Jul 022013
 

CC BY-NC-ND 2.0 by flickr user aling_

Time for the last month’s news. Hope you all are having fun out there. This month’s image is the theoretical flower for the month: the rose.

Gender-related news…

  • A preliminary report presented at the Endocrine Society meeting in June appears to confirm that cross-sex hormone therapy is safe in the short term (12 months). Summary.
  • Finasteride, a commonly used anti-androgen used to prevent hair loss in both cisgender men and transgender women, has now been reported to reduce alcohol consumption. Summary.
  • GnRH agonists, also called “puberty blockers”, have been shown to be safe in one study. The prime concern for years has been about bone health. Previous studies had shown a drop in bone density while on the medication. This new study confirms that bone density returns to normal after going off GnRH agonists. Summary. This study will be covered more thoroughly in a later blog post.
  • The folks at Skepchick did a wonderful piece on a recent news article on an intersex person. Check it out!

Sexuality

  • In high doses, testosterone appears to help cisgender women retain their sex drive after hysterectomy/oophorectomy. The rub? Testosterone should be given either through the skin (creams, patches, etc) or by intramuscular injection. Summary.
  • Many cisgender men are now being treated for “low testosterone levels”… when their testosterone levels were never checked. This could be very risky. Summary.
  • Exodus International has apologized to gay people and closed down. Exodus was well known for its promotion of reparative therapy for gay people. Summary.
  • The American Medical Association has come forward arguing that the ban against blood donation by men who have had sex with men (the “gay blood ban”) should be lifted. Summary. The FDA recently reviewed their policy, but decided that the ban should stay. Currently in the United States, any man (male-bodied) who has had sex with a man since 1977 is ineligible to give blood. Additionally, any woman (female-bodied) who has sex with a man who had sex with a man since 1977 is ineligible to donate for the next 12 months. The FDA’s policy on trans folk is unclear, but some trans folk report being turned away because of their gender identity.
  • A case report of “foot orgasm syndrome” was reported in the literature. A woman reported having orgasms whenever her feet were stimulated. Summary.
  • A study found that people who practice BDSM (bondage, dominance/submission, sadomasochism) are not psychologically “sick”. Summary. I’ll be covering this study in a later post. It’s interesting and need a lot of breaking down.
  • A study by Durex reports that the vast majority of people enjoy sex most when they are emotionally attached to their partner(s). Summary. Because a sex study conducted by a condom maker is totally not biased.

And the biggest item of news? The US Supreme Court declared that Section 3 of the Defense of Marriage Act was unconstitutional. Federal and state governments are currently scrambling to figure out all the ramifications. And Proposition 8, here in California, was effectively reversed. Marriage equality now exists in my home state. Yipee!

Did I miss a piece of news? Let me know in the comments!

Oct 192012
 

Data from a University of Maryland School of Medicine survey were just released showing that nearly four out of ten lesbians do not get regular pap smears. Pap smears screen for cervical cancer, among other things. Cervical cancer is usually caused by the human papilloma virus (HPV). HPV can be spread by skin-to-skin contact, so lesbians are just as much at risk for getting HPV as bisexual or heterosexual women. Screening is important to detect precancerous changes and cancer in their earliest stages so that treatment can be done when it’s most effective, preventing deaths.

Why do so few lesbians get their screenings? The primary reasons cited in the survey were: a) not having a physician referral, and b) not having a physician. Together, these two reasons account for 34.8% of study participants. We already know that lack of access to care is a big problem in gender and sexual minority communities. This just helps to confirm it. The survey authors note that lesbians who were open with their physicians about their sexual orientation were more likely to be screened than those who weren’t open.

There has been a recent change to pap smear recommendations. Pap smears are no longer recommended every year for most people. Screening starts at 3 years after first sexual activity, or age 21, whichever is first. From age 21-30, screen every 3 years, then from age 30-65, screen and do an HPV test every 5 years. After 65, no screening is recommended. If a pap smear is abnormal, screenings become more frequent. I should also note that these guidelines apply to everyone with a cervix, regardless of gender identity.

I, personally, think it’s highly advisable for everyone to know their HPV status and get vaccinated if possible, in addition to regular pap smears. HPV vaccines are not a replacement for pap smears because they don’t vaccinate for all HPV strains which cause cervical cancer. However, vaccines do protect against some.

EDIT (10/21/2012): I should also note that during a pap smear, a physician can do other screenings. This includes gonorrhea/chlamydia screening, looking for signs of other STDs or vaginal cancer, and checking the ovaries for lumps.

Jul 022011
 

I’ve gotten some questions in, so it’s time to do a question and answer post!

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Question: Can urethral sounding be done with cooking oil?

Answer: NO. Cooking oil = edible fat = energy. Micro-organisms (like bacteria) can use it as a source of food. Using cooking oil in the urethra can increase your chances of a urinary tract infection (or bladder infection or kidney infection…). Use a lubricant without glycerin instead.

 

Question: Can rubber urethral sounds be used by women?

Answer: Rubber should not be used for sounds for women or men. Why? They cannot be sterilized at home. The recommended method of sterilization (very hot steam in a pressure cooker) will ruin the rubber (Source). Stick to sounds made of stainless steel to be safe.

 

Question: Why does urethral sounding feel good?

Answer: That depends on whether your genitals are male or female. For men, it can stimulate the corpus spongiosum, which can be pleasurable. For women, it can stimulate the Skene’s Gland, which can also be pleasurable.

 

Question: Do heterosexual women get anal cancer?

AnswerYes.

 

Question: What kind of steel is used in genital piercings?

Answer: Surgical steel. There are a few grades of surgical steel that are appropriate. Specifically, “steel that is ASTM F-138 compliant or ISO 5832-1 compliant; ISO 10993-(6,10, or 11) compliant; or (EEC [European Economic Community] Nickel Directive compliant.)” (Source).

 

Question: Can HPV be passed by oral sex?

Answer: Yes. It’s been implicated in head and neck cancers for that very reason.

 

Question: Why is it bad to do rope bondage on joints?

Answer: Two big reasons. First, joints are very sensitive. If they get damaged, they take a long time to recover and may not recover at all. So it’s best to avoid damage. Second, a lot of nerves and blood vessels travel through joints. This makes them ideal for cutting off blood/nerve supply to a limb… definitely a no-no.

 

Question: Can a post-operative transsexual have an orgasm?

Answer: Yes. The quality of the orgasm may be different than it was before transition. A recent study came out about sexual health for transmen.

 

Question: Would a genital piercing affect the way I pee?

Answer: If it passes through the urethra, yes. If it could be in the path of the urine, yes (e.g., labia or foreskin piercings). Otherwise, probably not.

Apr 232011
 

Time for another type of self-exam: testicular self exams (TSEs)

The American Cancer Society currently has no recommendations regarding testicular self exams – they say there aren’t enough data regarding their effectiveness. Some doctors, however, still recommend monthly self exams starting around age 14. Like breast exams, they:

  • Are a great way to get to know your body (especially for those of you who are going through body changes, or haven’t learned your body)! You’re better able to catch any changes, which you can then discuss with your doctor. Partner(s) can also be involved in exams, which can help keep them from getting boring.
  • Can lead to false positives (thinking that there’s something seriously wrong when there isn’t), which can be stressful and costly, and false negatives (thinking there’s nothing wrong when there is), which can be fatal.

Anyone with balls (testicles) can do a TSE — anyone else must examine someone else’s. Women, transmen, and anyone who has had an ochiectomy don’t have to do TSEs because they don’t have balls – they’re not at risk for testicle-related problems. Folks who are on the receiving end of cock and ball torture (warning!: graphic images) may especially wish to do TSEs to monitor for changes.

The timing of a TSE is not especially important. Some physicians say it should be monthly, but there isn’t a consensus that I’m aware of. Pick a day at a regular interval and stick to it!

How to do a TSE:

  • It’s best to do a TSE right after (or during) a warm bath or shower. The warmth relaxes the skin of the scrotum, making it easier to feel the inside bits (there’s no thickly bunched wrinkly skin in the way!).
  • Using both hands, gently feel one testicle at a time. Roll it between your fingers – how does it feel? Any unusual lumps or bumps? Does it feel different than usual, or does it hurt? Make sure you feel all of both testicles.
  • Take a look at the skin of your scrotum. Any unusual bumps or swelling?
  • Make sure you mention any changes to your doctor.
  • That’s it! Kids Health, The Testicular Cancer Resource Center, and the American Cancer Society all have guides too if you need them.

What are you feeling? (Warning: all the links in this section have explicit images.)

  • The American Cancer Society has a nicely simplified diagram.
  • The scrotum usually contains two testicles, plus a bunch of blood vessels and nerves (which you might be able to feel). Each testicle has an epididymus and a ductus deferens (aka vas deferens). The epididymus is a highly coiled tube-like structure that sits on the top and back of the testicle. The ductus deferens is also a tube, going from the epididymus up into the body, where it eventually connects with the urethra.
  • Testicles make sperm. The sperm enter the epididymus, where they’re stored and finish developing. During ejaculation, the sperm go whizzing out of the epididymus into the ductus deferens, into the urethra, and out the tip of the penis (along with other fluids that are added along the way).
  • It’s perfectly normal for testicles to be different sizes or to hang at different heights.
  • If you need help figuring out what’s what, and what’s normal,  ask your doctor.

If you find something during a TSE, don’t panic. It probably isn’t cancer. There are lot of other things it could be – some potentially bad, others not so much. You do need to mention it to your doctor just in case.

Apr 032011
 

Besides feeling good and being great fun, foreplay is important! Foreplay allows more time and stimulation for full arousal, which will likely make whatever activity you’re going to do easier and more pleasurable. Psychologically, foreplay helps lower inhibitions and increases emotional connectedness.

What physically goes on during arousal in foreplay?

For men, the most obvious change is the erection of the penis. Not all penises become erect when a man is aroused – this is especially true for older men. The glans (tip) of his penis may swell, and the foreskin, if he has one, may retract. He will also produce pre-ejaculatory fluid (pre-cum) which comes out through his urethra – this is produced by the bulbourethral glands (also known as Cowper’s glands), near the base of the penis. Why does this happen? Erection and foreskin retraction allow for easier penetration. Pre-ejaculatory fluid helps lubricate the urethra. It also contains chemicals that neutralize any remaining urine in the urethra (Urine is acidic and could be damaging to sperm).

For women, the most obvious changes are lubrication of her vagina (this is produced by the cervix of the uterus). Her vagina expands and the cervix lifts, creating more room in her vagina. Her labia change shape and color in response to increased blood flow, and her clitoris becomes swollen. Why does this happen? Largely to make vaginal penetration easier. Lubrication eases movement within the vagina, and the enlargement of the vagina allows larger items to penetrate. Also, for women, it may help with achievement of orgasm.

There are a bunch of ideas surrounding foreplay that may or may not be true. Here are a few:

  • “Men don’t really need foreplay, and women do.” I don’t think so. A fairly recent study found that both men and women need about ten minutes to reach (physical) peak arousal (Source). So physically, I’d say no. The study didn’t, however, look at mental arousal which could be a factor.
  • “Foreplay increases sexual satisfaction and chance of orgasm.” Maybe….maybe not. While the popular media and personal anecdotes definitely support this idea, a study of Czech women found that duration of sex was more important than the duration of foreplay. So the jury’s out on this one. My money, though, is on the statement being true.
  • “One technique is guaranteed to work on everybody.” Not true! Everyone is different. This is where communication is crucial.
  • “Aim for these erogenous zones.” Not as easy as it sounds. An erogenous zone is supposed to be one with heightened sensitivity…but it’s different for every person and for each situation. For a common example, look at feet. Some people find their feet to be very sensual and erotic. Others don’t feel much with their feet, and some can’t stand having their feet touched at all because they’re too sensitive. The best way to find out where they are? Explore!

What counts as foreplay? That depends very much on the people involved. I think I’ve managed to come up with a few categories of activities, though…

  • Sensual touch: including with  hands, fur, leather, metal, lips (kissing), body paint, temperature (ice/hot wax, etc) and breath. Massage (with or without oils). Includes pain and impact play (e.g., flogging).
  • Psychological play: including dirty talk, humiliation, and roleplaying.
  • Erotic dress and teasing: including strip teases, erotic clothing,
  • Preparatory: Getting ready for a “special night” – cooking, eating special foods (or feeding them to someone), getting dressed up all nice, bathing with extra care, etc.
  • Bondage: including rope, chains, leather, and handcuffs…and anything else you can think of.
  • Voyeurism: watching others having sex – whether with pornography or live.
  • Misc: talking, erotic games, tantra

All of this brings up what is probably the most important part of foreplay (or, heck, any relationship-based act): Communication. Your partner(s) are not psychic, so communicate, communicate, communicate! Even if it’s embarrassing.

There are a couple of things that may cause problems with foreplay or arousal that I feel I should mention. Physical problems or illnesses can make some foreplay activities difficult if not impossible. Nerve damage can affect otherwise sensitive areas. Erectile dysfunction and vaginal dryness are relatively common, especially as we get older. Psychology can also affect everyone’s foreplay (not just women!). Trauma especially can have debilitating effects on sexuality. Some medications or drugs can also affect sexuality. If you’re having troubles with anything like what I’ve mentioned, start by talking with your partner(s). Still need help? Try talking with your doctor or a qualified sex therapist – they ought to be able to help.

The take-away message? Foreplay is good for your sex, good for your relationship(s), and good for you. Go have fun!