What does virginity mean in today’s world?
When I was growing up, the term “virgin” referred to a person who had never had sexual intercourse—for girls, that meant having an intact hymen—but it also referred to one who was not engaged in sexual activity. In today’s world, I think that the definition of a virgin seems to be outdated, at best. Hearing that some of my teenage patients believed they were still virgins, even though they were having oral or anal sex, was the first thing that prompted me to reconsider the definition of virginity. Virginity certainly does not preclude sexual activity. What counts as sexual activity is the exchange of any kind of bodily fluid—including kissing! That exchange of fluids also happens when a penis enters the mouth, vagina, or rectum—all of which constitute sexual activity.
If you are part of the LGBT community, you may not ever have had sexual intercourse— especially since that term usually refers to sex between a man and a woman—but you may be sexually active. The definition of losing one’s virginity is complicated and personal. It means 50 different things to different people. It’s really up to you to decide what losing your virginity means. When you are ready to be sexually active with a person you feel comfortable and safe with, then it’s the right time to engage in sexual activity. Don’t ever let anyone make the decision for you as to when you should become sexually active. “Don’t worry, you’ll still be a virgin” is not a reason to let someone coerce you into a sexually active relationship that includes everything but sexual intercourse. Virginity is not the point. The point is to make the decision on your own, when you’re ready
What is HPV?
HPV is one of the most common sexually transmitted infections in the United States. There are more than 40 HPV types that infect the genital area of women and men. It’s possible for someone to get more than one type of HPV. HPV can infect the genitals, anus, mouth, and throat. Most people with HPV do not know they have it and may never develop symptoms or other health problems. The good news is 9 out of 10 HPV infections will go away by themselves within 2 years.
What are the health problems caused by HPV?
- Genital warts (warts on the genital areas)
- Cervical cancer (cancer on a woman’s cervix)
- A type of head and neck cancer called oropharyngeal cancer (cancer in the back of throat, including the base of the tongue and tonsils) in women and men
- Anal cancer (cancer on the anus) in women and men
- Vulvar and vaginal cancer (cancer on the vulva or vagina) in women
- Penile cancer (cancer on the penis) in men
What is the wart HPV?
Genital warts look like small, skin-colored or pink growths on the labia, vagina, anus and penis. They are often described as small cauliflowers in appearance occurring individually or in groups. They are most commonly painless but can cause itching and tenderness. Once they are diagnosed through inspection or biopsy they can be treated through excision or through medication such as Podophyllin or Trichloroacetic acid. The medical treatment is typically repeated weekly for 4 to 6 weeks until the warts disappear.
How is HPV spread from partner to partner?
HPV is contracted through skin-to-skin contract typically during sexually contact. This includes penetration with the penis, vaginal or anally, oral sex and hand-to-genital contact. It’s often best to avoid any sexually partner that have genital warts or a known history of HPV. The problem is that most people are unaware that they carry HPV, especially men. Men do not have an equivalent to the PAP smear for women that allows detection of HPV. Unless men have warts or a history of them, they have no way of detecting this epidemic virus. Another frustration for women is that the condoms don’t provide complete protection against HPV. HPV may live at the base of the penis or in other exposed areas that can pass HPV to the woman during sexual intercourse. Straight and same-sex couples are equally high risk to HPV exposure and transmission. You cannot contract HPV by sharing a towel with a roommate or sitting on a toilet seat.
How can I avoid getting HPV?
The best way to avoid getting HPV is not to have any sexual contact until you are ready and prepared to protect yourself against sexually transmitted infections (STI’s). If you decide to become sexually active, you should get vaccinated against HPV, practice safe sex by using condoms and/or dental dams and getting regular PAP/HPV testing.
Can I get HPV from a toilet seat?
No, you cannot get the human papilloma virus (HPV) or any other sexually transmitted infection (STI) from a toilet seat. HPV is the most common STI affecting 80 to 90% of men and women. HPV is an epidemic and highly contagious, but you cannot get it from a toilet seat.
What is the HPV Gardassil vaccine?
Girls and boys who are 11 or 12years old should get the HPV vaccine. The vaccine is safely given to people up to 45years old. The vaccine is recommended to straight, gay and bisexual people.
How safe is the HPV Gardassil vaccine?
The HPV vaccine has a very safe track record with no serious safety concerns. Gardassil 9, the most recent HPV vaccine, can prevent 90% of the HPV high risk types including 6, 11, 16, 18, 31, 33, 45, 52 and 58. Most side effects are mild such as pain, redness and soreness in the arm where the shot was given. Other mild side effects include fainting, dizziness, fever, headache, nausea and muscle or joint pain. Some people have fainting spells and jerking movement after receiving the injection but this can happen with any type of medication given with a needle. And with any vaccination a rare anaphylactic allergic reaction can occur. These minor side effects are worth the risk since the HPV vaccine may prevent cervical cancer.
I am so embarrassed and ashamed that I have HPV. It makes me feel dirty.
If you have HPV, you are in good company since it is the most common sexually transmitted infection (STI) with over 90% of women and 80% of men exposed to it. HPV is epidemic and highly contagious. There is absolutely no reason to feel shameful if you tested positive for HPV, it’s easily and innocently transmitted.
Since HPV is easily spread from person to person through sexual contact during vaginal, anal and oral sex, choosing a sexual partner has to be done carefully, now more so than ever. Casual sex can be dangerous knowing this type of information. Whether you are 15y or 45y, now you can protect yourself from this dangerous virus.
How do I tell my new partner that I have HPV? How should I speak to my partner about having HPV?
Discussing a sensitive topic like HPV with a new partner can feel challenging at best. Open and honest communication is a must for establishing a healthy relationship.
Here are some steps to follow when having this conversation:
1. Educate yourself: Make sure you have accurate information about HPV, including transmission, prevention, and treatments options. This will help you answer any questions your partner may have.
2. Find the right time and place: Find a comfortable and private setting where you both can have an uninterrupted conversation. It’s important to have this discussion when you are both calm and relaxed and not being naked for the first time together.
3. Share your diagnosis: Be honest about your HPV diagnosis. It’s essential to explain that HPV is a common sexually transmitted infection, both in men and women.
4. Provide information about HPV: Explain what HPV is, how it’s transmitted, and the potential health risks associated with it. Let your partner know that some people with HPV never have any symptoms making it difficult to know who has HPV.
5. Talk about prevention: Discuss ways to prevent the transmission of HPV. The most effective method is to use barrier methods, like condoms, consistently during sexual activity. However, note that condoms may not fully protect against all HPV infections due to the nature of the virus.
6. Encourage vaccination: Highlight the importance of HPV vaccines, which can protect against high-risk HPV types. Encourage your partner to consider getting vaccinated if they haven’t already done so.
7. Answer questions and concerns: Be open to any questions or concerns your partner may have. Listen attentively and provide accurate information to address their doubts. Meeting with a healthcare professional is always an option to help clarify any information about HPV.
Remember, 80 to 90% of women and men already carry HPV and have healthy relationships, and you will too! Approach the conversation with empathy and understanding.
What are the different types of birth control options?
Luckily, we have many choices in selecting a birth control that works best for a woman and her specific concerns. If a woman has concerns about side effects from the hormonal forms of birth control such as the pill, I may talk to her about considering the IUD. If a woman doesn’t like taking a pill every day because she is forgetful, she may want to consider any of the long-acting birth control methods or the Nuvaring. If the cost is a concern, the pill may be the least costly and most effective option depending on her insurance coverage. I find it useful to go through each of the methods to see if a woman might not have considered one of the forms, she knew very little about.
- Oral contraception-the “pill”
- Long-acting hormonal birth control-Depo Provera, Nexplanon
- IUD without hormones and with hormones
- Barrier Methods-Diaphragm, Cervical Cap and Condoms
- Rhythm Method
- Withdrawal Method
- Sterilization-Permanent Contraception
How does the pill work as a birth control?
Oral contraception or “the pill” is still the most popular method of birth control in the United States. For many, it’s a girl’s best friend!
The birth control pill is meant to simulate (or mimic) your menstrual cycle while preventing ovulation, so starting the pill on the first day of the cycle or first Sunday once your cycle starts is recommended. When you start the pill in the middle of the cycle you are already going against the “flow” (literally!) of your normal hormonal rhythm. As a result, irregular bleeding will most likely occur and it may last for a couple of months while your body adjusts to the birth control pill.
There are 2 kinds of birth control pills:
- Combination pills with both estrogen and progesterone which is the most common type of birth control pill
- Progesterone only pills also known as the mini pill for those who cannot take estrogen.
If you don’t want to take a daily pill orally you can use the NuvaRing which is a vaginal “oral contraception” alternative that you leave inside the vagina for 3 weeks.
The pregnancy prevention success rate of the pill if taken perfectly is 99%. But we are not perfect and some pills are missed or forgotten so the true real time pregnancy prevention rate is 93%.
What are the most common side effects of the birth control pill?
The most common side effects from the birth control pill include irregular bleeding, nausea, breast tenderness, bloating and headaches. It’s important to know these side effects are temporary and if they don’t go away in 2 to 3 months you should change to another type of pill–because there are many different types and combinations of estrogen and progesterone depending on your side effects and body type. Study after study does not show weight gain to be a side effect of the pill.
The cause of these side effects depends on how sensitive you are to these man-made or synthetic estrogen and progesterone hormones. There are many different brands of OCP’s each varying in the types and doses of these 2 key hormones. Some women are more sensitive to one or both of these hormones exacerbating these side effects.
What are some of the health benefits of the birth control pill?
The birth control pill has many health benefits, in addition to being a great birth control. The many female friendly health benefits include making the period regular, lighter, less crampy, controls acne, balances hormones, helps with symptoms related to PMS, hormonal migraines, pain caused by endometriosis, protects against ovarian cancer, anemia and is covered by most insurance plans.
How does the birth control pill control irregular periods?
Since the pill serves as the ideal period regulator, going off the pill will reset your menstrual cycle to how it was before you started the pill. If you were perfectly regular prior to being on the pill, chances are you will not have any unusual side effect as you go off the pill. You should get your normal period back within 1 to 3 months of going off the pill.
If you had irregular periods prior to being on the pill, you will most likely have irregular cycles once you stop taking it. This may appear as not having a period for 3 or more months or having irregular bleeding with no regular pattern.
Is skipping the placebo pills on my birth control is safe to do?
The most common birth control pill pack consists of 28 small tablets that are taken each day and when the 28 pills are finished a new pack starts up again. The active pills, containing estrogen and progesterone, are taken during the first 21 to 24 days depending on the brand. The remaining 7 to 4 pills are called “placebo” pills since they do not contain any hormones. Sometimes placebos are sugar pills while others are iron tablets. The main purpose of the placebos is to remind you to take a pill every day. It’s easy to forget or skip pills so when you are in the habit of taking a pill every day you are more likely to be consistent and compliant making the pill an effective birth control method.
There are no risks in skipping the placebo pills in a birth control pack. Skipping the placebos will not make the birth control pill any less effective in preventing pregnancy. The main risk is forgetting to start the next pill pack at the appropriate time and getting completely out of sync. Getting out of the routine of taking a daily pill can lead to irregular bleeding and an unplanned pregnancy!
It’s always recommended to discuss the risks and benefits of skipping any medications with your health care provider even if they are placebo pills.
What is the progesterone only, Depo Provera and the arm implant, forms of birth control?
The birth control method called Depo-Provera (sometimes referred to as “the depot injection” or “the shot”) is a hormonal contraceptive. It contains the hormone progesterone and works by suppressing ovulation, thickening cervical mucus to prevent sperm from reaching the egg, and thinning the lining of the uterus to discourage implantation. It is typically given as an injection in the arm or butt every 12 weeks.
The most common side effects of Depo-Provera include irregular or prolonged bleeding, spotting between periods, weight gain, breast tenderness, mood changes, and decreased libido (sex drive). Some may also experience bone mineral density loss, which is why it is recommended for short-term use (up to two years).
Nexplanon is a long-acting reversible contraceptive (LARC) that comes in the form of a small rod implanted under the skin of the upper arm. It releases the progesterone hormone etonogestrel into the body, which works similarly to Depo-Provera by preventing ovulation, thickening cervical mucus, and thinning the uterine lining.
Common side effects of Nexplanon include irregular or prolonged bleeding, spotting between periods or unpredictable bleeding, periods of no bleeding, or prolonged bleeding. Other potential side effects may include headaches, weight gain, breast pain, mood changes, acne, and decreased libido. It is important to note that side effects can vary among individuals, and not everyone will experience them.
It’s important to consult with a healthcare professional to discuss the potential benefits and side effects of any specific birth control method to determine the best option for you.
How is the IUD used as a birth control?
There are several types of intrauterine devices (IUDs) available. The two main categories are hormonal IUDs and non-hormonal IUDs.
1. Hormonal IUDs: These release a small amount of progestin hormone into the uterus, which thickens cervical mucus and thins the lining of the uterus. This makes it harder for sperm to reach the egg and reduces the chance of pregnancy.
Some common hormonal IUDs include Mirena, Kyleena, Liletta, and Skyla. These IUD’s can be left inside the uterus for 3 to 8 years depending on the one inserted.
2. Non-hormonal IUDs: These contain copper, which creates an environment in the uterus that is toxic to sperm, preventing fertilization.
A common non-hormonal IUD is the Paragard and it can be left inside the uterus for 10 years.
Both types of IUDs are highly effective forms of contraception. They are typically inserted into the uterus by a healthcare provider during a short office visit.
The IUD has been around a long time but for many it’s the “new kid” on the block since women of all ages are now considered eligible to use it. IUD’s are now being recommended to women who have never had a baby which was the group of people who traditionally used the IUD. Now, the IUD is a great alternative for women who have never had been pregnant. It is ideal and well tolerated by teenagers as well.
If you are considering using an IUD, I recommend discussing your questions and concerns with a healthcare provider who can provide personalized guidance based on your specific situation.
What are the most common side effects of the IUD?
As far as side effects, everyone’s experience may vary. Women using the copper (non hormonal) IUD may experience heavier, longer and more painful periods.
Those using the progesterone IUD may experience irregular bleeding, spotting and cramping during the first 3 to 6 months. Some women will not have a period at all, which is often a welcomed side effect. In rare cases, expulsion or perforation of the uterus can occur.
What are some of the barrier methods used for birth control?
Barrier methods including the diaphragm, cervical cap and condoms are not as reliable in preventing pregnancy but are alternatives for those women who are sensitive to the hormonal effects of other birth control options. Condoms should primarily be used for preventing sexually transmitted infections and not pregnancy.
What is the Rhythm Method and Withdrawal Method?
The Rhythm Method relies on you tracking your menstrual cycle, especially ovulation, and avoiding sex during your most fertile days. It’s a non-hormonal option with the high chance of accidental getting pregnant.
The Withdrawal Method or Pull-Out method is where your male partner doesn’t ejaculate inside the vagina. Since there is a small amount of sperm released prior to a man ejaculating this method also has a high failure rate and is not a reliable birth control option. I like to refer to this method as “Pull and Pray” since it is an unreliable birth control method.
What is Plan B or emergency contraception?
Plan B is also known as the “morning after pill” or “emergency contraception” when accidents happen…and they do! If reliable birth control was not part of the game “plan” serious tactics can be taken to make sure you cannot get pregnant. Plan B can be used within 72 hours of having sex to prevent getting pregnancy by 89%. It is most effective when taken within 24 hours of having sex. Creating a “Plan A” of a reliable birth control method is a whole lot less stressful than needing to go to Plan B. Better safe than sorry.
Who shouldn’t use hormonal birth control or Plan B?
If you smoke cigarettes after the age of 35y, have thrombophilia, a history or a family history of blood clots, a genetic problem that causes clotting or are having surgery or any condition that prevents you from moving around or getting up, you are even more at risk for blood clots and should not use the pill or Plan B as a form of contraception.
If you have high blood pressure you should not be taking the birth control pill with estrogen and progesterone.
