Em & Lo's RSS Feed Em & Lo's Daily Email Feed Be Our Facebook Friend! Follow Us on Twitter!

Good Vibes Sex Toys

Buy on Amazon Kindle!

Christmas Story Lamp on Amazon


Archive | What’s Up Doc? RSS feed for this section

Dear Dr. Kate: Like Fine Wines, Do Vaginal Aromas Change with Age?

April 5, 2012

0 Comments

photo via Flickr

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions every few weeks on EMandLO.com. To ask her your own question, click here.

Dear Dr. Kate,

I’m a fully grown woman, about to turn 32. I’ve just noticed my vagina has changed ‘tone’, it appears I have begun to smell more like a woman in her 30′s, it’s hard to describe but definitely a change. Is this normal? Am I imagining things?

– Je Ne Sais Quoi

Dear JNSQ,

All vaginas don’t smell, or taste, the same…but they do all smell. Odor tends to come from sweat – the vulva and vagina have sweat glands, too. And the scent may change as our menstrual cycle progresses, in response to hormones, or at the end of the day. It’s also possible that it changes over time or with changes in diet. Noticing vaginal odor, if it’s your normal one, does not mean you don’t have good hygiene or (god forbid) should start douching. No need to buy those scented sprays, either – the chemicals may give you a bad reaction, and do you really want to smell like a spring meadow? So if you think your odor is different in a bad way, head to your gyno – make sure it’s not vaginosis, a lost tampon or condom (don’t laugh, it happens), an STD, or a bit of urine leakage.  But if you’ve been checked out by your gyno, then rest assured that your scent is normal.

– Dr. Kate
Gynotalk
dr_kate_100

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. She generously shares her medical wisdom with EM & LO readers every few weeks. Check out more of her advice and ask her a question at Gynotalk.com.



Dear Dr. Joe: Why Don’t I Stand at Attention Anymore?

March 29, 2012

2 Comments

photo via flickr

Every few weeks, Dr. Joe DeOrio, a urologist in Chicago, tackles questions about male sexuality here on EMandLO.com. To ask Dr. Joe your own question, click here.

Dear Dr. Joe,

My erection isn’t at as high an angle as it once was (it’s a little droopier). Is there anything I can do to get that standing-at-attention look back?

– Flopsy

Dear Flopsy,

Okay, first things first. Erectile Dysfunction (ED) is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. That doesn’t sound exactly like your problem, but you may be on the way, so listen up.

Here’s how we get an erection. Excitement starts in our brains, causing arousal, and the brain sends a signal via the nervous system to the penile arteries. That signal says: open up and let the blood in. Blood flows in, and a chubby ensues.

A breakdown in this process at any point results in weakened erections and possibly erectile dysfunction. If the problem is in our heads (anxiety, lack of sexual interest, stress, etc.), then it is psychogenic. Brain can’t send the signal down to the arteries? Neurogenic. The signal arrives, but the arteries just don’t do their job? Well, that’s vasculogenic. Neurogenic and vasculogenic ED, frequently lumped together and labeled “organic” erectile dysfunction, imply that there is a physical problem, not just a psychological one.

Now, while it’s not “normal” to have erectile dysfunction, it certainly is very common – about 50% of men aged 40-70. And truthfully, a little decrease in your turgor with age is probably expected. We can’t be 18 forever! The most common etiology for erectile problems is vascular in origin, but in younger patients, I tend to see a lot of psychogenic erectile dysfunction as well.

So how can you get your stiffy back up to snuff? In essence, improving your erections involves reversing the abnormal process that is causing them. As you can imagine, that is not the easiest question to answer, given the variety of causes. But here’s some general advice:

Get enough sleep. Control stress. Get out of a bad relationship. Find a partner that you actually find attractive and care about. Stop smoking. Cut back on alcohol or quit altogether. Stop using recreational drugs. Try to minimize prescription medications if possible. Lose weight if necessary. Improve your diet. Exercise (both cardio and resistance).

Basically, improve your health. In fact, your erectile strength is a decent measure of your overall health, especially your cardiovascular health. Most of us have a pretty good idea about our unhealthy habits, so it’s up to us to have the discipline and motivation to change them.

Finally, please consider seeing a physician. ED is associated with obesity, diabetes, heart disease, high blood pressure, high cholesterol, and a myriad of other medical conditions. Get checked out — diagnosing problems early often finds them treatable and even curable. Your doctor might even offer some magic blue diamonds to help see you through some tough times…

– Dr. Joe

Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.



Dear Dr. Kate, Why Am I Not Wet Even When I’m Turned On?

March 22, 2012

0 Comments

photo via Flickr

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions every few weeks on EMandLO.com. To ask her your own question, click here.

Dear Dr. Kate,

Why am I not wet sometimes, even when I am turned on?

– Sahara

Dear Sahara,

Sometimes your body hasn’t caught up to your brain. Sometimes a medication causes decreased lubrication (antihistamines are a big culprit), or it’s a reaction to the condoms or spermicide. It might be stress or anxiety, or even smoking or drinking before sex. And pain with sex can certainly make you dry. But in most cases, you simply need more focused foreplay before intercourse — and it’s okay to expect it. You wouldn’t expect him to enter you before he’s erect, right? If you’re stilling feeling dryer than you’d like after that kind of attention, there’s no shame in adding a high-quality, water-based lubricant to the mix.

– Dr. Kate
Gynotalk
dr_kate_100

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. She generously shares her medical wisdom with EM & LO readers every few weeks. Check out more of her advice and ask her a question at Gynotalk.com.



Dear Dr. Vanessa: Should You Get Tested If You’re In a Relationship?

March 15, 2012

4 Comments

photo via flickr

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions on EMandLO.com. To ask her your own question, click here.

Dear Dr. Vanessa,

Should you still get tested regularly if you are in a relationship?

– Snuggling But Not Smug

Dear SBNS,

That’s a good question. It all depends on how old you are, what kind of relationship you are in, how long you have been in it, and what you and your partner’s sexual transmitted infection (STI) status is.

Couples do not need regular screening for STIs if they have been together for years, have had no other sexual partners during that time, and know for sure that neither partner is infected with HIV or another long-term infection such as herpes. That said, women should continue to have routine Pap tests to screen for abnormal cervical cells that might lead to cancer, whether they are in a monogamous or casual sexual relationship, or are not currently sexually active.

If you are uncomfortable with the idea of a regular STI screening, it might help to know that all people at one time or another fall into a category of people who should undergo routine screening. Routine screening for STIs is recommended for women and men aged 25 or younger; people who have more than one sex partner or who are involved with someone who has had more than one partner; people in new relationships; and people who have serial relationships that last a year or less.

There are good reasons for regular testing for most sexually active people. Most sexually transmitted infections have no signs or symptoms, so people don’t know they have them, and they can infect other people without knowing it. Some infections can stay in the body for years without symptoms. HIV, for example, doesn’t have symptoms for about ten years, on average. Other infections that can stay hidden in the body for years include herpes and syphilis.

Tests for STIs have changed over the years. Many require a urine sample, saliva, or just a finger prick for a blood sample. Most tests are painless.

So if you are sexually active, get tested at least once a year unless you are in a long-term, mutually monogamous relationship, and you know both you and your partner are infection-free. Regular screening is a very good way to protect yourself and your partner from infections that can cause long-term health problems.

Meanwhile, here are best wishes for your good sexual health,
Vanessa
Planned Parenthood

dr_vanessa_cullins

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America. She generously shares her medical wisdom with EM & LO readers every few weeks.



Dr. Kate’s Top 5 Reasons Why Contraception Should Be Covered

March 8, 2012

1 Comment

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions every few weeks on EMandLO.com. To ask her your own question, click here. This week, she addresses the recent debates about contraception.

I’m an OB/GYN, and my specialty is family planning. This means that I spend my time counseling patients, teaching students and residents, and conducting research–all about contraception. You can imagine the questions I’ve been asked in the past few weeks about President Obama’s rule about mandatory coverage for birth control with few exceptions. What started as a debate about the rights of religious employers versus the rights of the women (Catholic and non-Catholic alike) who work for them has devolved into something ugly. It feels like in the furor about the Bill of Rights, and “cafeteria Catholics,” and insurance mandates, essential information has been overshadowed. So these are my top 5 reasons why it’s vitally important that contraception be covered for ALL women:

  1. Contraception makes periods better. Less bleeding, less cramping, fewer missed days of school or work or life, just because of menstruation. ESPECIALLY true for women who have dangerous amounts of bleeding each month.
  2. Contraception makes health better. The longer you use the birth control pill, you lower your chance of ovarian cysts, PID, endometriosis, uterine and ovarian cancer.
  3. Contraception makes sex better. When they’re not worried about pregnancy, couples can have sex whenever they want to, at any time of the month.
  4. Contraception makes families healthier. Even if a couple wants a houseful of kids, pregnancies are healthiest when they’re spaced apart.  Getting pregnant too soon after birth puts the growing fetus AND its mother at risk.
  5. Contraception saves lives. Pregnancy can be wonderful when it’s wanted, but it’s always risky. Doctors don’t make pregnant women sign a consent that they’re risking blood clots, hemorrhage, hysterectomy, seizures and death…but they are. And no woman should have to face these risks unless she’s truly ready.

– Dr. Kate

Gynotalk
dr_kate_100

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. She generously shares her medical wisdom with EM & LO readers every few weeks. Check out more of her advice and ask her a question at Gynotalk.com.



Dear Dr. Vanessa: Why Am I Always Wet?

February 16, 2012

1 Comment

photo via flickr

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions on EMandLO.com. To ask her your own question, click here.

Dear Dr. Vanessa,

I have a very embarrassing problem: my vagina is always wet all the time and it affects my sex life to the point where I don’t want to have sex any more. Even my partner has commented on the problem. I had an episiotomy when I gave birth and I’m worried that my vagina muscles have weakened. Am I normal?

– Watership Down

Dear WD,

It is not unusual for the vagina to feel different for a while after giving birth, and some change in vaginal secretions is not unusual either. From what you describe, however, you may be experiencing something a bit uncommon, but it is not possible to diagnose your condition through an online conversation.

It is unlikely that this wetness is related to the episiotomy or childbirth, unless you have suffered a fistula or abnormal connection between your bladder or rectum and your vagina. Excessive wetness is usually the result of a genital infection or some other minor condition. For the correct diagnosis and treatment, it is very important that you talk with and be examined by your gynecologist.

It can be embarrassing to talk with your provider about vaginal issues, particularly if it relates to your sexual function, but don’t let that get in the way of your health or pleasure. Make an appointment for a gynecological visit right away, and be very frank about your experience when you talk with your doctor. Remember, there is usually a simple solution.

Meanwhile, here are best wishes for your good sexual health,

Vanessa
Planned Parenthood

dr_vanessa_cullins

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America. She generously shares her medical wisdom with EM & LO readers every few weeks.



Dear Dr. Joe: Can I Use the Backdoor with Hemorrhoids?

February 2, 2012

4 Comments

photo via flickr

Every few weeks, Dr. Joe DeOrio, a urologist in Chicago, tackles questions about male sexuality here on EMandLO.com. To ask Dr. Joe your own question, click here.

Dear Dr. Joe,

Is it safe for me to enjoy receiving anal play if I have hemorrhoids?

– Backdoor Bob

Dear B.B.,

I guess the pertinent words here are “safe” and “enjoy.” If your definition of a safe and enjoyable sexual experience involves potential pain and bleeding, then we might be in business.

Okay, okay…maybe I’m exaggerating a bit, so let’s get into it. Surrounding the anal canal are plexuses of veins. In addition to performing the normal function of veins (returning blood to the heart), these plexuses may also contribute to fecal continence. A hemorrhoid is simply an abnormal dilation, or varicosity, of one of these veins. Since there are veins located both within the anal canal and at the level of the anus itself, one can develop both internal and external hemorrhoids.

Internal hemorrhoids are usually painless, and you might not even know that they are there. With irritation, however, they may bleed. Occasionally, they can prolapse, or stick out from the anus. Besides being a little unsightly, prolapsed hemorrhoids may become strangulated and lose their blood supply, which can be painful. External hemorrhoids, on the other hand, are often visible, appearing like a bulge at the anal verge. They are sometimes painful, they frequently itch or cause irritation, and they often bleed.

So what causes these little bundles of joy? Truth is, we don’t really know for sure. Hemorrhoids are associated with chronic constipation, occupations that involve prolonged sitting or standing, pregnancy, obesity, chronic diarrhea, and the abuse of laxatives — in essence, conditions that produce straining or increased intra-abdominal pressure or conditions that cause chronic irritation to the anal canal.

Does anal sex cause hemorrhoids? The jury is still out on that one. Undoubtedly, anal sex can increase anal pressure and cause some spasm. And it can also cause irritation, especially if you don’t use enough lubrication. Despite these facts, however, I suspect that anal sex, properly performed, will not result in hemorrhoids. In the presence of pre-existing hemorrhoids, however, anal sex can certainly irritate, inflame, or disrupt them, which can lead to pain, bleeding, and prolapse.

My recommendation? If you know you have hemorrhoids, treat them properly before attempting anal sex. Oftentimes, hemorrhoids will spontaneously resolve by increasing dietary fiber, maintaining good hydration, and moving about a bit during the workday. If that doesn’t do the trick, see a surgeon. There are a multitude of treatments that he or she can offer.

If you don’t know that you have hemorrhoids, if you are ignoring my advice and attempting anal sex anyway, or if you are just looking to prevent hemorrhoids, follow the common recommendations for healthy anal play: use plenty of lubrication, go slowly, and do not do anything painful. And don’t forget that the risk for acquiring STDs is higher with anal sex, so be safe.

– Dr. Joe

Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.



Dear Dr. Kate: Can the Cervix Get Hurt During Intercourse?

January 26, 2012

11 Comments

photo via Flickr

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions every few weeks on EMandLO.com. To ask her your own question, click here.

Dear Dr. Kate,

What does it feel like when a man’s penis hits the cervix during intercourse? I think it’s happened to me, but it doesn’t happen every time my partner and I have intercourse with deeper penetration. Can it hurt the cervix? How can this be avoided during sex while still allowing for deep penetration?

– Perplexed Cervix

Dear P.C.,

Deep penetration during intercourse can be immensely satisfying, and make you feel really connected to your partner….but sometimes has the less-satisfying effect of causing you pain. When the cervix is bumped, it can cause cramping in your uterus that ranges from mild to severe, or cause a dull aching or pressure-like feeling throughout your pelvis. Some women are more prone to cervical contact, if their uterus is tipped back towards their tailbone (or “retroverted”), bringing the cervix up and closer to the vaginal opening. The good news is that while cervical contact may hurt, it doesn’t hurt your cervix – no damage done. The best way to avoid it is to be maximally aroused before penetration – when the vagina is fully engorged, it gets longer and wider, and gives the penis more room to play, hopefully away from your cervix. Extra lubricant couldn’t hurt, as well.

– Dr. Kate
Gynotalk
dr_kate_100

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. She generously shares her medical wisdom with EM & LO readers every few weeks. Check out more of her advice and ask her a question at Gynotalk.com.



Dear Dr. Kate, Is It Okay to Use Orgasms as a Sleep Aid?

January 12, 2012

2 Comments

photo via Flickr

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City and she answers your medical questions every few weeks on EMandLO.com. To ask her your own question, click here.

Dear Dr. Kate,

I sleep so much better after an orgasm! Sometimes when I’m having trouble sleeping I whip out my vibe and I just pass right out after I finish. Why is this and is it alright that I use orgasms as a sleep-aid?

– Bloody Mary

Dear Mary,

It’s a stereotype that only men want to pass out after coming – climax makes many people a little sleepy. Those muscle contractions aren’t just in your vagina – many women feel their orgasm through their pelvis and legs as well, and feel like they’ve had a work-out after they come. Add to the physical exertion the orgasmic mind-blowing that clears out much of the brain debris from the day…and I think you’ve found a great way to relax enough to fall asleep at night. Much better to get yourself off than to get yourself habituated to sleeping pills.

– Dr. Kate
Gynotalk
dr_kate_100

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City. She also lectures nationally on women’s health issues and conducts research on reproductive health. She generously shares her medical wisdom with EM & LO readers every few weeks. Check out more of her advice and ask her a question at Gynotalk.com.



Dear Dr. Vanessa: Can I Use More Than One Contraceptive?

January 5, 2012

0 Comments

photo via flickr

Every few weeks, Dr. Vanessa Cullins, a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America, will be answering your questions on EMandLO.com. To ask her your own question, click here.

Dear Dr. Vanessa,

Is it possible to be on more than one contraceptive method at the same time? For example can I take the pill and also get an IUD? Or take the pill and get the shot or wear the patch?

– Backup Betty

Dear BB,

There’s a saying that too much of a good thing ain’t always good, and while some of us could certainly benefit by being more vigilant about using birth control, we also need to be careful not to put our health at risk when combining methods.

The main reason a woman might want to use two methods at once is to prevent pregnancy and sexually transmitted infections (STIs). The condom—male or female—is the best way to reduce your risk for an STI. Some women like to use other forms of birth control, such as spermicide, a diaphragm, an IUD, or implant along with condoms so they can have better protection against pregnancy than with a condom alone.

That said, you should never use male and female condoms together, neither should you use the female condom with the ring, because one can pull the other out of place or cause tearing. The diaphragm, cervical cap, and sponge are barrier methods that also provide some protection against STIs. But remember, these methods will only protect parts of the body that are covered—which in this case is the cervix. It all has to do with coverage, so if your bare skin comes in contact with active herpes sores or genital warts you are still at risk.

With regards to combining methods like the pill and patch or the birth control shot and the pill, each of these methods uses hormones to prevent pregnancy. You should not use multiple hormonal methods at the same time. Taking that much hormone places you at increased risk for serious blood clots—which are rare with hormonal contraceptives unless the doses are extremely high.

The IUD is a superb form of birth control, and it is highly unlikely that a provider would recommend using it in combination with any other method except a condom to prevent STIs.

Whatever your contraceptive choice, here’s to enjoying yourself, and best wishes for your good sexual health!

Vanessa
Planned Parenthood

dr_vanessa_cullins

Vanessa Cullins, MD, MPH, MBA, is a board-certified obstetrician/gynecologist and vice president for medical affairs at Planned Parenthood® Federation of America. She generously shares her medical wisdom with EM & LO readers every few weeks.