study found that most doctor’s office visits only last 13-16 minutes. Professor Bruce Y. Lee at Johns Hopkins calls the average crammed doctor’s visit “archaic” in an article for Forbes, and says, “there is little time to actually listen or talk to patients and maybe not enough time to carefully examine them.”

The LGBTQ population seems to be catching on to the fact that primary care physicians may not know the right questions to ask their patients. That would explain why gay, lesbian and bisexual respondents were 20-30 percent more likely than straight respondents to rate having a doctor with the same sexual identity as them as “very important.” LGBTQ people are especially vulnerable to discrimination and may face barriers to health care that heterosexual people don’t. Some technology, like the entrepreneurs who launched an app to connect LGBTQ patients to gay-friendly doctors, is helping to make this easier. But it’s a quick fix to a much more systemic problem, considering so many primary care physicians don’t ask about sexual health problems at all.

Complete Article HERE!

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

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

STI symptom checker: Unprotected sex risks sexually transmitted infections

By Lauren Clark

[S]TIs – the common abbreviation for sexually transmitted infections – can be passed on via unprotected sex.

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

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

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

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

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

Gonorrhoea

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

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

– pain or a burning sensation when passing urine

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

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

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

– pain or a burning sensation when urinating

– inflammation (swelling) of the foreskin

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

Syphilis

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

Early symptoms:

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

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

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

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

Later symptoms:

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

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

– white patches in the mouth

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

– swollen glands

– occasionally, patchy hair loss

Chlamydia

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

– pain when urinating

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

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

– in men, pain and swelling in the testicles

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

Complete Article HERE!

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Some drugs can cause unwanted sexual side effects in men

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[Y]ou might assume that erectile dysfunction, or ED, is a normal problem that men face as they age. But because men (and women) take more medications as they age, the experts at Consumer Reports’ Best Buy Drugs report that side effects from those drugs are a little-known yet common cause of ED.

“Many medications can affect things like erectile dysfunction, desire and ejaculation in different ways and through different mechanisms of action,” says J. Dennis Fortenberry, former chair of the board of the American Sexual Health Association and the Donald Orr Professor of Adolescent Medicine at Indiana University School of Medicine.

Medications that can have these effects include high blood pressure drugs such as beta blockers, including atenolol (Tenormin), clonidine (Catapres), metoprolol (Lopressor) and methyldopa (Aldomet), and diuretics such as hydrochlorothiazide (Hydrodiuril).

Popular antidepressants and anti-anxiety drugs such as alprazolam (Xanax), diazepam (Valium), duloxetine (Cymbalta), fluoxetine (Prozac) and paroxetine (Paxil) can cause sexual problems such as delayed ejaculation, reduced sexual desire in men and erectile dysfunction. Lesser-known drug types that can also cause such sexual problems include antihistamines such as diphenhydramine (Benadryl) and antifungal drugs such as ketoconazole (Nizoral).

Surprisingly, heartburn drugs, including famotidine (Pepcid) and ranitidine (Zantac) are known to reduce sexual desire in men. In addition, reduced desire and erectile dysfunction have been reported in men taking the powerful painkillers oxycodone (OxyContin) and hydrocodone (Vicodin), muscle relaxers such as baclofen (Lioresal), and even over-the-counter ibuprofen (Advil, Motrin).

And perhaps not surprisingly, the more drugs a man takes, the greater his odds are of experiencing an issue. For example, in a 2012 study of men ages 45 to 69, those who took three to five drugs were 15 percent more likely to have erectile dysfunction than men taking two or fewer. Men who took six to nine drugs were 51 percent more likely to have erection problems.

What you can do

Before making any change to your medications, talk with your doctor, says David Shih, a board-certified emergency medicine physician and executive vice president of strategy on health and innovation at CityMD, a network of urgent care centers in the New York metro area and Seattle.

If appropriate, your physician can make changes such as “lowering the medication dose, switching to a new medication or a combination therapy of lower doses each,” notes Shih.

Your doctor may also suggest temporarily stopping a medication — often referred to as taking a “drug holiday” — before having sex, if that is possible.

If you’ve just started taking a new drug, sexual side effects may disappear as your body adjusts. But if after a few months they don’t, discuss it with your physician. He or she will want to rule out other conditions that could cause your sex drive to take a nose-dive.

“The prescribing physician will need to explore if these symptoms are from cardiovascular disease, depressive disorder, diabetes, neurological disease and other illnesses,” says Shih.

Even suffering from sleep apnea is known to affect sexual interest or response.

That’s why, if you experience ED, it’s important to get to your doctor’s office for a detailed discussion about what could be causing it.

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These scientists say you’ll probably never have heart-stopping sex

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[H]eart patients have worried that they may die suddenly from having sex, but a new study suggests they probably won’t.

Researchers found that less than 1 percent of people who experienced sudden cardiac arrest were having, or just had, sex. Now Sumeet Chugh, one of the study’s authors, has some “happy news” to tell his nervous patients.

“As a cardiologist, from time to time, in an awkward way, patients would ask me, ‘You know doc, what’s my risk of dying suddenly with sexual activity?’ We could say to them it’s probably low, but we never had data,” Chugh said. “Now we have data to answer that question.”

Researchers described sudden cardiac arrest as a “mostly lethal condition” that manifests as “an unexpected collapse and loss of the pulse.”

More than 300,000 people die of sudden cardiac arrest every year in the United States, yet about 1 in 100 men and 1 in 1,000 women experience sudden cardiac arrest relating to sexual activity, according to the study, which was presented at the American Heart Association’s Scientific Sessions and published in the Journal of the American College of Cardiology.

The community-based Oregon Sudden Unexpected Death Study examined data on more than 4,500 sudden cardiac arrests in the Portland, Ore., metropolitan area from 2002 to 2015. Of those, 34 were related to sex, and most were men with a history of heart diseases.

Researchers collected medical records, autopsy data and details of what the person was doing when sudden cardiac arrest occurred. Any cases that occurred during sex or within one hour of having sex were considered related to sexual activity.

Sudden cardiac arrest occurred during sexual activity in 18 cases and within minutes of it in 15 cases. In one case, the timing could not be determined.

“We were pleasantly surprised to see how low it was,” said Chugh, the associate director of the Heart Institute for Genomic Cardiology at Cedars-Sinai in Los Angeles.

This study is an opportunity to reassure patients that they can return to a good quality of life, including sexual activity, said Nieca Goldberg, who is the medical director for the Joan H. Tisch Center for Women’s Health at New York University. She is also an AHA spokeswoman and was not involved with the study.

“These are real concerns of our patients,” she said. “We have so many tools to prolong people’s lives. We want them to have a good quality of life, returning to exercise, eating a healthy diet and returning to sexual activity.”

The study also shows that sex “obviously isn’t as strenuous as we thought,” Chugh said, and Goldberg agreed. Sex, in general, is equivalent to walking up two flights of stairs, she said.

But a concerning result of the study, Chugh and Goldberg noted, is that it seems to suggests that sexual partners aren’t very willing to perform CPR, or don’t know how to do it, if a partner goes into sudden cardiac arrest.

Within 10 minutes of sudden cardiac arrest, a person is likely to die, and only one-third of those who experienced sudden cardiac arrest relating to sexual activity received bystander CPR, according to the study.

“We would think that if the witness is right there, everybody would get CPR,” Chugh said. “But it turns out only a third of the subjects got CPR. And since most of the subjects were men it seems like two-thirds of the women really didn’t do the CPR.”

“It’s a good idea to be aware of CPR, know how to do CPR, and do CPR even if it’s as awkward and difficult a scenario as cardiac arrest during sexual activity,” Chugh said.

On average, those who went into sudden cardiac arrest related to sexual activity were five years younger and more likely to be African American than the rest of the cases, the study states. Sudden cardiac arrest in relation to sexual activity was also more likely to have ventricular fibrillation, when the heart pumps little to no blood, according to the study.

Researchers did not examine how often patients in the study had sex, the type of intercourse, or how long it lasted. In any case, the results show that there isn’t a high risk associated with sex and sudden cardiac arrest, Chugh said.

Complete Article HERE!

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It’s Surprisingly Hard to Ban Toxic Sex Toys

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But Here’s How to Protect Yourself

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[T]hese days, most of us will carefully check ingredients lists for gluten and trans fats, demand that our water bottles be made without BPA, and seek out paraben-free, body-safe cosmetics. But the average person can’t tell you what a toxic sex toy is—or even that they exist. Unfortunately, in the unregulated sex toy industry, plenty of sex toys are potentially rife with products that can hurt you (and not even in the fun, kinky way).

Perhaps the most well-known offender in terms of toy toxicity is a group of chemicals known as phthalates, a plasticizer that can be blended with other substances to make them softer and more flexible. A spotlight’s been shone on phthalates in recent years, as publications like Bustle and Bitch, and feminist-oriented sex shops like Good Vibes and Babeland have spoken out against them.

So why all the hullabaloo? It turns out that phthalates may have side effects when they come into contact with your body that could potentially be terrible for you—and aren’t disclosed by most sex toy manufacturers. According to Amanda Morgan, D.H.S., a faculty member at the School of Community Health Sciences at the University of Nevada, Las Vegas, who wrote her master’s thesis on harmful sex toy materials, phthalates are known endocrine disruptors that can cause health problems. “[Phthalates] mess with your hormones; they can cause birth defects, or other things related to liver or kidney functioning,” Morgan told me, referencing studies that have linked phthalates to irregular fetal development, early-onset puberty, and lower sperm counts, among other issues. “They can really mess you up because they pretend to be your hormones, and so your body’s hormonal cycle gets knocked out of whack from exposure to these things.”

When you hear horror stories about sex toys, though, it’s not necessarily phthalates that are to blame. One of the most common anecdotal complaints about toxic toys is that they cause skin irritation: “I first thought [it] was a yeast infection or BV, because of extreme itching and burning on my inner labia,” reports one reader who wrote in to sex toy review blog Dangerous Lilly. “My ass suddenly felt like it was on fire. A burning sensation spread throughout my butt,” recalled sex educator Tristan Taormino about a questionable dildo she used. One Playboy story described a dildo that caused a woman “such severe pain that she could barely speak.”

I asked Emily S. Barrett, Ph.D., a professor at the Rutgers University School of Public Health who has done extensive research on the prenatal effects of endocrine disruptors like phthalates, whether these reported burning sensations fit with her understanding of the chemicals. She told me she hasn’t seen evidence that phthalates irritate the skin in this way, and that they tend to “act on a much more subtle level most of the time.”

So what is causing these health problems? According to Amanda Morgan, phthalates aren’t the only sketchy ingredient still getting into our sex toys. As part of her thesis research, Morgan tested 32 sex toys to determine their chemical makeup. What she found was pretty scary: The toys she tested typically contained 30 to 35 percent chlorine. She said PVC, a material commonly used to make inexpensive sex toys, always contains chlorine (hence the chemical name “polyvinyl chloride”). Even scarier, in 2006, BadVibes.org—an organization that, full disclosure, is linked to pro-toy-safety sex shop The Smitten Kitten—ran lab tests on four popular sex toys. They found that two of them were made of PVC and contained “very high levels of phthalate plasticizer.”

“We use chlorine to kill bacteria in things,” Morgan said. “If you are being exposed to this high level of chlorine, especially in a sensitive membrane area [like the vagina or rectum], we could definitely chalk that up to causing irritation, burning, or messing up the environment by exposing it to something that is, as we know, a sterilization product.” So with the short-term burning effects of chlorine and the long-term endocrine effects of phthalates, PVC is, Morgan said, “definitely one of the worst sex toy materials we’ve seen.”

Now, you might be thinking, “OK, great to know! I’ll just buy only safe toys from now on!” Well, it’s not so simple. Since the sex toy industry is unregulated, it doesn’t fall under the current purview of the Food and Drug Administration. According to FDA press officer Angela Stark, that’s because the agency “does not regulate devices meant purely for sexual pleasure. It does, however, regulate genital devices that have a medical purpose such as vibrators intended for therapeutic use to treat sexual dysfunction or to supplement Kegel exercises.” Of course, the vast majority of sex toys don’t fall under this “health aid” umbrella.

The responsibility of regulating sex toys could potentially fall to the Consumer Product Safety Commission, but Morgan told me the understaffed CPSC is already in charge of regulating over 15,000 types of products—not to mention the products themselves. The complex issue of sex toy regulation would be a big ask on top of all that.

Add to all of this the fact that the current Congress likely wouldn’t rush to make a bold, sex-positive statement by mandating sex toy safety, and there are plenty of reasons your sex toy might not meet body-safe standards. “Our government doesn’t generally like to talk about people pleasuring themselves,” Morgan pointed out.

Beyond that, though, Morgan adds that regulating the sex toy industry might not even be the best solution to getting rid of toxic toys anyway. “If something is federally regulated, that means that the federal government—depending on where they are in their political leanings at that time—could potentially make it illegal to have these products, by saying they are ‘dangerous’ and then regulating them out of existence,” she reasoned. “You get certain types of people in power, and they may not believe in sexual health, wellness, [or] self-pleasuring. It might go against their core values, and therefore they [might] use their political agenda and the federal regulation system to regulate these products out of people’s hands.”

It’s a conclusion that Zach Biesanz, a legal assistant in the office of New York’s Attorney General, came to in his 2007 paper in the journal Law & Inequality: “Special regulation of the sex toy industry would be unreasonably burdensome from a regulatory standpoint,” he wrote. “Only banning these toxins outright will suffice to protect consumers from phthalates’ harmful and even lethal effects.”

In the meantime, how do you tell if a toy is safe? Sex toy experts like Morgan, Smitten Kitten founder Jennifer Pritchett, and seasoned sex toy reviewer Epiphora all recommend buying toys made of phthalate-free, body-safe materials like pure silicone, stainless steel, glass, and hard plastic. Still, it’s difficult to know what’s what in an industry that mislabels its products so frequently. “Sniff your sex toy,” said Morgan. “That’s the easiest thing you can do. If you smell these products and they don’t smell like anything, then it most likely is a stable chemical compound like silicone.” Phthalates and PVC, however, smell “like chemicals,” according to Morgan, “like a new shower curtain,” according to Epiphora, and “like a headache,” according to Pritchett. The sex toy smell test might sound a little weird, but it’s a pretty good first line of defense.<

Morgan also recommends buying toys made by “companies that take a lot of pride in making good-quality, body-safe toys,” citing Tantus and Jimmyjane as examples. Other companies that proudly declare their products body-safe include We-Vibe, Fun Factory, Vixen Creations, and Funkit Toys.

And when in doubt, find a reviewer you can trust. Sex toy review blogs abound on the internet —Epiphora, Dangerous Lilly, and Formidable Femme, to name just a few—and while you’d be wise to take claims about sex toys with a grain of salt in this unregulated industry, sometimes the preponderance of good or bad reviews about a particular company or toy can suggest conclusions about its safety (or lack thereof).

Most important, though, demand body-safe sex toys by buying only from companies you can trust. “Consumers vote with their pocketbook,” said Tantus founder Metis Black. “Support the businesses that make safe toys a priority, that use their resources to educate, that take a stand and advocate for consumers.” She added that while pure silicone toys are expensive now—especially in comparison to PVC toys, which can often be under $30 a pop versus $100+ for silicone—more consumer demand for body-safe toys will create a larger supply at lower prices, as bigger companies with more resources start making nontoxic toys in larger quantities. That’s just sex toy economics.

Bloggers, consumers, and ethical toymakers alike all dream of a future in which no sex toys will burn your junk, give you infections, or cause long-term bodily harm. It seems reasonable enough. And if we keep fighting for it, maybe one day it’ll be reality.

Complete Article HERE!

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Here’s what happens when you get an STI test — and if it comes back positive

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By Erin Van Der Meer

[I]f you’ve never had an STI test, you’re probably imagining it’s a horrendously awkward experience where a mean, judgmental doctor pokes around your nether regions.

But like getting a needle or going to your first workout in a while, it’s one of those things that seems much worse in your mind than it is in reality.

For starters, often you don’t even have to pull down your pants.

“If someone comes in for a routine test for sexually transmissible infections (STIs) and they don’t have any symptoms, they usually don’t need a genital examination,” Dr Vincent Cornelisse, a spokesperson for the Royal Australian College of General Practitioners, told Coach.

“The tests that are ordered will depend on that person’s risk of STIs – some people only need a urine test, some need a self-collected anal or vaginal swab, and some people need a blood test.

“We aim to make this process as hassle-free as possible, in order to encourage people to have ongoing regular testing for STIs.”

Cornelisse says the embarrassment and stigma that some of us still feel about getting an STI test is unnecessary.

“STIs have been around for as long as people have been having sex, so getting an STI is nothing to be ashamed about, it’s a normal part of being human.

“Getting an STI test is an important part of maintaining good health for anyone who is sexually active.”

If you’re yet to have an STI test or it’s been a long time, here’s what you need to know.

How often do you need an STI test?

On average it’s good to get an STI test once a year, but some people should go more often.

“Some people are more affectionate than others, so some need to test every three months – obviously, if someone has symptoms that suggest that they may have an STI, then a physical examination is an important part of their assessment.”

As a general rule, people under 30, men who have sex with men, and people who frequently have new sexual partners should go more often.

To get an STI test ask your GP, or find a sexual health clinic in your area – the Family Planning Alliance Australia website can help you locate one.

What happens at the test?

As Cornelisse mentioned, the doctor will ask you some questions to determine which tests you need, whether it’s a urine test, blood test or genital inspection.

You’ll be asked questions about your sexual orientation, the number of sexual partners you’ve had, your sexual practices (like whether you’ve had unprotected sex), whether you have any symptoms, whether you have injected drugs, and whether you have any tattoos or body piercings.

Your results will be sent away and returned in about one week.

What if you test positive?

There’s no reason to panic if your results show you have an STI – if anything, you should feel relieved, Cornelisse says.

“If you hadn’t had the test, you wouldn’t have realised you had an STI and you wouldn’t have had the opportunity to treat it.

“Most STIs are easily treatable, and the other ones can be managed very well with modern medicine. So don’t feel shame, feel proud – you’re adulting!”

You’ll need to tell your recent sexual partners. While it might be a little awkward, they’ll ultimately appreciate you showing that you care about them.

“People often stress about this, but in my experience people appreciate it if their sexual partner has bothered to tell them about an STI – it shows them that you respect them,” Cornelisse says.

“Also, if this is a sexual partner who you’re likely to have sex with again, not telling them means that you’re likely to get the same STI again.”

The risks of leaving an STI untreated

You can probably think of 400 things you’d rather do than go for an STI test, but the earlier a sexually transmitted infection is caught, the better.

A recent spate of “super-gonorrhea” – a strain of the disease resistant to normal antibiotics –can result in fertility problems, but people who contract it show no symptoms, meaning getting tested is the only way to know you have it, and treat it.

“Untreated STIs can cause many serious problems,” Cornelisse warns.

“For women, untreated chlamydia can cause pelvic scarring, resulting in infertility and chronic pelvic pain.

“Syphilis is making a comeback, and if left untreated can cause many different problems, including damage to the brain, eyes and heart.

“If HIV is left untreated it will result in damage to the immune system — resulting in life-threatening infections and cancers — which is called AIDS.”

There is a long-term treatment for AIDS, but this depends on it being caught early.

“People living with HIV now can live a healthy life and live about as long as people without HIV, but the chance of living a healthy life with HIV depends on having the HIV diagnosed early and starting treatment early.

“Which it’s why it’s so important to be tested regularly, particularly as many STIs often don’t cause symptoms, so you won’t know you have one.”

Looking at the big picture, if you have an undiagnosed and untreated STI, you could give it to your sexual partners, who pass it onto theirs, which is how you got it.

“Getting a regular STI test is not only important for your own health, it also makes you a responsible sexual partner,” Cornelisse says.

“I encourage people to discuss STI testing with their sexual partners. If your sexual partners are also getting tested regularly, it reduces your risk of getting an STI.”

Complete Article HERE!

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6 sexually transmitted infections you should know about and how to treat them

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“Sex is great, but safe sex is better

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[S]exual Health Week upon us, which means it’s time to have that awkward STI chat.

You might be in a loving relationship or think you’re a few decades past your sexual prime, but the STI talk isn’t just for teenagers. According to research last year there has been a surge in sexually transmitted infections in the over 45s (with a dramatic 25% increase in STI diagnosis in women over 65s).

Meanwhile, back in December, it was reported that a third of Brits with an STI caught it while in a relationship – the survey also revealed 39% of people didn’t tell their partner they had an infection.

STIs have been with us for centuries. In the past mercury, arsenic and sulphur were used to treat venereal disease – which had serious side-effects, including death due to mercury poising. The introduction of Penicillin and modern medicine in the 20th century meant, thankfully, the big difference now is that greater awareness and modern medicine means they can be treated much more effectively.

Prevention and education is best practice, so here are what you need to know about six of the more commonly-known STIs…

1. Chlamydia

Chlamydia is the most common STI in the UK mainly due to many people not knowing that they have it. Symptoms can vary between men and women and most have no symptoms at all.

Men can experience pain or burning whilst urinating, cloudy discharge from the tip of their penis, and discomfort in their testes.

Women can sometimes experience a similar discomfort when urinating and discharge from their vagina, pain and/or bleeding during or after sex, and heavier or irregular periods. Usually though, they have no symptoms at all.

If chlamydia is untreated it can lead to serious pelvic infections and infertility so it is very much worth getting checked regularly.

How to treat it

Chlamydia can be diagnosed through a simple urine test, and fortunately can be treated with a single dose of antibiotics.

2. Genital Warts

Genital warts are the second most common STI and can be identified as small fleshy growths around the genitals or anal area. The warts are generally not painful, however may be itchy and irritable. While condoms are the best preventative method for genital warts because they are spread by skin-to-skin contact the area around the genitals my still become infected.

Treatment

Creams and freezing can get rid of them.

3. Genital Herpes

Genital herpes is a common infection and is caused by the same virus that causes cold sores (HPV).

Symptoms can occur a few days after infection and can generally be identified by small uncomfortable blisters which can really hurt – making urinating or just moving around very uncomfortable. The blisters go away by themselves after about 10 days but very often come back again whenever your immunes system gets a bit low or distracted.

Treatment

Unfortunately, there is currently no definitive cure for genital herpes, however each attack can be very effectively managed by using anti-viral medications which you can get from your doctor. Try to have the medications on hand because the sooner you use them in each attack the better they will work.

4. Gonorrhoea

Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae or gonococcus. It can spread easily through intercourse, the symptoms are similar to those of chlamydia except usually more pronounced. If the person experiences discharge from their penis or vagina it can either be yellow or green in colour and there can be quite a lot of it.

Like Chlamydia though, the symptoms are not always present.

Treatment

The infection can be identified through a swab or urine test, and can be treated with antibiotics. Unfortunately, bacteria is getting resistant to more and more antibiotics and treatment is getting more difficult. Right now, though it is still well treated with an antibiotic injection.

5. Pubic lice or ‘crabs’

Crabs have commonly been seen as the funny STI and are often the punch line to many a joke. But as with all STIs, the reality really isn’t very funny.

Also known as pubic lice, crabs can be easily spread through bodily contact. They are usually found in pubic, underarm and body hair, as well as in beards and sometimes in eyebrows and eyelashes. The lice crawl from person to person, and can take weeks to become visible. They are usually spotted due to itchiness and in some cases people can find eggs in their hair.

Treatment

Pubic Lice can usually be treated using creams or shampoos which can be purchased readily from pharmacies.

6. HIV

Of all the STIs mentioned HIV probably is the most famous and feared. In the 1980s having HIV was effectively a death sentence and, tragically, it brought with it huge stigma. Thankfully, today modern drugs have had a huge impact on the HIV community, enabling them to live happy and healthy lives. But what is it?

HIV is a virus which attacks the immune system and is most commonly spread through unprotected sex. Many people with HIV appear healthy and do not display any symptoms, but they may experience a flu-like illness with a fever when they first become infected.

The final stage of HIV is AIDS, this is where the immune system is no longer able to fight against infections and diseases.

Treatment

There is currently no cure for HIV – however, modern medicine has come a long way enabling people to live long and otherwise normal lives.

Sex is great, but safe sex is better. If you’re concerned about STI’s visit your local sexual health clinic for a screening.

Complete Article HERE!

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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

[W]hile HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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Men who have sex with men account for over 80% of syphilis infection rates in the US

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MSM are 106 times more likely to get syphilis than men who exclusively have sex with women

Doctors advise waiting for the skin to heal after shaving before having sex

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A new study of syphilis transmission rates reveals men who have sex with men account for 81.7% of cases in the United States.

This study found gay, bisexual or men who have sex with men are 106 times more likely to get the sexually transmitted disease.

Researchers analyzed data collected in 2015 and compiled the first of its kind state-by-state report on syphilis rates.

The study found gay and bisexual men living in the South had the highest rates of the disease, such as North Carolina, Mississippi and Louisiana.

North Carolina, for example, had 748 cases per 100,000 gay and bisexual men.

Alaska had the fewest cases, with only 73 cases per 100,000 gay and bisexual men.

HIV infects healthy immune cells in the human body by inserting its DNA into the cell’s genome

Fred Wyand, spokesman for the American Sexual Health Association urged people to look at the broader picture.

Wyand said: ‘Better access to healthcare, more welcoming attitudes, better support systems are all important, of course,’ WebMD reports.

‘We need to understand there are challenges faced by many gay and bisexual men greater than what most folks endure,’ Wyand concluded.

For a full list of State-specific cases of syphilis, check out the Morbidity and Mortality Weekly Report.

Why do men who have sex with men report higher numbers of syphilis?

A further breakdown highlights men who have sex with men accounts for 309 cases per 100,000.

This is in contrast to men who only have sex with women accounting for 2.9 cases per 100,000.

And women with 1.8 cases per 100,000.

Dr Robert Grant, chief medical officer of the San Francisco AIDS Foundation explains why this might be the case.

Grant told CBS News: ‘Now that we have effective therapies for HIV, people who were previously untested and tested infrequently are now getting tested.

‘Sexually transmitted infections tend to go together.

If they come in and ask for HIV testing, we test for syphilis, chlamydia and gonorrhea as well.

‘People have everything to gain and nothing to lose by getting an HIV and syphilis test.

‘This report will help reinvigorate people’s awareness and hopefully send the message that by getting a test and following through with treatment, we can decrease or even eliminate syphilis as a problem,’ Grant said.

Complete Article HERE!

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Undoing the STIgma: Normalizing the discourse surrounding STIs

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April is STD/STI Awareness Month.

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[L]et’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

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