Check out my post on Bloom Enjoy Yourself and their new site, about why sexual health is as important as many of the other things us Healthcare Practitioners are telling you to do as part of a healthy lifestyle (i.e. exercise!) More sex means a healthier life? Read on!
I think the ladies will have a new reason to get their motors running, and fellas, you are WELCOME!
Yours in Good Health
B
It always fascinates me that some celebrities try a cosmetic “treatment” they seemly don’t have side effects, so they tout to everyone how great it is, and then a new trend is born. Some of the procedures that people undergo as forms of cosmetic treatments are pretty intense, and can have some major long-term side effects, so you really need to be aware of what can happen. As all of you know, I love to hop on trends that make your life easier, like laser hair removal, but I do think that we need to think about the procedures we want/get before we just jump into it. The latest trend in Hollywood? Scrotal Ironing, AKA “tightening the tackle”, which was really brought into the spotlight by George Clooney a few weeks ago (and he won’t confirm whether he was being tongue in cheek or actually had the procedure). I have covered the scrotal shortening procedure, for those hanging low, but this is more a cosmetic procedure to tighten wrinkles….
What is Scrotal Ironing?
Basically, the scrotum is made of very thin skin, just like the skin under your eyes, which can become loosened over time, and scrotal ironing is similar to a face lift….just for down below. By using a light laser treatment, the skin tones are evened, wrinkles are diminished, and hair is removed as well. The procedure itself takes around an hour (and you my need more than one session), with a cost around $575. The procedures have a small amount of pain associated with them, given the sensitive area and all, but numbing creams can be used to diminish the discomfort. And after all your treatments, you can turn back the hands of time and have a wrinkle-free, hair free, and nicely toned scrotum….if that’s what you’re looking for in life, but it is not without side effects!
So Smooth, George!
Are There Side Effects?
There are always side effects with every procedure, and scrotal ironing is no different. They range from very mild, like skin irritation, or slight burns due to the use of the laser too close or too long in one area, which are temporary (but quite uncomfortable, I would imagine). Then there is a much more intense side effect, which is a risk of retrograde ejaculation; when men get to the point of ejaculation, the semen is unable to leave through the tip of the penis, so it goes into the bladder, and is removed form the body during urination. That will directly reflect a man’s ability to procreate, because they cannot ejaculate semen from their penis into their partner (or sample jar- however you choose to do it), and it may have to be removed another way, if you are looking for a viable semen sample for procreation.
The Final Verdict?
If you feel the need to tighten your tackle or Iron your scrotum, for whatever reason you feel it is necessary, if you are fertile and looking to procreate, you should talk to your Healthcare Practitioner (HCP) before dropping $575 and booking that appointment. Retrograde ejaculation seems to be a much rarer side effect, but it is still a risk. And, I don’t have a scrotum, obviously, but men seem so protective and hypersensitive about that area, I couldn’t imagine all you men running to get this done, but apparently George Clooney has more than just a swooning effect on women! Just think about the risk vs benefit of a smooth scrotum before jumping under that laser!
Yours in Good Health
B
Not too long ago I wrote about the morning after pill, what it is, and how it works. At that time, it was available Over-The-Counter (OTC) to women 17 years old and over, and below that, women (girls) needed to get a prescription to use the medication to prevent pregnancy.
When used within 72 hours after another failed form of birth control, there is a 90% success rate in preventing unwanted pregnancy. I know there is some debate among people, but from a strictly medical standpoint, it is not an abortion pill, because it merely causes irritation to the lining of a uterus, thus not allowing anything to adhere or become fertilized and start growing. It won’t abort and already growing fetus, and should not be taken if you already know that you are pregnant. 
Recently, legislation has changed. It has been highly debated at which age group the pill should become available without prescription, in 2011, here in the US, it was decided that above 17 years old can get it as an OTC. More recently legislation has changed (granted it is being opposed) so that women of any age can obtain the medication as an OTC. I have mixed emotions on this one: I think that everyone should have a right to medications that would help to prevent pregnancy after a mistake/failed birth control attempts, but should 10, 11, 12-year-old girls be able to walk in and get the morning after pill, if they are sexually active, and not be counseled regarding Sexually Transmitted Infections, or the effects of the Plan B medications on their body, or on how it would be better for them to be on regular birth control, if they continue to choose to be sexually active. And then there are the young girls that don’t choose to be sexually active but may be forced. Are we missing a population that needs our help and interventions?
How do parents feel about this? Would you want to know if your young daughter was using the morning after pill? I guess not giving young women the option of having Plan B as OTC, leads them to possibly make other unhealthy choices, or try home “remedies” to prevent pregnancy, which may be dangerous.
I do like the option of women/girls having the right to make their own medical decisions without the need to get an HCP appointment and then get the prescription filled, and there has been no proven negative effects on their bodies (physically) but I am wondering the mental/psychological effects,and if we could do better as HCPs to intervene and help these women. I am really torn, and I am interested what you all think about this, as it is something that almost every woman has an opinion on: When are we being too free with Plan B administration, and when should we step in?
Yours in Good Health
B
The reason why many people don’t go get regular HIV and Sexually Transmitted Infection (STI) testing is because they are embarrassed to talk to their healthcare practitioner (HCP) that they have a relationship with, and get nervous to go to STD clinics because they are worried about stigma if they see anyone they know. One way to break that stigma? the new OraQuick at home HIV testing kit. It only takes about 20 minutes to get results, and has everything that you need to test yourself for HIV-1 and HIV-2 (the two main strains of HIV). Of course, if you are at high risk for STI’s and have symptoms, you should still go and get a full HIV and STI panel of testing with physical assessment by your HCP. But it is fast, efficient HIV testing in the comfort of your own home; but how it works might be confusing.
How does the at-home test work?
This OraQuick HIV test is the only FDA approved at home HIV testing kit currently on the market. The kit comes with very easy to read and specific directions, but the test itself does not require any blood, so you do not need to poke or prick yourself to draw blood. It uses the fluid and cells from your gums to test for the HIV antibodies; you just need to use the swab that is included in the kit, rub it over your upper and lower gums, then put it in a little test tube of fluid (provided). That will test the cells and fluid of your gums for the HIV antibody and you will have your results in 20 minutes. The results read in a similar fashion to a pregnancy test, there is always one line that should show, once you start the test, which is the control line, to let you know that the test is working properly. If both lines illuminate, then you are positive. Of course positive results do need to be sent to a lab for a further test and you need to have them confirmed by an HCP, just to ensure that the test is correct. They offer 24/7 support online, along with videos on how to perform the test and interpret the results directly on their website.
Where can I get the test?
You can buy the OraQuick at any local pharmacy here in the US (CVS, Walgreens, Wal-Mart, Kroger, Rite Aid, and Navarro.) And you can also check out the OraQuick website to purchase the test directly from them. The tests cost $39.99 USD per test and are good for one sample.
The bottom line?
If you are specifically in need of HIV screening/testing, this is a great option for those without an HCP or if you cannot get into a clinic for testing. That being said, if you are at risk for HIV, you are most likely at risk for other STI’s and I do suggest getting checked out by an HCP so they can physically assess you and test for a whole array of STI’s that you may or may not be aware that you are at risk for. HIV is just one of many Sexually Transmitted Infections, so please know your risks, cut those risks by using condoms, or other barrier methods, to prevent the spread of infection. So be safe, choose your partners wisely, and get tested frequently.
Yours in Good Health
B
I was quite shocked that crabs (AKA pubic lice) is as prevalent as it is. But in the past week I have been asked about it three different times from people all over the US, which made me think that this topic needed a little discussion related to what crabs are, how you get them, and how to treat them. I wasn’t sure how prevalent they are, but they are clearly around, and infections are on the rise.
What are crabs?
Crabs are also known as pubic lice (Pthrius pubis) and they are parasitic insects that feast off the blood of humans and live in coarse hair (i.e. pubic hair, eyebrows, eyelashes, chest hair, armpits, mustaches, & beards) causing itching, discomfort, and rashes. So you can understand how they can not only be really irritating, awkward, and kind of gross to think about, right? They pass from person to person usually through sexual intercourse (or sexual acts) but they can also jump from person to person through hugging or other close contact (sharing towels, clothes, bedding, etc.) Despite the fact that crabs can’t live very long away from the warmth of a human body, they are still the most contagious STD, and if an infected person has sex with a non-infected person, the risk of getting crabs is about 90% for that previously non-infected person. That is pretty shocking, and horrifying…a 90% chance?!? Plus the lice live from about 1 to 3 months, and in that “lifetime” the average female lice has about 300 eggs, which means they breed quickly and frequently! These parasites spread quickly.
What are the signs and symptoms of infection?
Usually the only symptom is itching….extreme itching. Sometimes you can visualize the bite marks on your skin, they are bluish in color, due to the bruising from them sucking your blood to the surface, but it is very hard to see. Sometimes there are little red bumps from the bites, and then scratching them. Most often the itching and discomfort brings people in to their HCP.
How do I treat it?
First, when you find out that you are infected, let the people you live with and sexual partners know about the crabs, and clean all sheets, clothing, towels, etc in water that is at least 130F and dry it thoroughly in a dryer to kill off the lice living in the sheets. If some of these items cannot be washed, then have them dry cleaned. You can also buy an over the counter (OTC) treatment from your local pharmacy, like Permethrin 1% creme, that you apply to the affected areas (not near eyes), leave on for 10 minutes, then wash out and with a fine toothed comb, comb through the hair to remove all eggs and dead lice. Usually this one time treatment works, but you MUST see an HCP to get treatment if the OTC doesn’t work, if you are pregnant, children under 2 years old, or teens under 18. There are some treatments that are prescription only, so you need to see your HCP and get diagnosed. One other option, after you treat the area, is to shave off all affected areas (this is a little radical and not usually suggested by most HCPs) but if there is no hair to cling onto, there will be no pubic lice….just make sure to kill off the current infestation you have. Makes sense right?
Can I prevent it?
Well, you can ask partners if they have crabs, which I would hope they would abstain from sexual contact if they knew they had crabs, but its worth an ask. Unfortunately, condoms do not prevent the spread of crabs, which is a total bummer. If you have previously been infected (or are infected currently), make sure to wash or dry clean everything (as stated above, use the OTC treatment, and if symptoms are not cleared up, go see your HCP for further treatment, and bleach your bathroom/anything you use on your hair/body hair for grooming.
So unfortunately, it is highly contagious and can be an awkward treatment, but limiting your sexual partners, and asking about STD’s is a start at prevention. Also, use your intuition: if you see someone scratching their crotch or just all over when you’re out with them, ask them if they have some sort of skin issue or lice. If they say they are just super itchy and they don’t know why? Steer clear!!
Yours in Good Health
B
I feel like more and more people lately have been pulling me aside to ask me questions about either a low sex drive, no sex drive, or men are having erectile dysfunction (at young ages)…and each time I ask, “Is there any chance you are on an antidepressant or SSRI”? Without a doubt, the answer is always “yes, is this related?” and the lightbulb goes off. This makes me think that HCPs don’t necessarily do a great job preparing patients for the side effects of these medications that can be used to treat anxiety, depression, post traumatic stress disorder (PTSD), along with other issues. It is neither abnormal to have these side effects nor be on one of these medications….just to get that out there! And there are certain Selective Serotonin Reuptake Inhibitors (SSRIs)/antidepressants that cause more sexual side effects than others.
What is considered sexual dysfunction?
Well, a lack of interest in sexual intimacy for someone who once had a higher sexual drive is considered sexual dysfunction, along with erectile dysfunction (for men) and vaginal dryness and decreased sensitivity (for women). Also, for both sexes, antidepressants can lead to a decrease in the ability to achieve orgasm….or make it much more difficult to reach orgasm. This happens in one form or another to almost everyone at some point in their lives (whether they want to admit it or not) and many antidepressants just increase these issues, but they are so helpful in treating depression and anxiety.
What Antidepressants have a lower risk of sexual side effects?
-Buproprion (Wellbutrin- in all forms including XL and SR)
-Mirtazapine (Remeron and Remeron SolTab)*
*One study showed a very high rate of sexual dysfunction, while a couple of other studies showed much lower rates. Due to that, I am suggesting it as a lower rate drug, but you should talk it out with your HCP.
Which ones have higher rates of sexual dysfunction?
-Celexa
-Lexapro
-Paxil (almost half of all users experience sexual dysfunction)
-Prozac
-Zoloft
-Effoxor
-Cymbalta
Is there anything I can do to combat the sexual side effects?
YES! If your antidepressant is working well and you feel good on it, there is no need to change medications (it is an option if you are just starting a medication or are switching meds, you can ask your HCP for one that may have lower sexual side effects), but there are also other options to help and improve your sexual desire while improving your mental state, because a huge component of the sexual dysfunction is mind over matter. Really. People stress themselves out because they do not have a strong sexual desire, so they anxious about performing, etc. and then they have difficulty performing. Some tips to try to work through it:
-Talk to your partner about your concerns…sometimes talking about it alleviates some of the fears related to sexual performance.
-If you take your antidepressants at night, schedule to take it a little later that night if you plan on having a special night with your significant other.
-Talk to your HCP about lowering your dose, do you ned to be on the dose you are? Also, there are studies that show some people do very well on drug “holidays”; maybe taking their antidepressants Sunday through Thursday so they have a good level of the drug in their system but they can have more of a sexual desire on weekends.
-Add another medication: 50-100mg of Viagra or 5-20mg of Cialis taken before sexual activity has been shown in studies to improve arousal, erectile function, and lead to meaningful orgasm (men). Low doses of Viagra have also been found to help women with their sexual arousal and ability to reach orgasm.
I am not advising to stop medications or decrease doses without talking to your HCP, they know you and your needs better than I do, but it is important to talk about these things with them. Really, they should be asking you how your sex life is after you start these medications…but if they don’t screen you, tell them! We are so used to getting questions like this, it is great to have it out in the open, so please do not suffer in silence, your HCP will work with you no matter what route you want to take in treating your side effects from your antidepressants.
So get chatting with your HCP and get humping with your partner (safely) 😉
Yours in Good Health
B
Many people are unclear as to what Erectile Dysfunction (ED) actually is, despite those really ridiculous Cialis and Viagra commercials on TV (which can be horribly awkward to watch in mixed company at times!!) ED affects between 15 and 30 million men in the US and approximately 22.3% of all office visits to HCP’s are for ED. It is something that many men are embarrassed about and feel unable to speak to their partner about, and it can cause huge rifts in relationships. It is important to know that signs and talk to your partner about it, it is a physical issue that is normal, and totally fixable, so go to the doctor together and make it a couple problem, and don’t let your partner suffer and feel badly alone!
What exactly is the definition of ED?
It’s the inability to maintain an erection that is firm enough to have sex, on an ongoing basis, along with trouble getting an erection, difficulty maintaining an erection, and/or a reduced sexual desire. If you have any of these symptoms, especially if you have diabetes or heart disease, you should go see your HCP and talk to them about it, your options, and to find out what might be going on with your body. Don’t let it get too far that your partner might get upset or think that they are the one causing the problem…be open about it and go to see your HCP.
What are the causes?
There are SO MANY possible causes of ED, in which some are physical, mental, and a combination of the two. Some physical causes are: heart disease, atherosclerosis, high blood pressure, diabetes, obesity, metabolic syndrome, Parkinson’s disease, Multiple sclerosis, low testosterone, Peyronies disease (a build up of scar tissue in the penis), tobacco use, alcohol (alcoholism), substance abuse, pelvic/spinal cord surgery, enlarged prostate, and prostate cancer. So, obviously it goes from being something that is easily fixed, to things that are more serious. As far as psychological issues: stress, depression, anxiety, fatigue, and relationship issues can all cause ED. Another psychological reason that many men have a form of ED, in this current society, is due to the inability to get their partner pregnant; we have a society wrought with infertility and it can case serious relationship problems on many levels. As well, many medications that your HCP might put you on for various health issues, can also cause ED.
Before you go to your HCP appt:
Write down symptoms that you have had even including things that you might think unrelated to ED. Also, write down any life changes going on, including anything that might be causing relationship stress. An update list of current prescribed and over the counter medications are always important to bring to every appointment, but especially to an appointment regarding ED. Try to bring your partner to your appt and both of you talk before you go and both write down list of questions both separately and together.
What might happen at/after your appt?
A physical exam, which is standard at all appointments, but your HCP will inspect your penis, testicles, and check for nerve feelings. Most likely you will have blood drawn to assess your risk of heart disease, diabetes, cholesterol, and testosterone levels. A urinalysis may be performed to also look at your risk of diabetes, etc. An ultrasound may be done to look at blood flow to your penis, it uses a plastic probe on the outside of your penis to project a video of the current blood flow (a non invasive exam). They also might have you go home and perform an overnight erection tests; many men have erections at night during sleep, and have no idea that they had an erection, if the test is positive, then the reason you have ED is psychological. What they will ask you to do is to put a piece of tape that they will give you (it is easily split) around your penis, and if you wake up in the morning and the tape it split open, you’ve had an erection.
How do we treat it?
You can take oral pills like Viagra, Cialis, and levitra which are medications that enhance your bodies natural nitric oxide levels which helps muscles relax and allows more blood flow to your penis, allowing for a stronger erection. You may need to change doses and change times that you take before getting an erection. You need to talk to your HCP to take these drugs if you also take any nitrate drugs like nitroglycerin, Imdur, or Isosorbide because you can have too much of a build up of nitrates in your blood. Also be careful with blood thinners and alpha blockers (for enlarged prostate). Your HCP will have to discuss using medications if you have had a stroke, have either low blood pressure or uncontrolled high blood pressure, heart disease or heart failure, and/or uncontrolled diabetes.
Other medication options:
Alprostadil injections: a small needle is inserted in the base or side of the penis and you inject the medication, due to the small size of the needle there is usually little to no pain, and you can get an erection within 5-20 minutes and the erection usually lasts around an hour.
Alprostadil penis suppository: Using a special applicator, you insert a small suppository 2 inches up the inside of the urethra. The side effects can be pain, bleeding from the urethra, dizziness, and can cause a fibrous build up inside your penis.
Testosterone replacement: if you have low testosterone levels, oral supplements can help to increase your levels and ability to maintain/obtain an erection.
Other options:
Penis pumps: a hallow tube with a hand or battery-powered pump, you put your penis inside, pump out the extra air, which causes blood to flow to the penis and cause an erection, you need to put a tension ring on the base of your penis, then remove the pump. The erection usually lasts long enough to have sex, then remove the tension ring.
Penile implants: implants are surgically places on both sides of the penis, either inflatable or semi rigid rods. The inflatable implants, are inflated before sexual intercourse to help obtain an erection and the semi rigid rods allow for a firm but flexible penis at all times. Due to it being surgical in nature, there is a risk of infection, and usually a later option for ED.
Blood vessel surgery: at times a leaking vessel can cause a decrease in blood flow to the penis, a simple surgical procedure may be able to fix that problem.
Psychological counseling: if the problems are psychological in nature, counseling can help to talk about the problems and may help to decrease ED issues.
How can you fix it with lifestyle changes?
If you use tobacco, quit. Lose weight to get to a healthy level, exercise regularly, get treatment for alcohol and drug abuse, and work through relationship issues with your partner and with the help of a professional.
Alternative medicine:
Acupuncture is said to help with ED and relieve stress and anxiety, so it can help with some psychological problems.
Due to all of the possible causes, it is not only the first sign that something serious might be going on, but it also is something that might be fixed simply and easily, so I really encourage seeing an HCP early to talk about it. Be open and honest with yourself, your partner, and your HCP. ED is not something to be embarrassed about or something that you should allow to ruin a relationship. If you notice any of these problems with yourself or your partner, please talk about it and go see you HCP ASAP!!
Yours in Good Health
B
