Emergency Contraception Emergency contraception consists of methods that can be used by women after sexual intercourse to prevent pregnancy. Emergency contraception methods have varying ranges of effectiveness depending on the method and timing of administration. Types of Emergency Contraception Intrauterine Device Cu-IUD ECPs UPA in a single dose (30 mg) Levonorgestrel in a single dose (1.5 mg) or as a split dose (1 dose of 0.75 mg of levonorgestrel followed by a second dose of 0.75 mg of levonorgestrel 12 hours later) Combined estrogen and progestin in 2 doses (Yuzpe regimen: 1 dose of 100 µg of ethinyl estradiol plus 0.50 mg of levonorgestrel followed by a second dose of 100 µg of ethinyl estradiol plus 0.50 mg of levonorgestrel 12 hours later) Initiation of Emergency Contraception Timing Cu-IUD The Cu-IUD can be inserted within 5 days of the first act of unprotected sexual intercourse as an emergency contraceptive. In addition, when the day of ovulation can be estimated, the Cu-IUD can be inserted beyond 5 days after sexual intercourse, as long as insertion does not occur >5 days after ovulation. ECPs ECPs should be taken as soon as possible within 5 days of unprotected sexual intercourse. Comments and Evidence Summary. Cu-IUDs are highly effective as emergency contraception (283) and can be continued as regular contraception. UPA and levonorgestrel ECPs have similar effectiveness when taken within 3 days after unprotected sexual intercourse; however, UPA has been shown to be more effective than the levonorgestrel formulation 3–5 days after unprotected sexual intercourse. The combined estrogen and progestin regimen is less effective than UPA or levonorgestrel and also is associated with more frequent occurrence of side effects (nausea and vomiting). The levonorgestrel formulation might be less effective than UPA among obese women. Two studies of UPA use found consistent decreases in pregnancy rates when administered within 120 hours of unprotected sexual intercourse. Five studies found that the levonorgestrel and combined regimens decreased risk for pregnancy through the fifth day after unprotected sexual intercourse; however, rates of pregnancy were slightly higher when ECPs were taken after 3 days. A meta-analysis of levonorgestrel ECPs found that pregnancy rates were low when administered within 4 days after unprotected sexual intercourse but increased at 4–5 days (Level of evidence: I to II-2, good to poor, direct). Advance Provision of ECPs An advance supply of ECPs may be provided so that ECPs will be available when needed and can be taken as soon as possible after unprotected sexual intercourse. Comments and Evidence Summary. A systematic review identified 17 studies that reported on safety or effectiveness of advance ECPs in adult or adolescent women. Any use of ECPs was two to seven times greater among women who received an advance supply of ECPs. However, a summary estimate (relative risk = 0.97; 95% confidence interval = 0.77–1.22) of five randomized controlled trials did not indicate a significant reduction in unintended pregnancies at 12 months with advance provision of ECPs. In the majority of studies among adults or adolescents, patterns of regular contraceptive use, pregnancy rates, and incidence of STDs did not vary between those who received advance ECPs and those who did not. Although available evidence supports the safety of advance provision of ECPs, effectiveness of advance provision of ECPs in reducing pregnancy rates at the population level has not been demonstrated (Level of evidence: I to II-3, good to poor, direct). Initiation of Regular Contraception After ECPs UPA Advise the woman to start or resume hormonal contraception no sooner than 5 days after use of UPA, and provide or prescribe the regular contraceptive method as needed. For methods requiring a visit to a health care provider, such as DMPA, implants, and IUDs, starting the method at the time of UPA use may be considered; the risk that the regular contraceptive method might decrease the effectiveness of UPA must be weighed against the risk of not starting a regular hormonal contraceptive method. The woman needs to abstain from sexual intercourse or use barrier contraception for the next 7 days after starting or resuming regular contraception or until her next menses, whichever comes first. Any non hormonal contraceptive method can be started immediately after the use of UPA. Advise the woman to have a pregnancy test if she does not have a withdrawal bleed within 3 weeks. Levonorgestrel and Combined Estrogen and Progestin ECPs Any regular contraceptive method can be started immediately after the use of levonorgestrel or combined estrogen and progestin ECPs. The woman needs to abstain from sexual intercourse or use barrier contraception for 7 days. Advise the woman to have a pregnancy test if she does not have a withdrawal bleed within 3 weeks. Comments and Evidence Summary.The resumption or initiation of regular hormonal contraception after ECP use involves consideration of the risk for pregnancy if ECPs fail and the risks for unintended pregnancy if contraception initiation is delayed until the subsequent menstrual cycle. A health care provider may provide or prescribe pills, the patch, or the ring for a woman to start no sooner than 5 days after use of UPA. For methods requiring a visit to a health care provider, such as DMPA, implants, and IUDs, starting the method at the time of UPA use may be considered; the risk that the regular contraceptive method might decrease the effectiveness of UPA must be weighed against the risk of not starting a regular hormonal contraceptive method. Data on when a woman can start regular contraception after ECPs are limited to pharmacodynamic data and expert opinion. In one pharmacodynamic study of women who were randomly assigned to either UPA or placebo groups mid-cycle followed by a 21-day course of combined hormonal contraception found no difference between UPA and placebo groups in the time for women’s ovaries to reach quiescence by ultrasound and serum estradiol; this finding suggests that UPA did not have an effect on the combined hormonal contraception. In another pharmacodynamic study with a crossover design, women were randomly assigned to one of three groups: 1) UPA followed by desogestrel for 20 days started 1 day later; 2) UPA plus placebo; or 3) placebo plus desogestrel for 20 days. Among women taking UPA followed by desogestrel, a higher incidence of ovulation in the first 5 days was found compared with UPA alone (45% versus 3%, respectively), suggesting desogestrel might decrease the effectiveness of UPA. No concern exists that administering combined estrogen and progestin or levonorgestrel formulations of ECPs concurrently with systemic hormonal contraception decreases the effectiveness of either emergency or regular contraceptive methods because these formulations do not have antiprogestin properties like UPA. If a woman is planning to initiate contraception after the next menstrual bleeding after ECP use, the cycle in which ECPs are used might be shortened, prolonged, or involve unscheduled bleeding. Prevention and Management of Nausea and Vomiting with ECP Use Nausea and Vomiting Levonorgestrel and UPA ECPs cause less nausea and vomiting than combined estrogen and progestin ECPs. Routine use of antiemetics before taking ECPs is not recommended. Pretreatment with antiemetics may be considered depending on availability and clinical judgment. Vomiting Within 3 Hours of Taking ECPs Another dose of ECP should be taken as soon as possible. Use of an antiemetic should be considered. Comments and Evidence Summary. Many women do not experience nausea or vomiting when taking ECPs, and predicting which women will experience nausea or vomiting is difficult. Although routine use of antiemetics before taking ECPs is not recommended, antiemetics are effective in some women and can be offered when appropriate. Health-care providers who are deciding whether to offer antiemetics to women taking ECPs should consider the following: 1) women taking combined estrogen and progestin ECPs are more likely to experience nausea and vomiting than those who take levonorgestrel or UPA ECPs; 2) evidence indicates that antiemetics reduce the occurrence of nausea and vomiting in women taking combined estrogen and progestin ECPs; and 3) women who take antiemetics might experience other side effects from the antiemetics. A systematic review examined incidence of nausea and vomiting with different ECP regimens and effectiveness of anti nausea drugs in reducing nausea and vomiting with ECP use. The levonorgestrel regimen was associated with significantly less nausea than a nonstandard dose of UPA (50 mg) and the standard combined estrogen and progestin regimen. Use of the split-dose levonorgestrel showed no differences in nausea and vomiting compared with the single-dose levonorgestrel (Level of evidence: I, good-fair, indirect). Two trials of anti nausea drugs, meclizine and metoclopramide, taken before combined estrogen and progestin ECPs, reduced the severity of nausea. Significantly less vomiting occurred with meclizine but not metoclopramide (Level of evidence: I, good-fair, direct). No direct evidence was found regarding the effects of vomiting after taking ECPs.

CHLAMYDIA TESTIMONIALS Reading all of these stories, makes me want to share mine. I was dealing with a guy for ten years, never contracted a STD from that relationship. I decided to try and end that relationship to begin another one. This new guy and I never had intercourse but engaged in oral sex. He told me that his ex-gf contracted chlamydia and told me to get tested. I did. Results came back, I got chlamydia and gonorrhea. My ten years partner was negative and showed me his results. New dude claimed he got results but refused to show me his results. Just by receiving oral sex look what happened to me. They say STDs can be contracted only by anal and vaginal, but in my case oral too. Be Careful ladies. Have the man get tested before dealing with them. Female patient, 25 Name, Title Previous Next 20 to 29

How To Choose A Lube The Big Lube Guide For many people with a vagina, irregardless of arousal, they need lube – whether it’s just how their body is, or it’s a side effect of a medication they’re on, or it’s part of their health issues OR the sex toy they’re using is particularly textured. It’s normal to use lube! But not all lube is created equal. In fact, I’m sorry to tell you that most readily-available commercial lubes SUCK. Plus, the best lube for sex (vaginal) may not be the best lube for anal sex and may not be the best lube for masturbation. Chances are pretty good that if you’re using a quality sex toy made from body-safe materials and you are experiencing irritation and burning anyways, the irritation and burning is coming from your lube. Whether it’s bad for you, bad all around, or it went bad. Yes, lube does expire! And most of us aren’t about to make yam lube, either, so I’ve gotta help you find the best commercial lubes out there that won’t poison your genitals. Explain it Like I’m 5 – What’s Osmolality? LUBE-OSMO-QUICK We’ve got three situations – the best is if the lube is iso-osmotic – meaning your cells and the lube sit there next to each other, happy, making each other better. They’re content. If the osmolality is low, i.e. hypo-osmotic, then the lube is like my Italian best friend’s mom – eat, eat! It’s feeding the cells too much water, and at some point they will burst. When does this matter the most? If you’re trying to conceive. Hypo-osmotic lubes would kill the lil swimmers. The most common situation is when the osmolality is high, i.e. hyper-osmotic. It’s the vampire situation – the lube comes in all charming at first and things seem okay. The lube feels really slippery, which is great! But it’s slippery because it’s drinking the moisture from your cells. When they have no more to give, they are dead and dry. The outer layer of cells will slough off and leave your mucus lining very vulnerable, like standing in a snowstorm without winter gear. STI transmission can increase and at-risk people are at greater risk for infections – this is the same group of people who need to use more lube than the average person. Diabetics, those with a compromised immune system, those undergoing treatment for cancer, etc. If your partner has Herpes, you’re doing everything you can to avoid transmission – consider the lube, as well. Stick to iso-osmotic lubes. Molality is defined as the amount of substance (measured in mol) of solute, divided by the mass (in kg) of solvent, (not the mass of the solution). In other words, it’s the measurement of the mass of the stuff that’s dissolved in a liquid. Osmolality is a variation of molality that only takes into account solutes that contribute to a solution’s osmotic pressure, and Osmotic Pressure in this instance is the measure of the tendency of a solution to take in water by osmosis. Unfortunately we’re largely left to guess when it comes to osmolality because only a small handful of lubes have been tested. In addition to those listed in this chart I found a few extra listed here (including Probe brand which seems to be pretty close to iso-osmotic) and I also contacted the makers of System Jo lube who say that the Agape version is at 350 and the new version of H2O (which will be released in October) will have an osmolality of 200 (current is 800). We can make educated guesses on the osmolality by knowing a few things: that certain ingredients cause the osmolality to increase. So by avoiding those ingredients we can have a better shot at a lube that plays nice with our body. Of course, you can also avoid this by using coconut oil or silicone-based lubes. We don’t know how osmolality affects hybrid lubes (which are water-based with a little silicone added) because no one has ever tested them. Do they suddenly get to skip the rulebook because of the small amount of silicone? Maybe? But to stay safe, pick hybrids with very few ingredients. LUBE-Osmolality Second you need to consider pH. pH results are easy to come by – you can buy pH test strips yourself and test out your lube (or your mucus) at home if it’s not on this list below. The pH of the vagina can range from 3.5 – 7 depending on where you are in your cycle, if you have an infection, if you’re pre/post menopausal, etc. Post-menopausal women tend to have a higher pH. Higher pH is also associated with bacterial vaginosis but it can also be the normal course of cycle for you. Anal lubes need a higher pH so a lube that is good for your lower-pH vagina could really sting when used for buttsex. Let’s go back to the vagina though for a minute. If you’re trying to conceive, you need a slightly higher pH as well to be friendly to sperm. Lubes with a low pH can sting and burn. Lubes with a higher pH than the vagina can bring on yeast infections and bacterial vaginosis OR just feel itchy (butt or vag) without the infection. Notice how Replens, once again, seems to be unfriendly to the very group it is targeted at? That’s considerably lower than it should be. The pH numbers below are less disconcerting, overall, versus the osmolality ratings but you should still refer to this chart. In addition to the glory of Sliquid there are other stand-out brands, but we have lubes that ranked super high in osmolality ranking right on target in pH. But that doesn’t make them okay because the next factor is…. LUBE-pH INGREDIENTS! READ YOUR LABELS! Sometimes there are so many scientific words in the ingredients list that we don’t even know what they are. Are they safe? Will they burn, are they a known irritant? There are a lot of problematic ingredients and this goes way beyond parabens. In fact, it’s been suggested that parabens might not be the Big Bad Monster – studies about the effects of parabens have been done by feeding mass doses of it to mice…naturally, they’re going to experience bad side effects! You may never use enough lube to rack up enough parabens to cause cancer but some people are allergic to parabens. Of course, paraben is also a xenoestrogen, but a weak one. Xenoestrogens can have a feminizing effect on masculine bodies and masculinizing effects on feminine bodies. The other top two ingredients to avoid are glycerin(e) and propylene glycol. Both of these greatly increase the osmolality of the lube (making it a lube to avoid) and both can cause sensitivities (and for some, yeast infections). Other lube ingredients are listed below and any of them can cause irritation in addition to: increased STI transmission; killing off of the good bacteria; increase of bad bacteria; allergic reactions. AVOID: Glycerin(e), Propylene Glycol, Nonoxynol 9, Chlorhexedine Gluconate, Petroleum Oils, Polyquaternium-15, Benzocaine, Sugars & Sugar Alcohols, Ureas Why you should avoid Benzocaine. It numbs you, which is not really a good thing. I am unsure if the numbing creams for premature ejaculation will transfer the numbing agent to the vagina, but benzocaine is an irritant. Benzocaine used for those experiencing painful sex or those wanting to make anal play less scary is just a bad idea because pain is your body’s way of saying HEY STOP. You can end up with injuries, microtears to the delicate tissue, and major problems. A note for Celiacs or those with extreme gluten-sensitivity: Avoid “Oat Beta Glucan” which is found in Sutil. I contacted the company about that ingredient (because not all oat is contaminated with gluten, but some super sensitive people react to oats no matter what) and they have confirmed that there is gluten present in that lube. When I was trying it out I also licked it and it made me ill for a day, so it’s enough gluten that if gluten makes you sick even in tiny quantities, avoid this lube. Avoid Vitamin E (tocopherals) unless the company can assure you they are not derived from a gluten-containing grain. These can also be derived from soy, for those with soy allergies. Sliquid’s Organics line uses Vitamin E and this is what they have to say about it: Our Natural Tocopherols are extracted from wheat germ, sunflower, and safflower oils. One thing to keep in mind (and you can find this info on http://glutenfreedietitian.com and other sites) is that refined oils are exempt from allergen labeling by the Food Allergen Labeling and Consumer Protection Act, and the European Food Safety Authority, because the refining process renders them virtually free (undetectable) of allergenic proteins. Consuming refined wheat germ oil is still not recommended for anyone with a gluten allergy, however, there is still another refining step where the Vitamin E (tocopherol) is extracted from the refined oil. Add to that, the amount of Natural Tocopherols in any one bottle of Sliquid Organics is less than 5%. For a highly sensitive person, or someone who just wants to be extra careful, we would suggest the Naturals line from Sliquid. In fact, for anyone with any food allergy, we recommend Sliquid Naturals, just to be safe. Note: if your lube is paraben-free it can go bad much more quickly. There are preservatives that are natural but they don’t seem to do quite as good a job as paraben preservatives. Keep an eye on the color of your lube and the odor. If it’s off, toss it. Try to avoid pump bottles (air = bacteria) or sticking your finger in the lube bottle. RESEARCH YOUR INGREDIENTS: Lately I’ve been looking into various lubes when someone has mentioned that they caused burning/irritation, and I’m finding even more weird and suspect ingredients. I usually just Google the individual ingredients and read over the first few results. Some sites will make something sound worse than it is, some will whitewash it. Some will confuse you. I mean why would you put an abrasive agent that’s normally found in toothpaste, in a lube? But there it was, in a System Jo arousal gel (and shamefully, System Jo doesn’t publish ingredients so thank goodness for reviews). UNDERSTAND SENSITIZERS: If in your research you find that an ingredient is referred to as a “sensitizer” it means that the likelihood a person will react to these ingredients depends on how much they’ve used them – sensitivity it cumulative and increases with use. This means you can find yourself not reacting at first, but reacting after your 2nd or 3rd bottle or even 4th or 5th use of the first bottle. UREAS are one example of sensitizers, and you’ll find these in a lot of cosmetic ingredients (so they’re a common irritant to sensitive-skinned people). LUBE-Irritants What about the FDA? What about lubes that make medical claims? A bunch of experts were polled on their thoughts about the FDA and lube. Most said “oh, absolutely, we welcome the FDA, the FDA knows best!”. But as Sarah Mueller pointed out – the FDA doesn’t always know best. They approved Nonoxynol 9, after all, and it’s been shown to INCREASE STI transmission! The FDA testing process doesn’t actually test how a lube will affect human genitals! They test it on rabbits – their eyeballs and vaginas. In fact it really does seem like the FDA cares about two things: that you pay your fee (which can range from $20,000 to $300,000) and that you either do animal testing or go to much length to prove you do NOT need animal testing. So what if you wanted only lubes that are FDA-approved? Well let’s consider that the awful KY Yours-And-Mine duo (hideous ingredients) is FDA approved. Surgilube is FDA-approved. Another troubling fact: If your lube is FDA-approved then you DO NOT have to list your ingredients. Anywhere. This spells trouble for those that are high risk or have allergies. Just consider Surgilube – they say it’s proprietary so they won’t tell you even if you ask because of allergies. Just because it’s FDA-approved doesn’t mean it’ll be iso-osmotic, a good pH or free from common irritants. The FDA-approval process for lubes needs a major overhaul before I think it’s something Good For The Public. STI Prevention Claims Something I’m seeing a sharp increase in is lubes containing carrageenan, and the lube companies making claims about STI prevention. There have been some studies on this and they’ve had positive results, but a lot more research needs to be done. I would, for now, be wary of these claims. Just because a lube with this ingredient, for this claim, is FDA-approved does not mean it can prevent the spread of an STI. They’re not stamping a seal of approval or efficacy. One such FDA-approved lube is called Divine 9 / Carraguard, from Carrashield Laboratories. They make some grand, yet vague, claims on their website that might lead you to believe that they’ve proven that their lube can prevent the spread of certain STIs but you have to really hunt and read for the truth: The excellent results in the NCI laboratory studies have led to the launch of three large scale human clinical trials using Divine 9. These are the only three human clinical trials in the world on HPV prevention using a topical gel and Divine 9 is featured in all three. While no conclusive evidence exists yet that Divine 9 with CarraShield will block HPV in humans, the results of the NCI tests were compelling enough to justify multi-million dollar investments in these three Phase 2 human trials. CarraShield Labs will provide updates as the data collection continues. At this time CarraShield Labs makes no medical claims about Divine 9 and provides this information strictly for educational purposes. So they’ve gotten it classified as a medical device and gone for FDA-approval to give the idea of something grand and medicinal, but the tests aren’t conclusive and there haven’t been enough tests, or tests on humans. The human tests aren’t concluded, I believe. Basically, anytime you see a lube making any claim that it can help prevent the spread of any STI, don’t believe them. The large-scale clinical trials and conclusive results are not here yet. When they happen it will be major news. LUBE RECOMMENDATIONS: First I want to say that osmolality and pH and ingredients don’t play a role in pure plant oils like coconut oil, or silicone lubes. We don’t know what role they play in hybrid lubes (which can be really awesome – there’s not really enough silicone in a hybrid lube to fuck up most silicone sex toys, but it’s enough to give that slippery, long-lasting appeal). Check the ingredients on the hybrids and avoid the bad stuff if you’re sensitive. Unfortunately, even some of these good lubes can irritate very sensitive people sometimes. While the amount of citric acid in lubes like Sliquid is small, sometimes it’s enough to irritate someone. I understand that most people don’t want to buy their lubes online but unless your local drugstore carries Good Clean Love (some do) or Sliquid (rare) the brands I’d recommend are going to be found online. This isn’t the most accessible, I know, but for many people it’s necessary. If you care about what’s going in your body and strive for non-porous body-safe sex toys, consider overhauling your lube kit, too. I would recommend the following lubes based on ingredients, pH and known/assumed osmolality: Water-based Lubes: All Sliquid brand (and their Organics line) are good on the osmolality, pH and ingredients lines. Organics line can have aloe which can present issues for some and all Sliquid has a small amount of citric acid as a preservative. Only the most sensitive would be bothered by it. Try: • Sassy for a thicker anal lube and H20 for a thinner lube – Both of these are free of aloe • Sea also has aloe; it contains carrageenan which MAY help prevent the spread of HPV, plus other oceanics-ingredients to help with inflammation and dryness • Sliquid Pack to try out various types • While I prefer that you shop for lube at sex toy stores, Amazon does carry Sliquid if you just need to purchase lube and not sex toys. • Lovehoney US and Lovehoney UK carry some Sliquid lubes, but not all. • Smitten Kitten carries a few of the Sliquid Organics lubes • The Organics Line has some organic ingredients and all of them contain Vitamin E and Aloe, amongst other natural stuffs. Good Clean Love 2 is a good brand, also, for pH and ingredients. Definitely check out the Almost Naked variety. I’ve got a review here! Love the stuff! • SheVibe seems to carry the whole line • Smitten Kitten carries two GCL products • Amazon also carries Good Clean Love Smitten Kitten, a progressive queer-and-female-friendly shop based in Minnesota, carries brands that many other sex toy stores don’t. • Hathor Aphrodesia – they have Sutil which sells like hotcakes; it is much longer-lasting than most water-based lubes on the market. The regular H.A. has some interesting ingredients like Horny Goat Weed which can contribute to bad taste. Note: Sutil contains Oat Beta Glucan, which is a gluten ingredient. Company has confirmed there is gluten in the lube. • WaterSlide which could be really great for those sensitive to most ingredients – it’s a thin, slippery lube with nearly no taste. • Aloe Cadabra which rates well on taste, too. • Southern Butter’s Bliss On is rated well by SK. There is some alcohol in it, but so far no one has reported irritation. • Smitten Kitten’s curated sample packs. Each pack contains 5-6 lube samples from different brands, all of them true, body-safe lubes. They’ll also send you their Lube Info pamphlet. SheVibe carries: • Probe is good on both osmolality and pH and is formulated to feel more like natural vaginal lubrication • Coconu has a water-based lube that looks good • Blossom Organics looks decent, but contains Vitamin E and I can’t get an answer on the source so those with soy allergies and gluten limitations should steer clear Goodvibes has their own Please brand. The Liquid and Gel are the water-based. I found another option through Amazon. Astroglide makes a Naturals lube that is shockingly free of any crap ingredients. I don’t know where it falls on the osmolality scale; sensitive folks should pay attention to the ingredients for anything they might find irritating. YES brand is under FDA scrutiny and a sort of “lockdown” for import into the US while they wait on becoming FDA-certified. But I’d heard so much good stuff about this brand that I had to locate it. You can find it on Amazon and according to YES, it should be genuine YES brand lube. How they’re doing it, I don’t know; the seller must be partnered with a European seller. You can find YES brand at Lovehoney US and Lovehoney UK, because all Lovehoney US orders come from the UK. Hybrid Lubes These are awesome because they combine the toy-safety of water-based with just a littttttle silicone (how much varies between brands). Now since silicone doesn’t affect osmolality or pH, and there haven’t been studies on hybrids, we don’t know how hybrids fare on osmolality or pH. So for that reason I still say to avoid osmolality-raising ingredients and irritants. I used to enjoy Wet’s Syngery lube but it has ingredients I can’t recommend. Spunk lube seems to have some popularity but it contains every ingredient I tell you to avoid! Plus there are multiple silicones in it and they’re high up on the list, which means it may not play as nice with silicone toys. These three are the only ones I can find that meet my requirements for safe ingredients. • Sliquid Silk – Found at: SheVibe, Early to Bed, Tantus, and Amazon • Sliquid Organics Silk – Found at: SheVibe, Early to Bed, and Amazon • GoodVibes Please Cream comes highly recommended. It does contain some alcohol in the middle of the ingredients list, and citric acid at the end, so there’s a chance for irritation. Plant-Based Oil Lubes Naturally there’s good ole plain coconut oil – please be sure you get the right kind though! It has to be unrefined, virgin coconut oil – don’t get the liquid/fractionated. Read this guide for all the ins and outs of using coconut oil. I feel that pure coconut oil is perhaps the best starting point for vaginas stretching out into the plant-based oil lube world, as we know that coconut oil is low-comedogenic and anti-microbial (can help with infections). There’s also Sliquid’s oil blend to consider or YES brand oil blend available at Amazon or Lovehoney US / UK. Also look at The Butters, soon to be in a retail store near you, I hope. I don’t recommend Coconu because of their sham marketing which says that silcone is practically toxic. They also hide the fact that their lube will destroy many sex toys materials and get you quickly on the road to this mess. Please note that oil lubes are not good with most condoms/protection – only nitrile and polyurethane condoms. Also to note that oil lubes should never be used on porous material sex toys like most male masturbators, TPR, PVC, etc. It’s safe with pure silicone, metal, some wood, glass, hard plastic and ceramic. LUBES AND CONDOMS I’m working on having this section fleshed out a little better. It seems that most condoms are using a silicone-based lube. What if you don’t want that? What if you can’t tell what type of lube they are using? My best bet right now is to tell you to find non lubricated condoms and pair them with your own lube that you know isn’t irritating to you. SheVibe carries Atlas brand; Smitten Kitten carries Trojan Enz. Even though I go over this elsewhere, I’ll say it here: If you choose to use plant-oil based lubes (coconut oil, etc) then you must use polyurethane condoms. You can also use the nitrile-based FC2. FLAVORED LUBES Flavored lubes (or conversely, totally taste-neutral lubes) that are completely safe, pH good, osmolality good, etc etc are going to be hard to come by. I hear mixed things on the Sliquid Swirls to be honest. It seems to be very much YMMV because what one person thinks is as tasty as a Jolly Rancher, the next is ready to puke. This is a section I will be working on, both sides of the coin. FISTING POWDERS J Lube and X Lube are just a few fisting powders I’ve heard about. Basically it’s a powder, you add water and mix it up. The result is a thick gel which is economical and plentiful. J Lube was made for birthing livestock; it contains a lot of sugar and is not safe for vaginas. X Lube claims not to use sugars, but I’m not really sure about their ingredient which is listed as PEO. Wikipedia says PEO and PEG are the same thing – polyethylene glycol….a petrochemical we’re to avoid. I’m waiting on more information before passing a judgment. Vaginal Tightening/Shrink Creams and Gels I’m putting this here because I haven’t yet done a whole entire post on it. These aren’t a lube, but they’re often sold with lubes. These can be dangerous, or just won’t work. They often work by doing one of two things (or both): Drying you out on purpose or creating a mild allergic reaction. Inflammation = feeling “tighter”. Yet as you can imagine, this does a real number to your mucous lining and overall vaginal health. It increases your risk for infections and the spread of STI. It increases your risk for microtears of the vaginal wall, even. In short, it’s never a good thing. A dry vagina is not a good thing. If you want to improve vaginal health overall, buy some kegel beads. I’ve also seen herbal “teabag” like things you shove up in the vagina like a tampon and frankly, anything like that…even if it’s natural…can have adverse affects you’re not expecting. It can throw off your pH, lead to infection, you can have an allergic reaction, etc. Herbal doesn’t mean safe (unless it’s the FORIA THC “tampons” for menstrual cramps – that one is legit). FINAL TIPS If you see a gynecologist, try taking along your own lube because chances are pretty good that they’re using either KY or Surgilube, both of which are vagina poison. The doctors aren’t trained to know this stuff. If you have ever experienced dryness, irritation during sex, etc after a check-up then this is why. And when you do bring your own lube tell them why! Point them to badvibes.org to educate them on the dangers of the crappy lubes they’re using. Tips to soothe the burn of an irritating lube or a lube that is incompatible with your pH: I finally sleuthed out some tips and present them here. Irritation with some chemicals can build over time; you can be fine for awhile with the lube you have or an ingredient in your favorite lube and then one day…you’re bothered by it. It happens. If you have a vagina, you’ve read by now that your vaginal pH can change over time, or where you are in your cycle. It can be a good idea if you’re particularly sensitive to lubes to occasionally test your own pH and the pH of your favorite lube. LUBES TO AVOID KY is a hated brand. It contains an ingredient commonly found in mouthwash. That’s right, an antiseptic. This is irritating AND not necessary! Astroglide, yikes. Polyquaternium-15 promotes viral activity and is found in four different Astroglide varieties. ID Glide has never been a favorite of mine, the ingredients are crap and the osmolality is high. Pjur makes great silicone lubes, but their water-based leaves a lot to be desired. Same with Wet brand. Don’t buy lubes (or anything else that is a topical for your genitals) that don’t publish their ingredients. In my research I’ve been looking for brands/varieties to recommend and have had to leave them off the list because I can’t find the ingredients. System Jo, Spunk lube, XR Brand’s Tom of Finland lubes or Passion lubes (basically anything by XR brands), and many more. Some reviewers published the Spunk lube ingredients but there seems to be a little variation. I can’t see why any company would avoid publishing the lube ingredients, but it raises a red flag for me. Resources and other great lube articles: * Graphics, charts, and research courtesy of BadVibes.org / The Smitten Kitten * Interview with Sarah Mueller with even more tidbits about her lube research * Lorax of Sex breaks down the types of lube * Sexational! explains osmolality * Lube osmolality study Organics Natural Ingredients Purified Water, Plant Cellulose (from Cotton), Aloe Barbadensis*, Natural Tocopherols (Vitamin E), Cyamopsis (Guar Conditioners), Extracts of Hibiscus*, Flax*, Green Tea* & Sunflower Seed*, Citric Acid (Citrus Fruits), Phenoxyethanol (Rose Ether) ↩ Ingredients: Organic Aloe Barbadensis Leaf Juice, Xanthan Gum, Agar, Potassium Sorbate, Sodium Benzoate, Citric Acid, Natural Flavors ↩ Sutil is formulated with regenerating hyaluronic acid for dry and sensitive skin, including the genital area. Hyaluronan has the ability to bind large amounts of water to provide increased lubrication, enabling optimal regeneration of the skin. ↩ Ingredients: Purified Water, Xylitol, Aloe Barbadensis Leaf Juice, Potassium ascorbyltocopheryl phosphate (Vitamins C & E), Pectin, Chamomilla Recutita (Matricaria) Flower Extract, Hydroxyethylcellulose, Phenoxyethanol. ↩

Importance of Partner Treatment If tests show that you have an STI, your sex partners — including your current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested. If they're infected, they can then be treated. Each state has different requirements, but most states require that certain STIs be reported to the local or state health department. Public health departments often employ trained disease intervention specialists who can help notify partners and refer people for treatment. Official, confidential partner notification can help limit the spread of STIs, particularly for syphilis and HIV. The practice also steers those at risk toward counseling and the right treatment. And since you can contract some STIs more than once, partner notification reduces your risk of getting reinfected. Local Clinics

I got someone pregnant-what do I do? So you got someone pregnant? Read on for what do next and how to be supportive in the event of an unplanned pregnancy Father's Rights and Responsibilities There is a lot of advice out there for girls who find themselves facing an unwanted or unexpected pregnancy but there is very little information out there for guys. It takes two to make a baby but all too often when the pregnancy is announced the guy gets lost in the confusion. Teen fatherhood is not something to be taken lightly and along with responsibilities to the mother and the child; you have rights that you need to know about. LEARN MORE How To Be Supportive Accidentally getting a girl pregnant is probably the last thing you ever expected — or wanted — at this time in your life. However, here you are, reeling from the news that the woman you have slept with is pregnant with your baby. LEARN MORE

3 Empowering Sex Tips We Should Be Giving Young Women Like many girls, I got my first sex tips from women’s magazines. I learned how to stand to appear thinner when naked. I learned which positions put my sexiest body parts on display. I learned hundreds of ways I should touch a penis, whether I liked it or not. Sex sounded grown-up and exciting, but also scary – though I couldn’t pinpoint why. I totally see why now, though. It sounded like sex would make me an object – like once I walked through the door of a man’s (it was always presumed to be a man’s) bedroom, I’d leave my humanity on the other side of it. Actually having sex as a teenager was equally confusing. I wanted to be my partners’ hot, sexy lover and their fellow human, but it always felt like I had to pick one. When I tried to be both, they’d punish me for it. In college, after enthusiastically initiating a hookup with someone I met at a frat party, and openly enjoying it, he got behind me and air-humped me in front of his friend while I was trying to talk. It felt like his way of saying, “In case you got as much out of this as me, I’m going to make sure you still don’t leave feeling equal” – as if my comfort with the situation took the fun away from him. As if he were trying to win a game aimed at convincing me to hook up, and I wasn’t even letting him play. He’d learned it, too: that women’s role in sex was to deny or “give in to” what men wanted, not want anything themselves. (And that LGBTQIA+ people don’t exist, apparently.) I didn’t just learn this from magazines. I learned it from musicians who implicitly or explicitly referred to their sexual partners as “bitches,” “hos,” and conquests. I observed it on TV shows that existed to let men ogle naked women. I learned it from men who treated rape as “locker room” behavior. Thankfully, during college and after, I absorbed other ideas about sex and women’s role in it. Here are some of the healthier messages I got – and wish we’d all get sooner. 1. Do What You Desire, Not What You’re Just Okay With Desire was strangely absent from the sex lessons I received from adults and peers alike – or at least the desires of people other than men were absent. I learned all about men’s supposed desires. I learned men’s desires were uncontrollable. That they would try to use me to satiate them. That I had the “powerful” position of deciding if their desires would be fulfilled (if they were “nice guys” who didn’t rape, that is). In addition to erasing non-binary people, this belief system renders women incapable of consent. You can’t, after all, consent to something you don’t desire. So, until I understood that my desires mattered, sex seemed, by nature, non-consensual. No wonder it scared me. Then, in my freshmen year of college, I went to a talk about sex. And unlike other sex talks I’d attended, it didn’t reduce women to victims. “Do what you desire, not what you’re just okay with,” the speaker said. Before, I thought being okay was the most I could hope for. I thought if a guy wants to do something and you’re okay with it, it was just spiteful not to let him do it. But, as this speaker recognized, that sets you up for an unequal exchange and makes consent blurry. Instead, he suggested, say no if you’re not excited about something, and you can always change your mind. I learned another version of this advice at a cuddle party years later: “If it’s not a ‘hell yes,’ it’s a ‘no.'” By affirming people’s right to say hell yes, we help them say no when there’s no hell yes in them. And by affirming their right to say no, we make room for more hell yeses to safely come out. 2. Express What You’re Thinking – And Ask Your Partner What They’re Thinking Women’s magazines offered tips for the hottest things to say in bed, but they rarely taught me to express how I actually felt. And they also didn’t teach me how to figure out how my partners felt. Any vocalizations that happened in bed were supposed to be for the sake of a performance. Communication in the bedroom should accomplish the opposite, though: expressing what you’re truly thinking. I didn’t know it was okay to say I wanted sex, or more sex, or a different kind of sex. I didn’t know it was okay to admit the current activity was doing absolutely nothing for me. I didn’t know it was okay to say if I was in pain or to say I felt pressured into something. Those things weren’t “guaranteed to turn him on,” after all. But expressing what you’re thinking is more than okay. It should be a requirement, especially if the alternative is to be uncomfortable or unsatisfied. This also means it’s important to find out what your partners are thinking, particularly when you’re not sure what they want. Discussions of sexual violence usually paint women merely as potential victims or survivors, but we are highly capable of ignoring others’ boundaries and pressuring them. Instead of teaching women to merely compliment their partners’ sexual prowess, questions like: “Do you want this? Are you good? What do you want? Do you like that?” should be part of everyone’s vocabulary. This not only makes sex better, but it’s also vital for keeping it consensual. And no, it doesn’t “kill the mood.” In what other activity is talking to your companion considered a detraction from the fun? 3. Make Sure You’re Getting as Much Out of This as Your Partner (And Vice Versa) I put that second part in parentheses because women already know this. We’re taught it’s our job to ensure our partners are getting at least as much out of the encounter as we are. In a study on college students’ attitudes toward hookups, one woman said, “I will do everything in my power to like whoever I’m with, to get [him] off.” And here’s what another woman said of receiving pleasure in hookups: “I didn’t feel comfortable, I guess. I don’t know. I think I felt kind of guilty almost, like I felt like I was kind of subjecting [guys] to something they didn’t want to do, and I felt bad about it.” It makes sense, then, that men are more likely to receive oral sex than women during college hookups, and both teen boys and girls say oral is a bigger deal when it’s performed on a woman. I always thought I understood that I deserved as much as my partners. It seems like common sense that both people should get something equal out of every exchange, right? But like the latter student, I never expected orgasms from my sexual encounters. Since I wasn’t getting them, I assumed my body was just too difficult, even though it wasn’t difficult when I was on my own. That’s what we’re taught: “Women are harder to please. Our bodies are ‘tricky.’ Men are microwaves, while women are ovens.” (Wrongfully assuming that all women are cisgender, these statements usually attribute such differences to sexual anatomy.) Then, when we don’t get much pleasure out of sex, we think, “Welp, that’s just my body being all womanly and complicated again.” No. It’s not. It could be a number of things, like anxiety getting in the way, lack of knowledge on your or your partners’ part, or a lack of effort on their part. But it’s not the inevitable result of you being a woman. We deserve to stop resigning ourselves to “meh” sex lives, and go after what we want. The idea that we shouldn’t pursue our desires sets us back in all sorts of ways outside the bedroom. It’s time we take back our right to pleasure in all areas. What all these tips basically boil down to is: “It’s totally valid to have a sexuality, express it, and expect others to care about it.” I never cease to be amazed by how confused people are when women have a sexuality. When I talk about masturbation, porn, or anything else to even suggest I’m a sexual being, one of several things happens: People assume I’m looking to be subservient to men because I’m obviously just sexual for them. They resent me for seeking my own pleasure. They assume I’m just hypersexual and “out-there.” When people react negatively to women being sexual, what they’re really doing is reacting negatively to women being human. And when we teach women not to be sexual and just be sexy, we’re denying their humanity. Of course, women – and everyone – can be sexy if they want. But they also, unconditionally, deserve the right to be sexual, whether they’re sexy or not. I hope that one day, it’ll be normal for a woman to have a sexuality – because that’ll mean people will honor her expression of it. I also hope people abandon the cliché “women want this, men want that” model of sex and honor the sexualities of people of all different genders and sexual orientations. And I hope we can move toward that by giving everyone these alternative “sex tips.” WEBSITE

Social Media Resources Most are familiar with Instagram, Snapchat, and TikTok. To some parents, the idea that these popular social media sites might actually provide helpful information to teens about sexual health and sexual empowerment might seem ridiculous. However, in the past few years teens have been taking sexual empowerment into their own hands and sharing real stories and information to educate their peers. The following are some examples of educators and activists. @sexelducation Sexologist Emily L. Depasse is on a mission to "redefine the narratives around STIs," and considering that she's already amassed nearly 30,000 followers, it seems like she's been pretty successful in using her platform to spread an important message. Her casual sex series offer templates for having tough conversations — like how to bring up your STI screening, support a partner who discloses an STI, or reveal your herpes status to your sexual partners — all of which are aimed at de-stigmatizing sexually-transmitted infections . Whether you want to learn more about protecting yourself from STIs , or you have one and could use some positive affirmations, @sexELDucation is definitely worth a follow. Mission @drlauramcguire Dr. Laura McGuire is not only a sexuality educator, trauma-informed specialist, and inclusion consultant, but she's also the founder of the National Center for Equity & Agency , a #MeToo-era consulting firm that specializes in sexual misconduct prevention. Basically, Dr. McGuire is dedicated to creating a culture of consent by schooling you on what it means and how to provide it. Moreover, they shed a spotlight on what it means to heal from sexual trauma. The best part? They're not afraid to tackle the tough subjects, like victim-blaming and healing from trauma — or tackle complicated questions, like, "How do I give consent to a long-term partner I've already been intimate with many times before?" @evyan.whitney You might have heard about birthing doulas, but what's a sexuality doula? Well, according to Ev'Yan Whitney , who coined the term, it's someone who "educates, facilitates, supports, and holds space for women and femme-identifying folks who are ready to step out of shame, confusion, and fear within their sexuality and into erotic empowerment—whatever that looks like for them." In addition to providing how-to posts (like asking for what you want sexually), Whitney also offers glimpses into her own personal journey of healing. They also created the #sensualselfiechallenge , a five-day radical self-love program that's aimed at encouraging you to celebrate your sexuality and your body in bold ways (no nudes required). @allbodieshealth Looking for some sexual health realness? Then make sure Allbodies is on your feed — it's an online platform for reproductive and sexual health, and it's brimming with super useful info, all of which has been reviewed by experts. Here, you'll find announcements about their latest digital health classes (which range from communication pleasure with partners to fertility preservation and dating after trauma . But you'll also get answers to questions you never dared to ask, like why you may be experiencing excessive vaginal sweating , or what the risks of oral sex are when one partner has herpes . @sexedsteph Given that @sexedsteph is a certified sex educator, reproductive justice advocate, and sex researcher, you can definitely expect a wide range of facts on her account — from the wonders of lube and emergency contraception to how antibiotics may affect your birth control. @KillerAndASweetThang If you don't already follow @killerandasweetthang , run — don't walk — to add this digital sex/mental health resource to your feed. Eileen Kelly — the gal behind this uber-popular IG — has been called Gen Z's Dr. Ruth , and that just about says it all. Between the hilarious sex-themed memes, stunning depictions of sensuality, and educational pointers (hello, Anal 101), this is one account that's bound to boost your intimacy IQ while also keeping you endlessly entertained. @shanboody The fact that @shanboody has collected 367K followers at this point speaks to just how valuable, relatable, and entertaining her content is. Shan Boodrram is a certified intimacy educator, which means she teaches people to be more competent and confident in the bedroom for a living. And from #couplesquarantine intimacy tips to facts about erectile dysfunction and the anatomy of the vulva, truly no topic is off-limits for her. @drshemeka Since Dr. Shemeka Thorpe is a sexuality educator & researcher whose account fuses sex ed with self-care. In other words, she doesn't just want you to know more about sex — she also wants you to have more satisfying experiences. So, you may quickly notice that all of her posts, no matter what the subject of the content, center around eliminating shame from your sex life. PS: Dr. Thorpe happens to be the co-founder of @theminoritysexreport , a space for people of color to have conversations around sexuality, which is def also worth a follow. @givingthetalk This Instagram account bills itself as "sex ed for this century" and that description honestly couldn't be more accurate. Not only is all the content on @givingthetalk medically accurate, sensitive, and incredibly insightful, but it's also inclusive of all genders, races, and identities. Gotta love the "Real Talk" posts, which cover such conundrums as what to ask yourself before establishing consent with a partner, ways to give and ask for consent, and how to revoke consent. @ericasmith.sex.ed Sex educator Erica Smith is on a quest to break down purity culture and encourage a more sex-positive societal mindset. Better yet, she continually shares statistics and other straight-up facts to support that goal. If you find yourself frustrated with how sex is portrayed in the media or advertising, or you're just trying to foster a healthier sexual relationship with yourself, this account is surely worth a follow. @sexedwithsarah Sarah Cyr-Mutty, M.Ed, is a freelance sex educator, reproductive justice activist, and a lot of her content on @sexedwithsarah revolves around the nitty-gritty of consent, as well as gender identity, and sexual orientation. In addition to empowering quotes (like, "no is a complete sentence!") and advice (like ways to end a sexual experience without having to fake an orgasm), her account is loaded with practical reminders — like the little gem above.

4389cbc0-adea-42ad-b09b-88e5714a23ec < Back Ending A Pregnancy There are two ways of ending a pregnancy: in-clinic abortion and the abortion pill. Both are safe and very common. If you’re pregnant and thinking about abortion, you may have lots of questions. We’re here to help. Is abortion the right option for me? Abortion is very common, and people have abortions for many different reasons. Only you know what’s best for you, but good information and support can really help you make the decision that is best for your own health and well-being. Why do people decide to have an abortion? If you’re thinking about having an abortion, you’re so not alone. Millions of people face unplanned pregnancies every year, and about 4 out of 10 of them decide to get an abortion. Some people with planned pregnancies also get abortions because of health or safety reasons. Overall, 1 in 4 women in the U.S. will have an abortion by the time they’re 45 years old. Sometimes, the decision is simple. Other times, it’s complicated. But either way, the decision to have an abortion is personal, and you’re the only one who can make it. Everyone has their own unique and valid reasons for having an abortion. Some of the many different reasons people decide to end a pregnancy include: They want to be the best parent possible to the kids they already have. They’re not ready to be a parent yet. It’s not a good time in their life to have a baby. They want to finish school, focus on work, or achieve other goals before having a baby. They’re not in a relationship with someone they want to have a baby with. They’re in an abusive relationship or were sexually assaulted. The pregnancy is dangerous or bad for their health. The fetus won’t survive the pregnancy or will suffer after birth. They just don’t want to be a parent. Deciding to have an abortion doesn’t mean you don’t want or love children. In fact, 6 out of 10 people who get abortions already have kids — and many of them decide to end their pregnancies so they can focus on the children they already have. And people who aren’t already parents when they get an abortion often go on to have a baby later, when they feel they are in a better position to be a good parent. The bottom line is, deciding if and when to have a baby is very personal, and only you know what’s best for you and your family. What can I think about to help me decide? Family, relationships, school, work, life goals, health, safety, and personal beliefs — people think carefully about these things before having an abortion. But you’re the only person walking in your shoes, and the only person who can decide whether to have an abortion. The decision is 100% yours. Here are some things to consider if you are thinking about an abortion: Am I ready to be a parent? Would I consider adoption? What would it mean for my future if I had a child now? What would it mean for my family if I had a child now? How would being a parent affect my career goals? Do I have strong personal or religious beliefs about abortion? Is anyone pressuring me to have or not have an abortion? Would having a baby change my life in a way I do or don’t want? Would having an abortion change my life in a way I do or don’t want? What kind of support would I need and get if I decided to get an abortion? What kind of support would I need and get if I decided to have a baby? Decisions about your pregnancy are deeply personal. You hold the power to make decisions that are best for you in order to stay on your own path to a healthy and meaningful life. There are lots of things to consider, and it’s totally normal to have many different feelings and thoughts when making this decision. That’s why it’s important to get factual, non-judgmental information about abortion. Support from family, friends, partners, and other people you trust can also be helpful. But at the end of the day, only you know what’s right for you. Who can I talk with about getting an abortion? Lots of people lean on others to help them with their decision. It’s good to choose people who you know are understanding and supportive of you. Your local health center has caring professionals that can answer any questions you may have. They'll give you expert care, accurate information about all your options, and non-judgmental support along the way — no matter what you decide about your pregnancy. Other family planning centers and private doctors may also talk with you about your decision. But be careful when looking for a reliable health center, because there are fake clinics out there that claim to offer information about pregnancy options and abortion. They’re called Crisis Pregnancy Centers, and they’re run by people who don’t believe in giving you honest facts about abortion, pregnancy, and birth control. Crisis pregnancy centers are often located very close to Planned Parenthood health centers or other real medical centers, and have similar names — they do this to confuse people and trick them into visiting them instead. No one should pressure you into making any decision about your pregnancy, no matter what. So it’s important to get the info and support you need from people who give you the real facts and won’t judge you. If you’re having a hard time finding someone in your life to talk with, check out All-Options. All-Options has a free hotline that gives you a confidential space to talk about making decisions about a pregnancy. They’ll give you judgment-free support at any point in your pregnancy experience, no matter what you decide to do or how you feel about it. When do I have to make a decision? It’s important to take the time you need to make the best decision for you. It’s also a good idea to talk to a nurse or doctor as soon as you can so you can get the best medical care possible. The staff at your local Planned Parenthood health center is always here to provide expert medical care and support, no matter what decision you make. Previous Next

e60af237-32f8-4921-be14-d5d3b7aed5bf < Back Planned Parenthood There are two ways of ending a pregnancy: in-clinic abortion and the abortion pill. Both are safe and very common. If you’re pregnant and thinking about abortion, you may have lots of questions. We’re here to help. Previous Next

What Is Sexual Orientation? It’s not completely known what causes someone to be lesbian, gay, straight, or bisexual, but your sexual orientation probably started at a very young age. This doesn’t mean that you had sexual feelings, just that you had feelings about who you were attracted to. As you get older these feelings get stronger and shape your sexual identity. Sometimes sexual orientation changes over time. And sometimes it stays the same throughout your life. But sexual orientation isn’t a choice, and can’t be changed by therapy, treatment, or pressure from family or friends. You also can’t “turn” a person gay. For example, a girl who plays with toys traditionally made for boys isn’t going to become a lesbian because of that. Sexual orientation can feel incredibly simple — you’re a girl who’s always liked both guys and girls and you identify as bisexual — or it can feel way more complex. It may take several years to understand your sexual orientation or come out. Some people call themselves questioning, which means they aren’t sure about their sexual orientation or gender identity. This is common — especially for teens.

Human Papillomavirus (HPV) Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Some health effects caused by HPV can be prevented by the HPV vaccines. What is HPV? Should I get the HPV vaccine? HPV is the most common sexually transmitted infection (STI). HPV is a different virus than HIV and HSV (herpes). 79 million Americans, most in their late teens and early 20s, are infected with HPV. There are many different types of HPV. Some types can cause health problems including genital warts and cancers. But there are vaccines that can stop these health problems from happening. How is HPV spread? You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms. Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected. This makes it hard to know when you first became infected. Does HPV cause health problems? In most cases, HPV goes away on its own and does not cause any health problems. But when HPV does not go away, it can cause health problems like genital warts and cancer. Genital warts usually appear as a small bump or group of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. A healthcare provider can usually diagnose warts by looking at the genital area. Does HPV cause cancer? HPV can cause cervical and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils (called oropharyngeal cancer). Cancer often takes years, even decades, to develop after a person gets HPV. The types of HPV that can cause genital warts are not the same as the types of HPV that can cause cancers. There is no way to know which people who have HPV will develop cancer or other health problems. People with weak immune systems (including those with HIV/AIDS) may be less able to fight off HPV. They may also be more likely to develop health problems from HPV. How can I avoid HPV and the health problems it can cause? You can do several things to lower your chances of getting HPV. Get vaccinated. The HPV vaccine is safe and effective. It can protect against diseases (including cancers) caused by HPV when given in the recommended age groups. (See “Who should get vaccinated?” below) CDC recommends HPV vaccination at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. For more information on the recommendations, please see: https://www.cdc.gov/vaccines/vpd/hpv/public/index.html Get screened for cervical cancer. Routine screening for women aged 21 to 65 years old can prevent cervical cancer. If you are sexually active: Use latex condoms the right way every time you have sex. This can lower your chances of getting HPV. But HPV can infect areas not covered by a condom – so condoms may not fully protect against getting HPV; Be in a mutually monogamous relationship – or have sex only with someone who only has sex with you. Who should get vaccinated? HPV vaccination is recommended at age 11 or 12 years (or can start at age 9 years) and for everyone through age 26 years, if not vaccinated already. Vaccination is not recommended for everyone older than age 26 years. However, some adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their healthcare provider about their risk for new HPV infections and the possible benefits of vaccination. HPV vaccination in this age range provides less benefit. Most sexually active adults have already been exposed to HPV, although not necessarily all of the HPV types targeted by vaccination. At any age, having a new sex partner is a risk factor for getting a new HPV infection. People who are already in a long-term, mutually monogamous relationship are not likely to get a new HPV infection. How do I know if I have HPV? There is no test to find out a person’s “HPV status.” Also, there is no approved HPV test to find HPV in the mouth or throat. There are HPV tests that can be used to screen for cervical cancer. These tests are only recommended for screening in women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30 years. Most people with HPV do not know they are infected and never develop symptoms or health problems from it. Some people find out they have HPV when they get genital warts. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers. How common is HPV and the health problems caused by HPV? HPV (the virus): About 79 million Americans are currently infected with HPV. About 14 million people become newly infected each year. HPV is so common that almost every person who is sexually-active will get HPV at some time in their life if they don’t get the HPV vaccine. Health problems related to HPV include genital warts and cervical cancer. Genital warts: Before HPV vaccines were introduced, roughly 340,000 to 360,000 women and men were affected by genital warts caused by HPV every year.* Also, about one in 100 sexually active adults in the U.S. has genital warts at any given time. Cervical cancer: Every year, nearly 12,000 women living in the U.S. will be diagnosed with cervical cancer, and more than 4,000 women die from cervical cancer—even with screening and treatment. There are other conditions and cancers caused by HPV that occur in people living in the United States. Every year, approximately 19,400 women and 12,100 men are affected by cancers caused by HPV. *These figures only look at the number of people who sought care for genital warts. This could be an underestimate of the actual number of people who get genital warts. I’m pregnant. Will having HPV affect my pregnancy? If you are pregnant and have HPV, you can get genital warts or develop abnormal cell changes on your cervix. Abnormal cell changes can be found with routine cervical cancer screening. You should get routine cervical cancer screening even when you are pregnant. Can I be treated for HPV or health problems caused by HPV? There is no treatment for the virus itself. However, there are treatments for the health problems that HPV can cause: Genital warts can be treated by your healthcare provider or with prescription medication. If left untreated, genital warts may go away, stay the same, or grow in size or number. Cervical precancer can be treated. Women who get routine Pap tests and follow up as needed can identify problems before cancer develops. Prevention is always better than treatment. < Previous Next >

31cbe5db-89f4-4152-9d76-287f9c86c8a7 < Back Emergency Contraception Emergency contraception consists of methods that can be used by women after sexual intercourse to prevent pregnancy. Emergency contraception methods have varying ranges of effectiveness depending on the method and timing of administration. Types of Emergency Contraception Intrauterine Device Cu-IUD ECPs UPA in a single dose (30 mg) Levonorgestrel in a single dose (1.5 mg) or as a split dose (1 dose of 0.75 mg of levonorgestrel followed by a second dose of 0.75 mg of levonorgestrel 12 hours later) Combined estrogen and progestin in 2 doses (Yuzpe regimen: 1 dose of 100 µg of ethinyl estradiol plus 0.50 mg of levonorgestrel followed by a second dose of 100 µg of ethinyl estradiol plus 0.50 mg of levonorgestrel 12 hours later) Initiation of Emergency Contraception Timing Cu-IUD The Cu-IUD can be inserted within 5 days of the first act of unprotected sexual intercourse as an emergency contraceptive. In addition, when the day of ovulation can be estimated, the Cu-IUD can be inserted beyond 5 days after sexual intercourse, as long as insertion does not occur >5 days after ovulation. ECPs ECPs should be taken as soon as possible within 5 days of unprotected sexual intercourse. Comments and Evidence Summary. Cu-IUDs are highly effective as emergency contraception (283) and can be continued as regular contraception. UPA and levonorgestrel ECPs have similar effectiveness when taken within 3 days after unprotected sexual intercourse; however, UPA has been shown to be more effective than the levonorgestrel formulation 3–5 days after unprotected sexual intercourse. The combined estrogen and progestin regimen is less effective than UPA or levonorgestrel and also is associated with more frequent occurrence of side effects (nausea and vomiting). The levonorgestrel formulation might be less effective than UPA among obese women. Two studies of UPA use found consistent decreases in pregnancy rates when administered within 120 hours of unprotected sexual intercourse. Five studies found that the levonorgestrel and combined regimens decreased risk for pregnancy through the fifth day after unprotected sexual intercourse; however, rates of pregnancy were slightly higher when ECPs were taken after 3 days. A meta-analysis of levonorgestrel ECPs found that pregnancy rates were low when administered within 4 days after unprotected sexual intercourse but increased at 4–5 days (Level of evidence: I to II-2, good to poor, direct). Advance Provision of ECPs An advance supply of ECPs may be provided so that ECPs will be available when needed and can be taken as soon as possible after unprotected sexual intercourse. Comments and Evidence Summary. A systematic review identified 17 studies that reported on safety or effectiveness of advance ECPs in adult or adolescent women. Any use of ECPs was two to seven times greater among women who received an advance supply of ECPs. However, a summary estimate (relative risk = 0.97; 95% confidence interval = 0.77–1.22) of five randomized controlled trials did not indicate a significant reduction in unintended pregnancies at 12 months with advance provision of ECPs. In the majority of studies among adults or adolescents, patterns of regular contraceptive use, pregnancy rates, and incidence of STDs did not vary between those who received advance ECPs and those who did not. Although available evidence supports the safety of advance provision of ECPs, effectiveness of advance provision of ECPs in reducing pregnancy rates at the population level has not been demonstrated (Level of evidence: I to II-3, good to poor, direct). Initiation of Regular Contraception After ECPs UPA Advise the woman to start or resume hormonal contraception no sooner than 5 days after use of UPA, and provide or prescribe the regular contraceptive method as needed. For methods requiring a visit to a health care provider, such as DMPA, implants, and IUDs, starting the method at the time of UPA use may be considered; the risk that the regular contraceptive method might decrease the effectiveness of UPA must be weighed against the risk of not starting a regular hormonal contraceptive method. The woman needs to abstain from sexual intercourse or use barrier contraception for the next 7 days after starting or resuming regular contraception or until her next menses, whichever comes first. Any non hormonal contraceptive method can be started immediately after the use of UPA. Advise the woman to have a pregnancy test if she does not have a withdrawal bleed within 3 weeks. Levonorgestrel and Combined Estrogen and Progestin ECPs Any regular contraceptive method can be started immediately after the use of levonorgestrel or combined estrogen and progestin ECPs. The woman needs to abstain from sexual intercourse or use barrier contraception for 7 days. Advise the woman to have a pregnancy test if she does not have a withdrawal bleed within 3 weeks. Comments and Evidence Summary.The resumption or initiation of regular hormonal contraception after ECP use involves consideration of the risk for pregnancy if ECPs fail and the risks for unintended pregnancy if contraception initiation is delayed until the subsequent menstrual cycle. A health care provider may provide or prescribe pills, the patch, or the ring for a woman to start no sooner than 5 days after use of UPA. For methods requiring a visit to a health care provider, such as DMPA, implants, and IUDs, starting the method at the time of UPA use may be considered; the risk that the regular contraceptive method might decrease the effectiveness of UPA must be weighed against the risk of not starting a regular hormonal contraceptive method. Data on when a woman can start regular contraception after ECPs are limited to pharmacodynamic data and expert opinion. In one pharmacodynamic study of women who were randomly assigned to either UPA or placebo groups mid-cycle followed by a 21-day course of combined hormonal contraception found no difference between UPA and placebo groups in the time for women’s ovaries to reach quiescence by ultrasound and serum estradiol; this finding suggests that UPA did not have an effect on the combined hormonal contraception. In another pharmacodynamic study with a crossover design, women were randomly assigned to one of three groups: 1) UPA followed by desogestrel for 20 days started 1 day later; 2) UPA plus placebo; or 3) placebo plus desogestrel for 20 days. Among women taking UPA followed by desogestrel, a higher incidence of ovulation in the first 5 days was found compared with UPA alone (45% versus 3%, respectively), suggesting desogestrel might decrease the effectiveness of UPA. No concern exists that administering combined estrogen and progestin or levonorgestrel formulations of ECPs concurrently with systemic hormonal contraception decreases the effectiveness of either emergency or regular contraceptive methods because these formulations do not have antiprogestin properties like UPA. If a woman is planning to initiate contraception after the next menstrual bleeding after ECP use, the cycle in which ECPs are used might be shortened, prolonged, or involve unscheduled bleeding. Prevention and Management of Nausea and Vomiting with ECP Use Nausea and Vomiting Levonorgestrel and UPA ECPs cause less nausea and vomiting than combined estrogen and progestin ECPs. Routine use of antiemetics before taking ECPs is not recommended. Pretreatment with antiemetics may be considered depending on availability and clinical judgment. Vomiting Within 3 Hours of Taking ECPs Another dose of ECP should be taken as soon as possible. Use of an antiemetic should be considered. Comments and Evidence Summary. Many women do not experience nausea or vomiting when taking ECPs, and predicting which women will experience nausea or vomiting is difficult. Although routine use of antiemetics before taking ECPs is not recommended, antiemetics are effective in some women and can be offered when appropriate. Health-care providers who are deciding whether to offer antiemetics to women taking ECPs should consider the following: 1) women taking combined estrogen and progestin ECPs are more likely to experience nausea and vomiting than those who take levonorgestrel or UPA ECPs; 2) evidence indicates that antiemetics reduce the occurrence of nausea and vomiting in women taking combined estrogen and progestin ECPs; and 3) women who take antiemetics might experience other side effects from the antiemetics. A systematic review examined incidence of nausea and vomiting with different ECP regimens and effectiveness of anti nausea drugs in reducing nausea and vomiting with ECP use. The levonorgestrel regimen was associated with significantly less nausea than a nonstandard dose of UPA (50 mg) and the standard combined estrogen and progestin regimen. Use of the split-dose levonorgestrel showed no differences in nausea and vomiting compared with the single-dose levonorgestrel (Level of evidence: I, good-fair, indirect). Two trials of anti nausea drugs, meclizine and metoclopramide, taken before combined estrogen and progestin ECPs, reduced the severity of nausea. Significantly less vomiting occurred with meclizine but not metoclopramide (Level of evidence: I, good-fair, direct). No direct evidence was found regarding the effects of vomiting after taking ECPs. Previous Next