Category: Health Concerns

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Why Sexual Health Matters

— An Essential Aspect of Overall Well-Being

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Regarding our overall well-being, it is crucial not to overlook sexual health. While physical and mental health often take the spotlight, we must not underestimate the importance of sexual health in maintaining a fully functional life. It impacts our physical well-being and plays a significant role in emotional stability. Therefore, prioritizing this aspect of our well-being is essential. In this blog post, we will delve into how good sexual health contributes to a healthier lifestyle.

1. Contributes to Longevity

Good sexual health can remarkably contribute to longevity. Regular sexual activity has been linked to an extended lifespan, promoting physical health in many ways. It works as a form of exercise, burning calories, and strengthening muscles, and it can also boost the immune system, helping the body fend off illness and disease.

Furthermore, it stimulates the release of endorphins and other hormones with myriad health benefits, such as reducing stress, improving sleep, and enhancing heart health. The doctors at Atlanta Men’s Clinic usually recommend regular sexual activity for their patients, which can significantly contribute to a longer and healthier life. Testosterone therapy, a treatment for low testosterone levels, is also known to improve sexual health and overall well-being.

2. Enhances Emotional Connection

Sexual activity can foster a deep emotional connection, especially with an intimate partner. During sex, our bodies release oxytocin, a hormone that promotes feelings of bonding and trust. This strengthens the bond between partners and helps improve overall mental well-being.

Moreover, regular sexual activity can boost self-esteem and confidence, leading to a more positive outlook. For individuals struggling with mental health issues, such as depression or anxiety, incorporating good sexual health practices can significantly impact their emotional well-being. It allows for a safe and intimate space to connect with another person, which can be incredibly therapeutic.

3. Prevents Sexual Dysfunction

Maintaining good sexual health plays a pivotal role in preventing sexual dysfunction. This is an umbrella term for conditions that prevent an individual from enjoying or participating in sexual activity. These conditions include erectile dysfunction, low libido, premature ejaculation among men, arousal disorders, orgasmic disorders, and sexual pain disorders among women.

Regular sexual activity can increase blood flow to the genitals, which can help prevent or alleviate erectile dysfunction. Moreover, maintaining a healthy lifestyle – incorporating exercise, balanced nutrition, adequate sleep, and reduced stress levels – can notably improve sexual performance and prevent dysfunction. Regular check-ups with medical professionals can also help identify and treat underlying issues.

4. Promotes Communication and Consent

Good sexual health practices also involve open and honest communication with sexual partners. Conversations about boundaries, desires, and consent can create a safe space for both individuals to express themselves freely. This not only leads to a more fulfilling sex life but also promotes healthy relationships.

Furthermore, being aware of one’s sexual health and practicing safe sex is crucial in preventing sexually transmitted infections (STIs). Regular STI screenings, protection, and vaccination can significantly reduce the risk of contracting or spreading infections.

5. Promotes Heart Health

Sexual activity serves as a form of exercise that promotes heart health. During sexual activity, the heart rate rises, increasing blood circulation throughout the body, including the heart itself, thereby strengthening the cardiovascular system. It also helps lower blood pressure, a key factor in heart disease prevention.

In addition, engaging in sexual activity releases hormones like oxytocin and endorphins, which can effectively alleviate stress and anxiety, thereby promoting heart health. Given that stress and anxiety are recognized as risk factors for heart disease, reducing these factors can significantly lower the likelihood of developing cardiac problems. Therefore, incorporating regular sexual activity into a well-rounded lifestyle can play a vital role in maintaining a healthy heart.

6. Improves Sleep Quality

Sexual activity has been linked to improved sleep quality due to the release of certain hormones. Post orgasm, the body releases prolactin, a hormone that contributes to feelings of relaxation and sleepiness. Moreover, the previously mentioned oxytocin, also known as the ‘love hormone,’ fosters emotional bonding and promotes better sleep.

This is because oxytocin counteracts the effects of cortisol, the stress hormone, thus helping the body to relax and enabling more restful sleep. Additionally, the physical exertion associated with sexual activity can contribute to better sleep, as it can help tire the body out, making it easier to fall asleep and stay asleep. Therefore, regular sexual activity can benefit good sleep hygiene, contributing to more restful and rejuvenating sleep.

Sexual health should not be overlooked when it comes to maintaining overall well-being. Incorporating good sexual health practices into our daily lives can improve physical, emotional, and relational well-being. Whether it is through regular sexual activity, communication, and consent with partners, or prioritizing medical check-ups, taking care of our sexual health can have a positive impact on our overall health and longevity. So, let us not underestimate the importance of sexual health and make it a priority in our self-care routines.

Complete Article ↪HERE↩!

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

— A Pill After Sex

By Apoorva Mandavilli

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article ↪HERE↩!

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Ways To Ask Your New Partner To Get Tested This Sexual Health Awareness Month

By Zayna Allen

Having new sexual partners can be fun and exciting, but it’s important to make responsible decisions. That includes having tough conversations. But luckily for you, September is Sexual Health Awareness Month! What better time to have an open and honest discussion about one of the most crucial aspects of any romantic relationship: sexual health.

Sexual health awareness empowers individuals to make informed decisions about their physical and emotional well-being. It also helps maintain trust and transparency in a relationship, whether long-term or just for the moment.

One of the most essential discussions with a new partner is getting tested for sexually transmitted infections. While this conversation may feel daunting, it’s necessary for any sexual dynamic to keep you and your partner safe. Here are some ways to have the conversation with ease.

Conversations About Getting Tested

Consider Timing

One of the most important aspects about initiating this type of conversation is choosing the best moment. Timing is everything. Avoid discussing this sensitive topic when you or your partner are stressed, tired, or in the middle of an argument. When introducing the conversation, make sure to make it as normal as possible. Begin by stressing that sexual health is a part of responsible adulting. Present the idea of getting tested as something you both do for each other’s peace of mind. Emphasize that it’s not about trust but rather about taking care of each other’s health.

Use “I”

As with any difficult conversation with a partner, using “I” statements is essential. This helps you avoid sounding accusatory. For example, say, “I think it’s important for both of us to get tested” instead of “You should get tested.” Creating a safe space should be one of the top priorities.

Remain Patient and Supportive

Although you are doing your best to create a calm conversation, you should always brace yourself for their reaction. Your partner could be entirely on board, or they could take offense to the conversation and need some time to think. No matter what, you should remain patient and supportive regardless of their initial response.

Respect Your Partner

Respect your partner’s decision, whatever it may be. Whether they agree to get tested immediately or need more time, continue to communicate openly and empathetically about your relationship’s health and well-being. Stand firm on your stance that this is important to you.

Lead With Confidence

Asking your new partner to get tested doesn’t have to be awkward. Remember to embrace it with confidence and compassion, knowing it’s vital to nurturing the dynamic between you.

Complete Article ↪HERE↩!

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Sex after prostate cancer

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

Why this happens

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

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

Prostate cancer treatment and erectile dysfunction

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

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

Recovery after prostate cancer treatment

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

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

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

Rehabilitation and aids

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

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

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

Complete Article ↪HERE↩!

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List of Sex Hormones in Females and Males

By Serenity Mirabito RN, OCN 

Sex hormones are chemicals responsible for reproduction and sexual desire. Common female sex hormones include estrogen and progesterone, while testosterone is abundant in most males.

Sex hormones are produced by the ovaries, testes, endocrine system, and adrenal glands. Menstruation, age, and certain medical conditions can cause fluctuations in sex hormones. Females and males can balance sex hormones through hormone deprivation or replacement therapy.

This article will review sex hormone production, function, and ways to achieve hormonal balance.

Sex vs. Gender

This article uses the terms “male” and “female” as labels referring to a person’s chromosomal, anatomical, or biological makeup without regard to which gender or genders they identify with.

Where Are Sex Hormones Produced?

Females and males have different sex hormones. However, they do share some of the same ones but each with different functions.

Females

The main hormones that contribute to sexual health and desire in females are estrogen, progesterone, and testosterone. Although the ovaries are responsible for most female sex hormones, other tissues can also produce them. These include:1

  • Estrogen (estradiol, estrone, estriol): Although made primarily by the ovaries, estrogen is also produced by the adrenal glands and adipose (fat) tissue.
  • Progesterone: Besides the ovaries, progesterone is produced by the adrenal cortex, corpus luteum, and placenta.
  • Testosterone: Although more abundant in males, testosterone is also essential in females. Testosterone is made in small amounts by the ovaries and adrenal glands.

Males

Androgens are the main sex hormones produced by males. Androgens are responsible for male characteristics and reproduction. Several types of androgens are made in the male body, which include:1

  • Testosterone: Produced in the Leydig cells of the testes and small amounts in the adrenal gland.
  • Dihydrotestosterone (DHT): In adults, about 10% of testosterone is metabolized into DHT by the enzyme 5-alpha reductase. A rise in DHT levels initiates puberty in younger males.
  • Estrogen: This hormone plays a vital role in males. In addition to being produced by the testes, the enzyme aromatase converts testosterone into estrogen.2

Function of Each Sex Hormone

Sex hormones are not only responsible for sexuality and fertility but also are crucial for the growth and development of muscles and organs.1 Additionally, sex hormones help prevent medical conditions such as cardiovascular disease and bone deterioration.

Growth and Development

Estrogen is responsible for the sexual and reproductive development of females. Breast development, pubic and armpit hair, and the start of menstruation are all influenced by estrogen.1

Progesterone contributes to a healthy uterine lining for the implantation and growth of a fertilized egg.3 Progesterone is also essential for maintaining pregnancy and reducing bleeding and miscarriage.

Testosterone and DHT initiate puberty in young males.1 These hormones are responsible for penile and testicular growth, growth in height, and facial hair growth.

Arousal

Estrogen and testosterone are the main hormones affecting arousal and sexual desire. In females, the menstrual cycle causes fluctuations in sex hormones, resulting in feeling more aroused just before ovulation, when estrogen levels are at their highest.4

High levels of progesterone, however, can cause a decrease in sexual desire. Although testosterone may increase libido in some females, estrogen is the primary sex hormone linked to female sexual desire.4

In males, testosterone levels correlate to male libido. Age, obesity, and hypogonadism decrease testosterone, thereby reducing sexual arousal.

Organ Health

Estrogen and testosterone are important in preserving muscle strength as you age. In the first year of menopause, for example, about 80% of a female’s estrogen is lost, resulting in significant muscle loss and frailty.

Decreased estrogen levels can lead to osteoporosis (decrease in bone mass and density) and increased risk of cardiovascular events. Testosterone improves cachexia (complicated metabolic syndrome characterized by muscle mass loss) in cancer and other inflammatory-based conditions.5

Immune System

One study showcased how sex hormones influence immune system cells. Androgens (testosterone and DHT) and progesterone boost an immunosuppressive response (improving autoimmune disorders), while estrogen strengthens humoral immunity (the body’s ability to fight infection). However, more research is needed.6

Mood and Brain Function

Research continues to prove that sex hormones affect the entire brain. Depression, memory loss, brain plasticity, and mood disorders result from decreasing estrogen levels. Cognitive impairment during menopause has been shown to improve with estrogen treatment and may protect against stroke damage, Alzheimer’s disease and Parkinson’s disease.7

How Sex Hormones Fluctuate

Hormone fluctuation is normal in both sexes. Premenopausal females will experience hormonal changes throughout the menstrual cycle. Estrogen and progesterone levels are low just before the start of menstruation but are higher around ovulation. As females age, sex hormone levels drop, leading to menopause.8

In males, testosterone levels are highest in the morning and decrease throughout the day. Testosterone decreases at 1% to 3% yearly between 35 and 40.5

Sex Hormone Disorders

Sex hormone disorders can affect physical and mental quality of life. In some instances, they can even be deadly. Types of sex hormone disorders include:

  • Premenstrual dysphoric disorder (PMDD): Due to falling levels of estrogen and progesterone 10 to 14 days before menstruation, severe depression and anxiety can be experienced by some females. PMDD affects approximately 5% of premenopausal females.9
  • Menopause: Females 45 to 55 will begin to notice the inevitable symptoms of decreasing estrogen and progesterone levels. Brain fog, reduced muscle mass, and hot flashes are common symptoms of menopause.10
  • Erectile dysfunction (ED): As testosterone levels fade with age, having and maintaining an erection can be difficult. ED usually occurs in men over age 50.11
  • Hyperestrogenism (high estrogen levels): Too much estrogen can cause certain types of cancer, polycystic ovary syndrome (PCOS), and infertility.
  • Hyperandrogenism (high androgen levels): Too much testosterone can cause PCOS, hirsutism, acne, male-pattern baldness, menstrual irregularities, infertility, and virilization.

Can You Balance Sex Hormones?

Understanding the cause of sex hormone imbalances is essential to creating a treatment plan. If the sex hormone imbalance is due to a medical condition, then treating that condition should be considered. If the hormonal imbalance is due to aging or there is no treatment for the cause, then the following options could help improve sex hormone imbalances.

  • Lifestyle: Eating a well-balanced diet, exercising, maintaining a healthy weight, eliminating alcohol use, and getting enough sleep can impact hormone levels in a positive way.12
  • Herbs and supplements: Some herbs and supplements claim to restore hormonal balance. Nigella sativa could increase estrogen levels, improving the symptoms of menopause.13
  • Hormone therapy (HT): Replacing estrogen, progesterone, and testosterone with synthetic (human-made) forms can help increase low levels of sex hormones. HT can be given as oral medication, patches, creams, vaginal suppositories, subdermal pellets, or injections. Birth control is a form of hormone therapy. HRT is also a vital part of gender-affirming care.14
  • Hormone deprivation therapy: Some medications block hormones, reducing the effects of having too much of a particular hormone. Aromatase inhibitors, for example, prevent estrogen production, and gonadotropin-releasing hormone analogs and antagonists are used to block estrogen, progesterone, and testosterone. Gonadotropin-releasing hormone analogs are used to pause puberty in youths undergoing gender-affirming care.14

If you’re experiencing symptoms of sex hormone imbalances, talk to a healthcare provider about having a sex hormone blood test done to help identify potential imbalances.

Summary

Estrogen, progesterone, testosterone, and dihydrotestosterone (DHT) are sex hormones in males and females. Sex hormones are important in reproduction, fertility, sexual desire, and overall health. Sex hormones fluctuate with the menstrual cycle and with age.

There are several ways you can balance sex hormones, including lifestyle changes and medications. Talk to a healthcare provider if you believe you’re experiencing symptoms of a sex hormone imbalance.

Complete Article ↪HERE↩!

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Women’s sexual desire often goes undiscussed

– Yet it’s one of their most common health concerns

Many women are afraid to voice concerns about low desire to their doctors.

By

Female sexual desire is frequently misunderstood. Despite desire (also known as libido or sex drive) being the most common sexual health concern for women, most women aren’t really taught about it growing up. And if they are, the information is often inaccurate.

This lack of education not only perpetuates misinformation, stigma and shame about female sexual desire, it can also have a major effect on wellbeing and perceptions of satisfaction in intimate relationships.

Discrepancies in sexual desire and satisfaction are often reported as key reasons for relationship difficulties. Low sexual desire also has a negative impact on body image and self-confidence.

But it’s never too late to understand desire and the many ways it can change – not just each day, but throughout life.

Desire is constantly changing

Sexual desire is best understood as a transient state. This means it can be affected by an array of factors – including stress, hormones, physical and mental health, certain medications, lifestyle and the balance of intimacy and eroticism in a relationship.

Desire is also a multifaceted response, which can either follow or occur at the same time as pleasure or arousal. This means feeling “in the mood” may not happen until after a woman is aroused. Desire can also occur with or without a partner and will vary in frequency and intensity. Sexual desire can also be affected by many environmental factors, which helps explain why it may wane during periods of stress or in longer term relationships.

Even factors such as gender roles and norms are thought to cause low sexual desire for women in heterosexual relationships. One study proposes that the inequities in the division of household labour, the objectification of women and gender norms surrounding sexual initiation (in which men are presumed to be the primary instigators of sex while women are presumed coy), all result in low sexual desire for women.

Understanding that desire is a transient and multifaceted response can help women to see that low desire isn’t a problem with our bodies – and that treating it may be a matter of addressing problems in other parts of their lives. It also helps to understand that it’s normal for desire to change and fluctuate, even on a daily basis, depending on what’s going on in a person’s life.

Certain life transitions can have a major effect

Pregnancy, the post-partum period, perimenopause and menopause are all significant transitional periods in women’s lives that can also have a major impact on sexual desire.

There are a number of reasons why this may be. For example, body changes that may happen during these transitional periods can affect body image and self-esteem, which in turn affects desire. Hormone changes can affect mood, and may also result in physical changes – such as vaginal dryness and dyspareunia (genital pain that occurs before, during or after sex), which are known to affect desire.

Perineal trauma (damage to the perineum during birth) can cause pain which may make women desire sex less. Experiences of pregnancy loss and infertility are also shown to lower sexual desire.

Importantly, these life transitions also affect other areas of our lives – and may lead to stress, fatigue, changes in relationship roles and less time for intimacy. This can all, in turn, lead to lower sexual desire.

Expecting that sexual desire may change or decrease during these periods can be helpful, as it may reduce self-blame and shame.

Desire can be cultivated

Desire can be cultivated at any stage of life. Recent psychosocial approaches to addressing low sexual desire emphasise the importance of balancing intimacy and eroticism, which is a focus on sensuality and pleasure over arousal and orgasm. Research indicates that, while intimacy is essential in healthy partnered sexuality, eroticism helps increase desire by promoting mystery and sexual excitement.

Sexual desire experts also suggest good strategies for cultivating desire including regularly communicating what feels good and what doesn’t with your partner, planning for sexual activity and finding ways to reduce distraction so you can focus on your body during sex.

Evidence-based treatments for low desire include mindfulness therapy, which can help women reduce distraction, increase focus on the sensations, thoughts and emotions they’re experiencing in the moment and help target negative self-judgment. Another treatment, sensate focus touch, which involves using non-sexual touch to promote more open sexual communication among couples, has also been shown to increase desire.

Sexual desire is unique to each person. If women were taught what sexual desire is and what to expect across our lives, they would be less likely to suffer the ill effects of this misunderstanding. Sexual desire is not a problem to be solved – but a skill to be learned and cultivated throughout life.

Complete Article ↪HERE↩!

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Can Men Get Periods?

— Cisgender men don’t have menstrual periods, but testosterone levels vary from day to day, which may cause some mental and physical effects.

By Kimberly Holland

Like women, men experience hormonal shifts and changes. Every day, a man’s testosterone levels rise in the morning and fall in the evening. Testosterone levels can even vary from day to day.

Some claim that these hormonal fluctuations may cause symptoms that mimic the symptoms of premenstrual syndrome (PMS), including depression, fatigue, and mood swings.

But are those monthly hormonal swings regular enough to be called a “male period”?

Yes, claims psychotherapist and author Jed Diamond, PhD. Diamond coined the term Irritable Male Syndrome (IMS) in his book of the same name, to describe these hormonal fluctuations and the symptoms they cause, based on a true biological phenomenon observed in rams.

He believes cisgender men experience hormonal cycles like women. That’s why these cycles have been described as “man-struation” or the “male period.”

A woman’s period and hormonal changes are the result of her natural reproductive cycle, sex therapist Janet Brito, PhD, LCSW, CST says. “The hormonal changes she endures are in preparation for possible conception. [Cisgender] men do not experience the cycle of producing ovocytes, nor do they have a uterus that gets thicker to prepare for a fertilized egg. And if conception does not occur, they do not have a uterine lining that will be released from the body as blood through the vagina, which is what is referred to as a period or menstruation,” Brito explains.

“In this definition, men do not have these types of periods.”

However, Brito notes that men’s testosterone levels can vary, and some factors can influence testosterone levels. As these hormones shift and fluctuate, men may experience symptoms.

The symptoms of these fluctuations, which may share some similarities with symptoms of PMS, may be as close to “male periods” as any man will get.

IMS is supposedly the result of dipping and oscillating hormones, specifically testosterone. However, there’s no medical evidence of IMS.

However, it’s true that testosterone plays an important role in a man’s physical and mental well-being, and the human body works to regulate it. But factors unrelated to IMS can cause testosterone levels to change. This is thought to lead to unusual symptoms.

Factors that can influence hormonal levels include:

  • age (a man’s testosterone levels start declining
    as early as age 30)
  • stress
  • changes in diet or weight
  • illness
  • lack of sleep
  • eating disorders

These factors can also impact a man’s psychological well-being, Brito adds.

The symptoms of so-called IMS mimic some of the symptoms women experience during PMS. However, IMS doesn’t follow any physiological pattern the way a woman’s period follows her reproductive cycle, as no hormonal basis of IMS exists. That means these symptoms may not occur regularly, and there may be no pattern to them.

Symptoms of IMS are vague and have been suggested to include:

  • fatigue
  • confusion or mental fogginess
  • depression
  • anger
  • low self-esteem
  • low libido
  • anxiety
  • hypersensitivity

If you’re experiencing these symptoms, there is likely something else going on. Some of these symptoms may be the result of testosterone deficiency. Testosterone levels do naturally fluctuate, but levels that are too low can cause problems, including:

  • lowered libido
  • behavior and mood problems
  • depression

If these symptoms persist, make an appointment to talk with your doctor. This is a diagnosable condition and can be treated.

Likewise, middle-aged men may experience symptoms as their natural levels of testosterone begin to fall. This condition, colloquially called andropause, is sometimes referred to as male menopause.

“When it comes to andropause, which does show up in the [anecdotal] research, the symptoms tend to be fatigue, low libido, and [it] tends to affect middle-aged men due to low testosterone levels,” Dr. Brito says.

Lastly, the term male period or man-struation is used colloquially to refer to blood found in urine or feces. However, Brito says, bleeding from the male genitals is often the result of parasites or an infection. No matter where the blood is located, you need to see your doctor for a diagnosis and treatment plan as soon as possible.

IMS isn’t a recognized medical diagnosis, so “treatment” aims to:

  • manage symptoms
  • adapt to the emotions and mood swings when they
    occur
  • find ways to relieve stress

Exercise, eating a healthy diet, finding ways to relieve stress, and avoiding alcohol and smoking may help stop these symptoms from happening. These lifestyle changes can also help a variety of physical and mental symptoms.

However, if you believe your symptoms may be the result of low testosterone, see your doctor.

Testosterone replacement may be an option for some men with low hormone levels, but it does come with risksTrusted Source.

If your doctor suspects another underlying cause, they can schedule tests and procedures to help rule out other problems.

If you believe your partner shows signs of severe hormonal changes or low testosterone, one of the best ways to help him is to have a conversation. You can help him seek out professional help and find ways to manage any symptoms, regardless of their underlying cause.

Bad days that cause crabby attitudes are one thing. Persistent emotional or physical symptoms are something entirely different, and they’re a possible indication that you should see your doctor.

“[Symptoms] are serious if they are bothering you. See a doctor if your symptoms bother you. See a sex therapist if you need help revitalizing your sex life or see a mental health professional if you are experiencing depression or anxiety,” Brito says.

Likewise, if you’re bleeding from your genitals, you should seek medical attention. This isn’t a form of a male period and instead may be a sign of an infection or other condition.

Complete Article ↪HERE↩!

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How to keep your sex life thriving after prostate cancer

— Poor sexual function is the most common consequence of prostate cancer treatment, but support through the NHS is patchy and many men suffer in silence.

By Laura Milne

When BBC presenter Gabby Logan and her husband Kenny, the former Scotland rugby union winger, experienced difficulties with their sex life after he had his prostate removed last year, rather than keep it under wraps, they decided to make a podcast about it.

The couple, who have been married for 22 years, discussed their issues in an interview about Kenny’s prostate cancer diagnosis and subsequent erectile dysfunction on Gabby’s podcast The Mid Point.

Kenny, 51, who won 70 international caps representing Scotland, said his wife, 50, had expected the passion in their relationship to be reignited “immediately” after his operation and when he was unable to perform, it knocked his confidence badly.

He said: “When we first tried to have sex after the operation, Gabby said, ‘Oh, it’s not working, that’s it, it’s not working’. You didn’t even give me a chance. What actually happened from that was my confidence went rock bottom.

Gabby and Kenny’s experience is far from unusual. In the UK, prostate cancer is the most commonly diagnosed cancer in men and more than 395,000 were living with it, or had been successfully treated for it, in 2018.

According to the Life After Prostate Cancer Diagnosis (LAPCD) study of 35,000 men in the UK, funded by men’s health charity Movember, poor sexual function is the most common consequence of prostate cancer treatment (79 percent with prostate cancer compared with 48per cent of men in the general population).

Unfortunately, the problem remains one that is either not addressed routinely or at all in prostate cancer care.

The LAPCD study found that 56 per cent of men were not offered any help with sexual dysfunction following their treatment.

Problems with sex can lead to stress, anxiety, anger and even shame.

Some men don’t like to talk about vulnerable feelings because they think they should be “strong and silent”. Others avoid talking because they’re overwhelmed or trying not to burden their partner.

But learning how to face these challenges and work through them can strengthen your sexual wellbeing, explains Dr Karen Robb, Implementation Director for Cancer at Movember. “Sexual wellbeing – the balance between the physical, social and emotional aspects of sex – has not always been a common topic of conversation, but fortunately that is changing,” she says.

“Talking about sex after prostate cancer can be uncomfortable but open communication between you and your partner, if you have one, is a key part of sexual recovery following treatment. Acknowledge what has changed for you so that you can do something about it, with the right support.”

Almost every kind of prostate cancer treatment, including surgery, can cause sexual dysfunction, the most common of which is erectile dysfunction or ED, following a prostatectomy (surgical removal of the prostate).

This means that although you may feel aroused or in the mood for sex, chances are you’ll have difficulty getting an erection.

Why does ED happen after prostate cancer surgery?

“Surgery to remove the prostate affects the nerves and blood supply around the penis,” explains Karen. “The penis needs a healthy blood flow to get an erection. Without this, it won’t become as hard as it did before surgery.”

During surgery, the entire prostate is removed. The nerves that help create erections run down the left and right sides of the prostate gland. The surgeon can usually take out the prostate without causing permanent harm to the nerves on either side.

But if your cancer is too close to the nerves, they may need to be cut out.

How long does ED last after surgery?

It might take some time to improve, and the level of function you get back depends on a number of things including your age, lifestyle, any medications you take and whether you had nerve-sparing surgery.

As Karen explains: “Some things you can work on, such as exercise and keeping a healthy weight.

“Some are a bit more out of your control. However, all are things you can talk about with your doctor and see what recommendations they have that can help.”

What can you do about ED after prostate cancer?

Sex and intimacy after prostate cancer can look different for everyone, but there are options to keep your sex life thriving. Exploring new ways to have sexual pleasure and intimacy is essential after treatment and can even be a way of improving your erections.

There are different types of ­medication and sexual aids that you can try, all with pros and cons.

Everyone is unique so you may need to try out a few options a number of times and perhaps in combination to settle on the best solution for you. Discuss this with your healthcare provider.

To support men and their partners following prostate cancer treatment, Movember has launched an evidence-based online guide
called Sex and Intimacy After Prostate Cancer.

Informed by sexual health experts, it covers ED, dealing with physical changes after surgery, connecting with a partner, restoring intimacy, and coping with stress and anxiety. It also provides practical strategies, such as exercises, information about medication and devices, and how to have conversations with your doctor or care team.

“It’s vital to talk and not to just ignore it”

Chris Pedlar, 56, took early retirement from the Environment Agency in 2022 after 33 years, and lives with his partner in Devon. Nine years ago, Chris became the third generation in his family to bediagnosed with prostate cancer.

“My grandfather died from prostate cancer and my father was treated for it when he was 60. He went on to live for another 25 years, cancer free. He made sure that I started having PSA tests at 45 and I was picked up as having medium-risk cancer at 48.

“I opted for surgery rather than radiotherapy as I knew I would have the option of additional radiotherapy later on.

“Due to my father’s experience, I knew beforehand what to expect. Although I recovered quickly from the surgery itself, I had some of the usual side effects, including erectile dysfunction and some minor urinary problems, which I’ll have for life. I tried all the usual interventions such as injections, which made me feel terrible, and pumps which, while they serve a purpose, are a huge commitment. It didn’t put me off seeking advice though.

“Sex is an important part of a relationship and just because you’ve had a cancer diagnosis, it doesn’t mean that part of your life is over.

“Cancer can put a massive strain on a relationship – it affects both partners and you need to be able to talk about it honestly with each other. My partner and I have found that humour is the best way to deal with the problems we had, and I was determined from day one, this was not going to get me down.

“Because of the stage my cancer was at when it was discovered, I wasn’t able to have nerve-sparing surgery. That meant drugs like sildenafil (Viagra) shouldn’t have worked for me because of the nerve damage caused by the surgery. Everyone’s situation is different, but I never gave up hope, and after three years I asked my doctor if I could give sildenafil a try to see if it would help in any way, and I was pleasantly surprised to find it worked for me.

“From the beginning, I decided to be very open about my cancer. I recognise that not everyone deals with the experience in the same way. A lot of men bury their heads in the sand and won’t ask for help, even though it is having a negative impact on their lives.

“I was comfortable with talking to my doctor about ED because I wanted to find a solution – but a lot of men are reluctant to even mention it and so they just suffer in silence, which can have a negative effect on their mental health and their relationships.

“We need to work harder to break down those barriers that prevent men from talking about problems seeking help and seeing their GP when they need to.”

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Anal Douching

— How to Prepare and Do It Safely

If you’ve ever considered exploring anal play, it’s natural to have concerns about the potential mess involved. While this mess is nothing to be ashamed of, many people seek a cleaner experience and turn to anal douching. Let’s explore precisely what anal douching is and how to do it safely so that you can focus on pleasure rather than the mess.

By Rhiannon John, MSexol

  • Anal douching involves flushing the rectum with a liquid solution using tools like shower enemas, bulb enemas, fleet enemas, or enema bags.
  • People douche to reduce fecal matter in the rectum for a cleaner experience during anal sex, regardless of sexual orientation.
  • Some research suggests that anal douching may damage the protective cells in the rectum, potentially increasing the risk of STI and HIV transmission.
  • Alternatives to douching include maintaining a high-fiber diet, using wipes for cleanup, using a sex blanket or dark-colored sheets for sheet protection, and prioritizing personal comfort and enjoyment during anal play.

Anal douching explained

Anal douching refers to the practice of cleaning or flushing out the rectum by introducing a liquid solution into the anus. It involves using a specialized device or tool, such as a shower enema, bulb enema, fleet enema, or enema bag, to flush water or a mild saline solution into the rectal area.

The process typically involves filling the device with the desired cleansing solution, gently inserting the nozzle into the anus, and releasing the liquid into the rectum. After a brief period, the expelled liquid and any residual waste are eliminated by emptying the bowels.

Why do people douche?

Many individuals choose to douche to minimize fecal matter in their rectum, providing a cleaner experience during receptive anal sex and reducing concerns about the potential mess. Although it is frequently practiced within the gay community, anal douching can be utilized by anyone interested in engaging in anal play.

Is it anal douching safe?

Some research has found that using anal douches can lead to damage to the outer layer of cells that line the inner surface of the rectum. These cells serve as a protective barrier and are crucial for the overall health and proper functioning of rectal tissues. When this protective barrier is compromised or damaged, it can potentially increase the risk of sexually transmitted infections (STIs) and HIV.

If you do want to use a douche, it is crucial to prioritize safety by using the appropriate equipment. It is recommended to purchase douches from reliable sources like a pharmacy or a sex store and carefully follow the instructions on the packaging.

Making your own douche at home is not advisable, as it could cause injury. Furthermore, always ensure that your hands or gloves are freshly cleaned before using a douche, and allow sufficient time between douches. It is important to note that if you have anal fissures or hemorrhoids, douches are not recommended. It is always best to consult a medical professional if you have doubts or concerns about using a douche.

Products needed to douche

To anal douche yourself at home, you will need to select a type of douche, as well as either water or a saline solution, to enter into the rectum. Both saline solution and water can be used for anal douching, and the choice between the two ultimately depends on personal preference and individual needs. However, there are a few different types of douches available.

  • Shower enema. A shower enema is a douching method that utilizes a special attachment that can be connected to a shower head. This attachment allows the water to flow directly into the rectum. It typically provides a continuous and controlled stream of water, making it convenient for those who prefer a thorough cleaning. Shower enemas are often adjustable, allowing the user to regulate the water pressure and temperature.
  • Bulb enema. A bulb enema, also known as a bulb syringe or anal bulb, consists of a rubber or silicone bulb attached to a nozzle. This type of douche is manually operated by squeezing the bulb to expel the liquid into the rectum. Bulb enemas are generally small and compact, making them easy to use and convenient for travel.
  • Fleet enema. Fleet enema is a commercially available pre-packaged douche product that comes in a disposable bottle. It contains a saline solution or a combination of water and laxative agents. Fleet enemas are commonly used for bowel cleansing and constipation relief but can also be used for anal douching. They typically feature a lubricated nozzle attached to the bottle, allowing easy insertion and controlled liquid delivery.
  • Enema bag. An enema bag is a larger-capacity douching device that consists of a bag or reservoir made of rubber or silicone and long tubing with a nozzle. The bag is filled with the desired cleansing solution, and a clamp on the tubing controls the flow of liquid. Enema bags provide the flexibility to adjust the flow rate and volume of the liquid according to personal preference.

How to douche

If you’re looking to safely douche, follow the steps outlined below.

Prepare yourself

Firstly make sure that your hands are clean and that you have read the instructions of your douche kit. Fill the reservoir with lukewarm water or a saline solution. Don’t use harsh chemicals or soaps in the solution, as they irritate the rectal lining. It’s best to use a solution specifically formulated for anal douching, which can be purchased from a pharmacy or sex store. Next, apply a water-based lubricant to the tip of the nozzle to make insertion more comfortable.

Position yourself

Find a comfortable position that allows easy access to the rectal area. Many people find it helpful to douche in the shower to help with the mess, using a squatting motion to help with insertion.

Insert the nozzle and squeeze in the solution

Gently and slowly insert the nozzle into the rectum. Take your time and listen to your body’s signals to avoid any discomfort. Depending on the type of douche kit you’re using, squeeze the bulb or follow the specific instructions provided with the kit to release the cleansing solution into the rectum. Avoid using excessive pressure to prevent any potential damage to the rectal lining.

Remove the nozzle and the solution

Once the solution is inside, remove the nozzle and allow yourself some time to hold the liquid inside. Then, gently evacuate the contents into the toilet or shower. You may need to repeat this process several times until the expelled fluid is clear.

Clean and store the equipment

After you’re done, if your douche isn’t disposable, thoroughly clean the nozzle and reservoir with warm water and mild soap. Ensure the douche is completely dry before storing it in a clean and hygienic place.

How often can you douche?

While there is no specific scientific consensus on how frequently you should douche, it is generally recommended by healthcare professionals to limit douching to 2–3 times per week.

Is douching different for women and men?

Since men and women have the same rectal anatomy, anal douching is generally the same for all individuals with functioning rectums. However, the methods and tools used for anal douching can vary depending on personal preference and individual needs.

It’s worth mentioning that when people commonly refer to “douching” in the context of people with vaginas, they usually refer to vaginal douching, which is a different practice altogether unrelated to anal douching.

Do I need to douche?

The decision to douche is a personal decision. While anal douching is one way to reduce the presence of fecal matter in the rectum, alternative methods are available. These include maintaining a high-fiber diet, which can involve incorporating sources of fiber such as psyllium husk and avoiding foods that may cause stomach discomfort.

If you aren’t into douching, there are other ways that you can help to manage the mess so that you can focus on pleasure instead.

  • Have wipes on hand. Having wipes readily available during anal play can assist with cleanup.
  • Use a sex blanket. Using a sex blanket can provide added protection and convenience. Placing a blanket beneath you or in the immediate vicinity can help catch any fluids or messes during anal play. This can help minimize the impact on your bedding and make cleanup more manageable.
  • Use dark sheets. Some individuals find it helpful to use dark-colored sheets and a sex towel during anal play. By using dark-colored sheets, any potential stains or marks from lubricants or other fluids are less likely to be noticeable or cause concern.

Ultimately, whether or not to douche is a personal preference based on your comfort level and preferences. The main idea is to create an environment where you can fully enjoy the experience without unnecessary concerns about cleanliness.

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

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

By

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Why Do My Testicles Hurt When I Ejaculate?

— Sometimes ‘hurts so good’ turns into ‘it just plain hurts.’ Find out why.

By Kurtis Bright

Balls are weird.

Use whatever adjectives you want to describe them: sensitive, vulnerable, goofy, defenseless, squishable. The fact remains, these things are kind of crazy when you think about them.

Now consider that for testicles to produce healthy sperm—it is their main job, after all—they have to basically live outside a man’s body. This is so they maintain a temperature that’s about 2 degrees cooler than the rest of him. 

They dangle like a bizarre pair of rotund, fleshy earrings from the spermatic cords, which, if twisted, can cause a testicle to begin dying within hours. And of course, we all know what happens if someone gives them a swift kick.

The ‘hurts so good’ part of sex shouldn’t be unplanned testicular pain.

Nature’s a wonderful thing but, really, who would deliberately come up with a design like this?

Of course, you associate ejaculating with pleasure, but it may come as a surprise that for some, there can be pain involved. Let’s get straight to the question that plagues some men: Why do my testicles hurt when I ejaculate?

An infection could cause pain in your testicles when you ejaculate

Simple explanations are nice when it comes to medicine and sexual health. It’s always good when straightforward problems can be answered with straightforward solutions. Sometimes, that’s true with testicular pain during ejaculation if it turns out to be an infection. Typically, that means you get a round of antibiotics for a week or two, and you’re good to go.

“Infection can certainly be a reason for testicular pain,” said Amy Pearlman, M.D., a men’s health specialist and co-founder of Prime Institute in Fort Lauderdale, Florida. “Those can be much easier to treat: they get tested, and if it’s positive, you treat them.”

Keep in mind, though, that an infection is likely to be pretty noticeable. It might be more acute when you ejaculate, but if you have an infection involving the testicles, it’s always going to be with you.

“If someone has an infection, it’s going to hurt all the time until it’s treated,” Pearlman said. “You’re not going to have pain only when you ejaculate. The testicle is usually enlarged or they have a red, hot scrotum. An infection is going to be pretty obviously different on a physical exam.”

Scar tissue could cause pain in your testicles when you ejaculate

If you’ve ever learned about Peyronie’s disease, you know that scar tissue in the genital region can dramatically affect such sensitive and delicate structures.

A type of scar tissue unrelated to Peyronie’s can build up on the inside of the urethra and may cause a man to experience pain when he ejaculates. Imagine a hoarder’s apartment with decades’ worth of old newspapers piled up along the hallway. If a crowd of people tried to jam through there all at once at a high rate of speed, they’re going to get clogged. That’s what happens with scar tissue in the urethra.

“Oftentimes, where scar tissue develops in the urethra is in front of the ejaculatory duct, toward the tip of the penis,” Pearlman said. “So when the ejaculatory fluid is trying to go in, it’s trying to go past this scar tissue and it has trouble doing that. That can cause a high-pressure situation back toward the testicles.”

Testicle retraction could cause pain when you ejaculate

In case you missed it earlier, balls are weird.

For instance, they move up and down in response to temperature, exertion, anxiety or sexual stimulus. Sometimes, though, when a man ejaculates, the testicle may pull up so high it retracts up into the body cavity. This movement, combined with the sudden surge of semen coursing through the system at high speeds, can cause discomfort.

“Sometimes, the testicle will retract upward during different types of activity,” Pearlman said. “It could be if they’re anxious or if someone goes outside when it’s cold, it will retract. But sometimes, too, with ejaculation or sexual activity, the testicle can sometimes ride all the way up and into the groin region.”

Chronic pelvic pain syndrome

A phenomenon known as “referred pain” often comes up when discussing male sexual health issues. That’s because the entire pelvic region is filled with nerves that connect muscles, organs and sexual structures with a variety of functions and conditions that can affect them.

For instance, the pelvic floor muscles—a sling-like apparatus that runs from your pubic bone in the front underneath to the tailbone in the back—are involved in urination, defecation, sexual functioning, ejaculation and helping your core keep you upright.

It’s crisscrossed with branches of the pudendal nerve that links the spine and brain to the penis, prostate gland and testicles. When something goes awry down there, the nervous system may register it as pain but not be able to provide an entirely accurate picture of where that pain originates.

The more sensitive something is—we’re looking at you, testicles—the more likely we are to “think” that’s where the pain originates.

“You have to separate out testicular pain into acute pain and chronic pain. Prostatitis and prostate infections can cause painful ejaculations, for instance. But more often than not, what we see is chronic pelvic pain syndrome (CPPS) being the cause. It’s usually a pelvic floor muscle spasm issue,” said Neel Parekh, M.D., a men’s fertility and sexual health specialist with Cleveland Clinic.

He said it’s pretty straightforward.

“When the pelvic muscles are tight, those are the same muscles that contract during ejaculation,” Parekh added. “So when you ejaculate, you’re contracting an already tight muscle, which causes further pain and discomfort.”

Conclusions

Yes, testicles are weird, but they’re the only ones we’ve got, and most of the conditions described mentioned here aren’t going to get better on their own. It’s also worth noting that infections and CPPS can get worse if they’re ignored.

The “hurts so good” part of sex shouldn’t be unplanned testicular pain. Don’t let your weird buddies suffer unnecessarily. Plan to talk to your doctor as soon as you start to feel pain down there during sex.

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What Your Penis Says About Your Health

— Changes in penis performance or appearance may signal heart issues, diabetes and more

Your penis serves some big roles in your body. Of course, it houses a drainage system that allows your body to get rid of urine. It’s also a key player in the reproductive process and the act of making whoopie.

But did you know your penis also offers a window to your health? It turns out the performance or appearance of your penis can provide clues about what’s happening to you physically and mentally.

So, what secrets can the appendage reveal? Let’s look at six potential learning opportunities with urologist Ryan Berglund, MD.

1. Heart health

Erectile dysfunction, or the inability to get or maintain an erection, isn’t an unusual occurrence. Your penis may just decide to not cooperate at times for a multitude of reasons, many of which are no big deal.

But if you consistently have trouble getting or keeping your penis up, it might signal heart disease and blood flow issues.

A 2018 study linked erectile dysfunction (ED) to increased risk of heart attack, cardiac arrest and stroke. Dr. Berglund notes that almost two-thirds of people who’ve also had heart attacks also experience ED.

“Erectile dysfunction, particularly if you’re younger, should be regarded as a warning sign for heart disease,” he adds.

2. Diabetes

Difficulty getting or maintaining an erection also may signal the onset of diabetes, which can damage the nerves, blood vessels and muscle function that work in tandem to get your penis up.

Research shows that someone with diabetes is three times more likely to report instances of ED. In addition, ED often occurs 10 to 15 years earlier and is more severe in those with diabetes.

3. Mental health issues

The mind plays a very large role in the function of the penis, says Dr. Berglund. Psychological issues such as depression, anxiety and stress can lower sex drive and keep your penis from performing as it should.

Relationship troubles can hinder operations below the belt, too. Ditto for alcohol, smoking and drug use.

4. Scar tissue

Having intercourse with a less-than-firm erection can damage your penis and lead to the development of Peyronie’s disease, a disorder in which scar tissue within the penis causes a curvature.

The condition can lead to a noticeable bend in your penis. A curve greater than 30 degrees is considered severe. The loss of length or girth is possible, too.

ED can cause more flaccid erections that increase your risk of Peyronie’s disease. Talking to a healthcare provider about difficulties getting a hard erection and getting treatment could reduce your chance of sustaining the injury.

5. Infection

Lumps and bumps aren’t unusual on a penis. Blood vessels, pimples and pearly penile papules (small, pearl-like bumps) are just a few of the things you might notice on your penis, shares Dr. Berglund. In most cases, they’re nothing to worry about.

But how can you tell if there’s something more serious going on?

If the bump is painful or there’s an open or weeping sore, get it checked out ASAP. It may be a sexually transmitted infection such as herpes or syphilis. Less pain but lots of itchiness could signal genital warts or molluscum contagiosum (a viral skin infection).

6. Cancer

A discoloring of your penis along with painless lumps, crusty bumps or a rash could be a sign of penile cancer. Symptoms typically appear on the penis head or foreskin and should get checked by a medical professional.

The rate of penile cancer is relatively low in the United States, at 1 in 100,000. But it’s much more common in Africa, Asia and South America.

Final thoughts

It’s important to pay attention to what’s happening downstairs. Changes in the performance or appearance of your penis may be a sign of a larger health issue.

Is the topic comfortable to talk about? Maybe not. But if something with your penis feels or looks different, tell a healthcare provider. It’s a discussion that’s important for your overall health.

Complete Article ↪HERE↩!

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The Health Issues Men Don’t Talk About

— (But They Really Should)

It’s taken a long time. But there is finally a growing awareness of the importance of discussing health issues openly and honestly.

By Northern Life

A lot of men shy away from discussing their health concerns because of social stigmas and embarrassment. Sometimes it’s because they simply don’t know where to turn for help. Addressing these issues openly and providing the necessary information and support is crucial.

Testicular Cancer

Testicular cancer is another health issue that often goes unaddressed due to embarrassment or fear. However, early detection is crucial for successful treatment and improved outcomes. It happens when abnormal cells develop in the testicles.

Common symptoms include a painless lump or swelling in one or both testicles. You might notice a feeling of heaviness in the scrotum or that your testicles have changed shape or weight. These symptoms can also be caused by other conditions, it’s true, but you need to talk to a doctor if you notice any of them.

Regular self-examinations are recommended. By familiarizing themselves with the normal size, shape, and weight of their testicles, men can quickly identify any changes or abnormalities. If a lump or other concerning symptoms are noticed, it is crucial to consult a doctor promptly.

While the topic of testicular cancer may be uncomfortable to discuss, early detection and treatment can significantly improve the chances of a full recovery. Men should prioritize their health by raising awareness and openly discussing this issue.

Erectile Dysfunction

Erectile Dysfunction (ED) affects a significant number of men, but it remains shrouded in silence. ED refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. It can stem from various factors, including physical, psychological, or lifestyle-related causes. It’s normal to have trouble getting or maintaining an erection sometimes. But persistent problems can have a significant impact.

One common physical cause of ED is the restricted blood flow to the penis. Diabetes, high blood pressure, or cardiovascular disease can be potential causes. You might also suffer from ED if you are dealing with stress, anxiety, or depression. It’s probably not too surprising to learn that smoking, drinking too much booze, and not having an active lifestyle can increase the risk of developing it.

The first step in addressing ED is to have an open conversation with a healthcare professional. Doctors can help identify the underlying causes and recommend appropriate treatment options.

It is essential to recognize that ED is a treatable condition. By breaking the silence and seeking medical assistance, men can regain control over their sexual health and improve their overall well-being. If you want to learn more about treatments for ED, then you can check out what’s available at The Independent Pharmacy. They are a regulated online pharmacy that can help you find the right prescription and over-the-counter treatment.

Mental Health

Societal expectations that encourage men to be stoic and tough can create barriers to seeking help. However, mental health issues can affect anyone. It doesn’t matter what your gender is.

Depression, anxiety, and stress are widespread right now. Men need to understand that seeking help for these kinds of issues is a sign of strength. Mental health professionals are trained to provide support and guidance in managing these conditions. There’s therapy, medication, or a combination of both. Lifestyle changes such as regular exercise, healthy eating, and practicing stress-reducing techniques like meditation or mindfulness can also help to

By breaking the silence surrounding mental health and seeking appropriate support, men can effectively manage their mental health conditions and lead fulfilling lives.

Prostate Health

Prostate health is a critical aspect of men’s overall well-being. But it can be so tough for people to talk about it openly. Prostate cancer is the most common cancer among men, and it is essential to address it openly. Early detection is crucial for successful treatment and improved outcomes. However, the fear, stigma, or lack of awareness surrounding prostate cancer can discourage men from discussing it or seeking regular screenings.

Regular prostate screenings are recommended for men over the age of 50. You should get one earlier if you have a family history of prostate cancer. These screenings can help detect any abnormalities in the prostate gland and identify potential cancerous cells.

By breaking the silence and openly discussing prostate health, men can become proactive in monitoring their prostate health, addressing any concerns, and seeking timely medical intervention when necessary. Open conversations and awareness about prostate health can help save lives and ensure a better quality of life for men as they age.

Sexual Health And STDs

Sexual health is integral to overall well-being, and men should prioritize discussions about it. Safe sexual practices and regular check-ups can help prevent and detect sexually transmitted diseases. They also mean that you can enjoy an active sexual life.

Engaging in unprotected sexual activity or having multiple sexual partners can increase your risk of catching something. Open and honest communication with sexual partners about sexual health is essential. Discussing sexual history, STD testing, and using barrier methods such as condoms can help reduce the risk of contracting or spreading STDs. Regular STD testing is recommended, especially after engaging in unprotected sexual activity or changing sexual partners.

If diagnosed with an STD, it is crucial to seek prompt medical treatment and inform any sexual partners to prevent further transmission. A lot of STDs can be treated with antibiotics or antiviral medications. Additionally, healthcare providers can offer guidance on preventive measures, safe sexual practices, and regular screenings.

Men can reduce the stigma surrounding STDs, increase awareness, and take necessary precautions to protect themselves and their partners by promoting open conversations about sexual health,

Substance Abuse And Addiction

Substance abuse and addiction are significant health concerns that affect men disproportionately. Societal expectations and pressures can sometimes lead men to turn to substances such as alcohol, tobacco, or drugs as coping mechanisms, as we saw a lot during the pandemic. There can be serious mental and physical consequences when any of those substances are abused.

Breaking the silence surrounding substance abuse and addiction is essential. Men should be encouraged to seek support. There are treatment options out there, from counseling to detox and rehab programmes.

Men can smash the stigma associated with seeking help and create a supportive environment for those struggling with these issues when they talk about them. Addiction is a treatable condition, and men can embark on a journey towards recovery and regain control over their lives with the right support,

Wrapping It Up

Addressing the health issues men often avoid discussing is crucial for their well-being. By breaking the silence and encouraging discussions about these topics, men can take control of their health, seek appropriate medical assistance, and lead healthier, fulfilling lives. Remember, it’s time to break the barriers and prioritize men’s health through open dialogue and support. There is no such thing as an embarrassing health concern. And you might just be amazed by how much better you feel once you start talking.

It’s taken a long time. But there is finally a growing awareness of the importance of discussing health issues openly and honestly. The idea of “embarrassing” health problems is being challenged more and more frequently. But some topics still get swept under the carpet, especially when it comes to men’s health.

A lot of men shy away from discussing their health concerns because of social stigmas and embarrassment. Sometimes it’s because they simply don’t know where to turn for help. Addressing these issues openly and providing the necessary information and support is crucial.

Complete Article ↪HERE↩!

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

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

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

By Molly Callahan

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

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

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

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

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

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

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

Q&A

with Katharine O’Connell White

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

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

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

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

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

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

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

White: Hopefully—although I’m hesitant.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Sex After 60?

— You Need to Know About STD Prevention

By

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

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

STD Rates Rise Along with Sex After 60

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

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

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

Why the STD Boom Among Boomers?

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

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

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

Let’s Talk About Sex After 60

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

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

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

4 Tips for STD Prevention

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

Talk to Your Partner

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

Use Protection

Condoms or other barrier methods used during intercourse prevent infections.

Looking for Senior Healthcare?

UVA Health geriatricians are experts in senior care.

Get Screened & Encourage Partners to Do the Same

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

Know STD Symptoms

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

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

Get Treated

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

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

Talk to Your Doctor

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

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