Authors: Debby Herbenick,Vanessa Schick
SEXY TIMES
It’s common for women and men to incorporate sexual-enhancement products into their sex lives. Using sex toys, creams, or lubricants can add novelty to a relationship, be a fun part of sex play, or help to make sex feel more comfortable, romantic, sexy, or more easily orgasmic. However, many sex toys don’t come with instructions for safe or pleasurable use—let alone vagina-friendly instructions. To make the most of your sexual experiences, consider the following:
I wish girls were taught from younger ages the correct names for all body parts, and empowered to love their genitals. I wish there was continued movement away from vaginal orgasms being the “preferred” kind.
—
E
LIZABETH,
41, Michigan
PERIOD DOS AND DON’TS
Most women experience menarche between the ages of ten and fourteen and reach menopause by their early fifties. Women in the United States and many Western countries don’t tend to have large numbers of children. This means that women will commonly spend three to four decades of their lives having monthly (or thereabouts) periods. Whether you started menstruating last month or twenty years ago, you can benefit from the health-related period tips in this section.
Women have a wide variety of period products to choose from including tampons, pads, pantyliners, menstrual cups, and menstrual sponges. Most women can use any of these without upsetting the vulva or vagina goddesses. Others have to choose more carefully based on their own health needs. We describe all of the products in detail in chapter 5, but here are a few things to consider when pondering the impact of period products on your health:
Tampons
Tampons are one of the most popular methods of period management among women in the United States. But that doesn’t mean that women can’t benefit from being reminded about how to use them for the safest possible experience. First and foremost, let’s start with a few tips on the greatest danger associated with tampons: TSS.
What’s TSS? It stands for toxic shock syndrome. If you have never known anyone who has ever had it, you are in good company. At the height of the TSS scare, only thirty-five people were diagnosed with it (and ten of those people were men). Of the women, the majority had vaginal symptoms, which suggested it was related to menstruation.
4
Then, in 1980, use of a certain super-absorbency tampon was found to be linked to TSS. Hence, the association with tampons. The tampons that were linked with TSS risk were quickly taken off the market, and the FDA has done a fine job of monitoring the market since then. TSS in connection with period products still occurs, but it is extremely rare. There is approximately one case of TSS out of every one hundred thousand menstruating women per year.
4
That isn’t 1 percent—not even .1 percent or .01 percent. Only .001 percent of women have been diagnosed with TSS.
So, what’s with the scary warning on your tampon packages/instructions? Although it is unlikely that you will get TSS, if you do, it can have some very serious health consequences including shock, liver and kidney failure, and possibly even death if left untreated. If you think you have it, don’t panic! Over 95 percent of women will recover from it, which are some pretty good odds.
4
Still, as with most things, TSS gets worse the longer it goes untreated. So, to be on the safe side, take out your tampon and consult a doctor if you have the following symptoms:
4
In addition to being aware of the symptoms, you can reduce your risk by taking a few extra precautions. First, always try to choose the tampon with the lowest absorbency necessary to get the job done. Researchers are mixed on how much this actually matters, with one study finding that there really are no notable safety differences between ultra- and super-plus-absorbency tampons.
5
Although these absorbencies don’t even sound that different, we still recommend this because it is better to be safe than sorry, and it just seems like a good general rule to use as little absorbency as needed. Besides, it can be uncomfortable to insert a large tampon without the proper lubrication!
That brings us to rule number 2: Change your tampon often in accordance with the recommendations listed on the tampon package insert or from your healthcare provider. Tampons that are left too long inside the vagina can cause bacterial infections or, although rare, can increase the risk of TSS. We know it’s easier on you and the bank account to leave the tampon in until it feels ready to pop, but it is better to follow the guidelines and change them every few hours. Following these steps can help to reduce the risk of TSS, which, although rare, can be deadly.
In addition to TSS, we’ve seen some scary emails floating around the cyber universe that make it seem as though regular tampons will cause all sorts of health problems (for example, that they contain asbestos). We know of no evidence that supports these claims. In fact, the US Food and Drug Administration (FDA) issued a statement in 1999 indicating that it had “no evidence of asbestos in tampons.”
6
And given the choice between believing the FDA or emails that also claim to come from foreigners who want to transfer millions of US dollars into your bank account, we’ll believe the FDA.
Menstrual Pads and Pantyliners
It is recommended that women only use menstrual pads or pantyliners on days that they are menstruating. If you find that you experience excessive vaginal discharge and want to use pads or liners for this reason, consider checking in with a healthcare provider before doing so. As we’ve mentioned, using pads or liners too often can cause or contribute to genital itching, redness, and/or irritation.
Sex and Your Period
Although some women avoid having sex while on their period, others are quite happy to have sex with a partner while menstruating. For some women, sexual pleasure and orgasm seem to help with any period-related discomfort, such as cramps. Also, some women find that they’re highly aroused while menstruating. If you want to have sex while menstruating, it is a perfectly common thing to do—and it is not “unhealthy.” Of course, any time there is exposure to blood there may be a greater risk of infection, so you’ll want to make sure to use a condom and/or talk with your partner about each of your STI histories. A tip: some people find it helpful to lay a towel down on the bed or other area (floor?) where they plan to have sex to reduce the likelihood of staining one’s sheets.
BIRTH CONTROL
Women and men commonly have questions about birth control. They want to know how effective different types of birth control are, how much they cost, and how easy they are to use. Perhaps you’ve also wondered how certain birth-control methods interact with your precious v-parts, the vulva and vagina. Given the dozens of different types of birth control available, we don’t have room to go over every single one here. However, this brief overview of common birth-control methods and how they relate to your vulva and vagina, or your sex life, should be a good start:
Male Condoms
Most women who have male sexual partners find that male condoms are incredibly vagina-friendly. After all, male condoms—when used correctly and consistently, and when they stay intact (which they nearly always do)—keep semen away from the vagina, thus reducing the risk of infection and unintended pregnancy. That’s pretty vagina-friendly, if you ask us! Every now and then, though, women will say that they feel irritated after having sex with a condom-clad partner. If you are sensitive or allergic to latex condoms, choose condoms made of something other than latex, such as polyurethane. Even if you’re not sensitive or allergic to condoms, you may find that your vagina and vulva are more comfortable when you use a certain brand of condom. It’s possible that you may be reacting to the lubricant on the condom, if it’s pre-lubricated. Make note of condoms that work particularly well with your body and keep some on hand so that you’ll be ready to have safer sex.
Female Condoms
American women rarely use female condoms; they are more commonly used by women and promoted by health groups in other countries. Female condoms look like pouches. The closed end is inserted head first into the vagina with the outer edges folding over the vulva. Some women find that using a female condom gives them more control over having safer sex. Condom-using couples may find this a fun, pleasurable, and safe (albeit sometimes expensive) way to diversify their sex lives.
NuvaRing
The NuvaRing is a vaginal-ring contraceptive. Women only need to insert one ring into the vagina and then leave it there for three weeks. Some women worry that leaving the NuvaRing in the vagina for three weeks is unhealthy for the vagina. It’s not (that is, assuming the ring stayed in its original packaging and then a woman washed her hands before opening the package, removing the ring, and inserting it into her vagina). Women also sometimes wonder if male partners will feel the NuvaRing during sex. In one study of women using NuvaRing and their partners, nearly 70 percent of men said that they never felt the ring during sex (it’s inserted pretty far up the vagina).
7
Those who do feel the NuvaRing don’t, for the most part, appear to be bothered by it. However, every woman is built differently, and every couple has bodies that fit together differently and different ways of having sex, including favorite or go-to sex positions. If you try the NuvaRing and find it’s uncomfortable for either one of you during sex, you may be able to remove it during sex (but not for long—ask your healthcare provider for details), as long as you remember to reinsert it soon afterward. Otherwise, consider other birth-control options that may be a better fit for you.