FAQs

Can a virgin get a sexually transmitted infection?

Yes. Virginity has different meanings for different people. Some women and men believe they are preserving their virginity if they have sex play that does not involve vaginal intercourse. But they can still get certain sexually transmitted infections from anal, oral, and even kissing (such as herpes and syphilis).

Does masturbation cause loss of semen, does it affect my ability to have children?

Semen contains sperm, seminal fluid and prostaglandins. The testes produce sperms regularly, and so masturbation does not affect the sperm production. Masturbation is an enjoyable and harmless activity and does not cause loss of semen. Therefore it does not affect the ability to have children.

How can I protect myself from pregnancy and infection?

Regular condom usage provides protection from both pregnancy and infection. Washing, douching, urinating immediately after sex, using special positions, antiseptics, creams etc, DO NOT prevent pregnancy or infection. Precum (few drops of clear liquid are formed at the tip of the penis much before ejaculation) contains sperm (that can lead to pregnancy), and HIV (if your partner is infected). Therefore, a man should wear the condom as soon as he gets an erection. Your partner can practice wearing a condom during masturbation.

I have a lot of pain during periods. What should I do?

Pain or heaviness in breasts, lower abdomen, lower back and/or thighs before or during periods is quite common. It might help to use a hot water bag and/or gently massage the lower abdomen. Gentle exercise like walking and doing routine daily activities is helpful in preventing muscles from cramping up. In case of extreme pain, excessive flow or irregular cycles, please consult a gynaecologist as soon as possible. Avoid taking medicines on your own to hasten or delay periods.

I have heard people use the terms sex, sexuality and sexual orientation, but I don’t know what they mean

Sex refers to the biological, anatomical, physiological and chromosomal difference between females and males present at birth such as the presence of a vagina or penis, menstruation or sperm production, difference in genetic make-up etc. Sex is also used to describe physical sexual acts that include, but are not limited to,  vaginal, anal, oral intercourse, masturbation and kissing among other acts.

Sexuality is the erotic aspect of the human experience throughout life, experienced in fantasies, desires, beliefs and behaviors. Aside from its reproductive aspects, sexuality encompasses gender identity, gender norms and roles and sexual orientations and identities. Also, sexuality is influenced by the interaction of social, biological, economic and political dimensions, particularly as constructed under patriarchal and heteronormative systems of power that run society.

Sexual orientation, on the other hand, describes and categorizes sexual attraction towards the other, mainly as whether attraction is towards people of the same sex/gender, a different sex/gender, or to more than one gender. Sexual orientation can be seen as categories (heterosexual, homosexual, bisexual) or as a fluid description of sexual desire and attraction.

I missed my period. I should have had it last week. Do you think I’m pregnant?

The only way to be sure of pregnancy early on is to have a pregnancy test. Pregnancy tests are accurate after a missed period — some can even detect pregnancy a few days before a missed period.

The most obvious symptom of pregnancy is a missed period. Other possible symptoms include:

  • nausea
  • inexplicable fatigue
  • sore or enlarged breasts
  • headaches
  • frequent urination

However, it is possible that any combination of these symptoms could also indicate that a woman is premenstrual, or that she has the flu or some other illness.

Many women, especially young women, have normally irregular periods. These irregularities may include missed periods and other changes in the menstrual cycle. These irregularities can vary from month to month. Although pregnancy is the most common reason for missing a period, irregularity is also caused by illness, travel, worry, or stress.
Pregnancy testing is the only way to be sure.

My colleague’s sense of humor is considered unusual at my workplace. He likes to tell sexually explicit jokes and uses language that is sexually explicit while speaking.

This may or may not be sexual harassment depending on how the office workers feel about his behavior. One person may find a situation uncomfortable and threatening while another may not. This can also change from context to context. E.g. – Telling the same jokes at an office party may be acceptable to his co-workers versus telling them during a work meeting, which may upset them. For this situation to not be considered sexual harassment, all of his co-workers or the co-worker must be comfortable with this behavior.

What are the benefits of masturbation?

Masturbation is one of the best safer sex techniques: a way of pleasuring yourself that carries with it no risks of HIV, Sexually Transmitted Infections, or pregnancy. Sex therapists believe that if you are able to have a healthy sexual relationship with your own body, chances are that you will enjoy sex with another person more. Also it feels nice :)

What is gender and how is it different from sex?

Gender is how societies view men and women, how they are distinguished, and the roles assigned to them. People are generally expected to identify with a particular gender, that has been assigned (gender assignment) to them, and act in ways deemed appropriate for this gender. While gender roles are based on expectations that a culture has of behavior appropriate for male or female, gender identity is an individual’s sense of belonging to the category of men or women or neither of the two. We attribute a gender (gender attribution) to someone.

Sex (male and female) describes a (usually) either/or categorization of humans based on their biology, whereas gender (men and women) describes the social dimension of these two categories. Gender is how societies view, and distinguish between, men and women not through their biology but through assigning gender norms (assigned masculine and feminine roles to thoughts, behaviors, dress codes, politics etc…). While gender roles are based on expectations that a culture has of behavior appropriate for men or women, gender identity is an individual’s sense of belonging to the category of men or women or neither of the two (gender queer, transgender, genderless…). People are generally expected to identify with a particular gender (either man or woman), which has been assigned (gender assignment) to them at birth based on a complex set of cues, which vary from culture to culture. These cues can range from the way a person looks dresses and behaves to the context in which they do so and also on their relationship with and use of power.

A man believes that he has the right to have sex with his wife whenever he wants and that it is her duty to provide it. Even when she refuses, he insists on having sex with her. Where do we classify such behavior?

If he forces his wife to have sex against her will, it is called marital-rape. Just because they are married does not mean that either partner can force the other to have sex. Each sexual encounter even between spouses should be consensual. Being married or in a relationship with a person does not mean one is always willing to have sex; there are times when they may not want to and this should be respected.

How do I confirm my pregnancy?

There are three main ways to test if you are pregnant: urine test, blood test, and an ultrasound.

  • Urine test: It can be bought at any pharmacy and in some supermarkets. It can accurately detect pregnancy after a missed period; some can even detect it a few days before the missed period. The advantages of this method is that it is more affordable and you can do it in the privacy of your own home.
  • Blood test: It can be done in most clinics and hospitals. Blood tests can detect a pregnancy earlier than a urine test, but they are more expensive.
  • Ultrasound: Ultrasounds are done by gynecologists in private clinics, primary healthcare centers, and hospitals. They can detect whether or not you are pregnant and how far along you are in the pregnancy. 

For people who are not married, seeing a physician about pregnancy-related issues might be a difficult experience since many report being talked down to and being judged for getting pregnant out of wedlock. However, some of our callers do share positive experiences they’ve had with their physicians, so feel free to contact the hotline and see if there are friendly non-judgmental doctors in your area.

I have had sex once with my boyfriend? Can I get pregnant?

Yes, a single sexual contact can lead to pregnancy or STIs (sexually transmitted infections), even if it is the first time for either or both the partners. A girl can get pregnant even on the first intercourse because getting pregnant is dependent on whether or not an egg has been released in her body (ovulation). Since there is no 100% guarantee that the egg will be released on a particular day or time, one cannot say for sure that she will or will not get pregnant. Similarly, one cannot tell whether or not one will get any infection because just by looking at a partner one cannot make out whether or not the partner has an infection. Also, many infections (including HIV) do not have symptoms. Sometimes one takes the risk of having unsafe sex assuming that the partner belongs to a “respectable” family or looks “clean” and therefore will not have engaged in risky behavior. People’s socio-economic status is no shield against infection as infections do not pick and choose their clients. These reasons make it essential to use a condom each time one has sex or engages in activities that pose no/less risk to self and partner.

I tried using tampons once. I developed rashes, and it hurt. Why? I had heard that they are better than pads.

Some women prefer tampons to pads. You should use what you find most comfortable. Although it might take some time and effort to learn how to use a tampon, it is safe and convenient if used properly. A tampon can cause discomfort if it is not correctly inserted and/or positioned. If you are tense while inserting a tampon, it might hurt you. Read the instructions manual carefully to insert a tampon properly. Tampons must be changed every four to six hours to prevent infection. You might have developed a rash because you had not changed for a long time. Some people are also very sensitive to the material used in the tampon.

Is masturbation harmful?

Masturbation is an enjoyable and perfectly harmless activity. Both men as well as women masturbate. It does not matter how often you do it as long as it does not interfere with the other things you have to do or does not involve anyone else without their consent. Masturbation will not affect your sex life negatively. It is a legitimate sexual activity in its own right and does not cause weakness, stunted growth, pimples, or any psychological problem.

What does homosexual, heterosexual, bisexual mean?

These are categories of sexual orientation that can either describe a behavior or an identity. As an identity, some people who are attracted to the opposite sex self-identify as heterosexual, some attracted to the same sex self-identify as homosexual and some attracted to both sexes self-identify as bisexual. Some women who are attracted to other women might label themselves lesbians and some men attracted to other men may label themselves as gay. These categories also refer to behaviors and not identities; you can read more about this in the next question.

What is the difference between transsexual, transgender, and intersex persons?

Transgender persons: Individuals who does not identify with the gender assigned to them at birth and want to change through changing their behavior and/or appearance to suit their preferred gender expression. The term transsexual may be used when someone undergoes surgery, hormonal medication or other procedures to make these changes. They may or may not identify as homosexual, bisexual or heterosexual; do not mistake gender identity and sexual orientation to be the same or necesaarily linked to one another.

Intersex person: An individual born with the physical characteristics of both males and female,  have external sex organs that are not easily distinguishable as female or male, or have sex chromosomes that are different from the usual xx — female — or xy — male. These differences in chromosomes may not appear on the body and so they may live their whole lives and never know. These individuals may or may not identify as men or women.

What should be the ideal size of one’s penis in order to satisfy a woman? I am nervous that I will not be able to satisfy my partner because my penis is not big.

If the penis is about 5cm long when erect, a man is perfectly capable of arousing and satisfying his partner. This is because it is in the first 4cm of a woman’s vagina that there are maximum nerve endings. These nerve endings are responsible for sensation. And, more than the vagina, it is the clitoris (located above the vaginal opening, just where the inner lips meet) that is sensitive to sensation. So if you and your partner were to concentrate on how you do what you do, whether it is with the penis or fingers or mouth, rather than the length of your penis, chances are that both of you will enjoy sex much more. Incidentally, the length of your penis has nothing to do with your ability to enjoy sexual pleasure either. It is the connection, chemistry, and technique, not size, that matters.

Can a woman get pregnant if a man ejaculates near her vagina, i.e. without penetration?

Yes, a woman can get pregnant any time sperm enters the vulva or is inside the vagina. This means that ejaculation near the vagina can also lead to pregnancy. This is possible when the vaginal lubrication (wetness) provides a medium for the sperm to swim into the woman’s body. There is no way of knowing the probability that pregnancy will occur when semen comes in contact with the vulva or vagina, even if the woman still has a hymen. Pregnancy can be determined using a home pregnancy test or more accurately through a pregnancy test done in a laboratory

How can one know if s/he has a sexually transmitted infection (STI)? How long does one take to become sick after getting an STI?

As the name suggests, an STD is transmitted through unsafe sex with an infected person. Symptoms of STDs vary and can appear within 1 week of exposure to 3 weeks. Symptoms of STD for men are quite easy to spot, usually appearing in/around the genital area. In women many STDs may not manifest symptoms initially. In men, symptoms include, a yellow/white discharge from the penis, inflammation of the testicles and prostate gland. A common symptom in women is a change in vaginal discharge – it may increase, become yellow or greenish, or develop a foul smell. Other symptoms common to all include boils/ blisters/ rashes, burning during urination and irritation and/or discharge from the anus. Untreated STDs can cause cervical and other cancers, chronic hepatitis, pelvic inflammatory disease, infertility, and other complications. However, when diagnosed and treated early, almost all STDs are completely curable.

Is it safe to take the pill continuously to avoid having periods?

Yes, it is — except for women who should not take the pill at all. Likewise, it is safe to continuously use some other hormonal methods, like Depo-Provera injections, the Mirena IUD, or the vaginal ring to suppress menstruation.

Many women would rather not menstruate using hormonal contraception to control their cycles for various reasons — to plan a trips, travels, athletic event, to alleviate medical conditions such as endometriosis, to avoid discomforts like PMS, for convenience, or simply because they don’t like menstruating.

Sometimes I feel like I am a woman, other times I feel like a man. And oftentimes, I feel like I can’t identity with either. What does that mean?

Not finding yourself in one gender identity, or not feeling like you belong to either, is very normal and common. Some people choose the identity of being gender non-conforming, others choose that of being non-binary, and that doesn’t necessary mean that you are confused or not picky. Gender, even though it is a social construct, is also very deep and personal. Finding a term that works for you, and an identification that represents that part of you can be a source of comfort.

What are induced abortions and spontaneous abortions?

An abortion is the induced or spontaneous termination of a pregnancy. A spontaneous abortion occurs when a pregnancy terminates without any medical or surgical intervention, as in the case of a miscarriage. Induced abortions involve surgical or medical procedures for termination of the pregnancy.

 

What is asexuality?

Asexuality is a broad term that people of diverse sexual needs and desires, or lack of, can identify with. It is strongly associated with not prioritizing sexual needs and desires in one’s life and relationships. While many find asexuality and lack of sexual desire in general or towards other people to be an intrinsic part of themselves, others may think of themselves as asexual for reasons beyond innate lack of desire. It is different from celibacy in the sense that it is not driven by an avoidance of sex due to particular beliefs and values, but rather by one’s relationship with desire and needs. Asexual people may not have sexual relationships with others, but still fulfill their sexual needs through masturbation and forms of self-pleasure. However, asexual people can still form meaningful relationships with others that may or may not include sex. They may desire to be on their own, or have more intimate romantic relationships with asexual or sexual people. Just like any other identity, it does not necessarily define one’s sexual behavior and practices, but rather how they view themselves and relate to others for as long as it makes sense to them.

What is cunnilingus, fellatio, and outercourse?

Cunnilingus: A partner uses their mouth/tongue to stimulate a woman’s genital area. Cunnilingus is often casually referred to as ‘going down on’ or ‘giving head’.

Fellatio: The partner uses their mouth/tongue to stimulate a man’s penis. It is also called ‘giving head’, ‘going down on’, ‘blow job’ and ‘sucking off’.

Outercourse: Sex without penetration into a vagina or an anus. It allows a couple to be sexual, more intimate, and even orgasmic with one another without having sexual intercourse. With outercourse, no semen, vaginal fluids, or blood is shared between partners. As a result, outercourse protects against pregnancy and some sexually transmitted infections (STIs). Some outercourse pleasuring possibilities include hot talk, sexy stares, erotic fantasy, spicy role-plays, sensual massage, showering or bathing together, strip-tease, mutual masturbation, phone or e-mail sex, and dry sex (a.k.a., dry humping, or frottage).

Yeah, but doesn’t thickness matter?

The thickness or circumference of the penis is really not of concern for sexual satisfaction. This is because the walls of the vagina are muscular and elastic and they can stretch or contract to accommodate anything that ranges in size from a little finger to a baby’s head. In fact, a very thick penis may scare your partner or put her off. Some degree of curvature of the penis is also normal.

A couple of nights ago I fooled around with my same-sex best friend. Does that mean I’m a lesbian, gay or bisexual?

Not necessarily. Sexual orientation — homosexual, heterosexual, or bisexual — is not based solely on the sex of the people we may have sexual contact with. It is based on the sex to which we are predominantly attracted. Someone who is gay or lesbian, for example, has a primary erotic, psychological, emotional, and social interest in people of the same sex. Likewise straight people have a primary erotic, psychological, emotional, and social interest in people of the opposite sex.

Often people have sex with partners outside of their sexual orientation. For example, there are people with predominately same-sex fantasies and erotic attractions who have opposite-sex partners. There are people who just enjoy playing with partners outside their sexual orientations every once in a while, and they do not care to be labeled and may very well be comfortable with their sexuality as such without any labels. The terms lesbian gay bisexual (LGB) are labels that some people wish to identify with and many others don’t. Just because someone is attracted-to and/or has sex with a member of the same sex does not mean they should self-identify as lesbian, gay or bisexual.

It is possible that our understanding of our sexual orientation will change as we grow up through childhood, adolescence, and adulthood. And we may have partners of the opposite or the same sex or both. But because there is such a cultural stigma against non-hetero orientations, it may take a while for some to feel comfortable playing out their desires and feelings.

Can a woman get pregnant from pre-cum?

Yes, a woman can get pregnant from pre-cum. Pre-cum is the fluid released by the penis as a lubricant when it is excited, and while it usually has no sperm or dead sperm, some sperm cells may still linger in it. This means that there is no guarantee that if intercourse happens during the women’s ovulation period, a pregnancy won’t happen.

I always thought that I am a transman, but the problem is, I do feel attracted to men, and that confuses me.

Your gender identity does not have that kind of relationship to sexuality. They’re both intersectional but represent two realities. So you can be trans* and gay, or non-binary and straight, and so on. One does not set the other in stone.

I was just diagnosed today with HPV. I’m wondering about the HPV vaccine. If someone has HPV already, will the vaccine prevent future outbreaks?

It depends on the type(s) of HPV (human papilloma virus) a person has.
In 2006, the U.S. Food and Drug Administration (FDA) approved a vaccine, Gardasil, that protects against four of the 40 types of HPV that are sexually transmitted. Two of the types, 6 and 11, are the ones that cause 90 percent of the outbreaks of genital warts. The two others, 16 and 18, cause 70 percent of cases of cancer of the cervix. They are also associated with cancers of the vulva, penis, anus, or throat.

There is no clear evidence that the vaccine will protect an already infected person. Because, however, a person may be infected with one of the HPV types covered by the vaccine but not with another, the vaccine will protect against the HPV type(s) that a person does not already have. The new vaccine does not offer protection against all the types of HPV that cause cervical cancer. So sexually active women are urged to continue to have regular Pap smear tests; a test that detects cervical cancer in its early, treatable stages.

Is it true that using a tampon could tear the hymen? Would that mean that I am no longer a virgin?

The hymen is a thin and highly elastic membrane present in the vagina. Using a tampon does not tear the hymen, as it is elastic. The hymen may however break or stretch during the course of running, cycling or exercising, at any point in life. So, the presence or absence of an intact hymen does not indicate whether or not a woman has had sex. There is no “proof of virginity” for either a woman or a man.

I’ve never been able to have an orgasm when I have sex. Is something wrong with me? I try really hard, but it never happens.

Many women have “inhibited orgasm” — they have reached orgasm in the past, but no longer can, and some may have never had an orgasm at all. The truth is that about 70% of women are able to reach orgasm during clitoral masturbation and only 30% from vaginal intercourse, yet most are made to feel that something is wrong with them if they don’t have vaginal orgasms. In cultures like ours, that place a high value on vaginal intercourse, many women do not receive sufficient clitoral stimulation to bring them to orgasm more quickly, if at all. In most kinds of partnered sex play — manual, body-rubbing, oral, anal, or vaginal — a man’s penis is directly stimulated. This is often not true for a woman’s clitoris.

Some women who cannot reach orgasm do not feel that orgasm is important for their sexual experience. Some women feel cheated. Some women “fake” orgasm in order to end sex play or to please their partners, who may not realize that they aren’t reaching orgasm. Masturbating can help you relax with your body and listen to its sexual wants. Once one is more comfortable with themselves then the frustration of not climaxing with a partner would not be as upsetting. Afterwards you may give yourself time to experience that with your partner with the reassurance that you can achieve orgasms but just awaiting till you reach that with your partner. Remember to open the lines of communication with your partner, here are some tips on communicating with a partner.

What is erectile dysfunction?

Erectile dysfunction (ED) or impotence is the inability to maintain or achieve an erection. ED can result from physical conditions such as chronic illness, diseases, aging of the body, over-consumsion of alcohol nd specific drugs, or from psychological causes such as dislike of sex or sexual partner, stress, anxiety, depression, or abuse. Impotence can occur at any age and has different manifestations.

What is the difference between medical abortion and surgical abortion?

Abortions can be done in multiple ways depending on the pregnant person’s circumstances and preferences. While both methods are very efficient at ending a pregnancy, there are pros and cons to each that can help you make a decision that works for you:

  1. Medical abortion: it is done by taking pills that can help you end a pregnancy, and depending on where you live and your circumstances, it can either be done in hospital/clinical environment or at home. The main pill to be taken is misoprostol (also known as cytotec) with an efficiency of 90-95%, but can be supported with mifepristone, raising the efficiency rate up to 99%. Many women prefer this method because it’s cheaper, can be done at home, and is not an invasive procedure.
  2. Surgical abortion: it is performed through different surgical procedures depending on what stage of pregnancy you’re in and how much money you have. Surgical abortions include curettage, aspiration abortion, and dilation and evacuation abortion (D&E). It is more expensive, but has an efficiency rate of 100%. However, it can lead to complications if not performed well. Many women prefer this method for the convenience of ending the pregnancy within half an hour, the possible added assurance of having medical staff around, and the discretion of doing it in a hospital/clinic if you live with others at home.

Can a woman become pregnant if her partner pulls out before ejaculating?

The pull out method (also called withdrawal) is much more effective when you do it correctly.

  • Of every 100 women whose partners use withdrawal, 4 will become pregnant each year if they always do it correctly.
  • Of every 100 women whose partners use withdrawal, 27 will become pregnant each year if they don’t always do it correctly.

Couples who have great self-control, experience, and trust may use the pull out method more effectively. Men who use the pull out method must be able to know when they are reaching the point in sexual excitement when ejaculation can no longer be stopped or postponed. If you cannot predict this moment accurately, withdrawal will not be as effective.

Even if a man pulls out in time, pregnancy can still happen. Some experts believe that pre-cum (fluid released right before ejaculation), can pick up enough sperm left in the urethra from a previous ejaculation to cause pregnancy.

Men who use withdrawal as a contraceptive method must always be able to feel when they are reaching the point in sexual excitement when ejaculation can no longer be stopped or postponed. And they must pull out when they reach this point. Its users say that withdrawal has the advantages of being easy to access, easy to use, and free of side effects and cost. Non-users believe it causes anxiety and decreased pleasure during sexual intercourse. The most important disadvantage of withdrawal, even when used consistently and correctly, is that it offers no protection against sexually transmitted infections.

I am a woman and want to know if I can contract HPV by performing oral sex on a woman who has it? A lot of the information available seems to pertain to mostly heterosexual activity.

Yes, it is possible. HPV, the human papilloma virus, can be passed from partner to partner through any intimate skin-to-skin activity. Women who have sex with women, and men who have sex with men, and people who have sex with the other sex are all at risk for becoming infected with HPV and many other sexually transmitted infections.

Most often, HPV infections resolve on their own. But in some cases they stay. And certain kinds of HPV can lead to cervical cancer. That’s why it is very important for women who have sex with women, whether or not they identify as lesbians, to have periodic gynecological visits and Pap tests to detect abnormal growths in the cervix that could lead to cancer. Early detection and treatment save thousands of women’s lives.

I really enjoy watching pornography but when im having sex I feel really insecure about my skills in bed? Is that normal?

It’s important to know that pornography most often does not depict reality. It may lead to unrealistic expectations about sex and sexuality. What you should know about pornography is that:

First: the models or actors in pornographic images are often chosen for abnormally large sex organs and breasts. Their bodies are cosmetically, and often surgically or hormonally, enhanced. Pornographic photos are often altered in the printing or photographic process. Hair and blemishes are removed. Musculature and facial features are highlighted. And teeth are straightened and whitened. You can have healthy sex lives without looking like this.

Second: in staging sexually explicit scenes for the camera, models and actors often take fairly uncomfortable positions to allow their sex organs to be seen while having sex. This makes the sex acts themselves quite unrealistic.

Third: The videos that you watch take many hours of casting that get edited to become the videos that they are. Men are made to look like they can last with an erection for hours and that they should not cater to pleasuring women.

Fourth:  a lot of pornography is tailored for individuals who have quite a narrow range of audiences. Most mainstream porn is created to please men and the porn that is made “for her” is usually erotic and very soft porn assuming that is womens sole pleasure from watching porn.
Its important to realize that many healthy, caring adults use pornography. Many people use it to enhance their sex lives knowing that it is much more about fantasy than it is about reality.

If a woman says she’s had a curettage, does that mean that she had an abortion?

Not necessarily. Dilation and curettage (D&C) is a procedure that involves stretching open the cervix with medication and/or instruments called dilators and then removing all or part of the uterine lining — the endometrium — with a spoon-shaped instrument called a curette. D&C is done for many reasons. It may be done to:

  • perform an abortion
  • remove remains of the placenta after childbirth or miscarriage
  • diagnose or rule out endometrial cancer
  • diagnose or remove suspected polyps
  • diagnose and treat problems with heavy or abnormal bleeding
  • follow up on Pap or other tests that indicate abnormalities in the uterus

Is there any treatment for premature ejaculation? Do exercises or medicines such as the many alternative medicines advertised everywhere help at all?

First of all, please consult a qualified doctor before you take any medicines. Premature Ejaculation is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. Premature ejaculation is subjective. Ejaculation time differs from person to person and also from time to time for the same person. Many men feel insecure about their sexual staying ability when they compare themselves to the fantasy standards of porn. The reasons for premature ejaculation can be many, ranging from over excitement, anxiety over sexual performance, stress, or relationship problems with partner. Here are a couple of things you can do to last longer. Masturbate to orgasm 1-2 hours before you have sex. Many men find that this helps them stay longer when they have sex with a partner. It helps to get to know your body and to teach yourself to last longer through masturbation. Most men report that there’s a point during arousal when they know they’re about to ejaculate. The idea is to stop or slow down for a few seconds before this point while masturbating. This technique is called the stop-start technique. You may find that you need to practice this for some time before you see results. Also, if you want to pleasure your partner for longer, you can also use other techniques like digital stimulation (using your fingers) or perform oral sex on her/him.

What causes homosexuality?

That question is as difficult to answer as ‘what causes heterosexuality?’ No one knows for sure. Some foolishly suggest that maybe a person turned lesbian because she had a bad experience with a man, or a man became gay because a woman mistreated him. If this were truly the case, then there should be many more lesbian and gay people, shouldn’t there?

What is meant by the terms peri-menopause and climacteric?

Perimenopause- The period before a woman reaches menopause. During this time, the ovaries begin to produce less oestrogen, a hormone that helps regulate menstruation. Perimenopause can begin to occur a few years prior to menopause. Within the last two years of perimenopause, oestrogen production decreases more rapidly, which can lead to menopausal symptoms such as hot flushes, changes in libido, and vaginal dryness.

Perimenopause and menopause are often thought of as a time when women experience diminished sexual desire. While libido (sexual desire) might decrease, this idea may have more to do with prevailing social attitudes that look down upon women’s expression of sexuality, after they have fulfilled their reproductive responsibilities towards the family.

Climacetric: When men begin to produce decreased level of testosterone, usually around the age of 45-65. This has been linked with the female menopausal process. Unlike menopausal women, this is not often accompanied by decreased sexual libido.

Can I get pregnant if I have sex with a man on my period?

Yes, it can happen. It is possible for a woman to get pregnant from intercourse during her period, especially if her menstrual cycle is brief.

It is also possible that a woman may think she is having her period when she is not. It is also possible to get pregnant during breakthrough vaginal bleeding.

It’s not only women with short cycles who need to be careful about unprotected vaginal intercourse during menstruation. Even when cycles are long and regular, ovulation may occur on different days in different cycles.

Can lesbians or gays be cured?

Attempts to clinically or therapeutically ‘treat’ homosexuality, although may cause temporary changes, is a violent practice. Although we believe sexuality is fluid, and attraction changes, this has to happen organically and forceful attempts to change sexual desire and behavior are emotionally harmful.

Can shaving infected hair get rid of scabies and pubic lice?

No. Shaving, dousing with kerosene, hot baths, and other so-called remedies won’t work. Scabies and pubic lice are tiny insects are parasites that may be transmitted through sexual and intimate contact or from infested bed sheets and clothing. Symptoms usually include intense itching of the genitals and anus. To get rid of these parasites one needs to shower with a medication from neck-to-toe and dry clean or boil all towels, bed sheets, and clothes exposed. Treat the partner as well to avoid re-infection.

Scabies and pubic lice are highly contagious and condoms in this case can’t completely protect from infection because they don’t cover all the areas that are.

Is it true that medical abortions don’t work?

While surgical abortions have a higher efficiency rate, the rate of efficiency for medical abortion is still very high (90%-99%). However, biases against medical abortion still exist for many reasons. Some healthcare providers are not up to date with advances in medical abortion due to the legal contexts in the countries they work in that would legally restrict access to medications anyway. Others simply prefer performing surgeries that would bring in more income. Also, there’s a general inclination in medicine towards medicalizing women’s bodies and health to an extent that dismisses self-medicating as a legitimate way, despite it being integral to our history of healing, and therefore gives control over our reproductive health to hospitals and clinics.

Lately sex has been really painful. Does this mean that something is wrong?

Painful intercourse has many causes.

In women, the causes are more varied and complex: There may be vaginal dryness, which could be caused in two ways. It could be that a woman is not aroused enough to lubricate because there has not been enough foreplay before penetration. Or, she may not have enough of the hormone estrogen in her system to create lubrication. This type of vaginal dryness is often associated with perimenopause or menopause. Other physical causes include endometriosis, infection, yeast overgrowth, or allergic reaction to latex or spermicide.

Emotional causes of painful intercourse for women include gender identity conflict, a history of rape or incest, or intense childhood suppression of sex, all of which can lead to vaginal spasms that prevent penetration. Other emotional causes include hostility, anger, or resentment toward her partner or previous partners.

It is best to consult a health care professional to determine the cause and get the best treatment.

My breasts are small and sagging. How can I increase their size and improve their shape?

The size of a woman’s breasts has no bearing on her interest in sex or her ability to give or receive pleasure. So don’t fret! Exercise and massage do not increase the size of breasts; they strengthen and tone the muscles around the breasts. Perfectly hemispherical breasts can be created through surgery and other techniques only. Your sexuality is not confined to certain parts of your body. Your whole body, regardless of size, shape, colour and weight, is sexual. Enjoy it.

Why is my period late?

If your period is late, that might be caused by many reasons, such as stress, weight fluctuation, the weather, or medication. Sometimes it’s an indication of something more serious, and in case it is persistent, it’s advisable to see a physician. If you have had sex recently, it could mean you are pregnant. In that case, you can do a urine test the first day after your missed period.

Can medical abortion medications be detected in a blood or other type of test?

No, a blood test or other type of test (like biopsy) will NOT show that a woman used Misoprostol (one of the medical abortion methods). Doctors cannot recognize the difference between spontaneous miscarriage and induced abortion unless they find physical traces of the pills (if they were administered vaginally instead of sublingually).

How can I make my orgasms better or stronger?

Many women and men find that the longer they postpone orgasm, the stronger it is. Many women also find that clitoral stimulation during vaginal intercourse makes orgasm more likely and more powerful. Both women and men can do exercises to strengthen the pelvic floor muscles that play a very important role in orgasm. Kegel exercises are done by tightening and relaxing the muscles used to stop urination. Strengthening these muscles can also alleviate urinary incontinence, improve sexual sensation, and aid muscle tone recovery from childbirth. Because they are internal muscle exercises, they can be done privately anywhere, anytime. Kegels should be done five times in a row, several times a day:

1.     Tighten pelvic muscles a little, and hold for five seconds.

2.     Tighten a little more, and hold for five seconds more.

3.     Tighten as much as possible, and hold for another five seconds.

4.     Relax the muscles in reverse steps, holding five seconds at each step.

Is it infectious or dirty to have sex while on my period?

There is nothing dirty or unclean about menstruation. Blood from menstruation is no more likely to infect a woman’s partner than sweat, saliva, or vaginal secretions caused by sexual arousal. We know that menstrual fluid itself is not infectious, and it does not cause disease or sickness. Some women today enjoy their periods as a proud reminder of their femininity. Many others see it as an uncomfortable inconvenience that they could do well without. And many have found that they can enjoy their sexuality and express themselves sexually during menstruation.

My friends tell me that I sound too insecure about my body and my looks, and that i take an abnormally long time getting ready to go out. When does caring about my looks become a problem?

Many people are concerned to a greater or lesser degree with some aspect of their appearance. If looking good becomes a significant distress or handicap in at least one area of your life then it my be defined at body dysmorphic disorder (BDD). For example, someone with BDD might avoid certain social and public situations to prevent themselves from feeling uncomfortable and worrying that people are rating them negatively. Alternatively a person may enter such situations but remain very self conscious. He or she may camouflage themselves excessively to hide their perceived defect by using heavy make up, brushing their hair in a particular way, changing their posture, or wearing heavy clothes. They may spend several hours a day thinking about their perceived defect and asking themselves questions that cannot be answered (for example, ”Why was I born this way?”, “If only my nose was straighter and smaller”) They may feel compelled to repeat frequently certain time consuming behaviors such as:

  • Checking their appearance in a mirror or reflective surface
  • Seeking reassurance about their appearance
  • Checking by feeling one’s skin with one’s fingers
  • Cutting or combing their hair to make it “just so”.
  • Picking their skin to make it smooth.
  • Comparing themselves against models in magazines or people in the street

While BDD is a very medical term we need to remember that the social context in different places of the world may skew the intensity of it. In Lebanon looking good is too connected to being “decent” “classy” “clean” and from “good” upbringing; all of which are also problematic.

Should a guy wear a condom / woman use a dental dam when receiving oral sex? Does it prevent any diseases?

Using condoms or dental dams can reduce the risk of infection for both partners. The infections most commonly transmitted by oral sex are gonorrhea, herpes, hepatitis, and syphilis.

The risks from oral sex are generally lower than the risks from vaginal or anal intercourse.

We only have anal sex so that my partner does not get pregnant. Is that OK?

Anal sex has a high risk of transmitting infection and does not completely prevent pregnancy. This is because, the distance between the anus and the vagina is not much and few drops of semen may spill into the vagina during anal sex. Also, condoms and lubricants are essential here since the anal area is a breeding ground for a number of viruses and bacteria and there is more risk of injury in anal sex because it is less elastic and dryer than the vagina. These factors make transmission of infection from one partner to another easier. If you practice anal sex, always use a condom and a water- based lubricant, like KY Jelly. Using oil or cream causes infection and damages the latex of the condom.

About 3 weeks ago I had a cold sore on my lip and had sex with my boyfriend. He gave me oral sex during that time. Today, my vulva is extremely itchy, red, and irritated. Could my fiancé have picked up my cold sore on his lips and infected me with it?

You will need to be examined by a qualified health care provider to see if you have a sexually transmitted infection or some other condition that is irritating you. But it is possible for infections to follow the route you describe. For example, although herpes virus-1 (HSV-1) is most commonly associated with cold sores around the mouth, it can infect the sex organs. And, while herpes virus 2 (HSV-2) is most commonly associated with infections of the sex organs, it can infect the mouth and throat.

During oral sex — anilingus (on an anus), cunnilingus (on a vulva), or fellatio (on a penis) — the HSV-1 or HSV-2 in a cold sore can be passed directly to the sex organs or anus. It is also possible for the fluid from the “weeping” sore to be passed from mouth to mouth and then to the sex organs where it can start an infection. That’s why it’s best for people with open herpes sores, oral or genital, to refrain from intimate contact with other people.

If you are diagnosed with herpes, it may be a good idea for your partner to be tested, too. There are medications available today that reduce the number and severity of outbreaks and also reduce the risk of one partner infecting the other.

How soon after sex can pregnancy be detected?

Pregnancy tests can detect pregnancy after a missed period — some can even detect it before a missed period.

Despite what some people think, pregnancy doesn’t start the day a couple has intercourse. It can take up to seven days after sex for the sperm and egg to join and form a fertilized egg. Then, it can take up to eight days, or more, for the fertilized egg to bury itself in the lining of the uterus. Pregnancy begins when this happens.

If you do not want to be pregnant and you’ve had unprotected vaginal intercourse, don’t wait to find out two weeks later with a pregnancy test. Emergency contraception can be started within 120 hours (five days) after intercourse. Emergency contraception is available without a prescription from pharmacies, under the name NorLevo or PlanB.

I used to get wet just at the thought of stimulation but now it’s difficult to get wet. What can I do?

Changes in sexual arousal and lubrication patterns may also be associated with other events in a woman’s life. Having a new sex partner, or being with the same partner for many years, may affect the patterns of all the stages of a woman’s sexual response cycle: desire, arousal, excitement, and orgasm. Various health conditions — including depression and diabetes, for example — may also affect her sex drive. Age itself also has an effect. In fact, during perimenopause and menopause, many, if not most, women experience vaginal dryness.

Women who would like increased lubrication should not be shy about using over-the-counter lubricants to enhance sexual pleasure. There are hundreds of products on the market to choose from. There are only two important cautions: Oil-based lubricants can damage latex condoms. Silicone-based lubricants can damage barrier contraceptives made of silicone, such as FemCap, and a wide variety of sex toys that are also made of silicone. So, if you use sex toys or latex condoms, you won’t go wrong if you purchase a water-based lubricant.

Is it safe to have an abortion with pills if I’ve already had one in the past?

Women are fertile for about 40 years. Some women need more than one abortion with pills. Having a safe abortion, or more than one safe abortion, does not impact a woman’s health or ability to have children in future.

My boyfriend gets upset that sometimes my vagina is looser than other times. He thinks I’m cheating, but I’m not. What’s going on?

Here are five possibilities:

1. Some men tend to be anxious about their sexual performance. Some have an exaggerated sense of jealousy. It’s always best to discuss such problems with a partner. But some men may put the blame on their partners because they are unable to recognize their own insecurities.

2. Women’s vaginas are less elastic when they are not sexually aroused. They become more elastic — “looser” — the more sexually excited they become. A woman may feel “tighter” to a man when she is less aroused, less comfortable, and having less pleasure than her partner.

3. Hormonal shifts during a woman’s menstrual cycle affect vaginal secretions and may affect vaginal elasticity. She may feel “looser” on certain days of her cycle than on others.

4. Certain drugs, such as antihistamines or marijuana, may make the walls of the vagina feel dry so they seem “tighter.”

5. A woman’s vagina may feel tighter or looser in different positions for intercourse.

A friend says she heard that millions of women who have had abortions suffer from something called “post-abortion syndrome,” which she says is just like post-traumatic stress syndrome. Is that true?

No, it’s not true. Post-traumatic stress disorder is recognized as a legitimate psychological diagnosis by the American Psychiatric Association. So-called “post-abortion syndrome” is not.In fact, severe emotional disturbance after childbirth, sometimes referred to as postpartum psychosis, occurs somewhat more frequently than severe emotional disturbance after abortion. Interestingly, research has shown that rates of post-partum psychosis decrease in societies that legalize abortion.

Studies suggest that while severe emotional disturbance following abortion is very rare, it is more likely for women who have

  • delays in getting abortion
  • medical or genetic reasons to abort a wanted pregnancy
  • severe pre-existing or concurrent psychiatric illness
  • conflict over abortion

Feeling emotional disturbance after an abortion doesn’t have to be restricted to any of these reasons either, and it is important to recognize the validity of feelings of loss or sadness even if you are terminating an unwanted pregnancy. At the same time, studies suggest that the majority of women who have abortions experience relief after.

Can all women of any age use the pill?

Young women and older one often choose the pill for its contraceptive and non-contraceptive benefits. Not only can the pill help prevent a surprise unintended pregnancy later in life, it can also help regulate menstruation during perimenopause, help reduce symptoms of PMS or certain symptoms of perimenopause, and help protect against ovarian and endometrial cancer.

The pill, however, for fear of strokes cannot be used by women 35 or older who smoke.

One other thing: the pill cannot protect against sexually transmitted infections. So, be sure to practice safer sex including condom use.

Can Prozac affect my sex drive? I never feel intimate anymore, and it’s really hurting my relationship — my partner gets so upset thinking I don’t find him/her attractive anymore. I just don’t feel like having sex, ever.

Antidepressants are of many categories one of which is called selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Celexa, Lexapro, and Paxil. SSRIs are used to treat depression, anxiety, panic disorder, and other conditions, including premenstrual dysphoric disorder. A possible side effect of SSRIs includes decreased sex drive and/or more difficult orgasm — for women and men. Each SSRI may have different effects on different people.

Talk with your health care provider if you feel this medication affecting your sex life. Your provider may be able to substitute a different SSRI or a different kind of medication.

Similarly, share with your partner any concerns you may have about changes in your sex drive — no matter what the reasons may be. It may be difficult to assure partners that one’s feelings are not about them, but it is worth trying — communication is everything. Understandably, partners may find it difficult to accept that their significant other’s appetite for sex has changed, especially if it needs to be for an extended or indefinite period of time.

My periods are irregular. The cycle varies between 14 and 20 days. Is there any safe period for me?

To begin with there is no absolutely “safe period” during the period cycle if you mean safety from conception. This is especially true for those with irregular cycles like yours. The maximum chance of conception usually occurs 14 days before the next period. That’s the day when ovulation takes place (an egg is released in the woman’s body). If a woman has unprotected sex with a man at that time, she can get pregnant. If you do not know for sure when you will have your next period, it is not possible to calculate when ovulation has occurred. So, you will have to be on a contraceptive method or your partner will need to use a condom every time you have sex if you want to avoid getting pregnant. Bleeding twice a month is not always a healthy sign. You may want to consult a gynecologist to discuss the frequency and irregularity of your periods as well as get a prescription for a contraceptive pill.

My vulva’s color is darker than my skin. Does this mean I have an infection?

Vulvas can change in color and sometimes become darker as we grow, particularly around the labias (also called lips). This is very normal for most people, and the change is often the result of changes in hormones, such as puberty, taking pills, pregnancy, and so on. Labias also get darker when aroused as a result of the blood rushing into the area. There’s no reason to worry when that happens, it’s very normal. Unless there’s bumps, scars, pimples, warts or rashes, it’s most likely to be just that.
Sometimes shaving darkens the area around the vulva as well and causes ingrown hairs. Moisturizing the area helps reduce the irritability and dryness caused by shaving.

What are RTIs and STIs?

RTI stands for Reproductive Tract Infection. It refers to infections that affect the reproductive tract. RTIs are caused by an overgrowth of organisms that are normally present in the vagina or when bacteria or micro-organisms are introduced into the reproductive tract during sexual contact or through medical procedures.

STI stands for Sexually Transmitted Infection, refers to infections transmitted through sexual contact.

Is having an abortion emotionally and psychologically dangerous?

No. Most women feel relief after an abortion. Serious emotional problems after abortion are much less likely than they are after giving birth. People who are anti-abortion may make false claims about this. They want people to believe that most women who choose abortion suffer severe and long lasting emotional trauma that they label “post abortion trauma”. This is not true.

Scientific studies over the last 20 years have found that emotional reactions to having abortion are relatively positive with two exceptions; women who had psychological problems before the pregnancy and women who have to terminate a wanted pregnancy.

I’ve heard that the pill and other hormonal methods of birth control will lower my sex drive? Is that true?

The side effects of the pill have been studied for more than 40 years. Many of these studies have examined the effect of the pill on sexual desire and arousal. A recent review of 30 original studies concluded that using the pill, the patch, the ring, and the shot has no effect on sexual desire or arousal for most women. For other women, sexual desire and arousal are affected: Some experience more sexual desire and arousal. Some experience less.

The causes of these changes may be psychological — for example, a woman may enjoy her sexuality more when she doesn’t need to worry about getting pregnant. Some may be hormonal — for example, the estrogen in the pill may affect the testosterone in a woman’s body in ways that influence her sex drive. If a woman experiences an unwelcome change in her sex drive and thinks it is caused by her method, she may want to change to another method.

What exactly do people mean when they say “safer sex”? Is it always about condoms?

Condoms are an important part of safer sex, but safer sex means more than just using condoms. Safer sex is a relative term. It is anything you decide to do to lower the risk of becoming infected or infecting someone else with a sexually transmitted infection. Here are some examples:

  • If you decide to have sexual intercourse, using a latex or female condom makes it safer.
  • If you decide to have oral sex instead of unprotected vaginal or anal intercourse, it is safer
  • If you decide to have protected oral sex (condoms or dental dams used) instead of unprotected oral sex, it is safer.
  • If you decide to rub against each other with your clothes off instead of having intercourse or oral sex, it is safer. Rubbing against each other with your clothes on is even safer.
  • If you decide to masturbate each other instead of rubbing against each other with your clothes off, it is safer.
  • If, after masturbating each other, you wash your hands before touching your own genitals, it is even safer.
  • If you decide to masturbate alone or have phone sex or cybersex instead of physical contact with someone else, it is even safer.

Does using the pill really help cure acne?

Yes. Less acne is one of the many non-contraceptive advantages to using combined hormone methods of birth control — the pill, the patch, and the ring. In fact, as many as one third of the prescriptions written for the pill are not written for birth control; they are written for the non-contraceptive benefits.

How is HIV transmitted?

There are four routes of transmission for HIV:

  1. Unprotected sex with an infected person.
  2. Infected mother to child, either during pregnancy, delivery or through breast feeding.
  3. Through contaminated blood and blood products (including organ and tissue transplants)
  4. Sharing of unsterilized used infected needles, syringes and other medical equipments like dentists’ instruments.

Is it true that men want more sex than women?

All people, regardless of their gender can have sexual desires and have the right to express themselves sexually. In some societies, it is believed that men’s desire should be considered before women’s and that only men should experience sexual pleasure. However, this is not true.

How accurate are pregnancy tests after abortion?

The pregnancy hormone, HCG (human chorionic gonadatropin), can remain in the body for up to 60 days after an abortion. Similarly, HCG levels can be measurable for weeks after childbirth. This can lead to pregnancy tests with false positive results for women who take home pregnancy tests.

Women who use home pregnancy tests and who are concerned that pregnancy is continuing or another pregnancy has occurred can consult their health care provider to test for the precise levels of HCG in the blood, or have an ultrasound to check.

I’ve heard that it is not good to have sex during pregnancy. Is this true?

It is important for any sexual activity to be consensual and also that care be taken. Unless there are clear instructions from the doctor to abstain as in the case of a difficult pregnancy, there is no reason a couple cannot be sexually active throughout the woman’s pregnancy. Activities like mutual masturbation and oral sex can be engaged until the end of term.

What is the window period?

HIV test do not look for the presence of HIV in the body: they look for the presence of antibodies produced by the immune system when it encounters HIV. It may take up to 3 months for the body to produce enough HIV antibodies to produce a positive test result. This three month period between infection and a positive test is known as the window period. During this time a person is already infected and capable of spreading HIV.

I heard it’s dangerous to take the Pill for more than 10 years. Is that true? Is there a limit?

No, it’s not true, and there is no limit to how long a woman can take the pill. Millions of women around the world have taken the pill since the FDA approved it in 1960. It has been the most scrupulously tested medication of our time.

Countless women take the pill from adolescence through perimenopause. Many stopped taking the pill only when they wanted to become pregnant and started taking it again after giving birth. Women not only rely on it for contraception but for menstrual regularity and other benefits. These benefits include

  • less menstrual flow and cramping
  • less infection of the fallopian tubes (pelvic inflammatory disease), which often leads to infertility
  • fewer ectopic pregnancies (those in a fallopian tube)
  • fewer noncancerous breast growths
  • fewer ovarian cysts
  • reduced risk of cancer of the lining of the uterus and of the ovaries
  • less iron-deficiency anemia that results from heavy menses
  • less acne
  • fewer premenstrual symptoms, as well as related headaches and depression
  • protection against osteoporosis — loss of bone mass
  • less excess body hair
  • less vaginal dryness and painful intercourse associated with menopause

The fact is that over the long term, use of the pill has offered many health benefits to millions of women worldwide.

Is abortion ever really necessary to save a woman’s life?

Yes. There are many health conditions in which abortion may become critical to protect a woman's life. There is, for example, a form of pregnancy-related high blood pressure that can be life threatening. The medical term for it is preeclampsia. It occurs in seven percent of pregnant women. If it is untreated or doesn't respond to treatment, it can lead to convulsions, failure of various organ systems, coma, or death. Abortion may be the only way to save the woman's life.

Certain other conditions, such as severe diabetes, heart disease, or trauma from car accidents, may also require abortion to save a woman's life. Termination of pregnancy is also essential to save the life of a woman with an ectopic/tubal pregnancy (a pregnancy outside the uterus).

What is the difference between HIV and AIDS?

HIV or the Human Immunodeficiency Virus is a virus that slowly, over a period of time, destroys a person’s immune system, if present in their body. Because of a weakening immune system, the person may develop infections and diseases and that is called AIDS. There is presently no cure for AIDS. One can however, protect oneself from being infected by following some simple precautions like: Always having sex with a condom, getting blood tested before having a transfusion, using only disposable syringes and not sharing needles.

Do I need to have an abortion if I have en ectopic pregnancy?

An ectopic pregnancy occurs when the fertilized egg is implanted outside the uterus, usually in the fallopian tubes. It is not a valid pregnancy and is often categorized as a medical emergency since it eventually bursts in the body if not terminated in time. Terminating an ectopic pregnancy is not considered an abortion, and even in countries where abortion is criminalized or legally restricted, its termination is a healthcare issue that does not fall under such penal codes. 

It is often accompanied by severe abdominal pain. And while it cannot be detected as ectopic through a urine test, it will show on an ultrasound. So if you have an ectopic pregnancy, the next step is to get it terminated medically or surgically.

Who should be tested for HIV? How often? Are the results always 100 percent accurate? How are they done?

Anyone who has been at risk of being infected should be tested. That means any person who has had unprotected vaginal or anal intercourse or who has shared needles with someone. Pregnant women who are at risk can be tested and treated so that their babies can be born uninfected.

It takes up to three months after infection for the tests to be accurate. Results that show no infection are accepted as accurate — unless unsafe sex or sharing needles happened within three to six months of testing. Tests are double-checked if they show infection. Testing has gotten simpler and faster over the years with the prick test which takes one drop of blood and can detect the virus within 6 weeks after the episode of unprotected sex.

Can’t HIV pass through condoms? Why use them if they don’t even work to prevent sexually transmitted infections?

The virus is embedded in blood, semen, or vaginal fluids, none of which can get through an intact condom. Condoms offer the best protection against sexually transmitted infections for sexually active people and they protect against unintended pregnancy.

Latex condoms offer very good protection against HIV making the risk of HIV transmission with a condom reduced by as much as 10,000 times. They also reduce the risk of other sexually transmitted infections, including chlamydia, gonorrhea, herpes, HPV (human papilloma virus), PID (pelvic inflammatory disease), syphilis, and trichomoniasis.

Does taking antibiotics make the pill less effective?

Only one antibiotic is known to make the pill less effective. That is rifampin (brand names include Rifadin and Rimactane), a special medication used to treat tuberculosis. Other antibiotics do not make the pill less effective.

Certain other medicines may make the pill less effective. These include

  • certain anti-HIV protease inhibitors
  • certain anti-seizure medications
  • a particular anti-fungal medication, griseofulvin (Fulvicin, Gris-PEG, Grifulvin V, Grisactin, and Gristatin), which is used to treat severe, often life-threatening fungal infections

It is always wise to know how other medications may interact with the pill. Some medications may be less effective when used with the pill. These include

  • Analgesics (pain medications) — for example, acetaminophen (Pamprin, Tylenol, Parcetamol, aspirin-free Excedrin, and others)
  • Antihypertensives (for high blood pressure) — for example, cyclopenthiazide (Prothiazide)

The effects of some medications may be exaggerated when used with the pill. These include

  • Antidepressants — for example, imipramine (Janimine and Tofranil)
  • Bronchodilators — for example, theophyline (Primatene, Theo-Dur, Marax, Bronkotabs, Quibron Tedra, and others)

Tranquilizers — for example, benzodiazepam (Valium, Ativan, Librium, Serax, Tranxene, Xanax, and others)

The morning after having sex I always have pee that burns. I’ve noticed it happen more than once and it goes away. I always use condoms so i dont think its an STI. Why is that?

Having sex can introduce bacteria into the vagina and urethra, causing urinary tract infections (UTIs). That could create a burning sensation during urination. When you sleep after sex you leave the bacteria to grow and then the next morning it burns but you would have cleaned out your urinary tract. What could help is to always remember to pee after you have sex so that you clean out your tract and avoid the burning feeling later.

Many women dont get symptoms for STIs, condoms are protective, but it would be good to have regular checkups for STIs and especially in the case of unprotected sex.

Will I be able to get pregnant and have children after a medical abortion?

Medical abortions do not affect ability to conceive or bear a child in the future. In fact, if a woman does not want to become pregnant at this time, it is important to start using contraceptives as soon as she starts having sexual relations again.

Does having an abortion really lead to breast cancer?

No. There is no truth to this at all. Many studies, including one of 1.5 million women in Denmark, have found no link between cancer and abortion — none.

I have heard that the pill can cause depression, is this true?

There are conflicting study results around the link between the hormonal pill and mental health. While some research findings support the relation between depression and hormonal methods, others do not necessarily draw a link between them. However, we know that a lot of women report increasing feelings of anxiety, sadness and depression after taking the pill, especially if they have a history with mental health fluctuation. If you start experiencing such symptoms, you can try to rule out other factors that may be contributing to that, or switch the brand you’re using to another that may have less impact on your well-being. Interestingly, a lot of women on the pill also report inclination to be more violent after getting on birth control. While taking a pill does not excuse being violent or abusive, feelings of anxiety and increased sensitivity can lead to less management of anger, especially if the person is already going through stressful times.

Is it true that emergency contraception causes abortion?

No. Abortion ends a pregnancy. Emergency contraception (EC) cannot end a pregnancy. EC works before a pregnancy begins. Pregnancy begins with the implantation of the developing fertilized egg in a woman’s uterus.

EC can be started within five days of unprotected intercourse. It prevents ovulation — the release of the egg. Or it prevents fertilization — the joining of the sperm and the egg — which usually occurs within six days of intercourse. In theory, it’s possible for EC to prevent implantation, but implantation doesn’t occur until five to seven days after fertilization. To read more about emergency contraception, click here.

Is it safe to take emergency contraceptives more than once during a menstrual cycle?

You do not need to worry about taking emergency contraceptives (EC) more than once during your menstrual cycle. EC pills work by delaying or preventing ovulation - when an egg is released from the ovaries. However, ECs are not a replacement for regular birth control methods. You can expect the following short-term side effects after taking EC:

  • Headache
  • Nausea and vomiting
  • Breast tenderness
  • Abdominal pain
  • Dizziness
  • Fatigue
  • Irregular bleeding patterns

Because ECs delay or prevent ovulation, this can affect the duration of your next menstrual cycle, making it either shorter or longer than usual. However, using EC does not impact your future fertility. 
 
Another form of EC is the copper intrauterine device (IUD) which can be inserted into the uterus within 5 days from having unprotected sex to prevent pregnancy from happening. This is also a more long-term and dependable method of contraception.

Can I use the daily combined oral pill as an emergency contraceptive?

No, the daily combined oral pill cannot be used as an emergency contraception because most brands do not contain levonorgestrel, the main component responsible for preventing ovulation and implantation of a fertilized egg. Contrary to popular belief, taking multiple daily combined oral pills at once does not carry out the same impact.
Most common brands such as Yasmin, Yaz, Diane, and Diva do not contain levonorgestrel. However, few brands do and if administered properly, can act as an emergency contraceptive. In Lebanon for example, microgynon, a daily combined oral pill, does have levonorgestrel, and when taken through the yuzpe method, acts as an emergency contraception.

What if I’m not interested in hormonal contraceptives? Can you also recommend other effective hormone-free methods?

Alternatives to hormonal methods include barrier methods, such as male or female condoms, the contraceptive sponge, the diaphragm, cervical cap. These methods have somewhat less effectiveness than hormonal methods, but do offer significant protection against unintended pregnancy. Behavioral methods, such as withdrawal (pulling out before ejaculation), outercourse, and “natural” methods, offer even less protection than barrier methods for typical users.

The reason why “natural methods” are less depended on is because sperm can live in a woman’s reproductive tract for up to six days. So it is possible for a woman to become pregnant from vaginal intercourse up to six days before she ovulates. Some women reduce the risk of pregnancy with the “Standard Days Method,” (also called the counting method) where they avoid unprotected intercourse from Days 8 to 19 of the woman’s cycle. (Day 1 is the first day of a woman’s period.) This 12-day “fertile window” takes into account the six days before ovulation in which pregnancy can occur from vaginal intercourse and allows for a slight margin of error that may occur in predicting ovulation. The “Standard Days Method” can work for women who have cycles between 26 and 32 days, and who have a regular and accurate menstrual cycle.

The only reversible method of birth control that offers the effectiveness of hormonal methods without hormones is the copper T, an intrauterine contraceptive, (formerly called an IUD — intrauterine device), which can be left in place for up to 12 years. IUCs are more than 99 percent effective and are, in fact, the most popular reversible contraceptives worldwide.

Women and men who know they will never want more children than they already have may also choose methods that are intended to be permanent and hard to reverse — vasectomy for men, tubal ligation for women.

Eighty-five percent of women of reproductive age who use no contraceptives during vaginal intercourse become pregnant each year.

No method of birth control is right for everyone. Although hormonal methods of birth control are safe and highly effective for most women, many women cannot use them. And some women do not want to use them.

I heard IUDs can cause infertility. Is that true?

It’s a common myth, but it’s not true. IUDs — intrauterine devices, increasingly referred to as IUCs (intrauterine contraceptives) — are among the safest, most effective, and least expensive methods of birth control available. In fact, they are the most popular form of reversible birth control in the world. More than 85 million women use IUDs.

The myth started in the 1980s. An insufficiently tested, defective brand of IUD — the Dalkon Shield — had to be removed from the market because of the damage it caused, including infections that led to infertility. Today’s IUDs are safe, effective, and do not cause infertility.

Sexually transmitted infections (STIs) cause infertility, not IUDs. If you have an IUD inserted while you have an STI, you increase your chance of infertility. That’s why most health care providers test for STIs before inserting IUDs.  IUDs do not protect against STIs.

I’m allergic to latex! What can I use instead of latex condoms?

There are two alternatives to latex condoms for people who are concerned about reducing the risk of sexually transmitted infections and unintended pregnancy. Female condoms are made of polyurethane. When used correctly and consistently, they’re up to 95 percent effective against pregnancy, and they also reduce the risk of infection. Currently, the only brand on the market is FC Female Condom.

Polyurethane male condoms are also available. Polyurethane condoms (both female and male) are usually more expensive than latex condoms, but they can be used with both oil — and water-based lubricants.

Can you tell me more about internal condoms?

An internal condom is a polyurethane pouch that has a flexible ring at both ends. It is approximately 7 centimeters wide and 18 centimeters long, and is inserted in the vagina. Its efficacy is known to be around 79-95%. It reduces the risk of STI and HIV transmission. It can be used by those with latex allergies and can be inserted up to 8 hours prior to intercourse. It can increase pleasure for both partners because the rim of the outer ring stimulates the clitoris and testes during sex. It does not affect fertility. However, it can be expensive and sometimes produces a noisy crackling sound during intercourse. Also, some women find it difficult to insert.
Usage: Add lubricant. Insert the closed end of the condom deep into the vagina to cover the cervix. The open end stays outside the vagina to partially cover the labia. After sex, remove the condom by twisting the outer ring and pulling it out gently to avoid spilling any semen.
Precaution: Do not use the external and internal condom together. Recommendations for the internal condom indicate a single usage for each condom. However, there is research being done to study whether disinfecting and cleaning an internal condom can allow for multiple usage.