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12.16.2008  BY DR. KATE
Hi Dr. Kate,

My girlfriend (age 25) and I (age 24) seem to have a countdown clock running whenever we start. Let me elaborate: when we are fooling around, we always begin with foreplay, but after 10-15 minutes of foreplay she'll have cramping. This obviously puts an end to anything further. We have never made it past foreplay in the two years we've dated. Also, we are both virgins. What can I/she/we do to get our sex life going?

Frustrated 


Dear Frustrated,

As arousal builds, so does muscle tension--not just in the genitalia, but all over. In your case, your girlfriend's muscles are getting so tense that they are cramping. You can try several things to reduce her amount of tension overall--give her a massage or take a hot bath together to relax her muscles before foreplay. She can even take ibuprofen (600 to 800mg) before bed. Once you're together and your girlfriend is aroused, bring her to orgasm--this will allow her muscles to unclamp, and some of the blood to start to leave her pelvis. Then you can try intercourse, which is more comfortable for many women after coming (maximum lubrication, maximum size to the vagina). If this works, you can try varing your foreplay to try and lengthen her arousal period.
 
Have any of you experienced cramping with arousal or after sex?

Hi Dr. Kate, 

I went to the gyno this month to have her look at a bump on my labia--and was diagnosed with HPV/genital warts, which was what I sort of figured I had. I felt bad and whatnot; I also had a talk with my boyfriend about me having HPV. I've read about it and tried get more educated about HPV, but I need some help. What can I do to get rid of the bumps faster? (I was prescribed Aldara.) Also, how can my boyfriend and I have safer sex (besides using condoms)? Since we're sure we both have it (even though he has no symptoms)...how does that work? Can we re-infect each other? If you have advice on how to live with it better that would be great too. 

HPV Newbie 


Dear Newbie, 

Faster treatment for warts include TCA (a topical solution applied by your gyno weekly until the bump disappears) and laser therapy (usually reserved for large warty patches, not just a single wart). TCA burns a bit, but generally works faster than Aldara, so it's another good option. Condoms do reduce HPV, but genital-to-genital contact alone can spread the infection. There's nothing else you and your guy can do to reduce your risk, though it's unclear whether or not a couple can pass the virus back and forth. The best news I can give you (and the truth!) is that if you're healthy (no diabetes or HIV and you don't smoke), you're likely to cure yourself of the virus within a year or two. Once this wart disappears, you can keep an eye out for others, but especially if your boyfriend doesn't show any warts, you're likely clearing the virus. So it's not something you're stuck with forever. But if you have any other partners in the future, it's a good reminder to keep using condoms to reduce your HPV risk. 

Best of luck, 
Dr. Kate

12.11.2008  BY DR. KATE
Hi Dr. Kate,

My boyfriend and I have been having sex for just over a year. We were using condoms, and now that I am on the pill, we rarely use them (we both prefer sex without one). I would really like to experience what it feels like to have him ejaculate inside me, but we are both freaked out about this for the obvious reason. Is there any time during the month when it would be "safest" for us to try this?? (When would the least likely time to become pregnant be?)

Thanks!
Inquisitive



Dear Inquisitive,

If you're using the birth control pill consistently (taking a pill every day, not skipping any), you're protected against pregnancy every day. The pill in essence turns your ovaries off while you're taking it. And they stay off, even during the placebo pills. So "perfect pill users" are 97 percent protected against pregnancy while they use it, no matter what day of the month they have sex.

Now, if you miss or skip pills, that's a different story--you should never skip any, and if you miss more than one (take more than one late) you should use a back-up method for a week. But otherwise, you're good to go!

Of course, I'm talking about "safe" with regard to pregnancy...sex isn't safe infection-wise without condoms, even if he pulls out (but I know you know this!).

Have fun,

Dr. Kate

12.09.2008  BY DR. KATE
Dear Dr. Kate,  

My question is this: I have a friend that is a 26-year-old married man. He's been married for about five years and has three kids. We were talking the other day in a circle of friends and the subject (as usual) turned to sex. He said that the smell and taste of his wife's vagina had changed dramatically since she had given birth and the odor was quite pungent no matter what. I have since been horrified--will my vagina have a strong odor and/or bad taste in the future when I decide to have children? I asked my friend about it and he said it happens to all women. Say it isn't so! 

Odorless in Orlando

10.23.2008  BY DR. KATE
Dear Dr. Kate,

Is it common for women to pass gas during sex? There have been times when my man is downtown doing a fine job and I lose control of that particular area. Is there anything I can do about it? I'm so embarrassed when it happens...fortunately it doesn't seem to faze my guy. I still would like to know is there a way to stop it? What if the next guy won't be so accepting?

Embarrassed

10.21.2008  BY DR. KATE

Hi Dr. Kate,

I was recently diagnosed with Trichomoniasis. My doctor gave me medication and it went away. I read in the pamphlet thing that came with the meds that it is an STD. Me and my partner are monogamous so how would I get an STD? My boyfriend had also recently been tested and all came out negative. Could that be because it is hard to detect? I had to go to the doctor twice before they got it right. I trust him that he isn't sleeping with any one else but contracting an STD makes me a little confused.

Triched

10.09.2008  BY DR. KATE

Dear Dr. Kate,

I have been sexually active for about 6 years now. Today me and my man had sex and I started bleeding during it. I think it might have been caused by the sex position--doggie style--because I also had the same problem with one of my exes. It seems like when we try that position it hurts more than usual--obviously not one of my favorites but it's one of his. How can I enjoy this position more without bleeding? Will this bleeding go away?

Bleeding From Behind

Dear Bleeding,

The position alone shouldn't cause bleeding, though that position can cause discomfort (from him hitting your cervix with the deeper penetration). So I think there's two issues...I think you should see your gyno to make sure that your pap smear is fine and that you have no vaginal/cervical infections (the most common causes of bleeding with intercourse). But the pain issue is a separate one. You don't have to try ANY position that makes you uncomfortable--or worse, in pain - no matter how much your boyfriend enjoys it. But if you want to try to make the position more comfortable, here are some things to think about...

Hi Dr. Kate,

A friend of mine and I have both been diagnosed with HPV in the last year--she is 29, I am 33. We both have abnormal, benign cells. We have both been told by our doctors that the HPV will likely clear on its own. I am in a sexually-active, monogamous relationship. She is seeing someone new but has been abstaining due to her diagnosis.

Now here is the question: My doctor told me that I don't need to worry about my boyfriend and I passing this back and forth (we always use condoms). My friend's doctor told her that if she has sex with someone, it's likely that she will give HPV to him, and that he will give it back to her. Basically that they can infect each other back and forth forever.

Is this how it works? Is it possible to pass HPV back and forth, keeping you both infected? This is an especially important question for my friend, since she was just denied health insurance because of the HPV (how messed up is that?), so she's really concerned about getting rid of it.

Many thanks for your answer. Any advice would be greatly appreciated.

09.30.2008  BY DR. KATE

Dr. Kate,

I had unprotected sex a few days ago (oral and penetration). I know it's stupid and I've been alternately kicking and lecturing myself ever since. What I'd like to know is this: how soon can I get tested for STDs? I don't mind going in several times to get the tests, since I know different things show up at different times, it's just I'd like to start getting answers to my worries as soon as possible. Thanks for your help.

Stupid and Worried

09.25.2008  BY DR. KATE

Dear Dr. Kate,

I have been on the Pill since the age of 18, and I am now 23. I requested the pill due to the fact I have extremely painful and long periods. The pill has been a wonder, but now I am concerned after reading that being on the pill for 5 or more years increases your risk of cervical cancer. I have only ever had 3 sexual partners, all of whom I used condoms with, and I am not in a relationship at present. I had a smear test done last year and everything was clear but am just a bit worried. I really don't want to come off the pill as I had 6 years of torture before being prescribed it. Any advice would be much appreciated.

Pill Lover

Dear Pill Lover,

The relationship between cervical cancer and the birth control pill is a tricky one. Some research has suggested that being on the pill makes it harder to clear the HPV virus if you become infected with it. And we know that HPV is the real culprit in cervical cancer. On the other hand, other studies have found NO relationship between being on the pill and developing serious pap smear abnormalities or cancer. So the truth isn't completely known yet.

What we DO know is that if you're screened regularly (pap smears every 2-3 years for most women), we'll pick up any abnormalities in your cervix in PLENTY of time to treat you before it turns into cancer. So if your paps have always been normal, and you always use condoms (which decreases your risk of HPV), I would stay on the pill. I wouldn't trade good birth control, and one that makes your quality of life so much better, for a theoretical risk.

Have any of you worried about your pap smears while on the pill?

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Em & Lo, more formally known as Emma Taylor and Lorelei Sharkey, are the self-proclaimed Emily Posts of the modern bedroom.

Dr. Kate is an OB/GYN at one of the largest teaching hospitals in New York City.

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