SEX QUESTION AND ANSWER PART 2

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.


LATE STAGE SYPHILIS
SYMPTOMS OF GONORRHEA
RETROGRADE EJACULATION: CAN IT BE "REVERSED"?
DO NO TESTICLES MEAN NO ERECTION? (TESTICULAR TORSION)
A PENIS WITH TWO HOLES (HYPOSPADIAS)
ADAM'S GOT AN APPLE... WHY NOT EVE?
KICKED BETWEEN HIS LEGS -- PAIN? STERILITY?
WHAT'S UP WITH MORNING ERECTIONS?
BALL ON BALL
MY VAGINA WON'T STOP DRIPPING HELP!
MENSTRUAL SYNCHRONY: FACT OR FICTION?
HOW SOON AFTER A MISCARRIAGE CAN YOU HAVE SEX?
IS IT OKAY TO HAVE A PAP TEST DURING YOUR PERIOD?
CAN I RESCHEDULE MY PERIOD?
DO I NEED TO CHANGE MY TAMPON AFTER USING THE BATHROOM?
FOURTEEN AND STILL BOOBLESS
WHAT IS DYSPLASIA?
TAMPONS OR PADS?
GIRLFRIEND GETS TOO WET
PMS!
AIR OUT VAGINA AT NIGHT?
CASTRATION EFFECTS
DOUCHING
COMING OUT TO MOM AND DAD

LATE STAGE SYPHILIS


What are the signs of an advanced case of syphilis, say 12 years down the road? Is treatment still possible or is it "too late"? I have reason to believe that I've been infected that long, and denying it. Would I still be contagious? Would I have been after five years?


-- Clue me in

--------------------------------------------------------------------------------


Dear Clue me in,


It is never "too late" to be diagnosed and treated for syphilis. In order to diagnose syphilis, two blood tests are run. If this battery of tests indicates the presence of syphilis, your health care provider may suggest other tests or may simply proceed with a treatment of penicillin by injection or an oral substitute, e.g. doxycycline or tetracycline. For some late, and even early, stages of syphilis, doctors will draw cerebrospinal fluid upon which they perform a number of tests to confirm the presence of syphilis in the central nervous system. After receiving treatment, you must have at least two follow-up blood tests (6 months and 1 year later) to insure that the infection has been adequately treated.


Naturally, the sooner you seek diagnosis and treatment the better. Allowed to go unchecked in your body, spirochete, the bacteria which cause syphilis, can invade and destroy your inner organs -- this includes your heart and brain. In the late stage of syphilis, you may develop heart disease, blindness, and/or mental incapacity depending upon where the bacteria struck. I assume your syphilis is not tertiary, i.e. late stage, and hopes that it won't reach that point. She wants to illustrate what could happen if you do not seek medical attention, say in a few more years down the road.


It would be impossible for me to tell you with any accuracy if you had been infectious after five years. In order to address this question and that of the signs of advanced stage syphilis, I will describe the run of the disease, from infection through the three stages of syphilis. Bear in mind that this is a generalization. Each patient experiences the disease at a pace and with symptoms unique to him or her.


Infection: Syphilis is spread through sexual or skin contact with someone who is infectious, meaning the infectious individual is in the primary, secondary, or early latent stage and symptoms are present. The bacteria leave the infectious person through open sores or rashes. The spirochete then penetrate the mucous membranes of the genitals, anus, mouth, or broken skin on other parts of the body.


Primary Stage: Anytime between nine days and three months after infection, a painless sore usually shows up, but not always. This sore, called a "chancre," resembles a pimple, blister or open sore. Normally it appears on the genitals or near where the bacteria entered the body. It often hides and many people never realize that it is there. On women, the sore can be found hidden in the vagina or the folds of the labia. On men, it usually hides in the folds of the foreskin, under the scrotum, or near the base of the penis. Men more often than women will also have swollen lymph nodes in the groin. At this stage, the chancre is very infectious. It will heal with or without treatment, but the bacteria will remain and begin to spread if untreated.


Secondary Stage: This stage begins one week to six months after the primary stage ends. It can last for weeks or months, perhaps up to a year. Secondary stage symptoms, which are all flu- like, can come and go for years. These symptoms may include a rash (over entire body or just on palms of hands and soles of feet), a sore in the mouth, swollen and painful joints, aching bones, and a mild fever or headache. Some people experience hair loss. Others discover a raised area around the genitals or anus. During this stage, the bacteria can be spread through mucous patches on the raised areas, called condylomalata.


Latent Stage: This can last anywhere from 10 to 20 years. During this stage, outward signs of the disease are absent (except possibly in the first few years of latency). However, the bacteria are active inside your body, multiplying and attacking internal organs. When second stage symptoms completely disappear, the disease is no longer infectious. At this point, the "rule of thirds" comes into play. Among the total number of latent syphilis cases, one-third will resolve (go away) on their own, one-third will stabilize, and one- third of the cases will evolve to the next and last stage.


Tertiary Stage: Serious effects of the spirochetes' activity of the latent stage begin to appear. This is when the heart disease, blindness, etc., that I mentioned earlier happen.


Syphilis can be diagnosed and treated with relative ease. Because of this, the past 25 years or so have seen a marked decline in the number of tertiary stage cases of syphilis and of deaths due to the disease.


Back to Top



SYMPTOMS OF GONORRHEA


What are the symptoms of gonorrhea?

--------------------------------------------------------------------------------


Dear Reader,


Gonorrhea is a sexually transmitted disease (STD) caused by the bacteria Neisseria gonorrhoeae, the gonococcus.


Although you're more likely to be symptomatic when infected with gonorrhea, as compared to other STDs such as chlamydia, one of the most common symptoms of this and other STDs is no symptom at all. If someone does experience signs of gonorrhea, which are similar to chlamydia symptoms, they often show up two to six days after exposure or infection.


In men, there is usually a yellowish discharge from the penis. Urination could also be painful, or burn, and feeling a need to pee may be more frequent. Untreated, gonorrhea can spread from the urethra to infect the prostate gland, seminal vesicles, Cowper's glands, and the epididymis, which, if inflamed and scarred, can lead to sterility.


In women, the urethra or cervix are affected, and sometimes the infection is so mild that it goes unnoticed, particularly with inflammation of the cervix. Other symptoms include a cloudy vaginal discharge, abnormal menstruation, painful urination, and lower abdominal discomfort. If women don't detect any symptoms and the infection is left untreated, it can lead to pelvic inflammatory disease (PID), resulting in ectopic pregnancy, pelvic abscesses, and infertility.


Gonorrhea can be transmitted through oral and anal sex as well. With infection via oral sex, symptoms include sore throat, tonsillitis, or no symptoms at all. When transmitted by anal sex, there can be inflammation of the rectum or anus, itchiness, pus-like or bloody discharge, feeling the need to have a bowel movement often, or no noticeable signs whatsoever.


To diagnose this disease, health care providers use a smear (discharge put on a slide that's looked at under a microscope) or, more commonly, grow a culture. DNA probes can also be used to make a diagnosis more quickly. Antibiotics are used for treatment, although certain strains of gonorrhea are resistant to certain types of antibiotics, such as penicillin, which would require the use of new antibiotics or a particular drug combo to effectively combat these resistant strains. Since people usually are infected with both gonorrhea and chlamydia, you and your partner(s) need to be treated for both diseases at the same time. Your health care provider will help determine what's best for you.


If you are diagnosed with gonorrhea, make sure that you take your full course of antibiotics and return for a checkup four to seven days after finishing the medication for a repeat culture to make sure treatment was effective. All of your partners need to be treated. It's important not to have vaginal, oral, or anal sex until you and your partner(s) are cured to avoid reinfection. Lastly, safer sex and regular check-ups can go a long way in the prevention of STDs.


Back to Top



RETROGRADE EJACULATION: CAN IT BE "REVERSED"?


One of my textbooks makes mention of retrograde ejaculation. It says that semen is released into the urinary bladder but it doesn't talk about the functional aspects. Can the problem be corrected? Is it a painful problem?


--------------------------------------------------------------------------------


Dear Reader,


During ejaculation, the internal sphincter, a muscle located between the prostate and the bladder, closes tightly, preventing a man from ejaculating and urinating at the same time. If this muscle relaxes, it can force some of the ejaculate backwards into the bladder, rather than out of the urethral tip. This is called retrograde ejaculation. The next time a man with this condition urinates, the urine is noticeably cloudy because it has been mixed with ejaculate. Health care providers or urologists can confirm the diagnosis of retrograde ejaculation by testing a man's urine for the presence of sperm.


Retrograde ejaculation has many causes. Certain medications that treat hypertension and prostate conditions; genital surgery; or, diseases, such as diabetes, which can cause nerve impairment in and around the bladder, cause ejaculate to flow backward. Often, retrograde ejaculation is a first sexual side effect for men with diabetes, who are the most commonly affected group. It's important to get an accurate diagnosis by a health care provider or urologist. Depending upon the cause of retrograde ejaculation, treatments and outcomes vary. Medications are usually used first, often pseudoephedrine initially, or imipramine.


Men with retrograde ejaculation still produce sperm. Sperm can be medically retrieved from the first urine sample after ejaculation. This sperm can be used for artificial insemination.


Men feel no pain, and usually no sensation at all, from having retrograde ejaculation. Strange and unfamiliar, however, may come to mind when they notice their orgasm is not accompanied by a "burst" of semen. Since orgasm and ejaculation are two separate physiological processes, a man with retrograde ejaculation can still feel intense pleasure and contractions during orgasm.


Back to Top



DO NO TESTICLES MEAN NO ERECTION? (TESTICULAR TORSION)


My friend had to have both of his testicles removed because of Testicular Torsion... will he be able to get an erection now?? What are the testicles for, anyway??


--------------------------------------------------------------------------------


Dear Reader,


Testicular torsion is a painful condition that occurs when the spermatic cord — which includes the vas deferens, arteries, veins, lymphatics, and nerves — twists and cuts off blood supply to the testicle (where sperm and testosterone are produced). It happens when a small ligament that normally attaches a testicle's base to the scrotum becomes loose, allowing the testicle to twist and turn. A man could be born with a loose ligament, and so have some predisposition for this, but testicular torsion can also be the result of trauma to the scrotum or really strenuous physical activity.


Most often occurring in males under the age of 30 years, testicular torsion is more common during infancy or adolescence. It is estimated that the condition affects about 1 in 4,000 males under 25 years of age in the United States.


Symptoms of testicular torsion include:


onset of sudden pain in a testicle swelling or tenderness of the scrotum nausea, vomiting, and/or fever abdominal pain fainting and light-headedness elevation of the testicle on the affected side Testicular torsion requires surgery. In most cases, surgery needs to be performed as soon as possible after the onset of symptoms — preferably within six hours — in order to save the testicle. A restriction of blood flow due to testicular torsion could, over time, lead to the atrophying (shrinking) of the testicle, or even infection.


Having one testicle removed need not diminish or reduce sex drive or erections. But because the testicles produce male hormones, men who have lost both of their testes may experience a reduction in sex drive and difficulty in getting and/or maintaining an erection. When both testicles have been removed, the next step is usually testosterone replacement therapy, which can be discussed with one's primary health care provider or urologist.


Back to Top



A PENIS WITH TWO HOLES (HYPOSPADIAS)


Why does my boyfriend's penis have two holes?


--------------------------------------------------------------------------------


Dear Reader,


Most likely your boyfriend was born with hypospadias, a relatively common abnormality that may affect up to 3 in 1000 newborn boys. Instead of having a urethral opening at the end of the penis, boys born with hypospadias have an opening on the underside of the shaft.


If this is a problem, the condition can be surgically corrected. Often, surgery is arranged before the child reaches school age. The surgery, performed under anesthesia, involves using a small piece of foreskin to fashion a tube to extend the urethra to the end of the penis. The original hole is most often left as is since the urethra now bypasses it. This probably explains why your boyfriend's penis has two holes; only one is functional.


Have you tried asking your boyfriend about the two openings? He has surely noticed that his penis has two holes and probably knows that this is rather unique; and, if he had surgery, perhaps his parents never told him about it.


It can sometimes be embarrassing to talk about genitals, even with our partners, but open and honest communication is an important part of any healthy relationship. Who knows, maybe once you bring up the subject, he might have some questions for you!


Back to Top



ADAM'S GOT AN APPLE... WHY NOT EVE?


Why do men have "Adam's apples" and women don't?

--------------------------------------------------------------------------------


Dear Reader,


The Adam's apple is a bulge in the larynx, or voice box, made of cartilage. Cartilage is simply supporting connective tissue that doesn't have blood vessels running through it. Our noses and ears are made of cartilage. The particular section that we call the Adam's apple is actually enlarged thyroid cartilage, called this because it is located right above the thyroid gland.


The thyroid cartilage is usually about the same size in both girls and boys until puberty, at which point the area gets bigger in some guys, and thus is more noticeable. The Adam's apple is considered a secondary sex characteristic, such as increased body hair, and is caused by more testosterone flowing through men's bodies. It has no real purpose.


Back to Top



KICKED BETWEEN HIS LEGS -- PAIN? STERILITY?

Why are hits in the testicles so painful??



(2)

I accidentally kicked my brother between the legs yesterday and it seemed to hurt him a great deal. I know that I may have done some real damage -- my mother said I should never kick him in the balls cause it can stop him from having kids. Could I have made him sterile? He was doubled up on the ground for about five minutes coughing and crying.

--------------------------------------------------------------------------------


Dear Readers,


Ouch! Hits to the testicles can really hurt because the genitals is one body part that has a very high concentration of nerves as compared to many other parts of the body, where nerves are more equally distributed. As a result, a light touch to the testes feels good, while a tight squeeze, hard yank, or heavy kick to the balls hurts like a you-know-what.


Whether or not such a blow can cause sterility is dependent on the severity of the impact. Under ordinary circumstances, getting whacked in the groin will not cause sterility. However, if a bruise develops, and if it's very large and major bleeding under the skin occurs, then this is something that needs to be looked at by a health care provider as sterility is a remote possibility.


Back to Top



WHAT'S UP WITH MORNING ERECTIONS?


Why is it when guys wake up they have an erection in the morning? Does this happen to ALL guys? Thanks.

--------------------------------------------------------------------------------


Dear Reader,


Many men think their penises are erect upon waking because of urine buildup in the bladder, but this is false. Morning erections are technically nighttime erections which happen during Rapid Eye Movement (REM) sleep (when most dreaming occurs), although men older than sixty years may have them during even non-REM sleep. Generally, we experience four intervals of REM sleep per night. These spontaneous woodies in the wee hours are caused by specific neuroreflexes that are stimulated during REM sleep.


Most guys have nocturnal erections throughout their lifetime, and their frequency, along with one's awareness of them, may vary. Nighttime/morning erections can be noticeably harder or stiffer than those had when awake. The penis can stay erect for up to two hours nightly, and not all men who have erections during the night wake up with one in the morning.


Back to Top



BALL ON BALL

I can't thank you enough for all the sexual answers I've received from here. It's helped me out on at least 10 sexual questions that I've had. My question is this:


On my right testicle I have a little knob of tissue about a third of the size of a regular sized marble. It's attached by a cord to the right (sort of) side of my testicle. It almost seems to be part of the main cord. It's never grown in size and I have no other abnormalities that I can tell in my genitals.


Thanks, curious about balls

--------------------------------------------------------------------------------

Dear curious about balls,

What you are describing is probably a cyst, usually benign, of the epididymis or the spermatic cord, which can frequently swell and cause tenderness. However, most of the time, the usual recommended course of action is to watch it (but not all the time!)


If you put a penlight behind the cyst, it should light up like a Christmas tree bulb if it is filled with fluid. If it does not light up, then seek medical attention.


Back to Top



MY VAGINA WON'T STOP DRIPPING — HELP!


I am a thirteen-year-old. I have a problem in my uh "area." See ya know the natural lube that comes out of a woman's vagina? Well, it is constantly dripping, and I don't have sex or anything. I always have to wear toilet paper in my underwear. Do I need to get it checked out by a doctor? Or can I treat it my self?


signed,ew gross


--------------------------------------------------------------------------------


Dear ew gross,


It can be hard to get answers about private areas issues, and you're brave to go ahead and ask.


It's difficult to tell what might be causing you to have natural lube dripping from your vagina, so it makes sense to get checked by a health care provider. A provider can treat you effectively after examining you to diagnose your symptoms. Is there someone who can help you to make an appointment, and maybe accompany you there? If you can't talk with your parents, or another relative, perhaps a school nurse, or a friend's parent, can assist. Unlike some other health situations, self-treatment is not really an option here.


A health care provider is a useful resource. It's hard to do, but you can talk with the provider, clothed, before you are examined, to tell her or him of your concerns. Or, you can write it in a letter for her or him to read before s/he examines you.


The natural lube you're talking about is often "discharge." Just as every woman's genitals look unique, every woman's discharge is unique, in terms of amount, color, and scent. A number of things can cause one's vaginal fluids to change character. A lot of women notice that their natural secretions change over the course of their menstrual cycle. At some times of the month, the natural vaginal lube may be thinner and more watery; at other times of the month, it may become thicker and stickier.


A number of other things can cause changes in vaginal fluids, including:


yeast infections bacterial infections sexually transmitted infections (STIs), such as gonorrhea, chlamydia, syphilis pregnancy the birth control pill allergies to anything used on the genitals, such as soaps, creams, powders, laundry detergent, fabric softeners, feminine hygiene spray, douches, spermicides medical conditions that change the balance of hormones (chemicals) in the blood When you go to a health care provider, s/he will ask you lots of questions about your body. The provider will probably want to know whether this lube is a change for you, or whether you've always had a lot of natural lubrication. You'll be asked if you are noticing anything else, such as a strong, unpleasant odor, or a new color or consistency. The provider will want to know if you have any other symptoms, such as pain, itching, or burning in your vaginal area, or any pain, burning, or other difficulties when you pee. S/he will probably examine your vulva, and may take a small sample of the secretion to look at under a microscope. If you have an infection, medicines are available to take care of it.


One last thought: some young women mistake urine leaking from their bladders for fluid leaking from their vaginas. If it is urine leaking, it could mean a bladder infection, which is pretty common in girls, young women, and women (again, there are medicines to treat bladder infections). Lots of girls and women also notice that they sometimes leak a little urine when they sneeze, cough, or laugh really hard. There's a reason for that expression, "I laughed so hard, I peed my pants!" It's pretty annoying when it happens, but normal. Girls and women have a very short distance between their bladders and the outside world, so pee can easily sneak out when laughter, for example, squeezes a full bladder.


Back to Top



MENSTRUAL SYNCHRONY: FACT OR FICTION?


Okay, so my mother does not believe, as I do, that when a group of women live closely together (i.e., in a dorm setting) that their menstrual cycles become roughly similar, due to the release of pheromones. I'm pretty sure that I heard this somewhere, but I can't find anything to back it up. I swear I'm not making it up, but my mom doesn't believe me.


Thanks for your help.


Hopes She's Right


--------------------------------------------------------------------------------


Dear Hopes She's Right,


You and your mother are not the only ones debating the facts surrounding menstrual synchrony (the tendency of women's menstrual cycles to converge). A heavy flow of controversy has existed ever since researcher Martha McClintock first reported the phenomenon in 1971 based on a study published in the scientific publication, Nature, that she conducted in a women's residence hall.


Some scientists claim that women who live together and/or have close emotional bonds (e.g., sisters, mothers and daughters, lovers) have periods that eventually start to coincide or overlap. Other studies have found no evidence of menstrual synchrony in these same groups. Because no research has been able to pinpoint the potential cause(s) of synchrony, other factor(s) may influence the timing of women's periods (e.g., stressor levels, sexual activity, ability to sense pheromones), confusing researchers and roommates alike.


Back to Top



HOW SOON AFTER A MISCARRIAGE CAN YOU HAVE SEX?


How long to wait for sex after a miscarriage? What if you already had sex too soon after a miscarriage? What will happen if you did?

--------------------------------------------------------------------------------


Dear Reader,


Assuming that you're asking how long a woman needs to wait after a miscarriage before resuming sexual activity, typically, the longer the pregnancy, the longer the waiting period before inserting anything into a vagina, including a penis, finger, tampon, or sex toy.


Women's experiences of miscarriage differ. For some, a miscarriage may occur within the first three to four months of pregnancy. If there are no complications — such as heavy bleeding, pelvic pain, vaginal odor, fever, or even continued pregnancy symptoms — sexual activity can resume two to three weeks afterwards. For others, a miscarriage may take place in the last five months of pregnancy. If this is the case, a woman needs to wait at least six weeks. Regardless of when the miscarriage occurs, women are advised to have a gynecological exam before having sexual intercourse again. The reason is that after a miscarriage, a woman is more susceptible to infection because the uterus and cervix remain partially dilated. If a woman is exposed to bacteria before the healing process is complete, the fallopian tubes, ovaries, uterus, cervix, and vagina could potentially become infected. It's also possible that bleeding can reoccur.


Back to Top



IS IT OKAY TO HAVE A PAP TEST DURING YOUR PERIOD?


Can having a Pap test during menstruation have effects on the result? I've heard not to get one during this period. Can it cause abnormal results? Why is this?


Thanks,Curious

--------------------------------------------------------------------------------


Dear Curious,


You're right about what you've heard: women don't usually have Pap tests done during their periods. Menstruation itself does not cause abnormal Pap smear results; but, menstrual blood could cause false-normal test results because it may make abnormal cervical cells difficult to see.


It's recommended that women schedule a Pap test between ten and twenty days following the start of their periods. It's also important not to douche, apply vaginal medication, and/or insert spermicide (as foam, cream, jelly, film, suppository, or tablet) for about two days before the exam because they may remove or obscure abnormal cells, preventing the most accurate test reading.


Back to Top



CAN I RESCHEDULE MY PERIOD?


This may seem a ridiculous question, but here goes. I have a trip planned to Hawaii and just realized that during my vacation time, I am scheduled to be on my period. Needless to say, that will definitely slow down my plans for ocean swimming and loads of tropical sex with my boyfriend. Is there a way to safely alter my cycle by missing birth control pills or other means?


Hawaii-bound

--------------------------------------------------------------------------------


Aloha Hawaii-bound,


A good question that's surely been on the minds of many women... How can menstruation time be rescheduled if it's to arrive during vacation, on your wedding night or during your honeymoon, when you finally hook up with your long distance lover, etc.? A healthy woman's menstrual cycle can only be altered if she's already on the Pill and has been using it for a few cycles. How easily she can manipulate her cycle depends on the specific birth control pill she's taking, as some are more effective at doing this than others. Women are strongly encouraged to talk with their health care provider, gynecologist, or nurse practitioner before attempting to adjust their cycle.


To miss an entire period:


28-day oral contraceptive (OC) pack usersWhen you reach the end of the active hormonal pills in a pack, begin the next set of active pills, skipping the week of inactive, placebo pills from the previous package.


21-day OC pack usersInstead of going through the pill-free week, start the next pack of active pills.


Continued use of the active pills postpones menstruation by not allowing withdrawal from hormones. However, this protocol does not guarantee that there won't be any menstrual bleeding. Sometimes spotting (light bleeding) can occur. This process has no effect on pregnancy prevention.


This period postponement procedure is not to be done more than occasionally, but it could be allowable, at most, every other cycle. However, the maximum is in no way recommended and needs to be reviewed and approved by a health care provider.


If there's enough time between now and your vacation, or for future consideration, another option to contemplate is Depo-provera. It's a progestin-only form of contraception administered every three months as an injection. Depo-provera disrupts the menstrual cycle, tending to make a woman's periods less regular. For most women on it, spotting between periods is fairly likely. Some women even stop having periods altogether after using Depo-provera for a while.


Back to Top



DO I NEED TO CHANGE MY TAMPON AFTER USING THE BATHROOM?


I've looked at your FAQ but I haven't found one like the one I have. When a woman uses a tampon, does she need to change it after she uses the bathroom? I would think that the string would get wet and could contribute to bacteria.


Thank you.

--------------------------------------------------------------------------------


Dear Reader,


There are no documented cases of infection from urinating while using a tampon. Urine itself is primarily salt water, and, unless there is some sort of problem, it contains no bacteria.


Some women change their tampons:


after peeing; because of concern with possible odor from urine on the string; before bowel movements; whenever they feel discomfort; before or after showering or bathing; before or after swimming or engaging in strenuous physical activity; before sexual intercourse; when it's full of blood; or, after six to eight hours of use.


It's important that you do what makes you feel comfortable.


Back to Top



FOURTEEN AND STILL BOOBLESS


I have written you four times and with no response. I am a fourteen-year-old female and I am as flat as a board. I would appreciate it if you would tell me the average age for first periods and boob growth rate. Is there anything I can do to help with m y small boob size and no period? I could live with that, but I want boobs. I am pretty, but as flat as a board.


Please respond this time. I beg you.


Boobless

--------------------------------------------------------------------------------


Dear Boobless,


Most books that have anything written on puberty and development say things like this: "breast development in girls occurs between eight and thirteen years of age," or "rapid body growth of girls during puberty takes place from age nine to age fifteen," a nd, "the average age for a girl's first period is 12.8 years." I think it is natural for you, at the age of fourteen, to read and hear this sort of information, to see these changes happening to most of your friends, and, subsequently, to wonder abo ut your own body.


The truth of the matter is, it is perfectly normal for puberty to begin later than age eight or nine, or twelve or fourteen. Unless you reach sixteen or seventeen years of age without any signs of the onset of puberty (e.g., breast growth, menstruation), there really isn't much cause for concern -- medically speaking, at least. Socially, it must be hard for you to see your friends' breasts begin to grow, hear them speak about wearing bras, and trade stories of their first periods. Unfortunately, there isn't anything you can do to rush your body. Exercises reputed to increase breast size (like in the movie, "Grease") actually help build up muscles in the chest -- breasts do not contain any muscle tissue. Thus, the best I can say is to be patient.


Have you talked with your mom about this "flat as a board" problem? Ask her when she got her period and when her boobs began to grow. This may shed some light on your own rate of development. You could speak with your health care provider. S/he has mo re insight into your health and previous development rates and can probably offer more concrete advice and information specifically for you. Alternatively, if there is a nurse at your school with whom you are comfortable, speak with her/him about your co ncerns. In some cases, certain medical conditions can cause a delay in development.


Some food for thought: for menstruation to begin, body fat needs to be about one-quarter of your total weight. If you are very athletic and muscular, expect it to take a while for your period to start. Women mountain climbers, by the end of a long clim b, find that their breasts have become smaller, and, for some, their periods cease until they regain some of the weight lost from such strenuous work at high altitudes.


Back to Top



WHAT IS DYSPLASIA?


Last week I went to my OB-GYN for a checkup. I had not been to the doctor in four years because I had moved and not found the time to look for one. (I know, not a good idea.) Well, the results of my Pap smear came back and my doctor said I had dysplasia. She also said that I did not have any signs of warts when she examined me. After questioning her on the origin of this, since I know little about dysplasia, she told me it was sexually transmitted. Is this true? I have heard that no one really knows where dysplasia comes from. I just want more information before I go in for my checkup before treatment. By the way, this didn't show up on my Pap smear four years ago, and I have had the same partner this whole time. Thank you!

--------------------------------------------------------------------------------


Dear Reader,


Yearly Pap smears allow us to keep tabs on cervical cell growth. We can see if they are growing and replacing themselves in a healthy manner, or if the cell growth has become abnormal.


Dysplasia means abnormal cell growth anywhere in the body. In your case, this abnormal growth has occurred on your cervix. Unchecked and untreated, it can progress, possibly to cancer; or, it can heal on its own. The more severe the dysplasia, the more likely it is to progress to cancer. Mild dysplasia may resolve on its own, without any treatment.


Cervical dysplasia has been associated with the presence of the human papillomavirus (HPV), which causes genital warts and is usually, although not always, sexually transmitted.


If you have an abnormal Pap smear, the result may not always say "abnormal with HPV changes." Although you've been with the same person for the past four years, and your last Pap was normal, HPV could have gone undetected before. It is important to have a Pap smear annually so that abnormalities can be detected early.


Dysplasia is further diagnosed with colposcopy, which looks at the whole cervix, and, sometimes, a tissue biopsy. Through colposcopy (a procedure that magnifies the area with a special microscope -- a colposcope), your doctor can directly view your cervix and any abnormalities. If your doctor sees any abnormal cells through the colposcope, she will remove them and send them to a lab. This is the biopsy part of the treatment. Depending on the biopsy results indicating the severity of the dysplasia, further treatment may be suggested, which can be simply observing it to see if it resolves spontaneously, repeating the Pap test more frequently, and probably repeating the colposcopy. Other treatment may be recommended to remove the abnormal tissue. A commonly used treatment is cryosurgery, a freezing technique.


Back to Top



TAMPONS OR PADS?


I am a twenty-year-old foreign student and I am new to the States. One of the first things I learned about the American way of life for women is that tampons seem to be used by my sister students more often than pads. I was not familiar with them before I arrived here and am rather worried about trying to use tampons myself, despite the advantages claimed for them. Maybe you can help by answering a few of my questions, as I find it embarrassing to talk about this as frankly as some American girls do.


1. Should one use pads or tampons? 2. What kind of pads or tampons are recommended, as I am not familiar with the brands in the stores here? 3. What particular advantages do these types have over others? 4. I have seen some pads described as "overnight." Does that mean very absorbent? Is it possible to wear a pad and a tampon at the same time? 5. What are panty liners? Do you also use them with pads and with tampons? 6. I have heard that tampons are sold to girls as young as thirteen. How is it possible that they can use them? 7. Are there any risks or dangers in using tampons? -- New to Playtex

--------------------------------------------------------------------------------


Dear New to Playtex,


You ask some great questions that many American women have as well. Here are some answers: wearing pads or tampons is a matter of personal preference. Pads, or sanitary napkins, come in a variety of shapes, sizes, and absorbencies. Overnight types are usually the bulkiest and the most absorbent, and panty liners are the smallest and the least absorbent. Women use different products depending on the heaviness of their flow.


Tampons are made of soft absorbent material and are inserted into the vaginal opening, like a battery into a flashlight, resting in the vaginal canal to absorb menstrual fluid. Tampons also come in various sizes and absorbencies, with or without deodorant, and with or without applicators. Brands also differ in size, effectiveness, and comfort. Tampons need to be changed frequently to prevent toxic shock syndrome (TSS). They may also be used with pads as backup in case they leak. Women can use tampons even if they haven't ever had sexual intercourse, and using tampons does not affect virginity.


Here's some guidelines for inserting the applicator-type tampons:


(1) Unwrap the tampon, being careful not to move the applicator plunger. Tampons with applicators usually have two parts, one that surrounds the tampon and is inserted into the vagina, and a thinner tube that acts like a plunger to push the tampon out of the plastic or cardboard.


(2) Try to relax. Get yourself in a comfortable position -- standing with one foot on the toilet, sitting with your knees apart, or squatting on the floor. Make sure the string is hanging out of the bottom of the applicator. Hold the tampon at the point where the two tubes meet with your thumb and third finger.


(3) Insert the tampon gently into your vagina until your fingers touch your outer vaginal lips. You may want to hold your lips apart with your other hand while you insert the tampon. It may help to jiggle the tampon slightly. You are not in danger of putting the tampon up too far or having it get lost in your vagina.


(4) While still holding the tampon in this position, use your forefinger or your other hand to gently and slowly push the plunger all the way. Then pull out the applicator and dispose of it in the trash.


(5) Once it's in, you should not be able to feel the tampon at all. If it's uncomfortable or painful, you can try pushing it up farther in your vagina, adjusting it with your finger, or taking it out and trying again with another tampon. A few more things: There is no reason to use deodorant tampons. In fact, they can be irritating to many women. Also, if a tampon is hard to pull out or shreds when you remove it, the tampon you are using is too absorbent and you need to switch to one with a lower absorbency rating. Lastly, one of the biggest health hazards with using tampons is toxic shock syndrome, or TSS. TSS is a rare, but life-threatening, bacterial infection that affects between one and seventeen menstruating women per 100,000. Studies have shown that using the super plus tampons, and leaving tampons in the vagina for long amounts of time, increase the risk of developing TSS. Symptoms include a sudden high fever, vomiting, diarrhea, fainting, dizziness, or a sunburnlike rash. To minimize the risk of TSS, wash your hands before inserting a tampon, change your tampon every four to six hours (especially on heavy flow days), and use the lowest absorbency tampon that is reasonable given the amount of your menstrual flow.


Adapted from THE COLLEGE WOMAN'S HANDBOOKCopyright 1995 by Rachel Dobkin and Shana SippyWorkman Publishing Co., Inc., New York


Back to Top



GIRLFRIEND GETS TOO WET


When making love with my girlfriend, she says she gets too wet, doesn't like it, and would like to know if there is anything she can do to lessen the wetness just a bit.


--Caring

--------------------------------------------------------------------------------


Dear Caring,


Your girlfriend may have cervicitis, a disease that is known to cause lots of discharge. Also, if you have oral sex, the germs of your own mouth and throat might be causing her discharge. Does she use an Intrauterine Device (IUD)? Any type of foreign body in the uterus can increase vaginal fluids.


There are women who expel large amounts of fluid upon orgasm; there are people of both sexes who pee a bit when highly aroused; and then there are people who are quite regularly wet when sexually aroused. However, for most individuals, hot and juicy are synonymous! You and she may be making a problem over what is, at worst, an inconvenience, and what would be for many people a blessing. If she has an examination and there is no medical cause for concern, you can try the "terry cloth approach." Keep a towel near the bed and use it sensuously to dry off your girlfriend and yourself during sex.


Back to Top



PMS!


Once a month I get PMS-y. I can deal with the bloating and cramps, (usually), but, honestly, I go crazy, loony, wacky. My emotions are completely out of control, from extremely happy to totally miserable and crying, with lots of grumpy behavior in between. I actually don't usually realize when I'm behaving irrationally, so when my boyfriend tries to point out that maybe my bouts of anger and tears are caused by hormones I attack him for telling me I'm just an irrational woman. Basically, is there any way to help these mood swings? I'm on birth control pills, which is supposed to help, but it doesn't really seem to do anything.


Thanks, Nuts

--------------------------------------------------------------------------------


Dear Nuts,


Premenstrual syndrome is the development of a wide range of symptoms for several days before, and sometimes during, the first day of most, or all, of your periods. Researchers disagree on a definition of PMS, and all efforts to find a biological basis for it so far have failed. These treatments may work for some women: antidepressants, birth control pills, some vitamins or minerals, and evening primrose oil. Hormone suppressants have not had clinical trials as a remedy for PMS -- although it is known that they can have severe side effects when taken in large doses over long periods of time.


Some women have found that home remedies, or rather preventatives, have been helpful in alleviating some of the symptoms of PMS. Reduce your salt, sugar, caffeine, and alcohol intake at least one week before your period is expected. Or, if that seems like too much to ask, try reducing one item at a time in your diet and see if there's any difference. Exercise helps premenstrually, as well as for cramps during your period. Although it seems as if that's the last thing you'd want to do, it can help. Also, vitamin B-6, or pyridoxine, may help. Good food sources include whole grains, green vegetables, molasses, nuts and seeds, poultry, potatoes, and fish. If you want to try a B-6 supplement, 25 - 50 mg a day may help. Avoid higher dosages because of toxicity -- discontinue use immediately if you get tingling sensations. Taking 400 mg/day of vitamin E along with vitamin B-6 may offer benefits as well.


Back to Top



AIR OUT VAGINA AT NIGHT?


Is there something wrong with me? I like to sleep in the nude without any panties on and my legs spread apart because it helps to air out my vagina. My pussy area gets so moist during the day that I cannot stand it. I am afraid that I will get a yeast infection or some fungi will grow on my vaginal lips if I don't air it out at night.


Pussy cat

--------------------------------------------------------------------------------


Dear Pussy cat,


It is my hunch that there is nothing wrong with you. Much as tears or ear wax are parts of the normal functioning of the eye and ear, all women normally secrete moisture and mucus from the membranes that line the vagina. These vaginal secretions help to control the growth of microorganisms that normally inhabit the vagina, and help to cleanse the vagina.


Vaginal secretions usually appear clear or slightly milky, and may be somewhat slippery or clumpy. When dry, they may be yellowish. Sexual arousal, stress, and/or ovulation at mid-cycle may lead to an increase in this discharge. Abnormal secretions are usually gray, yellow, or greenish in color, may resemble cottage cheese or foam in texture, and may have an unpleasant smell. They are usually symptomatic of vaginitis, and can be diagnosed by your health professional.


During the day, you might be more comfortable wearing cotton underwear and clothes that are loose-fitting in your genital area (skirts, baggie pants, panty hose with cotton inserts, etc.). This will help reduce the chance of vaginal irritations and infections. As to sleeping in the nude --I think "to each her/his own."


Back to Top



CASTRATION EFFECTS

When a man is castrated, does he lose all senses of the urge to have sex? Or, is it that he loses all ejaculation, but the urges are still there?


--------------------------------------------------------------------------------


Dear Reader,


Castration usually means removal of the testicles, which is where the male sex hormone, testosterone, is produced. At various times in history and in various cultures, boys have been castrated to serve as religious figures or servants, or to keep their singing voices in the upper register. These castrated boys are often called eunuchs or castrati. When a boy hasn't gone through puberty yet, castration will result in a less muscular frame, underdeveloped genitalia, lack of body hair, and a voice that doesn't change or deepen.


Castration can occur by accident (e.g. war/bomb injuries, torture and punishment, pelvic crushing from auto accidents, severe burns, self-mutilation, etc.), or be the result of surgery, perhaps for a medical condition such as testicular cancer or prostate cancer. Some medicines that treat prostate cancer result in "pharmacologic castration," because they prevent the production of testosterone. Some courts have ordered men who are habitually sexually abusive to undergo injections of medications to stop testosterone production, hoping that this measure will prevent these men from continuing to sexually abuse others.


At first, a man who has been castrated will still have a sexual urge. Over time, however, because he's no longer producing testosterone, he'll lose much of his libido or sexual desire. Medications can readjust the chemicals in his blood and bring back some sexual desire. Studies have also been done that show with increased stimulation, a castrated man can actually get an erection, have sex, and orgasm (although he won't have any sperm in his ejaculate, which would be minimal in volume).


Back to Top


DOUCHING


What's douching?

--------------------------------------------------------------------------------

Dear Reader,

Good question, pretty simple answer. Douching commonly means rinsing the vagina with water and/or a special solution using a container, tubing, and a nozzle (known collectively as a douche). In the past, women were advised to douche to prevent pregnancy when used right after sex, to treat vaginal infections, to wash away vaginal secretions, and to reduce odors.

Douching is no longer recommended for a number of reasons. We now know that, like most ovens, vaginas are self-cleaning; they continually regulate their mildly acidic environment. Douching, unfortunately, washes away the healthy bacteria lining the vagina, as well as alters its natural pH level. It can also spread existing vaginal infections to the uterus and fallopian tubes, or can introduce new ones that can lead to conditions such as pelvic inflammatory disease (PID). Last, but not least, douching does not prevent pregnancy.

COMING OUT TO MOM AND DAD

I love your website because you have such an open mind about things. That's why I'm writing to you for some advice. You see, I think I am finally ready to tell my parents that I'm gay. This is something I've wanted to do for a while now, but could not bring myself to introduce the subject. I suppose this has a lot to do with how they might respond. I think they'll be open minded and still love me now knowing that I'm gay -- it's not like I'll be a different person. But there's still that possibility that things may change irrevocably between us. What do you think? I know that National Coming Out Day is coming up, so I thought that might be a good time for me to "come out of the closet." But what should I say or do? I no longer want to hid e from them a very important part of who I am. Please offer me some of your wise words of wisdom.

To be or not to be "out of the closet?"

--------------------------------------------------------------------------------

Dear To be or not to be "out of the closet?",

One of the goals of National Coming Out Day (October 11th) is to motivate people to say, "I am proud of who I am." Whether or not your decision to talk to mom about your sexual identity was inspired by last week's celebration, bravo for your desire to be honest, to grow, and to be more true to yourself.

I tend to favor the direct approach: "Hi mom, I'm gay...this is important to me, and I would like to talk with you about it." Or, "I'm a lesbian...if you'd like, we can discuss what this means." This "cut-to-the-chase" method can get you right to th e "where will we go from here" stage, cutting out much of the agony that commonly precedes publicly saying, "I'm gay, lesbian, or bisexual." However, I certainly realize that being direct can be painfully difficult for both mother and child. So, in l ieu of a litany of suggestions for direct and indirect coming out strategies, here's a list of books and organizations that will likely boost your confidence and generate a variety of ideas during this important process:

1. Outing Yourself, by Michaelangelo Signorile
2. Coming Out to Parents, by Mary Borhek
3. Is It a Choice?, by Eric Marcus
4. Now That You Know: What Every Parent Should Know About Homosexuality, by Betty Fairchild and Nancy Hayward

Back to Top