Category Archives: Health Risks

Time for a Sexual Revolution In Health Care Treatment

Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?

By Zachary Hafner

When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.

It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.

It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?

Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.

Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.

Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.

It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.

Complete Article HERE!

Romping 50 Shades of Grey-Style? Rope in your Doctor

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Whips. Chains. Paddles. Rope. Thanks to the pop culture explosion that is 50 Shades of Grey, these words are now part of the mainstream sexual lexicon. But while the book and film franchise has increased awareness about kink, many people are still keeping their bedroom habits secret, and it’s impacting their health.

Amy in Winnipeg has lived the BDSM lifestyle (that’s bondage/discipline, dominance/submission, and sadism/masochism) and she’s the first to admit that, “it’s nothing like the tame version of the books or movies.” She’s experienced, abrasions, rope burn, sciatic nerve pain and spankings that left her so raw that “it got to the point where I had huge pieces of flesh missing…I couldn’t sit for a week.”

As Amy explains, “if not looked after properly, abrasions can lead to bacterial infections,” which is exactly what happened to her after a particularly painful spanking injury. “I went to the doctor to get cream and I explained myself,” she says.

While Amy wasn’t afraid to open up to her healthcare practitioner, she’s in a minority. According to a new study published in the Journal of Sexual Medicine titled “Fifty Shades of Stigma: Exploring the Health Care Experiences of Kink-Oriented Patients,” less than half of individuals surveyed were open with their doctors about their kinky sexual practices. The main reason for keeping quiet? Fear of judgement. Also, as the study highlights, many individuals are afraid their physician will misinterpret their consensual sexual acts as partner abuse.

It makes sense. While my experience with anything kink-oriented is extremely limited, years ago I sustained some gnarly carpet burns after an encounter with an ex. When I went to see my family doctor for my annual exam, I blurted out, “I slipped while playing a game of Twister with friends!” I have no idea why I thought this sounded remotely plausible to anyone, but it was the first thing that came to mind. In retrospect, I think she knew what the deal was, but chose to be discrete. However, not everyone is so lucky.

Despite increased visibility in pop culture, the stigma associated with BDSM is still very real. However, so are the potential risks. Injuries that arise from BDSM can potentially mushroom into more serious issues if left unattended. Anna M. Randall, LCSW, MPH, is a San Francisco-based sex therapist and the executive director of The Alternative Sexualities Health Research Alliance (TASHRA), the team behind the study. As she told Cosmopolitan magazine recently, “big bruises can develop into hematomas, for example.” She goes on to say that “there are rare injuries from rough sex that may lead to serious complications, such as torn vaginal tissue or scrotum injuries, and because more risky sexual BDSM behaviors may include controlling the breathing of

a partner, those with asthma face real risks if they’re not treated for attacks immediately.”

However, for Cassandra J. Perry, an advocate, researcher and writer, her injuries were all due to health conditions she didn’t realize she had at the time. Perry’s first injury occurred when she shredded the cartilage in her left hip joint (an injury called a labral tear.) She says, “even if you think you’re sex-savvy smart, you could probably be and likely should be safer!” Also, as she points out, “If we practice bdsm, that’s a good reason why we should have our annual physicals. And it’s a really good reason to pay attention to what our mind-body tells us. If something seems off, we need to be persistent with getting answers and care (when possible) and to be cautious when engaging in BDSM activities that may interact with some part of our health that concerns us.”

However, as Stella Harris, a Sex Educator & Intimacy Coach explains, “The risks of BDSM aren’t just physical.

Make sure to look out for the emotional implications, as well. Some of this play can be very intense, and you want to make sure you’ve planned all the necessary aftercare.” This is going to look different for everyone and can include everything from cuddling with your partner to routine check-ins with them over the following days.

Lastly, Harris reminds us, “I always advocate honesty with your medical professionals. When you’re finding a doctor, screen for someone you can be open and honest with, who has passing knowledge of kink, and who isn’t judgmental. If you go to the doctor with visible bruises, just be honest about it and tell them the bruises are from consensual kink activities. They might have questions, but it’s best to be clear and upfront, before they assume the worst.”

Complete Article HERE!

Caught in the modesty bind: Why women feel shy to consult doctors for their sexual well-being

By Aditi Mallick

“I was 17, when I first got sexually intimate with my boyfriend,” says Kriya (name changed), a 23-year-old IT professional from Hyderabad, while speaking to The News Minute.

“Later we were very scared, as it was the first time for both of us,” she recalls. She missed her periods that month. The 17-year old who had never once been to hospital alone, was scared and unsure of what to do next.

Trying to glean more information online just added to her worry over getting pregnant. Finally she discussed the issue with her boyfriend, and both of them decided to consult a gynaecologist.

“I was already very scared. After I told the receptionist my age, she kept staring at me. It made me so uncomfortable. While other patients were called by name, when it was my turn, she said ‘Aey, hello.…go!’ I felt so bad.

I expected at least the doctor to act sensitive. She first asked me what happened. When I told her, she started lecturing to me about our culture, and how young I am. It was a horrible experience. After the check-up, once I reached home, I burst out crying,” she shares.

From then on, Kriya has always felt too scared to discuss any sexual health problem with a gynaecologist. She is now 23, but in her view, nothing much has changed.

“Last month, I had rashes all over my vagina right up to my thigh. I just could not walk. It was painful. In the beginning, I used anti-allergic medication and antiseptic cream. But I was finally forced to go to a doctor. But even this time, I was ill-prepared for those weird looks.

The receptionist first asked for my name, then my husband’s name. For a moment, I panicked. After a pause I said, I am unmarried.”

Kriya feels that such unnecessary queries have nothing to do with a particular health problem and should not be asked: “We are adults and should not be judged for such things. After all, it is my decision. But society does not think so.”

Dr Kalpana Sringra, a Hyderabad-based sexologist agrees:“Doctors should not interfere in a patient’s personal life. But sadly, some do. A few are open-minded. They do not care whether the patient is married or not. We do at times have to ask about how frequently they have sex to ascertain the cause.”

Kalpana believes the rigid cultural restrictions and undue secrecy about anything related to sex are what makes patients uncomfortable sharing sexual health issues with their doctors.

Prapti (name changed), a 21-year old second year engineering student says: “Ï had  quite a few relationships, and faced initial problems like bleeding and pain during sex. I sometimes lose interest while having sex, due to this immense pain in the vagina.”

But she does not want to consult a doctor: “I prefer advice from friends. At least, they will not judge me.” She remembers the time she had to consult a doctor two years ago, when after having sex, the pain persisted for a whole day.

“The doctor did not even try to explain the reason. I kept asking her whether it was anything serious. But she deliberately chose to ignore me. Later I heard her murmur ‘this generation….uff’! When I shared this with my friends, I realised they too had been in similar situations.

According to Kalpana, only ten percent women come forward to consult a doctor for sexual well-being, of which the majority are planning to get married soon and want to get themselves checked for infection and related advice.

No woman ever goes to the doctor for this, unless it is absolutely avoidable. Not just unmarried women, but even married ones are ignorant in this regard. Young unmarried women are only more hesitant to ask or seek medical help, fearing society and parents, she says.

“Both married and unmarried women are not comfortable. They mostly come with their partners. To make them feel comfortable, we talk to the women alone. After a while, they open up about their problems.”

She also claims that 20% of women who suffer from vaginal infection like UTI and rashes after marriage too feel shy to discuss it with the doctor: “Men seem more comfortable discussing their sexual problems. 90% of our patients are men. But they tend to come alone.”

That was not the case with Jayesh (name changed), a 27-year old. He used to earlier hesitate to talk about his sexual health: “It was only a year back that I consulted a doctor for premature ejaculation, something that I suffered from the age of 23. I used to think if my friends get to know, they would make fun of me.”

The common issues that men in the age group of 18-80 are premature ejaculation and erectile dysfunction. “Most men confess that they force their wives to use contraceptive pills, as they do not want to wear condoms,” Kalpana says.

Gaurav (name changed), a 29-yearold unmarried man insists that he has never forced his girlfriend to use contraceptive pills, but they do sometimes prefer pills over condoms.

Gaurav who is sexually active does not feel ashamed or uncomfortable consulting a doctor, but that is not the case with his girlfriend: “Four years back, she once started bleeding after we had sex. Honestly, I was clueless how to handle the situation and whom to contact. We did not go the doctor, fearing prejudice.

My girlfriend is not at all comfortable consulting a doctor. She usually avoids going to a gynaecologist, as they ask whether we are married or not. It makes her uncomfortable. It happened a few times with us in Hyderabad. That’s why sometimes she prefers to use emergency contraceptive pills rather than consult a doctor.”

“Sex jokes are allowed, but people are otherwise shy talking about sex. Parents do not talk freely on the topic. It is still a taboo for Indian society,” Gaurav remarks.

When Preeti (name changed) -who is now doing an event management course- was in her final BCom year, she led an active sex life:

“I went for a party and got drunk. That night my friend and I had sex. I did not then realise that we had forgotten to use a condom. After missing my periods, I freaked out. I was confused and went to see a doctor. They first asked if I was married. I lied.”

She also admits to feeling uncomfortable while buying I-pills, condoms or pregnancy test devices: “Once a medical shopkeeper asked whether it was for me, with those around giving me judgmental looks.”

Fearing societal disapproval, several unmarried women tend to take medications, after consulting the internet.

“They go to medical stores or send their partners to buy medicines without consulting a doctor. Emergency contraceptive pills have several side-effects like, dizziness, vomiting etc. Some even try to abort through pills, which is life-threatening and can affect their health in the long run,” warns Kalpana.

Complete Article HERE!

Mouthwash Helps Kill Gonorrhea Germs in Mouth, Throat: Study

Listerine’s maker has long made the claim, and new Australian research seems to confirm it

by Robert Preidt

A commercial brand of mouthwash can help control gonorrhea bacteria in the mouth, and daily use may offer a cheap and easy way to reduce the spread of the sexually transmitted disease, a small study from Australia contends.

Gonorrhea rates among men are on the rise in many countries due to declining condom use, and most cases occur in gay/bisexual men, researchers said.

The maker of Listerine mouthwash has claimed as far back as 1879 that it could be used against gonorrhea, though no published research has ever proved it.

In laboratory tests, the authors of this new study found that Listerine Cool Mint and Total Care (which are both 21.6 percent alcohol) significantly reduced levels of gonorrhea bacteria. A salt water (saline) solution did not.

The researchers then conducted a clinical trial with 58 gay/bisexual men who previously tested positive for gonorrhea in their mouths/throats. The men were randomly assigned to rinse and gargle for one minute with either Listerine or a salt solution.

After doing so, the amount of viable gonorrhea in the throat was 52 percent in the Listerine group and 84 percent among those who used the salt solution. Five minutes later, men in the Listerine group were 80 percent less likely to test positive for gonorrhea in the throat than those in the salt solution group.

The study was published online Dec. 20 in the journal Sexually Transmitted Diseases.

The monitoring period after gargling was short, so it’s possible the effects of Listerine might be short-term, but the lab findings suggest otherwise, according to the researchers.

A larger study is underway to confirm these preliminary findings.

“If daily use of mouthwash was shown to reduce the duration of untreated infection and/or reduce the probability of acquisition of [gonorrhea], then this readily available, condom-less, and low-cost intervention may have very significant public health implications in the control of gonorrhea in [men who have sex with men],” Eric Chow and colleagues at the Melbourne Sexual Health Center wrote in the study. Chow is a research fellow at the center.

Gonorrhea, which is common in young adults, is spread by vaginal, oral or anal sex with an infected partner. It often has mild symptoms or none at all. If left untreated, it can cause problems with the prostate and testicles in men. In women, it can lead to pelvic inflammatory disease, which causes infertility and problems with pregnancy, according to the U.S. National Institutes of Health.

Complete Article HERE!

Good News: Porn Isn’t Bad For Your Sexual Health After All

Everyone can calm down now.

By

porn addiction, no such thing

Recently, a British National Health Service therapist suggested that access to porn is “damaging” to men’s health, particularly their sexual health, so naturally the internet freaked out, because porn is awesome and it’d be tragic if it really was unhealthy somehow.

The claim came from psychosexual therapist Angela Gregory, who stated that watching porn too much and too often is the reason more and more men in their teens and 20s are suffering from erectile dysfunction. She told BBC:

“Our experience is that historically men that were referred to our clinic with problems with erectile dysfunction were older men whose issues were related to diabetes, MS, cardio vascular disease. These younger men do not have organic disease, they’ve already been tested by their GP and everything is fine.

So one of the first assessment questions I’d always ask now is about pornography and masturbatory habit because that can be the cause of their issues about maintaining an erection with a partner.”

To supplement her argument that porn is no bueno, Gregory mentioned a youngster named Nick, who started jerking off to porn when he was 15, and loved it so much that it ruined his life and he needed medical help. Poor Nick.

“I found that when I was lying next to a girl a lot that I just wouldn’t be horny at all, despite being really attracted to the girl and wanting to have sex with her, [because] my sexuality was completely wired towards porn. At my peak I was probably watching up to two hours of porn every day.”

That’s a lot of porn. In fact that does sound excessive and potentially harmful.

However, there’s a small problem with Gergory’s claim: there’s no factual evidence. Hers is a subjective interpretation, therefore only a theory. So calm down. Porn isn’t bad for you, and it’s not messing up your junk’s ability to do its job.

The article published by BBC announcing Gregory’s theory even started out saying, “There are no official figures, but…” so readers should have known right then to not take it to heart. After all, if you’ve been beating off to porn for years and your equipment still functions and you have not turned into a sex offender, it must mean porn isn’t bad for you.

If it helps, there are actually studies that prove porn is beneficial. One Danish study from 2007 found that pornography has positive, yet minor, effects on sexual health. Another large study also definitively determined porn is not bad for you, and has literally no negative impact on men’s sexual health.

“Contrary to raising public concerns, pornography does not seem to be a significant risk factor for younger men’s desire, erectile, or orgasmic difficulties,” the authors wrote in the report.

See? You love porn, and porn loves you back just the same, so keep watching.

Complete Article HERE!