Thursday, November 29, 2007

14 Embarrassing Sex Questions – Answered!

Women’s nether regions are often considered terra incognita… mysterious, dark places that are unfamiliar even to women themselves. We first shed light on the matter by answering seven embarrassing sex questions. Now we’re back with seven more (plus the original seven, in case you missed ‘em)! We rounded up sexual health experts to weigh in on subjects that women are often too red-faced to discuss with their gynecologists – or even their girlfriends. We asked the blunt questions, and they answered. Read on to get the lowdown on what’s really going on down low.

1. Why aren’t my breasts a perfectly matched set?
Unless they’ve been surgically altered, most women’s breasts are not perfectly matched. That’s because breasts are made of mammary gland tissue and fat, and there are naturally different amounts in each, explains Dr. Glenn Updike, assistant professor of obstetrics and gynecology at Magee Women’s Hospital in Pittsburgh.

All women have some difference in their breasts; for some, the difference is more pronounced. Usually, this is only a cosmetic, and sometimes comfort, issue. (If it’s embarrassing or impacting your sex life, surgical remedies are available.) However, while different-sized breasts are common, if one breast suddenly becomes much larger than the other it could indicate an infection or tumor, so have your gynecologist evaluate it immediately.

2. Is it normal to pass gas during orgasm?
When you climax, the muscles around your genitals – including the sphincter muscle – relax, and when they do, it’s not unusual for a little gas to escape, says Dr. Millicent Comrie, MPH, founder and medical director of the Long Island College Center for Women’s Health in Brooklyn. But even before orgasm, because the penis rubs against the anus through the vaginal wall, the in-and-out motion may trigger gas, Comrie says. If it’s a frequent problem and really embarrassing to you, she suggests taking an over-the-counter anti-gas medication that contains simethicone before having sex.

3. If I had a dream about having sex with another woman, does that mean I’m gay or bisexual?
Not necessarily, says Michele Sugg, a certified sex therapist in Branford, Connecticut, and member of the American Association of Sexuality Educators, Counselors, and Therapists. It could mean you’re attracted to women (or a particular woman), but it could also mean you’re missing the closeness that friendships with women brings. “Sometimes women symbolize nurturance, love and closeness,” Sugg explains. “If you’re in a relationship with a guy and you’re not getting enough closeness, a dream like this might symbolize that you need more of that.”

It’s important to remember that an erotic dream doesn’t define your sexual identity. “Even if it means you feel sexually attracted to another woman, you don’t need to pigeonhole yourself,” Sugg says. “A lot of studies find that women’s sexuality is more fluid. Maybe at times you’ll be attracted to women and at times you won’t be. There’s a scale rather than being gay, straight or bi.”

4. Is a cold sore the same as herpes?
Cold sores don’t seem to carry the same stigma as genital herpes. But the fact is, strains of the same herpes simplex virus cause cold sores on the lips (and other areas of the face, chest, even the fingers), as well as the blisters around the genitals.

Herpes simplex virus 1 (HSV-1) usually occurs above the waist (generally through kissing or sharing eating utensils), while herpes simplex virus 2 (HSV-2) usually occurs below the waist (generally through sexual contact). But the reality is that you can get either virus in either area through oral-genital contact. “People aren’t as embarrassed to say ‘I get cold sores’, but fewer people are apt to bring up that they have genital herpes, although both of them could be in either place,” Updike says. Genital HSV-1 actually appears to be on the rise among adolescents, according to Comrie, “because they’re having oral sex instead of intercourse.” While both HSV1 and HSV2 are treatable, neither are curable.

Health experts say the popular belief that cold sores are benign stems from social perception – not medical reality. Actually, the virus strain that causes cold sores can, in some cases, also cause serious eye and brain infections. It’s estimated that 50%-80% of American adults have oral herpes, while 20% have genital herpes.

5. Can certain exercises really lead to better sex?
Absolutely. For starters, a good cardiovascular routine helps build energy and stamina. In addition, strength training and stretching can help you build muscles and improve your flexibility so you can get into – and maintain – various positions during sex.

The best exercise to improve sex is the Kegel squeeze – basically strength training for your pubococcygeus (or PC) muscles, which hold up your vagina, anus, uterus, bladder, and urethra. “The stronger these muscles are, the more intense your orgasms will be,” says Chicago sex and relationship therapist Laura Berman, Ph.D., author of Passion Prescription (Hyperion 2006).

To locate your PC muscles, try stopping the flow of urine when you pee. Hold the squeeze for five seconds, then release. Doing 50 to 150 Kegel squeezes a day will help keep those muscles in good sex shape. (Avoid doing Kegels regularly while urinating; it can lead to urinary tract and bladder infections.) “It builds the vaginal muscle up so you can really tighten around your partner,” Comrie says.

6. Is cybersex really cheating?
Those who take a Clintonian view of sex may not consider a volley of provocative emails to be cheating, given that the participants are only exchanging thoughts or fantasies, not bodily fluids. But ask yourself if you’d want your partner to read your exchange and if he’d be hurt, angry or resentful if he did. “If your partner wouldn’t feel comfortable with what you’re doing, you’re probably out of bounds in terms of your relationship agreement,” Sugg says. If the answer is yes, try to figure out what you’re looking for online that’s missing from your relationship. Maybe you’re bored with your sex life. Or your husband sees you as the mother of his children, while you still feel like a sex kitten. Or you want to try something extraordinary like role play or light bondage or even going to a sex party.

Rather than act out online, consider talking about it with your partner and expanding your sex life together. “When people can talk about their needs, there’s less It’s not cheating because it’s virtual,” Sugg says. Besides, real sex beats virtual sex any day.

7. Will my vagina be noticeably bigger after I have a baby?
If you push a baby out through your vagina, you can expect some stretching. “After delivery, the vaginal opening is anywhere from one to four centimeters bigger than it was before,” says Dr. Bruce Rosenzweig, director of urogynecology at Rush University Medical Center in Chicago. Whether your private parts snap back to pre-delivery size after your recovery depends on how big your baby was, how long you pushed, how well your OB repaired any tears, and whether you’re diligent about doing your postpartum Kegel exercises. “If you do those Kegel exercises to strengthen the vaginal muscles, the outcome is better,” Comrie says. If you had an episiotomy and your OB was meticulous about sewing it up, she adds, “you could be better than before.”

That said, after multiple deliveries, your vagina may still feel a bit roomier, and you may want more tightening than you’ll get from marathon Kegel sessions. If so, ask your gynecologist about vaginal reconstruction (aka perineoplasty or vaginoplasty), which can help lift and tighten the sagging muscles at the vagina’s opening and deeper inside.

8. I’ve never had an orgasm during intercourse. Is something wrong with me?
“If you can’t have orgasms with intercourse, you’re normal,” assures Stephanie Buehler, Psy.D., director of the Buehler Institute for sex therapy in Irvine, California. “Sometimes women get upset because their partners say “My last lover could have orgasms, so there must be something wrong with you.”

Now, assuming you don’t kick him to the curb for being an insensitive cad, you’re well within your rights to point out that about 70% of women don’t orgasm during intercourse without direct clitoral stimulation. You can also clue him in to the fact that it’s perfectly OK for one of you to lend a hand. “Touching your clitoris during sex really ups the chances that you’ll have an orgasm,” says Carol Queen, Ph.D., staff sexologist for the online sex toy boutique Good Vibrations (GoodVibes.com).

If you’ve never experienced an orgasm – and about 10% of women have not – you might consider investing in some slippery lube (not oil, which can irritate sensitive vaginal tissues) and spend some time experimenting alone. Don’t get discouraged if there are no immediate fireworks. “The first time, it might take an hour of stimulation to produce an orgasm; it might also take many tries to get comfortable with the feelings of strong arousal,” Buehler says.
(Worried a low libido is to blame? See our related story: 6 Reasons You’re Not in the Mood)

9. Where’s my G spot?
That’s the million-dollar sex question. Some researchers don’t believe in the G spot; others staunchly defend its existence but disagree about its exact location. One school of sex researchers maintains that the G spot is the glandular tissue around the urethra (found behind your pubic bone, about two inches inside your vagina). Others believe it’s really farther back, in a triangular area on the back of the bladder wall – called the trigone or T Zone – where three nerves come together. It’s probably some combination of these. But if your partner’s plucking the right strings, so to speak, does it matter which instrument he’s playing?

10. Can anal sex give me hemorrhoids?
Not as long as you’re relaxed and enjoying it, assures Ellen Barnard, MSSW, a sex educator/counselor and co-founder of A Woman’s Touch in Madison, Wisconsin (a-womans-touch.com). Hemorrhoids (painful swollen veins in the anal area) can result from excess pressure around your anus – say, when you’re really straining to go to the bathroom. But when you use a good lubricant and the penetration feels comfortable, not forced, there’s no risk of “backdoor sex” causing hemorrhoids.

In fact, some sex researchers believe tush play may actually prevent hemorrhoids. “It improves the strength and flexibility of the skin and muscles so that the anus is better able to respond to pressure, rather than bulging and producing hemorrhoids,” Barnard says.

11. Why don’t my privates look like a centerfold’s?
Beyond the extensive airbrushing magazine photos undergo, the hard truth is that even if you started with a nice, tight package, child birthing changes everything. Once you push a couple of 8- to 10-pound babies through the birth canal, things down there are gonna look more like Mary Poppins’ carpet bag than a cute little change purse.

Indeed, according Rosenzweig, some women’s vaginas sag so much that they complain of discomfort while walking.

Age is, not surprisingly, another culprit. You don’t expect to look like the pouty-lipped young things in Clearasil ads when you’re 45, right? Well, just as the lips around your mouth can thin with age, so can the lips in your southern hemisphere. “Women lose fat in that area, the elasticity and tone of the tissue decreases and the inner vaginal lips droop,” explains Dr. Dolores Kent, a Beverly Hills ob/gyn and cosmetic surgeon.

But in the same way women can opt for Restalyne or collagen to fill and plump, those who want to recapture the vaginas of their youth can have labiaplasty (trimming up the inner lips) and/or perineoplasty (tightening the vaginal opening). Although some women “have their vaginas done” because vaginal changes cause medical problems or make sex uncomfortable, Kent says that 85% of the women who come to her for such procedures are worried about aesthetics. “They’ve seen the men’s magazines and feel their vulvas aren’t pretty,” she says.

12. If I’m uncomfortable with how I smell down there, can I change it?
Sure, but you’re probably worrying needlessly, says Dr. Mary Jane Minkin, clinical director of obstetrics and gynecology at Yale University School of Medicine in New Haven, Connecticut. “Most of the women who come in saying I smell really bad smell fine,” she says. Still, if you’re concerned, see your gyn because strong odor (and discharge) is a sign of a bacterial infection. If there’s no infection and you’re still worried about your scent, avoiding spicy or pungent foods may help, Rosenzweig says.

Minkin often recommends an over-the-counter product called Rephresh that rebalances the vagina’s pH and makes you more fragrant. Don’t use douches or feminine sprays. Not only are they irritating, they can alter the vagina’s natural flora, which increases your risk of getting an infection and can mask an existing one.

13. Do I have a greater risk for infection if my genitals are pierced?
“It’s probably not a great idea to have foreign objects around your genitalia because areas that are prone to moisture and intimate contact are very attractive to bacteria,” Rosenzweig says. “But if you have great hygiene and a normal immune system, a genital piercing isn’t going to increase your risk for yeast infections or bacterial vaginosis.”

Still, some people always have a little redness or irritation around pierced areas, even when they’re in ho-hum spots like ears, noses or navels. So, if your piercing seems perpetually inflamed, take it out.

14. If I have been diagnosed with HPV once in the past, do I still have it? And am I still at risk for cervical cancer?
If you’ve had sex, you’ve probably bumped into human papilloma virus (HPV) – about 80% of sexually active people have been exposed to at least one of the 30 known strains of HPV. However, in the vast majority of cases – 90% – the infection clears up on its own. Odds are, you won’t even realize you had it. The thing to keep in mind is that while most HPV viruses come and go without notice, about 10 strains can increase your risk of developing cervical cancer.

The best way to protect yourself is with routine Pap tests, which look for changes in the cervix that could eventually become cancer. “We don’t know why some women develop cervical cancer and others don’t,” says Dr. Thomas Herzog, director of the division of gynecologic oncology at Columbia University in New York City. “But there are millions of women with HPV and just over 11,000 cases of cervical cancer in the U.S. each year, so if you’re screened regularly, it’s very unlikely you’ll develop cervical cancer. And if you did it would be caught extremely early and likely completely cured.”

Most women over 30 who’ve had three consecutive normal Paps are now advised to be screened only every two to three years. If you’re under 26, consider getting the new HPV vaccine, Gardasil, which protects against the four main strains of HPV responsible for about 70% of cervical cancers.

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