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What your gynecologist wishes you would do

By Linda S. Mihalov, MD, FACOG

No matter a woman’s age or how comfortable she is with her gynecologist, she may still be unsure about a few things — like which symptoms are worth mentioning, how often to make an appointment and how to prepare for an exam.

Based on my 30 years of providing gynecologic care to women of all ages, I thought it would be helpful to provide a few tips about how to make the most of your care visits.

Keep track of your menstrual cycle

Dr. Linda Mihalov

Menstruation is a monthly recurrence in women’s lives from early adolescence until around the age of 51, when menopause occurs. Because of the routine nature of this biological process, it’s easy to become complacent about tracking your periods. Thankfully, there are numerous smartphone apps that help make tracking periods easy.

Keeping track of your period is important for numerous health-related reasons. A missed period is usually the first sign of pregnancy. Determining the due date of a pregnancy starts from the date of the last menstrual period. Most forms of birth control are not 100 percent effective, and an unplanned pregnancy is best recognized as soon as possible.

Conversely, women attempting to get pregnant can use period tracking to learn when they are most fertile, which may greatly increase the chances of conception.

In addition, a menstrual cycle change can indicate a gynecologic problem, such as polycystic ovarian syndrome, or even uterine cancer. It is also often the first obvious symptom of health issues that have no obvious connection to the reproductive organs. When a regular menstrual cycle becomes irregular, it may indicate a hormonal or thyroid issue, liver function problems, diabetes or a variety of other health conditions. Women also often miss periods — or experience menstrual changes — when adopting a new exercise routine, gaining or losing a lot of weight or experiencing stress.

One late, early or missed period is not necessarily reason for alarm. But if menstrual irregularity is accompanied by other symptoms, a woman should schedule an appointment with her gynecologic care provider.

Get the HPV vaccine

Human papillomavirus, or HPV, is a very common virus. According to the Centers for Disease Control and Prevention, nearly 80 million Americans — about one in four — are currently infected. About 14 million people, including teens, become infected with HPV each year. Most people who contract the virus will clear it from their systems without treatment, but some will go on to develop precancerous or even cancerous conditions from the infection.

The HPV vaccine is important because it protects against cancers caused by the infection. It can reduce the rate of cervical, vaginal and vulvar cancers in women; penile cancer in men; and anal cancer, cancer of the back of the throat (oropharynx), and genital warts in both women and men.

This vaccine has been thoroughly studied and is extremely safe. Also, scientific research has not shown that young people who receive the vaccine are more prone to be sexually active at an earlier age.

The HPV vaccine is recommended for preteen girls and boys at age 11 or 12 so they are protected before ever being exposed to the virus. HPV vaccine also produces a more robust immune response during the preteen years. If you or your teen have not gotten the vaccine yet, talk with your care provider about getting it as soon as possible.

The CDC now recommends that 11- to 12-year-old girls and boys receive two doses of HPV vaccine — rather than the previously recommended three doses — to protect against cancers caused by HPV. The second dose should be given six to 12 months after the first dose.

Teen girls and boys who did not start or finish the HPV vaccine series when they were younger, should get it now. People who received some doses in the past should only get doses that they missed. They do not need to start the series over again. Anyone older than 14 who is starting the HPV vaccine series needs the full three-dose regimen.

Young women can get the HPV vaccine through age 26, and young men can get vaccinated through age 21. Also, women who have been vaccinated should still have cervical cancer screenings (pap smears) according to the recommended schedule.

Do not put off having children

Fertility in women starts to decrease at age 32 and that decline becomes more rapid after age 37. Women become less fertile as they age because they begin life with a fixed number of eggs in their ovaries. This number decreases as they grow older. Eggs also are not as easily fertilized in older women as they are in younger women. In addition, problems that can affect fertility — such as endometriosis and uterine fibroids — become more common with increasing age.

Older women are more likely to have preexisting health problems that may affect their or their baby’s health during pregnancy. For example, high blood pressure and diabetes are more common in older women. If you are older than 35, you also are more likely to develop high blood pressure and related disorders for the first time during pregnancy. Miscarriages are more common in older pregnant women. Losing a pregnancy can be very distressing at any age, but perhaps even more so if it has been challenging to conceive.

So, women who are considering parenthood should not put off pursuing pregnancy for too long or it may become quite challenging.

See your gynecologist for an annual visit

For women to maintain good reproductive and sexual health, the American College of Obstetricians and Gynecologists recommends that they visit a gynecologist for an exam about once a year. Generally, women should have their first pap test at age 21, but there may be reasons to see a gynecologic care provider earlier than that if there is a need for birth control or periods are troublesome, for instance. Although pap tests are no longer recommended every year, women should still see their provider annually for a gynecologic health assessment. This may or may not involve a pelvic exam.

Other reasons to visit a gynecologist include seeking treatment for irregular periods, sexually transmitted diseases, vaginal infections and menopause. Women who are sexually active or considering it can also visit a gynecologist to learn more about contraceptives.

During each visit, the gynecologist usually asks about a woman’s sexual history and menstrual cycle. The gynecologist may also examine the woman’s breasts and genitals. Understandably, a visit like this can cause discomfort among some women. However, periodic gynecological exams are very important to sexual and reproductive health and should not be skipped. The patient’s anxiety can be significantly decreased if she knows what to expect from the visit. Prepared with the knowledge of what actually occurs during an annual exam, women often find it can be a straightforward, rewarding experience.

There are several things women should do to prepare for a gynecological exam, including:

  • Try to schedule your appointment between menstrual periods
  • Do not have intercourse for at least 24 hours before the exam
  • Prior to the appointment, prepare a list of questions and concerns for your gynecologist
  • Since the gynecologist will ask about your menstrual cycle, it will be helpful to know the date that your last period started and how long your periods usually last

The pelvic exam includes evaluation of the vulva, vagina, cervix and the internal organs including the uterus, fallopian tubes and ovaries. Appearance and function of the bowel and bladder will also be assessed.

The gynecologic provider will determine whether a pap test is indicated, and order other tests as necessary, including tests for sexually transmitted infections, mammograms and screening blood work or bone density studies. Even a woman who has previously undergone a hysterectomy and, as a result, no longer needs a pap test can still benefit from visiting her gynecologist.

Primary care providers, including family practitioners and nurse practitioners, internists and pediatricians can also provide gynecological care.

Menopause

Menopause can be a challenging time. Changes in your body can cause hot flashes, weight gain, difficulty sleeping and even memory loss. As you enter menopause, you may have many questions you want to discuss with your gynecologist. It is important that you trust your gynecologist so you can confide in them and ask them uncomfortable questions. The more open you are, the better they can guide you toward the right treatment.

Complete Article HERE!

The right to say yes, no, maybe

Lessons from the BDSM community on why consent is not a one-time thing

By Jaya Sharma

She asked for it,” they say. Really? To be groped on the street by strangers when all one is trying to do is have a good time on New Year’s eve? Some years ago, at a sexuality workshop with teachers in Rajasthan that I was conducting while working with a feminist non-governmental organization, one of the men said, “Uski naa mein toh haan hai (When she says no, she actually means yes).” The men sat on one side, and women on the other (not by design), of the big hall at an ashram in Pushkar where the workshop was taking place. One of the women turned around and asked this man, “If a man makes a move on a woman, and if, instead of an initial no, she says yes, what happens? She is instantly labelled a slut.” The discussion concluded with what to me, in my 30 years in the women’s movement, seemed to be a pearl of wisdom: Women have the right to say no only when they have the right to say yes. It makes perfect sense, therefore, to discuss consent in the context of our ability to say yes, precisely at a time when the country around us is rife with conversations, online and offline, on gender-based sexual violence.

There is clearly an urgent need for a fundamental shift in our thinking about consent; about adding “yes” to the existing focus on “no”. We need to recognize that our ability to say “no” and our ability to say “yes” are inextricably linked. And, if I may move full steam ahead, there is also a need to recognize that there is a range of possibilities beyond “yes” and “no” in sexual encounters, which we may not talk about or bring into our struggle against sexual violence, but which exist nonetheless. And only a discussion on consent which acknowledges a woman’s freedom to say yes opens up the space for this.

I’m talking of the space for “maybe”, which allows us to explore, change our minds halfway through, surrender control completely—ways of “doing” consent that are in sync with the nature of our desires. I say “do consent” rather than “give” it, because consent is not a one-time-only thing to be given and never sought again. The most widespread and insidious assumption about consent is that it already exists—it is presumed. Another assumption is that negotiations around consent will kill the intense, spontaneous passion that we feel. If talked about at all, it is considered to be a thing that people are meant to do only before they have sex. “Are you okay with this?” In any case, what is “this”? I suspect it might be the ultimate peno-vaginal penetrative act (one act among thousands, but more often than not, considered a synonym for sex). None of this is necessarily any individual’s fault. In the midst of all these assumptions is the truth that societies, globally, don’t have a culture of talking, teaching, or learning about consent. Let’s move to a better scenario.

I am part of a community that has great expertise on consent—the Bondage Domination Sado-Masochism (BDSM) community. In BDSM, consent is sacrosanct. There are a range of mechanisms to ensure that consent is given and taken proactively and enthusiastically. Although not everyone uses the same mechanisms, these include “hard limits”, which are acts identified beforehand that can never be attempted. “Soft limits” refers to those acts which don’t fall within one’s comfort level, but which one is not entirely averse to trying or experiencing. Then there is of course the safe word, which is a predetermined, typically easy-to-recall word (many friends and I choose “red”) which would instantly and unconditionally end whatever is transpiring. The limits are negotiated beforehand. The process of negotiation can be hot.

Although I always ensure that I have a safe word, I have very rarely used it. Having a safe word gives me tremendous confidence to explore my desires and allow my boundaries to be pushed. The safe word also gives the other person the confidence to push my limits. I am not referring only to pain when I talk of pushing limits, but also to giving up control. In my experience, dominants often stop short of providing the extent of control that submissives desire, because they fear that they might push them too far. In this context, the safe word gives each person the confidence to continue going much further than they otherwise might have. I hope that others would like to try to use the safe word in their sex lives, however kinky it may or may not be.

Other than soft limits, hard limits and safe words, the other useful consent mechanism in my experience is the conversation that happens after the session, talking about how one felt about what happened. Such conversations have really helped me to connect in a deeper way with what turns me on or off, about my triggers and resistances. The honesty, directness and trust that has typified these conversations, even with virtual strangers whom I have played with (we call these BDSM sessions “play”), is precious.

The significance of these mechanisms goes well beyond BDSM. In the Kinky Collective, the group that seeks to raise awareness about BDSM and of which I am part, we share a lot about consent because we believe that everyone can learn and benefit from the ways in which consent is understood and practised in our community. It shows us ways of “doing” consent which are sexy, which help move us out of the embarrassment associated with negotiating consent, which don’t interrupt the flow of desire but, in fact, enable and enhance it. Most importantly, these ways of understanding and giving consent are in sync with the nature of human desire and with our need to explore, give up or take control, and importantly, our need to pursue pleasure, and not only protect ourselves from harm. BDSM shows us that making consent sacrosanct is not only the responsibility of the individual, but of the community. A lesson worth learning from the BDSM community is also that “slut”, whether used for a woman, man or transgender person, can be a word of praise and not a slur. It is not surprising perhaps that a community which enables this space for agency and desire, beyond the constraints of shame, to say “yes”, is also a community which has at its core consent.

Complete Article HERE!

The Ties That Bind

 An Exploration of Anchorage’s Kink Community

by K. Jered Mayer

“Here’s a couch you can sit and relax on, or whatever. I like to suck dick while the guy is reading. It’s the sapiosexual side of me.”

Surprised, I glanced at the man guiding me through the rooms to see if the statement was meant for me. It was not. Not all of it, anyway. Everything after introducing me to the furniture had been an aside to a friend of my leather-clad cicerone as they passed by, but it had been said so offhandedly and received so earnestly that I knew right then I had never been in a place quite like this before.

The Alaska Center for Alternative Lifestyles–mercifully acronymized and more commonly known as ACAL–has been labeled in the past as “Anchorage’s only sex club.” It’s an oversimplification that people are quick to correct, not least of all the Center’s founder, Sarha Shaubach. The website she set up for ACAL is done so in a way as to put focus on the real purpose behind the organization’s inception. Not for scintillation nor sexploitation. Certainly not for orgies, which require “a lot of planning and connection” to arrange. Instead, the focus is on community.

“Your Kink Community Home Base” graces the top of the main page, followed by a description promising “elevated kink education and foundation building,” as well as a “judgement [sic] free, body positive environment,” and protection and equipment for healthy exploration.

The FAQ section on their website goes even further into detail. Here, BDSM is defined as a more complex, overlapping number of ideas, and not just whips and chains and ball gags. There are answers in this area to questions about privacy, membership costs and advantages and various other things to expect regarding dress codes (there isn’t one), alcohol–there isn’t any of that, either; it’s critical there is zero confusion regarding consent–and what else is offered for those not interested in the tying or whipping side of it. And there is plenty offered: card games, movie nights, bootblacking (the polishing of one’s leathers) and regular classes on rope and knot work to promote healthy bondage and prevent serious injuries.

While the club itself had some initial troubles starting up–Sarha notably sent the Press a letter in December 2014 detailing her struggles getting ACAL up and running in the old Kodiak bar building while co-leasing the space with “Fuck It” Charlo Greene–classes, play sessions, recurring memberships and group events have proven strong enough to keep the community thriving.

So much so, in fact, that it was inevitable a larger venue would someday be needed. When that day came this last summer, ACAL didn’t need to look far to find it. Back in June, weekend events began being held in an 8,000-square foot space on 3rd Avenue. By July, they were fully moved in.

When ACAL finally came to my personal attention last month, they had fully settled into the location and I was chomping at the bit to write about it. Sexuality has always fascinated me in its myriad forms, as has people’s reactions to it and how readily some subscribe to an opinion based on what they think something is and not based on what it actually is.

I wanted to know. I wanted to learn.

ACAL offers a text-based subscriptions service to alert people of upcoming events. When I reached out to Sarha for the first time, she asked if she could sign me up for what she called “the same spam stuff” she gave to anyone interested in attending the Center for the first time. I agreed–I wanted to approach this from the ground up.

So it is that I found myself downtown on New Year’s Eve opening a door with a leather pride flag draped over it. I ducked inside and scaled a gray stone staircase, then waited my turn as the woman in the box office window politely explained to a couple men that no, this wasn’t the entrance to the Latin dance party that was also going on, that was the other side of the building, this was something much, much different. They shuffled back past me. It was my turn.

“Yeah, I’m here for the, ah…” At the time, I only knew it as the Alaska Center for Alternative Lifestyles, which was a rigid mouthful, or as the “fetish club,” which seemed remarkably ill-informed. Which I was. So I stammered.

“Are you here for the dance night or for ACAL,” she asked. I confirmed the latter. When she asked me if it was my first time attending, I confirmed that too and she handed me a five-page pamphlet on the rules to follow, appropriate and inappropriate behaviors and the safe word. Safety, discretion, clear-mindedness, consent and a zero-tolerance policy on hate speech were all heavily emphasized. I signed a consent sheet and returned it to the box office, where I was quizzed on what I had read before being allowed entry.

I passed my quiz with rainbow colors, paid my $25 non-member entry fee and had my license number written down and filed away with my paperwork. Once that was finished, I was assigned a guide to give me a tour of the facility.

“Normally, we’ve got the whole floor,” I was told. “But sometimes, like tonight, we rent out the big room to other events. Only this side is open tonight, but that’s okay. Sometimes I like that more. It’s more intimate.”

The first room I was led into was the social room. Cell phones are allowed here, but strictly for texts. Pictures are prohibited and people are asked to take calls outside, to maximize privacy. There are plenty of seats around the space to relax or recline upon. Snacks or food are customarily set out for guests, as are sodas and water. The night I went, there was a hummus plate. It was delicious.

The social area serves multiple purposes. Members and guests can meet here to discuss activities for the evening, or to shoot the shit, or to take a break from anything that was too exhausting or discomfiting in the play room. I saw an even mix of men and women sprawled out under a number of fantastic art pieces. Variety was the spice of life in the social room when it came to age, body types and dress. T-shirts and jeans here, corsets and leather chaps there. I saw smiling faces. I heard giggles, chuckles and guffaws. It felt safe. Relaxed.

From there, we moved into a second, transitional room. The room with the couch. While my guide took a moment to discuss oral sex preferences and unrelated plans for the weekend, I took in the small area. Some pornography sat on top of a cabinet for anyone needing a primer to get in the mood. On the walls were photos of bound men and women. There was a bookcase packed with books on sexuality and erotica. There was also a healthy collection of close-up, black and white photographs of vaginas with varying grooming situations and piercing statuses. It was fascinating to me, from an artistic perspective, to see such a display of body variance.

The last room, just beyond, was the playroom. Low-lit, blue themed. A long, padded table was positioned near the door for massages or wax play. A mattress was pushed against one corner on the right, covered in a Minions blanket that honestly struck me as the most out-of-place thing in the room. The bed was unoccupied, but the other corner on the right side was not, as a young man practiced different knots while binding his girlfriend. They moved thoughtfully, conscious of each other’s bodies, a sensuous grace about them.

To their left, against the center of the back wall, was a stand meant for kneeling over. A couple was wrapping up their spanking session. It was loud and vigorous and I could feel my cheeks flushing as aggressively as, well, hers.

And still there was more. Directly in front of me was a cushioned bench. A wooden overhang had a metal ring affixed to it. A man walked by me, trailed by a woman, as my tour guide described the layout. He stripped down to his underwear and his companion helped slip a restraint through the ring, binding his wrists above his head. She followed that with some light whipping and tickling. She massaged his bare back. She slapped his ass. The entire time, they communicated clearly.

There was one more room, an off-shoot to the left, that held a cage and two X-shaped structures one could be bound to. Whatever had been going on before I stepped in was over and the women there were busy getting dressed and cleaning the equipment.

My tour ended then, with an, “And there you go! Have fun!”

I did have fun, though I couldn’t help but feel a little like an outsider. I watched these men and women during intimate moments. A woman undressing while her friends bound her with thin rope. A young couple using the open floor space to wrestle, asserting dominance over each other. A lady in a frilly blue skirt being digitally stimulated by a man who looked like a sexy train conductor. I was a voyeur, drinking in the sights, but though I was fascinated, I wasn’t quite prepared for the role. I retreated after a while to the social room. Did I mention the hummus plate was delicious?

I left around midnight. The New Year. The ball had dropped, people were toasting. I left with nothing but positive impressions in mind.

But Sarha and I had agreed that you couldn’t gauge the Center based off one experience. And so a week later I returned. The full floor was open this time for a 12-hour lock-in event. I brought two women with me, neither of whom had ever been, to see how it felt to others.

On my return trip, the playroom I experienced the first time had been rearranged into a general activity room. There were more attendees as well, but fewer sexual activities. Instead, everyone was more focused on games like no-money strip poker and Cards Against Humanity.

My friends and I checked out the other half of the floor eventually, walking into a room I can only describe as cavernous. The floor was bare concrete, which tied up the winter cold and exposed it to us. Heat bars were plugged in, to little effect. A handful of lamps provided gloomy illumination.

There was plenty more room here to put on a show. Tables and mats were set up to lay and play upon. At the back, a silhouette screen and photographer were set up for discrete erotic photo sessions. To one side sat a Sybian. If you’re unfamiliar with those, it’s a sort of vibrating saddle to which you can secure a synthetic dick. A box nearby had an incredible assortment of different lengths, girths and angles.

The room was impressive and filled with orgasmic opportunities, but with so much cold and open space and with so few people occupying it, it felt almost too bare. I recalled my guide’s preference for the more intimate arrangements, and it made sense to me now. This felt less like a shared moment and more like an impersonal display, a sentiment shared by one of the women with me.

All the same, both of my companions–neither identified as particularly fetishistic or kinky–told me they could definitely feel the sense of comfort and community that permeated the walls of ACAL. It was a reminder, again, that this place was meant to be more than just a “sex club.”

My friends and I left and talked about the evening over drinks and in the days that followed I reached out to other members of Anchorage’s fetish and kink community to talk about their experiences in general and to see what their relationship with ACAL–if any–had been like. The majority of responses were positive, but not all of them.

In fairness and full disclosure, I did hear back from a pair of women who had been decidedly turned off by their visits. One lady told me she had been pressured multiple times by men ignoring the No Means No rule–victims of this harassment are encouraged to approach management immediately so the violator can be dealt with. Astoria, who gave me permission to use her name, told me she didn’t have confidence in the level of security or protection the club promised.

I can see how this could be a concern. Aside from having documented signatures and taking down license and ID numbers, there isn’t a way to effectively run background checks on everyone rolling through. Instead, members and guests are expected to be self-reliant and cautious through conversation. When it works–as in the case of convicted sex offender Daniel Eisman who broke his probation by attending last October–the nefarious entity is quickly rousted from the club. But when it doesn’t work? Well, it comes down to observation, communication, crossed fingers and a knock on wood.

That being said, my experiences with ACAL and my research into the community around it left me with the firm belief that these types of incidents are in the minority and that the heart of the organization beats around the desire to provide a sense of normalcy to lifestyles different than what most might be used to. They do this by promoting education, patience, discussion, acceptance and understanding that not everyone is going to get off to the same thing. And that’s okay! The lesson is to be comfortable with yourself.

Wrapping this up, I thought it best to end with something for people who might be on the fence. For that, I went back to the community. I asked Astoria–a 26-year-old local fetishist who says she’s tried just about everything–for one thing she would tell anyone curious about alternate lifestyles.

“SSC,” she said. “Safe, Sane and Consensual. That phrase is a big part of being kinky. People are in the lifestyle because it’s something they enjoy or need to get by with the rest of what life throws at you.”

Being safe, considerate of the comfort of others and treating people rationally. Crazy how key behaviors in an “alternative” lifestyle are the same things everyone should already be doing regularly.

And was there anything else I took home from the experience, I’m going to assume you’re asking. Did I come away with any new interests myself? Well, I’ll just have to get back to you. I’m a little tied up at the moment.

Complete Article HERE!

Nearly Half of U.S. Men Infected With HPV, Study Finds

Although a vaccine is available, too few are getting it when young

 

Many American men are infected with the cancer-causing human papillomavirus (HPV), but unlike women, men are more likely to stay infected throughout their lives, a new study finds.

About 45 percent of U.S. men are infected with the sexually transmitted disease, as are 45 percent of women. Among women, the prevalence of HPV infection drops to about 22 percent as they age, but it remains high among men, said lead researcher Dr. Jasmine Han. She is in the division ofgynecologic oncology at Womack Army Medical Center, in Fort Bragg, N.C.

“We don’t know why it stays high in men while it drops in women,” she said. “Among men it’s higher than expected.”

Han speculates that the virus may remain in men because it lives in the penile glands, while in women, the virus is near the surface of the vagina and is more easily shed.

Although a vaccine against HPV has been available since 2009, coverage remains low. Only about 11 percent of men and 33 percent of women have been vaccinated, Han said.

HPV is the most common sexually transmitted disease among men and women in the United States, according to background information in the study. About 79 million Americans are infected with some type of HPV, with approximately half of new infections occurring before age 24, the study authors said.

Most people infected with HPV don’t know they have it and don’t develop health problems from it, according to the U.S. Centers for Disease Control and Prevention.

But HPV is not a benign infection. More than 9,000 cases of HPV-related cancers occur in men each year. HPV is the cause of 63 percent of penile, 91 percent of anal, and 72 percent of oral and throat cancers, the researchers noted.

In addition, HPV among men is an indirect cause of cervical cancer in women. The virus is also responsible for 90 percent of genital warts. HPV can also lead to tumors in the respiratory tract, called respiratory papillomatosis.

Han believes that the HPV vaccine should be mandatory for both boys and girls.

The CDC recommends that all boys and girls aged 11 to 12 get two doses of the HPV vaccine.

“We want our children to be vaccinated with the HPV vaccine because it is a cancer vaccine,” Han said. “By getting vaccinated, you can prevent your sons and daughters from getting these HPV-associated cancers in later years,” she explained.

Fred Wyand is a spokesman for the American Sexual Health Association/National Cervical Cancer Coalition. “This study underscores that HPV is common in men, and that’s true throughout most of their lives,” he said.

“We’re doing a better job of getting young males vaccinated against HPV, but uptake is still way below the levels we’d like to see,” Wyand added.

To get parents to accept the vaccine for their children, Wyand suggested that doctors need to give a “clear, strong recommendation for vaccination and treat HPV immunization as a normal, routine part of adolescent vaccinations.”

To gauge the prevalence of HPV infection among men, Han and colleagues used data on nearly 1,900 men who took part in the 2013-2014 U.S. National Health and Nutrition Examination Survey. Samples from penile swabs were tested for HPV.

Overall, a little more than 45 percent of the men were infected with the cancer-causing virus. Among vaccine-eligible men, however, only about 11 percent had been vaccinated.

The lowest prevalence of the virus among men was about 29 percent for those aged 18 to 22, which increased to nearly 47 percent in men aged 23 to 27 and stayed high and constant as men aged, Han said.

It’s possible that the lower rate among younger men may have resulted from young men being vaccinated, the researchers said.

The report was published online Jan. 19 in the journal JAMA Oncology.

Complete Article HERE!

Talking With Both Daughters and Sons About Sex

By

Parents play a key role in shaping sexual decision-making among adolescents — especially for girls.

A 2016 review of more than three decades of research found that teenagers who communicated with their parents about sex used safer sexual practices. Likewise, new research from Dutch investigators who studied nearly 3,000 teenagers found that young adolescents who reported feeling close with a parent were unlikely to have had sex when surveyed again two years later.

Notably, both research teams found that daughters benefited more than sons, and that the effective conversations and relationships were typically had with mothers.

According to Laura Widman, lead author of the review study and an assistant professor of psychology at North Carolina State University, “parents tend to talk about sex more with daughters than with sons, and we can speculate that that’s what’s probably driving these findings. Boys may not get the messages as frequently or have the kind of in-depth conversations that parents are having with girls.”

Given the results of her research, Dr. Widman said that she “wouldn’t want parents to get the idea that they only need to talk to daughters. In fact, it may be the opposite. We need to find a way to help parents do a better job of communicating with both their sons and daughters so that all teens are making safer sexual decisions.”

That parents have more frequent conversations with their daughters about sex and sexual development may be prompted by biological realities. Menstruation, HPV vaccination (which remains more common in girls than boys), and the fact that birth control pills require a prescription might spur discussions that aren’t being had with sons.

Yet experts also agree that gender stereotypes play a powerful role in sidelining both fathers and sons when it comes to conversations about emotional and physical intimacy. Andrew Smiler, a psychologist who specializes in male sexual development, noted that women generally “have a better vocabulary for talking about feelings and relationships than boys and men do. Fathers may be a little more stoic, more reserved and more hands-off.” And, he added, “they may play to the stereotype of trusting boys to be independent and able to care for themselves.”

These same stereotypes can also tend to steer the conversation in one direction with daughters and another direction with sons. When parents do address sexual topics with their teenagers, they typically adopt a heterosexual frame with boys playing offense and girls playing defense.

“We usually view our girls as potential victims who need to be protected from pregnancy and rape,” says Sheryl Ziegler, a psychologist who provides mother-daughter seminars on puberty and sexual development, while boys are often cast as testosterone-fueled prowlers looking for nothing but sex. These assumptions often drive how parents approach the conversation. Dr. Mary Ott, an associate professor of pediatrics at Indiana University and the author of a research synopsis on sexual development in adolescent boys observed that, “when parents talk with boys, there’s an assumption that they’ll have sex and they are advised to use condoms. Whereas for girls, there’s more of a focus on abstinence and delaying sex.”

Parental concern about the negative consequences of adolescent sexual activity can reduce “the talk” to a laundry list of don’ts. Don’t get a sexually transmitted infection, don’t get pregnant or get a girl pregnant and don’t proceed without gaining consent. Critical as these topics are, Dr. Ziegler points out that they can “become the focus, so much more than having a quality conversation about why we are sexual beings, or talking about all of the ways we can express love.” And failing to acknowledge the pleasurable side of sex can, according to Dr. Smiler, hurt the credibility of adults. “When parents only acknowledge the scary side of the story,” he said, “teenagers can devalue everything else the parents have to say.”

So how might we do justice to conversations with both our daughters and sons about emotional and physical intimacy?

Over the years in my work as a clinician, I’ve come to a single tack that I take with adolescent girls and boys alike. First, I prompt teenagers to reflect on what they want out of the sexual side of their romantic life, whenever it begins. Why are they being physically intimate, what would they like to have happen, what would feel good?

Following that, I encourage each teenager to learn about what his or her partner wants. I urge them to secure not just consent, but enthusiastic agreement. Given that we also grant consent for root canals, gaining mere permission seems, to me, an awfully low bar for what should be the joys of physical sexuality. Dr. Smiler adds that any conversation about consent should avoid gender stereotypes and address the fact that boys experience sexual coercion and assault and “include the idea that boys can and do say no.”

Finally, if the parties are enthusiastically agreeing to sexual activity that comes with risks — pregnancy, infection, the potential for heartbreak, and so on — they need to work together to address those hazards.

Research suggests that this shouldn’t be a single sit-down. The more charged the topic, the better it is served, and digested, in small bites.

Further, returning to the topic over time allows parents to account for the rapidly shifting landscape of adolescent sexual activity. We should probably be having one conversation with a 12-year-old, an age when intercourse is rare, and a different one with a 17-year-old, half of whose peers have had sex.

Is it better for mom or dad to handle these discussions? Teenagers “want to have the conversation with someone they trust and respect and who will show respect back to the teen,” Dr. Smiler said. “Those issues are more important than the sex of the person having the conversation.”

How families talk with teenagers about their developing sexuality will reflect the parents’ values and experiences but, Dr. Ott notes, we’re all in the business of raising sexually healthy adults.

“We want our teenagers to develop meaningful relationships and we want them to experience intimacy,” she said, “so we need to move our conversations about sex away from sex as a risk factor category and toward sex as part of healthy development.” And we need to do so with our sons as well as our daughters.

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