Prostate-Cancer Screening: Men Should Forgo PSA Testing, Panel Advises

2012-05-23

Men should not get routinely screened for prostate cancer using the PSA test, a government panel recommends. The panel finds there is little evidence that testing for PSA, or prostate-specific antigen, saves men’s lives, and that it causes too much unnecessary harm from the treatment of tumors that would never have killed them.

The advice, published [PDF] by the U.S. Preventive Services Task Force in the Annals of Internal Medicine, extends the recommendation against routine prostate-cancer screening to men of all ages. The group had previously advised men ages 75 and older to avoid PSA testing.

The USPSTF, which in 2009 recommended that women delay routine mammograms until age 50, based its prostate-cancer-screening guidelines on a review of previous research, including two large studies in the U.S. and Europe. The studies compared cancer rates and survival between men who were routinely screened and those who were not, and found little to no mortality benefit from PSA screening over 10 years of follow-up.

Continue reading Prostate-Cancer Screening: Men Should Forgo PSA Testing, Panel Advises →

Oh No, Where Did It Go? When Things Get “Lost” In the Vagina

2012-05-22

While the vagina is actually a structure with side and back walls, women can get panic stricken when an item seems to get lost or is not retrievable. We get requests on our Community Board for help in getting things back out of the vagina. Similarly, as a clinician I would sometimes find “lost” objects during a speculum exaam.

Lost Condoms

According to some studies, 28-33% of condom users have reported breakage, slippage, or both. According to one study of 834 condom-protected sex acts, 7% involved slippage with sex and 8% had slippage during withdrawal. Either breakage or slippage could result in all or part of a condom being left inside the vagina.

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Study: Safe sex can be fun

2012-05-15

Safe sex, it seems, has gotten a bad rap, with one recent survey showing that a quarter of young men and women consider sex with a condom a “hassle.” But there’s hope yet, as other new research finds safe sex can be fun.

The new study of male condom users finds that certain factors, including a partner’s comfort, are linked with sexual pleasure during condom use. The results could help sex educators encourage safe sex, said study researcher Devon Hensel, a professor of adolescent medicine at the Indiana University School of Medicine.

“The number one take-home message is that safe sex can be pleasurable sex,” Hensel said. “The idea that using a condom somehow decreases the fun you have when you have sex is completely a misconception.”

Beliefs about safe sex
A survey released last week by the reproductive health research institute Guttmacher revealed that negative attitudes toward condoms are relatively widespread. Researchers conducted phone surveys with a nationally representative sample of 1,800 unmarried men and women ages 18 to 29.

Almost 70 percent of the women and 45 percent of the men surveyed were highly committed to avoiding pregnancy, but misconceptions about birth control were prevalent. For example, 40 percent of respondents said that using birth control didn’t matter that much in preventing pregnancy. [7 Surprising Facts About the Pill]

Among both men and women, 25 percent said that using a condom every time during sex was a hassle, the researchers reported in the journal Perspectives on Sexual and Reproductive Health.

Improving condom use
In her study, Hensel collected data from 1,599 men who, as part of the study, kept daily diaries of their sexual activities. In about 85 percent of the sexual encounters recorded, the men reported using a condom.

Older men were more likely than younger men to report pleasurable experiences while using condoms, the researchers reported in the May issue of the Journal of Sexual Medicine. Oral and manual genital stimulation were also associated with more satisfaction, as was greater condom comfort.

Men also experienced less pleasure during condom use when their partners were uncomfortable, the researchers found.

“His pleasure is reduced if she’s uncomfortable,” because of the condom, Hensel said.

The results are an argument for making questions about condom use a part of routine doctor’s care, she said. If lubrication or comfort are a problem for men, physicians should help their patients come up with solutions, Hensel said.

“There’s this long-standing stereotype about condoms as kind of being a downer, the thing we have to do because we’re responsible rather than the thing we want to do because it’s ultimately the more pleasurable thing because we’re being safe,” she said. “It can be safe and it can be pleasurable.”

You can follow LiveScience senior writer Stephanie Pappas on Twitter @sipappas. Follow LiveScience for the latest in science news and discoveries on Twitter @livescience and on Facebook.

These parties go way beyond Tupperware

2012-05-14

Picture this: A group of female friends lounge around a living room, noshing on snacks and sipping wine. At the center of the circle, a woman gives a presentation on her wares, sharing bits of knowledge with the hope that some of the women will choose to purchase her products.

I’ve just described a typical “party plan,” a marketing technique that melds a social event with direct product sales. Party plans are nothing new – Tupperware, Pampered Chef and Mary Kay have been around for decades.

What makes this scenario different is that the consultant isn’t hawking egg slicers or lipstick. Instead, she’s sharing the buzz on the latest vibrators, lubricants and other bedroom accessories.

It’s a creative, blush-free way to bring these products to women who may be squeamish or shy. But are the attendees walking away with more than just a bag of sex toys?

Sex toy parties have been around since the 1970s, although they didn’t truly begin to gain popularity until the ’80s and ’90s. These days, such get-togethers have gone mainstream, and most women I know have attended at least one, often at bachelorette parties.

It’s estimated that there are tens of thousands of consultants in this country, working for Pure Romance, Passion Parties, Intimate Expressions or one of the many other franchises.

As with other party plans, consultants give product presentations, with the host typically receiving merchandise or a discount in return. But that may be where the similarities between sex toy parties and, say, Tupperware parties end.

Sex toy parties go beyond simple commercialism and can teach women about their sexuality, according to Patty Brisben, founder of Pure Romance.

“We are not about the sale of a product – we are about the education behind it,” she says. “Our mission is to provide a very safe environment for women to learn about and discuss sex and sexuality. The bottom line is that people will not use their products if they don’t know how to use them or are intimidated.”

In fact, party-goers may rely on consultants to expand their knowledge about sexuality in general: A 2009 study by researcher Debby Herbenick and others at Indiana University’s Center for Sexual Health Promotion found that sex toy party consultants are often asked for accurate sex advice and may even have backgrounds in health or sexual education.

Similar research by the same authors, published in the November 2009 issue of Sexual Health, suggests that such parties allow women to learn more about specific topics, including increasing desire/arousal, orgasm, erection and ejaculation, and vaginal dryness and lubrication.

“Female in-home sex toy party facilitators have the potential to provide a diverse group of women with opportunities to access sexuality information, products, and communication,” they write.

While other party plans might involve testing out a recipe or demonstrating a makeover, sex toy parties tend to have greater goals. Passion Parties, for example, are primarily geared to women in couples; their mission involves fostering “passionate monogamy.” Surprise Parties seeks to help women achieve sexual fulfillment. And Pure Romance focuses on female empowerment.

“Sex toy parties should be a platform for women who want to be responsible for their own sexuality,” says Brisben. “We are the place for women to start getting a better understanding of their needs, their wants, and their desires. And when you understand the mechanics of what makes you feel good and why, it allows you to know what to ask for.”

Whether you’re easily embarrassed or totally comfortable talking about your sex life, sex toy parties can be a great opportunity to chat with your girlfriends, learn something new, and become a little – or a lot – more in tune with your sexuality.

Who knows – you might even leave with a few new treats. Above all, have fun. Isn’t that what parties are all about?
Post by: Ian Kerner Ph.D. – sex counselor
Filed under: Living Well • Relationships • Sex • Women’s Health

No Such Thing as a ‘Normal’ Vagina?

2012-05-07

Perhaps it need not be said that one vagina is not the same as the next, but medically speaking, doctors have long thought that all “healthy” vaginas had certain things in common — namely levels of some good bacteria.

But a new study led by Jacques Ravel at the University of Maryland School of Medicine reports that in fact not all women are created equal. The vaginal microbiome — the community of bacteria living in the vagina — varies considerably between women, the study found, and even within the same woman at different times.

The results, published this week in Science Translational Medicine, suggest that there may not be a single standard for a “normal” or “healthy” vaginal environment. Levels of bacteria that may signify bacterial infection in one woman may be healthy in another. The study involved 32 women who submitted vaginal bacterial swabs taken twice a week for 16 weeks.

“We were surprised at the extent of differences we saw between women, and the uniqueness of patterns observed with various individuals,” says Larry Forney, director of the Institute for Bioinformatics and Evolutionary Studies at the University of Idaho and one of the co-authors of the paper. “When you look at the 32 women, it’s hard to find two who are the same when it comes to their vaginal microbiota.”

(MORE: A Surprising Link Between Bacteria and Colon Cancer)

It’s the first study to document such dynamic differences, and could change the way doctors currently diagnose and treat vaginal infections. Yeast and bacterial infections affect about 25% to 30% of women in the U.S. on any given day. Rather than using a one-size-fits-all approach to treatment, each woman may require more tailored treatment.

Previous studies of the bacterial communities found in the vagina have relied only on samples taken at one point in time. Ravel and his colleagues took a series of samples because they wanted to learn more about changes to the bacterial communities over time: Do they fluctuate consistently? Do they differ between women? What external factors, like sexual intercourse or exposure to compounds, affect the makeup of the bacterial communities? Are certain microbial recipes better at warding off infections?

Scientists have known that in general that certain bacteria living in the vagina — Lactobacillus bacteria —can help combat yeast infections by releasing lactic acid and other acidic compounds that kill yeast and other bugs. But no studies had looked at the vaginal communities over time, and none had applied the latest genomic technology to DNA fingerprint the types of bacteria living in the organ.

Ravel and colleagues’ genomic analysis confirmed the existence of five main groups of bacterial communities in the vagina, but revealed for the first time that not all women harbor the same breakdown of these populations. In fact, even among the small number of women in the study, the researchers found great variation by race: Hispanic and African-American women tended to have microbiomes that are not thought to protect against infection as effectively as the bacteria that were more commonly found in white and Asian women.

But a bacterial makeup that may put one woman at risk of infection may just be a normal state for another. Similarly, even within the same woman, changes in the microbiome over time may be normal.

These results may help doctors individualize the diagnosis and treatment of vaginal infections. Currently, doctors treat all infections with the same antibiotics, as if they were caused by the same bacterial problems. The results aren’t ideal. On average, about 70% of women who are treated for bacterial vaginal infections will experience a recurrence, says study co-author Rebecca Brotman, assistant professor of epidemiology and public health at the Institute for Genome Sciences at the University of Maryland.

“With the microbiome of the vaginal communities, we can start thinking about personalized medicine for women,” says Ravel.

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.

Read more: http://healthland.time.com/2012/05/04/no-such-thing-as-a-normal-vagina/#ixzz1uAP9qpgp

G-spot found! Now, maybe we should lose it

2012-04-27

The search for the G-spot is a bit like the sexual equivalent of searching for UFOs: rarely does a year goes by without a new study either confirming or disproving the existence of this small area just inside the vagina, which – to varying degrees – is a source of sexual pleasure for women.

It’s not so much the pleasure-potential of the area that is in doubt, but rather whether the G-spot is an independent anatomic entity, or conversely, a part of the surrounding structure.

“The G-spot has been so difficult to identify because it is more of a physiological change – akin to swallowing or urinating – than an anatomic structure such as a nipple,” said Dr. Irwin Goldstein, editor-in-chief of The Journal of Sexual Medicine, after a study was published in his journal in 2010.

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Add Inches!! (No, Really, Men Can Make It Longer)

2012-04-24

Don’t worry, you didn’t just accidentally click on spam email. Though most advertised penis-enlargement methods are bogus, a new review of 10 existing studies suggests that some non-surgical techniques really can increase the length of a man’s organ.

Two urological researchers, Marco Ordera and Paolo Gontero of the University of Turin in Italy, examined outcomes from both surgical and non-surgical procedures for “male enhancement” in previous studies. Half of the studies involved surgical procedures performed on 121 men; the other half involved non-surgical enhancement techniques used by 109 men. (More on TIME.com: Ginseng + Saffron = Good Sex? Aphrodisiacs Found in Common Spices)

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He Wants Sex, She Doesn’t. Are Beads the Answer?

A fortieth birthday is a big deal that calls for a big present. How about 40 straight days of sex? That’s the gift that Carolyn Evans bestowed upon her husband, Ray, in January 2009. Immediately, she regretted it.

“I woke up the next morning and thought, I will not survive this,” says Evans, 40, who ostensibly did not receive an identical gift on her milestone birthday. “I was at a friend’s shop and I complained to him. He said maybe a token system will work better.”

Reaching under the counter, her pal pulled out a dusty Mason jar housing a collection of Venetian glass beads. Forty beads, to be precise.

Continue reading He Wants Sex, She Doesn’t. Are Beads the Answer? →

Can Bicycling Affect a Woman’s Sexual Health?

2012-04-05

Spending time on a bicycle seat, which has been linked to erectile dysfunction in men, may also be a hazard to a woman’s sexual health, a new study shows.

Many women who cycle or take spin classes are familiar with the numbness that sometimes can occur from sitting on a traditional bike seat. Bike seats are designed in such a way that body weight typically rests on the nose of the seat, which can compress nerves and blood vessels in the genital area. In men, this raises the risk of erectile dysfunction, something that has been documented in studies of male police officers on bicycle patrol.

But female cyclists have not been studied as closely. A study by Yale researchers in 2006 found that female cyclists had less genital sensation compared with a control group of female runners. As a result, some scientists believe that female cyclists probably are at similar risk for sexual problems as male riders.

In the latest study, the Yale researchers tried to determine whether there are specific factors that influence soreness and numbness among female riders. Forty-eight women took part in the study, each a consistent rider who cycled a minimum of 10 miles a week, but typically much more.

The women took their personal bikes and saddles into the lab. The researchers mounted the bikes on a stationary machine, and had the riders position their seats and handlebars according to their preference. As the women pedaled, they reported whether they felt soreness, numbness or tingling as a result of sitting on the bike seat, and a device was used to measure sensation in the pelvic floor.

Notably, it was the position of the handlebars that seemed to have the most effect. Women on bikes with handlebars positioned lower than their seats experienced more pressure in an area of soft tissue called the perineum, and had decreased sensation in the pelvic floor.

The researchers found that the lower the handlebars in relation to the saddle, the more a woman has to lean forward, forcing her to put a greater percentage of her body weight on the perineum. This problem is particularly likely to occur when a rider leans forward, flattens her back and puts her hands on the “drop bars” of a road or track bicycle for a more aerodynamic position.

“We’re basically showing that there may be modifiable risk factors associated with female riders,” said Dr. Marsha K. Guess, an author of the study and an assistant professor of obstetrics, gynecology and reproductive sciences at the Yale School of Medicine. “This better positions us to educate riders on safe riding practices that may actually be beneficial to reduction of pressure and lost sensation in the pelvic floor.”

The findings, published online in The Journal of Sexual Medicine, help shed further light on the problems faced by female riders, something that needs more long-term study, said Steven M. Schrader, a scientist at the National Institute for Occupational Safety and Health whose early research helped identify bike seat risks for male police officers on bicycle patrol.

Dr. Schrader said that over the years he has given speeches about his findings to groups of police officers who do bicycle patrol. Afterward, he said, women from the audience sometimes approach him and say, “It’s not just a men’s thing.”

“Women are having issues as well,” Dr. Schrader said.

Dr. Schrader’s research on officers showed that one of the best ways to eliminate or reduce pressure on the perineum is to use a bicycle saddle without a nose. The findings led the institute to recommend that police officers and other workers on bicycles use “no-nose” saddles, which put pressure on the sit bones, rather than the soft tissue of the perineum. Although he hasn’t studied use of the noseless saddles in women, he said he believes women would benefit as well.

“If you don’t put weight there,” he said, “there’s no pressure.”