SEX QUESTION AND ANSWER PART 1

The following questions have came into Mark's mailbox at some point in time. Research was conducted with reliable sources and the content have been included for your reading. This should not be taken as a substitute for a trip to your doctor should your medical condition call for it.


DO WOMEN HAVE WET DREAMS, TOO?
TWENTYSOMETHING MAN CONSIDERS CIRCUMCISION: IS IT SAFE?
WOMEN AND THEIR EGGS: HOW MANY AND FOR HOW LONG?
HOW LONG DO SPERM LIVE IF THEY DO NOT FERTILISE AN EGG?
FERTILE TIMES?
PREGNANT FROM SEMEN IN MOUTH?
PREGNANCY TEST -- HOW SOON AFTER SEX?
MORNING SICKNESS
YASMIN: A NEW BIRTH CONTROL PILL
CAN ORAL CONTRACEPTIVES CAUSE AN ABORTION?
BIRTH CONTROL PILLS FOR MEN?
BETWEEN PILL PACKS... IS SEX SAFE?
SIDE EFFECTS OF PILL
WHAT IS A FEMALE CONDOM?
PETROLEUM JELLY -- GOOD OR BAD AS LUBE FOR CONDOMS?
CONDOMS -- POROUS?
GETTING OFF DEPO-PROVERA HOW LONG WILL IT TAKE FOR ME TO GET PREGNANT?
IS THERE A DIFFERENCE BETWEEN BACTERIAL AND VIRAL STDS?
FALSE-POSITIVE HIV TESTS
HIV TRANSMISSION THROUGH URINE?
AIDS FROM RAW MEAT?
AIDS FROM MOSQUITO BITE?
AIDS--BARBER?
CHLAMYDIA?
HEPATITIS B
HEP C AND SEXUAL TRANSMISSION
URINARY TRACT INFECTION
IS IT POSSIBLE TO "BREAK" YOUR PENIS?


DO WOMEN HAVE WET DREAMS, TOO?

I'm a sixteen-year-old girl. Do females have wet dreams like boys??

asking
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Dear asking,

You betcha. In 1953, Alfred Kinsey, Ph.D., the famous sexuality researcher, found that nearly 40 percent of the 5,628 women he interviewed experienced at least one nocturnal orgasm (orgasms during sleep), or "wet dream," by the time they were forty-five years old. A smaller study published in the Journal of Sex Research in 1986 found that 85 percent of the women who had experienced nocturnal orgasms had done so by the age of twenty-one... some even before they turned thirteen. In addition, women who have orgasms during sleep usually have them several times a year. Dr. Kinsey and his colleagues defined female nocturnal orgasm as sexual arousal during sleep that awakens one to perceive the experience of orgasm. Girls and women who don't have orgasms in their sleep, or who don't know whether or not they've had them, are perfectly normal. It may be easier for men to identify their wet dreams because of the "ejaculatory evidence." Vaginal secretions could be a sign of sexual arousal without orgasm.

Similar studies find that a much higher percentage of boys and men experience wet dreams. This, combined with a greater focus on male sexuality by science and the public in general, are probably two big reasons why we don't hear very much about women's nighttime orgasms.

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TWENTYSOMETHING MAN CONSIDERS CIRCUMCISION: IS IT SAFE?

I am a male in his twenties, and I am considering circumcision. Is it safe to be circumcised at my age? And how many days do I need to recover?

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Dear Reader,

Circumcision is a safe procedure. For adult men, it is usually performed on an outpatient basis with local or regional anesthesia. The health care professional (often a urologist) will inject anesthetic around the base of the penis to numb the entire genital region. Once the area is numbed, the foreskin covering the glans is removed, usually by electrocautery. Stitches close the area from which the skin has been removed, and the penis is wrapped in gauze bandages that are typically left in place for the first 24 to 48 hours after the procedure. Barring any complications, a man can go back to his normal routine within a day or two after circumcision, but needs to refrain from all sexual activity, including masturbation, for four to six weeks, since erection can dislodge the stitches and interfere with healing.

Potential complications of adult circumcision include infection, bleeding or bruising, the removal of too much or too little skin, or dissatisfaction with penile appearance. In addition, some men who've been circumcised as adults report altered sexual feeling, including decreased penile sensitivity and changes in sexual response and arousal patterns. You might want to think about how changes in the appearance and/or sensitivity of your penis could affect you before choosing to be circumcised.

Men are often circumcised for religious, social, or cosmetic reasons. Some believe that circumcised penises are easier to clean or are more appealing to potential sexual partners, and can decrease cervical cancer risk in women who have sex with "cut" men. Adult men also might become circumcised for medical reasons; for example:

Phimosis This is when the foreskin cannot be properly retracted (pulled back) over the glans (head of the penis). This naturally occurs in infants and young boys who are not circumcised, usually resolving on its own with age. If this condition remains in adulthood, some men may develop a tight ring of scar tissue around their foreskin that makes retraction difficult, and can make erections and sex painful.

Paraphimosis With this condition, the foreskin that has been retracted over the glans becomes "stuck" and cannot be returned to its natural position. Paraphimosis can occur when foreskin is forcibly retracted (during sex, bathing, or medical procedures) and then not returned to its normal position. Penile piercings can cause this condition if the placement of the piercing causes irritation to the glans or forces the foreskin to stay retracted. Paraphimosis can cause swelling and an interruption of the blood supply to the glans, and is a medical emergency that can require immediate circumcision to save the tissue of the penis.

Balanitis An inflammation of the glans, balanitis is often caused by phimosis or lack of proper hygiene that allows smegma or other discharge from the penis to accumulate underneath the foreskin. This can cause recurrent penile or urinary infections that might be treated with circumcision.

As with any medical procedure, it's important to talk candidly with your health care provider about the potential benefits and possible complications to the procedure before you make your decision.


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WOMEN AND THEIR EGGS: HOW MANY AND FOR HOW LONG?

How many eggs does a woman have when she is born? Does a woman still have eggs when she starts menopause?

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Dear Reader,

Unlike men, who produce new sperm daily throughout most of their lifetime, women are born with a finite number of undeveloped eggs -- around one to two million -- in their ovaries.
When women reach puberty and start menstruating, only about 300,000 immature egg cells, or follicles, remain. Some of these begin to develop with each monthly cycle, but during this time, only one follicle matures into an ovum (egg) and bursts from an ovary into the fallopian tubes, initiating ovulation. Through a process known as atresia, many of the follicles that don't develop into mature egg cells degenerate. As a result, only a few hundred remain at menopause, which usually begins at around forty-five or fifty years of age; however, because of the hormonal changes that accompany menopause, the remaining follicles are unlikely to mature and become viable eggs.


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How long do sperm live if they do not fertilize an egg?

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Dear Reader,

Sperm live inside a vagina for about three to five days. The important thing about your question is that if you have sex without using contraception up to five days before an egg bursts from the ovary (ovulation), the egg could be fertilized. For example, you could have sex on Monday and fertilize an egg that is not released until Friday. The egg, on the other hand, has a much shorter lifespan -- about twenty-four hours. So, having sex right before ovulation -- and up to one day afterward -- would be prime for fertilization. Whether or not you want that to happen is another story....


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FERTILE TIMES?

When can a woman, during her menstrual cycle, be at high risk for pregnancy? I've heard two answers: fourteen days before or after your period. Which is it?

--Conceiving only ideas

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Dear Conceiving only ideas,

The simple answer to your question is that the egg bursts from the ovary (ovulation) approximately two weeks before the beginning of your next menstrual period. A common misunderstanding is that the egg bursts from the ovary at midcycle, halfway between menstrual periods. This is only true when the cycle is twenty-eight days long (something that cannot be known for certain until that particular cycle is over and menstruation begins).

A woman can become pregnant from unprotected intercourse up to five days before ovulation. Sperm can survive in a woman's body for three to five days, waiting to fertilize that egg during ovulation. Therefore, guessing how long your period usually is and counting backward fourteen days is not an effective method of birth control.

The fertility awareness method of birth control (a studied, standardized monthly procedure), however, can be quite effective if used diligently and properly. Being aware of your fertile times involves counting days, observing cervical mucus, taking your body temperature with a basal thermometer (see below for details) daily, and charting your own observations. This method also requires a highly motivated person.

Fertility awareness can be quite effective when taught carefully, understood thoroughly, and used correctly. The major disadvantages are the risk of pregnancy if you are not committed to using it correctly; it does not protect you from sexually transmitted diseases (STDs), including HIV infection; it takes at least two or three cycles to learn and use confidently; it can be sexually frustrating if you choose to abstain from intercourse rather than use a barrier method when you are fertile; and, most importantly, it may be impractical if you are not in a committed, cooperative relationship with your sexual partner.

P.S.: Basal body temperature is the temperature of the body when you first wake up. This needs to be measured using a basal thermometer [a basal thermometer is a special thermometer used to track ovulation that measures temperature in tenths of a degree, like the standard oral thermometer, but its numbers are magnified to make it easier for you to read your basal body temperature more clearly] immediately after waking in the morning to be most accurate. Women need to have a basal thermometer ready by the bed because any movement (even getting up from bed to get the thermometer) can cause the temperature to fluctuate.

Basal body temperature needs to be measured and recorded every day for several months; after a rise and a plateau, there will be a sharp drop in temperature followed by menstruation, which would indicate that the woman is ovulating.


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PREGNANT FROM SEMEN IN MOUTH?

I heard this from my sex ed teacher in high school, and I was wondering if he was correct. Can a girl get pregnant from having semen in her mouth? He said that if there are cuts inside her mouth, the sperm can get into the bloodstream and possibly get the girl pregnant.

Thanks, Wondering about my high school education

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Dear Wondering about my high school education,

No, a woman cannot get pregnant from having semen in her mouth (cuts or no cuts), nor from swallowing it, smelling it, feeling it, looking at it, or thinking about it. If your teacher did make this claim, he gets an "F" for needlessly Freaking people out. With the exception of egg implantation, pregnancy can occur only when sperm make their way to eggs via the vagina. This is also the case when women are artificially inseminated. Are you sure that your teacher wasn't talking about sexually transmitted infections (STIs) that might enter the body in this way? Teachers know a lot, but sometimes they are wrong. Glad you went searching for the truth that you can now present to your sex ed teacher by first clarifying what he said, and then respectfully making the correction, if it's necessary.


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PREGNANCY TEST -- HOW SOON AFTER SEX?

How soon after intercourse can one use a pregnancy test and get results?

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Pregnancy tests are sensitive enough that they can detect a pregnancy as early as one week after fertilization. It is not necessary to wait until a period is late or has been missed before testing for pregnancy. When used correctly, home pregnancy tests work well. They also provide privacy and convenience. Home pregnancy tests sometimes give erroneous results (usually false negatives); the most common reason for this is using the test too soon. If you think you may be pregnant, I suggest waiting seven to ten days after intercourse to test, following the test's directions carefully. If a home pregnancy test gives a positive result, make an appointment with your doctor, nurse practitioner, or local women's clinic for a confirmation. If you prefer, you can make an appointment for a pregnancy test directly instead of testing at home first. In either case, it can only be to your benefit to find out as early as possible if you're pregnant.


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MORNING SICKNESS


During my first pregnancy I had morning sickness ALL DAY for 8 months! Do you have any suggestions on how to avoid the nausea? I have heard (and tried) a lot of "old wives tales" but nothing seems to work...Please help me, as I would like to have another baby but I don't think I can go through that again!!


— Sick of being sick

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Dear Sick of being sick,


I am sorry to hear that you had such a difficult time with morning sickness that you are concerned about getting pregnant a second time. As you are probably aware, your obstetrician or midwife will not want to give you any drugs that could have teratogenic effects...ones that could impair the normal growth and development of the fetus. This is especially important during the first part of your pregnancy which usually coincides with the time most women experience morning sickness. Taking 50-100 mg per day of Vitamin B6 has been found to be nontoxic and helpful for some women, but definitely discuss this with your provider. Also, talk to other women to learn what worked for them or discuss your problem with the hospital's childbirth educator.


Often, each woman will find out what works for her, although sometimes nothing works. For example, eating crackers before you rise in the morning or eating something like a piece of cheese when you feel nausea or light-headed might help. You might try to remember your nausea. What made it worse or better? When was it worse or better? Was it only nausea or vomiting as well?


In some cases, a mother-to-be will experience very serious vomiting during a pregnancy, hyperemesis gravidarum. This can lead to hospitalization to rehydrate the body and to make sure that no electrolyte imbalances occur.


I am hopeful that your condition was not this serious and that your next pregnancy will be smoother. Remember, each pregnancy is different, so what happened in your first may not happen in your next.



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YASMIN: A NEW BIRTH CONTROL PILL


I would like to know about the new Yasmin birth control pill, what are the benefits, and the side effects?


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Dear Reader,


Yasmin, the most recent low-dose birth control pill to enter the market, was approved by the U.S. Food and Drug Administration (FDA) in May 2001. It is 99 percent effective in preventing pregnancy when used correctly, and works in the same way as other combination birth control pills. Each pill pack consists of 21 pills that contain the same amount of estrogen and progestin, to be taken one per day for three weeks, followed by seven placebo pills that are taken throughout the week, in order for a woman to get her period.


Yasmin is the only birth control pill to contain the synthetic progestin known as drospirenone — an alternative for women who experience adverse effects from other oral contraceptives. Drospirenone has antimineralocorticoid activity that influences the regulation of water retention and electrolyte balance in the body, as well as antiandrogenic (anti-male hormone) properties. It may even be effective in treating premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS).


As a result of this particular progestin, common benefits of Yasmin include:


less water retention less premenstrual weight gain fewer PMS and menstrual symptoms prevention of acne Similar to other birth control pills, possible side effects of Yasmin include:


headaches menstrual changes breast tenderness abdominal cramps and bloating nausea vaginal discharge Yasmin is not recommended for women who:


have kidney, liver, or adrenal disease, since drospirenone may increase potassium levels in the bloodstream. take certain medications, especially those that increase potassium levels in the body. have a history of blood clots or stroke. have a history of blood clots in the legs, lungs, or eyes. experience chest pain. have a history of or suspected cancer of the breast, lining of the uterus, cervix, or vagina. have unexplained vaginal bleeding. have a history of jaundice. have a liver tumor. In addition, women who smoke and/or have high blood pressure, diabetes, or high cholesterol need to take precautions if they take Yasmin.



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CAN ORAL CONTRACEPTIVES CAUSE AN ABORTION?


Can a woman abort the fetus if she continues to take the pill?

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Dear Reader,


No. Continuing to take the birth control pill before or after a pregnancy is confirmed will not abort the fetus. It's also unlikely that taking the pill will have an effect on fetal development. Oral contraceptives don't cause miscarriages because they don't work in that way. Birth control pills — generally made of estrogen and progestin, a synthetic progesterone — essentially prevent pregnancy by inhibiting ovulation or causing the cervical mucus to thicken. However, if a woman using progestin-only oral contraceptives continues with her pill pack while pregnant, she increases the chance of having an ectopic pregnancy (when the fertilized egg begins to develop outside of the uterus, often in the fallopian tubes). Ectopic pregnancies are dangerous and can be life threatening, so they need to be resolved quickly and appropriately. Some women can have sharp stabbing pains, cramps, or a dull headache that can become severe, while others may experience significant blood loss and go into shock if a fallopian tube bursts. These symptoms need to be reported to a midwife or obstetrician immediately.


On the other hand, specific medications, but not birth control pills, can end a pregnancy (a.k.a., a medical abortion). In the United States, Mifepristone, once known as RU-486, blocks the hormones that are needed to maintain a pregnancy. Methotrexate is another drug that stops a pregnancy from further development. A pregnant woman in need of a pregnancy termination can discuss this, as well as other options, with her health care provider or OB/GYN.



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BIRTH CONTROL PILLS FOR MEN?


I was wondering what information you have on the male birth control pill and when it could possibly be released on the market.


Thank you,Sam


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Dear Sam,


Finally, a male birth control pill, right? Well… almost. As clinical trials (research studies) continue in Europe and the United States, developers believe we will see this "wonder drug" on pharmacy shelves in about five to seven years.


So, what's taking so long? For one thing, scientists have found it challenging to control the male reproductive system. Women have a reproductive system regulated by a menstrual cycle, and are fertile for about 48-hours a month. (However, at exactly what point that 48-hour period of fertility will be during the month is unknown.) Scientists were able to develop the birth control pill, also known as oral contraceptives (OCs), based on the regularity of menstruation. Unlike women, men produce new sperm 24/7, through a process called spermatogenesis, at a rate of one-half billion sperm each day. Because of this male body phenomenon, developing an effective and reversible hormonal contraceptive for men, such as a male birth control pill, continues to challenge researchers.


In these studies, at least five different approaches to temporarily decrease or cease sperm production and function have been considered. They include:


In the man:


preventing sperm production interfering with sperm function interrupting sperm transport


In the woman partner:


preventing effective sperm deposit blocking sperm-egg interaction


Of these strategies, decreasing or preventing sperm production by using testosterone, the primary male sex hormone, either alone or in combination with another type of sex hormone called progestin, have shown the most promising results.


A pill containing synthetic testosterone and progestin taken by men in a clinical trial conducted in Italy showed evidence of lowering males' sperm counts to very low levels (below 3 million sperm per milliliter of ejaculate). Half of the participants had sperm counts of zero after taking this pill. It was also demonstrated to cause few undesirable side effects. In another type of research study, testosterone injections were administered in conjunction with combined progestin and testosterone pills. This was shown to be more effective than use of testosterone injections alone.


Either way, this extra surge of testosterone is designed to interfere with a complex sequence of hormonal reactions that begin in the brain and end in the testes, resulting in sperm production. To get more technical, this extra dose of testosterone withholds the amount of gonadotropin-releasing hormone (GnRH) secreted by the hypothalamus in the brain. GnRH stimulates the release of hormones called gonadotropins from the pituitary gland, which is also in the brain. Gonadotropins are hormones essential in signaling the testes to produce sperm. So, the suppression of GnRH ultimately results in preventing sperm production in the male and, as a result, helps to prevent pregnancy in the woman partner.


It is important to keep in mind, however, that maximum contraceptive effectiveness was not possible right away for any of the above mentioned combinations because it can take as much as 2 to 3 months for sperm counts to reach very low levels. This translates into a need for men or couples to plan in advance. In addition, the studies that involved a weekly injection schedule were shown to be particularly impractical. Because of this, other ways to improve the use and effectiveness of new male contraceptives are being investigated, including longer-acting male contraception that can deliver testosterone for 2 to 3 months. Also in development are testosterone-derivative implants and a vaccine that would be designed to prevent pregnancy for up to a year.


Even though a male birth control pill may seem like a great innovation, not all men agree. Some are nervous about the possible side effects that have resulted from a few of these clinical trials, which have included:


mood swings aggressiveness lack of libido acne weight gain lowered high density lipoprotein (HDL, the good cholesterol) levels impotence long-term infertility An effective male "pill" would undoubtedly put more of the responsibility for contraception on men, a possibility that goes against what men and women in many cultures have been used to. Male discomfort with this notion, along with the time and high cost of conducting clinical trials, are likely key reasons why funding for research about this topic has been low, postponing development of, and access to, a male birth control pill.


The contraceptive methods currently available for men are the condom and vasectomy. In the future, the male birth control pill may become easier for men and the rest of society to swallow.



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BETWEEN PILL PACKS... IS SEX SAFE?


My boyfriend and I are having sex 2 days after my menstrual cycle. I am on birth control. I finish my cycle on a Saturday and start the new cycle on Sunday. We usually have sex on the Saturday night before I start the new cycle. Is it safe to have sex even though you have finished your menstrual cycle but have not started taking the pill for the next cycle?Sincerely, Garfield


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Dear Garfield,


First of all, congratulations for being responsible about your lovemaking and protecting yourselves against an unwanted pregnancy, especially while you are in college and trying to reach other goals! I support that every child should be a wanted child... at the right time and under the best circumstances for you!


As for your question, you are protected during the time of your concern as long as you have been taking your birth control pills correctly. The synthetic estrogen and progesterone of your pills have altered the normal rise and fall of these natural hormones in your bloodstream, thereby preventing the maturation of an egg follicle in an ovary; altering the lining of the uterus, which makes it more inhospitable in the unlikely event an egg is released and fertilized; and creating a thicker cervical mucus which makes it more difficult for those feisty sperm to enter the uterus at all and make their way to fertilize an egg. However, all contraceptive methods have a failure rate and for the pill, the rate is about 3%, meaning 3 women out of 100 will get pregnant even though they are on the pill. So what I suggest, is that you and your partner think about what you might do in the event the pill fails you. This is very unlikely, but should be considered. For instance, you may want to add condoms or contraceptive foam to your contraceptive arsenal.



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SIDE EFFECTS OF PILL


My roommate is on the pill now, and she seems to be having some unpleasant symptoms: bleeding, decreased appetite, etc. I've heard some awful stories about what this form of contraception can do to young women. Should I advise her to see a doctor?


Thanks, Worried


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Dear Worried,


The way the pill works is that it enters your bloodstream, travels through your body and affects your tissues and organs, just as natural estrogens and progesterone do. The hormones in the pill, however, are synthetic and can have exaggerated side effects on some women. Some of the more common effects are the two you noted, breakthrough bleeding and decreased appetite. As far as the breakthrough bleeding, it usually happens during the first or second pill cycle and often clears up after that, as your uterus gets used to the new levels of hormones in your body. If breakthrough bleeding doesn't stop after a few months, see a practitioner to find out whether you need to try a different brand or whether you may have another problem. Breakthrough bleeding does not mean that the pill isn't working as a contraceptive.


Nausea is a common early negative effect of the pill, as the estrogen in the pill may irritate the stomach lining. Nausea usually goes away after three months; antacid tablets or taking the pill with dinner usually gives relief. Again, if this symptom persists, seeing a practitioner and switching to a pill with twenty micrograms of estrogen might offer relief from the nausea and decreased appetite.


Other common side effects of the pill are headaches, depression, change in intensity of sexual desire and response, vaginitis and vaginal discharge, urinary tract infection, changes in menstrual flow, breast changes, skin problems, gum inflammation, it can aggravate asthma, and increase your incidence of contracting viral illnesses. All of these are common side effects, which means not to be alarmed, but to discuss them with your practitioner to see what changes can be made to reduce the discomfort.


Any problem lasting more than two or three cycles should be reported to a health practitioner. The following are symptoms of serious problems: severe pain or swelling in the legs (thigh or calf), bad headache, dizziness, weakness, numbness, blurred vision (or loss of sight), speech problems, chest pain or shortness of breath, abdominal pain. Report these immediately; they mean you should stop taking the pill.



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WHAT IS A FEMALE CONDOM?


what is a female condom?


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Dear Reader,


A female condom is a method of contraception worn by women that's inserted inside the vagina before intercourse. Made of soft polyurethane (a type of plastic), it's shaped like a long tube or sheath — with one closed end and one open end — creating a barrier between the penis and the vaginal canal. Similar to the male condom, when used consistently and correctly, the female condom prevents pregnancy and protects against HIV and other sexually transmitted infections (STIs). For some women, the female condom is an ideal form of contraception because it is woman-controlled — women can take the initiative to protect themselves, particularly those whose partners are unwilling or unable to use male condoms. It can also be a good alternative for those who have a latex sensitivity or allergy.


The female condom can be a bit intimidating to someone who has never seen or used one before. Once familiar with it, it can be easy to use. If you look at the female condom, you'll notice that at each end, there's a flexible polyurethane ring. These rings help to keep the female condom in place once it's inserted. The fixed outer ring has an opening, where the penis glides in and out of the vagina during intercourse. The moveable inner ring secures the tube in place and is closed off by polyurethane so that it can collect the ejaculated sperm.


To insert the female condom:


hold the sheath at the closed end and pinch the inner ring so that it becomes long and narrow. gently insert the inner ring end as far into the vagina as possible, using your index finger to push up the inner ring until your finger reaches your cervix (similar to how a diaphragm would be inserted). It won't go in too deep or get lost inside your vagina. When in place, it'll cover the opening of the cervix and line the vaginal walls. A general indicator is that you'll no longer be able to feel the ring. The outer ring must always remain outside the vaginal opening. before having intercourse, be sure that it hangs straight and isn't twisted. Then, add water-based lube on the penis and/or to the inside of the female condom to increase comfort and decrease noise. after intercourse, twist the outer ring, gently remove the female condom, and discard (don't flush it down the toilet). If you choose this method of contraception, carefully read the instructions enclosed in the box before use.


Some women like to practice inserting the female condom a few times before having intercourse so they can become comfortable using it. Keep in mind that each female condom can only be used once. Also, never use the female condom together with a male condom. Friction between the two could cause the male condom to pull off or the female condom to be pushed inside the vagina.


Before using this method of contraception, consider the following advantages and disadvantages:


Advantages:


A woman can take the initiative and offer her partner the choice between his or her condoms. It provides protection against HIV and other STIs since the polyurethane acts as a barrier. It can be inserted immediately or up to eight hours before having intercourse. A man doesn't have to be fully erect when his partner uses the female condom. Those who are sensitive or allergic to latex are often able to use products made of polyurethane. It can be purchased over-the-counter. Disadvantages:


It's more expensive than male condoms. It may be awkward to use because the outer ring must stay outside of the vagina during intercourse. Since the female condom is inserted into the vagina, it's necessary to be comfortable touching the genital area. It may cause irritation. Without enough lube, it can make strange sounds.



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PETROLEUM JELLY -- GOOD OR BAD AS LUBE FOR CONDOMS?

I want to ask if I can use Vaseline to substitute K-Y or Aqualube when making love with condoms?


Wondering?

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Dear Wondering?,


No, No, No!


Vaseline is petroleum jelly, which is not water-soluble. When you put it on your hands and try to wash it away with water, it doesn't budge. It just sort of moves around, but it doesn't dissolve. That's why it increases the chances of getting a vaginal or anal infection when used during vaginal and anal sex, since bacteria don't easily wash away. Also, when petroleum jelly is used with condoms, it eats away at the rubber (latex), decreasing the effectiveness of condoms. (Instead, use petroleum jelly to moisturize very dry skin.)


Water-soluble lubes (and never oil-based ones), plus a bit of saliva, are the things to use. With their silicone-like fluidity, they create more pleasure, too!


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CONDOMS -- POROUS?


I have a friend who is very religious and has been telling his children that since the AIDS virus is so much smaller than the pores in a condom, it affords no protection, thereby making abstinence the only option that makes sense. Is there any truth to this story whatsoever, or is he just using this as an excuse to scare his kids? (Not that I would go around his wishes with his family -- just curious.)


--Atheist

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Dear Atheist,


Latex condoms, which are the least expensive, most accessible type of condoms at the moment, are designed so as not to allow transmission of the HIV virus, or any virus for that matter. The HIV virus is larger than the pores in condoms.


Lambskin condoms, on the other hand, are made from sheep intestines, and are now advertised as a contraceptive, but not as effective against STD transmission.


Because both user error and manufacturer error exist, condom use constitutes "safer" sex, as opposed to 100 percent safe sex. The only 100 percent safe sex is no oral, anal, or vaginal sex, or abstinence. Tips for using condoms to insure greatest effectiveness in protecting against both pregnancy and HIV (and other sexually transmitted diseases) include storing condoms in a cool, dry place and out of direct sunlight, and using them before their expiration date. If using a lube with your condom, make sure that it is water-based, as oil-based lube causes the latex in condoms to deteriorate.



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GETTING OFF DEPO-PROVERA — HOW LONG WILL IT TAKE FOR ME TO GET PREGNANT?


I have been on the Depo shot now for a year and I am supposed to have another shot September 6th, but my husband and I want to have another baby. How long should it take for me to get pregnant?


Kerri

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Dear Kerri,


Since the Depo-provera shot is given at three-month intervals, planning ahead is important. If you and your husband want to try to conceive in the near future, you may choose not to have another injection.


Although it is possible for fertility to resume once the last injection has worn off, women experience an average of ten months after the injection for ovulation to return. After stopping Depo-provera, more than 90 percent of women become pregnant within two years.


Women's bodies respond differently to hormonal contraceptives. No one knows your body better than you do. Following are some basic questions to ask yourself:


How regular was your menstrual cycle before you used hormonal contraceptives? How easy has it been to conceive in the past? Are there any medical and family risk factors to consider?


Your answers to these questions may help you to determine how your body will respond once ovulation returns.


In case you want to use Depo at some point in the future, — after the birth of a child, for instance:


If a mother does not plan on breastfeeding, she can receive an injection within five days of giving birth.


If a mom decides to breastfeed, she can receive a shot six weeks after the birth of the child. The reason that it is advised to wait six weeks is that there are theoretical concerns that the injection may be a risk to infants in the first month. Another reason is that women should abstain from sex for at least six weeks after childbirth. Therefore, there is no need to prevent against pregnancy during these six weeks. In addition, the baby's suckling of the nipples during breastfeeding can delay the return of ovulation. This delay varies depending on a number of characteristics, including how often and how long a baby is breastfed at each feed. Since this delay varies among women, it is best to use a method of contraception to prevent pregnancy.


However, if a mother is breast- and bottle-feeding her newborn, it is recommended by medical providers that she receive the Depo injection within the first five days of her next menses. In the meantime, another contraception method needs to be used to prevent pregnancy.



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IS THERE A DIFFERENCE BETWEEN BACTERIAL AND VIRAL STDS?


What's the difference between a bacterial and viral STD?

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Dear Reader,


The main difference between these two categories of sexually transmitted diseases (STDs) is what causes them -- bacterial STDs are caused by bacteria and viral STDs are caused by viruses. As a result of being caused by different microorganisms, bacterial and viral STDs vary in their treatment. Bacterial STDs, such as gonorrhea, syphilis, and chlamydia, are often cured with antibiotics. However, viral STDs, such as HIV, HPV (genital warts), herpes, and hepatitis (the only STD that can be prevented with a vaccine) -- the four Hs, have no cure, but their symptoms can be alleviated with treatment.


In addition to bacteria and viruses, STDs can also be caused by protozoa (trichomoniasis) and other organisms (crabs/pubic lice and scabies). These STDs can be cured with antibiotics or topical creams/lotions.


One of the most common symptoms of an STD is no symptom, so it's important to go for check-ups (for example, up to 80 percent of women and 40 percent of men diagnosed with chlamydia may not experience symptoms). STDs need to be diagnosed correctly and fully treated as soon as possible to avoid complications that could be serious and/or permanent.



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FALSE-POSITIVE HIV TESTS


I recently had a routine HIV screening done for prenatal labs. It was positive. Thank GOD, western blot came out to be negative. My OB is reassuring me not to worry, that false-positives sometimes come out in pregnancy, and as long as the western blot is negative — I'm negative. Could you explain a little more in detail as to why and do you agree with my Dr.? I'm at very little risk otherwise and had a negative HIV test about five years ago and am with the same person (my husband).


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Dear Reader,


The Western Blot test is a confirmatory test that is definitive, provided you were not infected during the three-month window period before your exam. When your blood is tested for HIV, the lab first performs what is known as an EIA or ELISA (enzyme-linked immunosorbent assay). A negative EIA means that no antibodies were found in the blood and that the person is HIV-negative. A positive result is confirmed with a second EIA. If the second EIA is positive, a Western Blot must be done to ensure that the antibodies detected in the EIA test are really HIV antibodies. The Western Blot test can come back positive, negative, or inconclusive. It's uncertain why you were given your EIA result when your Western Blot was negative. The negative result is definitive, and you needn't worry.


About 0.2 percent of EIA tests give positive results that are proven false by the Western Blot test. This percentage does not vary between the general population and pregnant women. As noted in an article published in the August 14-28, 2000 Archives of Internal Medicine, an EIA can be falsely positive for several reasons, including a patient's autoimmune disease, multiple pregnancies, blood transfusions, liver diseases, parenteral substance abuse, hemodialysis, or vaccinations for Hepatitis B, rabies, or influenza.


There is a very, very small chance that a Western Blot result is incorrect. False negatives usually happen when people test during the window period. In low-risk groups, a false negative Western Blot result occurs 0.001 percent of the time. False positives occur even less frequently — 0.00001 percent. False positives most often result from volunteers in HIV vaccine studies, clerical error, contaminated specimens, or misinterpretation of the results.



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HIV TRANSMISSION THROUGH URINE?


Can the HIV be passed through urine?


Thanks,Curious

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Dear Curious,


No. HIV, the virus that causes AIDS (SIDA in Spanish), is transmitted via blood, semen, vaginal fluids, and breast milk. There have been no documented cases of HIV contraction from urine, sweat, and saliva.



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AIDS FROM RAW MEAT?


Is it possible to contract AIDS by handling raw bloody meat? --The butcher --------------------------------------------------------------------------------


Dear Butcher, HIV is a human virus so it can only be transmitted through human blood. Raw bloody animal meat does not carry the virus, therefore handling this meat will not be a risk. There also have been no documented cases of HIV being transmitted through food preparation or food serving.



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AIDS FROM MOSQUITO BITE?


Can you get AIDS from a mosquito bite? I heard you can't, but I'm really paranoid about this. Actually, it wasn't a bite -- I squashed the bug and all the blood in it splattered everywhere and then here I am with someone's blood on a cut in my finger. HELP! I'm really freaking out. I don't know if I should get tested or not again, because I did get tested before (negative), but the anguish of waiting for results was horrible. Maybe I'm just ultra paranoid?


--Bitten (or smitten?)

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Dear Bitten (or smitten?),


What you've heard is correct -- you can't get AIDS from a mosquito. According to the U.S. Centers for Disease Control and Prevention (CDC), mosquitoes do not inject blood when they bite, which means that mosquitoes do not transmit the virus. Even if the mosquito you squashed had just bitten an HIV infected person, the virus would not stay alive within the mosquito's body for more than a few minutes when outside the human body. HIV is actually a very fragile virus and it is impossible for the virus to be transmitted through inanimate objects, casual contact, or an insect vector. It does not mutate the cells within insects or animals as it does in humans. This is one reason why testing for a vaccine/treatment for HIV has been more difficult than with other diseases where clinical trials have been performed on animals first before humans. In any case, stop worrying about this one.



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AIDS--BARBER?


I must sound paranoid, but all this fuzz about AIDs keeps me a little worried every time I go to get a haircut. Is it possible to get AIDS by the use of a contaminated razor?


--An AIDS paranoid

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Dear An AIDS paranoid,


Any instruments used which may involve blood contact (i.e., ear piercing, manicures, barber,etc.) should be sterilized, both to be hygienic as well as to address public health issues. You can, and should, ask your barber about his/her practices. The virus is quite fragile, and is killed by heat, ordinary soap and water, household bleach solutions, alcohol, Lysol, or peroxide. In the unlikely event that the instruments are not sterilized, exposure to the air kills the virus, usually in a matter of seconds. Materials that could theoretically carry the virus in small amounts have not been implicated as the cause of any case of AIDS.



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CHLAMYDIA?


Could you tell me about the symptoms of chlamydia and if one test is enough to detect that disease? Thank you.


Curious

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Dear Curious,


Chlamydia is a sexually transmitted disease (STD) caused by Chlamydia trachomatis. As with some other STDs, the most common symptom of chlamydia is no symptom at all. Comparatively, more women than men are asymptomatic -- up to 80 percent of women and 40 percent of men diagnosed with chlamydia may not experience symptoms.


Semen or cervical secretions transmit chlamydia. It usually takes one to three weeks for symptoms to show up, if at all. If you've given unprotected oral sex to someone with chlamydia, it's possible, but unlikely, to get a sore throat. This is even less likely if you've gone down on a woman -- the penis is much more effective in transmitting chlamydia to a partner's throat.


In men, the chlamydiae make their way into the urethra, where they can cause discharge and burning when urinating, especially during that first trip to the bathroom in the morning. Some women will experience itching, vaginal discharge, and burning during urination. More often than not, the infection will manifest as mucopurulent cervicitis, a discharge around the cervix. This symptom often goes unnoticed because it is difficult to detect without examination by a health care provider.


Unchecked and untreated chlamydia can lead to a number of problems, including sterility for men and women alike. If given free reign to divide and multiply, chlamydiae can infect the epididymis (where sperm mature) in men who do not experience any symptoms at first. These men may eventually experience sensations of heaviness and discomfort in their testicles, and inflammation of their scrotal skin. In women, chlamydiae can cause pelvic inflammatory disease (PID) and scarred fallopian tubes. Women who develop PID are also at higher risk for chronic pelvic pain and ectopic pregnancy (when a fertilized egg implants outside of the uterus). PID and ectopic pregnancies can be life-threatening. (For more information on PID, see the postscript below.)


It is extremely important to be tested for chlamydia, as well as for other STDs, even if you don't have any symptoms if you're sexually active with partners. And yes, one test is enough to determine the presence of Chlamydia trachomatis. Basically, the test involves collecting material from your urethral or cervical area with a swab, and sending the sample to a lab for analysis. The results of this test will determine how you and your health care provider will proceed with education and treatment for you and your partner.



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HEPATITIS B


Just wondering what you could tell me about Hepatitis B. My mother was just recently diagnosed with it, so I'd like some more information about what it is, what it does, who gets it, and the like.


-Curious

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Dear Curious,


Hepatitis B is a liver disease characterized by inflammation of the liver and liver cell damage. It is caused by the Hepatitis B virus (HBV), present in the blood and all body fluids of an infected individual. Most hepatitis cases are acute, lasting less than one year. Each year, six to ten percent of Hepatitis B infections in the United States become chronic, meaning the person continues to be highly contagious, and risks developing cirrhosis of the liver and liver cancer.


Hepatitis B can be transmitted through any contact of contaminated blood or body fluids with breaks in the skin or mucous membrane of an uninfected person. Hepatitis B is primarily transmitted through sexual contact and needle sharing -- much like HIV transmission -- or through blood transfusion. In some areas of the world, Hepatitis B is endemic and may be transmitted to offspring who become chronic asymptomatic carriers. If you were born in a high-risk area, you need to be evaluated to determine if you are a Hep B carrier.


At first, a person infected with Hepatitis B will not show any signs of disease -- no symptom is one of the most common symptoms. Some people experience mild flulike symptoms (i.e., fever, aches, loss of appetite, fatigue). As the disease progresses, many people develop temporary jaundice (a yellowing of the skin) and dark urine.


Safer sex and avoiding unsterile needles (for drugs and tattoos) help prevent Hepatitis B transmission. As a matter of fact, Hepatitis B is the most preventable sexually transmitted disease (STD), primarily because there is a vaccine for it, which is administered in three injections over a six-month period. Because Hepatitis B is highly contagious, all those who have had close personal contact with someone infected with the virus need to be screened and vaccinated. If you are a college student, I strongly urges you to get the Hepatitis B vaccination because college is a common place for coming into contact with STDs, and you need all the protection you can get.



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HEP C AND SEXUAL TRANSMISSION

Several years ago I contracted Hepatitis C from a blood transfusion. I am a female and was wondering the likelihood of transmitting it to my boyfriend during intercourse. What precautions can we take? Can it be transmitted during oral sex?


-C

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Dear C,


The hepatitis C virus is spread mainly through contact with an infected person's blood and blood products via:


Blood transfusions or organ transplants (particularly before 1992, when blood was not routinely screened for hep C) Unsterilized or inadequately sterilized needles (from sharing I.V. needles for drugs or by an accidental needle-stick) Exposure through cuts, wounds, and medical injections (this includes getting body piercing or tattoos with contaminated equipment) Among the hepatitis viruses, hep C carries with it the lowest risk of sexual transmission, especially unlikely when in the context of a monogamous, long-term relationship. It can happen, as can transmission from mother to child during birth, but both are uncommon occurrences. It would also be unlikely to transmit the hepatitis C virus through oral sex.


If other sexually transmitted diseases (STDs) are not a concern to you and your boyfriend, the use of condoms is not absolutely necessary. If you want, you and your boyfriend can consult with your health care provider for her/his advice. However, this is a matter of personal choice -- if you or your boyfriend feel safer and more relaxed using condoms, then there's your answer.



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URINARY TRACT INFECTION


I think I may have some kind of urinary tract infection. It came on very suddenly, about three nights ago. And when I pee, there is a burning sensation when my bladder has almost emptied. It's not an STD because I'm in a monogamous relationship, and yes, I'm sure! Please help. Thank you.


--Burning Up

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Dear Burning Up,


Urinary tract infections (UTIs) are so common that most women and some men get at least one at some point in their lives. They are usually caused by bacteria, such as E. coli, which travel from the colon to the urethra and bladder (and occasionally the kidneys). Trichomoniasis and chlamydia can also cause UTIs; stress, low resistance, poor diet, damage to the urethra from childbirth, surgery, etc., can predispose you to getting them as well. Often, a sudden increase in sexual activity triggers a case of "honeymoon cystitis," or urinary tract infection.


Cystitis is the most common form of UTI. It is rarely serious if treated. Symptoms may include:


Feeling like you need to pee every few minutes Burning when you try to pee Needing to pee with hardly anything coming out Some blood in your pee (pink pee) Pain just above your pubic bone Strong odor to your morning's first pee To prevent UTIs, treat mild infections, and avoid reinfections, try the following self-help measures:


Drink lots of fluids every day. Urinate frequently, emptying your bladder completely each time. Wipe yourself from front to back after a bowel movement to keep bowel bacteria away from your urethra (for women only). Wash your hands before having sex, and after contact with the anus before touching the vagina. Make sure you are well-lubed before intercourse. Pee before and after sex. For women, change sanitary napkins and tampons frequently during your period. Cut down on or eliminate caffeine, alcohol, and sweets. Eat well and get enough rest. Manage your stress. Wear loose clothing. Drink unsweetened cranberry juice. When a UTI doesn't respond to self-help treatment within twenty-four hours, or recurs frequently, see a health care provider. Treatment is usually with antibiotics, and a drug called Pyridium, which will relieve the pain and turn your urine a bright orange. Untreated UTIs can lead to serious infections of the kidneys, so if pain and symptoms persist, make sure you see a provider.



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IS IT POSSIBLE TO "BREAK" YOUR PENIS?

I was wondering if it is possible to fracture or "break" my penis when it is erect. I have heard that it is possible and that it is painful. Can it be corrected and will it go back to normal?

-M

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Dear M,

Even though there are no actual bones in a boner, it is possible to break one's penis. To understand how this incredibly rare and painful event can occur, we first need to review a little (or not so little) penile anatomy. The shaft of the penis is comprised of two chambers of spongy tissue, the corpora cavernosa, which run along the inside length of the penis. Erections occur when, in response to physical and/or mental triggers, the nerves of the penis signal the surrounding muscles to relax, allowing blood to pour into the corpora cavernosa. A thick membrane surrounding the corpora cavernosa, the tunica albuginea, keeps the blood that is being pumped into those spongy chambers from being able to escape. The result — a stiffer, larger, and more rigid rod. Although your erect penis may feel rock-hard, it is still flesh and blood.

Penile fractures occur when an erect penis is thrust against a harder, less flexible object. This could happen if someone enthusiastically plunges and pumps his penis into a partner, or a pillow let's say, and misses or "over-runs" the intended opening and instead hits a pubic bone, headboard, or other hard surface. If the object is hard enough, and the erect penis is thrust with enough force, that thick membrane surrounding the corpora cavernosa can tear, causing an audible "cracking" sound, abrupt loss of erection, severe pain and bruising, and a penis that is typically "bent" to one side or the other.

Penile fractures are a medical emergency and must be evaluated and treated immediately. In severe cases, it is possible to damage the urethra, interfering with urination. Treatment for penile fractures consists of immediate evaluation, and, most often, surgical intervention to repair the tunica albuginea and restore or preserve erectile function and the ability to pass urine. Similar to other fractures, the sooner the broken part is "set," the less likely permanent damage and misshapenness will result.

Even though many penile fractures can be fixed, it's probably safer and more pleasurable to focus on finesse rather than force when working and playing with an erection.

Again, broken penises are really hard to come by, so try not to let stories about this highly unlikely occurrence stand in the way of the happiness that your erect penis might bring to you and others.


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