Barb's Daily Dose

Help, I forgot my Birth Control Pill

If I had a nickel for every time that I heard that!  This is a very scary experience, but don't fear, the answers are right here:

If you forgot 1 pill:  

Take it as soon as you remember, and use a back up method of birth control for 3 days to be safe.  You may notice some breakthrough bleeding or spotting for a few days.

If you forgot 2 pills in a row

Take 2 pills as soon as you can, and 2 more the next day to catch up. Use a back up method of birth control for 3 days to be safe. You may notice some breakthrough bleeding or spotting for a few days.

If you're always forgetting pills

Consider switching to another method of birth control.  Stay tuned, we'll talk about the options in the next few weeks.  There's:

NuvaRing

Mirena

Depo-Provera

Implanon

And my favorite, a girl's best friend, Condoms.

  

Teen Girls & Sex

Teaching Teen Girls: 5 Signs A Guy Is Only Interested in Sex 

This is another guest blog, by my favorite teen expert, Vanessa Van Petten. She is the teen author of the parenting book “You’re Grounded!” She writes a parenting blog along with 12 other teen writers from the kid's perspective to help parents. Her work as a young family peacemaker have been featured in the Wall Street Journal, Teen Vogue, Fox 5, CBS 4 and much more! 

How do parents teach their teen daughter that they have to learn whether or not a guy is only interested in sex? It is an important dating lesson, one that teens are learning earlier and earlier. Here are a few tips I like to give teen girls when they start thinking about boys and dating: 

#1 Actions Speak Louder Than Words 

Boys can be smooth talkers. One thing I try to impress upon girls (even on my 23 year-old friends) is that girls read way more into language than boys. Some boys—not all, might stretch the truth if it means they will get to hook-up with you. That is why listening to actions, is almost more important than listening to words. Does he say he cannot wait to see you, but forgets to call? Does he say that he does not care if you hook-up, but then is very physical when you see each other? 

#2 Learn to Read Faces 

Most people actually display most of their emotions on their faces. Teen boys especially are not very good at hiding their true emotions. This can be a great way to see if he is telling the truth and how he really feels. Look at his face the instant you say ‘no’ to doing something you are uncomfortable with. Does he look sad, scared, embarrassed or worried? These are all OK emotions. If he looks angry, resentful, bored or annoyed this is not a good sign. 

#3 How Do His Friends Treat You 

Guys always talk to their guys about sex and you. I find that if you meet his friends and they have heard about you, talk to you and take an interest in you, your guy probably shared his idea that he likes you more than just for sex. If they ignore you, make lewd comments or snicker when you come in, you might want to have a talk with one of his friends, or with your guy for more information on how he thinks about you and your relationship.  

#4 What Does He Remember and Talk About 

If a guy remembers things about what you talk about, he is actually interested in what you have to say, not just what you have to ‘put-out.’ If he seems to take an interest in you and talks about things other than sex, you are probably with a boy who actually cares about you and not just the sex. 

#5 When Do You Interact 

This one can be tricky, because sometimes teen boys can only interact when parents are asleep or in certain time frames. Yet, teen girls need to learn to pay attention to the interaction schedules. Are boys only calling when it is late at night or when they want to get together? Do teen boys want to go to parties with you, but not dates or spend any alone time unless you are hooking up? This can be a sign that they only want a sexual interaction. 

I think these signs are important to talk to your teen daughters about, but also remember to explain to them that teen boys are also just as nervous and might be acting strange or weird because they are uncomfortable. The best policy is always to be as open and honest with your feelings and in your relationships. 

Visit Vanessa's website OnTeensToday.com for more information on teens, dating, sex and everything they are dealing with.  

Myths about Urinary Tract Infections

Here are my top 5 myths that I hear all the time about Urinary Tract Infections.

#1 Wiping matters - If only I had wiped myself differently, this wouldn't have happened.  Not true. Studies show that contrary to what your mom told you or you heard way back when, you don't have to wipe front to back or back to front or sideways. It doesn't matter.  

#2 Drink lots of water to flush out the bacteria - Ok, this was a trick. 

The Va Jay Jay is Dry Dry

Vaginal Dryness 

When you buy your ticket on the hormonal roller coaster, affectionately known as menopause, sorry, but there probably isn’t a stop at splash mountain. Nope, menopause brings lots of unexpected twists and turns and one big secret, your Va Jay Jay will be a lot dryer. 

Can you say Sahara? 

Yes, there will be more wrinkles, but you knew that. What many of my patients are surprised by is how dry their skin is, especially in the vagina. Gosh darn it! Sorry, I was just channeling Tina Fey, imitating a certain governor. Now that you don’t have to worry about pregnancy, all of a sudden, your ability to lubricate recedes like a middle-aged man’s hairline. 

Infections are more common 

Sorry to say, that when the vagina is dry, it means that the pH is off balance allowing less of the good health bacteria (lactobacillus) to grow and more of the bad bacteria that cause vaginal and bladder infections to grow. 

What to do? 

Think about talking to your health care provider about treatments. There’s good news. Even if you’re not interested in hormones to treat hot flashes and night sweats, a minimal amount of vaginal estrogen used regularly will help restore the balance and help you avoid infections. 

Interested in more information about sex during menopause?  Get my Menopause Download.

Vulvar Pain part 3

Last month, Mary Buxton, LCSW and AASECT Certified Sex Therapist wrote on Vulvar pain.  Today, we'll hear from the folks at the National Vulvodynia Association.

Michelle's Story

Michelle, is a 37 year-old woman, who has experienced pain in her external genital area (the vulva) since her very first gynecological exam. Like many women, she didn’t know that exams weren’t supposed to cause discomfort.  After suffering for many years with painful symptoms, Michelle knew something was wrong.  Yet, she had to consult four medical professionals over the course of 10 years before she finally obtained an accurate diagnosis of vulvodynia! Michelle is not alone. 

Teen Girls, Sex & Boys

Girls have more power than they think, they can make men prove they're worthy. So make them jump through a few hoops."

Let me translate that. Girls need to learn how to figure out when boys are lying!

Ok, let me be less harsh, and more clinical.  Girls need to translate the verbal messages that boys often use to coax, coerce, pressure or otherwise manipulate girls into having sex with them. 

The research

Recently 2 researchers from the UK, Dr. Hayter and Dr. Harrison found that there were huge differences in the ways that young men and women talked about sex and that young women need help " to develop the social skills they need to resist pressure from boys..." 

They need to not accept at face value what they might be hearing. They need to ask a few more questions, kick the tires so to speak before deciding if this guy is worthy of their time.

"Well, he said........"  fill in the blank with one of the following:

• He really loved me
• He wanted to spend more time with me
• His girlfriend didn't understand him
• I was special
• He really likes me 
• He had never felt this way before
• He couldn't go out, but we could just hook up

The list goes on and on.  

The next sentence is often, too often. "Then we had sex and he now he's disappeared. He doesn't even text me.  I don't understand, he said that he really liked me."

They say whatever works

I try to give the guy the benefit of the doubt. "Well, in that moment, he probably did love you."  Or "I hate to break it to you, but sometimes men lie to get women to sleep with them."  Really, hard to believe, but it's true. 

Or how about this take on it from a guy:  Yes, he does like you! and Yes, you are special, but girls have to ask a few more questions, and they are: 

• Just how special are you? 
• How long do think he's going to like you?
• How long do you think he'll think you're special?  
• An hour or 2?  
• A day?  Week, month, years?

Not all men do this, but as the comedian Billy Crystal said, "Women need a reason to have sex, Men just need a place."

Sharon Stone also said, "Women may be able to fake orgasms, but men can fake entire relationships."

There are some good guys out there who are interested in you as a person, and there are some who are only interested in sex. I've said this statement to women who are 17 and women who are 47.  

And yes, of course, some women do the same thing, but right now, I'm ranting about men.

Please notice, that I said SOME men. I do not mean to suggest that all men are like this. Likewise, I'm not making any judgments about these men.  There are powerful hormonal influences at work here, and they are universal.  

I'm not cynical, really I'm not 

I like men, I'm married to a man and I have 2 very nice brothers, who are decent guys. But my brothers and a lot of male friends have confirmed this. When I've asked them if men lie to have sex with women, they look at you with raised eyebrows, and say something profound like, "DUH."

So, girls, wake up! Ask a few more questions.  Kick the tires. As one male friend says, "Girls have more power than they think, they can make men prove they're worthy. So make them jump through a few hoops."

• What if you say No? 
• What if you say Maybe later? 
• What if you say Nice try, I'm flattered, but I don't know you well enough
• What if you say not right now? 
• What is he willing to do for you? 
• Is he willing to spend the afternoon helping you babysit your nephew? 
• Is he interested in going out or just hooking up when convenient?  
• What happens when you say maybe later? 
• Is he willing to get tested for STDs before sex?  
• Is he willing to use a condom?  
• Is he willing to......

Hmmm, you get to learn a lot about a person when you make reasonable requests and see how they react. Yes, you are special!

Make sure he's worthy!  

And remember sex is never 100% safe, 100% of the time. STDs and accidental pregnancy are no laughing matters, so protect yourself.

Post Baby Dry Spell

I was just asked if there was a scientific explanation for the loss or decrease of sex drive or libido that some women experience after childbirth if women are breast-feeding? 

I think most moms would say, "Hello!  We're tired."  I think sleep deprivation for all parents is the # 1 factor for their completely normal decline in canoodling. 

There are other factors at play here when women breastfeed. The hormone prolactin that makes milk, inhibits the release of estrogen (our #1 hormone for sexiness and libido.) Remember that there are more estrogen receptors in the vulva (private girl parts, this is my scientific term) than any other place in the body. 

Women who breastfeed may notice that their private girl parts don't look the same as they did in the past. The labia shrinks and things are a little less moist. Some would say Desert Dry. This isn't from a vaginal birth, because it happens for women who had a C-Section. 

What happens is that mother nature doesn't want women to be hot for their partners too soon after giving birth. In order for that baby to have enough milk to survive, it's essential that a mom NOT ENJOY SEX and make another baby, which would decrease milk supply. 

In a nutshell

Prolactin inhibits Estrogen which decreases libido, makes areas Sahara dry, changes arousal patterns and frankly prolongs the time it takes to have an orgasm. Many breastfeeding moms find that having an orgasm takes Forever and they give up and get some sleep. (unless the breast stimulation overrides that, which is another story).

Choices

If you like to bet, when new parents are in the Casino of Love, and given the choice between Sex & Sleep, they choose Sleep more often than Sex. Read more on Sex Versus Sleep

Vulvar Pain part 2

Guest Blog with Mary Buxton, LCSW

AASECT Certified Sex Therapist 

Mary has generously offered to write a few guest blogs on a subject most of us need help with, but may be reluctant to ask about, sexuality.  Today is the 2nd part in a series on Vulvar Pain.  Read Part 1

How a sex therapist might help

The sex therapist might give cognitive (how you think) and behavioral (what you do) homework assignments to the woman and / or the couple.  These assignments involve one or more of the following approaches to treatment in a step by step sequence of home practice.

Cognitive therapy is changing how you think which in turn changes how you feel.  Examples:

1. Teach the woman and her partner about multidimensional view of pain and their type of vulvo-vaginal pain
2. Changing the way you think to reduce pain catastrophizing and avoidance
3. Developing coping self statements to manage the anxiety and pain
4. Sexual fantasies to help distract and relax

Yeastie Beasties part 2

A few days ago we talked about yeast infections and how they occur.  Today we'll cover treatment and prevention.

Treatment: 

There are many effective over the counter and prescription treatments for yeast infections. No matter what you use though, it takes 3 days to feel complete relief. There are creams and suppositories for the vagina that are offered in 1 day, 3 day or 7 day treatments.

You may also have been prescribed Diflucan, an oral medication. Partners usually don’t need to be treated. 

What about Yogurt? 

• Yes, I’m here to tell you, this works. Eat more yogurt for a few good reasons. 
• It’s loaded with calcium 
• It’s loaded with protein 
• The lactobacillus in yogurt helps your stomach and vagina maintain a healthy ph and prevents yeast from overgrowing. 

Vulvar Pain

Guest Blog with Mary Buxton, LCSW

AASECT Certified Sex Therapist 

Mary has generously offered to write a few guest blogs on a subject most of us need help with, but may be reluctant to ask about, sexuality.  Today is the first part in a series on Vulvar Pain.

Q: What is Vulvar Pain Syndrome?

A: Vulvar Pain syndrome happens in two different ways. Provoked vestibulodynia is a big word that translates to having pain in the vulvar area on touch.  That touch can be from attempted vaginal penetration for intercourse or medical exam, tampon use, tight clothing or other sources of touch.  Somewhere between 12-15% of women in the US suffer from this problem. 

On the other hand, unprovoked vestibulodynia does not require touch for pain to be felt.  These women experience a chronic burning of the vulvar area and comprise 6-7% of the general population.

Q: What is the impact of this problem on a woman’s life?

A: She might experience painful intercourse or the inability to have intercourse due to the tightening of the pc (or pubococogyeal) muscle.  That muscle surrounds the vaginal opening and can clamp shut in response to and anticipation of pain. 

She might develop:

• Anxiety
• Guilt
• Negative feelings toward sexuality