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Today’s teen troubles: Sex, drugs and texting on the go

June 14, 2016Behaviour, blogSRH Matters

Today’s teen troubles: Sex, drugs and texting on the go

2016-06-14

It’s a question every mom and dad wants answered: What are their kids really up to?

Today, parents are getting some insight from the Centers for Disease Control and Prevention’s Youth Risk Behavior Survey, which has been conducted every other year since 1991. It now covers 118 health behaviors, as well as statistics on obesity and asthma.

The report notes that the prevalence of most health-risk behaviors — such as riding with a driver who had been drinking alcohol, physical fighting and current cigarette use — has decreased. Some behaviors and outcomes have not changed, including suicide attempts treated by a doctor or nurse, smokeless tobacco use, having ever used marijuana and attending physical education classes. Some have increased, such as being obese or overweight and not drinking milk.

The survey “helps us identify newly emerging behaviors and monitor long-standing youth risk behaviors over time,” said Laura Kann (PDF), chief of the CDC’s School-Based Surveillance branch. “While overall trends for the 2015 report are positive, the results highlight the continued need for improvements in reducing risks among teens.”

The 2015 survey includes results from a national survey, 37 state surveys and 19 large urban school district surveys, conducted among students in grades nine through 12. In all, more than 15,000 students took part in the survey. Participation was voluntary, and responses were kept anonymous.

Here are the highlights from each of the report’s six categories, as well as some insight from CNN’s extensive reporting on all of these areas of health and wellness.

1. Motor vehicle crashes remain the top cause of death.

Motor vehicle crashes are the leading cause of death for people ages 10 to 24, accounting for 23% of deaths in that age group, according to the CDC.

“Nationwide, 42% of students who had driven a car or other vehicle during the past 30 days reported texting or emailing while driving,” according to the report. “This percentage did not change from 2013.”

Every day, more than eight people are killed and more than 1,100 are injured in crashes that are reported to involve a distracted driver, according to the CDC. In addition to texting or emailing while driving, the agency warns about activities such as talking on a cell phone, eating or using a navigation system.

Currently, 46 states, plus Washington, Puerto Rico, Guam and the U.S. Virgin Islands, ban texting while driving for drivers of all ages, according to the Governors Highway Safety Association.

“When you’re texting and driving, your reaction time decreases, your concentration decreases,” said CNN Chief Medical Correspondent Dr. Sanjay Gupta. “People have likened it to driving with a blood-alcohol level of .08. Just like they say, you don’t let friends drive drunk; you don’t let friends drive while texting, either.”

New technology allows drivers to utilize auto-replies if someone tries to text or call while you’re behind the wheel. Other apps can monitor your speed (via your phone’s accelerometer) and disable your phone if it detects you’re moving too fast.

“Your best bet, which is something I’ve started doing as well, is just put the phone out of reach,” Gupta said. “However long it takes you to get home, most of those calls, those emails, those texts — they can wait.”

2. Cigarette smoking is down, but …

The report offers good news about where things stand now but is wary about the future.

“Current cigarette smoking is at an all-time low, which is great news,” CDC Director Dr. Tom Frieden said. “However, it’s troubling to see that students are engaging in new risk behaviors, such as using e-cigarettes.”

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Current cigarette use has decreased significantly, from 28% in 1991 to 11% in 2015, according to the report. But 24% of high school students reported using e-cigarettes in the past 30 days. This is the first time the survey has measured e-cigarette use.

In May, the Food and Drug Administration finalized a rule that allows the agency to regulate e-cigarettes, cigars and hookahs in the same manner it regulates traditional cigarettes.

From a health perspective, teenagers — especially between ages 15 and 17 — are most vulnerable to addiction, at a time when their brains are still developing, according to a report released last year by the Institute of Medicine (PDF).

“Tobacco (is) arguably the most addictive substance on the planet, which has no redeeming qualities whatsoever, in any way, shape or form,” Gupta said. “No matter what your age, smoking is one of the single worst things you can do to your body.”

Some studies have shown that e-cigarettes can be an effective aid in smoking cessation. Other research, which has focused on teens, found that those who used e-cigarettes were more than three times as likely to smoke traditional cigarettes.

“We must continue to invest in programs that help reduce all forms of tobacco use, including e-cigarettes, among youth,” Frieden said.

3. Teens are trying opioids, too.

“Nationwide, 17% of students had taken prescription drugs (e.g., Oxycontin, Percocet, Vicodin, codeine, Adderall, Ritalin or Xanax) without a doctor’s prescription one or more times during their life,” the report said.

Taking a prescription that hasn’t been written for you by your doctor for an explicit purpose is almost never a good idea. What’s more, in many places, it’s illegal to share pills that have been prescribed to you with someone else. Without consulting your doctor, there’s also no way of knowing what reaction you will have or what kind of interaction could occur because of another drug you might be taking or a pre-existing condition you may have.

The biggest potential problem, though, is “stacking.” It’s when someone combines one medication with another prescription drug, an illegal drug or alcohol. It can amplify the effects of one or both substances and can put your health at great risk.

4. Fewer young people are sexually active.

The percentage of high school students who are currently sexually active — meaning they had sex during the past three months — has been decreasing since 1991, according to the report. It dropped from 38% in 1991 to 30% in 2015.

But, “among high school students who are currently sexually active, condom use decreased from 63% in 2003 to 57% in 2015.”

Because of either misinformation or a lack of information, many teens are under the impression that sex while using birth control is safe sex. The bottom line: There is no pill that protects against sexually transmitted infections, with one notable exception. A medication called PrEP has been shown to be almost as effective as condoms in preventing sexual HIV transmission. Currently, the pill (brand name Truvada) is recommended by the CDC only for those at high risk of contracting the virus.

Nationwide, just 10% of students had ever been tested for HIV, according to the report. Some high school students may be worried about getting tested because they’re afraid their parents will find out through their health insurer.

One simple solution for families would be to make getting tested a yearly occurrence, at a minimum, in an effort to remove some of the stigma. If the tests comes back negative, you’ve put your mind at ease. If you do test positive, the sooner you go on medication, the better — and you won’t pass the virus on to someone else.

5. They’re skipping the soda.

The obesity epidemic in this country is getting worse. But there was a glimmer of hope in today’s report, which found a significant decrease in young people drinking soda one or more times a day. It was down from 27% in 2013 to 20% in 2015.

Calories consumed from sugar-sweetened beverages are far worse for you than calories consumed from food, even the fatty fast-food variety. That’s because without the fiber — say, in the skin of an apple — the sugar hits your liver all at once in a sort of “sugar tsunami.” What’s more, added sugars, like the kind found in sugar-sweetened beverages, are far worse for you than naturally occurring ones in fruit and dairy products.

Diet soda isn’t much better. Some interesting researchhas shown that people who drink diet soda may consumer fewer calories overall, but a higher percentage of their calories came from “discretionary foods,” such as cookies, chips, French fries and ice cream. The authors of that study say people who drink diet soda may feel justified to eat worse foods because they’re “saving” calories when it comes to their drinks, or they may drink diet because they feel guilty about eating unhealthy foods.

If you’re looking for a caffeine kick, switch to coffee or tea. If it’s the fizz you’re looking for, try seltzer with a squeeze of lemon or lime.

6. Screen time is eating into outside time.

“Sedentary behaviors are still problematic,” said Dr. Stephanie Zaza (PDF), director of the CDC’s division of Adolescent and School Health. “Although TV watching for more than three hours a day decreased from 43% in 1999 to 25% in 2015, this behavior has been completely replaced by the use of computers.”

“From 2003-2015, the percentage of high school students playing video or computer games or using a computer three or more hours per day (for non-school related work) nearly doubled, from 22% to 42%,” according to the report.

There is an upside to that. Even the most simple games are more active (at least mentally) than passively watching television. The downside? Nearly every parent would agree that when they were a kid, this time was spent outside, doing something active.

The good news is that this might just be one of the simplest problems to fix: Put down the phone and get outside.

CNN’s Nadia Kounang contributed to this report.

The Strange Reason Your Skin Itches When You Work Out

June 10, 2016blog, Sexual HealthSRH Matters

The Strange Reason Your Skin Itches When You Work Out

2016-06-10

Breaking a sweat might spark a surprising urge—the one to itch.

Itchy skin is actually a pretty common response to exercise, says Michael J. Ryan, Ph.D., associate professor of exercise science at Fairmont State University

When you get moving, your heart pumps more blood to your working muscles, like your thighs while running, or your chest while bench pressing. This fills millions of capillaries.

“As the capillaries expand, they push outward, stimulating surrounding nerve cells, which in turn sends signals back to your brain,” explains Ryan.

The result? Your brain translates these signals as an itch.

The only thing you can do to lessen the itch is to maintain a workout routine. If you exercise regularly, your brain gets accustomed to the signals and starts to ignore them.

But the longer the break you take from the gym, the more intense the itch will be when you return, says Ryan.

If your itching comes with welts, hives, or a feeling of faintness, call your doctor. This could be a more serious case called exercise-induced urticaria.

Parent Acts: When my son’s armpits smell like rotten cauliflower

June 8, 2016Sexual Health, UncategorizedSRH Matters

Parent Acts: When my son’s armpits smell like rotten cauliflower

2016-06-08

By Kelly Wallace, CNN

Parents: What do you do when your tween stinks? 02:14

Story highlights

In the “Parent Acts” video series, CNN’s Kelly Wallace asks parents to role play
Be proactive and talk with your children about body changes before they happen, expert advises

Kelly Wallace is CNN’s digital correspondent and editor-at-large covering family, career and life. Read her other columns and follow her reports at CNN Parents and on Twitter @kellywallacetv.

(CNN)“Oh, puberty,” laments Amanda Rodriguez, a mom of three boys, ages 8, 11 and 14.

I had asked her about that moment when she knew that her older boys definitely needed to start wearing deodorant.

“All of the smelly fun a girl can handle,” the Frederick, Maryland, mom joked, noting how the body odor is just beginning with her middle son.

“I would say the first few months are the hardest,” said Rodriguez, founder of the blog Dude Mom. “Initially, they are reluctant, even rebellious, and unwilling to accept the fact that deodorant is a requirement and no longer a fun novelty. It’s like they are nose-blind to the fact that they are ripe. They need constant reminders, lots of smell checks, extra time to prepare for each day.”

As a parent, there is a plenty of adjustment too, she says. “I have to remember to remind them that they need to get up early to shower and put on deodorant before they leave,” she said. “It’s a habit we all have to work together to form.”

Lisa Flick Wilson, a mom of twin boy-girl tweens who are 11, almost feels like she has this “laboratory just exploding at all times right before” her eyes.

“You harken back to that time when you were that one in grade school that stunk and you were like, ‘God, I wish my mom would have told me I stunk!’ “

But how exactly do you give your tween or teen that information, especially if they signal that they have no interest in discussing the topic?

In the second installment of our new CNN Digital Video series “Parent Acts,” we asked parents to act out what their children do and say when it comes to the body odor conversation, and then we had a parenting expert listen to their roleplay to weigh in with advice.

Tell the kids it’s ‘bacteria poop’

Erik Fisher is a psychologist working in the Atlanta area and co-author of “The Art of Empowered Parenting: The Manual You Wish Your Kids Came With.”

He says parents want to be careful not to use shame, guilt, humiliation or embarrassment to get any message across. “OK, they might feel those things as a result of the discussion, that’s part of the human experience, but when you use it as a weapon, that surrounds the whole thing with something that really doesn’t become the learning experience you want it to be,” he said.

Flick Wilson, who lives in Atlanta, says she’s honest with her kids. She’ll ask whether they put on deodorant in the morning and encourages them to choose their own when they go to the store. ” ‘You go pick it out. It’s for you. It’s your special thing. You’ve got a special place in your bathroom you keep all this stuff,’ ” she’ll tell them. “That makes them want to use it more.”

Being proactive is a good thing, said Fisher, who recommends introducing children as they are coming of age to what is going to happen to their bodies so they’ll know what to expect.

And once you start noticing changes happening, you can ask your kids whether they notice them, too. “You know, often we don’t smell ourselves very well, so you might say, ‘Are you aware of what’s going on? So every now and then check your armpits,’ something like that. ‘What do you smell?’ “

He also says parents can add more science to the conversation. They can tell kids that what’s actually happening is that skin cells are dying on their bodies, and when you have dead skin cells sticking to oils on the body, you get bacteria.

“The best part is, you say … ‘And you know what that smell really is? It’s bacteria poop,’ ” said Fisher, “And my daughter was like, ‘Oh, Dad, I didn’t need to know that.’ … A lot of kids are like that, but then they go, ‘Oh, wow.’ So then they realize why it’s not just that you smell. It’s that there’s a health issue that you have to be concerned about and be aware of as you grow older.”

Sometimes, kids just learn on their own

But even after the conversations, some kids might still be reluctant to accept their new reality, which may be partly motivated with wanting to defy their parents and not do what they suggest, said Fisher.

Some people need the social embarrassment to realize people are noticing, he said. “So you let them learn naturally. You give them enough room, and that’s kind of what I say. I give my daughter enough room to step in it and go, ‘How did that feel?’ ” he said.

Rodriguez, the mom of three, said that with her 14-year-old, and now her 11-year-old, she feels like she spends a few months when everything smells “just really rank” and she is constantly riding one of the boys about “being foul.”

“And then, all of a sudden you’re choking on Axe body spray and scraping gobs of hair gel off your bathroom sink,” she jokes. “The switch is just flipped (probably by some girl, gah!) and the ‘I don’t-want-to-stink-light’ is officially on. Parenting goal achieved.”

She started to talk with her boys about body changes in the fourth grade by giving them a book about boys’ bodies. She let them read it independently and then discusses it with them from time to time. “We try to focus on the positives, that they are going to get taller and stronger, and then we weave in some hygiene lessons as they come up,” she said.

Flick Wilson, the mom of twin teens, says she’s tried to be as open with her kids as possible, about everything from body changes to body hair to deepening voices, which is quite a contrast from the way she grew up.

“I think that as much as I loved my Catholic school upbringing, it was never a conversation you had, whether it was body changes or sexuality or you name it,” she said. “And so, I think for me, I’ve been very much like, ‘I want this not to be an anxiety-ridden conversation’ … and so we’ve kind of always talked about it.”

Any fun conversation starters on how to have the body change talk? Share them with Kelly Wallace on Twitter @kellywallacetv.

Sex life becomes more adventurous after 40! Reaching 40 could actually make your sex life more adventurous and sexual pleasure does not decrease with age, says a study.

June 2, 2016blog, Sexual HealthSRH Matters

Sex life becomes more adventurous after 40! Reaching 40 could actually make your sex life more adventurous and sexual pleasure does not decrease with age, says a study.

2016-06-02

Far from resulting in loss of libido, reaching 40 could actually make your sex life more adventurous, says a study. The findings are based on a survey of 2,400 Canadians, between ages 40 to 59, about their their sexual health, happiness and pleasure, in addition to their sexual behaviour and attitudes. ‘There is a public perception that as we age, sex becomes less important, less enjoyable and less frequent,’ said Robin Milhausen, sexuality and relationship researcher at the University of Guelph in Canada. ‘The study findings indicate that most midlife Canadians are indeed leading satisfying and active sexual lives,’ Milhausen said in press release. The study was conducted by leading condom company Trojan in partnership with Sex Information and Education Council of Canada (SIECCAN).

The researchers found that sexual pleasure does not decrease with age. Regardless of age category, 65 percent of the respondents said their last sexual encounter was very pleasurable. The overwhelming majority of the respondents said that their current primary relationship is emotionally satisfying . The research also revealed that as they got older, the respondents were more likely to be adventurous.

More than half of those surveyed (63 percent) said they are more interested in trying new things to enhance pleasure than they were a decade ago. Lubricant use for intercourse increased with age with 22 percent of men and 26 percent of women aged 55 to 59 using lube at last sexual intercourse. Vibrator use was common, with 40 percent of women reporting that they used a vibrator the last time they masturbated. ‘Sexual and relationship satisfaction were highly interrelated – and the most emotionally satisfied in their relationships reported the highest level of pleasure,’ Milhausen said. ‘And married people are reporting sex as pleasurable as their single counterparts, in fact, married men reported more pleasure at last sexual encounter than single men,’ Milhausen noted.

Source: IANS

Infertility can take the fun out of women’s sex lives

June 2, 2016blog, Sexual HealthSRH Matters

Infertility can take the fun out of women’s sex lives

(Reuters Health) – Women seeking fertility treatment, particularly young women, may experience a negative impact on their sex lives, although it will likely dissipate over time, according to a U.S. study.

“We weren’t surprised at all to find sexual distress in couples who are infertile,” said senior study author Dr. Tami S. Rowen of the University of California-San Francisco’s Irene Betty Moore Women’s Hospital. “Sex takes on a really different meaning for people trying to get pregnant.”

Infertility affects approximately 6.7 million women in the United States, Rowen and her colleagues write in the journal Sexual Medicine. Couples with infertility have significantly more anxiety, depression and stress, and that can have an ongoing effect on quality of life and the health of a marriage.

To gauge the impact on sexual health among women, the researchers surveyed 382 women in couples seeking fertility treatment at academic or private clinics in the San Francisco area.

Almost 60 percent of couples included in the study were seeking treatment for female infertility only, while 30 percent involved female and male infertility factors and 7 percent involved only male factor infertility.

The study team measured what they termed sexual impact with a seven-item questionnaire, including questions about a participant’s amount of sexual enjoyment, perceived attractiveness to partner, inability to have sex because of fertility problems and persistent thoughts about having a child during intercourse.

The results were then translated into a sexual impact score ranging from zero to 90, with higher scores indicating more severe impact.

The majority of participants were between 20 and 45 years old. More than 40 percent had been married at least five years and three-quarters had no children. Many had been treated with oral medications, injectable fertility drugs and intrauterine insemination before entering the study.

On average, the women had a sexual impact score of 38, compared to 25 for men in a previous study of the same couples.

Women who perceived their fertility issues as due only to male factors had the lowest sexual impact, while those who believed their own infertility was the only cause had the highest sexual impact scores.

“Women carry this burden so much and there’s so much emotion tied to women’s reproductive goals,” Rowen said. “We felt in general that most people actually attribute it to themselves more than it was overall attributable, a lot of times it’s male and female factor both.”

Women younger than age 40 had higher impact scores than those over age 40, though this was not true for women who already had a child, according to the results.

“I think it would be really interesting to do a study of how often doctors talk to patients about sex lives,” Rowen said.

When she sees patients struggling with infertility, Rowen added, she talks to them about making sure sex is fun and not a chore, even though they are having sex every day for a specific purpose.

“It seems that emotional problems are common among infertile women,” said Dr. Lucia Alves S. Lara of Ribeirao Preto Medical School at the University of Sao Paulo in Brazil, who was not part of the study.

“A previous study showed that women seem to be more affected than men in their sexual life and they have greater tendency to classify the marital relationship as bad when the couple fails to conceive,” she told Reuters Health by email.

SOURCE: bit.ly/25hFvj0 Sexual Medicine, online May 7, 2016.

Under the covers with men’s sexual health issues

June 2, 2016blog, Sexual HealthSRH Matters

Under the covers with men’s sexual health issues

New treatments on offer for many problems men may perceive as being embarrassing or distressing

Do a quick Google search for women’s health. You’ll receive approximately 152 million results. Do the same for men’s health and you will get 22.3 million. Is this sexism in another guise, or is it purely indicative of male reluctance to discuss their health issues, even with Dr Google?

Under the covers with men’s sexual health issues

Consultant urologist and andrologist at University Hospital Waterford (UHW)Ivor Cullen says men should be aware that there is a wide range of solutions to many problems they may perceive as being embarrassing or distressing.

Cullen trained in several ground-breaking techniques during his time working in the leading urology centre at University College London Hospital. Many of these have not been available in Ireland until now.

Breakthroughs in fertility medicine have not just been confined to female fertility issues; the area of male infertility has seen a revolution in recent times, says Cullen.

Sexual dysfunction has also moved on from the “little blue pill”. When Viagra doesn’t work, there are many other options for men struggling with erectile dysfunction.

The important thing to remember is that no worrying or “embarrassing” health problem can be addressed if a man doesn’t approach his GP or health professional about it, Cullen says.

Erectile dysfunction

Erectile dysfunction affects about half of all men at some point in their lives. For some it may just be temporary, but for others it can be a persistent problem. For some this can be treated with physiotherapy and muscle re-education exercises. It can also be treated with medications – the phosphodiesterase type 5 inhibitors (such as Viagra).

However, for those men who do not respond to these treatments, there is now the surgical option of an inflatable penile prosthesis.

As part of this procedure, hydraulic pumps are inserted so that men with erectile dysfunction can have functioning erections and have sex normally.

Although this procedure has been offered in Ireland before, in Cullen’s opinion, the uptake has been quite poor, mainly owing to a lack of knowledge in the area among both patients and the health profession at large.

“Penis implant surgery is just not requested or desired by patients as they are unaware of the option,” says Cullen, contrasting this with his experience in London where a significant proportion of men with ED are aware of and will choose the implant surgery as an option when the medications fail.

“It has been offered to a limited number of patients in one or two centres. There is very little knowledge about penis implant surgery. No one talks about it here, but in other parts of the world that’s not the case, it’s quite commonplace.”

According to Cullen, common candidates for this procedure are younger men with type 1 diabetes who often ultimately get erectile dysfunction early in life, often starting after the age of 40 and medication eventually does not work.

In addition, men who have had their prostates removed or had radiation or hormonal treatment, usually as a result of prostate cancer, would also benefit from this surgery, as the majority of these will lose the ability to have an erection and often will not respond to the usual medications.

The procedure can be carried out by Cullen and his team at UHW. A three-piece hydraulic inflatable implant is inserted, which isn’t visible externally. A small pump sits in the scrotum, much like a third testicle, explains Cullen. The two-piece prosthesis is implanted in the penis, while a reservoir is laced in the lower abdomen. When the pump is squeezed, the fluid goes from the reservoir into the prosthesis and makes it erect.

This ensures a rigid erection every time, satisfactory for penetrative intercourse and dispensing with the need for expensive medications or injections.

“Obviously that’s not for everyone but it is a fantastic addition to our options. Satisfaction rates with penile implant surgery are always remarkably high – 90-95 per cent. In a well-chosen patient who is properly counselled, it can be a wonderful option for erectile dysfunction,” Cullen says.

Kandasana the Best Yoga Position for Improved Sexual Functioning

May 25, 2016blog, Sexual HealthSRH Matters

Kandasana the Best Yoga Position for Improved Sexual Functioning

2016-05-25

Some men today prefer to take part in natural, alternative therapies for their healthcare needs. This is also true when it comes to erectile dysfunction.Many men are embarrassed or afraid to address the condition with their doctor. Others do not want to take medication if there is a natural alternative, though ED drugs are safe, with very few side effects. Then there are those who are very interested in yoga, acupuncture, reiki, and other alternative practices, and believe in their therapeutic benefits. Yoga expert Abhishek Sharma suggests kandasana for ED. This is a particular yoga position or asana, recommended for millennia to conquer what was traditionally called impotence. According to Sharma it is also effective against premature ejaculation. The idea comes from traditional Ayurvedic medicine. Here the chakras—a line of nexus points starting at the crown and ending at the groin, control the flow of an unseen energy force. This yoga position is said to open up the chakra of the navel, and release sexual energy. In a medical sense, it may open up and stimulate the blood vessels of the groin and pelvic region, leading to better circulation. A lack of blood flow is one of the biggest causes of ED.

Understand that this position is not recommended for those with a bad back or knee injury. To perform it you first sit with your legs out in front of you. Stretch your legs sideways and then fold them at the knee. Pull in your legs toward you. Inhale slowly and place your feet against your navel using your hands. You need to practice balance at this time. Keep your back straight. Hold this position for a few breaths. Slowly lower your legs to the floor during exhalation. You can rest for thirty seconds and then repeat the pose. Make sure to learn it from an instructor in order to perform it correctly. It is important to realize that no scientific studies back the use of yoga to undo ED. Many physicians do say that sexual functioning can improve greatly through exercise and an overall healthy lifestyle. Still, any man experiencing ED should talk with his doctor or an urologist as a more pressing, potentially life-threatening condition may be the cause.

Your First Gynecologist Exam

May 9, 2016blog, Sexual HealthSRH Matters

Your First Gynecologist Exam

2016-05-09

If you’ve never been to a gynecologist, you may be nervous about what happens during an ob-gyn exam. Put yourself at ease and use it as an opportunity to learn more about your body and your health.

By Madeline Vann, MPH | Medically reviewed by Lindsey Marcellin, MD, MPH

A gynecologist is a doctor who specializes in women’s reproductive health issues. When you first try to find a gynecologist, you may see that some are called obstetrician-gynecologists or ob-gyns. This refers to the training they have undergone to treat women from adolescence through pregnancy and delivery.

If you haven’t been to an ob-gyn before, you may wonder why you should find a gynecologist and what to expect when you get there.

Reasons why you should have a gynecologist exam include:

To learn about birth control options
To learn about screening for and preventing sexually transmitted diseases
For an annual pelvic exam
Screening for reproductive cancers, such as a Pap smear, starting at age 21 and then every two years (some women may need to have it more frequently, based on their doctor’s recommendations, while others may only need it every three years)
To find out about human papillomavirus (HPV) vaccination
For care for yourself and your baby during pregnancy

When to See a Gynecologist

Guidelines about when to have a gynecologist exam include:

When you are 21 or earlier if you become sexually active
If you have unusual bleeding or irregular periods
If you stop having periods for three months or more
If you suspect or know you are pregnant
If you have been trying to get pregnant without success
If you have pelvic pain
When you are between 40 and 50 to get your first mammogram referral
After menopause for bone density screening referrals

How to Prepare for a Gynecological Visit

Take these steps to make sure you get the most out of your gynecologist exam:

Do not douche, have vaginal intercourse, or use a vaginal cream or suppository for 24 to 48 hours before your visit.
Write down anything that has been worrying you, such as irregular periods or unusual discharge or discomfort — and bring pen and paper to write down the answers.
Bring a list of all medications, vitamins, and herbal supplements that you are taking.
Be able to share your family health history, especially reproductive health problems in family members.

What to Expect at Your First Gynecologist Exam

Here is what you can expect at your ob-gyn appointment:

Health history. A nurse will ask you questions about your personal health history and your family health history. She may also ask about health behaviors such as drinking alcohol, smoking, using illegal drugs, and sexual history. Some of the questions may feel very personal to you, but remember that everything that you share is private between you and your doctor unless you give written permission for it to be discussed with someone else.
Vital signs. The nurse will weigh you and check your blood pressure.
Pre-exam. You will be given a gown that opens in the front to wear and a sheet to cover your legs. You will need to remove all clothes including undergarments.
Discussion. Your ob-gyn will talk to you briefly about your concerns and will explain the gynecologist exam to you. This is a good time to bring up any questions you have.
Breast exam. Your ob-gyn will use her fingers to feel each breast and nipple in a pattern. This is to find unusual lumps or changes in tissue and skin.
Pelvic exam. You will lie on the exam table with your knees bent and your feet resting in stirrups to keep your legs apart. Your ob-gyn will sit at the end of the table for the exam. “A pelvic exam includes inspection of the vulva, insertion of a speculum to allow inspection of the vagina and cervix, the bimanual exam with two fingers in the vagina and another hand on top of the abdomen to examine the uterus, fallopian tubes, and ovaries,” explains ob-gyn Concepcion Diaz-Arrastia, MD, director of gynecological oncology and associate professor at Baylor College of Medicine. The speculum is an instrument that slides smoothly into your vagina to stretch it slightly so your doctor can take samples from your cervix. The pelvic exam should not be painful, but there may be some discomfort or pressure, and the speculum may feel cold at first.
Pap smear. During the pelvic exam, your doctor may take cells from your cervix for a Pap smear, which tests for precancerous changes of cervical cells. This is not painful.
STD testing. If you request it or your doctor recommends it, she can also take samples from your vagina to be tested for sexually transmitted diseases (STDs). Some STDs have to be found using a blood test.
Discussion. Your doctor will let you know if she sees anything unusual and may recommend additional testing based on this exam, such as a mammogram, bone density test, or blood work. This is another opportunity for you to ask more questions, including any about her findings or suggestions. The results of the Pap smear and STD tests will not be available for a week or more, but at this point your doctor can give you a prescription for birth control or any medication that you need.

You may be nervous about having your first gynecologist exam, but think of your ob-gyn is your partner in sexual health. She should become the practitioner you feel most comfortable talking with about some of your most private health issues.

Learn more in the Everyday Health Sexual Health Center.

Trichomoniasis: Symptoms, Treatment and Causes

May 6, 2016blog, Sexual HealthSRH Matters

Trichomoniasis: Symptoms, Treatment and Causes

2016-05-06

Written by Lori Smith BSN MSN CRNP

Trichomoniasis is a sexually transmitted infection caused by a protozoan parasite and affects more than 8 million people in the US every year.

The infection is passed from partner to partner during sex. However, the incubation period for the infection is not entirely clear; incubation times are thought to range anywhere from 3-28 days after exposure to the parasite.

While trichomoniasis is highly curable, it can cause complications, especially in pregnant women. Woman infected during pregnancy are at risk for premature labor, low birthweight babies and infection transmission during birth.

In addition to pregnant women, the general population of women seems to be at a higher risk of contracting HIV when they have a trichomoniasis infection.

Fast facts on trichomoniasis

Here are some key points about trichomoniasis. More detail and supporting information is in the main article.

Trichomoniasis is a sexually transmitted infection often referred to as “trich”
Reinfection is common – around 1 in 5 people will be reinfected 3 months following completion of treatment
To prevent reinfection, patients and their sexual partners need to complete treatment
Vaginitis (inflammation of the vagina) is commonly caused by trichomoniasis
Only 30% of those infected with trichomoniasis develop symptoms
Trichomoniasis typically affects the vagina, vulva and urethra
Women affected with trichomoniasis during pregnancy are at a higher risk for premature labor.

Trichomoniasis, also referred to as “trich,” is a sexually transmitted infection caused by a microscopic, single-cell protozoan parasite called Trichomonas vaginalis. The parasite is spread from person to person via sexual intercourse.

In women, the area of the body that is affected by trichomoniasis most frequently is lower genital tract. In men, it is the urethra. The parasite does not typically infect other parts of the body such as the anus, hands or mouth.

According to the Centers for Disease Control and Prevention (CDC), trichomoniasis is the most common curable sexually transmitted disease (STD).

Risk factors for trichomoniasis

Those at an increased risk of being infected with trichomoniasis include:

Women, with older women more likely than younger women to become infected
People who have more than one sexual partner
People with a history of trichomoniasis or other sexually transmitted infections
People who have unprotected sex.

Symptoms of trichomoniasis

Up to 70% of people do not display any symptoms with a trichomoniasis infection. In particular, men with trichomoniasis are often asymptomatic.

When symptoms are present, trichomoniasis can affect men and women differently. These symptoms range in severity from minor cases of irritation to more extreme cases of inflammation involving discharge.

Symptoms of trichomoniasis for women include:

Frothy, foul-smelling vaginal discharge (clear, white, gray, yellow or green)
Blood in vaginal discharge
Genital irritation
Burning sensations in the genital region or during urination
Groin swelling
Painful intercourse (dyspareunia)
Urinary frequency
Painful urination (dysuria).

Symptoms of trichomoniasis for men include:

Urethral or penile discharge
Penile itching
Burning sensations after ejaculation or urination
Urinary frequency
Painful urination (dysuria).

trichomoniasis infection can increase the risk of an individual becoming infected with HIV, along with other sexually transmitted infections. This increased risk is attributed to the inflammation caused by trichomoniasis.

Trichomoniasis is linked to a number of complications for pregnant women:

Preterm birth
Premature membrane rupture
Low birth weight for babies (less than 5.5 pounds)
Potential transmission of infection to baby during birth.

Fortunately, trichomoniasis can be treated safely with antibioticsduring pregnancy.

Diagnosis of trichomoniasis

In order to diagnose a trichomoniasis infection, your health care provider will need to take a sample of vaginal or penile discharge or urine. They can either examine the sample under a microscope or send it to a laboratory for additional testing.

There are a number of steps that women can take to make the process of diagnosis easier for health care practitioners:

Do not douche for at least 24 hours before an appointment as this washes away discharge
Avoid using deodorant on the vulva – this masks smells and can cause irritation
Do not have vaginal intercourse or insert any object (including tampons) into the vagina for 24-48 hours prior to an appointment
If possible, schedule an appointment for when you are not on your period.

Previously, trichomoniasis would be diagnosed by growing a culture from a sample. Nowadays, diagnosis is much quicker, with health care providers able to utilize quicker tests such as rapid antigen tests and nucleic acid amplification.

Treatment for trichomoniasis

Trichomoniasis is easily treated in men and women, including those who are pregnant. Most commonly, treatment consists of a single dose of either metronidazole (Flagyl) or tinidazole (Tindamax), forms of antibiotic medication that kill parasites. This medication comes in pill form and is taken orally.

It is important that you and your sexual partners are treated following a diagnosis of trichomoniasis. You should also avoid having sex for a week following treatment. These measures help prevent reinfection.^1-3

You can prevent infection with trichomoniasis by using condoms or practicing abstinence.

If you think you have been exposed to trichomoniasis or think that you have the symptoms of an infection, speak with your health care provider for evaluation and treatment.

Sex After Pregnancy: When Can I Resume Intercourse?

May 6, 2016blog, Sexual HealthSRH Matters

Sex After Pregnancy: When Can I Resume Intercourse?

Most mothers will agree that the last thing on their mind after having a baby is sex. However, this is not often the case with their partner! On the other hand, some women may be ready to resume sexual intercourse shortly after having a baby. But when is the right time to resume sexual intercourse?

In general, it is recommended that sexual intercourse is avoided for the first 4-6 weeks following a vaginal or cesarean (C-section) delivery; however, it is important to speak with your health care provider before resuming sex.

Most often, especially in cases of a C-section, perineal tear or episiotomy, it is recommended to wait until after you are seen for your 6-week postpartum visit for the green light from a health care provider to resume sexual activity.

Following childbirth, your body is in a healing phase in which bleeding stops, tears heal and the cervix closes. Having intercourse too early, especially within the first two weeks, is not recommended due to a risk of postpartum hemorrhage or uterine infection.

When a woman is ready to resume sexual intercourse following the birth of a baby depends on several factors, including:

Pain levels
Fatigue
Stress
Sex drive
Fear of sex or pregnancy
Vaginal dryness
Postpartum depression.
What will sex after giving birth feel like?
Due to the hormonal changes experienced during the postpartum period, many women experience vaginal dryness, which may continue past the typical 4-6 week timeframe if breastfeeding; this is due to low levels of circulating estrogen.

Breastfeeding can also lower your sex drive. In addition to lower levels of circulating hormones, painful sex may accompany a perineal tear or episiotomy, which can last for several months following the birth of a baby.

Steps that can reduce pain associated with sex after pregnancy include:

Controlling the depth of penetration with varied sexual positions
Increasing vaginal lubrication
Taking pain medication
Emptying the bladder
Taking a warm bath.
Vaginal lubrication such as over-the-counter creams or gels may be useful in relieving the symptoms of vaginal dryness. If you are using barrier method birth control, using a water-based lubricant is recommended to avoid weakening the latex.

Alternatively, oral or manual stimulation may be an option during the healing process. For some people, an appointment with a pelvic floor rehabilitation specialist may be recommended to evaluate and treat painful postpartum sex.

Sex following childbirth may feel different due to decreased vaginal muscle tone and stretching. Typically, this laxity in vaginal tone is temporary, however, and is affected by factors such as genetics, the size of the baby, the number of previous births and the use of Kegel exercises.

Instructions on how to do Kegel exercises can be accessed here.

Hormones can cause a variety of interesting – and, at times, inconvenient – symptoms. For example, during sexual intercourse, your breasts may leak milk due to the hormonal response to orgasm. Try pumping before having sex to reduce this symptom.