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Dear Dr. Kate, Why Are Some Periods Worse Than Others?

December 23, 2011

1 Comment

photo by greenchartreuse

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 is my period worse some months more than others?

– Bloody Mary

Dear Mary,

Blame normal fluctuations in your hormone levels. Sometimes your uterus is stimulated with more prostaglandins, the chemicals that cause cramping, so you’re hitting the Advil bottle more than usual. And if your lining is thicker one month than another, you’ll see heavier bleeding and sometimes even clots. Variations like these are normal, albeit a pain to deal with. The easiest way to get predictable periods (both in flow and comfort) each month? Most hormonal birth control methods, especially the vaginal ring and the progesterone IUD (Mirena). They’ll make your periods lighter, shorter, and less crampy.

– 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, Can Hand Warts Be Transmitted to Genitals?

December 15, 2011

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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,

My boyfriend has 2 warts on his fingers. We have been trying to treat them to go away but in the meantime, is it possible to transmit these warts to my vagina? I have looked this up on various websites but can’t find a definite answer. One them has been there for almost 10 years (keeps regrowing) if that helps to clarify what type of HPV.

– Mrs. Toad

Dear Mrs. T.,

There are nearly 200 HPV virus types, and about 40 of them can infect the genitals. HPV viral strains tend to have a favorite vacation spot on your body, and don’t tend to travel outside of that area. Of course, there are exceptions; some high-risk genital wart strains can infect the mouth and throat during oral sex. But HPV 6 and 11, the two strains that together cause 90% of genital warts, don’t cause warts on other areas of the body. The reverse is also true; HPV on the fingers — most often from HPV 1 or 2 — is not likely to cause warts on his or your genitals. But to be even safer, cover up his warts with a Band-aid, finger cot or glove before he touches you.

– 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, What’s the Deal with Blue Balls?

December 8, 2011

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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,

What’s the deal with blue balls?

– The Indigo Boys

Dear T.I.B.,

“Blue balls” is a commonly used colloquialism describing pain or discomfort in the scrotum/testes that occurs after prolonged sexual stimulation without ejaculatory release. Despite your high school buddy’s arguments to the contrary, it is not a justification to demand sexual satisfaction. You’re not going to die, and you won’t damage anything.

Many men (and some medical professionals) consider this condition a myth, but any man that has experienced the dull ache appreciates its legitimacy. To be frank, I’m not sure what causes the pain. I’ve heard several hypotheses, most related to the epididymis, a small structure adjacent to the testes where sperm mature. The most commonly cited theories include the backup of blood in the epididymis or scrotum; swelling of the epididymis; and backup of sperm in the ejaculatory ducts, affectionately labeled “deadly sperm buildup.” Interestingly and for reasons that I cannot comprehend, the medical profession has not dedicated a great deal of effort into deciphering this medical conundrum.

Why not? Probably because it’s not dangerous, is self-limited, and has an easy fix. A fix you say? Yes. Pop one off. Huh? That’s right: ejaculate. To placate the more serious amongst you, I did do a proper medical search – even journeyed to the medical library to do so. No mention of blue balls in any of the major medical texts. An extensive literature review revealed only one mention of blue balls in the past 25 years. The October 2000 issue of Pediatrics reported a case study of a 14 year-old boy with recurring scrotal pain after messing around with his first girlfriend. The authors were happy to report that his condition promptly resolved once he started having intercourse – effective, but not my recommended remedy for a child.

Nonetheless, the treatment is valid. Ejaculation almost always “cures” the condition. This may be accomplished by any of the conventional methods. No partner? Opposed to masturbation? You could try a Valsalva manuever, which is forcefully attempting exhalation against a closed airway (imagine trying to “pop” your ears after air travel). One obscure reference from several decades ago even recommends trying to lift a car by its bumper. I guess whatever floats your boat, Superman – just don’t call me when you get a hernia.

Stay curious,

– 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 Yeast Infections Be Prevented?

December 1, 2011

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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,

Is there any way to prevent yeast infections?

– Itchy & Scratchy

Dear I.S.,

Not completely. The biggest risk factor for getting a yeast infection is having a vagina — not an easy risk factor to modify. But the more gently you treat your vulva and vagina, the less likely you are to get a yeast infection. This means three things: Limit your chemical exposure — no perfumed products like bubble baths and sprays, use simple soap in the shower, no daily pantiliners…and for god’s sake, no douching. Keep yourself dry, and let your vagina breathe — cotton underwear over nylon, no undies at night, get out of your workout clothes as soon as you’re done working out, change your tampons and pads frequently during your period. And limit your exposure to irritants — use just your fingers to clean yourself in the shower, no puffs or washcloths, and use a liquid clothes detergent over powder.

– 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 Being Overweight Affect Your Ability to Orgasm?

November 23, 2011

1 Comment

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,

Can obesity affect a woman’s ability to orgasm?

– California Queen

Dear CQ,

The science on this is less clear for women than it is for men. Obese men are more likely than other men to have erectile dysfunction, so they are definitely less likely to have orgasms than other men. This is true whether or not they are suffering from diabetes, heart disease, or other health conditions often associated with obesity and erectile dysfunction. Like other men with erectile dysfunction, obese men may use prescription medication such as Viagra in order to get and maintain an erection.

For women the evidence is less clear. Some studies have shown that obese women are just as capable of a satisfying sex life as other women. On the other hand, some studies have shown that obese women may have somewhat less capacity than other women for lubrication, orgasm, and sexual satisfaction.

Obese or not, there is another difference between women and men regarding orgasm and sexual satisfaction. Women’s attitudes about their bodies play a more important role in sexual satisfaction than men’s attitudes about their bodies. Women tend to be more concerned about their appearance than men. Women are also more likely to be self-conscious about their appearance during sexual activity than men, so they are more likely to be less sexually satisfied than men.

Women and men who are ashamed of their bodies for any reason are at risk for sexual dysfunction, including anorgasmia — lack of orgasm. Self-acceptance is the key to sexual satisfaction for both women and men. At a time in history when the media sets nearly impossible standards for attractiveness and vitality, it is very important for us to accept ourselves and each other for our own distinctive and individual beauty.

We’ll be healthier, happier, and able to take more pleasure in life when we are more self-accepting. Obese women and men can be very sexy, and they can get just as much sexual satisfaction as anyone else. Relationships help, too. Women and men in long-term relationships, obese or not, are likely to be less self-conscious about their bodies and more likely to enjoy them.

So whatever your body type, 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.



Dream Interpretation: I’m Crushing on My Boyf’s BFF

November 21, 2011

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photo by applescruff

Other people’s dreams are never interesting…except when they’re about sex. Each week, our dream analyst Lauri Loewenberg tells one lucky reader what their dirty dream means. Got a dream you want Lauri to analyze? Click here to submit it) This week, a reader asks Lauri:

I have a slight crush on my boyfriend’s friend. I dreamt that I went to see him to tell him how I felt. He stopped watching the football for me, which is weird because he would never do that for anyone. Suddenly there was music and acting and laughing and he was acting out some scene where he was on top of me but holding himself up. He was about to kiss me but had tears in his eyes. He said he couldn’t because I had blood, acting out a scene of a vampire maybe?! He then said he needed to talk to me. He started off saying he didn’t want to hurt my feelings and then proceeded to say that I know what I want and I’m confident and believe I’m too good to be stuck here. He said it in a nicer way but that was the gist (I think this may be relevant to my boyfriend wanting to get a job interstate and take me with him, in which conversation with the friend, he said, jokingly, that I should stay and live with him). Continuing on with the dream, I said no I’m actually just very shy, which is true. He said I should make that clear to people. I then admitted I ‘kinda’ liked him. I wasn’t looking at his face in the dream but he just said ‘hmm’. I couldn’t tell if it was good or bad. Please help!!!!!!!!!

Lauri: Crushing on your BF’s BFF? Oh my, that’s an interesting situation you’ve got there and you can bet this dream is trying to help you with it.

All the music and laughing in the beginning of this dream reflects how you feel on the inside when you see him or think of him. He then acts out a scene and winds up on top of/over you. That’s probably connected to you “pretending” that you don’t have these feelings when you’re around him and your boyfriend. He is holding himself over you because you are holding him in a position in your mind where you look up to him. The tears in his eyes are most likely your own inner tears. Deep down you know this revelation – were it ever to be found out – would bring tears and heartache with it. That’s also why he tells you he can’t kiss you. This is a no no. It would break up a friendship and a relationship.

What he continues to tell you in the dream is super important to pay attention to because that is really coming from your wiser, intuitive self. Long story short, it seems you are telling yourself that you are better than this, crushing on your BF’s BFF and that you need to move on from it rather than allowing yourself to be stuck in that torn mindset. Listen to thy inner self and thou shalt never be steered wrong!

Got a dream you want Lauri to analyze? Click here to submit it. Anonymity guaranteed! Don’t forget: you can get access to Lauri’s Instant Dream Decoding Dictionary on her site. And check out Lauri’s new book Dream On It, available everywhere!



Dear Dr. Kate, How Long Do STDs Take to Show Up on Tests?

November 17, 2011

4 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,

How soon after sexual relations would an STD test register a newly transmitted virus?

– Testy

Dear Testy,

Excellent question – depends on the virus or bacteria. Gonorrhea can show up the fastest, in about 4 days, followed by chlamydia (in 7 days) and syphilis (about 3 weeks), though all of these tests may take as long as a month to detect infection. HIV tests turn positive most often within 2 to 8 weeks (at about 3 weeks on average); since it may take longer to show up, the recommendation is to take one test at about 3 weeks, then test again about 3 months after exposure. HPV, on the other hand, can take months and possibly years before it shows up on testing or makes your pap smear abnormal. Herpes testing is generally only done if you have symptoms, which generally appear in 2 to 3 weeks. So bottom line – if you have sex without a condom, call your gyno the next morning for an appointment in about 3 weeks to first test for STDs. And if all comes out negative, test for HIV again in 3 months to be sure. Then remember how scary the waiting-for-results feels the next time you consider doing it without a condom!

– 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, My Little Man in the Boat Hurts When Stimulated

November 2, 2011

1 Comment

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 does it hurt to stimulate my clitoris and what can I do about it?

– Mrs. C

Dear Mrs. C.,

The clitoris is the biggest concentration of nerve endings in the body. And like teenagers at an emo concert, they can be extremely sensitive. Many women can’t bear direct touch to the clitoris – like looking directly at the sun, it causes more pain than pleasure. Try touching your clitoris through the clitoral hood—approach it from the side—or even through your underwear. Experiment with gentle touch as well, and you’ll figure out how much pressure is perfect to make you feel great.

– 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: Do Some Men Fart When They Ejaculate?

October 12, 2011

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,

My yoga teacher recently told me that 2% of all men fart when they ejaculate. She’d just learned about this in a sex ed course she was taking, but she forgot the name of the disorder. Have you ever heard of this? Is it true?

– Just Curious (No, Really)

Dear J.C. (N.R.),

Oh right, the ol’ shoot-and-poot? Yah, never heard of it – at least not until you asked. In ten years of urology practice, no one had ever asked me this question. But the idea seemed possible, since, at the moment of ejaculation, there is involuntary muscle contraction, and an increase in intra-abdominal pressure. The anal sphincter should contract as well to compensate for this force, but if one had a weak sphincter, I suppose that some gas could escape.

My initial literature searches were magically fruitless, but imagine my surprise when I stumbled across an article entitled “Flaturia: passage of flatus at coitus.” It was published in 2007 out of Cairo University. But it’s not in men; it’s in women. The mechanism of flatulence is not clear, but the theory is that, during vaginal intercourse, the penis puts repeated pressure on the lower anal canal. In some women, this buffeting causes relaxation of the internal anal sphincter, and eventual uncontrollable farting.

A Google search of “flaturia” brings up a bunch of results, but they all predominantly refer back to this article.

Stay curious,

– 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. Vanessa, Did My Girlfriend Give Me Herpes?

October 5, 2011

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,

I’ve been with my current partner for six months, and I just got diagnosed with herpes. My partner swears she didn’t cheat on me. Should I believe her?

– Herplexed

Dear Herplexed,

Believe her until you have real evidence to not believe her. Herpes may not be good evidence. A person can be infected with herpes for years — even a lifetime — without knowing it. That’s why it is possible for herpes to break out in someone whose partner has been sexually faithful. The infection could have been there before they met. A weakened immune system or other stress can set off an outbreak long after infection occurred. In many cases, there is no way to tell who infected whom.

At least 50 million U.S. women and men have herpes. One million new cases are diagnosed every year. Millions of others go undetected. With so many invisible infections being passed around, herpes has become one of the common risks of being sexually active.

Of course, folks who have active herpes sores shouldn’t have sex with anyone else until the sores are totally healed. They may also want to consider suppressive therapy — taking anti-herpes drugs to reduce the risk of passing the infection to uninfected partners. And they should always use condoms when they have sexual intercourse, which will help cut down the risk of transmission.

Best wishes for 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.