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The end of the year (and the beginning of the next) is the perfect time to head to your gyno for a check-up, if you're due for one. Think of it as getting a clean bill of sexual health as you enter 2009. Here are five things that you should consider asking your gyno about in your 20 minute visit:

  • STD testing. Don't assume that you'll get tested for "everything." Your gyno can do cervical (or urine) cultures for chlamydia and gonorrhea, vaginal tests for trichomonas, and blood tests for HIV, syphilis and hepatitis--all upon request.
  • Pap smear need. Unless you've had a recent abnormal pap, you can ask your gyno if you really need one. The latest recommendations call for a pap every two to three years.
  • Period relief. If you're beset with awful cramps or heavy bleeding every month, ask about ways to improve your periods. It may be a birth control prescription, or as simple as a high-dose anti-inflammatory medication.
  • Contraception. Ask for a prescription with enough refills of your pill, patch or ring to last you the entire year. Your gyno can give you a script for a three-month supply at a time that you can mail in to save money, if your insurance company offers this option.
  • Prescriptions. If you have herpes or recurrent yeast infections, you can get an advance prescription for acyclovir, Valtrex or Diflucan to have on hand for your next infection.
And if you have a lot of questions, bring a written list. It's normal to completely forget your concerns once you're shivering in that thin gown.

12.18.2008  BY DR. KATE
Dr. Kate,

I'm embarrassed to ask, but is it normal to wet the bed during sex?

Too Moist

Dear Too Moist, 

The fluids you see may be one of three things: 

1) Your own lubrication with or without semen, which would be totally normal. Using lubricant (yay) or not using condoms (grrr) might increase how much fluid you see after. Either way, make sure you play on both sides of the bed to share who has to sleep in the wet spot.
2) Female ejaculate: not common, but not abnormal or unhealthy. Some women do, some don't.

3) Urine: this is more likely if your bladder is full before sex, and when you're fully relaxed (and having fabulous, full-body orgasms). Make sure you empty your bladder before intercourse and practice your Kegels to reduce the chances.

In general, there's no such thing as too much moisture during sex--friction is great for your running shoes, not so much for your vagina.

Have any of you worried about what the "wet spot" might be?

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?


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) 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?)


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 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

Last week my partner saw K, a 30-year-old patient, who's been a happy oral contraceptive user for almost ten years. K has been with her partner for five years, and she came in for her annual exam last week complaining that her sex drive was non-existent for the past few months. Did K talk about her new stressful job, or her sick parent, or the rough economy? No -- she wants to get off the pill, believing that her birth control is killing her libido.

The pill has long been implicated as death to the sex drive. In fact, many well-run studies have shown that the pill has no effect on the libido for the vast majority of women who take it. Most studies show the same rates of high and low libido among users of the pill and users of placebos. Some studies have actually shown libido going up among pill users -- perhaps due to the peace of mind that comes from being on a reliable birth control method.

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?


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.


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...

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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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