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.

Aug 152011
 

Felching is the act of sucking semen out of an anus or vagina. It can be accompanied by “snowballing”, where the semen is shared between people orally. Felching can be done by both straight and gay partners. Felching is also relatively common in the gay male barebacking community. A recent study found roughly one in sex men who bareback also do felching.

There is relatively little information about felching in the academic literature. The greatest risk with felching or snowballing is the potential to spread STDs, including HIV and hepatitis. These diseases are spread most often from the inserting partner to the receptive partner. There is also a risk of spreading intestinal parasites, if the receptive partner has one. For that reason, it’s considered a “high risk sexual behavior”.

There is no way to use barriers to reduce risk with felching. The best way to protect oneself is to get all potential sexual partners STD tested before felching. Keep in mind that HIV can take up to three months to show up on an HIV test, so you may wish to wait until a test at three months is clean.

Resources:

Apr 152011
 

Vaginas can prolapse, but what does that mean? Vaginal prolapse happen when part of the vagina is either squished by other organs or protrudes from the vaginal opening. Most of the time it happens to women who have given birth, do heavy lifting, or have chronic constipation. Up to half of women can be affected over their lifetimes. More general information about vaginal prolapse, including treatment options, available here.

Vaginal prolapse can also happen in transsexuals. A new study surveyed 55 transsexuals (52 transwomen and 3 transmen) and found that four of them had vaginal prolapse; two needed surgery. That is about 7.2% – so transsexuals had fewer prolapses. Even so, transwomen and transmen need to be aware that both vaginas and neovaginas (warning: link contains graphic images) can prolapse.

You can see a review of the research here, and the original article here.

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!

Mar 252011
 

There is a report that a man was sentenced to two years in prison for breaking a restraining order. He was found naked in someone else’s farm, covered in cow manure, masturbating. This is apparently the third time he’s been caught trespassing. I read this article and thought, “Hmmm this is a good opportunity to talk about scat play!”.

Unlike urine, feces is not sterile at all. The colon (aka: the large intestine) is filled with lots of bacteria – mostly good ones. The feces that passes through the colon is, naturally, full of bacteria. These bacteria, while they may do good in the colon, are definitely not good to have elsewhere in the body. They can cause infection, like vaginal or urinary tract infections. If you have parasites or a virus, you’ll find them in feces too.

So how can a person play with feces safely? By:

  • using barriers like condoms, dental dams, and gloves to avoid contact with the feces. This is especially important for mucous membranes that are part of the vagina, penis, mouth, nose, and eyes. Skin, even when it looks healthy, can have microscopic cuts and tears. Barriers are safer than bare intact skin, which is safer than skin with cuts or tears. Breaks in the skin provide a way for ickies to get in!
  • only doing fecal play when physically well and the source of the feces is healthy and well, and especially avoiding times when having diarrhea.
  • not ingesting feces because of the possibility of disease.
  • not doing fecal play while pregnant or immunocompromised.

Non-human feces can carry different and harmful diseases. For example, cats can carry Toxoplasma gondii. It’s the bug that causes toxoplasmosis, which can be deadly in people with compromised immune systems.

Fecal play needs to be discussed with your physician. In case of illness, that physician needs to know what exposures you’ve had in order to make the best diagnosis. If your physician doesn’t know that you are exposed to feces, then s/he may miss something vital and misdiagnose you! (assuming you are sick)

Other resources:

Basic information

From Go Ask Alice!

Common parasites