Category Archives: Sexual Health

Don’t Put This Up There

Don’t Put This Up There

2018-06-12

From yogurt to oregano oil to lemon juice (OUCH!), the internet is chock-full of suggestions and remedies for women’s sexual health.

By Jen Gunter

People always want to know the most unusual object I’ve retrieved from a vagina.

I’ll never tell.

One, because the woman involved could recognize herself and feel betrayed. Yes, some items are that unusual.

The other reason is that the unfortunate sequence of events that ends with a visit to my OB-GYN practice or the emergency room is almost always the unanticipated consequence of sexual experimentation. Lots of objects seem sexually adventurous until the moment one realizes they are not. And realizes that they are stuck.

Sexual experimentation with household items is nothing new, though the nature of the object has changed slightly to match the times — think along the lines of a progression from a soda bottle to a diet soda bottle to an energy water bottle to a Kombucha bottle — over my 25 years of practice.

Another change I’ve noticed in that time is the increased touting of various “natural” and “ancient” vaginal remedies with household items. The reasons could range from “vaginal maintenance” (a term that, as an expert, I struggle to further qualify) to the treatment of yeast infections to contraception to improving sex lives.

There are two themes at play that seem simultaneously opposing yet complementary: that natural is best and that the vagina is so dirty, fragile or in need of nourishment (or all three) that it is one wrong pair of underwear or wet bathing suit away from complete catastrophe.

And this is how lemon juice (ouch), yogurt, garlic (double ouch), cucumber and oregano oil (super, mega ouch) are finding their way into vaginas worldwide. No, you are not reading a recipe for tzatziki sauce.

Many of these supposed natural therapies claim to have supporting science, although what is offered as proof is easily dismissed with a cursory knowledge of reproductive physiology. Lemon juice is recommended to acidify the vagina (it cannot). Yogurt is suggested because its bacteria could help repopulate the healthy, vaginal bacteria (commercial yogurts don’t have the right strains). Sea sponges are recommended for menstrual hygiene (testing has revealed they have bacteria and debris and they could introduce far more oxygen — a bad thing — into the vagina than a tampon or menstrual cup).

What is simultaneously fascinating and depressing is that these “newly discovered ancient therapies” are neither ancient nor effective. Instead they are the result of celebrity wellness sites, social media and even some doctors recycling material from health almanacs and digests that used to be found at the grocery store and repackaging their content under the guise of female empowerment.

What is science with its stodgy physiology and evidence-based medicine against the allure of the patient anecdote and the promise of a cure? Stories and confidence are what sells.

It’s possible that remedies like yogurt, garlic and so on were tried centuries ago as medicine, spermicide or sexual custom. But who cares if something was used historically if it has since been deemed ineffective or harmful? Blood letting for fever, mercury for vitality or syphilis, and animal dung as spermicide are all ancient medicinal practices, but that doesn’t mean we’re revisiting those therapies today.

In other words, all these so-called “ancient” sexual remedies were retired for a reason.

I get the allure. So many women are still uncomfortable speaking openly about genital health, and the internet offers privacy — not to mention community and validation. When all these needs are met, accuracy can seem secondary.

It is always best to see a health care professional for a diagnosis. We women do know our bodies, but there is so much crossover with symptoms that when women attempt self- diagnosis they are likely to misdiagnose more than 50 percent of the time. That’s worse than flipping a coin.

Researching symptoms and treatment options is always good, but to keep your internet hygiene in check (which requires far more effort than vaginal hygiene) these are the things that should send you screaming:

  • Run if the therapy is said to be “proven.” The degree to which something is supposedly “proven” to treat a medical condition is inversely proportional to the number of studies supporting that claim.

  • Run if something is being sold. Anyone selling a product is by definition biased, whether it is “Big Pharma” or “Big Natural.”

  • Run if the recommendation is homeopathic products. A recent studytells us that doctors who recommend homeopathy are more likely to deviate from standard medical guidelines. In other words they are more likely to practice bad medicine.

  • Run if the advice relies on testimonials. I would never tell my patient “Well Sarah S. said it worked for her!” Sarah S. is not the same thing as science.

  • Run if it involves inserting food vaginally for health reasons. This is nonsense.

  • Run if they recommend vaginal cleaning of any kind. For instance, I’ve been hearing about “vaginal steaming.” It’s well meaning, but woefully misinformed. If your bottom is sore, use a sitz bath.

It’s stunning that in this great age of information that can we have so much misinformation about our bodies and our sexuality. The internet has changed the speed at which we can acquire medical information, but certainly not the accuracy.

Dr. Jen Gunter is an obstetrician and gynecologist practicing in California. The Cycle, a column on women’s reproductive health, appears regularly in Styles.

 

 

 

 

Breaking sex talk taboo in Indian culture

Breaking sex talk taboo in Indian culture

n a nation where sex temples in Khajuraho or Shivling are worshipped, talking about sex in open is still considered a taboo in Indian society. With India having the largest adolescent population in the world, along with a thriving market for contraceptives, the country cannot afford to stay silent about its sexual health anymore, writes: SUBHANGI SINGH

When it comes to sex talk or sex education in India, the government brazenly ignores it, schools disregard it and the adults firmly push it under the carpet. The demographic diversity, in terms of age, sex, marital status, class, religion and cultural context, add the final nail in the coffin. What is absurd that in India where Khajuraho, known as the land of sex temples, is open for the world to worship, visit or make movies inspired from its sex sculptures,discussion on the subject sex, on the other hand, is sidelined considering morally disgraceful in the same society.

Jyoti (name changed) is an 18-year-old newly married girl from Agra. Jyoti shares the same predicament as most young married Indian girls in semi-urban areas. She narrated, “I don’t want to have kids right away. I have heard about contraceptives like Nirodh and Mala-D. But, I dare not bring it up with my husband. He might think I am too forward or that I have a promiscuous past. My mother will also be very pissed if she gets a whiff. Also, I must get pregnant within a year or people might think I am baanjh (infertile).” Such stories echo throughout north India. It is a built-up on multiple social phenomena, almost unique to South Asia and entrenched through its social institutions.

In a country where half the pregnancies are unplanned, a third of which are terminated by choice, the need for unmet contraception is huge. Government-run programs are often cosmetic in nature, only concerned with achieving their targets. In 2012, after a botched up female sterilisation camp in Bihar, resulting in complications experienced by several patients, activist Devika Biswas filed a petition in the Supreme Court of India. The Court finally ruled that such incidents violated components of Article 21 of the Constitution, i.e. the right to health and reproductive rights. The Court also ordered the discontinuation of such sterilisation camps, ensuring that no such fixed targets exist. Adult Indian women, let alone adolescents are mostly unaware about their sexual and reproductive rights.

Dr. Shefali Wadhwani Sharma, a gynaecologist at GMCH, Chandigarh reveals, “We often get girls in critical condition, who come in with a perforated uterus due to mishandled D&C abortions, done by unqualified caregivers like midwives, etc. Such is the social stigma that adolescent girls admitted with ruptured ectopic pregnancies refuse to admit that they have been sexually active. Young girls seldom get intimate checkups done until faced with acute medical emergencies. To avoid such cases, it is imperative that education about menstrual hygiene and sexual health becomes a part of school curriculum. Sexual health is a vital part of holistic healthcare and healthy women a keystone of women empowerment.”

The latest National Family Health Survey (NFHS), 2015-16, bears some good news. Use of contraception in single women has gone up from 2 per cent to 12 per cent in the last decade. Female sterilisation (36 per cent) is still the most popular form of modern contraception used, permanent or otherwise. However, women, especially adolescents, still lack sufficient knowledge about the dangers of unsafe sex and intimate infections. Religious and cultural obligations often dissuade them from practicing proper sexual/menstrual hygiene and/or using contraception. Most women still use ‘traditional’ contraceptive methods like monitoring menstrual cycles and ‘pulling out’, unaware that these methods are not only unreliable tools of family planning but also leave them vulnerable to Sexually Transmitted Infections (STIs) and Reproductive Tract Infections (RTIs).

Even in urban setups, girls admitting to sexual needs are slut-shamed. Trisha (name changed) is a 26-year-old single, financially independent woman who resides in New Delhi. “Once I dropped my bag at my workplace, spilling out a condom amongst other things. After that, the double entendres and indecent proposals continued for a month. I finally changed the job after a few months due to various reasons, this incident being one of them.” said Trisha. She continued, “When I visited a gynaec at a private clinic to get checked for late periods, I was welcomed with questions about my sex life, marital status and warnings about my biological clock ticking away. She also wanted to know if my parents knew! She ignored me when I tried giving background of my general health.” Such moral policing from healthcare providers, misconceptions and lack of trust about regular contraception methods, have led to rampant impetuous use of over the counter emergency contraceptives.

Government and private NGOs are now resorting to innovation to get the message across. Comedian Abish Mathew recently released a funny animated short film about the importance of maintaining good sexual health. Agents of Ishq, a multimedia project about ‘sex, love and desire’, is sprinkled liberally with humour to make it appealing for this generation. Population Foundation of India (PFI) is an NGO which has partnered with Doordarshan to spread awareness about sexual health, contraception and other taboo subjects, through a soap opera titled Mai Kuchh Bhi Kar Sakti Hoon..

Inclusion of Men

Although government programs and even NGOs that focus on youth reproductive and sexual health often limit their focus to females alone, men/boys play key roles as fathers, brothers, and partners. Often the male members of the family are key decision makers of the household in the largely patriarchal Indian society, necessitating participation of the male population in these programs. The patriarchal narrative also restricts men/boys from addressing their own reproductive and sexual health issues, the admission of which can render them weak in a society that teaches them to be macho. Information, education and communication about male sterilisation are inadequate, not only in society but the public health system as well. In the absence of a credible source of information and lack of inclusion in public awareness initiatives, men often ignore their sexual health issues which in turn can lead to mental trauma, male fertility issues and infections.

During the decade (2006-2016) between successive NFHS surveys, condom use declined by 52 per cent while the number of vasectomies conducted fell by 73 per cent, indicating a greater reluctance amongst men to use birth control. Only 5 per cent Indian males use condoms and male sterilisation forms a dismal 0.3 per cent of modern contraception used. Most Indian men consider vasectomy as an equivalent to castration. Majority of them are unaware about the ease of the procedure and the reversible nature of it. India is one of the few countries in the world where female tubal ligation is more popular form of permanent contraception than vasectomies, despite the fact that the ligation procedure is more complicated and requires greater post-operative care. The pitiful picture is worsened by the fact that men are taught from an early age that reproduction and subsequently, fertility, contraception and maternal healthcare are a ‘woman’s affair’.

As Dr. Sumeet Devgan, a consultant urologist at the Grecian Hospital, Mohali points out, “Young Indian men lack the open peer discussions prevalent in women and are reluctant to seek professional medical help for their sexual health needs. We often get cases with mismanaged self-medication for STIs, etc. We need to stop referring to sexual and reproductive health and rights as women’s issues; they are men’s issues as much. Given that use of contraceptives in India is riddled with social barriers, a systematic institutional approach with inclusion of men is required to result in better uptake of contraceptives and safe sex. On-ground work to engage men in taking shared responsibility, while still promoting women’s rights, is vital for sustained behavioural change.”

Half-hearted solutions

To spread sexual health awareness and establish dialogue between sexes, we need comprehensive sexuality education (CSE) at school level. CSE teaches the young about affirmative sexuality, informed consent, safe sex, etc. A similar program called Adolescent Education Program (AEP) was introduced by the government in India in 2007. But after several protests and moral policing, citing ‘inappropriate content’, the program was banned in several states. It was rolled out in select government/private schools with limited implementation. Though it covers issues like body image, gender and sexuality, violence and abuse, STIs, etc, it leaves out issues of negotiation and consent in intimate relationships. Even urban educational institutions are reluctant to include these programs to avoid ‘unnecessary sexualization’ of kids, according to an owner of a reputed private school.

The government also has a National Adolescent Reproduction and Sexual Health (ARSH) strategy, released in 2006 and various states have implemented their own versions of it; e.g. Himachal Pradesh has set up Yuva Paramarsh Kendras (YPKs) which work with health institutions, schools/colleges, youth festivals, etc. In 2008, the National Population Stabilization Fund (Jansankhya Sthirta Kosh) started a helpline (Ph: 1800-11-6555) to provide confidential counselling services regarding sexual and reproductive health problems. Rashtriya Kishor Swasthya Karyakram launched in collaboration with United Nations Population Fund (UNFPA) is a health program for adolescents in the age group of 10-19 years, to provide preventive, curative and counselling services with routine check-ups at primary, secondary and tertiary levels. Last year, the government also started an online distribution service of condoms which met with a good response. Several NGOs like PFI, Mamta and Haiyya are working extensively to raise awareness and remove the stigma attached to discussing sexual health and needs. But a large chunk of our population is unaware of the existence of such programs.

Technology has also helped bring these issues out of the closet by providing anonymity and peer participation. Online portals like Menstrupedia and ‘She and You’ provide a safe and anonymous environment to discuss taboo subjects like menstrual hygiene, STIs, contraception methods, etc. ‘She and You’ has started an initiative #JustSayIt, through which they want to break the awkwardness by hosting a series of events and making women open up about the very things they shy away from like sex, menstruation and their intimate health.  The start of such programs is a welcome change. Sadly, it is restricted to small pockets in India with limited public awareness. The recent government restrictions on advertising for condoms and emergency contraceptive pills don’t help. The lack of proper implementation, poor quality of resources and inadequate training and sensitisation by the government has led to policy failure. According to a 2013 UNPF review, delaying childbearing could reduce India’s projected 2050 population of 1.7 billion by 25.1 per cent. With an ever burgeoning young population, India cannot afford to stay silent about its sexual health anymore.

 

 

http://www.tehelka.com/breaking-sex-talk-taboo-in-indian-culture/

There’s No Such Thing As A ‘Normal’ Penis, Says Health Specialist

There’s No Such Thing As A ‘Normal’ Penis, Says Health Specialist

2018-06-11

But there is such a thing as an average one.

 

The stereotype holds that men who have penises spend a significant amount of time thinking about them, or thinking with them.

Man holds tape measure by his pelvis, with exaggerated perspective. Does he measure up?

Of course, you can’t think with a penis — it’s got a head, but no brain. And men are capable of thinking beyond the whims of an organ that is pretty important, but not all-controlling.

That doesn’t mean that penises aren’t important, for sexual health and even, if something goes awry, for health in general. But does having a penis mean you know what is or is not “normal”? And what even counts as “normal” for something that can vary so significantly from person to person? On the other hand, when is something definitely abnormal and worth checking out?

Read on for some information — and probably a good amount of reassurance.

What is the average size?

As many as 45 per cent of men are unsatisfied with their penis size, according to one 2006 survey, and most of those men wanted theirs to be larger. But the average range penis sizes is actually pretty, ahem, big.

“There may be no such thing as a ‘normal’ penis, but there is such a thing as an ‘average’ one,” Dr. Oliver Gralla, a men’s health specialist and author of Happy Down Below, told HuffPost Canada via email.

A study from the British Journal of Urology International that looked at 15,000 men from around the world found that the average flaccid penis length was 9.16 centimetres (3.6 inches), and the average erect length was 13.12 centimetres (5.2 inches). For girth, the flaccid average was 9.31 centimetres (3.7 inches) and the erect average was 11.66 centimetres (4.6 inches). Length is measured along the top of the penis, from where the base connects to the torso to the tip.

What’s more, the study found that outliers are pretty rare. Only five out of 100 men would have a penis longer than 16 centimetres (6.3 inches) erect, and only five out of 100 men would have one shorter than 10 centimetres (4 inches) erect. And research has shown that despite some stereotypes, age, race, and height are not accurate predictors of penis size.

So the myth of the superior penis is just that: a myth. Embrace humanity’s natural variations!

Grower or shower?

It is normal to be a grower (what Dr. Gralla refers to as a blood penis) and not a shower (what he calls a flesh penis). But it’s also normal to just be a shower.

The Journal of Urology study of 80 men found no correlation between size when flaccid versus erect, or between size and the age of the men. A Turkish study came to a similar conclusion.

What is a micropenis?

A micropenis is a penis that is well under the average size, about 2.5 standard deviations smaller than mean penis size — one standard is that the erect penis length is less than seven centimetres (2.7 inches).

The condition is rare, occurring in only about an estimated 0.6 per cent of those born with a penis, and there are several possible causes.

In some cases, micropenis can be treated in infancy with hormone injections, though this has no effect if the treatment begins in adults because penis growth stops after puberty. Surgery can also be an option in adults.

Partners are mostly fine with it

It turns out that the way men get to view their own penises — looking down from above — makes it look smaller, versus seeing it straight on or from the side. This may be why men seem more unsure about penis size than their partners do.

One study found that 85 per cent of women were satisfied with the size of their partner’s penis, but 45 per cent of men believed their penis was small. Another study asked women to indicate their preferred penis with a 3D model, and the majority chose a size only slightly above average, just above six inches erect.

There doesn’t seem to be much research on attitudes among same-sex partners about penis size, but one study did find that men who sleep with men were more likely to say they preferred to bottom during anal sex if they also rated their penis size as below average.

Men who rated their penis size as above average were more likely to say they preferred to top, while those who rated their size as average were more likely to say they were versatile on position.

But some things are abnormal

There are some things that are abnormal when it comes to penises, and if they show up they warrant medical attention because they can indicate a health issue.

Erectile dysfunction is an issue for many elderly men, but it doesn’t affect them exclusively. “Although more common in older men, even teenagers can struggle with erection issues,” Dr. Gralla said. In younger people, erectile dysfunction can be the result of a psychological issue, but it can also be the result of medical conditions like clinical depression or medication side effects.

There are other penile abnormalities or changes that can indicate a health issue. “Painful erections, palpable plaques, or slight deviations during erection can be the first signs of Peyronie’s disease, or IPP (induratio penis plastica),” Dr. Gralla said.

The disorder should be treated as early as possible, so see a doctor if you develop those symptoms.

https://www.huffingtonpost.ca/2018/06/08/normal-penis_a_23454201/

 

No evidence that sexbots reduce harms to women and children

No evidence that sexbots reduce harms to women and children

2018-06-05

“Sexbots” – sexualised robots that have realistic human characteristics – are no longer a thing of science fiction. They can be purchased in various appearances, and are typically female adults with customisable oral, vaginal, and anal openings. Childlike robotic models – sometimes referred to as “paedobots” – are produced by at least one company.

Proponents suggest that one of the main benefits of sexbots, either adult or paedobots, is “harm limitation” – referring to potential harms caused to women or children targeted in sexual violence.

An editorial published today in British Medical Journal Sexual and Reproductive Health addresses such claims directly.

Authors Chantal Cox-George and Susan Bewley argue the “precautionary principle” should reject the clinical use of sexbots until their postulated benefits, namely “harm limitation” and “therapy”, have been tested empirically. In other words, we need more evidence.

Further, from my perspective as a criminologist and forensic practitioner, I would argue that sexbots could be tools to empower some who sexually offend against women and children.

 

What does the science say?

To reach this conclusion, authors Cox-George and Bewley reviewed the available literature looking to determine if the arguments made by supporters of the use of sexbots to reduce violence and sex crimes can be substantiated.

Their article approaches this topic from a health care perspective, looking at four themes relevant to health care providers:

  • safer sex
  • therapeutic potential
  • potential to treat paedophiles and sex offenders
  • changing societal norms.

Cox-George and Bewley conclude that the claims of “harm limitation” are overstated: they found no reports of primary data relating to health aspects of the use of sexbots to support the proponents’ positive claims.

The authors also state that the market for sexbots will not be largely health care related – people will not be using these for therapeutic purposes, to diminish unwanted sexual urges, including an attraction to children.

https://theconversation.com/no-evidence-that-sexbots-reduce-harms-to-women-and-children-97694

It’s 2018, but young men still don’t want to talk about contraception – here’s why

It’s 2018, but young men still don’t want to talk about contraception – here’s why

2018-05-23

It’s a Friday night in a midsize university town in the Western US, and for many students, this means one thing: it’s time to party. University students head out for a night of drinking, dancing and often, sex. For many students attending large US universities, it’s more or less expected that they will have casual sex on a night out. But while attitudes toward casual sex have become more liberal, there’s been significantly less change when it comes to attitudes toward contraception.

Since the 1960s, when the birth control pill became widely available in the United States, research and development has focused on generating contraceptive methods for women to use. The feminist movement celebrated female contraceptives for giving women the power to control if and when they become pregnant. But somewhere along the way, a woman’s right to use birth control translated into a woman’s responsibility to use birth control.

Our research, recently published in Culture, Health & Sexuality, found that young men have a difficult time reconciling the idea that women should have control over their own bodies with the ideal that men should play an equal role in making decisions about contraception – especially since most forms of contraception alter women’s bodies to prevent pregnancy, rather than men’s.

A conflict of ideas

For our study, we held in-depth interviews with 44 young men at a large public university in the western United States to understand how they make decisions about contraception during their sexual relationships with women. The men we interviewed clearly articulated two sets of expectations: they thought that men should participate equally in decisions about contraceptive use, but that women should have the final say, since women bear much of the physical and social responsibility if they get pregnant.

Some men were worried that they might disrespect women’s bodily autonomy by bringing up the issue of contraceptives. Women were expected to request that men use a condom or otherwise communicate to men that they were not using a hormonal contraceptive. By deferring to women, men were attempting to be mindful of power dynamics that still privilege them.

We found that being confused about these competing ideas can prevent men from communicating clearly about contraceptives with their partners. As a result, men ultimately tasked women with initiating all communication about contraception, leaving their sexual partners with greater responsibility, work and financial costs related to getting contraception, and preventing pregnancy.

Bringing up birth control

In a culture where almost all forms of contraception are designed for women, most men couldn’t come to a satisfactory resolution between sharing equal responsibility for contraception and respecting a woman’s right to control her own body. What’s more, they said that this conflict contributed to their general reluctance to engage with the issue of contraception at all.

Our findings suggest that sexual health education aimed at young men must go beyond simply telling them to use condoms. Recent efforts to normalise “affirmative consent” and encourage men and women to communicate clearly about sex might also help raise the issue of contraception.

How researchers and sexual health practitioners can help to reconcile these opposing ideas is up for debate. New efforts to develop a birth control pill for men are promising, and would help to reduce the gender disparities in available methods. But the male pill is still in development and won’t be widely available for some time.

In the meantime, when in doubt, men should simply wear a condom. Men shouldn’t just assume that if women don’t say anything about contraception, it means they’re protected. It’s necessary to have the conversation – even if it’s uncomfortable. Men also can also learn more about female forms of contraception, so that they can understand the impact they have on women’s bodies and be more sensitive to women’s needs during these conversations.

Men should never assume that any woman is using a contraceptive method. If you don’t want to discuss contraception, then simply use a condom – and relieve women of the responsibility for requesting one.

In this, and other ways, we must cultivate an understanding of sexual relationships that goes beyond a battle of the sexes approach, in which men’s and women’s needs and desires are seemingly at odds. In this study, men lacked the tools they needed to engage in sex responsibly, which ended up placing greater responsibility on women.

http://theconversation.com/its-2018-but-young-men-still-dont-want-to-talk-about-contraception-heres-why-96951

Why STDs Like Gonorrhea and Syphilis Are on the Rise

Why STDs Like Gonorrhea and Syphilis Are on the Rise

2018-05-18

People have blamed dating apps for the rise of gonorrhea and syphilis. But there are a few sneakier factors at play here.

As if dating weren’t hard enough, singles in California have one more thing to worry about: the rise of sexually transmitted infections (STIs).

According to the California Department of Health, more than 300,000 cases of chlamydia, gonorrhea, or syphilis were reported in the state in 2017 alone. Overall, the transmission rate of these three STIs has spiked by a staggering 45 percent over the past five years.

But the rise of STIs isn’t just a concern in the Golden State. Figures from the Centers for Disease Control and Prevention (CDC) show that STIs are rising everywhere. From 2015 to 2016 alone, gonorrhea rates in men increased by 22 percent nationwide, while syphilis rates increased by 14.7 percent.

The biggest problem? Many men might not even know they’re infected with these STIs. About half of men don’t exhibit any symptoms of chlamydia, while many men with gonorrhea are similarly asymptomatic. The early signs of syphilis — small, painless sores around the mouth, genitals, or rectum — also tend to be subtle, and can easily be explained away as an ingrown hair.

The massive spike in STI rates is particularly concerning, given that just a decade ago, STI rates were on the declineBut “progress has since unraveled,” the CDC wrote in a 2016 report.

So what’s to blame for this unraveling? The answer is more complicated than you might think.

Over the past few years, many media outlets have published alarmist stories linking Tinder and Grindr to the rise in STIs. As recently as May 15, the Los Angeles Timesreported that some health experts partially attribute the spike to people having “more sexual partners linked to dating apps.”

But Matthew Prior of the National Coalition of STD Directors says we shouldn’t be so quick to point the finger at Tinder and Grindr. Most experts “don’t think it’s a primary reason that STDs are spreading,” he told MensHealth.com.

Instead, Prior and other public health experts attribute the nationwide spike in STIs to a confluence of different factors.

While STI rates have risen across the board, cases of syphilis in particular are on the rise among men who have sex with other men (MSMs, according to CDC lingo), who accounted for 80.6% of the new syphilis diagnoses between 2000 and 2016. That’s in part because MSMs are more likely to have receptive anal sex, which ups their risk of contracting STIs: the anus is narrow, doesn’t offer natural lubrication, and the skin tears easily, which means that STIs can easily enter the bloodstream.

Dr. Hunter Handsfield, Professor Emeritus of Medicine at the University of Washington Center for AIDS and STD, believes an additional reason why men who have sex with men may have gotten more lax about using condoms is because of PrEP, a daily medication taken to prevent HIV infection.

“Because HIV is now less of a worry, there’s less condom use,” Handsfield tells MensHealth.com. “That’s the biggest single change.”

According to the California data, half of chlamydia cases and a third of gonorrhea cases were among people under 25, indicating that young people in particular are at heightened risk. That’s in part because they simply don’t know that many of the most common STIs are asymptomatic, Heidi Bauer, the chief of the California Department of Public Health, told BuzzFeed News.

“I hear it all the time — they think, Well, if I have something, I will know it and I will just go in and get it treated. But the reality is the vast majority of these infections don’t cause any symptoms at all,” she said. “So people just pass them around without realizing it.”

Over the past decade, federal budget cuts have led to the closure of STI clinics across the country, making it harder for people to get tested and treated. In a 2016 report, for example, the CDC reported that more than 20 health department STI clinics had been shuttered in 2012 alone.

Prior also says there are now fewer Disease Intervention Specialists throughout the United States, who typically reach out to people infected with gonorrhea and syphilis to ensure they’re getting proper treatment and help them contact their sexual partners for testing.

“Those are really important access points for people to get STI care,” Prior explains.

Doctors may be tasked with knowing everything about our bodies, but some would rather avoid awkward sex talk, according to Prior.

“There’s a certain amount of stigma around STIs,” he explains. “Talking about sexual health and sexuality is not comfortable, even among healthcare providers. It’s easier to not talk about that.”

It’s not just that doctors are avoid talking to their patients about sex — they’re avoiding testing their patients for STIs altogether. Even worse, some don’t know how to properly treat patients with STIs in the first place: Prior says that that about one in five gonorrhea cases aren’t being handled adequately, with doctors prescribing one antibiotic instead of the two recommended by the CDC.

Given how much training doctors receive, it might be surprising to hear that they’re ill-equipped to treat STIs. But most physicians only receive about three to 10 hours of sexual health training during four years of medical school, says Prior.

“There’s a real need to educate providers nationally about what’s going on, and unfortunately the primary care provider network is ill-prepared to handle the STI epidemic,” Prior asserts.

How to protect yourself

Thankfully, gonorrhea, chlamydia, and syphilis are all easily treatable with a course of antibiotics. The problem is that most guys aren’t getting tested regularly, thereby putting their own health and that of their partners at risk.

If you are sexually active, you should be getting tested at least once a year, regardless of whether you are monogamous. And of course, if you or your partner haven’t been tested in a while, you should be wearing a condom every time you have sex.

More women experience partner violence in B’desh, India than Nepal: report

More women experience partner violence in B’desh, India than Nepal: report

2018-05-17

More women experience partner violence, both physical and sexual, in and than Nepal, according to a new report.

has been ranked second among thirteen Asian and Middle Eastern countries in terms of number of women experiencing partner violence, according to the Guttmacher-Lancet Commission’s report on sexual and reproductive health and rights.

According to the report, has the highest number of women who have faced partner violence, while has recorded the least number of such incidents.

fares better than in terms of women experiencing partner violence, the report said. also fares better than India, but data for that country has been given only for the last 12 months.

The can take different forms, physical, sexual, or psychological, and it encompasses harmful practices, such as child marriage, sex trafficking, honour killings, sex-selective abortion, female genital mutilation, and sexual harassment and 

Goal 5 of the Sustainable Development Goals (SDGs) includes targets calling for the elimination of against women and all harmful practices, such as child, early, and forced marriage, and female genital mutilation by 2030, the report said.

The report states that in India, where in 1971 permitted abortion under a broad criteria, most abortions did not meet legal requirements by 2015.

Abortions have become safer in some developing countries where grounds for legal abortion have been expanded.

The report stressed that improving health depends not only on implementing effective programmes, but also on advancing rights, including those frequently neglected in global discussions, such as the right to freely choose sexual partners and the right to safe and legal abortion care.

It also called on countries to tackle restrictive social norms, laws and policies, and to hold governments accountable to their commitments.

The commission also underscored the importance of gathering more evidence on the sexual and reproductive health needs of distinct populations that are often marginalised and vulnerable, including adolescents, people with diverse sexual orientations and gender identities, displaced people and refugees, and people living with disabilities.

(This story has not been edited by Business Standard staff and is auto-generated from a syndicated feed.)

http://www.business-standard.com/article/pti-stories/more-women-experience-partner-violence-in-b-desh-india-than-nepal-report-118051601338_1.html

Why doesn’t your husband want to have sex?

Why doesn’t your husband want to have sex?

2018-05-14

Contrary to conventional wisdom, sometimes it’s men who first lose sexual desire in a long-term relationship, a new study finds.

Men’s desire for sex can be as tricky as women’s, according to ­researchers at the University of Kentucky. Men often lose interest when they feel insecure, when they worry they are losing autonomy in a relationship, or when physical changes cause embarrassment. Pressure to be the ­initiator compounds the stress.

“We expect male desire to ­always be high and to be simple, like an on and off switch, while we expect women’s desire to be a complicated switchboard, but they are both complex,” says Kristen P. Mark, associate professor of health promotion and director of the Sexual Health Promotion Lab at the University of Kentucky and the lead researcher on the project, a broad look at men and women that analysed 64 studies on sexual ­desire conducted since the 1950s.

Psychologists say desire in both sexes ebbs and flows. And it’s ­natural for it to decline after the heady honeymoon period, which typi­cally lasts about 18 months to two years. Still, almost 80 per cent of married couples have sex a few times a month or more: 32 per cent reported having sex two to three times a week; 47 per cent ­reported having sex a few times a month, according to The Social ­Organisation of Sexuality: Sexual Practices in the United States, a 1994 University of Chicago study considered the most comprehensive in the field.

Women do lose desire more often than men: research shows that about one in three women — regardless of age — reports a lack of interest in sex for at least several months in the past year, compared with one in five men, ­according to Edward Laumann, a professor of sociology at the University of Chicago, who has studied sexual desire and dysfunction for 25 years. But experts say that men are often reluctant to talk about sexual troubles, so the problem may be more prevalent.

Mark’s research, published in March in the Journal of Sex ­Research, found that the reasons for a drop in desire generally fitted into three main categories — individual, interpersonal and societal. Some issues, such as stress, a drop in self-esteem or changes in their attraction to their partner, affect both men and women.

But men’s desire also wanes for different reasons. Men have ­trouble when they expect their ­desire to always remain high and it does not, or when they fail to make their relationship a priority. Sometimes men’s desire drops when a couple has sex for negative reasons — to avoid a fight, for example — rather than positive ones, such as to increase intimacy. Men also feel pressure to always be ready for sex and to initiate it.

There are often physical issues, as well. A man’s less-efficient bloodflow as he ages, diseases such as depression or medicines for issues such as high blood pressure or mood disorders can all hurt a man’s sex drive.

And these physical changes can cause emotional distress. Embarrassment is a big issue for men who have trouble getting or maintaining an erection, and so they may stop initiating sex. “For the guys who don’t like to do what they don’t do well, there will be avoidance, because they feel ashamed,” says Michael A. Perelman, co-­director of Weill Cornell Medicine’s Human Sexuality Program.

Unlike women, men often lose interest in sex when they are ­unhappy or insecure, Laumann says. Stress about a promotion, worry about a child, the transition to retirement “all undercut a man’s sense of his abilities and prowess”, he says.

And sometimes the problem does stem from the relationship. Sex can become routine in a long-term marriage, or partners grow apart. A man may harbour resentments, often about money. Or he may de-eroticise his wife. “He sees her as a good person, mother, supporter, but not as an exciting lover,” says Barry McCarthy, a psychology professor at American University.

Is the relationship doomed when a man — or a woman, for that matter — loses interest in sex? Not necessarily. But it’s definitely a signal that you need to evaluate what is going on. And there is the possibility that a decrease in desire for your partner may indicate that the person is no longer right for you, says Gurit Birnbaum, a social psychologist and associate professor of psychology at the Interdisciplinary Centre, a private university in Herzliya, Israel. You may have grown too far apart, or your goals, values or interests may have changed. “Your body may be telling you something,” she says.

But often the problems can be solved. This will require talking, the experts say, and it’s important to do that before it is too late. “A ­relationship becomes more fragile when it loses its sex aspect,” says Birnbaum.

Start by having a conversation outside of a sexual situation — go for a walk or have a glass of wine. Tell your spouse you miss having sex rather than criticising. Both partners should ease pressure by accepting that men, not just women, don’t want sex all the time. “Approaching hard conversations by being vulnerable ­upfront automatically creates a safer environment for a tough talk,” says Mark.

The Wall Street Journal

https://www.theaustralian.com.au/life/why-doesnt-your-husband-want-to-have-sex/news-story/4252b40db44be354e483bd7cab3dff85

Seven sexual health myths you should ignore

Seven sexual health myths you should ignore

2018-05-10

  1. You can’t get pregnant during menstruation

Menstruation is the process of the womb’s wall lining shedding off after unsuccessful fertilisation of an egg. While it is not common that pregnancy occurs during menstruation, it is still scientifically possible that intercourse during the period a woman sheds blood can lead to conception.

Sperm once shed into the birth canal can remain alive and viable between three to five days. During this time ovulation may take place followed by successful fertilisation.

  1. You can get an STI from a toilet seat

Venereal diseases are primarily passed from one infected person to the next through sexual contact. Some STIs, such as pubic lice, can also be spread through skin-to-skin contact or sharing clothes, towels or bedding.

In many cases direct contact of skin or genitals or other bodily fluids with infected people is required for successful infection to occur. Urine usually cannot carry STI, so toilet seats are safe on that count. Besides, most STI agents cannot survive outside the human body for a long time.

  1. You need a big penis to orgasm

A recent study shows that the average human penis is 13.12 cm long and 11.66 cm in circumference. The idea that a big penis automatically means satisfactory sexual experience for a woman is a fallacy.

Most women orgasm by stimulation to clitoris rather than inside the vagina. A woman can either experience clitoral orgasm or G-spot orgasm. A deep-penetrating penis is irrelevant to clitoral orgasms.

  1. You can’t get an STI from oral sex

You are more likely to get infected with an STI through sexual intercourse than through oral sex. However, some infections are spread much easily through oral sex. The most commonly passed on are herpes simplex, gonorrhoea and syphilis.

The best way to help protect yourself during oral sex is to use a male or female condom or a dam to cover your genital area or anus.

  1. Menopause kills a woman’s sex drive

Menopause, the age when a woman loses reproductive vigour, is often accompanied by symptoms such as hot flushes. However, losing the ability to procreate does not affect one’s sex drive. A woman well past menopause can experience good libido and also have a fulfilling sexual life.

  1. Birth control pills make you gain (or lose) weight

Tens of studies covering this subject have been conducted all over the world but none of them is yet to prove a correlation between oral contraceptives and weight gain, this is still a common belief among women of all ages.

Specifically, a review article published in 2006 analysed 44 previous trials and found that while some participants did gain weight during their studies, there was no evidence that their birth control was to blame.

  1. You have to use a cleaning agent to clean the vagina effectively

It is common behaviour that a proper bath is often accompanied by use of soap or shower gels. This has led to the belief that the vagina (especially internal walls) need to be cleaned with a cleaning agent like soap. It is from this belief that practices such as douching started being practiced.

Why I Spent International Women’s Day Serving Males

Why I Spent International Women’s Day Serving Males

2018-04-18

Being brave or vulnerable is neither male or female.

I’ve been reflecting on the fact that on March 8th, International Women’s Day, I was coordinating training for youth-serving professionals, including substance abuse counselors and social workers who provide services to adolescents and young adult males, 15-24 years-old to help these professionals inform young men about the importance of reproductive health and refer young men to reproductive health services. This is a big deal to me. International Women’s Day is an important day to me to mark the struggle that women face every day: That women need council, need community and need support, especially this year in the wake of the #metoo movement.

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I would whole-heartedly say that men also need council, community, and support. Part of the reason we have the #metoo movement is that culturally men aren’t encouraged to embrace these wonderful things. I just listened to a TEDtalk about bringing up strong girls (I am all for that) and how we need to teach our girls to be brave as this isn’t a typical attribute they are taught like boys are. I would also say we need to teach our boys how to be vulnerable. Or how about this…let’s move away from “genderfying” states of being. Being brave or vulnerable is neither male or female. It’s human.

My training event was a culmination of several years and hard work with many partners on the ground in Gaston, NC to improving young men’s knowledge about the need for reproductive health services and how to obtain these services and improving young men’s use of clinical reproductive health care services.

Engaging young men in teen pregnancy prevention can help prevent early fatherhood, which can have serious consequences for the young men, their partners, and their children. Young men are also more likely to exhibit pregnancy ambivalence, which is associated with a lowered likelihood of their partner using birth control. Engaging young men in sexual and reproductive health education and health care services is critical to preventing unintended pregnancy. But, only 25% of male adolescents report receiving sexual reproductive health services compared to approximately 50% of females. However, both male and female adolescents report an interest in receiving sexual reproductive health information from their providers.

Young men want to be involved in preventing pregnancies within their relationships….young men want connection…..young men want healthy relationships. We in public health have a role to play in this. If we empower young men to embrace their vulnerability and accessing sexual reproductive health services, this empowers young women. When we support the collective good we are lifted up as individual parts of the whole. The challenge, however, has been and continues to be the pragmatic application of the research to achieve our objective of increased gender equality.